IAMM2200-R002 (MR-O-12) IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 01/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 01/28/24 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) (MONTHLY TOTALS AS OF 01/31/24) * * * * * A V E R A G E S * * * * * * * COST PER COST PER UNITS PER COST PER CATEGORY OF SERVICE RECIPIENTS NUMBER OF UNITS OF TOTAL UNIT OF ELIGIBLE RECIPIENT RECIPIENT SERVED CLAIMS SERVICE PAYMENT SERVICE RECIPIENT SERVED SERVED INPATIENT 812 507 3,233 $8,828,339.14 $2,730.70 $13.63 4.0 $10,872.34 OUTPATIENT 4,348 5,395 1,083,010 $1,638,254.98 $1.51 $2.53 249.1 $376.78 CHILD PART HOSP 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 CHILD DAY TREATMENT 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 ADULT PART HOSP 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 ADULT DAY TREATMENT 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 SKILLED NURSING FACILITY 25 19 671 $311,012.83 $463.51 $0.48 26.8 $12,440.51 IHAWP IOWA PLAN LITE 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 IHAWP IOWA PLAN FULL 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 IHAWP HMO 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 IHAWP PCP 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 INTERMEDIATE CARE FACILITY 205 234 6,969 $158.53- $0.02- $0.00 34.0 $0.77- INTER CARE INT DISABLED 19 21 520 $285,322.23 $548.70 $0.44 27.4 $15,016.96 NURSING FAC FOR MENTAL ILL 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 HOME HEALTH 597 674 155,558 $1,727,379.09 $11.10 $2.67 260.6 $2,893.43 LEAD INSPECTION AGENCY 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 PHYSICIAN 5,884 11,256 40,135 $781,908.21 $19.48 $1.21 6.8 $132.89 CLINIC SERVICES 1,274 1,885 1,728 $3,636,213.67 $2,104.29 $5.61 1.4 $2,854.17 MEP CASE MANAGEMENT 1 0 0 $7,946.37 $0.00 $0.01 .0 $7,946.37 EHR INCENTIVE PAYMENTS 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 LAB AND RADIOLOGICAL 642 974 2,638 $122,586.98 $46.47 $0.19 4.1 $190.95 HABILITATION SERVICES 35 79 1,022 $104,618.44 $102.37 $0.16 29.2 $2,989.10 BEHAVIORAL HLTH INTERVENTN SVC 30 93 694 $19,357.21 $27.89 $0.03 23.1 $645.24 REHAB SUPPORT SERVICES 3 3 63 $3,517.29 $55.83 $0.01 21.0 $1,172.43 AMBULANCE SERVICES 258 173 318 $168,421.01 $529.63 $0.26 1.2 $652.79 LOCAL EDUCATION AGENCY 2,142 36,708 239,018 $5,686,086.43 $23.79 $8.78 111.6 $2,654.57 INFANT TODDLER 194 330 701 $9,842.82 $14.04 $0.02 3.6 $50.74 IHAWP WELLNESS EXAM BONUS 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 ACO VIS PAYMENTS 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 PRESCRIBED DRUGS 3,287 12,522 13,918 $1,236,646.19 $88.85 $29.54 4.2 $376.22 IOWA-PLAN-PMIC 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 DRUG CAPITATION 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 NEMT SERVICES 11,430 9,985 8,205 $20,603.46 $2.51 $0.03 .7 $1.80 INDIAN HEALTH SERVICES 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 FAMILY PLANNING SERVICES 125 132 143 $15,551.16 $108.75 $0.02 1.1 $124.41 IOWA CARE MED HOME CAPITATION 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 IOWA PLAN PROGRAM 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 MANAGED SUBSTANCE ABUSE 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 MENTAL HEALTH ACCESS PLAN 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 EPSDT SCREENING 76 74 48 $71,226.50 $1,483.89 $7.94 .6 $937.19 HMO SERVICES 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 PACE SERVICES 677 694 680 $2,857,468.68 $4,202.16 $4.41 1.0 $4,220.78 PATIENT MANAGEMENT 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 HEALTH INS PREMIUM PAYMENT 1,680 3,197 3,870 $464,577.13 $120.05 $0.72 2.3 $276.53 MEDICAL SUPPLIES 1,370 1,803 96,542 $164,295.01 $1.70 $3.92 70.5 $119.92 HEALTH HOME PROVIDER 108 146 31 $6,470.40 $208.72 $0.01 .3 $59.91 TCM PAYMENTS TO IOWAPLAN 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 IHAWP QHP 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 MCO 594,703 632,555 628,723 $486,050,823.85 $773.08 $750.33 1.1 $817.30 IAMM2200-R002 (MR-O-12) IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 01/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 01/28/24 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) (MONTHLY TOTALS AS OF 01/31/24) * * * * * A V E R A G E S * * * * * * * COST PER COST PER UNITS PER COST PER CATEGORY OF SERVICE RECIPIENTS NUMBER OF UNITS OF TOTAL UNIT OF ELIGIBLE RECIPIENT RECIPIENT SERVED CLAIMS SERVICE PAYMENT SERVICE RECIPIENT SERVED SERVED OTHER PRACTITIONER 4,783 21,306 77,816 $4,173,009.74 $53.63 $6.44 16.3 $872.47 FAMILY CENTERED PROGRAM 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 FAMILY PRESERVATION 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 TREATMENT FOSTER FAMILY CARE 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 GROUP TREATMENT THERAPY 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 DENTAL 84 88 85 $9,620.82 $113.19 $0.23 1.0 $114.53 ACCOUNTABLE CARE ORGANIZATIONS 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 OPTOMETRIST 253 233 323 $16,038.93 $49.66 $0.02 1.3 $63.39 CHIROPRACTIC 256 482 565 $3,338.66 $5.91 $0.08 2.2 $13.04 IOWA-PLAN-HAB 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 PODIATRIC 143 167 291 $8,369.56 $28.76 $0.01 2.0 $58.53 PREPAID AMBULATORY HEALTH PLAN 780,592 638,340 634,967 $9,647,678.94 $15.19 $14.89 .8 $12.36 PHYSICAL DISABILITIES SVCS 4 13 849 $3,522.61 $4.15 $0.01 212.3 $880.65 BRAIN INJ WAIVER SERVICES 142 310 12,172 $595,321.35 $48.91 $0.92 85.7 $4,192.40 PSYCHIATRIC 443 671 843 $51,659.14 $61.28 $0.08 1.9 $116.61 RESIDENTIAL CARE FACILITY 233 215 7,774 $69,366.36 $8.92 $0.11 33.4 $297.71 ID WAIVER SERVICE 563 950 45,053 $3,005,486.82 $66.71 $411.77 80.0 $5,338.34 CHILDRENS MENTAL HEALTH SVC 22 25 6,121 $30,210.27 $4.94 $73.50 278.2 $1,373.19 AIDS WAIVER SERVICES 1 1 1 $1,237.04 $1,237.04 $68.72 1.0 $1,237.04 ELDERLY WAIVER SERVICES 24 75 2,613 $33,307.06 $12.75 $9.29 108.9 $1,387.79 ILL & HANDICAPPED WAIVER SVCS 268 331 22,424 $632,592.89 $28.21 $486.24 83.7 $2,360.42 COUNTY OFFICE REIMBURSEMENT 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 MEP SERVICES 581 607 4,375 $282,625.00 $64.60 $0.44 7.5 $486.45 UNASSIGNED 1 0 0 $4,744,477.82 $0.00 $7.32 .0 $0.00 * A L L C A T E G O R I E S * 792,449 1,383,273 3,104,710 $537,526,173.56 $173.13 $829.80 3.9 $678.31 *** END OF REPORT ***