IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 09/30/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 09/23/23 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 2 62 $24,844 0 0 $00 2 62 $24,844 BLACK HAWK 3 93 $41,177 1 31 $13,347 4 124 $54,525 BOONE 0 0 $00 1 31 $44,457 1 31 $44,457 BREMER 1 31 $14,101 0 0 $00 1 31 $14,101 CALHOUN 1 12 $2,866 0 0 $00 1 12 $2,866 CARROLL 0 0 $00 1 30 $8,858 1 30 $8,858 CERRO GORDO 1 31 $14,278 0 0 $00 1 31 $14,278 CHEROKEE 1 18 $4,773 0 0 $00 1 18 $4,773 CHICKASAW 1 0 $1,026- 0 0 $00 1 0 $1,026- DALLAS 1 78 $34,407 1 62 $27,104 2 140 $61,512 DUBUQUE 2 123 $38,721 3 29 $14,585 5 152 $53,306 GREENE 1 31 $7,655 0 0 $00 1 31 $7,655 GRUNDY 1 31 $6,775 1 31 $14,423 2 62 $21,199 GUTHRIE 1 31 $12,799 0 0 $00 1 31 $12,799 HENRY 1 71 $21,430 0 0 $00 1 71 $21,430 IOWA 1 53 $24,223 0 0 $00 1 53 $24,223 JASPER 2 62 $27,986 2 178 $85,237 4 240 $113,224 LINN 1 31 $15,075 0 0 $00 1 31 $15,075 LOUISA 1 75- $11,863- 0 0 $00 1 75- $11,863- LYON 1 31 $6,221 0 0 $00 1 31 $6,221 MAHASKA 1 31 $14,002 0 0 $00 1 31 $14,002 MARION 2 62 $20,600 0 0 $00 2 62 $20,600 MARSHALL 146 4,683 $1,864,125 0 0 $00 146 4,683 $1,864,125 MONONA 1 31 $12,919 0 0 $00 1 31 $12,919 O BRIEN 0 0 $00 1 31 $14,217 1 31 $14,217 PALO ALTO 1 3 $770 0 0 $00 1 3 $770 PLYMOUTH 0 0 $00 1 30 $12,917 1 30 $12,917 POLK 6 216 $70,053 4 146 $78,414 10 362 $148,468 POTTAWATTAMIE 3 126 $35,601 0 0 $00 3 126 $35,601 SCOTT 1 26 $7,728 0 0 $00 1 26 $7,728 STORY 2 62 $27,589 2 93 $48,605 4 155 $76,195 TAMA 1 30 $10,523 0 0 $00 1 30 $10,523 WAPELLO 2 36 $15,419 0 0 $00 2 36 $15,419 WARREN 2 123 $28,148 0 0 $00 2 123 $28,148 WOODBURY 2 62 $12,675 4 123 $47,815 6 185 $60,490 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 09/30/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 09/23/23 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 193 6,205 $2,404,609 22 815 $409,986 215 7,020 $2,814,595 *** END OF REPORT ***