IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 04/30/25 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 04/26/25 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 4 93 $35,344 1 27 $14,740 5 120 $50,085 AUDUBON 1 31 $11,097 0 0 $00 1 31 $11,097 BENTON 1 31 $7,348 0 0 $00 1 31 $7,348 BLACK HAWK 3 15 $9,903 1 31 $13,818 4 46 $23,721 BOONE 0 0 $00 1 31 $45,428 1 31 $45,428 CALHOUN 1 15 $2,506 1 30 $14,961 2 45 $17,468 CERRO GORDO 1 31 $7,230 0 0 $00 1 31 $7,230 CHEROKEE 1 23 $3,791 0 0 $00 1 23 $3,791 CHICKASAW 1 31 $8,473 0 0 $00 1 31 $8,473 CLAY 1 31 $8,293 0 0 $00 1 31 $8,293 DALLAS 1 36 $9,433 3 81 $40,648 4 117 $50,082 DELAWARE 1 31 $12,760 0 0 $00 1 31 $12,760 DES MOINES 1 31 $9,068 0 0 $00 1 31 $9,068 DUBUQUE 1 31 $5,289 3 89 $46,575 4 120 $51,865 EMMET 1 31 $6,549 0 0 $00 1 31 $6,549 FRANKLIN 1 31 $15,164 0 0 $00 1 31 $15,164 GRUNDY 1 8 $2,409 1 31 $14,984 2 39 $17,393 GUTHRIE 1 30 $5,826 0 0 $00 1 30 $5,826 HARDIN 1 31 $15,164 0 0 $00 1 31 $15,164 HARRISON 1 31 $9,308 0 0 $00 1 31 $9,308 HENRY 3 92 $30,700 0 0 $00 3 92 $30,700 IOWA 3 93 $39,508 0 0 $00 3 93 $39,508 JASPER 2 72 $25,455 0 0 $00 2 72 $25,455 JOHNSON 2 62 $18,880 0 0 $00 2 62 $18,880 LEE 1 31 $10,396 0 0 $00 1 31 $10,396 LINN 1 30 $7,966 0 0 $00 1 30 $7,966 LYON 1 31 $5,940 0 0 $00 1 31 $5,940 MARSHALL 164 5,517 $2,190,431 0 0 $00 164 5,517 $2,190,431 MITCHELL 1 30 $1,941 0 0 $00 1 30 $1,941 MONONA 1 12 $1,258 0 0 $00 1 12 $1,258 MUSCATINE 1 0 $5,988 0 0 $00 1 0 $5,988 O BRIEN 0 0 $00 1 31 $15,978 1 31 $15,978 OSCEOLA 1 78 $18,388 0 0 $00 1 78 $18,388 PAGE 1 30 $9,663 0 0 $00 1 30 $9,663 POLK 6 198 $42,833 1 31 $34,505 7 229 $77,338 POTTAWATTAMIE 15 424 $143,563 0 0 $00 15 424 $143,563 RINGGOLD 2 46 $11,374 0 0 $00 2 46 $11,374 SCOTT 0 0 $00 1 27 $14,620 1 27 $14,620 STORY 1 28 $6,796 2 52 $27,203 3 80 $34,000 UNION 1 0 $306- 0 0 $00 1 0 $306- WAPELLO 1 14 $2,544 0 0 $00 1 14 $2,544 WARREN 2 184 $55,829 0 0 $00 2 184 $55,829 WAYNE 1 92 $18,774 0 0 $00 1 92 $18,774 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 04/30/25 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 04/26/25 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 WEBSTER 1 31 $7,763 0 0 $00 1 31 $7,763 WOODBURY 5 108 $28,547 1 31 $14,961 6 139 $43,508 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 3 AS OF 04/30/25 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 04/26/25 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 241 7,795 $2,869,205 17 492 $298,427 258 8,287 $3,167,633 *** END OF REPORT ***