| # | Provider | City | Claims | Total Paid |
|---|---|---|---|---|
| 1 | GEM DRUGS INC | RESERVE | 29 | $262.30 |
| 2 | MELANCON PHARMACY INC | CARENCRO | 2,734 | $76.04 |
| 3 | VIDRINE PHARMACEUTICAL GROUP, LLC | LAKE CHARLES | 740 | $15.92 |
| 4 | LAPHARMACY LLC | JEFFERSON | 53 | $0.00 |
| 5 | TERSCO LLC | NEW ORLEANS | 217 | $0.00 |
| 6 | PARKWAY PHARMACY LLC | STERLINGTON | 263 | $0.00 |