IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1
AS OF 02/28/25 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 02/22/25
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) 183,910 194,344 382,357 183,973,287.10 1,000.34 946.64
FEDERAL ONLY, PRESUMP IH(881) 1 3 8 1,262.22 1,262.22 420.74
FEDERAL ONLY, PRESUMP(886) 2 4 7 242.60 121.30 60.65
TOTAL FEDERAL ONLY - MONEY PAYMENT 183,913 194,351 382,372 183,974,791.92 1,000.34 946.61
FEDERAL ONLY -NO MONEY PAYMENT
REFUGEE 9 62 90 28,104.98 3,122.78 453.31
TOTAL FEDERAL ONLY -NO MONEY PAYMENT 9 62 90 28,104.98 3,122.78 453.31
TOTAL FEDERAL ONLY 183,922 194,413 382,462 184,002,896.90 1,000.44 946.45
FEDERAL-STATE
FEDERAL-STATE - MONEY PAYMENT
SSI AGED 7,352 8,432 16,890 8,892,765.30 1,209.57 1,054.64
SSI DISABLED 34,942 38,816 97,780 94,021,917.27 2,690.80 2,422.25
FOSTER CARE 867 974 2,004 646,377.79 745.53 663.63
SUBSIDIZED ADOPTION 9,334 9,516 23,569 6,814,388.80 730.06 716.10
SSA RCF IHHRC 135 7,689 15,884 37,805,936.44 280,043.97 4,916.89
SUBSIDIZED ADOPTION-INTERSTATE 72 78 201 136,368.69 1,894.01 1,748.32
TOTAL FEDERAL-STATE - MONEY PAYMENT 52,702 65,505 156,328 148,317,754.29 2,814.27 2,264.22
FEDERAL-STATE - NO MONEY PYMT
INTERMEDIATE CARE FACILITY 18,181 10,496 21,984 51,517,691.58 2,833.60 4,908.32
NON-INTERMEDIATE CARE FACILITY 48,970 52,591 113,127 55,956,186.79 1,142.66 1,063.99
CMAP 1,051 1,200 2,562 631,126.78 600.50 525.94
SUBSIDIZED ADOPTIONS 1,530 1,553 3,944 1,383,158.88 904.03 890.64
NO MONEY - ADC - VOLUNTARY 119,522 123,066 253,283 68,780,595.89 575.46 558.89
NO MONEY - SSI-SSA - VOLUNTARY 4,712 4,504 8,638 3,036,347.30 644.39 674.14
MED NEEDY - NO SPEND - CHILDRN 121 117 278 42,804.08 353.75 365.85
MED NEEDY - NO SPEND - AGED 6 6 13 928.16 154.69 154.69
IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2
AS OF 02/28/25 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 02/22/25
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 - WITH SPEND - AGED 0 2 1 12,312.02 0.00 6,156.01
MED NEEDY - WITH SPEND - DISAB 0 3 65 1,694.61 0.00 564.87
MED NEEDY - WITH SPEND - CRTKR 0 5 15 14,377.63 0.00 2,875.53
MAC SOBRA - PREGNANT WOMEN 8,042 8,452 16,283 7,152,623.59 889.41 846.26
MAC SOBRA - INFANTS 23,240 26,069 53,704 31,217,746.08 1,343.28 1,197.50
MAC SOBRA - CHILDREN 99,801 100,330 205,296 34,486,253.82 345.55 343.73
QUALIFIED MEDICARE BENE - AGED 7,508 2,929 8,520 581,390.25 77.44 198.49
QUALIFIED MEDICARE BENE - DISA 4,588 1,872 5,544 401,503.70 87.51 214.48
PRESUMPTIVE ELIG - PREG WOMEN 0 1 1 2.43 0.00 2.43
MAC (SOBRA/TXXI) CHILD 20,014 18,045 36,302 6,527,025.96 326.12 361.71
BREAST CERVICAL CANCER 63 76 130 231,922.80 3,681.31 3,051.62
ICARE PMIC MHI 300% 856 774 3,192 2,962,457.46 3,460.81 3,827.46
STATE ONLY - NO MONEY PAYMENT 1 1 2 286.86 286.86 286.86
BLENDED FAMP PME PREG WOMEN 1 0 0 0.00 0.00 0.00
LEGAL PERMANENT RESIDENT TXIX 7,931 8,309 16,902 3,175,474.47 400.39 382.17
LEGAL PERMANENT RESIDENT TXXI 1,188 1,078 2,128 356,145.05 299.79 330.38
FEDERAL ST, EX MIYA (375) 920 905 1,763 362,454.46 393.97 400.50
TOTAL FEDERAL-STATE - NO MONEY PYMT 368,246 362,384 753,677 268,832,510.65 730.04 741.84
TOTAL FEDERAL-STATE 420,948 427,889 910,005 417,150,264.94 990.98 974.90
FEDERAL-COUNTY
FEDERAL-COUNTY - MONEY PAYMENT
FED COUNTY ICF ID SSI 252 279 1,020 2,618,914.49 10,392.52 9,386.79
TOTAL FEDERAL-COUNTY - MONEY PAYMENT 252 279 1,020 2,618,914.49 10,392.52 9,386.79
FEDERAL-COUNTY - NO MONEY PYMT
INTERMED CARE FAC-INT DISABLED 13,930 13,698 46,741 112,379,882.34 8,067.47 8,204.11
TOTAL FEDERAL-COUNTY - NO MONEY PYMT 13,930 13,698 46,741 112,379,882.34 8,067.47 8,204.11
TOTAL FEDERAL-COUNTY 14,182 13,977 47,761 114,998,796.83 8,108.79 8,227.72
STATE ONLY
STATE ONLY - MONEY PAYMENT
IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 3
AS OF 02/28/25 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 02/22/25
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 6 6 12 2,158.87 359.81 359.81
TOTAL STATE ONLY - MONEY PAYMENT 6 6 12 2,158.87 359.81 359.81
STATE ONLY - NO MONEY PAYMENT
STATE ONLY - NO MONEY PAYMENT 4,521 210 327 31,803.06 7.03 151.44
TOTAL STATE ONLY - NO MONEY PAYMENT 4,521 210 327 31,803.06 7.03 151.44
TOTAL STATE ONLY 4,527 216 339 33,961.93 7.50 157.23
FEDERAL-COUNTY-STATE
FEDERAL-COUNTY-STATE MONEY
FED STATE COUNTY - MHI SSI 0 2 0 0.00 0.00 0.00
TOTAL FEDERAL-COUNTY-STATE MONEY 0 2 0 0.00 0.00 0.00
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 2 0 0.00 0.00 0.00
UNDEFINED
UNDEFINED SUBTOTAL
UNDEFINED CATEGORY 1,510 1,785 4,863 9,168,273.00 6,071.70 5,136.29
TOTAL UNDEFINED SUBTOTAL 1,510 1,785 4,863 9,168,273.00 6,071.70 5,136.29
TOTAL UNDEFINED 1,510 1,785 4,863 9,168,273.00 6,071.70 5,136.29
TOTAL S T A T E 625,089 638,282 1,345,430 725,354,193.60 1,160.40 1,136.42
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