IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 03/31/25 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 03/29/25 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) 184,199 187,196 388,144 133,381,937.79 724.12 712.53 FEDERAL ONLY, PRESUMP IH(881) 2 4 21 1,846.64 923.32 461.66 FEDERAL ONLY, PRESUMP(886) 0 2 9 5,259.16 0.00 2,629.58 TOTAL FEDERAL ONLY - MONEY PAYMENT 184,201 187,202 388,174 133,389,043.59 724.15 712.54 FEDERAL ONLY -NO MONEY PAYMENT REFUGEE 9 8 16 5,314.09 590.45 664.26 TOTAL FEDERAL ONLY -NO MONEY PAYMENT 9 8 16 5,314.09 590.45 664.26 TOTAL FEDERAL ONLY 184,210 187,210 388,190 133,394,357.68 724.14 712.54 FEDERAL-STATE FEDERAL-STATE - MONEY PAYMENT SSI AGED 7,942 7,288 14,932 4,789,671.89 603.08 657.20 SSI DISABLED 37,124 33,831 97,006 61,565,072.59 1,658.36 1,819.78 FOSTER CARE 885 853 2,280 504,756.47 570.35 591.74 SUBSIDIZED ADOPTION 9,317 9,308 24,901 6,143,323.69 659.37 660.00 SSA RCF IHHRC 8,148 853 3,412 6,760,305.61 829.69 7,925.33 SUBSIDIZED ADOPTION-INTERSTATE 75 75 208 81,017.06 1,080.23 1,080.23 TOTAL FEDERAL-STATE - MONEY PAYMENT 63,491 52,208 142,739 79,844,147.31 1,257.57 1,529.35 FEDERAL-STATE - NO MONEY PYMT INTERMEDIATE CARE FACILITY 9,630 16,852 35,870 80,825,626.99 8,393.11 4,796.20 NON-INTERMEDIATE CARE FACILITY 46,619 47,964 115,821 50,220,437.21 1,077.25 1,047.04 CMAP 1,104 1,032 2,390 464,839.28 421.05 450.43 SUBSIDIZED ADOPTIONS 1,531 1,528 4,451 1,239,561.10 809.64 811.23 NO MONEY - ADC - VOLUNTARY 118,626 113,864 253,835 50,210,515.51 423.27 440.97 NO MONEY - SSI-SSA - VOLUNTARY 5,041 4,756 10,669 4,216,710.31 836.48 886.61 MED NEEDY - NO SPEND - CHILDRN 124 124 294 42,395.94 341.90 341.90 MED NEEDY - WI SPEND - CHILDRN 0 1 1 0.00 0.00 0.00 IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 03/31/25 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 03/29/25 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 - NO SPEND - AGED 6 6 18 1,238.56 206.43 206.43 MED NEEDY - WITH SPEND - AGED 0 3 3 7,855.63 0.00 2,618.54 MED NEEDY - WITH SPEND - DISAB 0 3 25 3,340.38 0.00 1,113.46 MED NEEDY - WITH SPEND - CRTKR 0 7 15 17,072.05 0.00 2,438.86 MAC SOBRA - PREGNANT WOMEN 7,867 6,652 16,629 5,940,453.70 755.11 893.03 MAC SOBRA - INFANTS 22,003 20,093 46,774 17,579,520.92 798.96 874.91 MAC SOBRA - CHILDREN 99,820 96,967 214,166 26,670,695.23 267.19 275.05 QUALIFIED MEDICARE BENE - AGED 7,527 3,654 12,417 859,513.90 114.19 235.23 QUALIFIED MEDICARE BENE - DISA 4,566 2,323 8,148 553,087.70 121.13 238.09 PRESUMPTIVE ELIG - PREG WOMEN 0 3 4 595.45 0.00 198.48 MAC (SOBRA/TXXI) CHILD 19,751 18,929 41,984 5,605,575.35 283.81 296.14 BREAST CERVICAL CANCER 64 60 122 202,732.97 3,167.70 3,378.88 ICARE PMIC MHI 300% 868 807 4,465 3,110,820.38 3,583.89 3,854.80 STATE ONLY - NO MONEY PAYMENT 1 1 2 284.33 284.33 284.33 BLENDED FAMP PME PREG WOMEN 2 1 1 14.58 7.29 14.58 LEGAL PERMANENT RESIDENT TXIX 8,010 7,630 17,126 2,216,007.69 276.66 290.43 LEGAL PERMANENT RESIDENT TXXI 1,197 1,097 2,362 297,655.93 248.67 271.34 FEDERAL ST, EX MIYA (375) 909 898 1,839 338,057.85 371.90 376.46 TOTAL FEDERAL-STATE - NO MONEY PYMT 355,266 345,255 789,431 250,624,608.94 705.46 725.91 TOTAL FEDERAL-STATE 418,757 397,463 932,170 330,468,756.25 789.17 831.45 FEDERAL-COUNTY FEDERAL-COUNTY - MONEY PAYMENT FED COUNTY ICF ID SSI 247 264 1,203 2,715,808.96 10,995.18 10,287.16 TOTAL FEDERAL-COUNTY - MONEY PAYMENT 247 264 1,203 2,715,808.96 10,995.18 10,287.16 FEDERAL-COUNTY - NO MONEY PYMT INTERMED CARE FAC-INT DISABLED 11,958 13,663 52,629 108,969,410.58 9,112.68 7,975.51 TOTAL FEDERAL-COUNTY - NO MONEY PYMT 11,958 13,663 52,629 108,969,410.58 9,112.68 7,975.51 TOTAL FEDERAL-COUNTY 12,205 13,927 53,832 111,685,219.54 9,150.78 8,019.33 STATE ONLY STATE ONLY - MONEY PAYMENT IAMM4400-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 3 AS OF 03/31/25 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 03/29/25 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 2,000.18 333.36 333.36 TOTAL STATE ONLY - MONEY PAYMENT 6 6 12 2,000.18 333.36 333.36 STATE ONLY - NO MONEY PAYMENT STATE ONLY - NO MONEY PAYMENT 4,599 228 336 32,074.24 6.97 140.68 TOTAL STATE ONLY - NO MONEY PAYMENT 4,599 228 336 32,074.24 6.97 140.68 TOTAL STATE ONLY 4,605 234 348 34,074.42 7.40 145.62 FEDERAL-COUNTY-STATE FEDERAL-COUNTY-STATE MONEY FED STATE COUNTY - MHI SSI 2,049 2 3 5,527.70 2.70 2,763.85 TOTAL FEDERAL-COUNTY-STATE MONEY 2,049 2 3 5,527.70 2.70 2,763.85 FEDERAL-COUNTY-STATE NO MONEY TOTAL FEDERAL-COUNTY-STATE NO MONEY 0 0 0 0.00 0.00 0.00 TOTAL FEDERAL-COUNTY-STATE 2,049 2 3 5,527.70 2.70 2,763.85 UNDEFINED UNDEFINED SUBTOTAL UNDEFINED CATEGORY 1,331 2,031 5,562 14,701,642.31 11,045.56 7,238.62 TOTAL UNDEFINED SUBTOTAL 1,331 2,031 5,562 14,701,642.31 11,045.56 7,238.62 TOTAL UNDEFINED 1,331 2,031 5,562 14,701,642.31 11,045.56 7,238.62 TOTAL S T A T E 623,157 600,867 1,380,105 590,289,577.90 947.26 982.40 * * * E N D O F R E P O R T * * *