| # | Provider | ZIP | Codes | Claims | Total Paid |
|---|---|---|---|---|---|
| 1 | SUSSEX FAMILY DENTAL LLC | 53089 | 30 | 45,968 | $1.21M |
| 2 | FORWARD INTEGRATED SERVICES, INC. | 53089 | 3 | 8,381 | $742K |
| 3 | HAMILTON SCHOOL DISTRICT | 53089 | 5 | 27,580 | $302K |
| 4 | SHOPKO STORES OPERATING CO LLC | 53089 | 6 | 6,254 | $211K |
| 5 | WHEATON FRANCISCAN MEDICAL GROUP-SUSSEX, INC. | 53089 | 4 | 2,385 | $85K |
| 6 | HARTMAN, JOY | 53089 | 2 | 1,838 | $71K |
| 7 | MONFRE, THERESA | 53089 | 1 | 476 | $10K |
| 8 | WALGREEN CO | 53089 | 5 | 470 | $7K |
| 9 | CANTWELL-DURAND, ANDREA | 53089 | 1 | 63 | $2K |
| 10 | ABAD SANTOS, JOSE | 53089 | 4 | 56 | $1K |
| 11 | ARACKAL, NOEL | 53089 | 6 | 177 | $0.00 |
| 12 | ROUNDYS SUPERMARKETS INC | 53089 | 1 | 14 | $0.00 |