IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 08/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 08/24/24 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) 179,751 237,374 385,219 179,077,699.69 996.25 754.41 FEDERAL ONLY, PRESUMP IH(881) 3 2 3 182.82 60.94 91.41 FEDERAL ONLY, PRESUMP(886) 2 2 7 1,671.15 835.58 835.58 TOTAL FEDERAL ONLY - MONEY PAYMENT 179,756 237,378 385,229 179,079,553.66 996.24 754.41 FEDERAL ONLY -NO MONEY PAYMENT REFUGEE 95 163 272 69,345.63 729.95 425.43 TOTAL FEDERAL ONLY -NO MONEY PAYMENT 95 163 272 69,345.63 729.95 425.43 TOTAL FEDERAL ONLY 179,851 237,541 385,501 179,148,899.29 996.10 754.18 FEDERAL-STATE FEDERAL-STATE - MONEY PAYMENT SSI AGED 6,972 8,269 13,555 8,077,628.77 1,158.58 976.86 SSI DISABLED 35,774 42,616 86,525 90,939,040.92 2,542.04 2,133.92 FOSTER CARE 868 1,238 2,123 729,274.88 840.18 589.08 SUBSIDIZED ADOPTION 9,262 9,832 20,533 6,297,071.13 679.88 640.47 SSA RCF IHHRC 132 8,668 14,937 36,324,145.38 275,182.92 4,190.60 SUBSIDIZED ADOPTION-INTERSTATE 78 93 176 58,349.54 748.07 627.41 TOTAL FEDERAL-STATE - MONEY PAYMENT 53,086 70,716 137,849 142,425,510.62 2,682.92 2,014.05 FEDERAL-STATE - NO MONEY PYMT INTERMEDIATE CARE FACILITY 17,543 12,466 23,479 55,790,841.71 3,180.23 4,475.44 NON-INTERMEDIATE CARE FACILITY 47,672 71,902 120,761 53,431,908.25 1,120.82 743.12 CMAP 1,060 1,467 2,797 614,655.50 579.86 418.99 SUBSIDIZED ADOPTIONS 1,562 1,648 3,263 1,306,380.80 836.35 792.71 NO MONEY - ADC - VOLUNTARY 120,366 135,241 244,406 60,617,310.89 503.61 448.22 NO MONEY - SSI-SSA - VOLUNTARY 4,403 5,680 7,180 2,448,846.27 556.18 431.13 MED NEEDY - NO SPEND - CHILDRN 112 92 194 28,049.57 250.44 304.89 MED NEEDY - NO SPEND - AGED 1 3 2 89.93 89.93 29.98 IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 08/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 08/24/24 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 - DISABLE 2 0 0 0.00 0.00 0.00 MED NEEDY - WITH SPEND - AGED 0 2 6 653.12 0.00 326.56 MED NEEDY - WITH SPEND - CRTKR 0 2 2 352.40 0.00 176.20 MAC SOBRA - PREGNANT WOMEN 8,271 11,701 14,212 6,848,908.69 828.06 585.33 MAC SOBRA - INFANTS 26,026 37,533 65,260 36,526,179.58 1,403.45 973.18 MAC SOBRA - CHILDREN 100,083 109,733 179,802 28,178,532.93 281.55 256.79 QUALIFIED MEDICARE BENE - AGED 7,072 2,747 7,760 457,109.92 64.64 166.40 QUALIFIED MEDICARE BENE - DISA 4,285 1,605 4,646 313,205.11 73.09 195.14 MAC (SOBRA/TXXI) CHILD 17,881 14,899 23,290 4,515,913.70 252.55 303.10 BREAST CERVICAL CANCER 86 92 152 304,793.50 3,544.11 3,312.97 ICARE PMIC MHI 300% 837 709 1,675 2,559,941.71 3,058.47 3,610.64 STATE ONLY - NO MONEY PAYMENT 1 1 2 340.90 340.90 340.90 BLENDED FAMP PME PREG WOMEN 2 0 0 0.00 0.00 0.00 LEGAL PERMANENT RESIDENT TXIX 7,095 8,826 15,427 2,491,596.85 351.18 282.30 LEGAL PERMANENT RESIDENT TXXI 967 808 1,218 174,925.61 180.90 216.49 FEDERAL ST, EX MIYA (375) 952 954 1,641 395,923.28 415.89 415.01 TOTAL FEDERAL-STATE - NO MONEY PYMT 366,279 418,111 717,175 257,006,460.22 701.67 614.68 TOTAL FEDERAL-STATE 419,365 488,827 855,024 399,431,970.84 952.47 817.12 FEDERAL-COUNTY FEDERAL-COUNTY - MONEY PAYMENT FED COUNTY ICF ID SSI 273 324 903 2,916,057.00 10,681.53 9,000.18 TOTAL FEDERAL-COUNTY - MONEY PAYMENT 273 324 903 2,916,057.00 10,681.53 9,000.18 FEDERAL-COUNTY - NO MONEY PYMT INTERMED CARE FAC-INT DISABLED 13,822 12,577 31,235 97,061,046.70 7,022.21 7,717.34 TOTAL FEDERAL-COUNTY - NO MONEY PYMT 13,822 12,577 31,235 97,061,046.70 7,022.21 7,717.34 TOTAL FEDERAL-COUNTY 14,095 12,901 32,138 99,977,103.70 7,093.09 7,749.56 STATE ONLY STATE ONLY - MONEY PAYMENT IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 3 AS OF 08/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 08/24/24 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 STATE ONLY - MONEY PAYMENT 4 4 6 904.00 226.00 226.00 STATE ONLY - NO MONEY PAYMENT STATE ONLY - NO MONEY PAYMENT 4,180 156 223 25,777.10 6.17 165.24 TOTAL STATE ONLY - NO MONEY PAYMENT 4,180 156 223 25,777.10 6.17 165.24 TOTAL STATE ONLY 4,184 160 229 26,681.10 6.38 166.76 FEDERAL-COUNTY-STATE FEDERAL-COUNTY-STATE MONEY FED STATE COUNTY - MHI SSI 0 1 0 149.49 0.00 149.49 TOTAL FEDERAL-COUNTY-STATE MONEY 0 1 0 149.49 0.00 149.49 FEDERAL-COUNTY-STATE NO MONEY TOTAL FEDERAL-COUNTY-STATE NO MONEY 0 0 0 0.00 0.00 0.00 TOTAL FEDERAL-COUNTY-STATE 0 1 0 149.49 0.00 149.49 UNDEFINED UNDEFINED SUBTOTAL UNDEFINED CATEGORY 1,871 1,600 4,763 377,210,396.96 201,608.98 235,756.50 TOTAL UNDEFINED SUBTOTAL 1,871 1,600 4,763 377,210,396.96 201,608.98 235,756.50 TOTAL UNDEFINED 1,871 1,600 4,763 377,210,396.96 201,608.98 235,756.50 TOTAL S T A T E 619,366 741,030 1,277,655 1,055,795,201.38 1,704.64 1,424.77 * * * E N D O F R E P O R T * * *