IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 05/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 05/25/24 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 5 150 $56,529 0 0 $00 5 150 $56,529 AUDUBON 1 30 $11,638 0 0 $00 1 30 $11,638 BENTON 0 0 $00 1 280 $133,364 1 280 $133,364 BLACK HAWK 0 0 $00 1 30 $12,925 1 30 $12,925 BOONE 1 33 $26,228 1 30 $43,397 2 63 $69,625 BREMER 1 0 $87- 0 0 $00 1 0 $87- CALHOUN 1 92 $24,040 0 0 $00 1 92 $24,040 CARROLL 0 0 $00 1 0 $5,185- 1 0 $5,185- CEDAR 1 92 $25,111 0 0 $00 1 92 $25,111 CERRO GORDO 2 61 $13,660 0 0 $00 2 61 $13,660 CHICKASAW 1 25 $3,225 0 0 $00 1 25 $3,225 CLARKE 1 11 $2,961 0 0 $00 1 11 $2,961 CLAY 1 6 $1,819 0 0 $00 1 6 $1,819 CLINTON 1 44 $19,952 0 0 $00 1 44 $19,952 DECATUR 1 6 $628 0 0 $00 1 6 $628 DELAWARE 1 60 $16,582 0 0 $00 1 60 $16,582 DES MOINES 1 61 $11,966 0 0 $00 1 61 $11,966 DUBUQUE 1 60 $10,238 2 45 $26,872 3 105 $37,110 GRUNDY 0 0 $00 1 30 $13,976 1 30 $13,976 GUTHRIE 1 30 $13,269 0 0 $00 1 30 $13,269 HARRISON 3 113 $34,208 0 0 $00 3 113 $34,208 HENRY 1 30 $11,417 0 0 $00 1 30 $11,417 IOWA 2 120 $43,106 0 0 $00 2 120 $43,106 JASPER 1 30 $15,615 1 28 $13,932 2 58 $29,547 JEFFERSON 1 0 $9,226- 0 0 $00 1 0 $9,226- JOHNSON 3 68 $23,250 0 0 $00 3 68 $23,250 LEE 1 30 $11,067 0 0 $00 1 30 $11,067 LINN 4 142 $34,920 0 0 $00 4 142 $34,920 LYON 1 30 $5,746 0 0 $00 1 30 $5,746 MAHASKA 1 0 $1,917- 0 0 $00 1 0 $1,917- MARION 2 180- $76,863- 0 0 $00 2 180- $76,863- MARSHALL 174 4,811 $2,093,073 0 0 $00 174 4,811 $2,093,073 MILLS 1 122 $29,805 0 0 $00 1 122 $29,805 MITCHELL 1 0 $14- 0 0 $00 1 0 $14- MONONA 1 0 $14,150- 0 0 $00 1 0 $14,150- MUSCATINE 3 72 $17,755 0 0 $00 3 72 $17,755 O BRIEN 0 0 $00 1 27 $13,693 1 27 $13,693 PLYMOUTH 0 0 $00 1 30 $13,625 1 30 $13,625 POLK 9 98 $9,998 1 30 $24,162 10 128 $34,161 POTTAWATTAMIE 9 303 $106,790 0 0 $00 9 303 $106,790 SCOTT 2 121 $26,977 1 90 $42,685 3 211 $69,662 STORY 0 0 $00 1 29 $13,954 1 29 $13,954 TAMA 3 119 $33,146 0 0 $00 3 119 $33,146 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 05/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 05/25/24 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 UNION 1 30 $8,104 0 0 $00 1 30 $8,104 WAPELLO 2 60 $30,329 0 0 $00 2 60 $30,329 WARREN 2 92 $23,616 0 0 $00 2 92 $23,616 WAYNE 1 57 $13,352 0 0 $00 1 57 $13,352 WOODBURY 5 243 $64,252 4 120 $49,660 9 363 $113,913 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 3 AS OF 05/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 05/25/24 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 255 7,272 $2,772,131 17 769 $397,065 272 8,041 $3,169,197 *** END OF REPORT ***