IAMM4400-R002ADCADULT_Report_Id,IAMM4400-R002ADCADULT_Report_as_of_Date,IAMM4400-R002ADCADULT_ProgramID,IAMM4400-R002ADCADULT_SVCCAT,ADCadult_Recips,ADCadult_Units,ADCadult_Amt,IAMM4400-R002ADCCHILD_Report_Id,IAMM4400-R002ADCCHILD_Report_as_of_Date,IAMM4400-R002ADCCHILD_ProgramID,IAMM4400-R002ADCCHILD_SVCCAT,ADCchild_Recips,ADCchild_Units,ADCchild_Amt,IAMM4400-R002AGED_Report_Id,IAMM4400-R002AGED_Report_as_of_Date,IAMM4400-R002AGED_ProgramID,IAMM4400-R002AGED_SVCCAT,Aged_Recps,Aged_units,Aged_Amt,IAMM4400-R002BLIND_Report_Id,IAMM4400-R002BLIND_Report_as_of_Date,IAMM4400-R002BLIND_ProgramID,IAMM4400-R002BLIND_SVCCAT,IAMM4400-R002BLIND_Blind_recips,IAMM4400-R002BLIND_Blind_units,IAMM4400-R002BLIND_Blind_amt,IAMM4400-R002CMAP_Report_Id,IAMM4400-R002CMAP_Report_as_of_Date,IAMM4400-R002CMAP_ProgramID,IAMM4400-R002CMAP_SVCCAT,Cmap_Recips,Cmap_Units,Cmap_Amt,IAMM4400-R002DISABLED_Report_Id,IAMM4400-R002DISABLED_Report_as_of_Date,IAMM4400-R002DISABLED_ProgramID,IAMM4400-R002DISABLED_SVCCAT,Disab_Recips,Disab_Units,Disab_Amt,IAMM4400-R002DSH_Report_Id,IAMM4400-R002DSH_Report_as_of_Date,IAMM4400-R002DSH_ProgramID,IAMM4400-R002DSH_SVCCAT,dsh_recips,dsh_units,dsh_amt,IAMM4400-R002FCPRESUBSUB_Report_Id,IAMM4400-R002FCPRESUBSUB_Report_as_of_Date,IAMM4400-R002FCPRESUBSUB_ProgramID,IAMM4400-R002FCPRESUBSUB_SVCCAT,FCpresubsub_recips,fcpresubsub_Units,fcpresubsub_amt,IAMM4400-R002FEDCNTY_Report_Id,IAMM4400-R002FEDCNTY_Report_as_of_Date,IAMM4400-R002FEDCNTY_ProgramID,IAMM4400-R002FEDCNTY_SVCCAT,Fedcnty_recips,Fedcnty_units,Fedcnty_amt,IAMM4400-R002FEDONLY_Report_Id,IAMM4400-R002FEDONLY_Report_as_of_Date,IAMM4400-R002FEDONLY_ProgramID,IAMM4400-R002FEDONLY_SVCCAT,Fed_Recips,Fed_Units,Fed_amt,IAMM4400-R002ICAREMHI_Report_Id,IAMM4400-R002ICAREMHI_Report_as_of_Date,IAMM4400-R002ICAREMHI_ProgramID,IAMM4400-R002ICAREMHI_SVCCAT,IcareMHI_recips,Icare_units,Icare_amt,IAMM4400-R002ICAREPMIC_Report_Id,IAMM4400-R002ICAREPMIC_Report_as_of_Date,IAMM4400-R002ICAREPMIC_ProgramID,IAMM4400-R002ICAREPMIC_SVCCAT,IcarePMIC_recips,IcarePMIC_units,IcarePMIC_amt,IAMM4400-R002ICARESTATEONLY_Report_Id,IAMM4400-R002ICARESTATEONLY_Report_as_of_Date,IAMM4400-R002ICARESTATEONLY_ProgramID,IAMM4400-R002ICARESTATEONLY_SVCCAT,IcareSO_recips,IcareSO_units,IcareSO_amt,IAMM4400-R002ICF_Report_Id,IAMM4400-R002ICF_Report_as_of_Date,IAMM4400-R002ICF_ProgramID,IAMM4400-R002ICF_SVCCAT,IFC_Recips,ICF_units,ICF_amt,IAMM4400-R002MEDICAIDAGED_Report_Id,IAMM4400-R002MEDICAIDAGED_Report_as_of_Date,IAMM4400-R002MEDICAIDAGED_ProgramID,IAMM4400-R002MEDICAIDAGED_SVCCAT,FMaged_recips,FMaged_units,FMaged_amt,IAMM4400-R002MEDICAIDBLIND_Report_Id,IAMM4400-R002MEDICAIDBLIND_Report_as_of_Date,IAMM4400-R002MEDICAIDBLIND_ProgramID,IAMM4400-R002MEDICAIDBLIND_SVCCAT,IAMM4400-R002MEDICAIDBLIND_Blind_recips,IAMM4400-R002MEDICAIDBLIND_Blind_units,IAMM4400-R002MEDICAIDBLIND_Blind_amt,IAMM4400-R002MNNOSPND_Report_Id,IAMM4400-R002MNNOSPND_Report_as_of_Date,IAMM4400-R002MNNOSPND_ProgramID,IAMM4400-R002MNNOSPND_SVCCAT,nospnd_recips,nospnd_units,nospnd_amt,IAMM4400-R002MNWITHSPND_Report_Id,IAMM4400-R002MNWITHSPND_Report_as_of_Date,IAMM4400-R002MNWITHSPND_ProgramID,IAMM4400-R002MNWITHSPND_SVCCAT,Spend_recips,spend_units,spend_amt,IAMM4400-R002OTHER_Report_Id,IAMM4400-R002OTHER_Report_as_of_Date,IAMM4400-R002OTHER_ProgramID,IAMM4400-R002OTHER_SVCCAT,Other_Recips,Other_Units,Other_Amt,IAMM4400-R002OTHERBCC_Report_Id,IAMM4400-R002OTHERBCC_Report_as_of_Date,IAMM4400-R002OTHERBCC_ProgramID,IAMM4400-R002OTHERBCC_SVCCAT,BCC_Recips,BCC_Units,BCC_Amt,IAMM4400-R002OTHERICAREADLT_Report_Id,IAMM4400-R002OTHERICAREADLT_Report_as_of_Date,IAMM4400-R002OTHERICAREADLT_ProgramID,IAMM4400-R002OTHERICAREADLT_SVCCAT,Icareadlt_recips,Icareadlt_units,Icareadlt_amt,IAMM4400-R002OTHERICAREOB_Report_Id,IAMM4400-R002OTHERICAREOB_Report_as_of_Date,IAMM4400-R002OTHERICAREOB_ProgramID,IAMM4400-R002OTHERICAREOB_SVCCAT,Icareob_recips,Icareob_units,Icareob_amt,IAMM4400-R002OTHERTXIX_Report_Id,IAMM4400-R002OTHERTXIX_Report_as_of_Date,IAMM4400-R002OTHERTXIX_ProgramID,IAMM4400-R002OTHERTXIX_SVCCAT,Oxix_recips,Oxix_Units,Oxix_Amt,IAMM4400-R002REFUGEETXIX_Report_Id,IAMM4400-R002REFUGEETXIX_Report_as_of_Date,IAMM4400-R002REFUGEETXIX_ProgramID,IAMM4400-R002REFUGEETXIX_SVCCAT,Refugee_Recips,Refugee_Units,Refugee_amt,IAMM4400-R002STATEONLY_Report_Id,IAMM4400-R002STATEONLY_Report_as_of_Date,IAMM4400-R002STATEONLY_ProgramID,IAMM4400-R002STATEONLY_SVCCAT,SO_recips,SO_units,SO_amt,IAMM4400-R002TOTAL_Report_Id,IAMM4400-R002TOTAL_Report_as_of_Date,IAMM4400-R002TOTAL_ProgramID,IAMM4400-R002TOTAL_SVCCAT,TOTAL_recips,TOTAL_units,TOTAL_amt
IAMM4400-R002,11/30/08,ADC - ADULT,INPATIENT,626,1805,"$2,458,381.91 ",IAMM4400-R002,11/30/08,ADC - CHILD,INPATIENT,289,2020,"$2,039,452.14 ",IAMM4400-R002,11/30/08,AGED,INPATIENT,485,2169,"$632,283.11 ",IAMM4400-R002,11/30/08,BLIND,INPATIENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,INPATIENT,332,7535,"$2,201,447.67 ",IAMM4400-R002,11/30/08,DISABLED,INPATIENT,1694,10389,"$7,573,805.00 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,INPATIENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,INPATIENT,60,573,"$231,031.38 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,INPATIENT,157,915,"$359,961.80 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,INPATIENT,1,2,"$2,278.21 ",IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,INPATIENT,4,37,"$1,024.00 ",IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,INPATIENT,7,202,"$32,975.43 ",IAMM4400-R002,11/30/08,STATE ONLY,INPATIENT,7,15,"$17,257.55 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,INPATIENT,664,3005,"$748,220.04 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,INPATIENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,INPATIENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,INPATIENT,50,285,"$182,599.16 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,INPATIENT,167,686,"$995,006.20 ",IAMM4400-R002,11/30/08,OTHER,INPATIENT,1609,8655,"$10,742,323.08 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,INPATIENT,11,93,"$114,121.76 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,INPATIENT,1,0,"$2,877.06 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,INPATIENT,1,2,"$2,454.30 ",IAMM4400-R002,11/30/08,OTHER TXXI,INPATIENT,44,351,"$226,359.09 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,INPATIENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,INPATIENT,18,221,"$126,424.89 ",IAMM4400-R002,11/30/08,TOTAL,INPATIENT,6197,38960,"$28,690,283.78 "
IAMM4400-R002,11/30/08,ADC - ADULT,OUTPATIENT,8153,134505,"$3,426,715.28 ",IAMM4400-R002,11/30/08,ADC - CHILD,OUTPATIENT,6769,59903,"$1,617,971.56 ",IAMM4400-R002,11/30/08,AGED,OUTPATIENT,4061,93976,"$501,146.83 ",IAMM4400-R002,11/30/08,BLIND,OUTPATIENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,OUTPATIENT,1825,21362,"$516,798.66 ",IAMM4400-R002,11/30/08,DISABLED,OUTPATIENT,15160,365706,"$4,789,407.34 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,OUTPATIENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,OUTPATIENT,823,12164,"$254,663.28 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,OUTPATIENT,2502,55840,"$415,591.73 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,OUTPATIENT,30,233,"$8,390.17 ",IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,OUTPATIENT,11,1530,"$1,385.25 ",IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,OUTPATIENT,33,407,"$7,929.10 ",IAMM4400-R002,11/30/08,STATE ONLY,OUTPATIENT,81,972,"$27,036.33 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,OUTPATIENT,5077,127877,"$715,992.66 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,OUTPATIENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,OUTPATIENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,OUTPATIENT,439,10702,"$162,440.73 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,OUTPATIENT,411,11588,"$316,801.12 ",IAMM4400-R002,11/30/08,OTHER,OUTPATIENT,10564,128558,"$2,682,213.59 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,OUTPATIENT,97,1557,"$63,993.98 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,OUTPATIENT,5,0,"$2,600.54 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,OUTPATIENT,2,4,$170.15 ,IAMM4400-R002,11/30/08,OTHER TXXI,OUTPATIENT,1005,10715,"$258,607.06 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,OUTPATIENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,OUTPATIENT,292,5649,"$137,794.72 ",IAMM4400-R002,11/30/08,TOTAL,OUTPATIENT,56884,1043248,"$15,907,650.08 "
IAMM4400-R002,11/30/08,ADC - ADULT,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,CHILD PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,CHILD PART HOSP,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,CHILD DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,CHILD DAY TREATMENT,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,ADULT PART HOSP,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,ADULT PART HOSP,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,ADULT DAY TREATMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,ADULT DAY TREATMENT,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,SKILLED NURSING FACILITY,142,2178,"$52,007.54 ",IAMM4400-R002,11/30/08,BLIND,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,SKILLED NURSING FACILITY,1,10,"$3,368.31 ",IAMM4400-R002,11/30/08,DISABLED,SKILLED NURSING FACILITY,183,4081,"$1,686,518.74 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,SKILLED NURSING FACILITY,1,17,"$2,772.22 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,SKILLED NURSING FACILITY,5,61,"$6,469.65 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,SKILLED NURSING FACILITY,294,4828,"$19,241.61 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,SKILLED NURSING FACILITY,3,21,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,SKILLED NURSING FACILITY,1,40,"$37,072.00 ",IAMM4400-R002,11/30/08,OTHER,SKILLED NURSING FACILITY,2,15,"$20,903.81 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,SKILLED NURSING FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,SKILLED NURSING FACILITY,1,8,"$3,920.88 ",IAMM4400-R002,11/30/08,TOTAL,SKILLED NURSING FACILITY,631,11259,"$1,832,274.76 "
IAMM4400-R002,11/30/08,ADC - ADULT,INTERMEDIATE CARE FACILITY,2,21,"$3,027.52 ",IAMM4400-R002,11/30/08,ADC - CHILD,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,INTERMEDIATE CARE FACILITY,4595,140215,"$12,516,960.44 ",IAMM4400-R002,11/30/08,BLIND,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,INTERMEDIATE CARE FACILITY,1,14,"$1,699.69 ",IAMM4400-R002,11/30/08,DISABLED,INTERMEDIATE CARE FACILITY,591,18066,"$1,965,314.91 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,INTERMEDIATE CARE FACILITY,6,138,"$14,017.90 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,INTERMEDIATE CARE FACILITY,1,47,"$5,307.41 ",IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,INTERMEDIATE CARE FACILITY,7220,218167,"$22,933,722.39 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,INTERMEDIATE CARE FACILITY,3,16,"$2,607.32 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,INTERMEDIATE CARE FACILITY,4,66,"$6,599.44 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,INTERMEDIATE CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,INTERMEDIATE CARE FACILITY,12382,376750,"$37,449,257.02 "
IAMM4400-R002,11/30/08,ADC - ADULT,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,INTER CARE MENTAL RETARDA,2,119,"$40,961.97 ",IAMM4400-R002,11/30/08,DISABLED,INTER CARE MENTAL RETARDA,11,242,"$74,089.17 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,INTER CARE MENTAL RETARDA,8,326,"$116,693.30 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,INTER CARE MENTAL RETARDA,2101,70515,"$29,104,657.77 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,INTER CARE MENTAL RETARDA,1,31,"$9,163.91 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,INTER CARE MENTAL RETARDA,1,0,"($1,359,887.00)",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,INTER CARE MENTAL RETARDA,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,INTER CARE MENTAL RETARDA,2120,71233,"$27,985,679.12 "
IAMM4400-R002,11/30/08,ADC - ADULT,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,NURSING FAC FOR MENTAL ILL,3,93,"$16,420.69 ",IAMM4400-R002,11/30/08,BLIND,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,NURSING FAC FOR MENTAL ILL,12,342,"$73,741.15 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,NURSING FAC FOR MENTAL ILL,1,31,"$6,730.72 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,NURSING FAC FOR MENTAL ILL,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,NURSING FAC FOR MENTAL ILL,16,466,"$96,892.56 "
IAMM4400-R002,11/30/08,ADC - ADULT,HOME HEALTH,64,335,"$25,331.33 ",IAMM4400-R002,11/30/08,ADC - CHILD,HOME HEALTH,340,2527,"$58,374.42 ",IAMM4400-R002,11/30/08,AGED,HOME HEALTH,2433,54093,"$1,669,257.98 ",IAMM4400-R002,11/30/08,BLIND,HOME HEALTH,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,HOME HEALTH,56,152,"$7,806.09 ",IAMM4400-R002,11/30/08,DISABLED,HOME HEALTH,3492,108108,"$2,411,295.62 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,HOME HEALTH,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,HOME HEALTH,126,3326,"$76,410.64 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,HOME HEALTH,1070,47924,"$1,186,065.32 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,HOME HEALTH,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,HOME HEALTH,3,20,$84.96 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,HOME HEALTH,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,HOME HEALTH,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,HOME HEALTH,3515,81055,"$2,754,838.21 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,HOME HEALTH,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,HOME HEALTH,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,HOME HEALTH,58,1536,"$16,639.31 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,HOME HEALTH,26,425,"$42,124.67 ",IAMM4400-R002,11/30/08,OTHER,HOME HEALTH,581,3582,"$534,646.46 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,HOME HEALTH,3,11,"$1,119.36 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,HOME HEALTH,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,HOME HEALTH,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,HOME HEALTH,56,137,"$4,216.57 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,HOME HEALTH,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,HOME HEALTH,24,325,"$15,733.27 ",IAMM4400-R002,11/30/08,TOTAL,HOME HEALTH,11769,303556,"$8,803,944.21 "
IAMM4400-R002,11/30/08,ADC - ADULT,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,LEAD INSPECTION AGENCY,4,4,"$1,516.94 ",IAMM4400-R002,11/30/08,AGED,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,LEAD INSPECTION AGENCY,5,5,"$1,890.52 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,LEAD INSPECTION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,LEAD INSPECTION AGENCY,9,9,"$3,407.46 "
IAMM4400-R002,11/30/08,ADC - ADULT,PHYSICIAN,15826,31863,"$2,965,826.46 ",IAMM4400-R002,11/30/08,ADC - CHILD,PHYSICIAN,19663,33836,"$2,227,583.52 ",IAMM4400-R002,11/30/08,AGED,PHYSICIAN,6315,33679,"$339,908.74 ",IAMM4400-R002,11/30/08,BLIND,PHYSICIAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,PHYSICIAN,4188,7875,"$625,459.07 ",IAMM4400-R002,11/30/08,DISABLED,PHYSICIAN,24696,114194,"$4,162,178.89 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,PHYSICIAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,PHYSICIAN,2351,3652,"$225,231.93 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,PHYSICIAN,4628,13404,"$351,856.16 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,PHYSICIAN,48,121,"$10,179.94 ",IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,PHYSICIAN,33,152,"$1,632.12 ",IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,PHYSICIAN,94,153,"$6,006.64 ",IAMM4400-R002,11/30/08,STATE ONLY,PHYSICIAN,129,254,"$23,329.80 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,PHYSICIAN,7041,38315,"$471,283.71 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,PHYSICIAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,PHYSICIAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,PHYSICIAN,845,2333,"$156,547.79 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,PHYSICIAN,707,2769,"$229,763.43 ",IAMM4400-R002,11/30/08,OTHER,PHYSICIAN,28704,52542,"$4,337,984.08 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,PHYSICIAN,173,591,"$174,707.07 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,PHYSICIAN,9,0,"$8,594.95 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,PHYSICIAN,5,3,$280.32 ,IAMM4400-R002,11/30/08,OTHER TXXI,PHYSICIAN,3207,5100,"$341,791.66 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,PHYSICIAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,PHYSICIAN,555,1300,"$117,454.44 ",IAMM4400-R002,11/30/08,TOTAL,PHYSICIAN,117215,342136,"$16,777,600.72 "
IAMM4400-R002,11/30/08,ADC - ADULT,CLINIC SERVICES,2794,4206,"$574,043.91 ",IAMM4400-R002,11/30/08,ADC - CHILD,CLINIC SERVICES,3424,4387,"$563,084.48 ",IAMM4400-R002,11/30/08,AGED,CLINIC SERVICES,515,389,"$26,869.50 ",IAMM4400-R002,11/30/08,BLIND,CLINIC SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,CLINIC SERVICES,951,1456,"$187,165.87 ",IAMM4400-R002,11/30/08,DISABLED,CLINIC SERVICES,3158,4478,"$564,388.36 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,CLINIC SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,CLINIC SERVICES,492,672,"$77,054.55 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,CLINIC SERVICES,386,493,"$46,034.04 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,CLINIC SERVICES,10,11,"$1,611.56 ",IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,CLINIC SERVICES,3,2,$142.99 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,CLINIC SERVICES,12,22,"$2,800.10 ",IAMM4400-R002,11/30/08,STATE ONLY,CLINIC SERVICES,25,33,"$4,104.54 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,CLINIC SERVICES,482,533,"$33,900.00 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,CLINIC SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,CLINIC SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,CLINIC SERVICES,142,185,"$25,066.76 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,CLINIC SERVICES,56,94,"$12,188.97 ",IAMM4400-R002,11/30/08,OTHER,CLINIC SERVICES,6170,9437,"$1,604,924.93 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,CLINIC SERVICES,14,18,"$2,348.67 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,CLINIC SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,CLINIC SERVICES,2,3,$334.71 ,IAMM4400-R002,11/30/08,OTHER TXXI,CLINIC SERVICES,611,784,"$95,742.13 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,CLINIC SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,CLINIC SERVICES,118,163,"$23,255.15 ",IAMM4400-R002,11/30/08,TOTAL,CLINIC SERVICES,19201,27366,"$3,845,061.22 "
IAMM4400-R002,11/30/08,ADC - ADULT,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,MEP CASE MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,MEP CASE MANAGEMENT,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,LAB AND RADIOLOGICAL,2499,6663,"$151,282.57 ",IAMM4400-R002,11/30/08,ADC - CHILD,LAB AND RADIOLOGICAL,1201,2612,"$38,043.97 ",IAMM4400-R002,11/30/08,AGED,LAB AND RADIOLOGICAL,837,229,"$2,654.07 ",IAMM4400-R002,11/30/08,BLIND,LAB AND RADIOLOGICAL,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,LAB AND RADIOLOGICAL,336,1109,"$19,985.29 ",IAMM4400-R002,11/30/08,DISABLED,LAB AND RADIOLOGICAL,3003,5393,"$85,240.21 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,LAB AND RADIOLOGICAL,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,LAB AND RADIOLOGICAL,211,614,"$11,073.25 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,LAB AND RADIOLOGICAL,447,486,"$5,456.30 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,LAB AND RADIOLOGICAL,7,26,$361.44 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,LAB AND RADIOLOGICAL,1,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,LAB AND RADIOLOGICAL,6,15,$267.78 ,IAMM4400-R002,11/30/08,STATE ONLY,LAB AND RADIOLOGICAL,21,68,"$1,728.16 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,LAB AND RADIOLOGICAL,992,506,"$6,706.98 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,LAB AND RADIOLOGICAL,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,LAB AND RADIOLOGICAL,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,LAB AND RADIOLOGICAL,149,326,"$5,841.30 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,LAB AND RADIOLOGICAL,35,90,"$2,106.20 ",IAMM4400-R002,11/30/08,OTHER,LAB AND RADIOLOGICAL,2285,6376,"$119,308.93 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,LAB AND RADIOLOGICAL,19,69,"$1,097.87 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,LAB AND RADIOLOGICAL,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,LAB AND RADIOLOGICAL,3,19,$446.52 ,IAMM4400-R002,11/30/08,OTHER TXXI,LAB AND RADIOLOGICAL,157,467,"$7,578.10 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,LAB AND RADIOLOGICAL,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,LAB AND RADIOLOGICAL,73,218,"$3,826.49 ",IAMM4400-R002,11/30/08,TOTAL,LAB AND RADIOLOGICAL,12223,25286,"$463,005.43 "
IAMM4400-R002,11/30/08,ADC - ADULT,HABILITATION SERVICES,21,303,"$11,320.45 ",IAMM4400-R002,11/30/08,ADC - CHILD,HABILITATION SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,HABILITATION SERVICES,49,1281,"$69,495.60 ",IAMM4400-R002,11/30/08,BLIND,HABILITATION SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,HABILITATION SERVICES,15,241,"$14,822.87 ",IAMM4400-R002,11/30/08,DISABLED,HABILITATION SERVICES,2395,67332,"$3,424,369.83 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,HABILITATION SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,HABILITATION SERVICES,13,477,"$23,412.90 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,HABILITATION SERVICES,16,391,"$16,862.59 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,HABILITATION SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,HABILITATION SERVICES,1,2,$182.94 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,HABILITATION SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,HABILITATION SERVICES,13,778,"$31,989.74 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,HABILITATION SERVICES,27,472,"$25,300.75 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,HABILITATION SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,HABILITATION SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,HABILITATION SERVICES,29,941,"$72,903.74 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,HABILITATION SERVICES,4,29,"$1,669.96 ",IAMM4400-R002,11/30/08,OTHER,HABILITATION SERVICES,2,12,"$1,125.78 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,HABILITATION SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,HABILITATION SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,HABILITATION SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,HABILITATION SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,HABILITATION SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,HABILITATION SERVICES,5,168,"$3,582.74 ",IAMM4400-R002,11/30/08,TOTAL,HABILITATION SERVICES,2582,72427,"$3,697,039.89 "
IAMM4400-R002,11/30/08,ADC - ADULT,REMEDIAL SERVICES,152,3714,"$61,573.06 ",IAMM4400-R002,11/30/08,ADC - CHILD,REMEDIAL SERVICES,1714,44612,"$737,245.30 ",IAMM4400-R002,11/30/08,AGED,REMEDIAL SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,REMEDIAL SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,REMEDIAL SERVICES,544,16056,"$254,333.07 ",IAMM4400-R002,11/30/08,DISABLED,REMEDIAL SERVICES,527,16982,"$272,494.93 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,REMEDIAL SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,REMEDIAL SERVICES,1912,126652,"$1,287,490.84 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,REMEDIAL SERVICES,102,2669,"$46,925.42 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,REMEDIAL SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,REMEDIAL SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,REMEDIAL SERVICES,107,4305,"$67,810.44 ",IAMM4400-R002,11/30/08,STATE ONLY,REMEDIAL SERVICES,12,249,"$4,534.26 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,REMEDIAL SERVICES,3,75,"$1,525.18 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,REMEDIAL SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,REMEDIAL SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,REMEDIAL SERVICES,7,133,"$2,000.94 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,REMEDIAL SERVICES,1,48,$437.28 ,IAMM4400-R002,11/30/08,OTHER,REMEDIAL SERVICES,1424,37788,"$631,450.92 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,REMEDIAL SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,REMEDIAL SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,REMEDIAL SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,REMEDIAL SERVICES,240,5914,"$100,076.59 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,REMEDIAL SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,REMEDIAL SERVICES,40,919,"$2,500.41 ",IAMM4400-R002,11/30/08,TOTAL,REMEDIAL SERVICES,6449,260116,"$3,470,398.64 "
IAMM4400-R002,11/30/08,ADC - ADULT,REHAB SUPPORT SERVICES,6,0,$834.97 ,IAMM4400-R002,11/30/08,ADC - CHILD,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,REHAB SUPPORT SERVICES,8,15,"$11,730.08 ",IAMM4400-R002,11/30/08,BLIND,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,REHAB SUPPORT SERVICES,3,0,"($1,481.38)",IAMM4400-R002,11/30/08,DISABLED,REHAB SUPPORT SERVICES,462,334,"$73,045.95 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,REHAB SUPPORT SERVICES,1,0,($75.44),IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,REHAB SUPPORT SERVICES,5,0,($192.30),IAMM4400-R002,11/30/08,FEDERAL ONLY,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,REHAB SUPPORT SERVICES,10,0,"$2,361.11 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,REHAB SUPPORT SERVICES,4,-15,"($2,968.98)",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,REHAB SUPPORT SERVICES,4,0,"$3,233.44 ",IAMM4400-R002,11/30/08,OTHER,REHAB SUPPORT SERVICES,2,0,"($83,872.88)",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,REHAB SUPPORT SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,REHAB SUPPORT SERVICES,1,0,$124.20 ,IAMM4400-R002,11/30/08,TOTAL,REHAB SUPPORT SERVICES,493,334,"$2,738.77 "
IAMM4400-R002,11/30/08,ADC - ADULT,AMBULANCE SERVICES,178,184,"$28,330.46 ",IAMM4400-R002,11/30/08,ADC - CHILD,AMBULANCE SERVICES,102,99,"$13,023.34 ",IAMM4400-R002,11/30/08,AGED,AMBULANCE SERVICES,266,337,"$28,405.54 ",IAMM4400-R002,11/30/08,BLIND,AMBULANCE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,AMBULANCE SERVICES,53,55,"$8,294.57 ",IAMM4400-R002,11/30/08,DISABLED,AMBULANCE SERVICES,784,931,"$109,847.02 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,AMBULANCE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,AMBULANCE SERVICES,17,17,"$1,807.12 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,AMBULANCE SERVICES,104,116,"$11,766.56 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,AMBULANCE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,AMBULANCE SERVICES,2,2,$300.01 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,AMBULANCE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,AMBULANCE SERVICES,3,3,$325.60 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,AMBULANCE SERVICES,425,532,"$44,853.18 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,AMBULANCE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,AMBULANCE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,AMBULANCE SERVICES,18,18,"$2,952.42 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,AMBULANCE SERVICES,30,33,"$9,864.69 ",IAMM4400-R002,11/30/08,OTHER,AMBULANCE SERVICES,160,163,"$27,211.03 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,AMBULANCE SERVICES,3,3,$346.49 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,AMBULANCE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,AMBULANCE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,AMBULANCE SERVICES,15,15,"$2,180.97 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,AMBULANCE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,AMBULANCE SERVICES,11,11,"$1,702.39 ",IAMM4400-R002,11/30/08,TOTAL,AMBULANCE SERVICES,2164,2519,"$291,211.39 "
IAMM4400-R002,11/30/08,ADC - ADULT,LOCAL EDUCATION AGENCY,9,672,"$4,509.09 ",IAMM4400-R002,11/30/08,ADC - CHILD,LOCAL EDUCATION AGENCY,107,15918,"$91,413.46 ",IAMM4400-R002,11/30/08,AGED,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,LOCAL EDUCATION AGENCY,28,4283,"$27,078.37 ",IAMM4400-R002,11/30/08,DISABLED,LOCAL EDUCATION AGENCY,352,89716,"$642,061.45 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,LOCAL EDUCATION AGENCY,84,22521,"$160,454.38 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,LOCAL EDUCATION AGENCY,355,122750,"$936,840.42 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,LOCAL EDUCATION AGENCY,14,4497,"$25,106.27 ",IAMM4400-R002,11/30/08,STATE ONLY,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,LOCAL EDUCATION AGENCY,19,5143,"$40,659.33 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,LOCAL EDUCATION AGENCY,108,15403,"$94,853.43 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,LOCAL EDUCATION AGENCY,20,2459,"$14,393.89 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,LOCAL EDUCATION AGENCY,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,LOCAL EDUCATION AGENCY,1087,283362,"$2,037,370.09 "
IAMM4400-R002,11/30/08,ADC - ADULT,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,EARLY ACCESS SERVICES,62,251,"$6,079.26 ",IAMM4400-R002,11/30/08,AGED,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,EARLY ACCESS SERVICES,12,26,$658.62 ,IAMM4400-R002,11/30/08,DISABLED,EARLY ACCESS SERVICES,69,384,"$7,316.50 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,EARLY ACCESS SERVICES,25,76,"$1,757.23 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,EARLY ACCESS SERVICES,26,141,"$2,464.57 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,EARLY ACCESS SERVICES,3,12,$216.95 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,EARLY ACCESS SERVICES,81,283,"$6,872.57 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,EARLY ACCESS SERVICES,1,1,$50.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,EARLY ACCESS SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,EARLY ACCESS SERVICES,272,1174,"$25,415.70 "
IAMM4400-R002,11/30/08,ADC - ADULT,PRESCRIBED DRUGS,20147,55460,"$2,768,906.74 ",IAMM4400-R002,11/30/08,ADC - CHILD,PRESCRIBED DRUGS,17620,30840,"$1,814,745.43 ",IAMM4400-R002,11/30/08,AGED,PRESCRIBED DRUGS,3161,5128,"$65,466.91 ",IAMM4400-R002,11/30/08,BLIND,PRESCRIBED DRUGS,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,PRESCRIBED DRUGS,4370,9916,"$672,248.75 ",IAMM4400-R002,11/30/08,DISABLED,PRESCRIBED DRUGS,23661,99642,"$7,873,774.64 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,PRESCRIBED DRUGS,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,PRESCRIBED DRUGS,4696,11897,"$1,223,963.64 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,PRESCRIBED DRUGS,5841,18674,"$1,534,306.27 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,PRESCRIBED DRUGS,38,60,"$6,964.79 ",IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,PRESCRIBED DRUGS,6,8,$62.91 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,PRESCRIBED DRUGS,304,1031,"$95,093.41 ",IAMM4400-R002,11/30/08,STATE ONLY,PRESCRIBED DRUGS,151,370,"$24,493.85 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,PRESCRIBED DRUGS,9640,20589,"$363,867.20 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,PRESCRIBED DRUGS,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,PRESCRIBED DRUGS,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,PRESCRIBED DRUGS,1007,3197,"$144,595.90 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,PRESCRIBED DRUGS,246,1048,"$62,100.23 ",IAMM4400-R002,11/30/08,OTHER,PRESCRIBED DRUGS,24152,42993,"$2,406,211.11 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,PRESCRIBED DRUGS,194,744,"$50,630.64 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,PRESCRIBED DRUGS,90,83,"$8,639.00 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,PRESCRIBED DRUGS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,PRESCRIBED DRUGS,3391,5923,"$422,379.40 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,PRESCRIBED DRUGS,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,PRESCRIBED DRUGS,820,3689,"$226,576.05 ",IAMM4400-R002,11/30/08,TOTAL,PRESCRIBED DRUGS,118048,311292,"$19,765,026.87 "
IAMM4400-R002,11/30/08,ADC - ADULT,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,DRUG CAPITATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,DRUG CAPITATION,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,INDIAN HEALTH SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,INDIAN HEALTH SERVICES,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,FAMILY PLANNING SERVICES,6010,7075,"$632,643.40 ",IAMM4400-R002,11/30/08,ADC - CHILD,FAMILY PLANNING SERVICES,1003,1185,"$100,794.50 ",IAMM4400-R002,11/30/08,AGED,FAMILY PLANNING SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,FAMILY PLANNING SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,FAMILY PLANNING SERVICES,190,220,"$23,801.89 ",IAMM4400-R002,11/30/08,DISABLED,FAMILY PLANNING SERVICES,132,156,"$15,103.68 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,FAMILY PLANNING SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,FAMILY PLANNING SERVICES,44,49,"$5,865.73 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,FAMILY PLANNING SERVICES,21,23,"$1,033.90 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,FAMILY PLANNING SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,FAMILY PLANNING SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,FAMILY PLANNING SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,FAMILY PLANNING SERVICES,17,24,"$1,276.13 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,FAMILY PLANNING SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,FAMILY PLANNING SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,FAMILY PLANNING SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,FAMILY PLANNING SERVICES,36,46,"$3,808.75 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,FAMILY PLANNING SERVICES,6,7,$849.03 ,IAMM4400-R002,11/30/08,OTHER,FAMILY PLANNING SERVICES,378,423,"$44,940.91 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,FAMILY PLANNING SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,FAMILY PLANNING SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,FAMILY PLANNING SERVICES,1,2,$237.68 ,IAMM4400-R002,11/30/08,OTHER TXXI,FAMILY PLANNING SERVICES,83,109,"$10,708.67 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,FAMILY PLANNING SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,FAMILY PLANNING SERVICES,3,4,$353.05 ,IAMM4400-R002,11/30/08,TOTAL,FAMILY PLANNING SERVICES,7896,9323,"$841,417.32 "
IAMM4400-R002,11/30/08,ADC - ADULT,IOWA PLAN PROGRAM,37504,41788,"$1,306,546.74 ",IAMM4400-R002,11/30/08,ADC - CHILD,IOWA PLAN PROGRAM,63384,68873,"$683,837.33 ",IAMM4400-R002,11/30/08,AGED,IOWA PLAN PROGRAM,2,2,$155.19 ,IAMM4400-R002,11/30/08,BLIND,IOWA PLAN PROGRAM,1,1,$58.29 ,IAMM4400-R002,11/30/08,CMAP,IOWA PLAN PROGRAM,12961,14438,"$284,728.88 ",IAMM4400-R002,11/30/08,DISABLED,IOWA PLAN PROGRAM,48413,49985,"$3,688,817.69 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,IOWA PLAN PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,IOWA PLAN PROGRAM,10050,10471,"$993,710.62 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,IOWA PLAN PROGRAM,10619,10712,"$712,141.66 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,IOWA PLAN PROGRAM,103,132,"$3,533.64 ",IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,IOWA PLAN PROGRAM,22,23,"$1,471.76 ",IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,IOWA PLAN PROGRAM,343,357,"$35,132.73 ",IAMM4400-R002,11/30/08,STATE ONLY,IOWA PLAN PROGRAM,386,422,"$57,227.80 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,IOWA PLAN PROGRAM,2204,2231,"$150,462.36 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,IOWA PLAN PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,IOWA PLAN PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,IOWA PLAN PROGRAM,1358,1538,"$55,614.16 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,IOWA PLAN PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,IOWA PLAN PROGRAM,86678,97026,"$1,184,127.40 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,IOWA PLAN PROGRAM,237,240,"$25,261.28 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,IOWA PLAN PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,IOWA PLAN PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,IOWA PLAN PROGRAM,12539,13776,"$147,108.74 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,IOWA PLAN PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,IOWA PLAN PROGRAM,1306,1377,"$139,857.93 ",IAMM4400-R002,11/30/08,TOTAL,IOWA PLAN PROGRAM,287209,313392,"$9,469,794.20 "
IAMM4400-R002,11/30/08,ADC - ADULT,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,MANAGED SUBSTANCE ABUSE,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,MANAGED SUBSTANCE ABUSE,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,MENTAL HEALTH ACCESS PLAN,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,EPSDT SCREENING,99,106,"$5,561.93 ",IAMM4400-R002,11/30/08,ADC - CHILD,EPSDT SCREENING,2513,2756,"$251,356.79 ",IAMM4400-R002,11/30/08,AGED,EPSDT SCREENING,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,EPSDT SCREENING,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,EPSDT SCREENING,576,635,"$53,434.30 ",IAMM4400-R002,11/30/08,DISABLED,EPSDT SCREENING,156,189,"$7,949.08 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,EPSDT SCREENING,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,EPSDT SCREENING,138,151,"$8,598.92 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,EPSDT SCREENING,49,75,"$3,028.60 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,EPSDT SCREENING,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,EPSDT SCREENING,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,EPSDT SCREENING,22,22,$779.33 ,IAMM4400-R002,11/30/08,STATE ONLY,EPSDT SCREENING,5,5,$181.96 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,EPSDT SCREENING,3,4,$131.68 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,EPSDT SCREENING,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,EPSDT SCREENING,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,EPSDT SCREENING,4,4,$145.88 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,EPSDT SCREENING,1,1,$677.43 ,IAMM4400-R002,11/30/08,OTHER,EPSDT SCREENING,4542,4928,"$612,326.53 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,EPSDT SCREENING,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,EPSDT SCREENING,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,EPSDT SCREENING,1,1,"$1,051.94 ",IAMM4400-R002,11/30/08,OTHER TXXI,EPSDT SCREENING,348,374,"$29,194.48 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,EPSDT SCREENING,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,EPSDT SCREENING,2,2,$177.17 ,IAMM4400-R002,11/30/08,TOTAL,EPSDT SCREENING,8433,9253,"$974,596.02 "
IAMM4400-R002,11/30/08,ADC - ADULT,HMO SERVICES,857,896,"$244,570.71 ",IAMM4400-R002,11/30/08,ADC - CHILD,HMO SERVICES,1509,1607,"$179,935.71 ",IAMM4400-R002,11/30/08,AGED,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,HMO SERVICES,301,308,"$40,854.50 ",IAMM4400-R002,11/30/08,DISABLED,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,HMO SERVICES,2,2,$488.17 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,HMO SERVICES,1714,1782,"$258,156.65 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,HMO SERVICES,248,257,"$32,104.46 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,HMO SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,HMO SERVICES,4628,4852,"$756,110.20 "
IAMM4400-R002,11/30/08,ADC - ADULT,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,PACE SERVICES,3,3,"$10,016.00 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,PACE SERVICES,10,9,"$22,889.00 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,PACE SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,PACE SERVICES,13,12,"$32,905.00 "
IAMM4400-R002,11/30/08,ADC - ADULT,PATIENT MANAGEMENT,22699,22696,"$45,392.00 ",IAMM4400-R002,11/30/08,ADC - CHILD,PATIENT MANAGEMENT,40514,40512,"$81,024.00 ",IAMM4400-R002,11/30/08,AGED,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,PATIENT MANAGEMENT,7602,7600,"$15,200.00 ",IAMM4400-R002,11/30/08,DISABLED,PATIENT MANAGEMENT,2,2,$4.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,PATIENT MANAGEMENT,84,84,$168.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,PATIENT MANAGEMENT,1,1,$2.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,PATIENT MANAGEMENT,42,42,$84.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,PATIENT MANAGEMENT,4,4,$8.00 ,IAMM4400-R002,11/30/08,STATE ONLY,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,PATIENT MANAGEMENT,1,-1,($2.00),IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,PATIENT MANAGEMENT,57297,57297,"$114,594.00 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,PATIENT MANAGEMENT,8921,8923,"$17,846.00 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,PATIENT MANAGEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,PATIENT MANAGEMENT,137167,137160,"$274,320.00 "
IAMM4400-R002,11/30/08,ADC - ADULT,HEALTH INS PREMIUM PAYMENT,200,423,"$13,365.20 ",IAMM4400-R002,11/30/08,ADC - CHILD,HEALTH INS PREMIUM PAYMENT,287,644,"$15,524.58 ",IAMM4400-R002,11/30/08,AGED,HEALTH INS PREMIUM PAYMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,HEALTH INS PREMIUM PAYMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,HEALTH INS PREMIUM PAYMENT,63,129,"$4,376.71 ",IAMM4400-R002,11/30/08,DISABLED,HEALTH INS PREMIUM PAYMENT,602,1199,"$128,011.93 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,HEALTH INS PREMIUM PAYMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,HEALTH INS PREMIUM PAYMENT,142,288,"$10,627.15 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,HEALTH INS PREMIUM PAYMENT,556,1083,"$117,673.87 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,HEALTH INS PREMIUM PAYMENT,1,2,$6.44 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,HEALTH INS PREMIUM PAYMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,HEALTH INS PREMIUM PAYMENT,37,72,"$5,890.15 ",IAMM4400-R002,11/30/08,STATE ONLY,HEALTH INS PREMIUM PAYMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,HEALTH INS PREMIUM PAYMENT,36,61,"$10,722.81 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,HEALTH INS PREMIUM PAYMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,HEALTH INS PREMIUM PAYMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,HEALTH INS PREMIUM PAYMENT,3,9,$120.16 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,HEALTH INS PREMIUM PAYMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,HEALTH INS PREMIUM PAYMENT,2047,5141,"$124,941.13 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,HEALTH INS PREMIUM PAYMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,HEALTH INS PREMIUM PAYMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,HEALTH INS PREMIUM PAYMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,HEALTH INS PREMIUM PAYMENT,23,50,"$1,292.91 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,HEALTH INS PREMIUM PAYMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,HEALTH INS PREMIUM PAYMENT,3,8,$591.24 ,IAMM4400-R002,11/30/08,TOTAL,HEALTH INS PREMIUM PAYMENT,4000,9109,"$433,144.28 "
IAMM4400-R002,11/30/08,ADC - ADULT,MEDICAL SUPPLIES,991,26475,"$207,319.40 ",IAMM4400-R002,11/30/08,ADC - CHILD,MEDICAL SUPPLIES,839,15941,"$117,506.23 ",IAMM4400-R002,11/30/08,AGED,MEDICAL SUPPLIES,2872,160611,"$269,693.80 ",IAMM4400-R002,11/30/08,BLIND,MEDICAL SUPPLIES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,MEDICAL SUPPLIES,180,4063,"$21,869.96 ",IAMM4400-R002,11/30/08,DISABLED,MEDICAL SUPPLIES,8984,625317,"$1,817,567.25 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,MEDICAL SUPPLIES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,MEDICAL SUPPLIES,209,21440,"$81,870.86 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,MEDICAL SUPPLIES,2293,315516,"$525,785.53 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,MEDICAL SUPPLIES,4,9,$491.97 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,MEDICAL SUPPLIES,2,10,$61.39 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,MEDICAL SUPPLIES,16,1473,"$1,620.45 ",IAMM4400-R002,11/30/08,STATE ONLY,MEDICAL SUPPLIES,4,6,$456.23 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,MEDICAL SUPPLIES,4538,353784,"$586,538.62 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,MEDICAL SUPPLIES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,MEDICAL SUPPLIES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,MEDICAL SUPPLIES,221,15032,"$17,661.47 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,MEDICAL SUPPLIES,74,2623,"$33,491.42 ",IAMM4400-R002,11/30/08,OTHER,MEDICAL SUPPLIES,1035,21067,"$170,548.68 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,MEDICAL SUPPLIES,30,560,"$4,864.16 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,MEDICAL SUPPLIES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,MEDICAL SUPPLIES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,MEDICAL SUPPLIES,112,2448,"$16,863.74 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,MEDICAL SUPPLIES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,MEDICAL SUPPLIES,149,6680,"$24,564.38 ",IAMM4400-R002,11/30/08,TOTAL,MEDICAL SUPPLIES,22201,1573055,"$3,898,775.54 "
IAMM4400-R002,11/30/08,ADC - ADULT,OTHER PRACTITIONER,1471,2971,"$191,844.44 ",IAMM4400-R002,11/30/08,ADC - CHILD,OTHER PRACTITIONER,2165,5494,"$193,546.22 ",IAMM4400-R002,11/30/08,AGED,OTHER PRACTITIONER,342,1172,"$15,392.62 ",IAMM4400-R002,11/30/08,BLIND,OTHER PRACTITIONER,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,OTHER PRACTITIONER,477,1155,"$50,177.39 ",IAMM4400-R002,11/30/08,DISABLED,OTHER PRACTITIONER,2359,15503,"$327,028.48 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,OTHER PRACTITIONER,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,OTHER PRACTITIONER,490,1975,"$59,407.09 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,OTHER PRACTITIONER,829,13806,"$256,312.15 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,OTHER PRACTITIONER,2,5,$333.41 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,OTHER PRACTITIONER,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,OTHER PRACTITIONER,26,146,"$4,072.49 ",IAMM4400-R002,11/30/08,STATE ONLY,OTHER PRACTITIONER,15,21,"$2,079.90 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,OTHER PRACTITIONER,474,1792,"$45,882.43 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,OTHER PRACTITIONER,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,OTHER PRACTITIONER,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,OTHER PRACTITIONER,83,192,"$9,401.18 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,OTHER PRACTITIONER,59,133,"$9,147.69 ",IAMM4400-R002,11/30/08,OTHER,OTHER PRACTITIONER,3030,6991,"$318,492.04 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,OTHER PRACTITIONER,12,17,"$1,783.08 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,OTHER PRACTITIONER,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,OTHER PRACTITIONER,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,OTHER PRACTITIONER,358,1539,"$39,810.79 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,OTHER PRACTITIONER,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,OTHER PRACTITIONER,42,89,"$4,217.87 ",IAMM4400-R002,11/30/08,TOTAL,OTHER PRACTITIONER,12144,53001,"$1,528,929.27 "
IAMM4400-R002,11/30/08,ADC - ADULT,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,FAMILY CENTERED PROGRAM,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,FAMILY CENTERED PROGRAM,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,FAMILY PRESERVATION,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,FAMILY PRESERVATION,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,TREATMENT FOSTER FAMILY CARE,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,GROUP TREATMENT THERAPY,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,GROUP TREATMENT THERAPY,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,DENTAL,2935,3965,"$676,231.79 ",IAMM4400-R002,11/30/08,ADC - CHILD,DENTAL,4476,5370,"$691,722.95 ",IAMM4400-R002,11/30/08,AGED,DENTAL,508,635,"$81,593.04 ",IAMM4400-R002,11/30/08,BLIND,DENTAL,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,DENTAL,1096,1413,"$233,084.16 ",IAMM4400-R002,11/30/08,DISABLED,DENTAL,4021,5264,"$798,047.48 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,DENTAL,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,DENTAL,956,1161,"$146,865.28 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,DENTAL,1368,1579,"$140,977.77 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,DENTAL,19,21,"$3,285.23 ",IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,DENTAL,3,3,$177.34 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,DENTAL,27,32,"$3,809.40 ",IAMM4400-R002,11/30/08,STATE ONLY,DENTAL,16,19,"$4,503.35 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,DENTAL,836,1083,"$165,408.83 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,DENTAL,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,DENTAL,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,DENTAL,163,208,"$29,613.54 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,DENTAL,59,90,"$15,239.22 ",IAMM4400-R002,11/30/08,OTHER,DENTAL,6579,7876,"$1,108,199.53 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,DENTAL,12,17,"$3,201.12 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,DENTAL,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,DENTAL,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,DENTAL,1315,1540,"$264,090.85 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,DENTAL,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,DENTAL,96,121,"$19,817.15 ",IAMM4400-R002,11/30/08,TOTAL,DENTAL,24370,30397,"$4,385,868.03 "
IAMM4400-R002,11/30/08,ADC - ADULT,OPTOMETRIST,1677,2029,"$153,603.33 ",IAMM4400-R002,11/30/08,ADC - CHILD,OPTOMETRIST,1715,2014,"$135,113.71 ",IAMM4400-R002,11/30/08,AGED,OPTOMETRIST,691,1018,"$24,670.77 ",IAMM4400-R002,11/30/08,BLIND,OPTOMETRIST,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,OPTOMETRIST,515,612,"$42,669.59 ",IAMM4400-R002,11/30/08,DISABLED,OPTOMETRIST,2579,3488,"$178,632.26 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,OPTOMETRIST,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,OPTOMETRIST,492,568,"$36,974.94 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,OPTOMETRIST,683,834,"$38,779.84 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,OPTOMETRIST,7,9,$484.75 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,OPTOMETRIST,2,1,$100.81 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,OPTOMETRIST,25,28,"$1,775.61 ",IAMM4400-R002,11/30/08,STATE ONLY,OPTOMETRIST,13,14,"$1,081.86 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,OPTOMETRIST,805,1166,"$29,434.01 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,OPTOMETRIST,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,OPTOMETRIST,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,OPTOMETRIST,101,127,"$9,042.82 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,OPTOMETRIST,29,34,"$2,248.49 ",IAMM4400-R002,11/30/08,OTHER,OPTOMETRIST,2406,2824,"$188,858.76 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,OPTOMETRIST,15,20,"$1,224.89 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,OPTOMETRIST,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,OPTOMETRIST,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,OPTOMETRIST,533,598,"$41,215.76 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,OPTOMETRIST,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,OPTOMETRIST,82,100,"$8,846.26 ",IAMM4400-R002,11/30/08,TOTAL,OPTOMETRIST,12343,15484,"$894,758.46 "
IAMM4400-R002,11/30/08,ADC - ADULT,CHIROPRACTIC,1746,4028,"$142,967.29 ",IAMM4400-R002,11/30/08,ADC - CHILD,CHIROPRACTIC,864,1681,"$55,794.92 ",IAMM4400-R002,11/30/08,AGED,CHIROPRACTIC,450,1114,"$8,037.74 ",IAMM4400-R002,11/30/08,BLIND,CHIROPRACTIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,CHIROPRACTIC,203,457,"$16,023.26 ",IAMM4400-R002,11/30/08,DISABLED,CHIROPRACTIC,2213,5270,"$78,421.60 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,CHIROPRACTIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,CHIROPRACTIC,142,234,"$6,990.91 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,CHIROPRACTIC,295,670,"$8,698.86 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,CHIROPRACTIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,CHIROPRACTIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,CHIROPRACTIC,8,13,$338.48 ,IAMM4400-R002,11/30/08,STATE ONLY,CHIROPRACTIC,6,13,$445.38 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,CHIROPRACTIC,317,685,"$5,395.28 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,CHIROPRACTIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,CHIROPRACTIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,CHIROPRACTIC,87,190,"$5,563.03 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,CHIROPRACTIC,15,37,"$1,119.13 ",IAMM4400-R002,11/30/08,OTHER,CHIROPRACTIC,1385,3014,"$95,017.42 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,CHIROPRACTIC,13,29,$899.26 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,CHIROPRACTIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,CHIROPRACTIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,CHIROPRACTIC,255,488,"$17,576.76 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,CHIROPRACTIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,CHIROPRACTIC,54,115,"$3,982.38 ",IAMM4400-R002,11/30/08,TOTAL,CHIROPRACTIC,8000,18038,"$447,271.70 "
IAMM4400-R002,11/30/08,ADC - ADULT,PODIATRIC,257,382,"$45,920.75 ",IAMM4400-R002,11/30/08,ADC - CHILD,PODIATRIC,73,92,"$10,341.78 ",IAMM4400-R002,11/30/08,AGED,PODIATRIC,714,1070,"$10,860.38 ",IAMM4400-R002,11/30/08,BLIND,PODIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,PODIATRIC,28,40,"$3,855.95 ",IAMM4400-R002,11/30/08,DISABLED,PODIATRIC,1222,2135,"$78,394.77 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,PODIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,PODIATRIC,28,33,"$2,363.19 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,PODIATRIC,607,853,"$20,613.01 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,PODIATRIC,1,0,$27.46 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,PODIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,PODIATRIC,1,1,$4.01 ,IAMM4400-R002,11/30/08,STATE ONLY,PODIATRIC,3,3,$369.54 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,PODIATRIC,1125,1626,"$17,942.45 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,PODIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,PODIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,PODIATRIC,32,35,"$1,205.86 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,PODIATRIC,7,20,"$1,733.64 ",IAMM4400-R002,11/30/08,OTHER,PODIATRIC,115,146,"$14,087.86 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,PODIATRIC,6,10,$782.97 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,PODIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,PODIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,PODIATRIC,34,41,"$4,597.77 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,PODIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,PODIATRIC,21,25,"$2,449.66 ",IAMM4400-R002,11/30/08,TOTAL,PODIATRIC,4268,6512,"$215,551.05 "
IAMM4400-R002,11/30/08,ADC - ADULT,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,PHYSICAL DISABILITIES SVCS,449,18782,"$242,573.33 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,PHYSICAL DISABILITIES SVCS,178,7625,"$85,981.17 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,PHYSICAL DISABILITIES SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,PHYSICAL DISABILITIES SVCS,624,26407,"$328,554.50 "
IAMM4400-R002,11/30/08,ADC - ADULT,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,BRAIN INJ WAIVER SERVICES,1,53,"$4,877.52 ",IAMM4400-R002,11/30/08,BLIND,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,BRAIN INJ WAIVER SERVICES,306,15253,"$520,614.69 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,BRAIN INJ WAIVER SERVICES,35,1121,"$26,976.02 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,BRAIN INJ WAIVER SERVICES,261,12986,"$400,094.55 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,BRAIN INJ WAIVER SERVICES,443,20134,"$683,721.52 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,BRAIN INJ WAIVER SERVICES,1,0,($894.00),IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,BRAIN INJ WAIVER SERVICES,2,45,"$2,033.24 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,BRAIN INJ WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,BRAIN INJ WAIVER SERVICES,1025,49592,"$1,637,423.54 "
IAMM4400-R002,11/30/08,ADC - ADULT,PSYCHIATRIC,30,42,"$3,451.70 ",IAMM4400-R002,11/30/08,ADC - CHILD,PSYCHIATRIC,16,19,"$1,676.65 ",IAMM4400-R002,11/30/08,AGED,PSYCHIATRIC,155,244,"$7,169.15 ",IAMM4400-R002,11/30/08,BLIND,PSYCHIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,PSYCHIATRIC,16,72,"$3,971.35 ",IAMM4400-R002,11/30/08,DISABLED,PSYCHIATRIC,2571,5064,"$157,969.11 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,PSYCHIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,PSYCHIATRIC,16,39,"$3,425.89 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,PSYCHIATRIC,484,737,"$25,740.30 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,PSYCHIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,PSYCHIATRIC,4,6,$152.77 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,PSYCHIATRIC,1,1,$69.62 ,IAMM4400-R002,11/30/08,STATE ONLY,PSYCHIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,PSYCHIATRIC,255,461,"$12,292.47 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,PSYCHIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,PSYCHIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,PSYCHIATRIC,30,45,"$1,998.09 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,PSYCHIATRIC,32,86,"$4,518.07 ",IAMM4400-R002,11/30/08,OTHER,PSYCHIATRIC,37,71,"$7,107.42 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,PSYCHIATRIC,2,3,$171.74 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,PSYCHIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,PSYCHIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,PSYCHIATRIC,12,14,"$1,617.45 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,PSYCHIATRIC,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,PSYCHIATRIC,4,6,$432.70 ,IAMM4400-R002,11/30/08,TOTAL,PSYCHIATRIC,3654,6910,"$231,764.48 "
IAMM4400-R002,11/30/08,ADC - ADULT,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,RESIDENTIAL CARE FACILITY,301,10521,"$76,929.41 ",IAMM4400-R002,11/30/08,BLIND,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,RESIDENTIAL CARE FACILITY,1,4,$107.80 ,IAMM4400-R002,11/30/08,DISABLED,RESIDENTIAL CARE FACILITY,1335,41636,"$376,223.31 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,RESIDENTIAL CARE FACILITY,2,17,$512.05 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,RESIDENTIAL CARE FACILITY,14,381,"$3,143.25 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,RESIDENTIAL CARE FACILITY,5,133,"$1,652.75 ",IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,RESIDENTIAL CARE FACILITY,12,187,"$1,558.85 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,RESIDENTIAL CARE FACILITY,1,206,"$2,231.35 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,RESIDENTIAL CARE FACILITY,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,RESIDENTIAL CARE FACILITY,1661,53085,"$462,358.77 "
IAMM4400-R002,11/30/08,ADC - ADULT,MR WAIVER SERVICE,1,51,$668.10 ,IAMM4400-R002,11/30/08,ADC - CHILD,MR WAIVER SERVICE,2,4,$65.10 ,IAMM4400-R002,11/30/08,AGED,MR WAIVER SERVICE,78,4641,"$217,549.94 ",IAMM4400-R002,11/30/08,BLIND,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,MR WAIVER SERVICE,3,97,"$2,092.63 ",IAMM4400-R002,11/30/08,DISABLED,MR WAIVER SERVICE,1011,68066,"$2,797,664.43 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,MR WAIVER SERVICE,181,7077,"$191,691.80 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,MR WAIVER SERVICE,8205,542424,"$21,279,930.52 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,MR WAIVER SERVICE,12,306,"$12,587.71 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,MR WAIVER SERVICE,8,260,"($47,846.10)",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,MR WAIVER SERVICE,2,59,$733.88 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,MR WAIVER SERVICE,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,MR WAIVER SERVICE,4,101,"$2,833.37 ",IAMM4400-R002,11/30/08,TOTAL,MR WAIVER SERVICE,9467,623086,"$24,457,971.38 "
IAMM4400-R002,11/30/08,ADC - ADULT,CHILDRENS MENTAL HEALTH SVC,3,179,"$3,322.88 ",IAMM4400-R002,11/30/08,ADC - CHILD,CHILDRENS MENTAL HEALTH SVC,32,1841,"$35,400.88 ",IAMM4400-R002,11/30/08,AGED,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,CHILDRENS MENTAL HEALTH SVC,83,4915,"$89,222.69 ",IAMM4400-R002,11/30/08,DISABLED,CHILDRENS MENTAL HEALTH SVC,28,1199,"$23,794.84 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,CHILDRENS MENTAL HEALTH SVC,288,12466,"$286,617.31 ",IAMM4400-R002,11/30/08,STATE ONLY,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,CHILDRENS MENTAL HEALTH SVC,51,2595,"$51,991.53 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,CHILDRENS MENTAL HEALTH SVC,4,258,"$4,110.63 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,CHILDRENS MENTAL HEALTH SVC,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,CHILDRENS MENTAL HEALTH SVC,1,53,$845.01 ,IAMM4400-R002,11/30/08,TOTAL,CHILDRENS MENTAL HEALTH SVC,489,23506,"$495,305.77 "
IAMM4400-R002,11/30/08,ADC - ADULT,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,AIDS WAIVER SERVICES,15,1214,"$13,510.18 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,AIDS WAIVER SERVICES,32,2808,"$27,488.11 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,AIDS WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,AIDS WAIVER SERVICES,46,4022,"$40,998.29 "
IAMM4400-R002,11/30/08,ADC - ADULT,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,ELDERLY WAIVER SERVICES,3507,148739,"$2,174,662.72 ",IAMM4400-R002,11/30/08,BLIND,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,ELDERLY WAIVER SERVICES,34,1424,"$27,792.99 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,ELDERLY WAIVER SERVICES,1,117,"$1,522.32 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,ELDERLY WAIVER SERVICES,6311,285145,"$3,592,798.87 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,ELDERLY WAIVER SERVICES,5,30,"($9,122.42)",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,ELDERLY WAIVER SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,ELDERLY WAIVER SERVICES,4,278,"$3,723.01 ",IAMM4400-R002,11/30/08,TOTAL,ELDERLY WAIVER SERVICES,9604,435733,"$5,791,377.49 "
IAMM4400-R002,11/30/08,ADC - ADULT,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,ILL & HANDICAPPED WAIVER SVCS,1768,87183,"$1,420,686.74 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,ILL & HANDICAPPED WAIVER SVCS,22,1514,"$24,775.73 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,ILL & HANDICAPPED WAIVER SVCS,138,6850,"$128,093.52 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,ILL & HANDICAPPED WAIVER SVCS,1,2,$96.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,ILL & HANDICAPPED WAIVER SVCS,1,0,($100.00),IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,ILL & HANDICAPPED WAIVER SVCS,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,ILL & HANDICAPPED WAIVER SVCS,1,56,$721.52 ,IAMM4400-R002,11/30/08,TOTAL,ILL & HANDICAPPED WAIVER SVCS,1930,95605,"$1,574,273.51 "
IAMM4400-R002,11/30/08,ADC - ADULT,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,COUNTY OFFICE REIMBURSEMENT,0,0,$0.00 
IAMM4400-R002,11/30/08,ADC - ADULT,MEP SERVICES,5,5,"$2,088.17 ",IAMM4400-R002,11/30/08,ADC - CHILD,MEP SERVICES,37,38,"$17,205.48 ",IAMM4400-R002,11/30/08,AGED,MEP SERVICES,85,86,"$22,804.96 ",IAMM4400-R002,11/30/08,BLIND,MEP SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,MEP SERVICES,88,105,"$46,219.16 ",IAMM4400-R002,11/30/08,DISABLED,MEP SERVICES,1202,1256,"$342,514.11 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,MEP SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,MEP SERVICES,203,215,"$56,350.82 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,MEP SERVICES,7752,7953,"$2,108,276.09 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,MEP SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,MEP SERVICES,2,2,$429.55 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,MEP SERVICES,303,307,"$147,415.95 ",IAMM4400-R002,11/30/08,STATE ONLY,MEP SERVICES,1,1,$207.14 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,MEP SERVICES,133,136,"$36,716.12 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,MEP SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,MEP SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,MEP SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,MEP SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,MEP SERVICES,59,61,"$26,735.22 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,MEP SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,MEP SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,MEP SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,MEP SERVICES,6,11,"$4,789.04 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,MEP SERVICES,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,MEP SERVICES,7,7,"$2,256.48 ",IAMM4400-R002,11/30/08,TOTAL,MEP SERVICES,9858,10183,"$2,814,008.29 "
IAMM4400-R002,11/30/08,ADC - ADULT,UNASSIGNED,11,0,$0.00 ,IAMM4400-R002,11/30/08,ADC - CHILD,UNASSIGNED,53,0,$0.00 ,IAMM4400-R002,11/30/08,AGED,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,BLIND,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,CMAP,UNASSIGNED,12,0,$0.00 ,IAMM4400-R002,11/30/08,DISABLED,UNASSIGNED,15,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,UNASSIGNED,62,0,$0.00 ,IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,UNASSIGNED,1,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL ONLY,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,UNASSIGNED,2,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER,UNASSIGNED,38,0,"$8,975.98 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,OTHER TXXI,UNASSIGNED,6,0,$0.00 ,IAMM4400-R002,11/30/08,REFUGEE TXXI,UNASSIGNED,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,UNASSIGNED,3,0,$0.00 ,IAMM4400-R002,11/30/08,TOTAL,UNASSIGNED,189,0,"$8,975.98 "
IAMM4400-R002,11/30/08,ADC - ADULT,* A L L  C A T E G O R I E S *,48625,352842,"$16,155,581.58 ",IAMM4400-R002,11/30/08,ADC - CHILD,* A L L  C A T E G O R I E S *,70053,345080,"$11,779,380.65 ",IAMM4400-R002,11/30/08,AGED,* A L L  C A T E G O R I E S *,14466,663688,"$18,847,004.27 ",IAMM4400-R002,11/30/08,BLIND,* A L L  C A T E G O R I E S *,1,1,$58.29 ,IAMM4400-R002,11/30/08,CMAP,* A L L  C A T E G O R I E S *,14113,106472,"$5,512,337.71 ",IAMM4400-R002,11/30/08,DISABLED,* A L L  C A T E G O R I E S *,52714,1855566,"$48,766,486.51 ",IAMM4400-R002,11/30/08,OTHER ICARE CHRN DSH,* A L L  C A T E G O R I E S *,0,0,$0.00 ,IAMM4400-R002,11/30/08,FOSTER - PRESUB - SUB ADOPTS,* A L L  C A T E G O R I E S *,10140,229421,"$5,350,916.22 ",IAMM4400-R002,11/30/08,FED CNTY - FED CNTY STATE,* A L L  C A T E G O R I E S *,11427,1251117,"$59,810,931.94 ",IAMM4400-R002,11/30/08,FEDERAL ONLY,* A L L  C A T E G O R I E S *,127,675,"$38,521.18 ",IAMM4400-R002,11/30/08,OTHER ICARE MHI 300%,* A L L  C A T E G O R I E S *,19,1978,"$14,168.96 ",IAMM4400-R002,11/30/08,OTHER ICARE PMIC MHI 300%,* A L L  C A T E G O R I E S *,325,25554,"$725,522.70 ",IAMM4400-R002,11/30/08,STATE ONLY,* A L L  C A T E G O R I E S *,352,3270,"$202,629.12 ",IAMM4400-R002,11/30/08,INTERMEDIATE CARE FACILITY,* A L L  C A T E G O R I E S *,14927,1180726,"$33,733,640.65 ",IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY AGED,* A L L  C A T E G O R I E S *,0,0,$0.00 ,IAMM4400-R002,11/30/08,FEDERAL MEDICAID ONLY BLIND,* A L L  C A T E G O R I E S *,0,0,$0.00 ,IAMM4400-R002,11/30/08,MEDICALLY NEEDY NO SPEND DN,* A L L  C A T E G O R I E S *,1762,37341,"$914,363.40 ",IAMM4400-R002,11/30/08,MEDICALLY NEEDY WI SPEND DN,* A L L  C A T E G O R I E S *,806,19881,"$1,781,392.31 ",IAMM4400-R002,11/30/08,OTHER,* A L L  C A T E G O R I E S *,93440,517410,"$26,045,898.34 ",IAMM4400-R002,11/30/08,OTHER BREAST CERVICAL CANCER,* A L L  C A T E G O R I E S *,231,3982,"$446,554.34 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT 19-64,* A L L  C A T E G O R I E S *,94,83,"$22,711.55 ",IAMM4400-R002,11/30/08,OTHER ICARE ADULT OB,* A L L  C A T E G O R I E S *,10,34,"$4,975.62 ",IAMM4400-R002,11/30/08,OTHER TXXI,* A L L  C A T E G O R I E S *,12056,62396,"$2,109,070.63 ",IAMM4400-R002,11/30/08,REFUGEE TXXI,* A L L  C A T E G O R I E S *,0,0,$0.00 ,IAMM4400-R002,11/30/08,STATE ONLY,* A L L  C A T E G O R I E S *,1378,21693,"$878,564.81 ",IAMM4400-R002,11/30/08,TOTAL,* A L L  C A T E G O R I E S *,347066,6679210,"$233,140,710.78 "