IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 02/29/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 02/24/24 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 4 124 $45,532 0 0 $00 4 124 $45,532 AUDUBON 1 31 $12,466 0 0 $00 1 31 $12,466 BLACK HAWK 1 30 $7,144 1 31 $13,589 2 61 $20,734 BOONE 0 0 $00 1 0 $20- 1 0 $20- BREMER 1 31 $15,359 0 0 $00 1 31 $15,359 CEDAR 1 14 $1,345 0 0 $00 1 14 $1,345 CERRO GORDO 1 31 $14,535 0 0 $00 1 31 $14,535 CHEROKEE 2 29 $5,690 2 306 $137,598 4 335 $143,288 CHICKASAW 1 30 $6,060 0 0 $00 1 30 $6,060 DALLAS 0 0 $00 1 92 $42,946 1 92 $42,946 DUBUQUE 2 62 $15,315 3 58 $35,114 5 120 $50,429 GREENE 1 26 $7,341 0 0 $00 1 26 $7,341 GRUNDY 0 0 $00 1 31 $14,535 1 31 $14,535 GUTHRIE 1 31 $13,014 0 0 $00 1 31 $13,014 HENRY 2 92 $27,743 0 0 $00 2 92 $27,743 HOWARD 1 61 $12,445 0 0 $00 1 61 $12,445 IDA 2 50 $9,961 0 0 $00 2 50 $9,961 JASPER 2 62 $28,484 2 58 $32,565 4 120 $61,050 JEFFERSON 1 31 $8,247 0 0 $00 1 31 $8,247 JOHNSON 2 92 $33,399 0 0 $00 2 92 $33,399 LEE 2 31 $7,024 0 0 $00 2 31 $7,024 LINN 2 92 $27,106 0 0 $00 2 92 $27,106 LYON 1 31 $6,150 0 0 $00 1 31 $6,150 MARSHALL 155 5,219 $2,139,972 0 0 $00 155 5,219 $2,139,972 MONTGOMERY 1 89 $25,173 0 0 $00 1 89 $25,173 O BRIEN 0 0 $00 1 31 $14,423 1 31 $14,423 PLYMOUTH 1 31 $15,359 1 0 $3,125 2 31 $18,485 POLK 8 309 $84,196 4 171 $81,915 12 480 $166,112 POTTAWATTAMIE 7 155 $45,450 0 0 $00 7 155 $45,450 SCOTT 0 0 $00 1 31 $14,702 1 31 $14,702 SHELBY 0 0 $00 1 153 $82,602 1 153 $82,602 STORY 1 31 $15,359 2 52 $28,480 3 83 $43,840 TAMA 1 31 $10,861 0 0 $00 1 31 $10,861 TAYLOR 1 61 $12,056 0 0 $00 1 61 $12,056 UNION 2 120 $24,963 0 0 $00 2 120 $24,963 WAPELLO 2 108 $53,113 0 0 $00 2 108 $53,113 WOODBURY 4 111 $27,413 4 62 $32,122 8 173 $59,535 WRIGHT 1 31 $8,664 0 0 $00 1 31 $8,664 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 02/29/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 02/24/24 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 215 7,277 $2,766,955 25 1,076 $533,702 240 8,353 $3,300,658 *** END OF REPORT ***