Participant ClinicCounty Clinic Name Clinic Address Clinic .

Transcription

ClinicCountyClinic NameClinic AddressClinic CityClinicZipReferred ByLast NameReferred By FirstParticipantNameParticipant City CountyAdamsPrior Authorization601 Rosary eePrior Authorization105 E Main cy Medical Clinic Centerville19876 St Joseph AppanoosePrior Authorization19876 St nAudubon Family Audubon Family Healthcare kins Family Medical CenterVogelerStephanieCedar RapidsLinnClosed - EnrolledClosed UnreachableClosed UnreachableClosed UnreachableClosed terlooBlack HawkClosed - EnrolledBlackHawkCovenant Clinic50702PathmanathanSubaWaterlooBlack HawkBlackHawkCovenant Medical Center50702MustaficUnknownWaterlooBlack HawkClosed - DeclinedClosed UnreachableBlackHawkPartners in Ob/Gyn50702SolheimKarlaWaterlooBlack Hawk50702BernstromMitchelWaterlooBlack HawkGettmanSuzanneMartha Hall /TimothyIndependence BuchananWaterlooBlack HawkKiranWaterlooBlack HawkWaterlooBlack HawkClosed - DuplicateClosed - IntakeOnlyClosed Unreachable1015 S Hackett RdWaterloo2055 Kimball Ave Ste400WaterlooStatusClosed UnreachableClosed - IntakeOnlyClosed - DuplicateClosed - IntakeOnlyClosed UnreachableBlackHawkPrior AuthorizationBlackHawkFamily Medicine Waterloo Unity Point Clinic50703BlackHawkFamily Medicine Waterloo UnityPoint Clinic50703BlackHawkPeople Community Health Clinic50703BlackHawkPeoples Community Health ClinicBlackHawkPeoples Community Health Clinic50703GutzEmilyWaterlooBlack HawkClosed - DeclinedBlackHawkPeoples Community Health Clinic50703KaneSarahWaterlooBlack HawkBlackHawkPrior Authorization3562 Lafayette RdEvansdale50707CrawfordTammyEvansdaleBlack HawkBlackHawkPrior Authorization3562 Lafayette RoadEvansdale50707CrawfordTammyEvansdaleBlack HawkBlackHawkCovenant ClinicPathimanathanSubaWaterlooBlack HawkClosed - EnrolledClosed UnreachableClosed UnreachableClosed UnreachableBlackHawkCOVENANT MIDWIVES & WOMEN'S HEALTH905 Franklin stWaterlooIjaz50703Closed - Invalid

Clinic AddressClinic CityClinicZipReferred ByLast NameClinicCountyClinic NameBlackHawkFamily Medicine WaterlooBlackHawkFamily Medicine WaterlooHallBlackHawkFM waterlooBlackHawkReferred By FirstParticipantNameParticipant City CountyStatusWaterlooBlack HawkMarthaWaterlooBlack HawkHorriganTImWaterlooBlack HawkPEOPLES COMMUITY HEALTH CLINICIJAZKIRANWaterlooBlack HawkClosed - EnrolledClosed UnreachableBlackHawkPeoples Community Health ClinicBonthuisHeidiEvansdaleBlack HawkClosed - EnrolledBlackHawkPEOPLES COMMUNITY HEALTH CLINICGUTZEMILYWaterlooBlack HawkClosed - EnrolledBlackHawkPrior AuthorizationRenaudTroyLa Porte CityBlack HawkBooneBoone County Comp SpecialtyBOONE COUNTY COMPREHENSIVESPECIALTY CLINICBoone County Comprehensive SpecialtyClinic50036McIntireTraceyCoon RapidsCarroll50036TEMPLEDR.BooneBooneClosed - EnrolledClosed UnreachableClosed ve Specialty CareBremerWaverly Health CenterBremerWaverly Health Center- Women's ClinicBuchananPrior AuthorizationButler601 Highway 218 N564 K AVENUE1015 Union St Suite120BOONEBooneClosed - EnrolledClosed - AlreadyParticipatingClosed - DuplicateClosed UnreachableClosed UnreachableClosed ence BuchananPeople's Clinic Butler d - DeclinedClosed UnreachableButlerGreene Family Clinic - Mercy50636BischottPatriciaGreeneButlerClosed - DeclinedButlerGreene Family Clinic - Mercy50636BischottPatriciaGreeneButlerClosed - DeclinedButlerPrior Authorization502 3rd StreetParkersburg50665RekersGinaCarrollIowa Heart CenterCarroll51401FeijofskySuzanneLake CityCalhounClosed - EnrolledCarrollPrior Authorization405 S Clark St515 North d - InvalidCerroGordoMercy Interrnal Medicine50401HedrickLisaMason CityCerro GordoClosed - EnrolledCerroGordoMercy Medical Center North Iowa50401TalebAmeenCharles CityFloydClosed - Enrolled1094 220th Street1000 4th St SWJesupMason CityClosed - Enrolled

ClinicZipReferred ByLast NameReferred By FirstParticipantNameParticipant City County50401RoyDenulMason CityCerro Gordo50401SinghJasjitMason CityCerro GordoPrior Authorization1010 4th St Suite 240 Mason City1010 4th st sw suite340Mason City1010 4th Street SW,Suite 340Mason CitySinghJasjitCherokeeCherokee Regional Clinic300 Sioux Valley kee Regional Clinic300 Sioux Valley DrCherokee51012BrendaCherokeeCherokeeCherokee Regional Clinic300 Soiux Valley herokeePrior Authorization300 Sioux Valley eClosed - EnrolledClayAvera Medical Group Spencer51301PetersonJeffreySpencerClayClosed - DeclinedClayAvera Medical Group51334CookAnthonyEsthervilleEmmetClayAvera Medical GrpCookAnthonyEsthervilleEmmetClayPrior Authorization337 11th Street SWSpencerNelsonKathrynSibleyOsceolaClosed - DuplicateClosed UnreachableClosed - AlreadyParticipatingClaytonPrior Authorization200 MainGuttenbergDikkersMicheleMc GregorClaytonClosed - EnrolledClaytonRegional Family Health702 W Union StEdgewoodChristiansenScotIndependence BuchananClintonCommunity Health y Health 32DelmarClintonClintonPrior AuthorizationClintonPrior AuthorizationClintonClinicCountyClinic NameClinic AddressCerroGordoPrior AuthorizationCerroGordoPrior AuthorizationCerroGordoClinic City507 South 4th Street Clinton915 13th AvenueNorthClinton52052StatusClosed - InvalidClosed UnreachableClosed - IntakeOnlyClosed - IntakeOnlyClosed - DeclinedClosed UnreachableClosed - EnrolledClosed UnreachableClosed - DuplicateClosed UnreachableClosed ffmanThersaClintonClintonMMc-CClintonClintonClosed - InvalidClosed UnreachableClintonMMc-CCamancheClintonClosed - EnrolledClintonDr OsaroClintonClintonClosed - EnrolledDallasMMC ADELAdelDallasClosed - EnrolledOsaro1120 Greene StAdel50003BaltzellChristopher

Clinic CityClinicZipReferred ByLast NameReferred By FirstParticipantNameParticipant City p30 East Hickman Road Waukee50263ClinicCountyClinic NameClinic AddressDallasMerry Clinic PerryDallasPrior Authorization30 E Hickman RdDallasPrior AuthorizationDallasDallasClosed - EnrolledJennaPerryWest DesMoinesPolkClosed - IneligibleEngel-BrowerHannaWaukeeDallasClosed - EnrolledMercy Clinic PerrySohaStevenWoodwardDallasDallasMercy Family Care-PerryNobleJasonPolk CityPolkDecaturCommunity Health Centers of Southern Iowa 302 NW 14th StLeon50144SpearlJenniferLeonDecaturDecaturPrior AuthorizationLeon50144AllenNathanGarden GroveDecaturDesMoinesCOMMUNITY HEALTH CENTER52655ZwanzigerRebeccaBurlingtonDes MoinesDesMoinesCommunity Health Center Southeast IowaGreat River Medical Center - RespiratoryCare52655LhrigDR TIMOTHY52655Kiswani-BarleyDrBurlingtonDes MoinesKeokukLeeBurlingtonDes MoinesClosed - DeclinedClosed UnreachableClosed UnreachableClosed UnreachableClosed UnreachableClosed - IntakeOnlyClosed UnreachableClosed UnreachableClosed UnreachableWapelloLouisaClosed - InvalidClosed UnreachableDesMoines302 NE 14th StreetDesMoinesPrior AuthorizationDesMoinesBAFPDesMoinesCOMMUNITY HEALTH CENTER SE IADesMoinesGreat River Medical CenterDouglasPrior Authorization10109 Maple StreetOmaha68134JanssenMistyCouncil BluffsPottawattamieClosed - EnrolledDouglasPrior Authorization10109 Maple StreetOmaha68134JanssenCouncil BluffsPottawattamieDubuqueCare for Yourself52001MistyVisiting NurseAssociationDubuqueDubuqueClosed - EnrolledClosed UnreachableDubuqueMEDICAL ASSOCIATES52001STILLEDR RYANDubuqueDubuqueDubuqueMedical eWetscherSaraDubuqueDubuqueDubuqueUnity Point Clinic Finley CardiologyDubuqueUnity Point Clinic Finley CardiologyDubuqueMedical Associates Family Medicine1225 S Gear Ave1225 S Gear Ave Ste159WestBurlington52655W Burl350 North GrandviewAve Suite G3300Dubuque350 North GrandviewAve Suite G3300DubuqueLakeLisaClosed - EnrolledClosed UnreachableClosed UnreachableClosed - EnrolledClosed - AlreadyParticipating

ClinicZipReferred ByLast NameReferred By FirstParticipantNameParticipant City CountyCovenant Clinic50662DavisGaylaFayetteCOVENANT CLINIC50662DavisGaylaFayettePrior Authorization129 8th Avenue r Authorization1501 S Main St Ste 1Charles City50616SchweilerDavidCharles CityFloydClosed - EnrolledClosed UnreachableFranklinMCRHC Osage Clinic620 N 8th stOsage50431HaganmanMarkOsageMitchellClosed - DuplicateFremontMedical Clinic PC51640ParshallKylieSidneyFremontFremontMedical Clinic PC51653GoldenKristinTaborFremontGuthrieGCH Clinics50216StrehleJoshPanoraGuthrieGuthrieGCH Clinic Stuart50250McClearyMichaelStuartGuthrieClosed - EnrolledClosed UnreachableClosed UnreachableClosed - AlreadyParticipatingGuthrieGCH ClinicMcClearyMichaelStuartGuthrieHamiltonVandiest Family Clinic50595DuerrKathrynWebster CityHamiltonHamiltonVandiest Family Clinic50595EhnNicoleJewellHamiltonHardinIowa Falls Clinic50126SchmidtErinHamptonFranklinHardinPrior Authorization920 South Oak Street Iowa Falls50126ScottSarahCoulterFranklinClosed - EnrolledClosed UnreachableClosed UnreachableClosed - IntakeOnlyClosed UnreachableHardinMcFarland Clinic7413 Eddington Ave50627HenkenAbigalEldoraHardinClosed - EnrolledHardinMcFarland Clinic Eldora50627HeiarAaronEldoraHardinClosed - DuplicateHardinPrior Authorization50627HeiarAaronEldoraHardinClosed - IneligibleHarrisonCHI Logan51546GradyCarrieLoganHarrisonHarrisonCHi Logan51546GradyCarrieLoganHarrisonHarrisonCHI Logan51546AlvisNathanielLoganHarrisonClosed - EnrolledClosed - AlreadyParticipatingClosed - AlreadyParticipatingHarrisonCHI Logan51546AlvisNathanielLoganHarrisonClosed - EnrolledHowardCresco Medical Clinic52136SchlangenTraceyElmaHowardClosed - DuplicateClinicCountyClinic NameFayetteClinic AddressClinic City2350 Hospital Dr2413 Edginton AveEldoraEldoraFairbankBuchananStatusClosed UnreachableClosed - Declined

ClinicZipReferred ByLast NameReferred By FirstParticipantNameParticipant City County52136SchlangenTraceyElmaHowardStatusClosed Unreachable321 8th Avenue West Cresco52136DutkaJessicaCrescoHowardClosed - EnrolledWilliamsburg Family Medical Clinic498 N Highland Closed - EnrolledIowaWilliamsburg Family Medical Clinic498 N Highland StWilliamsburg52361mALLORYmICHELLEDeep RiverPoweshiekClosed - EnrolledJackonMaquokita Family Clinic52060LakinAlyssaMaquoketaJacksonClosed - DeclinedJacksonMedical anTyMarshalltownMarshallClosed - IneligibleClosed entesnierMatthewIowa CityJohnsonClinicCountyClinic NameHowardCVESCO Medical ClinicHowardPrior AuthorizationIowaClinic AddressClinic CityJasperNewton Clinic, PCJasperNewton Clinic, PC300 North 4th AvenueEast, Suite 200Newton300 North 4th AvenueEast, Suite 200NewtonJohnsonPrior Authorization1130 S Scott BlvdJohnsonFamily Medicine Iowa River Landing East52241BanuHussainGoose LakeClintonJohnsonFamily Medicine Iowa River Landing East52241BanuHussainGoose LakeClintonJohnsonIowa River Landing East Family Medicine52241ShaikShalinaKeokukLeeJohnsonDental Special Geriatric Dept322 Dental ScienceIowa CIty52242WellsEldridgeScottJohnsonFamily Medicine200 Hawkins DrIowa City52242RayBrigitWest BranchCedarJohnsonInternal Medicine200 Hawkins DrIowa City52242BarkerJasonCedar FallsBlack HawkJohnsonPeriodontics Clinic Univeristy of IA52242HumbertDavenportScottJohnsonUIHC200 HAWKINS DRIOWA CITY52242JohnsonUIHC - Family Medicine200 Hawkins DriveIowa City52242WilcoxGarrettIowa CityJohnsonJohnsonUIHC Family Med200 Hawkins DrIowa city52242ApantakuEloraNorth EnglishIowaJohnsonUniversity of Iowa Hospitals & Clinics200 Hawkins DrIowa City52242KrauseSaraCaseyGuthrieJohnsonPrior Authorization200 Hawkins DriveIowa City52243TerveenMargaretCedar RapidsLinnJohnsonPrior Authorization1067 Ryan CourtIowa City52246ShiMeiIowa CityJohnsonIowa CityClosed - IneligibleClosed UnreachableClosed - IntakeOnlyClosed - DuplicateClosed UnreachableClosed - EnrolledClosed UnreachableClosed UnreachableClosed UnreachableClosed UnreachableClosed - EnrolledClosed UnreachableClosed UnreachableClosed - IntakeOnlyClosed Unreachable

ClinicCountyClinic NameClinic AddressClinic CityClinicZipReferred ByLast NameReferred By FirstParticipantNameParticipant City CountyJohnsonPrior Authorization3 Lions DrN Liberty52317FarrellAngelaJohnsonJohnson County Public HealthJohnsonPrior AuthorizationJohnsonTaegerVincentCedar RapidsLinnIA River Landing East Family MedRobinsonKathleenIowa CityJohnsonJohnsonIRL East Family MedicineShaikShalinaBennettCedarJohnsonUHIC Ambulatory CareNeutsonAndreaDavenportScottJonesPrior AuthorizationSchepanskiAlissaTiptonCedarClosed - DeclinedClosed UnreachableClosed - AlreadyParticipatingClosed UnreachableClosed UnreachableClosed - IntakeOnlyClosed UnreachablejonesEASTERN IOWA HOME HEALTH CAREAnamosaJonesClosed - DuplicateKeokukKCHC Medical ClinicWhat CheerKeokukKossuthKossuth Regional Health CenterAlgonaKossuthLinnPrior AuthorizationLinnMercycare Community PhysiciansClosed - EnrolledClosed - IntakeOnlyClosed UnreachableClosed UnreachableLinnMonica MeekerLinnPrior AuthorizationLinnEastern Iowa Health CenterLinnPrior AuthorizationLinn1765 Lininger Lane1791 Hwy 64 ENorth LibertyAnamosa52205523101314 StuartSigourney52591EdwardsShellyGrindberg200 Virgil Ave600 7th St SE Suite101600 7th Street SE,Suite 101600 7th Street SE,Suite 101North LibertyJohnsonIowa CityJohnsonStatusMt Vernon52314DanielsBenMarionLinnCedar Rapids52401MeekerMonicaCedar RapidsLinnCedar Rapids52401MeekerMonicaCedar RapidsLinnCedar Rapids52401MeekerMonicaCedar RapidsLinnCedar RapidsLinn52402Closed - EnrolledClosed Unreachable52402KapfhamerKristyCedar RapidsLinnUnityPoint Multi-Specialty Clinic52402AnwerMuhammadCedar RapidsLinnLinnEastern Iowa Health Center52403MaturaRamyaMarionLinnLinnEastern Iowa Health Center52403MaturuRamyaCedar RapidsLinnClosed - DuplicateClosed UnreachableClosed UnreachableClosed UnreachableClosed Unreachable855 A Ave NE #200Cedar RapidsLinnMercy Care Vernon Village3933 Mt Vernon RdSELinnPrior Authorization1444 2 Ave SECedar Rapids52403RamseyMerrileeCedar RapidsLinnClosed - EnrolledLinnPrior Authorization830 4th Ave 8E Ste 1Cedar Rapids52404YoungerCiekMarionLinnClosed - DeclinedCedar Rapids52403SoenenAnnCedar RapidsLinnClosed - Declined

ClinicZipReferred ByLast NameUnity Point Westside Family Medicince52404JainLinnUNITY POINT WESTSIDE FAMILY MEDICINE52404JAINLinnAbbe Center52405LinnOb Gyn Associates PC52406LinnEASTER IOWA HEALTH CENTERLinnClinicCountyClinic NameLinnClinic AddressClinic CityReferred By FirstParticipantNameParticipant City CountyCedar RapidsLinnDR celloJonesEastern IA Health CenterWillisBradleyCedar RapidsLinnLinnEastern IA Health CenterLivermoreUrsulaCedar RapidsLinnLinnEastern IA Health CenterAnamosaJonesLinnEastern Iowa Health CenterLinnHYVEE Pharm AlbiaLinnPrior AuthorizationLinn520 11th Street NWCedar RapidsCEDAR RAPIDS LinnUI Womens Hlth 200Hawkins DrIowa City9255 Atlantic DriveSWCedar RapidsMazurEugeniaAlbiaMonroeVetschMichelleCedar RapidsLinnBowman Woods Family PracticeStewartTeresaCedar RapidsLinnLinnEIHC Eastern Iowa Health CenterJundalPrachiCedar RapidsLinnLinnWestside Family Medicine and Urgent CareCedar RapidsLinnLucasPrior AuthorizationLyonSanford Clinic Rock RapidsLyonSanford Clinic Rock RapidsLyonSANFORD CLINIC ROCK RAPIDSMahaskaPrior Authorization1229 C Ave EOskaloosa52577ScottJenRedfieldDallasMahaskaPrior Authorization1229 C Ave mpod1229 C Ave EastJohauuesTonyaUniversity Park MahaskaMahaskaPrior Authorization1229 C AveMillerEricOskaloosa1200 North 7th Street Chariton803 South GreenStreetRock aRock RapidsLyon51246RoemenRebeccaDoonLyonStatusClosed - EnrolledClosed UnreachableClosed - EnrolledClosed UnreachableClosed UnreachableClosed UnreachableClosed - IntakeOnlyClosed - EnrolledClosed UnreachableClosed - IntakeOnlyClosed - InvalidClosed UnreachableClosed UnreachableClosed - EnrolledClosed - IntakeOnlyClosed - AlreadyParticipatingClosed UnreachableClosed - IneligibleOskaloosaMahaskaClosed - DeclinedClosed UnreachableClosed - EnrolledClosed Unreachable

ClinicZipReferred ByLast NameReferred By FirstParticipantNameParticipant City CountyUnity Point Clinic Marion Family Medicine52302KonarskiJessicaMarionLinnStatusClosed UnreachableMarshallPrimary Health Care50158JohnsonBeckyMarshalltownMarshallClosed - EnrolledMarshallPrior AuthorizationCENTERAL IOWA HEALTHCARE-STATECENTER d - d - Declined57105GROSKREUTZDRTerrilDickinsonClosed - EnrolledClinicCountyClinic NameMarionMarshallClinic Address303 Nicholas DriveClinic CityMarshalltown1301 S CLIFF AVE STE601SIOUX FALLSMinnehahaAVERA MEDICAL GROUPMinnehahaAvera Medical Group aAVERA PULMONARY AND SLEEP57105GROSKREUTZDRTerrilDickinsonMinnesotaMAYO CLINIC55905GARCESDRFarmersburgClaytonClosed - EnrolledClosed - AlreadyParticipatingClosed UnreachableMitchellPrior Authorization50461HaganmanMarkOsageMitchellClosed - EnrolledMononaBARGESS FAMILY CLINIC-MAPLE VALLEY51034WALKERCHADUteMononaClosed - DuplicateMononaBurgess Family Clinic-Maple Valley51034WalkerChadUteMononaClosed - EnrolledMononaFAMILY MEDICINE CLINIC51040MontgomeryVillioca Family Health Center50864SchmadekeTomClarindaPageClosed - EnrolledClosed UnreachableMontgomeryVillisca Family Health Center50864MartinezEffieStantonMontgomeryClosed - EnrolledMontgomeryVILLISCA FAMILY HEALTH CENTERMuscatineUI Health Ventures52761MaharryDrMuscatineMuscatineClosed - IneligibleClosed neMuscatineMuscatineUnited Point Clinic52761WisemanKim52791MuscatinePrior AuthorizationMuscatineUI Healthcare MuscatineNebraskaMethodist Jennie Edmundson HospNotAvailableSanford Hartley620 North 8th Street Osage1518 Mulberry i Valley HarrisonClosed - EnrolledClosed UnreachableClosed - IntakeOnlyClosed UnreachableClosed UnreachableHartleyClosed - n

ClinicZipReferred ByLast NameReferred By FirstParticipantNameParticipant City County56267MehmertCathyBurlingtonDes MoinesJacksonLoriSioux CityWoodburyWaterlooBlack HawkClosed - DeclinedClosed UnreachableClosed UnreachableNaarahBurlingtonDes MoinesClosed - DeclinedNaarahBurlingtonDes MoinesDavenportScottDavenportScottCOMMUNITY HEALTH CAREClosed - DeclinedClosed UnreachableClosed UnreachableClosed UnreachableNotAvailableCOMMUNITY HEALTH CAREClosed - EnrolledNotAvailableCommunity Health CareNotAvailableCommunity Health CenterNotAvailableCOMMUNITY HEALTH CENTERNotAvailableCOMMUNITY HEALTH CENTERClosed - InvalidClosed UnreachableNotAvailableCOMMUNITY HEALTH CENTERClosed - InvalidNotAvailableCOMMUNNITY HEALTH CTRClosed - DuplicateNotAvailableFAM MEDClosed - IneligibleNotAvailableFamily Medicine ClinicNieuwenhuisDrNotAvailableGreat River Medical Center - Resp CareJwalaDrNotAvailableHealth SystemNotAvailableInternal Med Central CampusBlaessMichaelNotAvailablemcfarland clinicjensenmeaganNotAvailableMcFarland ClinicClinicCountyClinic NameClinic AddressClinic CityNotAvailableDIABNotAvailableCare For YourselfNotAvailableCare For vensteinNotAvail

ClinicCounty Clinic Name Clinic Address Clinic City Clinic Zip Referred By Last Name Referred By First . Johnson Dental Special Geriatric Dept 322 Dental Science Iowa CIty 52242 Wells Eldridge Scott Closed - Enrolled . Johnson UIHC Family Med 200 Hawkins Dr I