IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 1 AS OF 05/31/25 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 05/24/25 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 90 $40,076 1 0 $911 5 90 $40,988 APPANOOSE 1 25 $6,543 0 0 $00 1 25 $6,543 AUDUBON 2 35 $13,093 0 0 $00 2 35 $13,093 BLACK HAWK 3 94 $29,321 1 30 $13,368 4 124 $42,689 BOONE 0 0 $00 1 30 $63,149 1 30 $63,149 BUENA VISTA 1 25 $7,726 1 30 $13,959 2 55 $21,685 CALHOUN 0 0 $00 1 30 $14,501 1 30 $14,501 CERRO GORDO 1 16 $3,115 0 0 $00 1 16 $3,115 CHICKASAW 3 166 $45,582 0 0 $00 3 166 $45,582 DALLAS 0 0 $00 3 80 $39,559 3 80 $39,559 DECATUR 1 0 $20- 0 0 $00 1 0 $20- DELAWARE 1 30 $14,339 0 0 $00 1 30 $14,339 DES MOINES 1 27 $6,935 0 0 $00 1 27 $6,935 DUBUQUE 1 90 $26,178 3 85 $43,299 4 175 $69,477 EMMET 1 30 $6,304 0 0 $00 1 30 $6,304 FLOYD 1 61 $15,213 0 0 $00 1 61 $15,213 FRANKLIN 5 91 $18,748 0 0 $00 5 91 $18,748 GRUNDY 0 0 $00 1 30 $14,501 1 30 $14,501 HARDIN 2 1 $1,337 0 0 $00 2 1 $1,337 HARRISON 2 58 $14,818 0 0 $00 2 58 $14,818 HENRY 1 30 $15,167 0 0 $00 1 30 $15,167 IOWA 3 90 $44,408 0 0 $00 3 90 $44,408 JASPER 1 26 $15,450 0 0 $00 1 26 $15,450 JEFFERSON 2 61 $11,106 0 0 $00 2 61 $11,106 JOHNSON 2 0 $5,487- 1 29 $14,347 3 29 $8,860 JONES 1 28 $6,782 0 0 $00 1 28 $6,782 KEOKUK 1 28 $6,806 0 0 $00 1 28 $6,806 LEE 1 30 $11,974 0 0 $00 1 30 $11,974 LINN 3 99 $13,967 0 0 $00 3 99 $13,967 LYON 1 30 $5,723 0 0 $00 1 30 $5,723 MARION 2 122 $29,442 0 0 $00 2 122 $29,442 MARSHALL 167 5,069 $2,302,480 0 0 $00 167 5,069 $2,302,480 PAGE 1 61 $16,468 0 0 $00 1 61 $16,468 POLK 9 409 $102,735 1 30 $23,703 10 439 $126,438 POTTAWATTAMIE 15 466 $167,810 0 0 $00 15 466 $167,810 SCOTT 2 110 $25,255 1 28 $14,319 3 138 $39,575 SIOUX 2 123 $31,905 0 0 $00 2 123 $31,905 STORY 0 0 $00 2 54 $28,050 2 54 $28,050 WAPELLO 1 28 $7,021 0 0 $00 1 28 $7,021 WARREN 1 0 $2,866- 0 0 $00 1 0 $2,866- WASHINGTON 2 100 $19,420 0 0 $00 2 100 $19,420 WEBSTER 0 0 $00 1 23 $11,992 1 23 $11,992 WOODBURY 4 118 $31,149 3 90 $38,890 7 208 $70,039 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 2 AS OF 05/31/25 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 05/24/25 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 IAMM3800-R001 IOWA DEPARTMENT OF HUMAN SERVICES PAGE 3 AS OF 05/31/25 MEDICAID MANAGEMENT INFORMATION SYSTEM RUN DATE 05/24/25 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 252 7,867 $3,106,036 21 569 $334,556 273 8,436 $3,440,592 *** END OF REPORT ***