IAMM2200-R002 (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) (MONTHLY TOTALS AS OF 11/30/24) * * * * * A V E R A G E S * * * * * * * COST PER COST PER UNITS PER COST PER CATEGORY OF SERVICE RECIPIENTS NUMBER OF UNITS OF TOTAL UNIT OF ELIGIBLE RECIPIENT RECIPIENT SERVED CLAIMS SERVICE PAYMENT SERVICE RECIPIENT SERVED SERVED INPATIENT 503 486 2,331 $1,764,886.20 $757.14 $2.84 4.6 $3,508.72 OUTPATIENT 7,868 6,758 917,728 $897,986.34 $0.98 $1.44 116.6 $114.13 CHILD PART HOSP 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 CHILD DAY TREATMENT 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 ADULT PART HOSP 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 ADULT DAY TREATMENT 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 SKILLED NURSING FACILITY 24 24 512 $431,321.59 $842.42 $0.69 21.3 $17,971.73 IHAWP IOWA PLAN LITE 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 IHAWP IOWA PLAN FULL 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 IHAWP HMO 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 IHAWP PCP 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 INTERMEDIATE CARE FACILITY 258 324 9,397 $3,458,828.84 $368.08 $5.56 36.4 $13,406.31 INTER CARE INT DISABLED 14 27 766 $392,842.52 $512.85 $0.63 54.7 $28,060.18 NURSING FAC FOR MENTAL ILL 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 HOME HEALTH 714 1,137 210,090 $3,280,086.48 $15.61 $5.27 294.2 $4,593.96 LEAD INSPECTION AGENCY 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 PHYSICIAN 5,545 11,600 40,014 $707,216.50 $17.67 $1.14 7.2 $127.54 CLINIC SERVICES 1,429 1,960 2,355 $3,502,727.95 $1,487.36 $5.63 1.6 $2,451.17 MEP CASE MANAGEMENT 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 EHR INCENTIVE PAYMENTS 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 LAB AND RADIOLOGICAL 670 1,005 3,586 $127,743.89 $35.62 $0.21 5.4 $190.66 HABILITATION SERVICES 34 107 1,416 $212,035.65 $149.74 $0.34 41.6 $6,236.34 BEHAVIORAL HLTH INTERVENTN SVC 43 113 676 $17,778.76 $26.30 $0.03 15.7 $413.46 REHAB SUPPORT SERVICES 2 2 46 $5,151.54 $111.99 $0.01 23.0 $2,575.77 AMBULANCE SERVICES 130 153 151 $64,140.65 $424.77 $0.10 1.2 $493.39 LOCAL EDUCATION AGENCY 1,988 41,596 177,242 $5,897,310.95 $33.27 $9.48 89.2 $2,966.45 INFANT TODDLER 59 86 196 $3,348.58 $17.08 $0.01 3.3 $56.76 IHAWP WELLNESS EXAM BONUS 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 ACO VIS PAYMENTS 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 PRESCRIBED DRUGS 2,701 10,547 9,465 $1,046,872.29 $110.60 $25.81 3.5 $387.59 IOWA-PLAN-PMIC 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 DRUG CAPITATION 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 NEMT SERVICES 10,985 8,917 8,248 $20,754.35 $2.52 $0.03 .8 $1.89 INDIAN HEALTH SERVICES 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 FAMILY PLANNING SERVICES 87 95 95 $7,641.82 $80.44 $0.01 1.1 $87.84 IOWA CARE MED HOME CAPITATION 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 IOWA PLAN PROGRAM 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 MANAGED SUBSTANCE ABUSE 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 MENTAL HEALTH ACCESS PLAN 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 EPSDT SCREENING 80 79 76 $155,768.67 $2,049.59 $16.87 1.0 $1,947.11 HMO SERVICES 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 PACE SERVICES 716 716 716 $3,050,500.47 $4,260.48 $4.90 1.0 $4,260.48 PATIENT MANAGEMENT 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 HEALTH INS PREMIUM PAYMENT 1,473 2,916 2,916 $360,573.77 $123.65 $0.58 2.0 $244.79 MEDICAL SUPPLIES 1,265 1,935 84,755 $130,768.89 $1.54 $3.22 67.0 $103.37 HEALTH HOME PROVIDER 73 105 105 $19,977.15 $190.26 $0.03 1.4 $273.66 TCM PAYMENTS TO IOWAPLAN 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 IHAWP QHP 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 MCO 573,852 612,303 610,774 $505,533,515.87 $827.69 $812.36 1.1 $880.95 IAMM2200-R002 (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) (MONTHLY TOTALS AS OF 11/30/24) * * * * * A V E R A G E S * * * * * * * COST PER COST PER UNITS PER COST PER CATEGORY OF SERVICE RECIPIENTS NUMBER OF UNITS OF TOTAL UNIT OF ELIGIBLE RECIPIENT RECIPIENT SERVED CLAIMS SERVICE PAYMENT SERVICE RECIPIENT SERVED SERVED OTHER PRACTITIONER 4,731 25,610 72,180 $4,065,409.13 $56.32 $6.53 15.3 $859.31 FAMILY CENTERED PROGRAM 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 FAMILY PRESERVATION 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 TREATMENT FOSTER FAMILY CARE 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 GROUP TREATMENT THERAPY 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 DENTAL 76 85 83 $12,835.72 $154.65 $0.32 1.1 $168.89 ACCOUNTABLE CARE ORGANIZATIONS 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 OPTOMETRIST 211 230 293 $12,497.50 $42.65 $0.02 1.4 $59.23 CHIROPRACTIC 222 442 482 $7,924.96 $16.44 $0.20 2.2 $35.70 IOWA-PLAN-HAB 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 PODIATRIC 184 264 413 $5,851.70 $14.17 $0.01 2.2 $31.80 PREPAID AMBULATORY HEALTH PLAN 578,855 617,738 617,159 $9,392,090.80 $15.22 $15.09 1.1 $16.23 PHYSICAL DISABILITIES SVCS 6 10 470 $7,372.15 $15.69 $0.01 78.3 $1,228.69 BRAIN INJ WAIVER SERVICES 133 281 7,421 $582,665.08 $78.52 $0.94 55.8 $4,380.94 PSYCHIATRIC 438 717 810 $49,956.36 $61.67 $0.08 1.8 $114.06 RESIDENTIAL CARE FACILITY 240 384 11,202 $108,741.88 $9.71 $0.17 46.7 $453.09 ID WAIVER SERVICE 522 980 50,209 $3,120,181.49 $62.14 $0.00 96.2 $5,977.36 CHILDRENS MENTAL HEALTH SVC 19 22 1,535 $7,744.39 $5.05 $1,548.88 80.8 $407.60 AIDS WAIVER SERVICES 2 3 242 $2,223.45 $9.19 $0.00 121.0 $1,111.73 ELDERLY WAIVER SERVICES 27 68 1,644 $24,792.94 $15.08 $4,958.59 60.9 $918.26 ILL & HANDICAPPED WAIVER SVCS 239 309 10,254 $597,985.81 $58.32 $0.00 42.9 $2,502.03 COUNTY OFFICE REIMBURSEMENT 0 0 0 $0.00 $0.00 $0.00 .0 $0.00 MEP SERVICES 544 600 4,830 $312,018.00 $64.60 $0.50 8.9 $573.56 UNASSIGNED 1 0 0 $1,239,223.98 $0.00 $1.99 .0 $0.00 * A L L C A T E G O R I E S * 594,399 1,350,734 2,862,883 $550,639,295.06 $192.34 $884.84 4.8 $926.38 *** END OF REPORT ***