IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 03/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 03/24/24 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 ELIGIBILITY PROGRAM) AID CATEGORY NUMBER OF RECIPIENTS NUMBER OF TOTAL AVERAGE PAYMENT PER RECIPIENT ELIGIBLE SERVED CLAIMS PAYMENT ELIGIBLE SERVED FEDERAL ONLY FEDERAL ONLY - MONEY PAYMENT FEDERAL ONLY, IHAWP (531/501) 190,329 265,534 403,267 135,367,968.75 711.23 509.80 FEDERAL ONLY, PRESUMP IH(881) 4 4 6 720.75 180.19 180.19 FEDERAL ONLY, PRESUMP(886) 0 1 0 1,106.47 0.00 1,106.47 TOTAL FEDERAL ONLY - MONEY PAYMENT 190,333 265,539 403,273 135,369,795.97 711.23 509.79 FEDERAL ONLY -NO MONEY PAYMENT REFUGEE 138 176 341 71,658.01 519.26 407.15 TOTAL FEDERAL ONLY -NO MONEY PAYMENT 138 176 341 71,658.01 519.26 407.15 TOTAL FEDERAL ONLY 190,471 265,715 403,614 135,441,453.98 711.09 509.72 FEDERAL-STATE FEDERAL-STATE - MONEY PAYMENT SSI AGED 7,072 7,795 15,440 5,696,693.92 805.53 730.81 SSI DISABLED 35,878 41,565 98,253 68,300,213.28 1,903.68 1,643.21 FOSTER CARE 868 1,219 2,352 498,349.55 574.14 408.82 SUBSIDIZED ADOPTION 9,264 9,869 23,015 5,856,729.93 632.20 593.45 SSA RCF IHHRC 132 8,747 15,349 34,562,883.72 261,840.03 3,951.40 SUBSIDIZED ADOPTION-INTERSTATE 79 101 219 65,864.65 833.73 652.13 FOSTER CARE - INTERSTATE 0 1 2 203.24 0.00 203.24 TOTAL FEDERAL-STATE - MONEY PAYMENT 53,293 69,297 154,630 114,980,938.29 2,157.52 1,659.25 FEDERAL-STATE - NO MONEY PYMT INTERMEDIATE CARE FACILITY 17,544 12,515 24,416 53,812,505.11 3,067.29 4,299.84 NON-INTERMEDIATE CARE FACILITY 51,725 85,710 141,432 47,751,749.24 923.19 557.13 CMAP 1,025 1,387 2,659 512,041.41 499.55 369.17 SUBSIDIZED ADOPTIONS 1,591 1,713 4,041 1,216,105.02 764.37 709.93 NO MONEY - ADC - VOLUNTARY 125,322 145,505 261,905 47,186,371.25 376.52 324.29 NO MONEY - SSI-SSA - VOLUNTARY 5,031 6,063 9,312 3,337,991.86 663.48 550.55 MED NEEDY - NO SPEND - CHILDRN 108 80 159 26,805.91 248.20 335.07 IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 03/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 03/24/24 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 ELIGIBILITY PROGRAM) AID CATEGORY NUMBER OF RECIPIENTS NUMBER OF TOTAL AVERAGE PAYMENT PER RECIPIENT ELIGIBLE SERVED CLAIMS PAYMENT ELIGIBLE SERVED MED NEEDY - NO SPEND - AGED 13 12 24 438.69 33.75 36.56 MED NEEDY - NO SPEND - DISABLE 4 2 3 111.36 27.84 55.68 MED NEEDY - WITH SPEND - AGED 0 2 5 1,441.36 0.00 720.68 MED NEEDY - NO SPEND - CRTKR 1 1 3 20.93 20.93 20.93 MAC SOBRA - PREGNANT WOMEN 10,974 12,850 18,498 5,663,725.17 516.10 440.76 MAC SOBRA - INFANTS 27,943 39,082 67,530 18,167,205.85 650.15 464.85 MAC SOBRA - CHILDREN 104,780 122,903 193,684 23,183,571.60 221.26 188.63 QUALIFIED MEDICARE BENE - AGED 6,929 2,179 5,799 355,278.33 51.27 163.05 QUALIFIED MEDICARE BENE - DISA 4,130 1,278 3,327 201,334.70 48.75 157.54 PRESUMPTIVE ELIG - PREG WOMEN 0 1 3 39.48 0.00 39.48 MAC (SOBRA/TXXI) CHILD 16,573 13,994 21,659 2,687,443.32 162.16 192.04 BREAST CERVICAL CANCER 89 98 166 265,809.05 2,986.62 2,712.34 ICARE PMIC MHI 300% 883 762 2,506 2,847,825.06 3,225.17 3,737.30 STATE ONLY - NO MONEY PAYMENT 2 2 4 537.32 268.66 268.66 BLENDED FAMP PME PREG WOMEN 3 0 0 0.00 0.00 0.00 LEGAL PERMANENT RESIDENT TXIX 6,784 9,148 15,089 1,815,487.25 267.61 198.46 LEGAL PERMANENT RESIDENT TXXI 817 735 1,007 120,242.49 147.18 163.60 FEDERAL ST, EX MIYA (375) 1,000 965 1,634 308,262.69 308.26 319.44 TOTAL FEDERAL-STATE - NO MONEY PYMT 383,271 456,987 774,865 209,462,344.45 546.51 458.36 TOTAL FEDERAL-STATE 436,564 526,284 929,495 324,443,282.74 743.17 616.48 FEDERAL-COUNTY FEDERAL-COUNTY - MONEY PAYMENT FED COUNTY ICF ID SSI 292 320 840 2,535,978.64 8,684.86 7,924.93 TOTAL FEDERAL-COUNTY - MONEY PAYMENT 292 320 840 2,535,978.64 8,684.86 7,924.93 FEDERAL-COUNTY - NO MONEY PYMT INTERMED CARE FAC-INT DISABLED 13,374 12,199 37,191 93,442,514.83 6,986.88 7,659.85 TOTAL FEDERAL-COUNTY - NO MONEY PYMT 13,374 12,199 37,191 93,442,514.83 6,986.88 7,659.85 TOTAL FEDERAL-COUNTY 13,666 12,519 38,031 95,978,493.47 7,023.16 7,666.63 STATE ONLY STATE ONLY - MONEY PAYMENT IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 3 AS OF 03/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 03/24/24 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 ELIGIBILITY PROGRAM) AID CATEGORY NUMBER OF RECIPIENTS NUMBER OF TOTAL AVERAGE PAYMENT PER RECIPIENT ELIGIBLE SERVED CLAIMS PAYMENT ELIGIBLE SERVED STATE ONLY - MONEY PAYMENT 6 8 14 1,853.61 308.94 231.70 TOTAL STATE ONLY - MONEY PAYMENT 6 8 14 1,853.61 308.94 231.70 STATE ONLY - NO MONEY PAYMENT STATE ONLY - NO MONEY PAYMENT 2,829 101 163 17,618.00 6.23 174.44 TOTAL STATE ONLY - NO MONEY PAYMENT 2,829 101 163 17,618.00 6.23 174.44 TOTAL STATE ONLY 2,835 109 177 19,471.61 6.87 178.64 FEDERAL-COUNTY-STATE FEDERAL-COUNTY-STATE MONEY FED STATE COUNTY - MHI SSI 0 63 5 33,988.87 0.00 539.51 TOTAL FEDERAL-COUNTY-STATE MONEY 0 63 5 33,988.87 0.00 539.51 FEDERAL-COUNTY-STATE NO MONEY EXTENDED SLMB - BLIND 0 1 0 76.79 0.00 76.79 TOTAL FEDERAL-COUNTY-STATE NO MONEY 0 1 0 76.79 0.00 76.79 TOTAL FEDERAL-COUNTY-STATE 0 64 5 34,065.66 0.00 532.28 UNDEFINED UNDEFINED SUBTOTAL UNDEFINED CATEGORY 1,865 1,248 2,933 342,588,830.29 183,693.74 274,510.28 TOTAL UNDEFINED SUBTOTAL 1,865 1,248 2,933 342,588,830.29 183,693.74 274,510.28 TOTAL UNDEFINED 1,865 1,248 2,933 342,588,830.29 183,693.74 274,510.28 IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 4 AS OF 03/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 03/24/24 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 ELIGIBILITY PROGRAM) AID CATEGORY NUMBER OF RECIPIENTS NUMBER OF TOTAL AVERAGE PAYMENT PER RECIPIENT ELIGIBLE SERVED CLAIMS PAYMENT ELIGIBLE SERVED TOTAL S T A T E 645,401 805,939 1,374,255 898,505,597.75 1,392.17 1,114.86 * * * E N D O F R E P O R T * * *