IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 04/30/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 04/27/24 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 5 155 $55,728 0 0 $00 5 155 $55,728 AUDUBON 1 31 $193- 0 0 $00 1 31 $193- BLACK HAWK 1 61 $15,782 1 31 $13,359 2 92 $29,142 BOONE 0 0 $00 1 31 $50,909 1 31 $50,909 BREMER 1 0 $1,654- 0 0 $00 1 0 $1,654- BUCHANAN 1 0 $07- 0 0 $00 1 0 $07- CALHOUN 2 147 $37,774 0 0 $00 2 147 $37,774 CASS 1 0 $1,071 0 0 $00 1 0 $1,071 CEDAR 1 9 $2,090 0 0 $00 1 9 $2,090 CERRO GORDO 1 31 $14,535 0 0 $00 1 31 $14,535 CHEROKEE 1 0 $105- 2 86 $36,893 3 86 $36,787 CHICKASAW 1 61 $9,227 0 0 $00 1 61 $9,227 CLARKE 1 91 $24,155 0 0 $00 1 91 $24,155 DES MOINES 1 79 $17,296 0 0 $00 1 79 $17,296 DUBUQUE 1 20 $5,720 2 52 $26,158 3 72 $31,878 FLOYD 1 61 $16,561 0 0 $00 1 61 $16,561 GREENE 1 30 $8,472 0 0 $00 1 30 $8,472 GRUNDY 2 31 $17,447 1 31 $14,442 3 62 $31,890 GUTHRIE 1 31 $13,014 0 0 $00 1 31 $13,014 HARRISON 1 183 $47,521 0 0 $00 1 183 $47,521 HENRY 2 123 $35,972 0 0 $00 2 123 $35,972 HUMBOLDT 1 3 $826 0 0 $00 1 3 $826 JASPER 2 57 $26,007 1 31 $14,442 3 88 $40,449 JOHNSON 3 227 $91,575 0 0 $00 3 227 $91,575 LEE 1 31 $10,812 0 0 $00 1 31 $10,812 LINN 4 184 $31,023 0 0 $00 4 184 $31,023 LYON 1 31 $5,963 0 0 $00 1 31 $5,963 MADISON 1 22 $4,578 0 0 $00 1 22 $4,578 MAHASKA 2 24 $3,790- 0 0 $00 2 24 $3,790- MARSHALL 161 6,009 $2,367,993 0 0 $00 161 6,009 $2,367,993 MONONA 2 52 $12,814 0 0 $00 2 52 $12,814 MONROE 1 61 $14,571 0 0 $00 1 61 $14,571 O BRIEN 0 0 $00 1 60 $27,916 1 60 $27,916 PLYMOUTH 1 0 $22,611- 1 31 $14,079 2 31 $8,532- POLK 6 305 $81,652 2 60 $37,614 8 365 $119,266 POTTAWATTAMIE 9 379 $107,668 0 0 $00 9 379 $107,668 SAC 1 19 $4,618 0 0 $00 1 19 $4,618 SCOTT 1 10 $2,626 0 0 $00 1 10 $2,626 SHELBY 0 0 $00 1 31 $13,367 1 31 $13,367 SIOUX 1 61 $12,165 0 0 $00 1 61 $12,165 STORY 2 39 $9,456 1 28 $14,376 3 67 $23,833 TAMA 1 31 $10,322 0 0 $00 1 31 $10,322 UNION 2 31 $11,058 0 0 $00 2 31 $11,058 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 04/30/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 04/27/24 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 WAPELLO 3 93 $34,363 0 0 $00 3 93 $34,363 WARREN 3 90 $25,738 0 0 $00 3 90 $25,738 WOODBURY 10 372 $87,839 4 124 $51,338 14 496 $139,177 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 3 AS OF 04/30/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 04/27/24 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 246 9,275 $3,247,687 18 596 $314,899 264 9,871 $3,562,587 *** END OF REPORT ***