IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 08/31/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 08/27/23 ICF & ICF-ID VENDOR PAYMENTS BY COUNTY ICF ICF-ID TOTAL COUNTY RECIPIENT UNITS OF TOTAL RECIPIENT UNITS OF TOTAL RECIPIENT UNITS OF TOTAL SERVED SERVICE PAYMENTS SERVED SERVICE PAYMENTS SERVED SERVICE PAYMENTS ADAIR 1 31 $11,757 0 0 $00 1 31 $11,757 BLACK HAWK 4 121 $53,726 1 85 $36,454 5 206 $90,181 BOONE 0 0 $00 1 31 $44,689 1 31 $44,689 BREMER 1 31 $15,395 0 0 $00 1 31 $15,395 CARROLL 0 0 $00 1 31 $9,199 1 31 $9,199 CASS 1 7 $2,115 0 0 $00 1 7 $2,115 CEDAR 1 28 $4,501 0 0 $00 1 28 $4,501 CERRO GORDO 1 47 $17,204 0 0 $00 1 47 $17,204 CHEROKEE 0 0 $00 2 52 $22,174 2 52 $22,174 CRAWFORD 1 31 $1,373 0 0 $00 1 31 $1,373 DUBUQUE 2 50 $15,530 4 118 $53,524 6 168 $69,054 GREENE 1 31 $7,655 0 0 $00 1 31 $7,655 GRUNDY 1 31 $6,775 1 258 $116,081 2 289 $122,856 GUTHRIE 1 31 $12,799 0 0 $00 1 31 $12,799 HAMILTON 1 92 $22,191 0 0 $00 1 92 $22,191 HARRISON 1 28 $4,189 0 0 $00 1 28 $4,189 JASPER 2 59 $27,140 1 31 $14,423 3 90 $41,564 LEE 1 12 $2,898 0 0 $00 1 12 $2,898 LINN 3 140 $36,538 0 0 $00 3 140 $36,538 LYON 1 31 $6,221 0 0 $00 1 31 $6,221 MAHASKA 1 29 $13,438 0 0 $00 1 29 $13,438 MARION 2 62 $24,622 0 0 $00 2 62 $24,622 MARSHALL 144 4,876 $1,891,441 0 0 $00 144 4,876 $1,891,441 MITCHELL 1 31 $13,116 0 0 $00 1 31 $13,116 MONONA 2 132 $49,765 0 0 $00 2 132 $49,765 O BRIEN 0 0 $00 1 31 $14,217 1 31 $14,217 PAGE 1 58 $8,356 0 0 $00 1 58 $8,356 PLYMOUTH 0 0 $00 1 31 $12,995 1 31 $12,995 POLK 6 180 $63,568 3 89 $53,729 9 269 $117,298 POTTAWATTAMIE 4 169 $42,009 0 0 $00 4 169 $42,009 SHELBY 0 0 $00 1 31 $12,414 1 31 $12,414 STORY 2 62 $27,589 1 29 $14,380 3 91 $41,970 TAMA 2 31 $8,697- 0 0 $00 2 31 $8,697- WAPELLO 5 138 $44,133 0 0 $00 5 138 $44,133 WARREN 1 31 $6,967 0 0 $00 1 31 $6,967 WOODBURY 3 75 $15,906 4 122 $47,683 7 197 $63,589 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 08/31/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 08/27/23 ICF & ICF-ID VENDOR PAYMENTS BY COUNTY ICF ICF-ID TOTAL COUNTY RECIPIENT UNITS OF TOTAL RECIPIENT UNITS OF TOTAL RECIPIENT UNITS OF TOTAL SERVED SERVICE PAYMENTS SERVED SERVICE PAYMENTS SERVED SERVICE PAYMENTS STATE TOTAL 198 6,675 $2,440,233 22 939 $451,968 220 7,614 $2,892,202 *** END OF REPORT ***