| # | Provider | Location | Claims | Total Paid |
|---|---|---|---|---|
| 1 | 1093140493 | 15 | $420.00 | |
| 2 | MARIAN CLINIC, INC. | TOPEKA, KS | 33 | $360.00 |
| 3 | COMMUNITY HEALTH MINISTRY, INC. | WAMEGO, KS | 16 | $180.00 |
| 4 | MARTINEZ, FREDDIE | LAS VEGAS, NV | 19 | $36.90 |
| 5 | LESTER MOBILE DENTISTRY | ALEXANDRIA, LA | 375 | $0.00 |
| 6 | GASTON FAMILY HEALTH SERVICES, INC. | GASTONIA, NC | 17 | $0.00 |