All Medicaid billing entities listing FORMANEK, TERI (DIRECTOR) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Iowa | 1 | $1.12M |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | WEST LAKES SURGERY CENTER LLC | CLIVE, IA | Ambulatory Surgical Clinic/Center | $1.12M |