| # | Provider | ZIP | Codes | Claims | Total Paid |
|---|---|---|---|---|---|
| 1 | LINCOLN COUNTY PUBLIC HOSPITAL DISTRICT 1 | 99159 | 6 | 4,173 | $603K |
| 2 | LINCOLN COUNTY PUBLIC HOSPITAL DISTRICT 1 | 99159 | 12 | 2,515 | $258K |
| 3 | GREGG LIEDTKA DMD PLLC | 99159 | 8 | 398 | $7K |
| 4 | CONDON DENTAL SERVICES | 99159 | 2 | 38 | $622.70 |
| 5 | LINCOLN COUNTY PUBLIC HOSPITAL DISTRICT 1 | 99159 | 1 | 13 | $0.00 |