IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 12/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 12/28/24 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 $47,389 1 10 $4,542 6 160 $51,932 ADAMS 1 92 $17,104 0 0 $00 1 92 $17,104 AUDUBON 2 87 $21,382 0 0 $00 2 87 $21,382 BENTON 2 154 $33,926 1 29 $14,416 3 183 $48,342 BLACK HAWK 2 37 $10,102 1 30 $12,989 3 67 $23,091 BOONE 0 0 $00 1 30 $43,724 1 30 $43,724 CALHOUN 0 0 $00 1 30 $14,118 1 30 $14,118 CEDAR 1 31 $7,440 0 0 $00 1 31 $7,440 CERRO GORDO 2 51 $7,351 0 0 $00 2 51 $7,351 CHICKASAW 1 27 $5,739 0 0 $00 1 27 $5,739 CLINTON 4 169 $44,883 0 0 $00 4 169 $44,883 DALLAS 2 92 $19,917 3 307 $150,361 5 399 $170,278 DELAWARE 1 30 $11,195 0 0 $00 1 30 $11,195 DES MOINES 1 0 $00 0 0 $00 1 0 $00 DUBUQUE 2 126 $33,554 2 118 $58,694 4 244 $92,248 FAYETTE 1 0 $558- 0 0 $00 1 0 $558- GRUNDY 0 0 $00 1 30 $14,118 1 30 $14,118 HARRISON 1 30 $9,007 0 0 $00 1 30 $9,007 HENRY 3 30 $12,939 0 0 $00 3 30 $12,939 IDA 1 3 $00 0 0 $00 1 3 $00 IOWA 5 145 $49,565 0 0 $00 5 145 $49,565 JASPER 1 26 $12,470 0 0 $00 1 26 $12,470 JEFFERSON 1 92 $21,583 0 0 $00 1 92 $21,583 JOHNSON 3 92 $25,765 0 0 $00 3 92 $25,765 KEOKUK 1 36 $6,841 0 0 $00 1 36 $6,841 LEE 1 30 $8,831 0 0 $00 1 30 $8,831 LINN 2 30 $5,017 0 0 $00 2 30 $5,017 LOUISA 1 10 $2,555 0 0 $00 1 10 $2,555 LYON 2 60 $12,868 0 0 $00 2 60 $12,868 MAHASKA 1 50 $10,107 0 0 $00 1 50 $10,107 MARION 1 45 $7,284 0 0 $00 1 45 $7,284 MARSHALL 175 5,313 $1,989,667 0 0 $00 175 5,313 $1,989,667 MITCHELL 1 61 $13,095 0 0 $00 1 61 $13,095 MONROE 1 92 $23,652 0 0 $00 1 92 $23,652 MUSCATINE 1 61 $14,260 0 0 $00 1 61 $14,260 O BRIEN 0 0 $00 1 30 $14,483 1 30 $14,483 OSCEOLA 1 29 $4,876 0 0 $00 1 29 $4,876 PAGE 1 18 $3,823 0 0 $00 1 18 $3,823 PLYMOUTH 2 59 $13,947 0 0 $00 2 59 $13,947 POLK 8 150 $47,414 4 202 $103,239 12 352 $150,654 POTTAWATTAMIE 17 538 $167,487 0 0 $00 17 538 $167,487 SCOTT 2 26 $4,892 1 24 $14,052 3 50 $18,944 SIOUX 7 421 $108,466 0 0 $00 7 421 $108,466 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 12/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 12/28/24 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 STORY 1 0 $387 1 108 $53,218 2 108 $53,605 UNION 1 30 $8,104 0 0 $00 1 30 $8,104 WAPELLO 1 14- $00 0 0 $00 1 14- $00 WOODBURY 6 240 $47,966 1 153 $66,544 7 393 $114,511 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 3 AS OF 12/31/24 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 12/28/24 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 276 8,749 $2,892,313 19 1,101 $564,502 295 9,850 $3,456,815 *** END OF REPORT ***