IAMM2200-R003 (MR-O-12) IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 11/30/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 11/26/23 T I T L E X I X R E P O R T O F E X P E N D I T U R E S (BY CATEGORY OF SERVICE) (FISCAL YTD TOTALS AS OF 11/30/23) CATEGORY OF SERVICE RECIPIENTS NUMBER OF UNITS OF TOTAL SERVED CLAIMS SERVICE PAYMENT INPATIENT 2,503 2,815 15,123 $44,172,708.25 OUTPATIENT 12,458 33,768 5,865,461 $7,816,757.33 CHILD PART HOSP 0 0 0 $0.00 CHILD DAY TREATMENT 0 0 0 $0.00 ADULT PART HOSP 0 0 0 $0.00 ADULT DAY TREATMENT 0 0 0 $0.00 SKILLED NURSING FACILITY 68 148 2,619 $1,326,427.77 IHAWP IOWA PLAN LITE 0 0 0 $0.00 IHAWP IOWA PLAN FULL 0 0 0 $0.00 IHAWP HMO 1 0 0 $64.32- IHAWP PCP 0 0 0 $0.00 INTERMEDIATE CARE FACILITY 291 1,104 32,279 $11,563,938.50 INTER CARE INT DISABLED 28 128 3,715 $1,879,105.00 NURSING FAC FOR MENTAL ILL 0 0 0 $0.00 HOME HEALTH 1,446 4,411 1,380,551 $10,138,153.24 LEAD INSPECTION AGENCY 0 0 0 $0.00 PHYSICIAN 16,144 64,672 195,378 $4,758,427.64 CLINIC SERVICES 4,515 8,872 9,059 $20,546,095.13 MEP CASE MANAGEMENT 0 0 0 $0.00 EHR INCENTIVE PAYMENTS 0 0 0 $0.00 LAB AND RADIOLOGICAL 2,591 4,983 15,261 $450,282.42 HABILITATION SERVICES 49 656 4,153 $645,610.57 BEHAVIORAL HLTH INTERVENTN SVC 89 706 4,598 $141,816.92 REHAB SUPPORT SERVICES 4 14 304 $16,972.32 AMBULANCE SERVICES 917 1,331 1,324 $721,409.74 LOCAL EDUCATION AGENCY 2,653 85,788 647,215 $12,635,523.15 INFANT TODDLER 560 2,573 5,775 $83,210.01 IHAWP WELLNESS EXAM BONUS 0 0 0 $0.00 ACO VIS PAYMENTS 0 0 0 $0.00 PRESCRIBED DRUGS 6,527 68,345 63,858 $7,327,758.19 IOWA-PLAN-PMIC 0 0 0 $0.00 DRUG CAPITATION 0 0 0 $0.00 NEMT SERVICES 14,803 53,365 48,237 $111,975.99 INDIAN HEALTH SERVICES 0 0 0 $0.00 FAMILY PLANNING SERVICES 396 555 554 $62,822.22 IOWA CARE MED HOME CAPITATION 0 0 0 $0.00 IOWA PLAN PROGRAM 0 0 0 $0.00 MANAGED SUBSTANCE ABUSE 0 0 0 $0.00 MENTAL HEALTH ACCESS PLAN 0 0 0 $0.00 EPSDT SCREENING 269 278 266 $490,939.12 HMO SERVICES 0 0 0 $0.00 PACE SERVICES 729 3,371 3,335 $13,880,079.14 PATIENT MANAGEMENT 0 0 0 $0.00 HEALTH INS PREMIUM PAYMENT 2,061 20,221 20,221 $2,318,698.10 MEDICAL SUPPLIES 2,849 10,083 448,114 $801,278.06 HEALTH HOME PROVIDER 286 897 429 $62,699.11 TCM PAYMENTS TO IOWAPLAN 0 0 0 $0.00 IHAWP QHP 0 0 0 $0.00 MCO 842,335 3,402,348 3,393,643 $2,913,882,770.76 OTHER PRACTITIONER 10,942 65,762 296,155 $9,088,459.39 IAMM2200-R003 (MR-O-12) IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 11/30/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 11/26/23 T I T L E X I X R E P O R T O F E X P E N D I T U R E S (BY CATEGORY OF SERVICE) (FISCAL YTD TOTALS AS OF 11/30/23) CATEGORY OF SERVICE RECIPIENTS NUMBER OF UNITS OF TOTAL SERVED CLAIMS SERVICE PAYMENT FAMILY CENTERED PROGRAM 0 0 0 $0.00 FAMILY PRESERVATION 0 0 0 $0.00 TREATMENT FOSTER FAMILY CARE 0 0 0 $0.00 GROUP TREATMENT THERAPY 0 0 0 $0.00 DENTAL 457 527 529 $50,376.31 ACCOUNTABLE CARE ORGANIZATIONS 0 0 0 $0.00 OPTOMETRIST 924 1,175 1,351 $61,572.36 CHIROPRACTIC 599 2,601 2,873 $44,971.25 IOWA-PLAN-HAB 0 0 0 $0.00 PODIATRIC 555 1,041 1,867 $38,116.40 PREPAID AMBULATORY HEALTH PLAN 776,604 3,432,463 3,429,026 $46,226,164.66 PHYSICAL DISABILITIES SVCS 4 32 4,279 $17,218.44 BRAIN INJ WAIVER SERVICES 151 1,565 49,955 $2,773,312.68 PSYCHIATRIC 1,487 4,025 4,823 $279,765.92 RESIDENTIAL CARE FACILITY 358 1,674 47,287 $410,731.42 ID WAIVER SERVICE 625 5,067 263,290 $13,029,866.37 CHILDRENS MENTAL HEALTH SVC 32 175 25,988 $128,807.11 AIDS WAIVER SERVICES 1 6 6 $6,592.20 ELDERLY WAIVER SERVICES 27 340 9,818 $160,756.71 ILL & HANDICAPPED WAIVER SVCS 307 1,742 94,748 $3,052,188.06 COUNTY OFFICE REIMBURSEMENT 0 0 0 $0.00 MEP SERVICES 632 3,288 26,800 $1,731,280.00 UNASSIGNED 3 0 0 $2,613,954.05 * A L L C A T E G O R I E S * 868,445 7,292,915 16,420,267 $3,135,549,527.69 *** END OF REPORT ***