IAMM1800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 11/30/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 11/25/23 MEDICAID SUMMARY BY COUNTY MEDICALLY NEEDY - NO SPENDDOWN MEDICALLY NEEDY - WITH SPENDDOWN RECIPIENTS TOTAL RECIPIENTS TOTAL COUNTY ELIGIBLES SERVED PAYMENTS ELIGIBLES SERVED PAYMENTS ADAIR 3 3 $792 0 0 $0 ADAMS 0 0 $0 0 0 $0 ALLAMAKEE 0 0 $0 0 0 $0 APPANOOSE 0 0 $0 0 0 $0 AUDUBON 0 0 $0 0 0 $0 BENTON 1 1 $21 0 0 $0 BLACK HAWK 0 0 $0 0 2 $5,181 BOONE 2 2 $527 0 0 $0 BREMER 0 0 $0 0 0 $0 BUCHANAN 0 0 $0 0 0 $0 BUENA VIST 0 0 $0 0 2 $923 BUTLER 0 0 $0 0 0 $0 CALHOUN 2 2 $605 0 0 $0 CARROLL 0 0 $0 0 0 $0 CASS 2 2 $247 0 0 $0 CEDAR 0 0 $0 0 0 $0 CERRO GORD 2 2 $158 0 0 $0 CHEROKEE 0 0 $0 0 0 $0 CHICKASAW 0 0 $0 0 0 $0 CLARKE 3 3 $646 0 0 $0 CLAY 0 0 $0 0 0 $0 CLAYTON 1 1 $2 0 0 $0 CLINTON 1 1 $4 0 0 $0 CRAWFORD 0 0 $0 0 0 $0 DALLAS 0 0 $0 0 1 $163 DAVIS 0 0 $0 0 0 $0 DECATUR 0 0 $0 0 0 $0 DELAWARE 0 0 $0 0 0 $0 DES MOINES 2 2 $4 0 0 $0 DICKINSON 2 2 $460 0 0 $0 DUBUQUE 1 1 $230 0 0 $0 EMMET 0 0 $0 0 0 $0 FAYETTE 6 7 $1,457 0 0 $0 FLOYD 2 2 $605 0 1 $3,186 FRANKLIN 0 0 $0 0 0 $0 FREMONT 0 0 $0 0 0 $0 GREENE 0 0 $0 0 0 $0 GRUNDY 0 0 $0 0 0 $0 GUTHRIE 0 0 $0 0 0 $0 HAMILTON 0 0 $0 0 0 $0 HANCOCK 0 0 $0 0 0 $0 HARDIN 1 1 $302 0 0 $0 HARRISON 3 3 $614 0 0 $0 HENRY 2 2 $384 0 0 $0 HOWARD 0 0 $0 0 0 $0 HUMBOLDT 0 0 $0 0 0 $0 IDA 1 1 $230 0 0 $0 IOWA 0 0 $0 0 0 $0 JACKSON 0 0 $0 0 0 $0 IAMM1800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 11/30/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 11/25/23 MEDICAID SUMMARY BY COUNTY MEDICALLY NEEDY - NO SPENDDOWN MEDICALLY NEEDY - WITH SPENDDOWN RECIPIENTS TOTAL RECIPIENTS TOTAL COUNTY ELIGIBLES SERVED PAYMENTS ELIGIBLES SERVED PAYMENTS JASPER 0 0 $0 0 0 $0 JEFFERSON 0 0 $0 0 0 $0 JOHNSON 0 0 $0 0 0 $0 JONES 0 0 $0 0 0 $0 KEOKUK 1 1 $297 0 0 $0 KOSSUTH 0 0 $0 0 0 $0 LEE 2 2 $483 0 0 $0 LINN 10 10 $1,712 0 1 $18,030 LOUISA 0 0 $0 0 0 $0 LUCAS 0 0 $0 0 0 $0 LYON 1 1 $8,390 0 0 $0 MADISON 1 1 $192 0 0 $0 MAHASKA 1 1 $267 0 0 $0 MARION 1 1 $302 0 0 $0 MARSHALL 0 0 $0 0 0 $0 MILLS 0 0 $0 0 0 $0 MITCHELL 0 0 $0 0 0 $0 MONONA 0 0 $0 0 0 $0 MONROE 1 1 $2 0 0 $0 MONTGOMERY 0 0 $0 0 0 $0 MUSCATINE 0 1 $624 0 0 $0 O BRIEN 0 0 $0 0 0 $0 OSCEOLA 0 0 $0 0 0 $0 PAGE 1 1 $297 0 0 $0 PALO ALTO 0 0 $0 0 0 $0 PLYMOUTH 2 2 $422 0 0 $0 POCAHONTAS 0 0 $0 0 0 $0 POLK 26 25 $11,052 1 3 $27,698 POTTAWATTA 0 0 $0 0 2 $793 POWESHIEK 1 1 $2 0 0 $0 RINGGOLD 0 0 $0 0 0 $0 SAC 0 0 $0 0 0 $0 SCOTT 3 3 $6 1 8 $4,473 SHELBY 0 0 $0 0 0 $0 SIOUX 3 3 $424 0 0 $0 STORY 8 8 $1,584 0 0 $0 TAMA 1 1 $11 0 0 $0 TAYLOR 0 0 $0 0 0 $0 UNION 0 0 $0 0 0 $0 VAN BUREN 0 0 $0 0 0 $0 WAPELLO 0 0 $0 0 0 $0 WARREN 2 2 $384 0 0 $0 WASHINGTON 2 2 $503 0 0 $0 WAYNE 0 0 $0 0 0 $0 WEBSTER 1 1 $2 0 0 $0 WINNEBAGO 0 0 $0 0 0 $0 WINNESHIEK 0 0 $0 0 0 $0 WOODBURY 6 6 $700 0 1 $6,677 WORTH 0 0 $0 0 0 $0 IAMM1800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 3 AS OF 11/30/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 11/25/23 MEDICAID SUMMARY BY COUNTY MEDICALLY NEEDY - NO SPENDDOWN MEDICALLY NEEDY - WITH SPENDDOWN RECIPIENTS TOTAL RECIPIENTS TOTAL COUNTY ELIGIBLES SERVED PAYMENTS ELIGIBLES SERVED PAYMENTS WRIGHT 0 0 $0 0 0 $0 CENT. OFF 0 5 $329 0 0 $0 IAMM1800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 4 AS OF 11/30/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 11/25/23 MEDICAID SUMMARY BY COUNTY MEDICALLY NEEDY - NO SPENDDOWN MEDICALLY NEEDY - WITH SPENDDOWN RECIPIENTS TOTAL RECIPIENTS TOTAL COUNTY ELIGIBLES SERVED PAYMENTS ELIGIBLES SERVED PAYMENTS STATE TOT 111 112 $35,293 2 21 $67,129 *** END OF REPORT ***