IAMM4600-R002 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 11/30/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 11/26/23 E L D E R L Y W A I V E R S U M M A R Y B Y C O U N T Y ENROLLEES MEDICAL SERVICES WAIVER SERVICES TOTAL SERVICES AVG PAYMENT PER RECIP COUNTY ELIGIBLE RECIPS AMOUNT RECIPS AMOUNT RECIPS AMOUNT ELIGIBLE SERVED ADAIR 22 44 $102502 0 $0 44 $102502 $4659 $2330 ADAMS 7 16 $34172 0 $0 16 $34172 $4882 $2136 ALLAMAKEE 26 56 $123867 0 $0 56 $123867 $4764 $2212 APPANOOSE 70 136 $298988 0 $0 136 $298988 $4271 $2198 AUDUBON 11 22 $46987 0 $0 22 $46987 $4272 $2136 BENTON 50 89 $168229 0 $0 89 $168229 $3365 $1890 BLACK HAWK 400 782 $1730261 0 $0 782 $1730261 $4326 $2213 BOONE 49 108 $225859 0 $0 108 $225859 $4609 $2091 BREMER 25 47 $111046 0 $0 47 $111046 $4442 $2363 BUCHANAN 45 80 $179402 0 $0 80 $179402 $3987 $2243 BUENA VIST 40 70 $154111 1 $5331 71 $159442 $3986 $2246 BUTLER 24 44 $98257 0 $0 44 $98257 $4094 $2233 CALHOUN 21 54 $111092 1 $3589 55 $114681 $5461 $2085 CARROLL 49 94 $192233 0 $0 94 $192233 $3923 $2045 CASS 36 73 $144742 0 $0 73 $144742 $4021 $1983 CEDAR 23 36 $72617 0 $0 36 $72617 $3157 $2017 CERRO GORD 105 217 $478378 0 $0 217 $478378 $4556 $2205 CHEROKEE 26 46 $98251 0 $0 46 $98251 $3779 $2136 CHICKASAW 34 75 $179160 0 $0 75 $179160 $5269 $2389 CLARKE 42 96 $230642 0 $0 96 $230642 $5491 $2403 CLAY 58 107 $222387 0 $0 107 $222387 $3834 $2078 CLAYTON 38 79 $191701 0 $0 79 $191701 $5045 $2427 CLINTON 144 279 $593753 0 $0 279 $593753 $4123 $2128 CRAWFORD 18 34 $72625 0 $0 34 $72625 $4035 $2136 DALLAS 92 193 $443674 0 $0 193 $443674 $4823 $2299 DAVIS 19 34 $81163 0 $0 34 $81163 $4272 $2387 DECATUR 36 76 $166320 0 $0 76 $166320 $4620 $2188 DELAWARE 27 54 $115327 0 $0 54 $115327 $4271 $2136 DES MOINES 96 181 $392726 0 $0 181 $392726 $4091 $2170 DICKINSON 33 69 $149244 0 $0 69 $149244 $4523 $2163 DUBUQUE 157 329 $696058 0 $0 329 $696058 $4433 $2116 EMMET 15 31 $64075 0 $0 31 $64075 $4272 $2067 FAYETTE 52 112 $238981 0 $0 112 $238981 $4596 $2134 FLOYD 45 69 $145256 0 $0 69 $145256 $3228 $2105 FRANKLIN 13 26 $59796 0 $0 26 $59796 $4600 $2300 FREMONT 15 28 $59802 0 $0 28 $59802 $3987 $2136 GREENE 23 44 $106805 0 $0 44 $106805 $4644 $2427 IAMM4600-R002 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 11/30/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 11/26/23 E L D E R L Y W A I V E R S U M M A R Y B Y C O U N T Y ENROLLEES MEDICAL SERVICES WAIVER SERVICES TOTAL SERVICES AVG PAYMENT PER RECIP COUNTY ELIGIBLE RECIPS AMOUNT RECIPS AMOUNT RECIPS AMOUNT ELIGIBLE SERVED GRUNDY 12 26 $55541 0 $0 26 $55541 $4628 $2136 GUTHRIE 43 84 $179398 0 $0 84 $179398 $4172 $2136 HAMILTON 25 40 $85420 0 $0 40 $85420 $3417 $2136 HANCOCK 20 39 $89697 0 $0 39 $89697 $4485 $2300 HARDIN 53 100 $256462 0 $0 100 $256462 $4839 $2565 HARRISON 44 80 $170860 0 $0 80 $170860 $3883 $2136 HENRY 50 89 $188460 0 $0 89 $188460 $3769 $2118 HOWARD 14 27 $46734 0 $0 27 $46734 $3338 $1731 HUMBOLDT 15 32 $68344 0 $0 32 $68344 $4556 $2136 IDA 27 57 $115361 1 $191 58 $115552 $4280 $1992 IOWA 20 39 $81191 0 $0 39 $81191 $4060 $2082 JACKSON 36 67 $140977 0 $0 67 $140977 $3916 $2104 JASPER 75 156 $346055 0 $0 156 $346055 $4614 $2218 JEFFERSON 48 96 $209323 0 $0 96 $209323 $4361 $2180 JOHNSON 189 367 $802763 0 $0 367 $802763 $4247 $2187 JONES 37 80 $170872 0 $0 80 $170872 $4618 $2136 KEOKUK 29 46 $98259 0 $0 46 $98259 $3388 $2136 KOSSUTH 33 61 $128407 0 $0 61 $128407 $3891 $2105 LEE 86 165 $354557 1 $1200 166 $355757 $4137 $2143 LINN 465 972 $2069823 2 $4669 974 $2074492 $4461 $2130 LOUISA 16 34 $76880 0 $0 34 $76880 $4805 $2261 LUCAS 29 58 $128140 0 $0 58 $128140 $4419 $2209 LYON 15 32 $72595 0 $0 32 $72595 $4840 $2269 MADISON 36 81 $162079 0 $0 81 $162079 $4502 $2001 MAHASKA 81 172 $375878 0 $0 172 $375878 $4640 $2185 MARION 89 175 $367605 0 $0 175 $367605 $4130 $2101 MARSHALL 89 168 $354569 0 $0 168 $354569 $3984 $2111 MILLS 19 33 $63832 0 $0 33 $63832 $3360 $1934 MITCHELL 15 37 $72619 0 $0 37 $72619 $4841 $1963 MONONA 19 51 $106275 0 $0 51 $106275 $5593 $2084 MONROE 31 63 $132138 0 $0 63 $132138 $4263 $2097 MONTGOMERY 24 50 $85735 0 $0 50 $85735 $3572 $1715 MUSCATINE 114 216 $478418 1 $862 217 $479280 $4204 $2209 O BRIEN 28 62 $132682 0 $0 62 $132682 $4739 $2140 OSCEOLA 8 14 $34164 0 $0 14 $34164 $4271 $2440 PAGE 49 106 $226381 0 $0 106 $226381 $4620 $2136 PALO ALTO 17 44 $93982 0 $0 44 $93982 $5528 $2136 IAMM4600-R002 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 3 AS OF 11/30/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 11/26/23 E L D E R L Y W A I V E R S U M M A R Y B Y C O U N T Y ENROLLEES MEDICAL SERVICES WAIVER SERVICES TOTAL SERVICES AVG PAYMENT PER RECIP COUNTY ELIGIBLE RECIPS AMOUNT RECIPS AMOUNT RECIPS AMOUNT ELIGIBLE SERVED PLYMOUTH 30 68 $150045 0 $0 68 $150045 $5002 $2207 POCAHONTAS 17 35 $72378 0 $0 35 $72378 $4258 $2068 POLK 1633 3256 $7072769 2 $7314 3258 $7080083 $4336 $2173 POTTAWATTA 360 690 $1515601 1 $3852 691 $1519453 $4221 $2199 POWESHIEK 31 56 $115327 0 $0 56 $115327 $3720 $2059 RINGGOLD 28 57 $136395 0 $0 57 $136395 $4871 $2393 SAC 21 37 $76900 0 $0 37 $76900 $3662 $2078 SCOTT 427 847 $1781347 3 $5042 850 $1786389 $4184 $2102 SHELBY 16 32 $68352 0 $0 32 $68352 $4272 $2136 SIOUX 24 37 $72623 0 $0 37 $72623 $3026 $1963 STORY 95 187 $410008 0 $0 187 $410008 $4316 $2193 TAMA 15 11 $21129 0 $0 11 $21129 $1409 $1921 TAYLOR 19 35 $68350 0 $0 35 $68350 $3597 $1953 UNION 51 104 $217630 0 $0 104 $217630 $4267 $2093 VAN BUREN 22 51 $106540 0 $0 51 $106540 $4843 $2089 WAPELLO 158 305 $645248 0 $0 305 $645248 $4084 $2116 WARREN 85 194 $445200 0 $0 194 $445200 $5238 $2295 WASHINGTON 43 89 $195622 0 $0 89 $195622 $4549 $2198 WAYNE 24 46 $98253 0 $0 46 $98253 $4094 $2136 WEBSTER 94 176 $384563 2 $2414 178 $386977 $4117 $2174 WINNEBAGO 22 41 $81169 0 $0 41 $81169 $3690 $1980 WINNESHIEK 30 57 $115602 0 $0 57 $115602 $3853 $2028 WOODBURY 176 322 $663140 3 $1364 325 $664504 $3776 $2045 WORTH 9 18 $38445 0 $0 18 $38445 $4272 $2136 WRIGHT 69 140 $320373 1 $554 141 $320927 $4651 $2276 CENT. OFF 16 0 $0 0 $0 0 $0 $0 $0 ENROLLEES MEDICAL SERVICES WAIVER SERVICES TOTAL SERVICES AVG PAYMENT PER RECIP COUNTY ELIGIBLE RECIPS AMOUNT RECIPS AMOUNT RECIPS AMOUNT ELIGIBLE SERVED STATE TOTAL 7501 14840 $32075974 19 $36382 14859 $32112356 $4281 $2161