| # | Provider | City | Claims | Total Paid |
|---|---|---|---|---|
| 1 | BANNER PHARMACY SERVICES LLC | TUCSON | 329 | $808.48 |
| 2 | ARIZONA CVS STORES LLC | TUCSON | 63 | $118.58 |
| 3 | WALGREEN CO | MESA | 31 | $118.58 |
| 4 | ARIZONA CVS STORES LLC | PEORIA | 57 | $50.82 |
| 5 | GERMAN DOBSON CVS LLC | CHANDLER | 579 | $40.44 |
| 6 | ARIZONA CVS STORES LLC | PHOENIX | 27 | $16.94 |
| 7 | WALGREEN CO | AVONDALE | 22 | $16.94 |
| 8 | GERMAN DOBSON CVS, L.L.C. | TUCSON | 29 | $0.00 |
| 9 | ARIZONA CVS STORES LLC | YUMA | 12 | $0.00 |
| 10 | COBRE VALLEY REGIONAL MEDICAL CENTER | GLOBE | 32 | $0.00 |
| 11 | ARIZONA CVS STORES LLC | MESA | 14 | $0.00 |
| 12 | ARIZONA CVS STORES LLC | TUCSON | 74 | $0.00 |
| 13 | GERMAN DOBSON CVS, L.L.C. | TUCSON | 34 | $0.00 |
| 14 | WALGREEN CO | SIERRA VISTA | 90 | $0.00 |
| 15 | WALGREEN CO | PHOENIX | 50 | $0.00 |
| 16 | ARIZONA CVS STORES LLC | PHOENIX | 12 | $0.00 |