IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 07/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 07/27/24 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) 181,008 243,853 391,200 136,732,440.41 755.39 560.72 FEDERAL ONLY, PRESUMP IH(881) 4 7 14 1,413.39 353.35 201.91 FEDERAL ONLY, PRESUMP(886) 2 9 27 11,611.85 5,805.93 1,290.21 TOTAL FEDERAL ONLY - MONEY PAYMENT 181,014 243,869 391,241 136,745,465.65 755.44 560.73 FEDERAL ONLY -NO MONEY PAYMENT REFUGEE 92 173 328 78,403.32 852.21 453.20 TOTAL FEDERAL ONLY -NO MONEY PAYMENT 92 173 328 78,403.32 852.21 453.20 TOTAL FEDERAL ONLY 181,106 244,042 391,569 136,823,868.97 755.49 560.66 FEDERAL-STATE FEDERAL-STATE - MONEY PAYMENT SSI AGED 7,740 8,186 15,651 7,591,229.74 980.78 927.34 SSI DISABLED 38,175 42,720 89,233 67,204,951.12 1,760.44 1,573.15 FOSTER CARE 855 1,235 2,131 607,762.86 710.83 492.12 SUBSIDIZED ADOPTION 9,267 9,866 21,169 5,557,012.26 599.66 563.25 SSA RCF IHHRC 7,576 8,733 14,806 35,098,247.10 4,632.82 4,019.04 SUBSIDIZED ADOPTION-INTERSTATE 81 98 188 58,802.25 725.95 600.02 TOTAL FEDERAL-STATE - MONEY PAYMENT 63,694 70,838 143,178 116,118,005.33 1,823.06 1,639.21 FEDERAL-STATE - NO MONEY PYMT INTERMEDIATE CARE FACILITY 9,331 12,496 23,464 54,706,949.18 5,862.92 4,377.96 NON-INTERMEDIATE CARE FACILITY 45,180 76,667 125,022 44,967,320.15 995.29 586.53 CMAP 1,077 1,405 2,772 532,755.83 494.67 379.19 SUBSIDIZED ADOPTIONS 1,563 1,678 3,373 1,064,074.85 680.79 634.13 NO MONEY - ADC - VOLUNTARY 120,982 137,168 248,271 47,326,586.83 391.19 345.03 NO MONEY - SSI-SSA - VOLUNTARY 4,345 5,730 7,957 2,331,526.76 536.60 406.90 MED NEEDY - NO SPEND - CHILDRN 112 90 177 23,746.90 212.03 263.85 MED NEEDY - NO SPEND - AGED 2 4 8 1,670.59 835.30 417.65 IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 07/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 07/27/24 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 - DISABLE 2 1 0 0.13 0.07 0.13 MED NEEDY - WITH SPEND - AGED 0 5 4 397.79 0.00 79.56 MED NEEDY - WITH SPEND - DISAB 0 3 4 3,309.45 0.00 1,103.15 MED NEEDY - WITH SPEND - CRTKR 0 7 22 18,253.21 0.00 2,607.60 MAC SOBRA - PREGNANT WOMEN 8,431 11,708 14,342 5,362,875.59 636.09 458.05 MAC SOBRA - INFANTS 25,772 37,187 63,861 17,577,959.18 682.06 472.69 MAC SOBRA - CHILDREN 101,081 113,038 180,905 22,866,444.35 226.22 202.29 QUALIFIED MEDICARE BENE - AGED 7,048 2,932 9,826 553,416.62 78.52 188.75 QUALIFIED MEDICARE BENE - DISA 4,234 1,712 5,692 297,864.80 70.35 173.99 PRESUMPTIVE ELIG - PREG WOMEN 0 2 6 499.86 0.00 249.93 MAC (SOBRA/TXXI) CHILD 17,449 14,458 22,429 3,198,521.53 183.31 221.23 BREAST CERVICAL CANCER 86 93 149 270,315.06 3,143.20 2,906.61 ICARE PMIC MHI 300% 843 725 1,624 2,585,738.92 3,067.31 3,566.54 STATE ONLY - NO MONEY PAYMENT 1 1 2 339.02 339.02 339.02 BLENDED FAMP PME PREG WOMEN 4 0 0 0.00 0.00 0.00 LEGAL PERMANENT RESIDENT TXIX 7,003 9,051 15,534 1,923,273.02 274.64 212.49 LEGAL PERMANENT RESIDENT TXXI 924 794 1,209 147,875.18 160.04 186.24 FEDERAL ST, EX MIYA (375) 947 950 1,667 316,620.59 334.34 333.28 TOTAL FEDERAL-STATE - NO MONEY PYMT 356,417 427,905 728,320 206,078,335.39 578.19 481.60 TOTAL FEDERAL-STATE 420,111 498,743 871,498 322,196,340.72 766.93 646.02 FEDERAL-COUNTY FEDERAL-COUNTY - MONEY PAYMENT FED COUNTY ICF ID SSI 273 329 1,769 2,785,015.79 10,201.52 8,465.09 TOTAL FEDERAL-COUNTY - MONEY PAYMENT 273 329 1,769 2,785,015.79 10,201.52 8,465.09 FEDERAL-COUNTY - NO MONEY PYMT INTERMED CARE FAC-INT DISABLED 12,079 12,460 32,163 93,467,257.15 7,738.00 7,501.39 TOTAL FEDERAL-COUNTY - NO MONEY PYMT 12,079 12,460 32,163 93,467,257.15 7,738.00 7,501.39 TOTAL FEDERAL-COUNTY 12,352 12,789 33,932 96,252,272.94 7,792.44 7,526.18 STATE ONLY STATE ONLY - MONEY PAYMENT IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 3 AS OF 07/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 07/27/24 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 5 4 8 1,257.93 251.59 314.48 TOTAL STATE ONLY - MONEY PAYMENT 5 4 8 1,257.93 251.59 314.48 STATE ONLY - NO MONEY PAYMENT STATE ONLY - NO MONEY PAYMENT 4,008 168 260 26,739.09 6.67 159.16 TOTAL STATE ONLY - NO MONEY PAYMENT 4,008 168 260 26,739.09 6.67 159.16 TOTAL STATE ONLY 4,013 172 268 27,997.02 6.98 162.77 FEDERAL-COUNTY-STATE FEDERAL-COUNTY-STATE MONEY FED STATE COUNTY - MHI SSI 1,702 2 0 76.79 0.05 38.40 TOTAL FEDERAL-COUNTY-STATE MONEY 1,702 2 0 76.79 0.05 38.40 FEDERAL-COUNTY-STATE NO MONEY TOTAL FEDERAL-COUNTY-STATE NO MONEY 0 0 0 0.00 0.00 0.00 TOTAL FEDERAL-COUNTY-STATE 1,702 2 0 76.79 0.05 38.40 UNDEFINED UNDEFINED SUBTOTAL UNDEFINED CATEGORY 1,640 1,980 4,719 328,671,316.14 200,409.34 165,995.61 TOTAL UNDEFINED SUBTOTAL 1,640 1,980 4,719 328,671,316.14 200,409.34 165,995.61 TOTAL UNDEFINED 1,640 1,980 4,719 328,671,316.14 200,409.34 165,995.61 TOTAL S T A T E 620,924 757,728 1,301,986 883,971,872.58 1,423.64 1,166.61 * * * E N D O F R E P O R T * * *