County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Adams Prior Authorization 601 Rosary Drive Corning 50841 Brittany Corning Adams

Closed -

Unreacha

ble

Allamakee Prior Authorization 105 E Main St Waukon 52172 Ben Postville Allamakee

Closed -

Intake

Only

Appanoose

Mercy Medical Clinic

Centerville 19876 St Joseph Dr Centerville 52544 Carol Centerville Appanoose

Closed -

Enrolled

appanoose Prior Authorization 10109 Maple Street Omaha 68134 Misty Council Bluffs

Pottawatta

mie

Closed -

Enrolled

Appanoose Prior Authorization 19876 St Joseph Centerville Cassie Centerville Appanoose

Closed -

Unreacha

ble

audubon Audubon Family Healthcare 50025 Anissa Audubon Audubon

Closed -

Unreacha

ble

audubon

Audubon Family Healthcare

Clinic 50025

Christophe

r Audubon Audubon

Closed -

Unreacha

ble

Blackhawk Covenant Clinic 50702 Suba Waterloo Black Hawk

Closed -

Declined

Blackhawk Covenant Clinic Suba Waterloo Black Hawk

Closed -

Unreacha

ble

BlackHawk Covenant Medical Center 50702 Unknown Waterloo Black Hawk

Closed -

Unreacha

ble

Blackhawk

COVENANT MIDWIVES &

WOMEN'S HEALTH

Closed -

Invalid

Blackhawk Family Medicine Waterloo Waterloo Black Hawk

Closed -

Enrolled

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Blackhawk Family Medicine Waterloo Martha Waterloo Black Hawk

Closed -

Already

Participati

ng

Blackhawk

Family Medicine Waterloo

Unity Point Clinic 50703 Suzanne Independence Buchanan

Closed -

Unreacha

ble

Blackhawk

Family Medicine Waterloo

UnityPoint Clinic 50703

Martha

Hall /

Timothy Waterloo Black Hawk

Closed -

Duplicate

Blackhawk FM waterloo TIm Waterloo Black Hawk

Closed -

Enrolled

BlackHawk Greenhill 1015 S Hackett Rd Waterloo 50701 Meredith Waterloo Black Hawk

Closed -

Enrolled

BlackHawk Partners in Ob/Gyn 50702 Karla Waterloo Black Hawk

Closed -

Duplicate

BlackHawk

People Community Health

Clinic 50703 Kiran Waterloo Black Hawk

Closed -

Intake

Only

BlackHawk

PEOPLES COMMUITY

HEALTH CLINIC KIRAN Waterloo Black Hawk

Closed -

Unreacha

ble

BlackHawk

Peoples Community Health

Clinic 905 Franklin st Waterloo 50703 Waterloo Black Hawk

Closed -

Unreacha

ble

BlackHawk

Peoples Community Health

Clinic 50703 Emily Waterloo Black Hawk

Closed -

Declined

BlackHawk

Peoples Community Health

Clinic Heidi Evansdale Black Hawk

Closed -

Enrolled

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

BlackHawk

PEOPLES COMMUNITY

HEALTH CLINIC EMILY Waterloo Black Hawk

Closed -

Enrolled

BlackHawk

Peoples Community Health

Clinic 50703 Sarah Waterloo Black Hawk

Closed -

Enrolled

BlackHawk Prior Authorization

2055 Kimball Ave Ste

400 Waterloo 50702 Mitchel Waterloo Black Hawk

Closed -

Intake

Only

BlackHawk Prior Authorization 3562 Lafayette Road Evansdale 50707 Tammy Evansdale Black Hawk

Closed -

Unreacha

ble

BlackHawk Prior Authorization 3562 Lafayette Rd Evansdale 50707 Tammy Evansdale Black Hawk

Closed -

Unreacha

ble

BlackHawk Prior Authorization 601 Highway 218 N Troy La Porte City Black Hawk

Closed -

Enrolled

Boone

Boone County Comp

Specialty 50036 Tracey Coon Rapids Carroll

Closed -

Unreacha

ble

Boone

BOONE COUNTY

COMPREHENSIVE

SPECIALTY CLINIC 564 K AVENUE BOONE 50036 DR. Boone Boone

Closed -

Unreacha

ble

Boone

Boone County

Comprehensive Specialty

Clinic 50036 Dr Boone Boone

Closed -

Duplicate

Boone

Comprehensive Specialty

Care

1015 Union St Suite

120 Boone 50036 Tracy

Closed -

Unreacha

ble

Bremer Waverly Health Center Tripoli Bremer

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Bremer

Waverly Health Center-

Women's Clinic Ann Nashua Chickasaw

Closed -

Unreacha

ble

Buchanan Prior Authorization 1094 220th Street Jesup 50648 Mark Independence Buchanan

Closed -

Declined

Butler

People's Clinic Butler

County 50619 Courtney Clarksville Butler

Closed -

Unreacha

ble

Butler Prior Authorization 502 3rd Street Parkersburg 50665 Gina

Closed -

Enrolled

Carroll Iowa Heart Center 405 S Clark St Carroll 51401 Suzanne Lake City Calhoun

Closed -

Enrolled

Carroll Prior Authorization

515 North Main

Street Carroll 51401 Linda Carroll Carroll

Closed -

Invalid

cerro gordo Prior Authorization

1010 4th Street SW,

Suite 340 Mason City Jasjit

Closed -

Intake

Only

CerroGordo Iowa Specialty Hospital 50421 Dennis Belmond Wright

Closed -

Enrolled

CerroGordo Iowa Specialty Hospital Dennis Belmond Wright

Closed -

Enrolled

CerroGordo Mercy Interrnal Medicine 50401 Lisa Mason City

Cerro

Gordo

Closed -

Enrolled

CerroGordo

Mercy Medical Center

North Iowa 1000 4th St SW Mason City 50401 Ameen Charles City Floyd

Closed -

Enrolled

CerroGordo Prior Authorization

1010 4th st sw suite

340 Mason City 50401 Jasjit Mason City

Cerro

Gordo

Closed -

Unreacha

ble

CerroGordo Prior Authorization 1010 4th St Suite 240 Mason City 50401 Denul Mason City

Cerro

Gordo

Closed -

Invalid

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Cherokee Cherokee Regional Clinic 300 Soiux Valley Dr Cherokee 51012 Rebecca Holstein

Closed -

Unreacha

ble

Cherokee Cherokee Regional Clinic 300 Sioux Valley Dr Cherokee 51012 Chris Cherokee

Closed -

Intake

Only

Cherokee Cherokee Regional Clinic 300 Sioux Valley Dr Cherokee 51012 Brenda Cherokee

Closed -

Declined

Cherokee Prior Authorization 300 Sioux Valley Dr Cherokee 51012

Christophe

r Cherokee Cherokee

Closed -

Enrolled

clay

Avera Medical Group

Spencer 51301 Jeffrey Spencer Clay

Closed -

Declined

Clay Prior Authorization 337 11th Street SW Spencer Kathryn Sibley Osceola

Closed -

Already

Participati

ng

Clayton Prior Authorization 200 Main Guttenberg 52052 Michele Mc Gregor Clayton

Closed -

Enrolled

clayton Regional Family Health 702 W Union St Edgewood Scot Independence Buchanan

Closed -

Enrolled

Clinton Community Health Care 52732 Ashley Clinton Clinton

Closed -

Unreacha

ble

Clinton Community Health Care 52732 Ashley Clinton Clinton

Closed -

Duplicate

Clinton Dr Osaro Clinton Clinton

Closed -

Enrolled

Clinton MMc-C 52732 Delmar Clinton

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Clinton MMc-C Clinton Clinton

Closed -

Unreacha

ble

Clinton MMc-C Camanche Clinton

Closed -

Enrolled

Clinton Prior Authorization 507 South 4th Street Clinton 52732 Mona Clinton Clinton

Closed -

Unreacha

ble

Clinton Prior Authorization

915 13th Avenue

North Clinton 52732 Thersa Clinton Clinton

Closed -

Invalid

Dallas Mercy Clinic Perry Steven Woodward Dallas

Closed -

Declined

Dallas Merry Clinic Perry Perry 50220 Steven Perry Dallas

Closed -

Enrolled

Dallas MMC ADEL 1120 Greene St Adel 50003

Christophe

r Adel Dallas

Closed -

Enrolled

Dallas Prior Authorization

30 East Hickman

Road Waukee 50263 Hanna Waukee Dallas

Closed -

Enrolled

Dallas Prior Authorization 30 E Hickman Rd Waukee 50263 Jenna

West Des

Moines Polk

Closed -

Ineligible

Decatur

Community Health Centers

of Southern Iowa 302 NW 14th St Leon 50144 Jennifer Leon Decatur

Closed -

Unreacha

ble

Decatur Prior Authorization 302 NE 14th Street Leon 50144 Nathan Garden Grove Decatur

Closed -

Unreacha

ble

Des Moines BAFP

1225 S Gear Ave Ste

159 W Burl Lisa Burlington

Des

Moines

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Des Moines

COMMUNITY HEALTH

CENTER 52655 Rebecca Burlington

Des

Moines

Closed -

Unreacha

ble

Des Moines Community Health Center Burlington

Des

Moines

Closed -

Enrolled

Des Moines

COMMUNITY HEALTH

CENTER SE IA

Closed -

Invalid

Des Moines

Community Health Center

Southeast Iowa 52655

DR

TIMOTHY

Closed -

Intake

Only

Des Moines Great River Medical Center Wapello Louisa

Closed -

Unreacha

ble

Des Moines

Great River Medical Center -

Resp Care Dr

West

Burlington

Des

Moines

Closed -

Declined

Des Moines

Great River Medical Center -

Respiratory Care 52655 Dr Burlington

Des

Moines

Closed -

Unreacha

ble

DesMoines Prior Authorization 1225 S Gear Ave

West

Burlington 52655 Keokuk Lee

Closed -

Unreacha

ble

Douglas Prior Authorization 10109 Maple Street Omaha 68134 Misty Council Bluffs

Pottawatta

mie

Closed -

Enrolled

Dubuque Care for Yourself 52001

Visiting

Nurse

Association Dubuque Dubuque

Closed -

Unreacha

ble

Dubuque Care For Yourself Lori Sioux City Woodbury

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Dubuque Care For Yourself Waterloo Black Hawk

Closed -

Unreacha

ble

Dubuque MEDICAL ASSOCIATES 52001 DR RYAN Dubuque Dubuque

Closed -

Enrolled

Dubuque Medical Associates 52001 Sara Dubuque Dubuque

Closed -

Unreacha

ble

Dubuque Medical Associates 52060 Eric Maquoketa Jackson

Closed -

Ineligible

Dubuque

Medical Associates Family

Medicine Sara Dubuque Dubuque

Closed -

Already

Participati

ng

Dubuque

Unity Point Clinic Finley

Cardiology

350 North

Grandview Ave Suite

G3300 Dubuque 52001 Tauseef Dubuque Dubuque

Closed -

Unreacha

ble

Dubuque

Unity Point Clinic Finley

Cardiology

350 North

Grandview Ave Suite

G3300 Dubuque 52001 Tauseef Dubuque Dubuque

Closed -

Enrolled

Fayette Covenant Clinic 50662 Gayla Fairbank Buchanan

Closed -

Unreacha

ble

Fayette COVENANT CLINIC 50662 Gayla

Closed -

Declined

Fayette Prior Authorization 129 8th Avenue SE Oelwein 50662 Nasredin Oelwein Fayette

Closed -

Enrolled

Floyd Prior Authorization 1501 S Main St Ste 1 Charles City 50616 David Charles City Floyd

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Franklin MCRHC Osage Clinic 620 N 8th st Osage 50431 Mark Osage Mitchell

Closed -

Duplicate

greene

Greene Family Clinic -

Mercy 50636 Patricia Greene Butler

Closed -

Declined

greene

Greene Family Clinic -

Mercy 50636 Patricia Greene Butler

Closed -

Declined

Guthrie GCH Clinic Michael Stuart Guthrie

Closed -

Enrolled

Guthrie GCH Clinic Stuart 50250 Michael Stuart Guthrie

Closed -

Already

Participati

ng

Guthrie GCH Clinics 50216 Josh Panora Guthrie

Closed -

Unreacha

ble

Hamilton Vandiest Family Clinic 50595 Nicole Jewell Hamilton

Closed -

Unreacha

ble

Hamilton Vandiest Family Clinic 2350 Hospital Dr 50595 Kathryn Webster City Hamilton

Closed -

Unreacha

ble

Hardin Iowa Falls Clinic 50126 Erin Hampton Franklin

Closed -

Intake

Only

Hardin McFarland Clinic 7413 Eddington Ave Eldora 50627 Abigal Eldora Hardin

Closed -

Enrolled

Hardin McFarland Clinic Eldora 50627 Aaron Eldora Hardin

Closed -

Duplicate

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Hardin Prior Authorization 920 South Oak Street Iowa Falls 50126 Sarah Coulter Franklin

Closed -

Unreacha

ble

Hardin Prior Authorization 2413 Edginton Ave Eldora 50627 Aaron Eldora Hardin

Closed -

Ineligible

harrison CHI Logan 51546 Carrie Logan Harrison

Closed -

Enrolled

harrison CHi Logan 51546 Carrie Logan Harrison

Closed -

Already

Participati

ng

harrison CHI Logan 51546 Nathaniel Logan Harrison

Closed -

Already

Participati

ng

harrison CHI Logan 51546 Nathaniel Logan Harrison

Closed -

Enrolled

Howard Cresco Medical Clinic 52136 Tracey Elma Howard

Closed -

Duplicate

Howard CVESCO Medical Clinic 52136 Tracey Elma Howard

Closed -

Unreacha

ble

Howard Prior Authorization

321 8th Avenue

West Cresco 52136 Jessica Cresco Howard

Closed -

Enrolled

Iowa

Williamsburg Family

Medical Clinic 498 N Highland St

Williamsbur

g 52361 Michelle Brooklyn Poweshiek

Closed -

Enrolled

Iowa

Williamsburg Family

Medical Clinic 498 N Highland St

Williamsbur

g 52361 mICHELLE Deep River Poweshiek

Closed -

Enrolled

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

jackson Maquokita Family Clinic 52060 Alyssa Maquoketa Jackson

Closed -

Declined

Jasper Newton Clinic, PC

300 North 4th

Avenue East, Suite

200 Newton 50208 Ty Marshalltown Marshall

Closed -

Unreacha

ble

Jasper Newton Clinic, PC

300 North 4th

Avenue East, Suite

200 Newton 50208 Stephanie Newton Jasper

Closed -

Ineligible

Johnson

Dental Special Geriatric

Dept 322 Dental Science Iowa CIty 52242 Eldridge Scott

Closed -

Enrolled

Johnson Family Medicine 200 Hawkins Dr Iowa City 52242 Brigit West Branch Cedar

Closed -

Unreacha

ble

Johnson

Family Medicine Iowa River

Landing East 52241 Hussain Goose Lake Clinton

Closed -

Intake

Only

Johnson

Family Medicine Iowa River

Landing East 52241 Hussain Goose Lake Clinton

Closed -

Duplicate

Johnson HYVEE Pharm Albia

UI Womens Hlth 200

Hawkins Dr Iowa City Eugenia Albia Monroe

Closed -

Intake

Only

Johnson

IA River Landing East Family

Med Kathleen Iowa City Johnson

Closed -

Unreacha

ble

Johnson Internal Medicine 200 Hawkins Dr Iowa City 52242 Jason Cedar Falls Black Hawk

Closed -

Unreacha

ble

Johnson

Iowa River Landing East

Family Medicine 52241 Shalina Keokuk Lee

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Johnson IRL East Family Medicine Shalina Bennett Cedar

Closed -

Unreacha

ble

Johnson

Johnson County Public

Health Iowa City Johnson

Closed -

Unreacha

ble

Johnson

Periodontics Clinic

Univeristy of IA 52242 Davenport Scott

Closed -

Unreacha

ble

Johnson Prior Authorization 1130 S Scott Blvd Iowa City 52240 Matthew Iowa City Johnson

Closed -

Unreacha

ble

Johnson Prior Authorization 200 Hawkins Drive Iowa City 52243 Margaret Cedar Rapids Linn

Closed -

Intake

Only

Johnson Prior Authorization 1067 Ryan Court Iowa City 52246 Mei Iowa City Johnson

Closed -

Unreacha

ble

Johnson Prior Authorization 3 Lions Dr N Liberty 52317 Angela North Liberty Johnson

Closed -

Declined

Johnson Prior Authorization 1765 Lininger Lane

North

Liberty Vincent Cedar Rapids Linn

Closed -

Already

Participati

ng

Johnson UIHC 200 HAWKINS DR IOWA CITY 52242

Closed -

Unreacha

ble

Johnson UIHC - Family Medicine 200 Hawkins Drive Iowa City 52242 Garrett Iowa City Johnson

Closed -

Enrolled

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Johnson UIHC Family Med 200 Hawkins Dr Iowa city 52242 Elora North English Iowa

Closed -

Unreacha

ble

Johnson

University of Iowa Hospitals

& Clinics 200 Hawkins Dr Iowa City 52242 Sara Casey Guthrie

Closed -

Unreacha

ble

Jones Prior Authorization 1791 Hwy 64 E Anamosa 52205 Alissa Tipton Cedar

Closed -

Unreacha

ble

Keokuk KCHC Medical Clinic 1314 Stuart Sigourney 52591 Shelly What Cheer Keokuk

Closed -

Enrolled

Kossuth

Kossuth Regional Health

Center Algona Kossuth

Closed -

Intake

Only

Linn Abbe Center 520 11th Street NW

Cedar

Rapids 52405 Ellen Hiawatha

Closed -

Enrolled

Linn

Bowman Woods Family

Practice Teresa Cedar Rapids Linn

Closed -

Unreacha

ble

Linn

EASTER IOWA HEALTH

CENTER

Closed -

Unreacha

ble

Linn Eastern IA Health Center Bradley Cedar Rapids Linn

Closed -

Unreacha

ble

Linn Eastern IA Health Center Ursula Cedar Rapids Linn

Closed -

Intake

Only

Linn Eastern IA Health Center Anamosa Jones

Closed -

Enrolled

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Linn Eastern Iowa Health Center 52402 Cedar Rapids Linn

Closed -

Duplicate

Linn Eastern Iowa Health Center 52403 Ramya Marion Linn

Closed -

Unreacha

ble

Linn Eastern Iowa Health Center 52403 Ramya Cedar Rapids Linn

Closed -

Unreacha

ble

Linn Eastern Iowa Health Center CEDAR RAPIDS Linn

Closed -

Unreacha

ble

Linn

EASTERN IOWA HOME

HEALTH CARE 52310 Anamosa Jones

Closed -

Duplicate

Linn

EIHC Eastern Iowa Health

Center Prachi Cedar Rapids Linn

Closed -

Unreacha

ble

Linn Mercy Care Vernon Village

3933 Mt Vernon Rd

SE

Cedar

Rapids 52403 Ann Cedar Rapids Linn

Closed -

Declined

Linn

Mercycare Community

Physicians

600 7th St SE Suite

101

Cedar

Rapids 52401 Monica Cedar Rapids Linn

Closed -

Unreacha

ble

Linn Monica Meeker

600 7th Street SE,

Suite 101

Cedar

Rapids 52401 Monica Cedar Rapids Linn

Closed -

Enrolled

Linn Prior Authorization 200 Virgil Ave Mt Vernon 52314 Ben Marion Linn

Closed -

Unreacha

ble

Linn Prior Authorization

600 7th Street SE,

Suite 101

Cedar

Rapids 52401 Monica Cedar Rapids Linn

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Linn Prior Authorization 855 A Ave NE #200

Cedar

Rapids 52402 Kristy Cedar Rapids Linn

Closed -

Unreacha

ble

Linn Prior Authorization 1444 2 Ave SE

Cedar

Rapids 52403 Merrilee Cedar Rapids Linn

Closed -

Enrolled

Linn Prior Authorization 830 4th Ave 8E Ste 1

Cedar

Rapids 52404 Ciek Marion Linn

Closed -

Declined

Linn Prior Authorization

9255 Atlantic Drive

SW

Cedar

Rapids Michelle Cedar Rapids Linn

Closed -

Invalid

Linn

Unity Point Clinic Marion

Family Medicine 52302 Jessica Marion Linn

Closed -

Unreacha

ble

Linn

Unity Point Westside Family

Medicince 52404 Cedar Rapids Linn

Closed -

Enrolled

Linn

UNITY POINT WESTSIDE

FAMILY MEDICINE 52404

DR

ANSHUL Toledo Tama

Closed -

Unreacha

ble

Linn

UnityPoint Multi-Specialty

Clinic 52402

Muhamma

d Cedar Rapids Linn

Closed -

Unreacha

ble

Linn

Westside Family Medicine

and Urgent Care Cedar Rapids Linn

Closed -

Enrolled

Lucas Prior Authorization

1200 North 7th

Street Chariton 50049 Phillip Chariton Lucas

Closed -

Intake

Only

Lyon Sanford Clinic Rock Rapids

803 South Green

Street Rock Rapids 51246 Beta Rock Rapids Lyon

Closed -

Already

Participati

ng

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Lyon Sanford Clinic Rock Rapids 51246 Rebecca Doon Lyon

Closed -

Unreacha

ble

Lyon

SANFORD CLINIC ROCK

RAPIDS

Closed -

Ineligible

Mahaska Plumpod 1229 C Ave East Tonya

University

Park Mahaska

Closed -

Enrolled

Mahaska Prior Authorization 1229 C Ave E Oskaloosa 52577 Jen Redfield Dallas

Closed -

Declined

Mahaska Prior Authorization 1229 C Ave E Oskaloosa 52577 T Oskaloosa Mahaska

Closed -

Unreacha

ble

mahaska Prior Authorization 1229 C Ave Oskaloosa Eric Oskaloosa Mahaska

Closed -

Unreacha

ble

Marshall

CENTERAL IOWA

HEALTHCARE-STATE

CENTER CLINIC 50247 Amanda Marshalltown Marshall

Closed -

Declined

Marshall mcfarland clinic meagan Marshalltown Marshall

Closed -

Unreacha

ble

Marshall Primary Health Care 50158 Becky Marshalltown Marshall

Closed -

Enrolled

Marshall Primary Health Care Tim

MARSHALLTO

WN Marshall

Closed -

Unreacha

ble

Marshall PRIMARY HEALTH CARE DEBORAH Marshalltown Marshall

Closed -

Ineligible

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Marshall Primary Health Care Unknow Gilman Marshall

Closed -

Unreacha

ble

Marshall Prior Authorization 303 Nicholas Drive

Marshalltow

n 50158 Maria Marshalltown Marshall

Closed -

Declined

Minnehaha AVERA MEDICAL GROUP

1301 S CLIFF AVE STE

601 SIOUX FALLS 57105 DR Terril Dickinson

Closed -

Enrolled

minnesota DIAB 56267 Cathy Burlington

Des

Moines

Closed -

Declined

minnesota MAYO CLINIC 55905 DR Farmersburg Clayton

Closed -

Unreacha

ble

Mitchell Prior Authorization 620 North 8th Street Osage 50461 Mark Osage Mitchell

Closed -

Enrolled

monona

BARGESS FAMILY CLINIC-

MAPLE VALLEY 51034 CHAD Ute Monona

Closed -

Duplicate

monona

Burgess Family Clinic-Maple

Valley 51034 Chad Ute Monona

Closed -

Enrolled

montgomer

y

Villioca Family Health

Center 50864 Tom Clarinda Page

Closed -

Unreacha

ble

montgomer

y

Villisca Family Health

Center 50864 Effie Stanton

Montgome

ry

Closed -

Enrolled

montgomer

y

VILLISCA FAMILY HEALTH

CENTER

Closed -

Ineligible

Muscatine Prior Authorization 1518 Mulberry Ave Muscatine Muscatine Muscatine

Closed -

Intake

Only

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Muscatine UI Healthcare Muscatine Christina Muscatine Muscatine

Closed -

Unreacha

ble

Not

Available

Atkins Family Medical

Center Stephanie Cedar Rapids Linn

Closed -

Unreacha

ble

Not

Available Avera Medical Grp Anthony Estherville Emmet

Closed -

Unreacha

ble

Not

Available CHC Naarah Burlington

Des

Moines

Closed -

Declined

Not

Available CHC Naarah Burlington

Des

Moines

Closed -

Declined

Not

Available COMMUNNITY HEALTH CTR

Closed -

Duplicate

Not

Available FAM MED

Closed -

Ineligible

Not

Available FAMILY MEDICINE CLINIC 51040

Closed -

Enrolled

Not

Available Family Medicine Clinic Dr Sioux City Woodbury

Closed -

Ineligible

Not

Available Health System Luana Clayton

Closed -

Unreacha

ble

Not

Available

Internal Med Central

Campus Michael

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Not

Available McFarland Clinic Jefferson Greene

Closed -

Enrolled

Not

Available Mercy Care Jerry Tama Tama

Closed -

Enrolled

Not

Available MERCY EAST VILLAGE

Closed -

Enrolled

Not

Available Mercy Family Care Jason Perry Dallas

Closed -

Enrolled

Not

Available Mercy Family Care-Perry Jason Polk City Polk

Closed -

Unreacha

ble

Not

Available Mercy Medical Center Clinton Clinton

Closed -

Already

Participati

ng

Not

Available Mercy Medical Center Davenport Scott

Closed -

Intake

Only

Not

Available Mercy Medical Center Clinton Clinton

Closed -

Unreacha

ble

Not

Available Mercy Medical center

Closed -

Unreacha

ble

Not

Available Methodist Physians 57503 Thomas Council Bluffs

Pottawatta

mie

Closed -

Unreacha

ble

Not

Available Methodist Physicians Clinc Thomas Council Bluffs

Pottawatta

mie

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Not

Available Ob Gyn Associates PC 52406 Scott Monticello Jones

Closed -

Unreacha

ble

Not

Available OIHC FAMILY MEDICINE

Closed -

Enrolled

Not

Available Parks Area Clinic NS 2301 E 14th Mukati Des Moines Polk

Closed -

Enrolled

Not

Available Parks Family Practice Erin Des Moines Polk

Closed -

Unreacha

ble

Not

Available

PRIMARY HEALTH CARE

CLINIC

Closed -

Duplicate

Not

Available

Primary Healthcare at

Mercy Des Moines Polk

Closed -

Unreacha

ble

Not

Available Prior Authorization Clarinda Page

Closed -

Unreacha

ble

Not

Available Prior Authorization Unknown Des Moines Polk

Closed -

Intake

Only

Not

Available Prior Authorization Laurens

Pocahonta

s

Closed -

Unreacha

ble

Not

Available

SIOUX LAND COMMUNITY

HELATH CENTER TYLER Sioux City Woodbury

Closed -

Unreacha

ble

Not

Available

SIOUXLAND COMMUNITY

HEALTH

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Not

Available UHIC Ambulatory Care Andrea Davenport Scott

Closed -

Intake

Only

Not

Available UI Health Ventures 52761 Dr Muscatine Muscatine

Closed -

Unreacha

ble

Not

Available UIHV 52761 Michael Muscatine Muscatine

Closed -

Enrolled

Not

Available United Point Clinic 52761 Kim 52791

Closed -

Unreacha

ble

Not

Available Unity Point Cardiology 50309 Creston Union

Closed -

Enrolled

Not

Available Unity Point Cardiology Paton Greene

Closed -

Enrolled

Not

Available Unity Point Cardiology Sushma Indianola Warren

Closed -

Ineligible

Not

Available Unity Point Clinic Katie Norwalk Warren

Closed -

Already

Participati

ng

Not

Available Unity Point Clinic Jessica Marion Linn

Closed -

Declined

Not

Available Unity Point Clinic Peggy Muscatine Muscatine

Closed -

Enrolled

Not

Available Unity Point Clinic Des Moines Polk

Closed -

Enrolled

Not

Available Unity Point Clinic Simran Davenport Scott

Closed -

Intake

Only

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Not

Available

Unity Point Family

Medicine Beth Muscatine Muscatine

Closed -

Unreacha

ble

Not

Available

Unity Point Family

Medicine Amanda DAVENPORT Scott

Closed -

Enrolled

Not

Available

Unity Point Family

Medicine Lindsay Wyoming Jones

Closed -

Enrolled

Not

Available

Unity Point Family

Medicine Kevin Eldridge Scott

Closed -

Ineligible

o'brien Sanford Hartley Obrien

Closed -

Unreacha

ble

o'brien Sanford Hartley 51346 Angela Hartley Obrien

Closed -

Duplicate

Page

Charinda Regional Medical

Center Clarinda Page

Closed -

Unreacha

ble

Page Clarinda Medical Associates 220 Essie Davison Dr. Clarinda 51632 Steven Clarinda Page

Closed -

Enrolled

page

Clarinda Regional Health

Center 51632 Tish Clarinda Page

Closed -

Unreacha

ble

page CMA 51632 Autumn Clarinda Page

Closed -

Unreacha

ble

Page CRHC 51632 Amy Braddyville Page

Closed -

Enrolled

page Medical Clinic PC 51640 Kylie Sidney Fremont

Closed -

Enrolled

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

page Medical Clinic PC 51653 Kristin Tabor Fremont

Closed -

Unreacha

ble

Page Prior Authorization

One Jack Foster

Drive Shenandoah 51601 Todd Shenandoah Page

Closed -

Enrolled

page Prior Authorization 1 Jack Foster Drive Todd Shenandoah Page

Closed -

Enrolled

Page

Shenandoah Medical

Center Satya Shenandoah Page

Closed -

Unreacha

ble

PAGE

Shenandoah Physicians

Clinic 51601 Susan Shenandoah Page

Closed -

Unreacha

ble

Plymouth

Floyd Valley Healthcare

FMC 51031 Geri Lynn Le Mars Plymouth

Closed -

Declined

Pocahontas Prior Authorization

307 West Highway

10 Laurens 50554 Kylie Laurens

Pocahonta

s

Closed -

Unreacha

ble

Pocahontas Prior Authorization 608 NW 7th St Pocahontas 50574 Ted Pomeroy Calhoun

Closed -

Enrolled

Pochahonta

s Prior Authorization

307 West Highway

10 Kylie Laurens

Pocahonta

s

Closed -

Declined

Pochahonta

s Prior Authorization

307 West Highway

10 Laurens Kylie Laurens

Pocahonta

s

Closed -

Enrolled

Polk

BROADLAWNS FAMILY

PRACTICE

1801 HICKMAN

ROAD DES MOINES 50314 Des Moines Polk

Closed -

Unreacha

ble

Polk

Broadlawns Internal

Medicine Consult Clinic Jason Des Moines Polk

Closed -

Already

Participati

ng

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Polk DMU Clinic 3200 Grand Ave Des Moines 50312 April Des Moines Polk

Closed -

Enrolled

polk Mercy Beaverdale Clinic 50310 Mary Des Moines Polk

Closed -

Duplicate

polk Mercy Beaverdale Clinic Mary Des Moines Polk

Closed -

Unreacha

ble

Polk Mercy Capitol 4630 Douglas Des Moines 50309 Des Moines Polk

Closed -

Enrolled

Polk

Mercy West Family Practice

and Urgent Care 50325 Elizabeth Des Moines Polk

Closed -

Already

Participati

ng

Polk

Mercy West Family Practice

and Urgent Care 50325 Elizabeth Des Moines Polk

Closed -

Already

Participati

ng

Polk Oncol NS 1801 Hickman Rd Des Moines Julie Altoona Polk

Closed -

Unreacha

ble

polk Penn Ave Internal Medicine Lindsay Saint Marys Warren

Closed -

Unreacha

ble

polk Primary Health Care 50320 Rebecca Des Moines Polk

Closed -

Enrolled

Polk Primary Health Care Katy Ankeny Polk

Closed -

Intake

Only

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Polk

Primary Health Care @

Mercy 50314 Elizabeth Des Moines Polk

Closed -

Unreacha

ble

polk Primary Health Care Clinic 50320 Katy Ankeny Polk

Closed -

Duplicate

Polk Primary Health Care, Inc. 50314 Deanna Des Moines Polk

Closed -

Unreacha

ble

polk Primary Healthcare East 3509 E 29th St Louise Bondurant Polk

Closed -

Unreacha

ble

Polk Prior Authorization 5615 NW 86th St Johnston 50131 Jennifer Carlisle Warren

Closed -

Enrolled

Polk Prior Authorization 1350 Des Moines St Des Moines 50309 Sara

Closed -

Unreacha

ble

Polk Prior Authorization

2103 Ingersoll

Avenue Des Moines 50312 Robert Des Moines Polk

Closed -

Unreacha

ble

Polk Prior Authorization

6601 Southwest 9th

Street Des Moines 50315 Anne Altoona Polk

Closed -

Declined

Polk Prior Authorization 6601 SW 9th St Des Moines 50315 Anne Des Moines Polk

Closed -

Unreacha

ble

Polk Prior Authorization 4821 SW 9th St Des Moines 50315 Sheryl Des Moines Polk

Closed -

Intake

Only

Polk Prior Authorization 6601 SW 9th St Des Moins 50315 Lindy Des Moines Polk

Closed -

Declined

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Polk Prior Authorization 2301 E 14th St Des Moines 50316 Erin Des Moines Polk

Closed -

Intake

Only

Polk Prior Authorization 2901 86th St Urbandale 50322 Ed Urbandale Polk

Closed -

Enrolled

Polk Prior Authorization 2901 86th St Urbandale 50322 Ed

West Des

Moines Polk

Closed -

Enrolled

Polk Prior Authorization 5900 E University Pleasant Hill 50327 Tawnya Des Moines Polk

Closed -

Unreacha

ble

Polk Prior Authorization 5900 East University Pleasant Hill 50327 Illa Altoona Polk

Closed -

Enrolled

polk Prior Authorization

1211 Vine Street,

Suite 2224 Kathleen WDM Polk

Closed -

Enrolled

polk Southglen 50320 Unity Point Des Moines Polk

Closed -

Enrolled

polk Southglen Family Practice Amy Des Moines Polk

Closed -

Enrolled

Polk Southglen FP 7481 Hwy 65/69 Des Moines 50320 Jennifer Des Moines Polk

Closed -

Invalid

polk

UNITY POINT CLINCK PARKS

AREA 50316 Erin Des Moines Polk

Closed -

Declined

Polk

Unity Point East Des

Moines Family Medicine 50316 Alexandra Des Moines Polk

Closed -

Declined

polk UNITY POINT SOUTHGLEN Ankeny Polk

Closed -

Enrolled

polk UNITY POINT SOUTHGLEN

Closed -

Duplicate

polk Unity Point Southglen Jennifer Des Moines Polk

Closed -

Enrolled

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Pottawatta

mie All Care Health Center 51501 Kelly Sidney Fremont

Closed -

Unreacha

ble

pottawatta

mie All Care Health Center 51503 Christy Council Bluffs

Pottawatta

mie

Closed -

Declined

Pottawatta

mie All Care Health Center Teresa Council Bluffs

Pottawatta

mie

Closed -

Already

Participati

ng

Pottawatta

mie All Care Health Center Afeera Council Bluffs

Pottawatta

mie

Closed -

Intake

Only

Pottawatta

mie All Care Health Center Afeera Council Bluffs

Pottawatta

mie

Closed -

Declined

Pottawatta

mie CHI Health 51501 Joyce Council Bluffs

Pottawatta

mie

Closed -

Enrolled

Pottawatta

mie

Heartland Oncology and

Hematology 51503 Sakeer Neola

Pottawatta

mie

Closed -

Unreacha

ble

Pottawatta

mie

Methodist Council Bluffs

Ob/Gyn 51503 Lori Council Bluffs

Pottawatta

mie

Closed -

Enrolled

POTTAWATT

AMIE Methodist Edmunson 51503 Rachel Council Bluffs

Pottawatta

mie

Closed -

Unreacha

ble

POTTAWATT

AMIE

METHODIST JEANIE

EDMUNDSON HOSP 51503 Council Bluffs

Pottawatta

mie

Closed -

Enrolled

Pottawatta

mie METHODIST JENNIE PAUL Council Bluffs

Pottawatta

mie

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Pottawatta

mie

METHODIST JENNIE

EDMANDSON HOSP

Closed -

Already

Participati

ng

Pottawatta

mie

Methodist Jennie

Edmundson 51503 Dr Council Bluffs

Pottawatta

mie

Closed -

Unreacha

ble

POTTAWATT

AMIE

Methodist Jennie

Edmundson 51503 Evelyn Council Bluffs

Pottawatta

mie

Closed -

Unreacha

ble

POTTAWATT

AMIE

Methodist Jennie

Edmundson Hosp 51503 Council Bluffs

Pottawatta

mie

Closed -

Unreacha

ble

POTTAWATT

AMIE

Methodist Jennie

Edmundson Hosp

Missouri

Valley Harrison

Closed -

Unreacha

ble

POTTAWATT

AMIE

Methodist Jennie

Edmundson Hospital 51503 Council Bluffs

Pottawatta

mie

Closed -

Declined

POTTAWATT

AMIE

Methodist Jennie

Edmundson Hospital 51503 Red Oak

Montgome

ry

Closed -

Enrolled

pottawatta

mie Methodist Jennie Hosp Council Bluffs

Pottawatta

mie

Closed -

Unreacha

ble

Pottawatta

mie

METHODIST PHYSICAINS

CLINIC 51503 THOMAS Council Bluffs

Pottawatta

mie

Closed -

Unreacha

ble

Pottawatta

mie Methodist Physician Clinic 51503 Thomas Council Bluffs

Pottawatta

mie

Closed -

Enrolled

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Pottawatta

mie Methodist Physicians 51503 DR Nadia Carson

Pottawatta

mie

Closed -

Already

Participati

ng

Pottawatta

mie Methodist Physicians Clinic 51503 Thomas Carter Lake

Pottawatta

mie

Closed -

Unreacha

ble

Pottawatta

mie Methodist Physicians Clinic Thomas Council Bluffs

Pottawatta

mie

Closed -

Duplicate

Pottawatta

mie Prior Authorization

3135 W Broadway

Ste 100

Council

Bluffs 51501 Jamie Council Bluffs

Pottawatta

mie

Closed -

Enrolled

Pottawatta

mie Prior Authorization 1701 W Broadway Council Bluff 51501 Laura Council Bluffs

Pottawatta

mie

Closed -

Unreacha

ble

Pottawatta

mie Prior Authorization 1751 Madison Ave

Council

Bluffs 51503 Elizabeth Carter Lake

Pottawatta

mie

Closed -

Declined

pottawatta

mie Prior Authorization 3135 W Broadway Council Bluff Kavish Council Bluffs

Pottawatta

mie

Closed -

Unreacha

ble

Rinnggold Mount Ayr Medical Clinic 50854 Ron Kellerton Ringgold

Closed -

Duplicate

Rinnggold Mount Ayr Medical Clinic 50854 Ron Kellerton Ringgold

Closed -

Duplicate

Rinnggold Mount Ayr Medical Clinic 50854 Ron Kellerton Ringgold

Closed -

Enrolled

Sac McCray Rost Clinic 1160 3rd St Lakeview 51450 Mark Auburn Sac

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Sac Prior Authorization 301 Hynland Ave Sac City 50583 Bernadette Newell

Buena

Vista

Closed -

Unreacha

ble

Scott Cardiovascular Medicine 52803 Peter Davenport Scott

Closed -

Intake

Only

Scott Community Health Care 52801 Anne Davenport Scott

Closed -

Unreacha

ble

Scott Community Health Care 52801 Anne Davenport Scott

Closed -

Unreacha

ble

Scott Community Health Care 52801 Sarah Davenport Scott

Closed -

Intake

Only

Scott Community Health Care 52801 Stephanie Davenport Scott

Closed -

Unreacha

ble

Scott Community Health Care 52801 Stephanie Davenport Scott

Closed -

Intake

Only

Scott Community Health Care 52804 Davenport Scott

Closed -

Enrolled

Scott Community Health Care Ashlee Davenport Scott

Closed -

Invalid

Scott Community Health Care Davenport Scott

Closed -

Unreacha

ble

Scott Community Health Care Stephanie Davenport Scott

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Scott COMMUNITY HEALTH CARE

Closed -

Unreacha

ble

Scott COMMUNITY HEALTH CARE

Closed -

Enrolled

Scott Community Health Care Anne Davenport Scott

Closed -

Declined

Scott

COMMUNITY HEALTH

CENTER

Closed -

Invalid

Scott

COMMUNITY HEALTH

CENTER

Closed -

Unreacha

ble

Scott

COMMUNITY HEALTH

CENTER

Closed -

Invalid

Scott

Genesis Family Medical

Center 1345 W Central Park Davenport 52804 Davenport Scott

Closed -

Unreacha

ble

Scott Genesis Health Group 52722 Jason Bettendorf Scott

Closed -

Already

Participati

ng

Scott Genesis Health Group 301 N 4th St Eldridge 52748 Carla Eldridge Scott

Closed -

Ineligible

Scott Genesis Health Group Jason Bettendorf Scott

Closed -

Enrolled

Scott

Genesis Pulmonary

Associates 52807 Humphrey Davenport Scott

Closed -

Unreacha

ble

Scott Gensis Family Center 1345 W Central Pk Davenport 52804 DAVENPORT Scott

Closed -

Declined

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Scott Medicaid Referral 1345 W Central pk Davenport Dr Davenport Scott

Closed -

Enrolled

Scott Prior Authorization 2140 53rd Avenue Bettendorf 52722 Stacie Davenport Scott

Closed -

Unreacha

ble

Scott Prior Authorization

301 North 4th

Avenue Eldridge 52748 Carlos ELDRIDGE Scott

Closed -

Enrolled

Scott Prior Authorization 1345 W Central Pk Davenport 52804 Christina Eldridge Scott

Closed -

Enrolled

Scott Prior Authorization 4317 53rd Street Janki

Closed -

Enrolled

Scott Prior Authorization 1345 W Central Park Davenport Thang Davenport Scott

Closed -

Unreacha

ble

Scott Prior Authorization 1345 W Central Pk Davenport Jen ELDRIDGE Scott

Closed -

Enrolled

Scott Unity Point Clinic B

4480 Utica Ridge Rd

Suite 2236 Betterndorf 52722 Nilsn Davenport Scott

Closed -

Declined

Scott Unity Point Clinic B 4480 Utica Ridge Rd Bettendorf Nilesh Davenport Scott

Closed -

Enrolled

Scott Unity Point Spring St Davenport Scott

Closed -

Intake

Only

shelby

Myrtue Center Department

of Community Health 51537

HCCMS

Family

Health

Services Harlan Shelby

Closed -

Already

Participati

ng

sioux

Hawarden Regional

Healthcare 51023 Mindy HAWARDEN Sioux

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

sioux

Hawarden Regional

Healthcare 51023 Beau Hawarden Sioux

Closed -

Enrolled

south

dakota Avera Medical Group 51334 Anthony Estherville Emmet

Closed -

Duplicate

south

dakota

Avera Medical Group

Pulmonary 57105 Dr Estherville Emmet

Closed -

Enrolled

south

dakota Avera Pulmonary Ashton Osceola

Closed -

Unreacha

ble

south

dakota

AVERA PULMONARY AND

SLEEP 57105 DR Terril Dickinson

Closed -

Already

Participati

ng

Story McFarland Clinic PC 1215 Duff Ave Ames 50010 Ricardo Ames Story

Closed -

Unreacha

ble

Tama Prior Authorization 501 Clark Street Dysart 52224 Nicole Waterloo Black Hawk

Closed -

Invalid

Taylor CHI 50833 Allison New Market Taylor

Closed -

Already

Participati

ng

Taylor Hardin Clinic 408 Dodge St Bedford 50833 Michelle Coin Page

Closed -

Intake

Only

Taylor Hardin Clinic 408 Dodge St Bedford 50833 Michelle Coin Page

Closed -

Intake

Only

Taylor Lenox Medical Clinic 100 S Main St Lenox 50851 Darcy Lenox

Closed -

Enrolled

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Union GRMC 1700 W Townline St Creston 50801 Lonny Wilton Muscatine

Closed -

Invalid

van buren Fox RIver Clinic Birmingham Van Buren

Closed -

Declined

VanBuren Prior Authorization 307 Franklin Street Keosauqua 52565 James Bloomfield Davis

Closed -

Enrolled

Wapello Eddieville Clinic

PO Box 576 107 N

3rd Eddieville 52553 Shelley Eddyville Wapello

Closed -

Enrolled

Wapello

River Hills Community

Health Center Kim Ottumwa Wapello

Closed -

Ineligible

Warren Prior Authorization

307 East Scenic

Valley Avenue Indianola 50125 Sarah Milo Warren

Closed -

Unreacha

ble

Washington Prior Authorization

3056 Rivercrossing

Ct Riverside 52327 David Keokuk Lee

Closed -

Unreacha

ble

Washington Prior Authorization

3056 River Crossing

Court Riverside 52327 Elizabeth Washington

Washingto

n

Closed -

Unreacha

ble

Washington WCHC Family Medicine 1230 S Iowa Ave Washington 52353 Matthew Washington

Closed -

Enrolled

Webster Community Health Center

126 North 10th

Street Fort Dodge 50501 Darlene Badger Webster

Closed -

Unreacha

ble

Webster Community Heath Center

126 North 10th

Street Fort Dodge 50501 Ann Fort Dodge Webster

Closed -

Unreacha

ble

Webster Prior Authorization 176 N 10th St Fort Dodge 50501 Michelle Fort Dodge Webster

Closed -

Unreacha

ble

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Webster Prior Authorization 126 N10th St Ft Dodge 50501 Michelle Fort Dodge Webster

Closed -

Enrolled

Webster Prior Authorization 800 Kenyon Rd Fort Dodge 50501 Jennifer Fort Dodge Webster

Closed -

Enrolled

Webster Prior Authorization

126 North 10th

Street Jennifer

Closed -

Unreacha

ble

Winneshiek winneshiek medical center 52101 kristen Decorah

Winneshie

k

Closed -

Unreacha

ble

Woodbury Family Medicine Center 51104 Dr Sioux City Woodbury

Closed -

Unreacha

ble

Woodbury Family Medicine Clinic 51104 Dr Dakota City Dakota

Closed -

Invalid

woodbury Jackson Recovery 800 5th st Sioux City Rachel Sioux City Woodbury

Closed -

Enrolled

woodbury

Mercy Medical Center Sioux

City 51102 Sioux City Woodbury

Closed -

Unreacha

ble

Woodbury Prior Authorization 307 East Main Street Anthon 51004 James Correctionville Woodbury

Closed -

Unreacha

ble

Woodbury Prior Authorization

1021 Nebraska

Street Sioux City 51105 Lavone

Closed -

Declined

Woodbury

Sioux Land Community

Health 51105 Sioux City Woodbury

Closed -

Unreacha

ble

Woodbury

SIOUX LAND COMMUNITY

HEALTH CENTER 51105

Closed -

Enrolled

County Clinic Name Clinic Address Clinic City

Clinic Zip

Code

Referred

By First

Name

Participant

City

Participant

County Status

Woodbury

Sioux Land Community

Health Center 51105 Staci Sioux City Woodbury

Closed -

Unreacha

ble

Woodbury

Siouxland Community

Health Center 51105 Staci Sioux City Woodbury

Closed -

Enrolled

Woodbury

Siouxland Community

Health Center 51105 Staci Sioux City Woodbury

Closed -

Intake

Only

Woodbury

Siouxland Medical

Education Foundation 2501 Pierce St Sioux City 51104 Cara

Closed -

Ineligible

Woodbury

Siouxland Medical

Education Foundation 2501 Pierce St Sioux City 51104 Cara

Closed -

Duplicate