IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 12/31/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 12/23/23 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 5 151 $50,762 0 0 $00 5 151 $50,762 AUDUBON 1 30 $12,024 0 0 $00 1 30 $12,024 BLACK HAWK 2 44 $14,712 1 30 $12,911 3 74 $27,624 BOONE 0 0 $00 1 30 $35,999 1 30 $35,999 BREMER 1 30 $14,864 0 0 $00 1 30 $14,864 BUENA VISTA 1 31 $8,672 0 0 $00 1 31 $8,672 CARROLL 0 0 $00 1 0 $00 1 0 $00 CERRO GORDO 1 23 $12,055 0 0 $00 1 23 $12,055 CHICKASAW 2 15 $12,351 0 0 $00 2 15 $12,351 CLAYTON 1 61 $17,902 0 0 $00 1 61 $17,902 CRAWFORD 1 31 $4,338 0 0 $00 1 31 $4,338 DUBUQUE 2 96 $25,956 4 202 $89,235 6 298 $115,191 FRANKLIN 1 31 $9,060 0 0 $00 1 31 $9,060 GREENE 1 30 $7,408 0 0 $00 1 30 $7,408 GRUNDY 1 30 $6,541 1 30 $13,958 2 60 $20,499 GUTHRIE 2 61 $20,409 0 0 $00 2 61 $20,409 HENRY 1 30 $9,985 0 0 $00 1 30 $9,985 IOWA 1 30 $13,300 0 0 $00 1 30 $13,300 JASPER 4 112 $38,274 1 29 $13,936 5 141 $52,211 LEE 1 30 $10,392 0 0 $00 1 30 $10,392 LINN 1 30 $14,864 0 0 $00 1 30 $14,864 LYON 1 30 $5,956 0 0 $00 1 30 $5,956 MARION 1 30 $11,369 0 0 $00 1 30 $11,369 MARSHALL 148 4,814 $1,947,793 0 0 $00 148 4,814 $1,947,793 MONONA 2 60 $17,759 0 0 $00 2 60 $17,759 O BRIEN 0 0 $00 1 30 $13,958 1 30 $13,958 PALO ALTO 1 16 $4,134 0 0 $00 1 16 $4,134 PLYMOUTH 0 0 $00 1 29 $12,498 1 29 $12,498 POCAHONTAS 1 22 $1,836 0 0 $00 1 22 $1,836 POLK 10 321 $105,312 3 88 $52,036 13 409 $157,349 POTTAWATTAMIE 5 112 $29,046 0 0 $00 5 112 $29,046 SCOTT 2 94 $23,403 0 0 $00 2 94 $23,403 STORY 2 60 $24,822 1 27 $13,893 3 87 $38,716 TAMA 2 30 $18,735 0 0 $00 2 30 $18,735 UNION 1 91 $22,668 0 0 $00 1 91 $22,668 WAPELLO 2 40 $18,036 0 0 $00 2 40 $18,036 WARREN 1 30 $7,494 0 0 $00 1 30 $7,494 WOODBURY 2 58 $11,709 4 118 $46,119 6 176 $57,828 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 12/31/23 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 12/23/23 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 211 6,704 $2,553,958 19 613 $304,547 230 7,317 $2,858,506 *** END OF REPORT ***