IAMM2200-R003 (MR-O-12) IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 11/30/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 11/23/24 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 CATEGORY OF SERVICE) (FISCAL YTD TOTALS AS OF 11/30/24) CATEGORY OF SERVICE RECIPIENTS NUMBER OF UNITS OF TOTAL SERVED CLAIMS SERVICE PAYMENT INPATIENT 2,558 2,837 15,222 $27,264,748.71 OUTPATIENT 15,269 35,160 5,791,413 $7,633,157.70 CHILD PART HOSP 0 0 0 $0.00 CHILD DAY TREATMENT 0 0 0 $0.00 ADULT PART HOSP 0 0 0 $0.00 ADULT DAY TREATMENT 0 0 0 $0.00 SKILLED NURSING FACILITY 55 110 2,155 $2,066,036.58 IHAWP IOWA PLAN LITE 0 0 0 $0.00 IHAWP IOWA PLAN FULL 0 0 0 $0.00 IHAWP HMO 0 0 0 $0.00 IHAWP PCP 0 0 0 $0.00 INTERMEDIATE CARE FACILITY 459 1,475 42,341 $15,794,174.84 INTER CARE INT DISABLED 21 94 2,709 $1,316,786.89 NURSING FAC FOR MENTAL ILL 0 0 0 $0.00 HOME HEALTH 1,421 4,889 998,118 $13,254,679.06 LEAD INSPECTION AGENCY 0 0 0 $0.00 PHYSICIAN 15,430 59,999 209,951 $4,133,029.44 CLINIC SERVICES 5,131 10,895 11,377 $27,309,427.26 MEP CASE MANAGEMENT 0 0 0 $0.00 EHR INCENTIVE PAYMENTS 0 0 0 $0.00 LAB AND RADIOLOGICAL 2,692 5,498 19,619 $687,657.65 HABILITATION SERVICES 44 504 5,990 $847,883.91 BEHAVIORAL HLTH INTERVENTN SVC 66 642 5,023 $133,290.99 REHAB SUPPORT SERVICES 4 10 131 $12,311.97 AMBULANCE SERVICES 745 1,056 1,037 $447,717.59 LOCAL EDUCATION AGENCY 2,732 97,150 420,185 $13,268,085.45 INFANT TODDLER 438 1,360 3,036 $44,955.08 IHAWP WELLNESS EXAM BONUS 0 0 0 $0.00 ACO VIS PAYMENTS 0 0 0 $0.00 PRESCRIBED DRUGS 5,783 60,231 56,729 $6,864,632.78 IOWA-PLAN-PMIC 0 0 0 $0.00 DRUG CAPITATION 0 0 0 $0.00 NEMT SERVICES 15,139 44,986 39,846 $97,066.61 INDIAN HEALTH SERVICES 0 0 0 $0.00 FAMILY PLANNING SERVICES 406 616 612 $72,192.44 IOWA CARE MED HOME CAPITATION 0 0 0 $0.00 IOWA PLAN PROGRAM 0 0 0 $0.00 MANAGED SUBSTANCE ABUSE 0 0 0 $0.00 MENTAL HEALTH ACCESS PLAN 0 0 0 $0.00 EPSDT SCREENING 398 393 380 $734,665.43 HMO SERVICES 0 0 0 $0.00 PACE SERVICES 774 3,616 3,606 $15,163,481.71 PATIENT MANAGEMENT 0 0 0 $0.00 HEALTH INS PREMIUM PAYMENT 1,724 17,075 17,075 $2,142,325.15 MEDICAL SUPPLIES 2,878 11,036 540,226 $869,931.81 HEALTH HOME PROVIDER 155 459 314 $59,263.16 TCM PAYMENTS TO IOWAPLAN 0 0 0 $0.00 IHAWP QHP 0 0 0 $0.00 MCO 783,601 3,030,784 3,022,410 $4,217,042,743.53 OTHER PRACTITIONER 10,691 60,735 247,081 $9,704,757.22 IAMM2200-R003 (MR-O-12) IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 11/30/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 11/23/24 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 CATEGORY OF SERVICE) (FISCAL YTD TOTALS AS OF 11/30/24) CATEGORY OF SERVICE RECIPIENTS NUMBER OF UNITS OF TOTAL SERVED CLAIMS SERVICE PAYMENT FAMILY CENTERED PROGRAM 0 0 0 $0.00 FAMILY PRESERVATION 0 0 0 $0.00 TREATMENT FOSTER FAMILY CARE 0 0 0 $0.00 GROUP TREATMENT THERAPY 0 0 0 $0.00 DENTAL 360 478 468 $74,625.19 ACCOUNTABLE CARE ORGANIZATIONS 0 0 0 $0.00 OPTOMETRIST 876 1,052 1,276 $62,231.12 CHIROPRACTIC 539 2,270 2,405 $34,576.34 IOWA-PLAN-HAB 0 0 0 $0.00 PODIATRIC 629 1,197 1,921 $39,985.19 PREPAID AMBULATORY HEALTH PLAN 767,199 3,058,149 3,051,084 $46,540,998.05 PHYSICAL DISABILITIES SVCS 7 49 3,196 $28,772.53 BRAIN INJ WAIVER SERVICES 144 1,462 41,503 $2,909,519.41 PSYCHIATRIC 1,350 3,542 4,233 $278,202.43 RESIDENTIAL CARE FACILITY 312 1,303 35,721 $334,541.52 ID WAIVER SERVICE 590 5,107 245,850 $18,142,153.30 CHILDRENS MENTAL HEALTH SVC 35 153 19,757 $99,944.05 AIDS WAIVER SERVICES 2 16 1,400 $12,592.84 ELDERLY WAIVER SERVICES 30 362 8,626 $157,863.49 ILL & HANDICAPPED WAIVER SVCS 289 1,696 80,708 $3,130,064.45 COUNTY OFFICE REIMBURSEMENT 0 0 0 $0.00 MEP SERVICES 593 2,965 23,707 $1,531,472.20 UNASSIGNED 6 0 0 $6,805,749.56- * A L L C A T E G O R I E S * 808,382 6,531,411 14,978,441 $4,433,536,795.51 *** END OF REPORT ***