Wisconsin - Claims Paid - FPW - 2007-2010

Medicaid Expenditures for the Family Planning Only Benefit Plan

Claims Paid in SFY 2007 through SFY 2010Source: Bus Obj Claims Analysis Universe

Run Date: October 17, 2011

Billing

Provider

County Billing Provider Name Billing Provider Type SFY 2007 SFY 2008 SFY 2009 SFY 2010 Total

Adams ADAMS CO HEALTH & HUMANSVCS

Mental Health and

Substance Abuse

Services $22 $68 $91

MOUNDVIEW MEMORIAL HOSPITAL Independent Lab $399 $138 $538

Rural Health Clinic $1,540 $1,199 $1,595 $3,582 $7,916

MOUNDVIEW MEMORIAL HOSPITAL & CLINICS INCHospital $2,220 $5,823 $15,378 $27,433 $50,854

Physician Group $572 $572

PAMIDA PHARMACY 373 Pharmacy $3,197 $3,868 $3,225 $1,316 $11,606

PHILLIPS ROCHE A CRI PHARMAC Pharmacy $1,481 $1,464 $1,305 $1,656 $5,906

RIVERVIEW REHABILITATION Therapy Group $30 $30

ROCHE A CRI CLINIC SC Physician Group $339 $339

Rural Health Clinic $2,442 $2,270 $490 $118 $5,319

Ashland ASHLAND PATHOLOGY SERVICES Physician Group $709 $472 $565 $119 $1,866

BAD RIVER HEALTH SERVICES

Federally Qualified

Health Clinic (FQHC) $125 $137 $795 $1,058

Physician Group $105 $217 $94 $23 $439

CHEQUAMEGON CLINIC Physician Group $3,735 $2,201 $3,427 $3,821 $13,184

DENNIS SULLIVAN, MD Physician $12 $12

DOUGLAS CO COMMUNITY HLTH Family Planning Clinic $58,830 $246,566 $361,201 $666,598

ENT PROFESSIONAL ASSOCSC Physician Group $61 $61

ESSENTIA HEALTH ASHLAND CLINIC Physician Group $4,660 $4,963 $3,814 $6,668 $20,105

ESSENTIA HEALTH ASHLAND ORTHOPAEDICS CLINICPhysician Group $61 $61

FALL GENERALSURGERY LLC Physician Group $44 $184 $228

HUHN RX DRUGINC Pharmacy $6,912 $5,546 $4,676 $5,811 $22,945

JAMES A HAMP, MD Physician $30 $30

KENNETH N KRUTSCH MD SC Physician Group $78 $78

KENNETH N KRUTSCH, MD Physician $41 $41

KEVIN J MCCLELLAND, MD Physician $108 $108

MAINSTREET CLINIC SC Physician Group $1,534 $1,897 $1,895 $3,934 $9,260

of 114




Billing

Provider


MARJORIE A LINDEMANN, NP Nurse Practitioner $123 $123

MEMORIAL MEDICAL CENTER Independent Lab $389 $582 $432 $421 $1,824

Physician Group $126 $1,331 $1,457

MEMORIAL MEDICAL CENTER INC Hospital $597 $726 $8,665 $28,630 $38,618

NORTHERN WATERS OPHTHALMOLOG Physician Group $217 $217

PAMIDA PHARMACY #390 Pharmacy $1,605 $2,131 $2,181 $2,896 $8,813

THE MEDICINE SHOPPE Pharmacy $6,547 $7,065 $8,094 $6,317 $28,024

THOMAS A GUFFY, MD Physician $52 $52

WAL MART PHARMACY 101672 Pharmacy $4,028 $4,183 $5,721 $7,323 $21,256

WALGREENS #10758 Pharmacy $5,603 $5,603

Barron BARRON COUNTY DHHS Family Planning Clinic $77,760 $109,880 $71,117 $33,685 $292,441

BRANHAM HEALY ORTHOPEDIC Physician Group $116 $116

CUMBERLAND CLINIC Physician Group $1,915 $2,106 $3,136 $2,288 $9,445

CUMBERLAND MEMORIAL HOSPITAL Hospital $641 $685 $1,326

Independent Lab $24 $58 $83

DIAGNOSTIC RADIOLOGY ASSOC Physician Group $35 $156 $121 $312

ECONOFOODS PHARMACY #325 Pharmacy $991 $1,783 $457 $1,363 $4,595

HANDI LIFT INC Transportation $392 $392

JAMES PHARMACY Pharmacy $690 $2,513 $585 $1,246 $5,034

JAMES PHARMACY LTD Pharmacy $3,550 $943 $1,661 $3,014 $9,168

K MART PHARMACY #9704 Pharmacy $3,256 $1,969 $1,367 $2,445 $9,038

LAKEVIEW MEDICAL CENTER Anesthetist $129 $129

LAKEVIEW MEDICAL CTR Hospital $532 $5,954 $10,042 $16,528

LUTHER MIDELFORT NORTHLAND -MHSAnesthetist $253 $253

MARSHFIELD CLINIC CUMBERLAND Independent Lab $11 $43 $54

MARSHFIELD CLINIC LAKE Independent Lab $22 $22

MARSHFIELD CLINIC LAKESWOODS FAMILY CENTERIndependent Lab $10 $21 $31

MARSHFIELD CLINIC PHARMACY Pharmacy $2,839 $2,630 $3,259 $7,377 $16,106

MARSHFIELD CLINIC RICE LAKE CENTERIndependent Lab $831 $675 $808 $51 $2,366

of 114




Billing

Provider


MAYO CLINIC HEALTH SYSTEM NORTHLAND BARRON CLINICPhysician Group $2,362 $1,418 $2,734 $9,708 $16,222

MAYO CLINIC HEALTH SYSTEM NORTHLAND INCHospital $211 $1,449 $2,681 $4,341

MEDICATIONS PLUS PHARMACY Pharmacy $1,246 $869 $237 $1,968 $4,320

OHDE HEALTH MART PHARMACY Pharmacy $3,546 $4,755 $4,140 $10,055 $22,495

OSTERBAUER DRUG LTD Pharmacy $1,305 $643 $676 $1,595 $4,218

SCHNEIDER DRUG Pharmacy $577 $1,180 $1,340 $2,497 $5,594

SHOPKO PHARMACY #2132 Pharmacy $7,890 $7,582 $7,397 $12,417 $35,286

THE APOTHECARY Pharmacy $3,417 $2,622 $3,954 $4,888 $14,881

TURTLE LAKE MEDICAL ASSOC SC Physician Group $30 $30

TURTLE LAKE MEDICAL CLINIC Physician Group $159 $159

WALGREENS #11860 Pharmacy $3,699 $11,393 $15,092

WAL-MART PHARMACY 10-1446 Pharmacy $11,957 $16,396 $16,805 $30,172 $75,331

Bayfield LANGFORD PHARMACY Pharmacy $1,058 $643 $2,505 $2,308 $6,513

RED CLIFF COMMUNITY HEALTH

Federally Qualified

Health Clinic (FQHC) $1,556 $1,914 $2,353 $6,966 $12,790

Medical Equipment

Vendor $25 $34 $59

STEPHEN R KREUSER, MD Physician $72 $182 $254

THE LAKES COMMUNITY HEALTH

Federally Qualified

Health Clinic (FQHC) $145 $1,515 $1,660

Brown ALLAHYAR JAZAYERI, MD Physician $1,362 $439 $22 $1,824

AURORA BAYCARE MEDICALCTR Hospital $2,204 $1,717 $1,567 $9,296 $14,783

AURORA HEALTH CENTER Physician Group $14,530 $9,996 $11,639 $7,604 $43,768

AURORA MEDICAL GROUP Physician Group $1,119 $1,417 $1,676 $4,684 $8,897

AURORA MEDICAL GROUP INC Physician Group $1,358 $733 $1,768 $9,247 $13,107

AURORA PHARMACY INC Pharmacy $1,608 $2,463 $2,190 $2,744 $9,004

BAYCARE CLINIC LLP Physician Group $235 $338 $195 $1,528 $2,296

BELLIN ANESTHESIA ASSOCIATES SC Physician Group $233 $233

BELLIN HEALTH Independent Lab $10,010 $7,506 $8,426 $10,666 $36,607

of 114




Billing

Provider


BELLIN HEALTH FASTCARE Physician Group $59 $58 $116

BELLIN HEALTH FASTCARE GREEN BAYPhysician Group $20 $22 $216 $145 $402

BELLIN HEALTH PHARMACY Pharmacy $1,020 $1,368 $1,270 $1,266 $4,925

BELLIN MEMORIAL HOSPITAL Anesthetist $343 $343

Hospital $362 $494 $10,303 $19,788 $30,947

CARDIOLOGY ASSOCIATES OF GREEN BAY, LTDPhysician Group $60 $55 $115

CENTER FOR ASTHMA AND ALLERG Physician Group $30 $30

CLARK W STEVENS MD, MD Physician $2,719 $1,698 $1,002 $5,419

CLINICA HISPANA Physician Group $57 $58 $114

COPPS FOOD CENTER PHARMACY #8107Pharmacy $87 $87

COPPS FOOD CENTER PHARMACY #8111Pharmacy $34 $301 $335


CUB PHARMACY Pharmacy $1,229 $1,131 $681 $3,041

CVS PHARMACY#08535 Pharmacy $959 $1,213 $2,061 $2,682 $6,915

CVS PHARMACY#08541 Pharmacy $1,903 $4,030 $3,454 $3,473 $12,861


DANAE C STEELE MD, MD Physician $1,156 $3,280 $160 $4,597

DANIEL J LINEHAN, MD Physician $60 $60

DERMATOLOGY ASSOCIATES OF WISCONSIN SCPhysician Group $92 $299 $391

DERMATOLOGY ASSOCIATESOF WI Physician Group $55 $55

DOUSMAN CLINIC SC Physician Group $139 $120 $312 $231 $803

EDWARD G VOGEL, MD Physician $164 $164

ENDOCRINOLOGYASSOCIATESOFGREEN BAY, SCPhysician Group $60 $60

FMC ASHWAUBENON Physician Group $766 $1,536 $1,136 $2,459 $5,897

FMC ASHWAUBENON INTERNAL MEDICINE AND PEDIATRICSPhysician Group $60 $47 $204 $311

FMC BELLEVUE Physician Group $384 $2,658 $3,043

FMC DE PERE Physician Group $395 $349 $581 $993 $2,318

FMC DENMARK Physician Group $36 $30 $229 $296

FMC EAST DEPERE Physician Group $90 $87 $76 $251 $505

of 114




Billing

Provider


FMC HOWARD Physician Group $174 $250 $271 $2,473 $3,168

FMC LUXEMBURG Physician Group $66 $26 $57 $77 $225

FMC PEDIATRICS EAST Physician Group $73 $239 $312

FMC PULASKI Physician Group $86 $216 $230 $273 $804

FMC WEBSTER AVE Physician Group $1,608 $1,176 $926 $1,074 $4,783

FMC WRIGHTSTOWN Physician Group $57 $30 $58 $145

GBR SHEBOYGAN LLC Physician Group $37 $37

GREEN BAY ALLERGY ASTHMA AND Physician Group $98 $98

GREEN BAY ONCOLOGY LTD Physician Group $48 $48

GREEN BAY ORTHOPEDICS LTD Physician Group $43 $43

GREEN BAY RADIOLOGY SC Physician Group $25 $62 $361 $447

GREEN BAY SURGICAL CENTER

Ambulatory Surgical

Center (ASC) $207 $930 $1,137

HERBERT F SANDMIRE, MD Physician $204 $217 $421

HERBERT S COUSSONS, MD Physician $386 $182 $304 $873

HOSPITAL DIAGNOSTIC SERVICES Physician Group $30 $30

JOHN B FRAZIER, DDS Dentist $73 $83 $156

JOHN M HALE, MD Physician $26 $26

JOSEPH R DOBSON, DO Physician $142 $55 $197

JUDITH A HARDING, NP Nurse Practitioner $58 $58

K MART PHARMACY 4219 Pharmacy $133 $164 $354 $650

KATHLEEN G STEWARD, NP Nurse Practitioner $58 $58

KIMBERLY M WILLIAMS, NP Nurse Practitioner $163 $163

KRIDER PHARMACY & HOMEHEALTH Pharmacy $141 $115 $68 $371 $695

LINDA S HAEN, NP Nurse Practitioner $43 $43

LOREN P SCHOLL, NP Nurse Practitioner $43 $43

LOUANN WEIX, CRNA Anesthetist $174 $174

MARY A SAUVEY, MD Physician $57 $57

MEGAN E TEMP, MD Physician $183 $558 $503 $1,244

of 114




Billing

Provider


MICHAEL BROCKMAN, MD Physician $22 $22

MICHAEL C O TOOLE, MD Physician $735 $236 $1,034 $2,005

MICHAEL J SMULLEN, MD Physician $111 $111

NARAYAN AMARNANI MD SC Physician Group $19 $22 $199 $240

NEUROLOGY CONSULTANTS OF Physician Group $30 $266 $296

NEW COMMUNITY CLINIC

Federally Qualified

Health Clinic (FQHC) $30 $385 $415

NEW ENT SC Physician Group $174 $174

NEW MOMS SC Physician Group $1,855 $803 $2,658

NEW SURGICAL ASSOCIATES SC Physician Group $66 $66

OB GYN ASSOCIATES LTD Physician Group $73 $3,416 $9,702 $13,191

ORTHOPEDICS AND SPORTS MEDICINE SPECIALISTS OF GREPhysician Group $30 $30 $125 $185

OSCO DRUG #5036 Pharmacy $542 $542

OSCO DRUG #5054 Pharmacy $2,681 $2,681


PAMELA L NILES, NP Nurse Practitioner $242 $242

PATHOLOGY CONSULTANTS OF GREEN BAY, SCPhysician Group $4,065 $4,074 $4,316 $5,830 $18,285

PATHOLOGY PHYSICIANS LTD Physician Group $157 $245 $403

PERI L ALDRICH, MD Physician $80 $80

PHILIP L GOOLSBY, MD Physician $58 $58

PLANNED PARENTHOOD OF WI Family Planning Clinic $44,685 $156,989 $179,784 $225,793 $607,251

PREVEA CLINIC Independent Lab $3,985 $3,737 $3,850 $2,261 $13,834

Physician Group $13,757 $9,792 $6,931 $5,738 $36,218

PREVEA CLINICBEHAVIORALCARE

Mental Health and

Substance Abuse

Services $2,790 $43 $2,833

PREVEA HEALTH Independent Lab $3,350 $3,350

Physician Group $11,036 $11,036

PREVEA REGIONAL SERVICES Independent Lab $11 $11

of 114




Billing

Provider


PREVEA REGIONAL SERVICES INC Physician Group $95 $132 $227

PULASKI PHARMACY Pharmacy $1,137 $935 $334 $338 $2,744

RADIOLOGY CHARTERED Physician Group $25 $227 $252

RANDI M BURNHAM, NP Nurse Practitioner $60 $60

ROBERT A CAVANAUGH, MD Physician $1,541 $866 $242 $2,649

ROBERT K DEMOTT MD, MD Physician $1,286 $899 $1,163 $3,348

SAM'S PHARMACY 10-8149 Pharmacy $70 $70 $49 $82 $270

SHOPKO EXPRESS #501 Pharmacy $2,006 $1,312 $708 $1,211 $5,237

SHOPKO EXPRESS #502 Pharmacy $2,367 $2,332 $2,050 $2,799 $9,548

SHOPKO EXPRESS #506 Pharmacy $855 $693 $1,548



SHOPKO PHARMACY #2005 Pharmacy $2,599 $811 $911 $1,663 $5,983

SHOPKO PHARMACY #2177 Pharmacy $1,446 $2,221 $3,667

SHOPKO PHARMACY 2004 Pharmacy $5,166 $4,865 $3,638 $6,071 $19,741

ST MARYS HOSP MED CENTER Hospital $150 $589 $21,010 $10,854 $32,603

ST MARYS HOSPITAL MEDICAL Independent Lab $2,852 $5,900 $7,309 $4,691 $20,752

ST VINCENT HOSPITAL Hospital $678 $9,162 $18,800 $28,640

Independent Lab $4,055 $1,112 $398 $2,529 $8,094

ST VINCENT HOSPITAL CLINICS Physician Group $549 $74 $623

STOWE DRUG STORE Pharmacy $155 $55 $135 $344

STREUS PHARMACY INC Pharmacy $674 $833 $749 $1,700 $3,956

SURGERY SPECIALISTS OFGREEN Physician Group $108 $108

TARGET STORE T-1247 PHARMACY Pharmacy $2,178 $2,006 $1,871 $864 $6,920

TARGET STORE T-1483 PHARMACY Pharmacy $1,704 $1,906 $2,407 $4,042 $10,059

UROLOGY ASSOCIATES OF GREEN BAY,SCPhysician Group $48 $48

WALGREENS #03088 Pharmacy $14,321 $8,934 $8,070 $10,566 $41,891



of 114




Billing

Provider



WALGREENS #11339 Pharmacy $776 $7,481 $7,750 $16,007


WALGREENS 05746 Pharmacy $3,775 $3,739 $5,545 $5,128 $18,187






WISCONSIN OCULOPLASTICSLTD Physician Group $55 $55

WOMENS HEALTH CARE OB GYN SC Physician Group $1,777 $2,218 $1,223 $904 $6,122

WOMENS SPECIALTY CARE Physician Group $2,297 $2,297

YOON W CHUN MD, MD Physician $4,588 $3,275 $939 $8,801

Buffalo CITY DRUG STORE INC Pharmacy $396 $396

KASSEL CITY DRUG LLC Pharmacy $126 $496 $622

MONDOVI HEALTH MART PHARMACY Pharmacy $1,040 $1,070 $1,790 $1,307 $5,207

Burnett BURNETT MEDICAL CENTER Physician Group $26 $61 $87

BURNETT MEDICAL CENTERCLINIC Rural Health Clinic $3,312 $1,824 $1,373 $1,758 $8,267

BURNETT MEDICAL CENTERINC Hospital $496 $1,314 $2,702 $5,941 $10,453

Independent Lab $163 $398 $437 $309 $1,307

COUNTY OF BURNETT Family Planning Clinic $5,544 $3,285 $2,088 $1,177 $12,094

INGALLS FAMILY MEDICINECLINI Physician Group $2,366 $2,285 $1,591 $2,733 $8,976

OLSEN & SON DRUG Pharmacy $5,858 $3,669 $3,958 $2,280 $15,765

WOOD RIVER PHARMACY Pharmacy $6,243 $6,264 $4,369 $4,099 $20,975

YELLOW RIVER PHARMACY Pharmacy $1,515 $3,114 $3,945 $8,574

YELLOW RIVERPHARMACY INC Pharmacy $3,745 $2,749 $6,494

Calumet APOTHECARY SHOP Pharmacy $121 $119 $240

APPLETON CARDIOLOGY THEDACARE Physician Group $94 $78 $172

APPLETON MEDICAL CENTER Hospital $1,227 $3,360 $21,535 $28,356 $54,478

of 114




Billing

Provider


AURORA PHARMACY INC Pharmacy $221 $190 $506 $916

CALUMET MEDICAL CENTER Hospital $196 $1,615 $1,577 $3,388


CALUMET MEDICAL CENTER INC Independent Lab $46 $70 $116


CVS PHARMACY #05186 Pharmacy $2,679 $2,679

FMC BRILLION Physician Group $57 $332 $388

FRANCES E NELSON, NP Nurse Practitioner $12,900 $27,698 $39,140 $3,979 $83,718

IHC CALUMET EMERGENCY PHYSICIANS LLCPhysician Group $30 $30

MORTON PHARMACY Pharmacy $355 $276 $1,471 $2,102

NELSON FAMILYCLINIC LLC Rural Health Clinic $342 $837 $1,179

OCONNOR PHARMACY Pharmacy $203 $65 $943 $397 $1,609

RANDY T THEILER, MD Physician $57 $57

THEDACARE PHYSICIANS HILBERT Physician Group $2,479 $2,479

WALGREENS #13065 Pharmacy $167 $167



Chippewa CADOTT MEDICAL CENTER SC Physician Group $205 $249 $90 $544

CADOTT MILLER PHARMACY Pharmacy $1,282 $947 $324 $314 $2,867

CHIPPEWA CLINIC PHARMACY Pharmacy $1,286 $1,286

CLIFFORD T BOWE, MD Physician $22 $657 $679

CORNELL PHARMACY Pharmacy $945 $1,336 $147 $2,427

CORNELL PHARMACY INC Pharmacy $1,476 $2,372 $3,848

EDS HEALTH MART PHARMACY Pharmacy $372 $705 $311 $3,094 $4,482

EDS PHARMACY Pharmacy $351 $351

FAMILY HEALTH ASSOCIATES Physician Group $43 $43

FAMILY HEALTH MEDICAL Physician Group $1,333 $1,569 $1,177 $3,002 $7,082

GROUP HEALTHCHIPPEWA PHARMA Pharmacy $2,273 $2,180 $4,033 $902 $9,388

K MART PHARMACY 3735 Pharmacy $1,920 $1,246 $969 $1,005 $5,139

of 114




Billing

Provider


KONSELLA DRUG INC Pharmacy $781 $21 $802

KONSELLA HEALTH MART PHARMAC Pharmacy $736 $610 $1,346

MARSHFIELD CLINIC BLOOMER CENTERIndependent Lab $11 $11

MARSHFIELD CLINIC CHIPPEWA FALLS CTR LABIndependent Lab $139 $139

MARSHFIELD CLINIC LAKE HALLIE CENTERPhysician Group $14 $1,280 $1,294

MARSHFIELD CLINIC PHARMACY

Federally Qualified


MAYO CLINIC HEALTH SYSTEM CHIPPEWA VALLEY BLOOMERPhysician Group $129 $861 $402 $4,253 $5,646

MAYO CLINIC HEALTH SYSTEM CHIPPEWA VALLEY INCHospital $1,631 $1,631

MEDICINE SHOPPE Pharmacy $631 $681 $1,246 $4,937 $7,495

OLV PHARMACY Pharmacy $1,836 $1,086 $1,266 $1,364 $5,552

OUR LADY OF VICTORY HOSPITAL Hospital $305 $1,789 $4,314 $3,957 $10,366

Physician Group $30 $66 $375 $471

PAUL M IPPEL, MD Physician $131 $131

PLANNED PARENTHOOD OF WISCONSIN, INC.Family Planning Clinic $567,924 $412,735 $320,137 $29,034 $1,329,830


ST JOSEPHS HOSPITAL Hospital $1,808 $5,385 $36,592 $42,525 $86,310

Independent Lab $45 $363 $548 $1,025 $1,982

ST JOSEPHS HOSPITAL PHARMACY Pharmacy $51 $51



Clark CLARK CO FAMILY PLANNING Family Planning Clinic $56,820 $73,204 $54,348 $71,741 $256,113

MARSHFIELD CLINIC COLBY ABBO CENTER LABIndependent Lab $11 $11

MEMORIAL HOSPITAL INC Physician Group $675 $136 $811

MEMORIAL HOSPITAL INC #171 Hospital $1,584 $5,389 $7,907 $14,880

MEMORIAL MEDCTR GREENWOOD Rural Health Clinic $746 $656 $1,120 $1,496 $4,018

MEMORIAL MEDICAL CENTER Rural Health Clinic $1,592 $1,947 $2,186 $2,278 $8,003

MEMORIAL MEDICAL CENTER LABO Independent Lab $183 $198 $211 $674 $1,266

MEMORIAL MEDICAL CTR Rural Health Clinic $3,053 $2,320 $1,663 $3,722 $10,758

of 114




Billing

Provider


OLV PHARMACY Pharmacy $900 $900

OUR LADY OF VICTORY HOSPITAL Hospital $5,283 $5,283


OWEN WITHEE PHARMACY Pharmacy $3,133 $2,895 $3,235 $3,358 $12,621


SNITEMAN INC Pharmacy $4,234 $4,891 $3,182 $3,900 $16,207

VICTORY MEDICAL GROUP Rural Health Clinic $514 $299 $291 $1,106 $2,210

VICTORY MEDICAL GROUP OWEN Rural Health Clinic $378 $183 $103 $1,112 $1,775

Columbia BRUCE A KRAUS M.D., MD Physician $2,093 $2,093

COLUMBUS COMMUNITY HOSP INC Hospital $3,161 $7,762 $20,743 $11,418 $43,084

COLUMBUS COMMUNITY HOSPITAL Independent Lab $365 $139 $154 $235 $893

Physician Group $537 $649 $688 $450 $2,324

DIVINE SAVIOR HEALTHCARE Hospital $278 $1,518 $6,746 $13,885 $22,426

DIVINE SAVIOR HEALTHCARE INC Independent Lab $105 $234 $445 $448 $1,233

Physician Group $2,925 $3,139 $4,595 $3,862 $14,522

GENE R SORENSEN, DDS Dentist $310 $310 $620

HARRIS PHARMACY INC Pharmacy $841 $828 $1,447 $706 $3,822

JOHN E WALZ, MD Physician $22 $22 $44

K MART PHARMACY 3768 Pharmacy $787 $1,928 $2,963 $2,775 $8,454

LODI MEDICAL CLINIC Physician Group $264 $427 $691

PARDEEVILLE HOMETOWN PHARMACYPharmacy $91 $680 $465 $1,236

PLANNED PARENTHOOD OF WI Family Planning Clinic $123,833 $53,276 $177,109

PORTAGE RADIOLOGY SC Physician Group $12 $57 $70

POYNETTE HOMETOWN PHARMACY Pharmacy $460 $440 $136 $1,036

RANDOLPH HOMETOWN PHARMACY Pharmacy $426 $960 $212 $333 $1,932

RHYME DRUG Pharmacy $28 $30 $58

RIO HOMETOWN PHARMACY Pharmacy $160 $147 $136 $442

SAMUEL POSER, MD Physician $73 $43 $58 $95 $268

SHARROW DRUGS INC Pharmacy $2,104 $867 $919 $420 $4,309

of 114




Billing

Provider


STEPHEN C PAULK, MD Physician $22 $55 $77

STEWART F TAYLOR JR, MD Physician $22 $22

TRAVEL MART PHARMACY Pharmacy $1,931 $1,032 $1,768 $3,171 $7,902

VILLAGE DRUG Pharmacy $1,351 $323 $1,675

WALGREENS #10396 Pharmacy $352 $1,612 $2,670 $5,585 $10,220



WILZ DRUG INC Pharmacy $1,157 $848 $817 $506 $3,327

Crawford GREAT RIVER COMMUNITY MEDICAL CLINICPhysician Group $497 $497

GUNDERSEN CLINIC LTD Physician Group $1,532 $3,011 $1,853 $6,396

HARTIG DRUG CO INC Pharmacy $1,458 $1,425 $687 $2,222 $5,791

HIMRICHS SNYDER DRUGS Pharmacy $290 $290

KICKAPOO VALLEY MEDICAL Rural Health Clinic $78 $370 $496 $862 $1,806

KICKAPOO VALLEY MEDICALCLINI Physician Group $11 $11 $75 $96

PRAIRIE DU CHIEN MEMORIAL Hospital $1,499 $2,178 $1,846 $5,524

PRAIRIE DU CHIEN MEMORIAL HOSPITALPhysician Group $14 $96 $110

PRAIRIE PHARMACY INC Pharmacy $272 $441 $275 $524 $1,512

PRAIRIE PRESCRIPTION Pharmacy $51 $51

RONALD F FALCH, APNP Anesthetist $158 $158

SOLAR TOWN PHARMACY VMH Pharmacy $120 $441 $102 $995 $1,658


WAL-MART PHARMACY 10-0882 Pharmacy $3,045 $2,097 $2,148 $827 $8,117

Dane ACCESS COMMUNITY HEALTH CENTERS

Federally Qualified


Pharmacy $603 $603

ASSOCIATED PATHOLOGISTS Physician Group $630 $714 $397 $1,665 $3,406

ASSOCIATED PHYSICIANS LLP Physician Group $297 $667 $860 $1,029 $2,854

ASZANI S KUNKLER, NP Nurse Practitioner $121 $30 $151

BELLEVILLE HOMETOWN PHARMACY Pharmacy $764 $327 $154 $434 $1,679

of 114




Billing

Provider


BERGMANN PHARMACY Pharmacy $130 $130

BERGMANNS PHARMACY INC Pharmacy $1,168 $1,168

BERGMANNS PHARMACY INC Pharmacy $2,122 $453 $512 $3,087

BOARD OF REGENTS UNIV OF WI Independent Lab $699,538 $1,697,002 $1,673,881 $1,861,830 $5,932,251

BONE & JOINTSURGERY ASSOCIA Physician Group $91 $55 $146

COMMUNITY PHARMACY Pharmacy $7,446 $13,669 $6,106 $13,249 $40,470

COPPS FOOD CENTER PHARMACY #8102Pharmacy $322 $88 $218 $629

COPPS FOOD CENTER PHARMACY #8178Pharmacy $191 $24 $534 $789 $1,538


CROSS PLAINSPHARMACY LLC Pharmacy $497 $39 $25 $560

CUB PHARMACY Pharmacy $1,094 $653 $1,239 $148 $3,135

CVS PHARMACY #05584 Pharmacy $1,823 $1,823

DANE CO CYTOLOGY CENTERINC Independent Lab $10,273 $10,811 $11,534 $20,244 $52,863

DAVID L OLIVE, MD Physician $20 $20

DAVIS DUEHR SURGERY CENTER

Ambulatory Surgical

Center (ASC) $724 $724

DEAN HEALTH SYSTEMS INC Anesthetist $268 $107 $255 $631

Physician Group $50,616 $55,438 $58,358 $103,107 $267,519

DEAN MEDICAL CENTER DEPARTMENT OF PSYCHIATRY FISH

Mental Health and

Substance Abuse

Services $22 $66 $88

DEAN PHARMACY Pharmacy $2,292 $3,687 $2,401 $4,823 $13,204

DEFOREST HOMETOWN PHARMACY Pharmacy $846 $806 $1,137 $1,739 $4,528

DOOR CREEK PHARMACY Pharmacy $729 $107 $613 $612 $2,060

DOOR CREEK PHARMACY DEERFIEL Pharmacy $304 $681 $382 $365 $1,732

FORT HEALTHCARE INC Physician Group $137 $48 $234 $419

GHC EAST CLINIC PHARMACY Pharmacy $89 $96 $903 $1,087

GHC HATCHERYHILL PHARMACY Pharmacy $349 $605 $954

GHC PHARMACYCAPITOL Pharmacy $84 $327 $1,728 $2,139

of 114




Billing

Provider


GHC PHARMACYSAUK TRAILS Pharmacy $51 $270 $321

GHC SCW MAILPHARMACY Pharmacy $447 $447

GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WIPhysician Group $5,020 $2,970 $1,859 $8,083 $17,931

HARRIS PHARMACY Pharmacy $221 $90 $311

HY VEE PHARMACY 1391 Pharmacy $839 $839

JOHN NOON, MD Physician $37 $37

KENNETH H YUSKA Physician $30 $30

MADISON ANESTHESIOLOGY CONSULTANTSPhysician Group $193 $304 $497

MADISON AREA RENAL SPECIALISTS Physician Group $48 $48

MADISON BIRTH CENTER Nurse Practitioner $73 $73

MADISON RADIOLOGISTS SC Physician Group $22 $146 $628 $797

MALLATT PHARMACY Pharmacy $35 $186 $221

MCFARLAND HOMETOWN PHARMACY Pharmacy $212 $216 $482 $278 $1,189

MCGLYNN PHARMACY INC Pharmacy $84 $563 $441 $1,149 $2,237

MEDICINE SHOPPE 0605 LTD Pharmacy $300 $209 $558 $1,068

MERITER HOSPITAL INC Hospital $4,715 $8,889 $47,691 $97,705 $159,000

Physician Group $129 $273 $491 $540 $1,434

MERITER LABORATORIES Independent Lab $1,896 $3,547 $3,839 $7,270 $16,552

MERITER MEDICAL GROUP INC Physician Group $55 $37 $22 $748 $861

MICHAEL H MCDONALD, MD Physician $37 $37

MT HOREB PHARMACY Pharmacy $996 $609 $57 $562 $2,223

NEUHAUSER PHARMACY Pharmacy $320 $542 $891 $33 $1,787

NORTH SHORE RADIOLOGY ASSOCIATES OF MADISON SCPhysician Group $23 $49 $72

NORTHEAST FAMILY PRACTICE Pharmacy $538 $624 $928 $366 $2,456

OCONNELL PHARMACY LTD Pharmacy $546 $198 $216 $960

OREGON HOMETOWN PHARMACY Pharmacy $472 $121 $141 $1,036 $1,771

PETER S KAROFSKY, MD Physician $1,458 $42 $1,500

PICK N SAVE PHARMACY #6390 Pharmacy $169 $148 $318

PINNACLE PHARMACY OF MADISON Pharmacy $19 $19

of 114




Billing

Provider


PLANNED PARENTHOOD Family Planning Clinic $882,948 $891,764 $314,794 $188,639 $2,278,145

PLANNED PARENTHOOD OF WISCONSIN, INC.Family Planning Clinic $150,462 $130,509 $97,743 $216,744 $595,458

RONALD M WANEK, DDS Dentist $808 $808

SANDRA K ROOF, NP Nurse Practitioner $57 $57

SHAFER PHARMACY INC Pharmacy $89 $89

SHOPKO PHARMACY #2029 Pharmacy $1,398 $487 $989 $931 $3,804

SHOPKO PHARMACY #2032 Pharmacy $212 $280 $829 $126 $1,446

SHOPKO PHARMACY #2034 Pharmacy $264 $264

SHOPKO PHARMACY #2080 Pharmacy $452 $850 $1,030 $332 $2,665

ST MARYS HOSPITAL Hospital $1,048 $695 $41,175 $10,626 $53,545

Independent Lab $2,798 $3,237 $4,436 $6,210 $16,682

STEVEN D PETERSON, DDS Dentist $340 $340

STOUGHTON HOSPITAL ASSN Physician Group $495 $1,046 $910 $1,148 $3,600

STOUGHTON HOSPITAL ASSOC Hospital $1,008 $7,752 $23,433 $32,320 $64,513


TARGET STORE T-1069 Pharmacy $1,650 $1,961 $1,880 $5,491

TARGET STORE T-2106 PHARMACY Pharmacy $992 $2,075 $1,972 $5,040

TARGET STORE T-2491 PHARMACY Pharmacy $131 $550 $681

TERRY A BURKE, DDS Dentist $193 $730 $923

THOMAS P KUHN, DDS Dentist $954 $1,208 $67 $2,229

UNIV OF WIS HOSPITAL &CL Hospital $1,159 $4,734 $26,215 $84,743 $116,850

UNIVERSITY OF WISCONSIN HOSP Independent Lab $351 $351

UNIVERSITY OF WISCONSIN MEDICAL FOUNDATIONPhysician Group $48,958 $48,448 $19,556 $67,775 $184,736

UNIVERSITY OF WISCONSIN SYSTEMS ADMINISTRATIONPhysician Group $414 $1,388 $742 $1,280 $3,824

UNIVERSITY STATION PHARMACY Pharmacy $88 $87 $175

UW HEALTH CHILDRENS PHARMACY Pharmacy $236 $13 $249

UW HEALTH EAST PHARMACY Pharmacy $161 $123 $283

UW HEALTH ONCOLOGY PHARMACY Pharmacy $29 $29

UW HEALTH OUTPATIENT PHARMAC Pharmacy $278 $240 $312 $669 $1,499

of 114




Billing

Provider


UW HEALTH PHARMACY SERVICES Pharmacy $24,496 $48,907 $35,707 $31,072 $140,182

UW HEALTH WEST PHARMACY Pharmacy $355 $361 $716

UW MEDICAL FOUNDATION BELLEV Physician Group $666 $103 $769

UW MEDICAL FOUNDATION INC Physician Group $30 $30

UW MEDICAL FOUNDATION NORTHE Physician Group $2,367 $1,466 $3,834

UW MEDICAL FOUNDATION VERONA Physician Group $661 $601 $1,262

UW MEDICAL FOUNDATION WINGRA Physician Group $3,065 $1,625 $4,690

UW SYSTEMS Physician Group $27 $78 $105

UW SYSTEMS NORTHEAST Physician Group $619 $270 $888

UW SYSTEMS WINGRA Physician Group $2,045 $370 $2,415

VERONA HOMETOWN PHARMACY Pharmacy $227 $386 $160 $366 $1,139

VILLAGE PHARMACY & GIFTS Pharmacy $281 $30 $121 $380 $811








WALGREENS #10554 Pharmacy $1,182 $1,244 $2,265 $4,691




WALGREENS #11648 Pharmacy $674 $1,961 $2,636




WALGREENS 03393 Pharmacy $1,348 $1,409 $682 $1,049 $4,488


of 114




Billing

Provider











WALGREENS04240 Pharmacy $11,105 $14,367 $8,973 $10,986 $45,431



WAL-MART PHARMACY 10-1176 Pharmacy $1,694 $954 $1,976 $2,746 $7,370

WAL-MART PHARMACY 10-1267 Pharmacy $898 $785 $1,409 $2,650 $5,742

WAL-MART PHARMACY 10-3857 Pharmacy $518 $3,957 $6,472 $10,947

WAL-MART PHARMACY-10 2335 Pharmacy $1,405 $1,277 $4,998 $3,452 $11,131

WILDWOOD FAMILY CLINIC SC Physician Group $77 $104 $119 $871 $1,171

WILLIAM B HOBBINS, MD Physician $55 $55

WILLIAM E FOWLER, MD Physician $78 $78

WISCONSIN HEART SC Physician Group $94 $78 $30 $101 $303

WISCONSIN PATHOLOGISTS SC Physician Group $276 $325 $119 $691 $1,411

Dodge AGNESIAN PHARMACY BROWNSVILL Pharmacy $570 $570

AGNESIAN PHARMACY MAYVILLE Pharmacy $40 $40

AMERIPATH MILWAUKEE SC Physician Group $2,840 $1,995 $2,062 $1,920 $8,817

AURORA PHARMACY INC Pharmacy $1,308 $444 $1,612 $304 $3,667

AYAZ M SAMADANI MD SC Physician Group $37 $37

BDCH INC MEDICAL CLINICS Physician Group $55 $55

BEAVER DAM COMMUNITY HOSPITALS INCHospital $261 $279 $8,019 $29,461 $38,020

BEAVER DAM ORTHOPAEDICCLINIC Physician Group $30 $30

of 114




Billing

Provider


BEAVER DAM REFERENCE LAB Independent Lab $1,597 $2,013 $1,348 $1,842 $6,799

BEAVER DAM WOMENS HEALTH LTD Physician Group $3,313 $3,225 $1,248 $3,611 $11,396

CENTRAL OTOLOGIC LTD Physician Group $30 $30

CONSULTANTS LABORATORYOF Independent Lab $21 $32 $33 $85

DIRECTIONS COUNSELING CENTER

Mental Health and

Substance Abuse

Services $100 $100

DOUGLAS E BRICKER, MD Physician $12 $12

FAMILY & SPORTS ORTHOPAEDIC Physician Group $87 $171 $258

IHC-BEAVER DAM EMERGENCY PHYSICIANS, LLCPhysician Group $461 $535 $264 $1,260

INTEGRITY UROLOGIC SC Physician Group $55 $55

JAMES E MEADE, MD Physician $196 $63 $230 $488

JEFFERY A MEADE, MD Physician $30 $30

JULEE R RADTKE, NP Nurse Practitioner $133 $133

KEVIN L OHALLORAN, MD Physician $86 $86

LAEEKHA A ALI, MD Physician $65 $65

MARSHLAND PHARMACY Pharmacy $2,232 $3,336 $2,126 $6,001 $13,695

MEADE MEDICALCLINIC Physician Group $113 $625 $738

METROPOLITANWATERTOWNLLC Physician Group $30 $30

PLANNED PARENTHHOOD OF WISCONSIN, INC.Family Planning Clinic $137,950 $103,321 $100,846 $34,494 $376,612

RADIOLOGY ASSOC BEAVERDAM Physician Group $10 $10 $162 $182

RANDOLPH COMMUNITY CLINIC SC Physician Group $113 $62 $36 $114 $326


ST MARYS DEAN VENTURES INC Physician Group $4,009 $4,039 $3,346 $6,693 $18,088

TARA L PASSOW MD INC Physician Group $22 $22

TERRY L TURKE, MD Physician $27 $51 $27 $396 $501

THRIFTY WHITEDRUG #48 Pharmacy $2,336 $3,966 $233 $964 $7,498

UWHP WRMC CENTER FOR WOMEN'S HEALTHPhysician Group $2,146 $1,689 $2,998 $2,295 $9,128

UWHP WRMC DOCTORS COURT CLINIC Physician Group $60 $22 $82

of 114




Billing

Provider


UWHP WRMC HEART AND VASCULAR CENTERPhysician Group $30 $30

UWHP WRMC INTERNAL MEDICINE CLINICPhysician Group $140 $61 $200

UWHP WRMC JUNEAU CLINIC Physician Group $43 $100 $289 $961 $1,393

VANS CORNER DRUG INC Pharmacy $2,508 $2,841 $893 $6,241

VICTOR W CACERES, MD Physician $221 $138 $190 $167 $715

VILLAGE PHARMACY Pharmacy $226 $226

VITA PARK EYE ASSOCIATES SC Physician Group $74 $74



WAL-MART PHARMACY 10-1012 Pharmacy $476 $3,272 $4,921 $6,253 $14,922


WATERTOWN EMERGENCY PHYSICIA Physician Group $756 $311 $262 $343 $1,672

WATERTOWN FAMILY PRACTICE Physician Group $204 $30 $112 $916 $1,261

WATERTOWN INTERNAL MEDICINE Physician Group $314 $177 $491

WATERTOWN MEMORIAL HOSPITAL Independent Lab $1,388 $1,851 $1,765 $3,401 $8,405

WATERTOWN REGIONAL MEDICAL CENTER INCHospital $311 $2,335 $17,985 $18,801 $39,433

WAUPUN MEMORIAL HOSPITAL Hospital $244 $751 $2,834 $4,504 $8,333

Door AURORA HEALTH CENTER Physician Group $1,125 $590 $616 $4,000 $6,331

AURORA HEALTHCENTER Rural Health Clinic $126 $220 $346

AURORA NOR DOOR CLINIC Rural Health Clinic $87 $166 $254

AURORA PHARMACY INC Pharmacy $898 $703 $392 $1,624 $3,616

BAY PHARMACY Pharmacy $9,565 $6,993 $3,810 $5,071 $25,439

COMMUNITY CLINIC OF DOOR Family Planning Clinic $12,044 $8,053 $1,480 $21,577

DERMATOLOGY ASSOCIATES OF WISCONSIN SCPhysician Group $95 $193 $288

DOOR CO MEMORIAL HOSPITAL Hospital $3,240 $7,535 $13,886 $13,645 $38,307

DOOR COUNTY MEMORIAL HOSP Physician Group $3,004 $3,105 $3,532 $9,641

DOOR COUNTY MEMORIAL HOSPITA Independent Lab $638 $129 $274 $1,041

Rural Health Clinic $288 $187 $475

DOOR COUNTY MEMORIAL HOSPITAL Rural Health Clinic $5,430 $5,430

of 114




Billing

Provider


KAREN L BUTLER, MD Physician $830 $94 $22 $937 $1,883

LAKE SIDE SURGICAL ASSOCIATE Physician Group $22 $420 $441

MICHELE GEIGER BRONSKY, NP Nurse Practitioner $27 $27

PAMIDA PHARMACY #653 Pharmacy $2,507 $1,811 $1,061 $5,379

SISTER BAY PHARMACY INC Pharmacy $2,073 $1,678 $3,750



WELLNESS CENTER OF DOOR COUNTY Family Planning Clinic $133,393 $142,079 $173,635 $285,008 $734,115

WELLNESS CENTER OF DOOR COUNTY INCNurse Practitioner $1,033 $1,033

Douglas DOUGLAS CO COMMUNITY HLTH Family Planning Clinic $197,900 $129,879 $327,779

DULUTH CLINICSUPERIOR PHARMA Pharmacy $4,759 $3,629 $5,449 $4,477 $18,313

ESSENTIA HEALTH ST MARYS- SUPERIOR CLINICPhysician Group $2,927 $2,444 $3,524 $4,383 $13,277

FALKS LIGNELLPHARMACY Pharmacy $1,236 $1,907 $1,924 $3,376 $8,442

K MART PHARMACY 7206 Pharmacy $837 $695 $1,567 $1,034 $4,133

LAKE SUPERIOR COMMUNITY HLTH

Federally Qualified


MARINER MEDICAL CLINIC Physician Group $526 $577 $1,085 $1,238 $3,426

PEOPLES DRUGSTORE Pharmacy $672 $883 $159 $33 $1,747

SMDC CLINICALLABORATORYSUPER Independent Lab $89 $182 $242 $546 $1,058

ST MARYS HOSPITAL OF SUPERIOR Hospital $435 $16,003 $16,438

SUPERIOR CLINIC Physician Group $121 $121

TARGET T 889PHARMACY Pharmacy $3,442 $5,480 $4,176 $2,468 $15,566

WALGREENS#03064 Pharmacy $15,394 $18,603 $21,822 $20,948 $76,766


Dunn COLFAX HEALTH MART PHARMACY Pharmacy $354 $357 $150 $862

COLFAX PHARMACY Pharmacy $405 $39 $444

DUNN COUNTY PUBLIC HLTH Family Planning Clinic $117,058 $106,879 $101,060 $140,384 $465,381

ERICKSON FAMILY PHARMACY Pharmacy $1,299 $1,590 $1,223 $1,374 $5,485

K MART PHARMACY 3541 Pharmacy $207 $982 $1,866 $1,768 $4,823

of 114




Billing

Provider


LYNN M MUREL, MD Physician $291 $291

MARSHFIELD CLINIC MENOMONIE Independent Lab $73 $21 $11 $21 $126

MAYO CLINIC HEALTH SYSTEM RED CEDARHospital $1,127 $2,892 $13,645 $14,048 $31,712

MAYO CLINIC HEALTH SYSTEM RED CEDAR- ELMWOOD CLINIPhysician Group $143 $179 $89 $411

MAYO CLINIC HEALTH SYSTEM RED CEDAR- GLENWOOD CITYPhysician Group $43 $153 $94 $554 $843

MEDICINE SHOPPE 1685 Pharmacy $7,577 $10,680 $6,392 $8,763 $33,412

RED CEDAR MEDICAL CENTER Pharmacy $3,964 $3,840 $2,076 $1,928 $11,810

RED CEDAR MEDICAL CENTER INC Independent Lab $47 $287 $335

Physician Group $9,090 $9,259 $8,268 $13,400 $40,017

THE MEDICINE SHOPPE #527 Pharmacy $1,318 $1,663 $498 $1,036 $4,514

UNIVERSITY OF WISCONSIN Family Planning Clinic $102,170 $119,538 $102,864 $82,461 $407,032



Eau Claire BECKY L KAHLER THYSSEN, CNM Nurse Service $5,311 $5,311

CARYN I SCHULZ, MD Physician $30 $30

CHIPPEWA VALLEY ORTHOPEDICS Physician Group $226 $226

DECESARE ORTHOPEDIC CLINIC Physician Group $101 $101

EAU CLAIRE ANESTHESIOLOGISTS LTD Anesthetist $118 $118


EAU CLAIRE FAMILY PLANNING Family Planning Clinic $141,205 $149,041 $141,502 $174,648 $606,397

EAU CLAIRE GIASSOCIATES SC Physician Group $22 $22

EAU CLAIRE HEALTH MARTPHARM Pharmacy $12 $478 $2,642 $1,446 $4,578

EAU CLAIRE MEDICAL CLINIC Independent Lab $105 $105


EAU CLAIRE PHARMACY Pharmacy $322 $322

EAU CLAIRE WOMENS CARE Physician Group $2,395 $1,905 $2,742 $3,673 $10,715

EDGAR O HICKS, MD Physician $55 $30 $78 $163

GROUP HEALTHOAKWOOD HILLS Pharmacy $1,164 $1,164

GROUP HEALTHPUTNAM PHARMACY Pharmacy $26,439 $26,208 $16,270 $1,998 $70,914

of 114




Billing

Provider


GROUP HEALTHRIVERVIEW Pharmacy $1,033 $1,033

IRFANE M KHATIB, MD Physician $1,106 $789 $115 $2,010

JAMIE N LAMM, NP Nurse Practitioner $34 $34

JENIFER I BASSETT, MD Physician $95 $95

JOHN C MERRICK, MD Physician $37 $37

K MART PHARMACY 4051 Pharmacy $2,628 $4,316 $2,338 $3,819 $13,100

LINDA POIRIER, NP Nurse Practitioner $3,781 $4,763 $2,267 $10,811

MARSHFIELD CLINIC EAU Independent Lab $2,109 $3,256 $1,985 $5,562 $12,912

MARSHFIELD CLINIC EAU CLAIRE

Ambulatory Surgical

Center (ASC) $207 $207 $414

MARSHFIELD CLINIC OAKWOOD Independent Lab $156 $42 $43 $129 $369


MARSHFIELD CLINIC RIVERVIEW CENTER LABIndependent Lab $52 $21 $11 $84

MARSHFIELD CLINIC STRATFORD Independent Lab $23 $23

MAYO CLINIC HEALTH SYSTEM EAU CLAIRE CLINIC INCPhysician Group $3,463 $4,386 $2,609 $22,905 $33,363

MAYO CLINIC HEALTH SYSTEM EAU CLAIRE- LUTHER CAMPUHospital $119 $119 $5,802 $26,857 $32,897

Independent Lab $2,321 $1,758 $2,716 $10,206 $17,001

MAYO CLINIC HEALTH SYSTEM PHARMACY & HOME MEDICALPharmacy $2,918 $3,604 $4,300 $5,975 $16,797

MEDICAL X RAY CONSULTANTS Physician Group $74 $121 $378 $573

NORTHERN PINES EAR NOSE & THROAT SCPhysician Group $48 $48

OAKLEAF SURGICAL HOSPITAL Hospital $66 $7,523 $7,589

OBSTETRICS GYNECOLOGY CLINIC OF EAU CLAIRE SCPhysician Group $260 $785 $1,046

PAIN CLINIC OF NORTHWESTERN Physician Group $28 $135 $500 $663

PATHOLOGY SC Physician Group $3,981 $3,504 $1,491 $3,590 $12,566

PATRICIA T SONTAG, NP Nurse Practitioner $369 $369

PINE GROVE FAMILY PRACTICE Physician Group $176 $159 $378 $901 $1,613

PLANNED PARENTHOOD OF WISCONSIN, INC.Family Planning Clinic $31,792 $119,359 $151,151

RICHARD J DANIELS, MD Physician $37 $37

SACRED HEART HOSPITAL Hospital $340 $1,593 $10,086 $27,396 $39,415

of 114




Billing

Provider


SACRED HEARTHOSPITAL OF THE Independent Lab $5,220 $4,182 $4,532 $5,474 $19,409


STEVEN C IMMERMAN, MD Physician $37 $37

STEVEN D STENZEL, MD Physician $302 $967 $95 $1,364

SUSAN J MOMONT, MD Physician $533 $533


THOMAS P PELLER MD SC Physician Group $92 $92

THOMAS P PELLER, MD Physician $55 $55

U OF WISCONSIN EAU CLAIRE Family Planning Clinic $350,167 $356,332 $406,359 $341,505 $1,454,363

UW MEDICAL FOUNDTION EAU CLA Physician Group $4,966 $3,538 $8,504

VALUE CENTERHEALTH MART PHA Pharmacy $133 $839 $28 $1,001

VALUE CENTERPHARMACY Pharmacy $728 $728



WALLY SHONG HEALTH MART Pharmacy $179 $705 $1,396 $1,379 $3,659


WESTERN WISCONSIN UROLOGY Physician Group $11 $141 $152

WILLOW CREEK WOMENS CLINIC Nurse Practitioner $603 $8,113 $8,715

Florence FLORENCE MEDICAL CENTER Physician Group $547 $140 $22 $710

Rural Health Clinic $747 $1,391 $987 $1,336 $4,461

Fond du Lac AGNESIAN PHARMACY Pharmacy $4,272 $3,999 $2,676 $1,864 $12,811

AGNESIAN PHARMACY MERCURY MA Pharmacy $120 $207 $50 $279 $656

AGNESIAN PHARMACY NFDL Pharmacy $631 $257 $33 $922

AGNESIAN PHARMACY WAUPUN Pharmacy $2,338 $1,476 $1,393 $2,157 $7,365

AURORA HEALTH CENTER Physician Group $2,595 $2,300 $1,520 $3,523 $9,938

AURORA PHARMACY INC Pharmacy $1,092 $1,066 $1,375 $793 $4,326

BROWN H OTOPALIK, DDS Dentist $360 $360

CHN MEDICAL CENTER RIPON Physician Group $174 $200 $12 $702 $1,089

CLINIC OF ORTHOPEDIC SURGERY Physician Group $77 $77

of 114




Billing

Provider


CONSULTANTS LABORATORYOF Independent Lab $15,995 $18,908 $20,441 $23,204 $78,548

CONSULTANTS LABORATORYOF WI Independent Lab $21 $137 $53 $211

CONSUMER PRESCRIPTION CENTER Pharmacy $1,127 $776 $348 $2,251

DERMATOLOGY ASSOCIATES OF WISCONSIN SCPhysician Group $563 $563

FOND DU LAC PATHOLOGY CONSUL Physician Group $3,178 $3,696 $2,788 $3,856 $13,518

FOND DU LAC REGIONAL CLINIC Physician Group $19,154 $20,261 $18,501 $36,959 $94,876

K MART PHARMACY 7649 Pharmacy $1,638 $651 $720 $1,312 $4,321

KREMER PHARMACY Pharmacy $590 $134 $476 $1,294 $2,494

PAMIDA PHARMACY 249 Pharmacy $285 $285

PAUL A BOEDER, MD Physician $937 $937

PHARMACY PLUS Pharmacy $2,654 $883 $1,655 $2,580 $7,773

PICK N SAVE PHARMACY #6389 Pharmacy $722 $1,080 $193 $1,995

PLANNED PARENTHOOD OF WISCONSIN, INCFamily Planning Clinic $323,241 $280,287 $152,733 $62,210 $818,471

RIPON DRUG MANAGEMENT ENTERP Pharmacy $2,179 $1,726 $294 $973 $5,171

RIPON MEDICAL CENTER Hospital $510 $1,285 $2,869 $6,487 $11,151

Independent Lab $23 $103 $126



ST AGNES HOSPITAL Hospital $983 $7,259 $13,370 $14,472 $36,083

TARGET STORE T-0808 PHARMACY Pharmacy $37 $404 $698 $815 $1,955

THE VILLAGE APOTHECARYINC Pharmacy $236 $404 $418 $1,057





Forest FOREST COUNTY POTAWATOMI

Federally Qualified

Health Clinic (FQHC) $600 $438 $395 $1,434

PAUL LINDERUD DBA CRANDON REXALL PHARMACYPharmacy $244 $189 $374 $1,636 $2,443

PAUL LINDERUD DBA LAONA PHARMACYPharmacy $463 $762 $721 $781 $2,727

of 114




Billing

Provider


SOKAOGON CHIPPEWA HEALTH CLINIC

Federally Qualified

Health Clinic (FQHC) $240 $130 $219 $595 $1,184

WOLF RIVER PHARMACY Pharmacy $1,485 $1,205 $73 $1,193 $3,956

Grant BLUFF STREETCLINIC Rural Health Clinic $57 $36 $288 $381

BOHLMAN DRUGSTORE INC Pharmacy $1,927 $2,069 $1,342 $2,004 $7,342

BOSCOBEL AREA HEALTH CARE Hospital $310 $3,533 $2,192 $6,035

Independent Lab $97 $63 $271 $431

Physician Group $367 $79 $446

BOSCOBEL AREAHEALTH CARE Physician Group $30 $80 $302 $412

BOSCOBEL CLINIC SC Physician Group $1,660 $663 $699 $1,474 $4,496

C & M ASSOCIATES INC Anesthetist $47 $47

CARDINS PHARMACY Pharmacy $64 $32 $399 $2,166 $2,661

DAVID C BAINBRIDGE, CRNA Anesthetist $144 $144

DOCTORS PARKPHARMACY Pharmacy $1,046 $336 $106 $328 $1,815

GENE P WEGNER, MD Physician $12 $23 $35

GERT H HASSELHOF, MD Physician $57 $57

GRANT REGIONAL HEALTH CENTER Hospital $387 $1,491 $4,026 $5,904

Independent Lab $134 $137 $38 $308


HARTIG DRUG CO #15 Pharmacy $2,644 $2,881 $2,857 $1,667 $10,049

HARTIG DRUG CO INC Pharmacy $4,875 $3,349 $6,693 $6,369 $21,285

HIGH POINT FAMILY MEDICINE Physician Group $143 $132 $251 $526


LANCASTER FAMILY MEDICAL Physician Group $308 $444 $63 $277 $1,091

MEENAKSHI R MASKI, MD Physician $198 $77 $86 $492 $853

MUSCODA HEALTH CENTER Rural Health Clinic $27 $172 $116 $884 $1,198


POTOSI TENNYSON MEDICAL Rural Health Clinic $62 $62

RAVIKANT MASKI, MD Physician $139 $52 $176 $367

of 114




Billing

Provider


SCOTT A WALKER, MD Physician $30 $30

SOUTHWEST COMMUNITY ACTION Family Planning Clinic $229,566 $211,795 $182,250 $416,158 $1,039,768

SOUTHWEST HEALTH CENTER Hospital $165 $769 $11,977 $16,653 $29,564

Independent Lab $42 $30 $77 $815 $964



U OF WI PLATTEVILLE STUDENT Family Planning Clinic $66,853 $64,747 $72,522 $65,291 $269,413



Green ANGLIN TRANSPORT SERVICES IN Transportation $21 $21

NEW GLARUS HOMETOWN PHARMACY Pharmacy $249 $1,084 $289 $456 $2,077

PINNOW PHARMACY INC Pharmacy $1,902 $2,156 $2,129 $1,797 $7,984

PLANNED PARENTHOOD OF WI Family Planning Clinic $776 $61 $837

SCHULTZ PHARMACY Pharmacy $1,478 $1,142 $486 $884 $3,990


THE CLINIC PHARMACY Pharmacy $4,758 $5,047 $4,366 $3,764 $17,934

THE MEDICINEMART Pharmacy $489 $90 $131 $710

THE MONROE CLINIC Physician Group $4,819 $6,042 $4,329 $7,150 $22,341

THE MONROE CLINIC HOSPITAL Pharmacy $183 $195 $378

THE MONROE CLINIC INC Hospital $1,588 $6,045 $8,942 $20,473 $37,048

Independent Lab $342 $342



Green Lake BENTLEY PHARMACIES INC. Pharmacy $1,286 $954 $291 $576 $3,107

BERLIN MEMORIAL HOSPITAL Hospital $1,774 $5,690 $17,476 $12,288 $37,229

Independent Lab $3,942 $2,878 $2,514 $3,061 $12,395

CENTRAL WISCONSIN ANESTHESIO Anesthetist $174 $190 $131 $495

CHN DR GUBITZ Physician Group $124 $124

CHN MEDICAL CENTER BERLIN Physician Group $1,958 $1,930 $3,867 $4,000 $11,754

of 114




Billing

Provider


CHN MEDICAL CENTER GREEN LAKE Physician Group $196 $97 $293

CHN MEDICAL CENTER INTERNAL MEDICINEPhysician Group $150 $528 $678

CHN MEDICAL CENTER MARKESAN Physician Group $279 $72 $16 $36 $403

CHN MEDICAL CENTER PRINCETON Physician Group $57 $87 $1,137 $1,281

CHN MEDICAL CENTER PULMONARY & SLEEPPhysician Group $105 $270 $375

CHN MEDICAL CTR EASTRIDGE Physician Group $343 $313 $105 $647 $1,408

CHN OB/GYN Physician Group $1,749 $377 $2,126

CHN ORTHOPEDICS AND SPORTS MEDICINEPhysician Group $86 $86

CHN RADIOLOGY Physician Group $62 $62

COMMUNITY MEDICAL CENTER OF GREEN LAKE LLCPhysician Group $76 $76

DAVID E RESEN, MD Physician $1,535 $1,181 $719 $239 $3,674

DAVID R JONES, MD Physician $43 $22 $65

FIELD PHARMACY LLC Pharmacy $3,672 $3,487 $3,545 $2,071 $12,774

MARKESAN PHARMACY Pharmacy $1,070 $2,696 $747 $777 $5,290

RIPON MEDICAL CENTER Physician Group $402 $402

ROGERS NELSON AND LO SURGICAL ASSOCIATESPhysician Group $37 $37


WOMENS HEALTH & RESOURCE CEN Family Planning Clinic $20,748 $19,445 $19,221 $42,186 $101,600

Illinois FHN LEONARD C FERGUSONCANCER Physician Group $48 $48

FREEPORT MEMORIAL HOSPITAL Hospital $32 $32

GAUTAM GUPTA, MD Physician $120 $120

GUY R ABDERHOLDEN, MD Physician $30 $30

NIHAN & MARTIN PHARMACY Pharmacy $58 $58

NORTHPOINTE HEALTH Physician Group $160 $86 $247

QUEST DIAGNOSTICS LLC IL Independent Lab $19,144 $19,866 $24,531 $46,447 $109,989

ROCKFORD HEALTH PHYSICIANS Physician Group $93 $93

SAINT ANTHONY MEDICAL CENTER Hospital $23 $23

SWEDISH AMERICAN HOSPITAL Hospital $113 $113

WALGREENS 02003 Pharmacy $1,496 $503 $610 $200 $2,808

of 114




Billing

Provider


WALGREENS 02585 Pharmacy $13 $13


WALGREENS 06001 Pharmacy $282 $264 $774 $432 $1,751

WALGREENS 06002 Pharmacy $19 $11 $30


WAL-MART PHARMACY 10-5044 Pharmacy $190 $154 $210 $555

WAL-MART PHARMACY 10-5199 Pharmacy $372 $225 $597

WARREN DRUG STORE Pharmacy $149 $97 $40 $287

Iowa BLACKHAWK AREA HEALTH CARE Physician Group $30 $78 $108

CORNER DRUG HOMETOWN PHARMAC Pharmacy $622 $320 $470 $1,159 $2,570

DOUGLAS R PALMER, MD Physician $22 $22

EVERETT R LINDSEY, MD Physician $61 $61

GARY J GRUNOW MD, MD Physician $147 $57 $58 $287 $548

GORDON J GRIESHABER MD, MD Physician $30 $181 $211

IVEYS PHARMACY INC Pharmacy $848 $902 $988 $664 $3,401

KENT S KRAMER M D, MD Physician $58 $30 $88

MARK P BISHOP MD, MD Physician $57 $223 $280

MICHELE A ROELLI MD, MD Physician $117 $443 $560

MINERAL POINT MEDICAL CENTER Rural Health Clinic $150 $60 $114 $61 $385

PAMELA K RICE, MD Physician $47 $57 $104

SARAH E FOX MD, MD Physician $132 $132

SWANSON PHARMACY INC Pharmacy $290 $290

UPLAND HILLSHEALTH Hospital $251 $494 $2,430 $2,821 $5,997

UPLAND HILLSHEALTH INC Independent Lab $80 $314 $395




Iowa State DOUGLAS A SCHMID, MD Physician $95 $95

DUBUQUE INTERNAL MEDICINE PC Physician Group $30 $30

of 114




Billing

Provider


DUBUQUE RADIOLOGICAL ASSOCIATES, PCPhysician Group $22 $22

GUNDERSEN CLINIC LTD Physician Group $25 $25

HARTIG DRUG CO #2 Pharmacy $340 $340

HARTIG DRUG CO #4 Pharmacy $234 $234

HY VEE PHARMACY #3 1162 Pharmacy $225 $225

MEDICAL ASSOCIATES CLINIC PC Physician Group $202 $365 $866 $989 $2,422

MERCY FAMILY PHARMACY EAST Pharmacy $34 $34

PATHOLOGY ASSOCIATES Physician Group $37 $37

UNITED CLINICAL LABORATORIES Independent Lab $84 $207 $479 $351 $1,122

WALGREENS #09708 Pharmacy $191 $438 $469 $1,098


Iron IRON COUNTY HEALTH DEPARTMENT Family Planning Clinic $21,026 $19,717 $20,921 $33,590 $95,253

IRON COUNTY HUMAN SERVICES

Mental Health and

Substance Abuse

Services $112 $45 $157

MARSHFIELD CLINIC MERCER Independent Lab $10 $22 $22 $54


NORTHWOODS FAMILY ORTHO SC Physician Group $22 $22

ROWE WHITE CROSS PHARMACY Pharmacy $3,055 $2,146 $1,898 $412 $7,511

WHITE CROSS PHARMACY Pharmacy $1,541 $1,541

Jackson BLACK RIVER FALLS CLINIC Pharmacy $889 $1,453 $1,534 $1,777 $5,654

BLACK RIVER MEMORIAL HOSP Physician Group $91 $91

BLACK RIVER MEMORIAL HOSPITA Hospital $240 $453 $7,011 $7,703

HO CHUNK HEALTH CARE CENTER

Federally Qualified


HO CHUNK HEALTHCARE PHARMACY Pharmacy $279 $279

KROHN CLINICLTD

Mental Health and

Substance Abuse

Services $43 $43

of 114




Billing

Provider


Physician Group $359 $325 $388 $2,581 $3,654

PAUL E HELSTAD, DPM Podiatrist $30 $30

WAARVIK DRUGS INC Pharmacy $183 $183


Jefferson AURORA PHARMACY INC Pharmacy $575 $494 $270 $1,568 $2,907

FAMILY MEDICAL CLINIC Physician Group $47 $118 $165

FORT ATKINSON EMERGENCY PHYS Physician Group $27 $86 $207 $319

FORT HEALTHCARE INC Hospital $115 $115 $13,275 $13,213 $26,719

Physician Group $2,923 $1,546 $2,670 $6,548 $13,687

FORT MEMORIAL HOSPITAL Independent Lab $1,696 $1,456 $2,386 $5,920 $11,458

FORT MEMORIAL HOSPITALCRNA Anesthetist $143 $67 $67 $277

JEFFERSON Physician Group $37 $142 $179

JEFFREY A SMITH, MD Physician $37 $37

JOHNSON CREEK Physician Group $154 $235 $95 $483

K MART PHARMACY 9543 Pharmacy $846 $955 $445 $924 $3,170

LAKE MILLS URGENT CARE Physician Group $30 $30 $60

MUELLER DRUGS INC Pharmacy $1,906 $2,587 $1,995 $1,591 $8,080



PROHEALTH CARE MEDICAL ASSOCIATESPhysician Group $178 $187 $522 $946 $1,833

RICHARD E NEILS, MD Physician $74 $74


SHOPKO PHARMACY #2051 Pharmacy $762 $934 $1,682 $2,417 $5,795

THOMAS J TACKMAN, MD Physician $60 $60

TUTTLES PHARMACY INC Pharmacy $29 $208 $237

UW HEALTH PARTNERS WATERTOWN REGIONAL MEDICAL CENTPhysician Group $64 $64

UWHP WRMC JOHNSON CREEK CLINIC Physician Group $60 $222 $1,290 $1,572

UWHP WRMC LAKE MILLS CLINIC Physician Group $336 $538 $236 $1,337 $2,447

UWHP WRMC WATERLOO CLINIC Physician Group $190 $526 $715

of 114




Billing

Provider


WALGREENS #11176 Pharmacy $56 $513 $3,520 $4,088




WAL-MART PHARMACY 10-1776 Pharmacy $2,184 $3,521 $1,425 $980 $8,111

WAL-MART PHARMACY 10-3499 Pharmacy $1,387 $1,690 $3,077

ZIMBRIC PHARMACY Pharmacy $800 $122 $399 $2,214 $3,536

Juneau ELROY FAMILYMEDICAL CENTER Physician Group $133 $133

Rural Health Clinic $128 $143 $531 $557 $1,358

GUNDERSEN CLINIC LTD Physician Group $43 $96 $139

GUNDERSEN CLINIC WONEWOC Rural Health Clinic $91 $824 $319 $209 $1,443

HESS MEMORIAL HOSPITALINC Anesthetist $317 $317

Independent Lab $2,806 $4,423 $5,071 $6,736 $19,035

Physician Group $49 $59 $76 $379 $563

JACK A. BESANT,INC. DBA FOX PHARMACYPharmacy $193 $785 $687 $101 $1,766

MILE BLUFF CLINIC Physician Group $4,227 $5,253 $4,378 $6,780 $20,638

Rural Health Clinic $111 $57 $199 $1,864 $2,231

MILE BLUFF MEDICAL CENTER INC Hospital $306 $434 $4,963 $14,568 $20,271

NECEDAH FAMILY MEDICAL CENTER INCRural Health Clinic $63 $30 $113 $552 $759

NECEDAH FAMILY MEDICALCENTER Physician Group $37 $412 $449

NEW LISBON CLINIC Physician Group $659 $1,202 $1,220 $1,125 $4,206

Rural Health Clinic $101 $114 $129 $352 $695

PHILLIPS CLINIC PHARMACY Pharmacy $608 $841 $1,118 $2,566

PHILLIPS DRUG STORE INC Pharmacy $923 $177 $365 $181 $1,645

RAABES PHARMACY SC Pharmacy $1,531 $1,517 $2,683 $1,981 $7,713


Kenosha ABDUL G DURRANI MD SC Physician Group $95 $95

AFTAB A ANSARI, MD Physician $37 $37

ALLERGY & ASTHMA CLINIC OF KENOSHAPhysician Group $79 $79

of 114




Billing

Provider


AMTUL R AHMAD, MD Physician $36 $36

ANITA I INVEISS MD SC Physician Group $22 $433 $455

ANITA I INVEISS, MD Physician $57 $87 $48 $192

AURORA HEALTH CENTER KENOSHA Physician Group $9,522 $4,820 $4,766 $11,442 $30,550

AURORA MEDICAL CENTER Hospital $1,270 $4,273 $27,038 $15,827 $48,408

AURORA MEDICAL GROUP Physician Group $1,808 $612 $798 $4,162 $7,380


BARBARA S ROBINSON, MD Physician $480 $480

CHILDRENS HOSPITAL OF Hospital $465 $465

CHILDRENS MEDICAL GROUP Physician Group $106 $106

COMPREHENSIVE ORTHOPAEDICS Physician Group $1,319 $1,319

CVS PHARMACY#08774 Pharmacy $1,788 $4,629 $563 $554 $7,533


EAR NOSE ANDTHROAT FAMILY C Physician Group $196 $196

FAMILY CARE ASSOCIATES INC Physician Group $276 $276

FARAH SALAHUDDIN, MD Physician $95 $95

GENESIS MEDICAL CENTER OF KENOSHA, SCPhysician Group $22 $94 $398 $513

GOOD VALUE PHARMACY Pharmacy $691 $1,758 $367 $557 $3,373

GOOD VALUE PHARMACY MEDCARE Pharmacy $541 $70 $110 $110 $830

GWENDOLYN M PERRY BRYE, APNP Nurse Practitioner $1,343 $3,043 $2,339 $1,399 $8,123

IHC-KENOSHA RADIOLOGY, LLC Physician Group $12 $268 $1,041 $1,320

JAMES M BURY, MD Physician $48 $48

JAWAID QUDDUS, MD Physician $86 $285 $370

JOHN D DECARLO, MD Physician $57 $30 $87

JUNITH M THOMPSON, MD Physician $321 $458 $779

K MART PHARMACY 3088 Pharmacy $403 $3,532 $3,935

KARL B SCHEIDT MD SC Physician Group $95 $95

KENOSHA COMMUNITY HEALTH

Federally Qualified

Health Clinic (FQHC) $560 $522 $1,847 $13,057 $15,986

of 114




Billing

Provider


KENOSHA COUNTY HEALTH DEPT Family Planning Clinic $123 $151 $247 $376 $897

KENOSHA FAMILY PRACTICE SC Physician Group $117 $95 $212

KENOSHA PATHOLOGY CONSULTANTS Physician Group $315 $866 $244 $2,505 $3,930

KENOSHA RADIOLOGY CENTER LLC Physician Group $36 $36

KENOSHA UROLOGY CLINICSC Physician Group $280 $280

MAJED JANDALI MD SC Physician Group $48 $48

MIDWEST CENTER FOR WOMENS HEALTHPhysician Group $93 $285 $36 $185 $599

MIDWEST PHYS ANES SRVCS SC Physician Group $477 $477



PADDOCK LAKEFAMILY PRACTICE Physician Group $115 $252 $367


PICK N SAVE PHARMACY 6874 Pharmacy $294 $370 $198 $862


PRADEEP G KUMAR, MD Physician $109 $109

RODRIGO B MATA III MD SC Physician Group $109 $109

SHOPKO PHARMACY NO 2031 Pharmacy $458 $796 $1,083 $1,265 $3,602

SURYA MEDICAL GROUP SC Physician Group $262 $262


TIMOTHY J ZELKO, DO Physician $5,695 $3,561 $1,593 $386 $11,235

UHS PHYSICIAN CLINIC Physician Group $2,401 $3,381 $3,225 $14,572 $23,580

UNITED HOSPITAL SYSTEM INC Hospital $1,572 $4,685 $83,950 $195,823 $286,030

UNITED OCCUPATIONAL MEDICINE & WALK IN SERVICES, LPhysician Group $87 $112 $494 $2,441 $3,134






WALGREENS 07965 Pharmacy $565 $1,448 $1,073 $3,555 $6,641

of 114




Billing

Provider



WALGREENS#00518 Pharmacy $2,835 $1,650 $508 $1,082 $6,075


Kewaunee AURORA PHARMACY INC Pharmacy $4,659 $3,076 $3,453 $3,221 $14,409

FMC ALGOMA Rural Health Clinic $439 $334 $315 $411 $1,499

FMC KEWAUNEE Rural Health Clinic $432 $240 $177 $400 $1,250

LUXEMBURG MEDICAL CLINIC Physician Group $481 $223 $219 $358 $1,281

LUXEMBURG PHARMACY LLC Pharmacy $2,572 $1,889 $178 $1,462 $6,101

PAMIDA PHARMACY 046 Pharmacy $2,689 $1,545 $809 $37 $5,080

La Crosse CASS STREET PHARMACY Pharmacy $37 $155 $3,178 $1,833 $5,202

CLINIC PHARMACY OF WEST SALEM INCPharmacy $1,357 $495 $1,852

DEGEN BERGLUND Pharmacy $924 $4,068 $9,668 $7,724 $22,385

DEGEN BERGLUND INC Pharmacy $307 $558 $1,162 $1,192 $3,221

DEGEN BERGLUND PHARMACY Pharmacy $29 $29

FRANCISCAN SKEMP HEALTHCARE Independent Lab $65 $379 $4,267 $4,710

FSH HOLMEN CLINIC PHARMACY Pharmacy $1,238 $1,238

GUNDERSEN CLINIC LTD Pharmacy $1,637 $3,342 $2,058 $1,367 $8,404

Physician Group $29,419 $30,141 $31,762 $72,181 $163,503

GUNDERSEN LUTHERAN MEDICAL Independent Lab $7,085 $13,288 $12,527 $18,490 $51,390

Mental Health and

Substance Abuse

Services $55 $55

GUNDERSEN LUTHERAN MEDICAL CENTER INCHospital $1,564 $4,699 $55,532 $61,255 $123,050

K MART PHARMACY 4089 Pharmacy $228 $238 $1,073 $410 $1,949

KAREN H KEIL, MD Physician $55 $55

MAYO CLINIC HEALTH SYSTEM FRANCISCAN HEALTHCARE-LAHospital $137 $137 $13,596 $17,927 $31,796

MAYO CLINIC HEALTH SYSTEM FRANCISCAN MEDICAL CENTEPhysician Group $9,040 $4,508 $1,931 $14,063 $29,542

MCHS ONALASKA PHARMACY Pharmacy $379 $424 $472 $231 $1,506

MCHS SKEMP CLINIC PHARMACY Pharmacy $363 $262 $776 $660 $2,060

of 114




Billing

Provider


MCHS ST FRANCIS PHARMACY Pharmacy $208 $208

MICHAEL S MOSLING, DDS Dentist $267 $88 $355

OPTIONS IN REPRODUCTIVECARE Family Planning Clinic $595,281 $621,070 $675,566 $915,717 $2,807,634

PINNACLE PHARMACY OF LACROSS Pharmacy $32 $63 $95

QUILLINS HEALTH Q PHARMACY Pharmacy $407 $84 $483 $975

QUILLINS MAJOR DRUG Pharmacy $1,103 $265 $2,646 $1,497 $5,511





UNIVERSITY OF WISCONSIN LA C Family Planning Clinic $42,481 $38,992 $28,703 $23,343 $133,519






WEST SALEM PHARMACY Pharmacy $214 $304 $206 $724

Lafayette ARGYLE CLINIC Physician Group $93 $102 $194

FAMILY HEALTH OF LAFAYETTE COUNTYPhysician Group $636 $156 $314 $341 $1,446

MEM HOSP OF LAFAYETTE COUNTY Hospital $157 $157 $694 $599 $1,607

MEMORIAL HOSPITAL OF LAFAYET Physician Group $256 $256

SHULLSBURG CLINIC Physician Group $114 $166 $174 $84 $538

WHITFORD PHARMACY INC Pharmacy $2,026 $3,644 $3,331 $2,208 $11,210

Langlade ASPIRUS GENERAL CLINIC Physician Group $2,324 $480 $34 $2,838

ASPIRUS GENERAL CLINICELCHO Rural Health Clinic $240 $240

ELCHO PHARMACY INC Pharmacy $222 $222

FREEDOM VANS LLC Transportation $323 $323

GRETCHEN L TOLSMA, NP Nurse Practitioner $251 $30 $282

LAKESIDE PHARMACY Pharmacy $2,301 $1,785 $1,992 $2,547 $8,626

of 114




Billing

Provider


LANGLADE HOSPITAL Hospital $268 $3,234 $23,329 $26,830


Physician Group $32 $177 $1,304 $1,514

LANGLADE MEMORIAL HOSP GENERAL CLINIC ELCHOPhysician Group $96 $1,540 $457 $829 $2,922

LANGLADE MEMORIAL HOSPGENERA Physician Group $2,034 $4,402 $3,705 $7,964 $18,105

ROBERT W CROMER, MD Physician $66 $99 $258 $423

STEVE A WEBER, DO Physician $26 $244 $270

TOLSMA LLC Nurse Practitioner $120 $120



Lincoln ASPIRUS MERRILL CLINIC Physician Group $418 $808 $380 $1,606

ASPIRUS WAUSAU HOSPITAL MERRILL CLINICPhysician Group $68 $480 $548


GOOD SAMARITAN HEALTH CENTER Independent Lab $135 $135

Physician Group $233 $118 $55 $367 $773

GOOD SAMARITAN HEALTH CTR OF MERRILL WISC INCHospital $186 $527 $1,817 $5,634 $8,164

MARSHFIELD CLINIC MERRILL CENTER LABIndependent Lab $166 $211 $237 $344 $958


MERRILL HOMETOWN PHARMACY Pharmacy $629 $629

NORTHBAY PHARMACY INC Pharmacy $3,612 $2,549 $1,673 $1,630 $9,465

RADIOLOGY MERRILL SC Physician Group $57 $57

SACRED HEARTHOSPITAL Hospital $531 $2,459 $2,013 $5,003

SACRED HEARTST MARYS HOSPIT Independent Lab $173 $173

STOXEN PHARMACY Pharmacy $518 $39 $228 $1,112 $1,897



Manitowoc AURORA HEALTH CENTER Physician Group $3,416 $5,565 $3,936 $4,732 $17,649

AURORA MEDICAL CENTER OF Hospital $290 $2,861 $1,419 $4,570

AURORA MEDICAL GROUP INC Physician Group $1,399 $1,311 $1,432 $2,145 $6,287

of 114




Billing

Provider


AURORA PHARMACY INC Pharmacy $618 $1,142 $1,060 $1,926 $4,746

BELLIN HEALTH FAST CARE MANITOWOCPhysician Group $22 $20 $42

COPPS FOOD CENTER PHARMACY Pharmacy $158 $425 $583


CVS PHARMA CY #08545 Pharmacy $3,218 $4,638 $4,375 $5,870 $18,102

DAVID A SATCHELL, MD Physician $12 $12

DAVID E AUGUSTINE, MD Physician $30 $30

DERMATOLOGY ASC OF WI SC Physician Group $33 $102 $881 $1,016

EKATERINA ROMAN, MD Physician $43 $43

EVELYN D SBAR MD, MD Physician $22 $22

EYE CLINIC OF MANITOWOC SC Physician Group $86 $86

FMC MANITOWOC Physician Group $92 $92

HFM FAMILY MEDICINE Physician Group $1,956 $1,725 $1,981 $2,211 $7,873

HFM GASTROENTEROLOGY AND INTERNAL MEDICINEPhysician Group $30 $120 $150

HFM NEUROSCIENCE Physician Group $12 $12

HFM OTOLARYNGOLOGY Physician Group $78 $78

HFM PAIN CLINIC Physician Group $388 $388

HFM PEDIATRICS Physician Group $57 $30 $87

HFM PHARMACY Pharmacy $840 $2,089 $3,665 $2,845 $9,439

HFM TR HEALTH CENTER Physician Group $307 $58 $365

HFM UROLOGY Physician Group $52 $30 $42 $123

HFM WOMENS HEALTH Physician Group $2,792 $5,601 $7,125 $5,337 $20,855

HOLY FAMILY MEDICAL CENTER Independent Lab $3,859 $3,315 $2,384 $1,669 $11,227

HOLY FAMILY MEMORIAL INC Hospital $442 $3,571 $16,261 $5,514 $25,789

Physician Group $1,236 $1,057 $833 $873 $3,998

JAMES J KIYAK, MD Physician $79 $79

JENNIFER A GARVIN CRESS, MD Physician $150 $57 $166 $115 $488

JULIE H MARTIN, MD Physician $87 $30 $117

KARL C LARSON, MD Physician $50 $50

of 114




Billing

Provider


KIEL PHARMACY Pharmacy $512 $200 $189 $695 $1,595

LAKESHORE ENDOCRINOLOGY Physician Group $48 $48

LAKESHORE ORTHOPAEDICS Physician Group $121 $174 $295

LAKESHORE RADIOLOGY ASC PC Physician Group $37 $37

MANITOWOC PHARMACIES Pharmacy $3,952 $2,141 $1,052 $380 $7,524

MANITOWOC SURGERY CENTER LLC

Ambulatory Surgical

Center (ASC) $724 $25 $749

NOLAN R HETZ, MD Physician $151 $55 $205

ORTHOPAEDIC ASC OF MANITOWOC Physician Group $123 $111 $234

OSCO DRUG#5076 Pharmacy $1,457 $1,457

PATHOLOGY PHYSICIANS HFM Physician Group $287 $287


ROBERT A GAHL, MD Physician $60 $60

RODNEY J HALVORSEN MD, MD Physician $319 $319


SUSAN F KOEHLER, APNP Nurse Practitioner $546 $546

THE CANCER CARE CENTER Physician Group $27 $27

THE MEDICINE SHOPPE Pharmacy $814 $1,388 $3,491 $5,295 $10,988

THE MEDICINESHOPPE Pharmacy $1,858 $592 $906 $3,356




WOLFE PHARMACY Pharmacy $1,412 $1,246 $731 $1,992 $5,380

Marathon 29 SUPER PHARMACY Pharmacy $2,175 $1,436 $472 $317 $4,401

ASPIRUS BEHAVIORAL MEDICINE CLINICPhysician Group $47 $24 $72

ASPIRUS CLINIC PHARMACY Pharmacy $2,430 $2,304 $2,564 $1,708 $9,006

ASPIRUS DERMATOLOGY CLINIC Physician Group $37 $30 $52 $119

ASPIRUS EDGAR CLINIC Physician Group $87 $164 $30 $281

ASPIRUS ENDOCRINOLOGY CLINIC Physician Group $390 $390

of 114




Billing

Provider


ASPIRUS FAMILY HEALTH SPECIALIST Physician Group $1,010 $1,511 $3,307 $1,910 $7,738

ASPIRUS FAMILY PHYSICIANS Physician Group $368 $428 $323 $1,639 $2,758

ASPIRUS FAMILY WALK IN Physician Group $1,568 $2,976 $3,657 $3,162 $11,364

ASPIRUS FASTCARE CLINIC Nurse Practitioner $36 $136 $91 $263

ASPIRUS FREEMAN ADULT HEALTH Physician Group $57 $117 $429 $603

ASPIRUS HOSPITALIST PROGRAM Physician Group $48 $48

ASPIRUS KRONENWETTER CLINIC Physician Group $1,188 $1,320 $3,021 $2,569 $8,098

ASPIRUS MARATHON CLINIC Physician Group $423 $181 $529 $527 $1,661

ASPIRUS OB GYN ASSOCIATES Physician Group $3,967 $7,927 $8,201 $5,379 $25,475

ASPIRUS OB GYN CLINICS OUTREACH Physician Group $22 $136 $158

ASPIRUS PEDIATRICS Physician Group $88 $88

ASPIRUS PULMONARY AND CRITICAL CAREPhysician Group $30 $42 $108 $181

ASPIRUS REFERENCE LABORATORY Independent Lab $664 $770 $3,736 $7,518 $12,686

ASPIRUS REGIONAL CANCER CENTER Physician Group $126 $126

ASPIRUS RHEUMATOLOGY CLINIC Physician Group $78 $54 $30 $162

ASPIRUS SPECIALISTIST INC Physician Group $27 $27 $54

ASPIRUS SPECIALISTS INC Physician Group $47 $825 $872

ASPIRUS SPINE & NEUROSCIENCES INSTITUTEPhysician Group $192 $192

ASPIRUS WAUSAU HOSPITAL Hospital $485 $76,329 $16,074 $10,886 $103,774

ASPIRUS WAUSAU HOSPITAL FAMILY HEALTH SPECIALISTSPhysician Group $851 $851

ASPIRUS WAUSAU HOSPITAL FAMILY WALK INPhysician Group $1,061 $1,061

ASPIRUS WAUSAU HOSPITAL FREEMAN ADULT HEALTH CLINIPhysician Group $143 $143

ASPIRUS WAUSAU HOSPITAL INC FAMILY PHYSICIANSPhysician Group $320 $320

ASPIRUS WAUSAU HOSPITAL INC MARATHON CLINICPhysician Group $339 $339

ASPIRUS WAUSAU HOSPITAL INC WESTON CLINICPhysician Group $1,018 $1,018

ASPIRUS WAUSAU HOSPITAL INPA Pharmacy $46 $46

ASPIRUS WAUSAU HOSPITAL OB GYN ASSOCIATESPhysician Group $2,975 $2,975

ASPIRUS WAUSAU HOSPITAL WESTHILL MEDICAL SPECIALISPhysician Group $121 $121

ASPIRUS WESTHILL MEDICAL SPECIALISTPhysician Group $47 $208 $179 $55 $489

of 114




Billing

Provider


ASPIRUS WESTON CLINIC Physician Group $1,771 $2,089 $2,753 $3,970 $10,583

ASPIRUS WOMENS HEALTH Nurse Practitioner $115 $282 $397

ASPIRUS WOMENS HEALTH OBSTETRICSPhysician Group $57 $57

ASSOCIATES IN PATHOLOGYSC Independent Lab $10,577 $9,223 $12,568 $9,660 $42,027


BONE AND JOINT CLINIC SC Physician Group $237 $237

BREAST CENTER OF CENTRAL WISCONSINPhysician Group $37 $37

BRENDA J BANASZYNSKI, MD Physician $28 $28

CARDIOVASCULAR ASSOCIATES OF Physician Group $61 $61

CENTRAL WI ANESTHESIOLOGY SC Anesthetist $342 $577 $919

CHRISTOPHER J MAGIERA, MD Physician $30 $30

COUNTY MARKET PHARMACY Pharmacy $528 $1,286 $2,169 $1,815 $5,798

EAR NOSE & THROAT ASSOC Physician Group $30 $371 $401

EDGAR BETANCOURT, MD Physician $2,088 $5,217 $7,304

EYE CLINIC OF WISCONSIN SC Physician Group $22 $22

FAMILY PLANNING HEALTHSERVI Family Planning Clinic $1,231,565 $1,141,379 $1,240,988 $1,885,938 $5,499,870

GARY T SWEET JR, MD Physician $37 $37

GASTROINTESTINAL ASSOCIATES Physician Group $248 $248

HOPE CLINIC SC Physician Group $22 $171 $192

MARSHFIELD CLINIC Independent Lab $73 $42 $43 $54 $212


Federally Qualified

Health Clinic (FQHC) $37 $875 $1,739 $2,651

Pharmacy $5,791 $5,692 $6,819 $5,505 $23,807

MARSHFIELD CLINIC STRATFORD Independent Lab $63 $63

MARSHFIELD CLINIC WAUSAU Independent Lab $766 $797 $602 $1,510 $3,676

MARSHFIELD CLINIC WAUSAU AMB

Ambulatory Surgical

Center (ASC) $724 $1,447 $1,447 $3,618

MID WISCONSIN EAR NOSE & THROAT PROFESSIONALS SCPhysician Group $257 $257

MINISTRY MEDICAL GROUP Physician Group $112 $127 $593 $832

of 114




Billing

Provider


NORTH CENTRAL WISCONSIN REHA Physician Group $140 $140

ORTHOPAEDIC ASSOCIATES OF WAUSAU,S.C.Physician Group $47 $61 $108

PABLO E AMADOR, MD Physician $43 $43


PICK N SAVE PHARMACY #6404 Pharmacy $1,414 $1,414

PRIMARY CONNECTION HEALTH CA

Federally Qualified

Health Clinic (FQHC) $773 $1,396 $2,106 $2,482 $6,757

RADIOLOGY ASSOCIATES OF WAUSAU SCPhysician Group $106 $78 $394 $578

RANDAL C KUMM, MD Physician $30 $30

SAINT CLARESHOSPITAL OF WES Hospital $66 $4,241 $13,419 $17,726

SALLY S MATTINGLY, MD Physician $47 $47

SAM'S PHARMACY 10-6535 Pharmacy $31 $437 $468



SOUTHSIDE HOMETOWN PHARMACY Pharmacy $45 $45

SOUTHSIDE PHARMACY Pharmacy $1,521 $2,911 $1,854 $1,215 $7,501

ST CLARES HOSPITAL OF WESTON INC Physician Group $127 $127

SURGICAL ASSOCIATES SC Physician Group $89 $559 $648


THE DIAGNOSTIC & TREATMENT Independent Lab $2,272 $2,825 $3,889 $3,277 $12,262

THE DIAGNOSTIC & TREATMENT CENTERPhysician Group $273 $456 $587 $1,316

TRIGS PHARMACY Pharmacy $210 $1,552 $544 $1,302 $3,607

UROLOGY SPECIALISTS OFWISCO Physician Group $55 $128 $183

UW MEDICAL FOUNDATION Physician Group $36 $36

UW MEDICAL FOUNDATION INC Physician Group $1,097 $657 $1,754

UW SYSTEM Physician Group $408 $431 $839

WAL MART PHARMACY 10 2813 Pharmacy $3,715 $6,094 $8,629 $10,527 $28,966



of 114




Billing

Provider



YOUNGS DRUG STORE INC Pharmacy $318 $756 $196 $1,140 $2,411

Marinette ALEXANDER B MAMONOV, MD Physician $58 $58

AURORA MEDICAL GROUP INC Physician Group $2,523 $1,356 $2,422 $5,256 $11,556

AURORA PHARMACY INC Pharmacy $962 $568 $677 $616 $2,823

BAY AREA MEDICAL CENTER Pharmacy $400 $656 $893 $623 $2,572


BAY AREA MEDICAL CENTER INC Hospital $857 $1,951 $18,096 $24,433 $45,337

Independent Lab $5,756 $3,153 $4,333 $5,271 $18,513

BELLIN HEALTH FAST CARE MARINETTEPhysician Group $24 $394 $418

CALVIN D NOGLER, MD Physician $42 $47 $94 $183

CRIVITZ MEDICAL CLINIC Rural Health Clinic $536 $220 $356 $1,249 $2,361

CRIVITZ PHARMACY Pharmacy $3,974 $6,369 $9,720 $7,148 $27,210


DIANE E ROELL, NP Nurse Practitioner $30 $30

DR JOHN P BRIODY Physician Group $547 $624 $1,171

FAMILY CARE MEDICAL Rural Health Clinic $1,032 $841 $690 $1,260 $3,823

LIONEL V KURAN, MD Physician $60 $86 $146

MARINETTE COUNTY HEALTH& HUM

Mental Health and

Substance Abuse

Services $104 $104

NORTHEAST PHARMACIES INC Pharmacy $1,939 $1,598 $1,979 $1,603 $7,119

NORTHERN LIGHTS CLINICSC Physician Group $30 $316 $346

NORTHREACH HEALTHCARE LLC Physician Group $8,291 $6,136 $4,614 $4,573 $23,614

PESHTIGO FAMILY PRACTICE Rural Health Clinic $360 $93 $173 $952 $1,578

POUND COMMUNITY MEDICALCLINI Physician Group $11 $11

ROBERT E SONNENBURG, MD Physician $12 $12


VALUCARE CENTER Pharmacy $1,637 $1,446 $825 $165 $4,072

of 114




Billing

Provider


VILLAGE PHARMACY INC Pharmacy $1,643 $2,696 $2,750 $2,623 $9,711



WAUSAUKEE HEALTH CARE Rural Health Clinic $154 $420 $370 $84 $1,029

WAUSAUKEE MEDICAL CLINIC Physician Group $485 $354 $344 $829 $2,012

WISCONSIN MICHIGAN PHYSICIAN Physician Group $96 $96

Marquette AURORA PHARMACY INC Pharmacy $602 $553 $1,155

BENTLEY PHARMACIES INC Pharmacy $161 $697 $697 $2,512 $4,067

BENTLEY PHARMACIES INC Pharmacy $942 $630 $507 $624 $2,702

CHN MEDICAL CENTER MONTELLO Physician Group $697 $629 $56 $109 $1,492

SHAHADA G SHALASH, MD Physician $145 $145

Menominee MENOMINEE TRIBAL CLINIC

Federally Qualified


WOMENS PERSONAL HEALTHPROGR Family Planning Clinic $194 $84 $278

Michigan AFTER HOURS CLINIC Rural Health Clinic $26 $30 $81 $305 $442

CHARLES N IKNAYAN, MD Physician $22 $22

CVS PHARMACY#08549 Pharmacy $147 $464 $415 $579 $1,605

DANIEL J MCMAHON, MD Physician $103 $103

DCHS ORTHOPEDICS Physician Group $55 $55

DICKINSON COMEMORIAL HOSP Hospital $59 $224 $1,919 $253 $2,456

DICKINSON COUNTY HEALTHCARE Physician Group $102 $221 $322

DICKINSON OB/GYN CLINIC Physician Group $62 $1,402 $877 $2,341

DR HAROLD P CRISSINGER&DR Rural Health Clinic $137 $42 $178

DR RAY H CAMERON Physician Group $30 $30

ELLEN E VANLAANEN, DO Physician $30 $30

ESSENTIA HEALTH IRONWOOD CLINIC Physician Group $105 $105

FMC IRON MOUNTAIN 115 Physician Group $145 $145

FMC KINGSFORD Physician Group $30 $30

FMC NORWAY Physician Group $59 $59

of 114




Billing

Provider


GRAND VIEW CLINIC Physician Group $2,534 $1,989 $692 $2,843 $8,057

GRAND VIEW HEALTH SYSTEM Physician Group $191 $191

GRAND VIEW HOSPITAL Hospital $122 $520 $364 $64 $1,071

HAROLD P CRISSINGER, MD Physician $11 $11

HENKE & RYAN, P C Rural Health Clinic $338 $87 $52 $476

JAMES A BATTI, MD Physician $60 $60

JOHN GROENEVELD, MD Physician $128 $78 $206

JOHN M COOK, MD Physician $42 $113 $155

JOSEPH T DONOHUE, MD Physician $79 $79

K MART PHARMACY #3832 Pharmacy $636 $21 $251 $907

K MART PHARMACY #3833 Pharmacy $779 $1,151 $1,722 $210 $3,862


KINGSFORD FAMILY PRACTICE CL Rural Health Clinic $91 $50 $97 $91 $328

MARQUETTE GENERAL HOSPITAL Hospital $484 $117 $601

MI WI FAMILYPRACTICE ASSOC Rural Health Clinic $73 $308 $88 $518 $986

MICHELLE E DUNCAN, MD Physician $122 $122

NILAR SHEIN, MD Physician $47 $94 $142

NORTHERN MENOMINEE HEALTH CE

Federally Qualified

Health Clinic (FQHC) $79 $165 $244

NORTHSTAR HEALTH SYSTEM Hospital $22 $22

OSCO DRUG#5086 Pharmacy $261 $261

PATTI L PETERSON, MD Physician $47 $47

PUBLIC HEALTH DELTA & MENOMI Family Planning Clinic $2,129 $4,937 $640 $7,707

RADIOLOGY ASC OF IRON MOUNTA Physician Group $12 $12

RICHARD E BRUNER, DO Physician $57 $55 $112


STEPHEN C SLAJUS, DO Physician $55 $55

TERENCE D RYAN, MD Physician $111 $111

TERRY L STEEGE, NP Nurse Practitioner $58 $58

of 114




Billing

Provider


THE DRUG STORE OF IRON MOUNTAIN Pharmacy $838 $1,039 $998 $877 $3,752

THE MEDICINESHOPPE 1263 Pharmacy $177 $177

WALGREENS #11953 Pharmacy $183 $304 $486



WAL-MART PHARMACY 10-5444 Pharmacy $276 $613 $889

Milwaukee M M C SUNDARAM, MD Physician $30 $30

A2CL SERVICES LLC Independent Lab $12,582 $30,277 $55,066 $126,052 $223,977

AARON C BODNER, MD Physician $57 $57

ABALO NUNYAKPE, MD Physician $95 $95

ACL SERVICESINC Independent Lab $18,849 $18,849

ADVANCED HEALTHCARE SC Physician Group $8,771 $3,018 $11,789

ADVANCED PAIN MANAGEMENT Physician Group $169 $1,840 $8,340 $10,349

AFFILIATED INFECTIOUS DISEASE CONSULTANTS OF WIPhysician Group $42 $42

AIDS RESOURCECENTER OF Physician Group $94 $1,249 $48 $1,391

ALEJANDRO M VINLUAN, MD Physician $69 $69

ALEXANDER A ROMASHKO, MD Physician $55 $55

ALEXANDER T HAWKINS, MD Physician $30 $30

ALFREDO C MILLAN MD SC Physician Group $1,731 $1,211 $56 $2,997

ALFREDO C MILLAN, MD Physician $60 $60

ALL NIGHT TRANSPORT INC Transportation $22 $22

ALLEN H BABBITZ, MD Physician $78 $78

ALLERGY & ASTHMA CLINIC OF W Physician Group $92 $57 $109 $327 $586

ALLERGY RESEARCH AND CARE SC Physician Group $30 $30

ALLIANCE ENTAND HEARING CEN Physician Group $30 $61 $91

ALLISON M RING, MD Physician $55 $55

ALVARO ALEMAN, MD Physician $36 $36

ALVIN F WELLS, MD Physician $148 $148

AMANI A MAGUID, MD Physician $66 $66

of 114




Billing

Provider


AMERIPATH MILWAUKEE SC Physician Group $1,006 $1,605 $516 $1,060 $4,187

ANESTHESIA ASSOCIATES OF WI RAPIDS SCPhysician Group $184 $184

ANTHONY A FERGUSON MD SC Physician Group $134 $86 $220

ARRHYTHMIA CENTER FOR Physician Group $30 $30

ARTHUR A ARENA, MD Physician $829 $96 $44 $803 $1,772

ASMC PHARMACY Pharmacy $874 $1,623 $2,174 $3,178 $7,848

ASPEN ORTHOPAEDIC & REHAB Physician Group $44 $44

ASSISTED LIVING PHARMACY SER Pharmacy $35 $35

ASSOCIATED OBSTETRICIANS Physician Group $139 $70 $209

ASSOCIATION OF ORTHOPEDIC Physician Group $167 $89 $256

ATHLENE A ALEXIS, MD Physician $158 $158

AURORA ADVANCED HEALTHCARE I Physician Group $2,347 $11,914 $56,190 $70,452

AURORA HEALTH CARE INC Physician Group $409 $1,017 $2,091 $3,517

AURORA HEALTH CARE METRO INC Hospital $3,123 $12,918 $140,204 $47,983 $204,229

Physician Group $8,711 $10,008 $4,286 $41,143 $64,149

AURORA HEALTH CENTER Physician Group $974 $974

AURORA MEDICAL GROUP Physician Group $973 $354 $1,592 $7,243 $10,162

AURORA MEDICAL GROUP ALTERNA Physician Group $332 $329 $494 $1,155

AURORA MEDICAL GROUP ANESTHESIOLOGYPhysician Group $427 $427

AURORA MEDICAL GROUP FRANKLI Physician Group $295 $146 $801 $1,242

AURORA MEDICAL GROUP INC Physician Group $638 $958 $1,596

AURORA MEDICAL GROUP METRO Physician Group $1,594 $1,594

AURORA MEDICAL GROUP MILWAUKEEPhysician Group $5,239 $4,002 $3,913 $11,577 $24,731

AURORA MEDICAL GROUP WOMENS PAVILIONPhysician Group $436 $138 $674 $5,797 $7,045


AURORA SINAI MEDICAL CENTER Audiologist $48 $48

AURORA ST LUKES FAMILYPRACT Physician Group $343 $181 $3,696 $4,219

AURORA ST LUKES FRANKLIN Physician Group $12 $167 $786 $965

AURORA ST LUKES MEDICAL CENT Audiologist $157 $157

of 114




Billing

Provider



AURORA ST LUKES MEDICAL CTR Hospital $5,483 $8,396 $97,722 $68,720 $180,321

AURORA UW MIDWIFERY CENTER Physician Group $367 $893 $337 $1,597

AURORA WEST ALLIS MEDICAL CE Hospital $848 $4,470 $30,350 $13,633 $49,301

AURORA WISELIVES CLINIC Physician Group $317 $87 $928 $1,331

BABBITZ BURSTEIN AND NASH Physician Group $77 $77

BARRY K GIMBEL MD SC Physician Group $111 $111

BAYLON FAMILY PHYSICIANS LTD Physician Group $2,537 $5,023 $4,279 $8,291 $20,131

BEHAVIORAL HEALTH PHARMACY Pharmacy $28 $28

BEHAVIORAL HEALTH SERVICES

Mental Health and

Substance Abuse

Services $631 $631

BELLIN ANESTHESIA ASSOCIATES SC Physician Group $270 $270

BIOSCRIP PHARMACY INC Pharmacy $245 $870 $1,115

BORKOWF AND BORKOVEC MD SC Physician Group $20 $20

BURLEIGH PHARMACY INC Pharmacy $342 $229 $80 $1,044 $1,695

C M M SUNDARAM MD SC Physician Group $30 $61 $91

CARDIAC RHYTHM SPECIALISTS Physician Group $48 $43 $91

CARDIOTHORACIC SURGERYGROUP Physician Group $48 $48

CARLOS C TAN, MD Physician $22 $22 $44

CARLOS J RODRIGUEZ, MD Physician $120 $120

CARMEN L TERLIZZI III, MD Physician $57 $114 $171

CAROLINA G CONTI MD SC Physician Group $1,261 $846 $650 $1,585 $4,342

CARTER DRUG STORE INC Pharmacy $28 $274 $303

CENTER FOR DIAGNOSTIC IMAGING Physician Group $36 $36

CENTER FOR NEUROLOGICAL DISORDERSPhysician Group $154 $164 $100 $419

CENTER FOR PAIN MANAGEMENT Physician Group $78 $681 $2,010 $2,769

CESARZ NASSIF AND ASSOCIATES Physician Group $37 $37

CHA LEE, MD Physician $79 $118 $230 $427

of 114




Billing

Provider


CHARLES A SCHMITT, MD Physician $176 $176

CHILDRENS HEALTH SYSTEM Physician Group $97 $94 $126 $317

CHILDRENS HOSPITAL OF WI Physician Group $397 $538 $935

CHILDRENS HOSPITAL OF WISCON Hospital $409 $2,644 $12,091 $30,540 $45,683


CHRIS T WALDO, MD Physician $598 $598

CHRISTINE E KEATING, DO Physician $39 $39

CHRISTINE R BRYKE, MD Physician $48 $48

CITY OF MILWAUKEE HEALTH Independent Lab $50,455 $29,258 $79,714

CLAY J FRANK, MD Physician $55 $55

CLINIC LATINA Physician Group $1,133 $113 $207 $1,055 $2,509

CLINIC OF OBSTETRICS & Physician Group $55 $22 $60 $137

CLINIC OF UROLOGY Physician Group $30 $177 $207

COLUMBIA CENTER INC Hospital $1,112 $423 $1,535

COLUMBIA ST MARYS Hospital $3,252 $3,252

COLUMBIA ST MARYS COLUMBIA C Independent Lab $389 $4,603 $3,611 $8,603

COLUMBIA ST MARYS HOSPITAL Hospital $16,644 $30,766 $143,255 $107,408 $298,072

COMMONWEALTHMEDICAL GROUP Physician Group $237 $170 $136 $543

COMMUNITY OPTIONS FOR RECOVE

Mental Health and

Substance Abuse

Services $101 $101

COMPASSIONATE DOCTORS INC Physician Group $55 $55

COMPREHENSIVECARDIOVASCULAR Physician Group $47 $95 $142

CRAIG A REICH, MD Physician $112 $30 $142

CSM HOSPITAL MILWAUKEE Physician Group $6,923 $7,416 $3,866 $49,615 $67,821

CURTIS A CRIMMINS, MD Physician $91 $91

CVS PHARMACY# 05390 Pharmacy $987 $987

CVS PHARMACY#01267 Pharmacy $218 $383 $924 $1,524

CVS PHARMACY#03394 Pharmacy $617 $1,079 $1,696

of 114




Billing

Provider


CVS PHARMACY#08762 Pharmacy $1,769 $2,043 $289 $1,020 $5,122


CVS PHARMACY#08765 Pharmacy $1,665 $537 $2,201

CVS PHARMACY#08766 Pharmacy $1,006 $2,356 $1,566 $405 $5,333

CVS PHARMACY#08767 Pharmacy $493 $698 $475 $1,199 $2,865

CVS PHARMACY#08768 Pharmacy $366 $553 $31 $3,094 $4,044


CVS PHARMACY#08770 Pharmacy $44 $250 $128 $814 $1,236

CVS PHARMACY#08771 Pharmacy $226 $328 $1,924 $1,183 $3,661

CVS PHARMACY#08772 Pharmacy $211 $359 $265 $835


CZARINA A HELF, MD Physician $57 $57

DAN FITZGERALD PHARMACY INC Pharmacy $56 $28 $431 $515

DANIEL H ROSLER, MD Physician $143 $143

DAVID ABELSON MD SC Physician Group $1,771 $36 $1,807

DAVID ABELSON, MD Physician $512 $512

DAVID E AMOS, MD Physician $47 $47 $334 $78 $506

DAVID G KAMPER, MD Physician $60 $60

DAVID J SIVERHUS, MD Physician $55 $141 $196

DAVID S HASKELL, MD Physician $174 $174

DAVID W OLSON, MD Physician $30 $464 $494

DEMATTIA MEDICAL GROUPLLC Physician Group $61 $61

DENTAL ASSOCIATES FOX VALLEY Dentist $712 $1,537 $2,248

DEPENDABLE CARE TRANSPORT Transportation $75 $75

DERMATOLOGY SERVICES SC Physician Group $81 $81

DEVANG V GANDHI, MD Physician $36 $94 $130

DONALD J BACCUS, MD Physician $82 $82

DONALD K MIDDLETON MD SC Physician Group $22 $111 $133

DONNA PITTER, MD Physician $39 $67 $106

of 114




Billing

Provider


DRS KHAN & ALMAS Physician Group $4,217 $2,361 $5,405 $7,513 $19,496

EDITH A MCFADDEN, MD Physician $30 $139 $169

EDWARD J ROSENTHAL, MD Physician $58 $48 $48 $154

EMERGENCY MEDICINE SPECIALISTS Physician Group $272 $272

EMMANUEL S MANUEL MD, MD Physician $48 $48

ENT ASSOCIATES SC Physician Group $10 $10

ENT SPECIALISTS OF MILWAUKEE Physician Group $55 $55

EPILEPSY & SEIZURE CARE SPEC Physician Group $278 $278

ERMED SC Physician Group $31 $31

EVAN K SAUNDERS MD SC Physician Group $228 $47 $275

EYE CARE SPECIALISTS SC Physician Group $47 $55 $516 $1,109 $1,727

FAMILY DOCTORS SC Physician Group $30 $209 $239

FAMILY MEDICINE ASSOCIA Physician Group $87 $87

FAMILY PRACTICE CLINICOF MAY Physician Group $794 $794

FROEDTERT CLINIC PHARMACY Pharmacy $16 $12 $23 $51

FROEDTERT HOSP OUTPAT PHARMA Pharmacy $43 $43 $86

FROEDTERT HOSPITAL Hospital $13,579 $11,524 $242,748 $192,992 $460,843

GARY S HAUKE, MD Physician $751 $751

GEOFFREY NKWAZI, MD Physician $267 $281 $547

GEORGE V CHANDY, MD Physician $114 $94 $207

GERALD L IGNACE INDIAN

Federally Qualified


GI ASSOCIATES LLC Physician Group $585 $2,511 $3,096

GOKAY CARE TRANSPORT Transportation $22 $22

GOODS TRANSPORTATION INC Transportation $65 $65

GORAN T RUDIC MD SC Physician Group $136 $72 $208

GOUHAR Y KHAN, MD Physician $1,212 $1,175 $2,387

GREAT LAKES Physician Group $5,563 $3,418 $7,763 $14,660 $31,404

GREAT LAKES NEUROSURGICAL Physician Group $47 $47

of 114




Billing

Provider


GREATER MILWAUKEE OTOLARYNGOLOGY LLCPhysician Group $61 $444 $505

GREATER MILWAUKEE PLASTIC SU Physician Group $78 $78

GREATER MILWAUKEE SURGICAL Physician Group $30 $30

HAKJOONG KIM, MD Physician $48 $143 $191

HAROLD K RICHES, DO Physician $91 $91

HEALTH CARE FOR THE HOMELESS

Federally Qualified

Health Clinic (FQHC) $912 $297 $2,000 $2,125 $5,334

HEART & VASCULAR SPECIALISTS Physician Group $30 $30

HEART CARE ASSOC Physician Group $120 $120

HISPANIC MEDICAL CENTER Physician Group $145 $145

HLS MEDICAL SERVICES SC Physician Group $407 $491 $1,528 $1,328 $3,753

HYPERBARIC & WOUND CARE ASSOCIATESPhysician Group $71 $71

INFECTIOUS DISEASE SPECIALISTS OF SE WI SCPhysician Group $61 $61

INNOVATIVE PAIN CARE LLC Physician Group $55 $55

ISAAC COGGS HERITAGE HEALTH Pharmacy $1,535 $2,578 $4,112

JAMES ETHINGTON, MD Physician $58 $58

JAMES H BARNETT, MD Physician $99 $99

JAMES H LANGENKAMP, MD Physician $87 $87

JANINE JAMES, MD Physician $167 $48 $214

JAVIER A RINCON, MD Physician $30 $30

JAWAD H KHAN MD SC Physician Group $95 $359 $454

JEFFREY J ANDEREGG, MD Physician $176 $176

JEREMIAS B VINLUAN, MD Physician $1,019 $1,547 $682 $1,733 $4,980

JEWEL OSCO 3618 Pharmacy $475 $475

JOCELYN K EICHE, MD Physician $57 $57

JOHN A ALBERT, MD Physician $51 $93 $63 $207

JOHN C ROGERS, MD Physician $47 $30 $835 $912

JOHN D SUSON, MD Physician $37 $37

JOHN E DANIELS MD SC Physician Group $22 $22

of 114




Billing

Provider


JOHN J BRENNAN, MD Physician $130 $243 $373

JOSELITO A BAYLON, MD Physician $48 $48

JOSEPH P HERZOG, MD Physician $100 $100

JOSEPH S KOSTRZEWSKI DO SC Physician Group $306 $306

JOSEPH S KOSTRZEWSKI, DO Physician $73 $429 $502

K MART PHARMACY 4395 Pharmacy $13 $338 $351

K MART PHARMACY 3182 Pharmacy $132 $132

K MART PHARMACY 3618 Pharmacy $1,737 $1,737

K MART PHARMACY 4380 Pharmacy $13 $31 $44


KAREN S WATSON, MD Physician $57 $57

KARIM BAKHTIAR MD SC Physician Group $745 $745

KATHLEEN M TREBIAN, MD Physician $57 $58 $114

KATZOFF RIHAWI SC Physician Group $47 $30 $450 $528

KENNETH D DEMBNY, MD Physician $55 $55

KENNETH S SCHER, MD Physician $108 $108

KEVIN A WEIDMAN, MD Physician $30 $455 $411 $896

KHAN MEDICAL ASSOCIATES SC Physician Group $87 $1,130 $1,217

KHIZZAR SHAUKAT, MD Physician $57 $57

KIM A HANSEN, MD Physician $55 $55

KUMAR V IYER, DDS Dentist $640 $640

KURT R OELKE, MD Physician $172 $47 $22 $240

LAABS INC Pharmacy $141 $12 $105 $259

LABOTTS PHARMACY Pharmacy $46 $46

LAKESHORE MEDICAL CLINIC Physician Group $5,370 $2,397 $4,147 $23,251 $35,166

LATHA RAJA SHANKAR, MD Physician $22 $22

LAWRENCE A STERKIN, MD Physician $79 $79

LAYTON AVENUE DERMATOLOGY Physician Group $177 $689 $866

LEE MEDICAL CLINIC SC Physician Group $58 $58

of 114




Billing

Provider


LEONARDO APONTE, MD Physician $97 $97

LEWIS CHAMOY, MD Physician $55 $55

LINCOLN HEALTH CENTER Physician Group $905 $219 $1,125

LUCINDA K FENSKE MD SC Physician Group $466 $466

LUCINDA K FENSKE, MD Physician $30 $30

LUTFI T TOMBULOGLU, MD Physician $378 $1,487 $1,865

LUZ STELL MORENO, MD Physician $57 $421 $477

M R SETHI MDSC Physician Group $461 $657 $2,866 $3,984

MADHAVI A PAREKH, MD Physician $87 $22 $109

MADISON MEDICAL AFFILIATES Physician Group $34 $91 $192 $3,918 $4,233

MALA THENAPPAN, MD Physician $55 $55

MAQBOOL ARSHAD, MD Physician $30 $61 $91

MAQSOOD AHMAD, MD Physician $60 $60 $90 $210

MARK E HODGSON, MD Physician $171 $171

MARNI K HEBERT, NP Nurse Practitioner $186 $88 $273

MARQUETTE NEIGHBORHOOD HEALTH CENTERNurse Practitioner $36 $697 $1,408 $4,150 $6,292

MARTIN E SAMUEL, MD Physician $109 $109

MARVIN E SATTLER, MD Physician $61 $61

MASROOR MUNIM, MD Physician $235 $235

MATTHEW B LEE, MD Physician $98 $98

MAURICIO TOVAR, MD Physician $109 $30 $546 $686

MCMC RADIOLOGY LLC Physician Group $36 $140 $175

MCMC URGICARE LLC Physician Group $449 $219 $877 $1,244 $2,790

MCW DEPARTMENT OF PSYCHIATRY

Mental Health and

Substance Abuse

Services $336 $336

MEDICAL CONSULTANTS Physician Group $48 $347 $394

MEDICAL DIAGNOSTIC IMAGING Physician Group $36 $36

MEDICAL MANAGEMENT ASSO Physician Group $808 $368 $152 $1,358 $2,686

of 114




Billing

Provider


MEDPOINT FAMILY CARE CENTER Physician Group $751 $171 $3,673 $2,062 $6,658

MEDPOINT PHARMACY INC Pharmacy $111 $256 $367

METRO NEUROSURGICAL SC Physician Group $348 $348

METROPOLITAN ANESTHESIOLOGISTS SCPhysician Group $295 $295

MICHAEL A DIDION, DO Physician $211 $211

MICHAEL H GILMAN DO SC Physician Group $469 $469 $938

MICHAEL J HAFRAN, MD Physician $30 $30

MICHAEL J KUHN JR, MD Physician $252 $252

MICHAEL N KATZOFF, MD Physician $47 $47

MIDWEST ANESTHESIA CONSULTAN Physician Group $55 $203 $259

MIDWEST AREA PHYSICIANS LLC Physician Group $1,086 $1,086

MIDWEST COMPREHENSIVE PAIN Physician Group $97 $79 $176

MIDWEST NEPHROLOGY ASSOCIATES Physician Group $47 $398 $687 $1,132

MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL,LLCHospital $3,430 $3,430

MIDWEST URGENT MEDICALSERVIC Physician Group $195 $154 $350

MILWAUKEE CARDIAC CARE LLC Physician Group $242 $242 $485

MILWAUKEE CLINIC OF ORTHOPEDIC SURGPhysician Group $30 $22 $52

MILWAUKEE COBEHAVIORAL

Institution for Mental

Disease $3,247 $464 $1,220 $4,931

MILWAUKEE EYECARE ASSOCIATES Optometrist $141 $141

MILWAUKEE HEALTH SERVICES

Federally Qualified


Physician Group $804 $1,796 $506 $3,106

MILWAUKEE IMMEDIATE CARE CENTERPhysician Group $1,014 $117 $655 $1,785

MILWAUKEE INTERNAL MEDICINE ASSOC INCPhysician Group $264 $264

MILWAUKEE MIDWEST MED BLDG Independent Lab $245 $750 $708 $653 $2,356

MILWAUKEE NEPHROLOGISTS SC Physician Group $95 $286 $381

MILWAUKEE NEUROLOGICALINSTIT Physician Group $61 $61

MILWAUKEE ORTHOPEDIC SPECIAL Physician Group $78 $78

of 114




Billing

Provider


MILWAUKEE PAIN TREATMENT SER Physician Group $791 $791

MILWAUKEE RADIOLOGISTS LTD SC Physician Group $257 $1,241 $1,598 $3,097

MLK HERITAGEHEALTH CENTER Pharmacy $3,678 $8,823 $12,502

MOHAMMAD E RASSOULI, MD Physician $52 $48 $100

MOHAMMED R SETHI, MD Physician $94 $94

MUHAMMAD Y KHAN, MD Physician $30 $30 $48 $108

NEAL H POLLACK, DO Physician $714 $714

NEBOJSA R STEVANOVIC, MD Physician $77 $166 $244

NEURODIAGNOSTIC CLINIC OF MILWAUKEE SCPhysician Group $108 $108

NEUROLOGY ALLIANCE SC Physician Group $270 $270

NEUROLOGY NEURODIAGNOSTIC CENTER SCPhysician Group $101 $101

NEWPORT PHARMACY Pharmacy $242 $106 $75 $422

NOEMI A PRIETO MD SC Physician Group $30 $150 $342 $522

NORMAN D BUEBENDORF, MD Physician $37 $67 $104

NORTH AVENUE FAMILY MEDICAL CENTER LLCPhysician Group $634 $634

NORTH SHORE ORTHOPAEDICS SC Physician Group $48 $48

NORTH SHORE PATHOLOGISTS Physician Group $118 $197 $1,104 $2,196 $3,614

NORTH SHORE UROLOGY SC Physician Group $22 $22

NORTHEAST OB GYN SC Physician Group $93 $93

NOVA MEDICAL CENTER LLC Physician Group $78 $48 $469 $595

OAK CREEK URGENT CARE LLC Physician Group $20 $47 $473 $847 $1,387

OAKWOOD FAMILY MEDICAL CLINIC SCPhysician Group $48 $114 $162

OLUSOJI OYESANYA, MD Physician $971 $971

OMNI FAMILY MEDICAL CLINIC Physician Group $255 $538 $2,468 $7,652 $10,912

ONCOLOGY ALLIANCE SC Physician Group $113 $483 $596

OPHTHALMOLOGY ASSOCIATES SC Physician Group $170 $170

OPTHALMOLOGYASSOCIATES SC Physician Group $116 $116

ORTHOPAEDIC ASSOCIATES OF MILWAUKEE, S.C.Physician Group $55 $22 $136 $212

ORTHOPAEDIC HOSPITAL OF WISCONSINHospital $283 $5,313 $6,753 $12,349

of 114




Billing

Provider


ORTHOPEDIC SURGEONS OFWISCO Physician Group $30 $472 $1,554 $2,056

















PAIN MANAGEMENT & TREATMENT Physician Group $746 $523 $1,269

PAIN MANAGEMENT CENTER OF WISCONSIN,S.C.Physician Group $199 $255 $454

PAUL D BURSTEIN, MD Physician $79 $79

PEDIATRIC & ADULT MEDICINE Physician Group $412 $88 $237 $845 $1,582

PEDIATRIC DIAGNOSTIC IMAGING Physician Group $36 $36

PEDIATRIC DIAGNOSTIC IMAGING SC Physician Group $36 $36 $72

PEDIATRIC RADIOLOGIC SERVICE Physician Group $49 $25 $74

PERO G KOMOZEC, MD Physician $36 $36

PHASE II ENTERPRISES Transportation $22 $22


PICK N SAVE PHARMACY #6366 Pharmacy $89 $34 $135 $257

PICK N SAVE PHARMACY #6416 Pharmacy $193 $193

of 114




Billing

Provider









PICK N SAVE PHARMACY #6879 Pharmacy $167 $813 $1,203 $418 $2,601

PICK N SAVE PHARMACY #6880 Pharmacy $209 $206 $123 $1,661 $2,200

PICK N SAVE PHARMACY #6882 Pharmacy $140 $1,448 $1,795 $1,015 $4,399

PICK N SAVE PHARMACY #6883 Pharmacy $33 $81 $17 $131

PICK N SAVE PHARMACY #6885 Pharmacy $29 $149 $222 $675 $1,076

PICK N SAVE PHARMACY 6371 Pharmacy $244 $1,060 $1,330 $629 $3,263

PICK N SAVE PHARMACY 6387 Pharmacy $999 $920 $353 $158 $2,430

PLANK ROAD RADIOLOGY Physician Group $47 $47 $94


PLANNED PARENTHOOD OF WISC Family Planning Clinic $1,468,879 $1,039,266 $513,652 $151,378 $3,173,176


PRESCRIPTIONS PLUS GOOD VALU Pharmacy $229 $278 $507

PRIMO R TAMAYO, MD Physician $47 $47

PROCARE MEDICAL GROUP Physician Group $5,615 $5,576 $11,321 $31,859 $54,371

PROGRESSIVE COMMUNITY HEALTH CENTERS

Federally Qualified


PULMONARY & CRITICAL CARE Physician Group $30 $30

PULMONARY MEDICINE CONSULTAN Physician Group $101 $101

RACHAEL L WEIDERHOLD, DO Physician $30 $58 $88

RADIOLOGY ASSOCIATES OF MILW Physician Group $35 $509 $95 $638

RADIOLOGY SPECIALISTS OF Physician Group $71 $434 $830 $1,335

RAJASHRI S MANOLI, MD Physician $78 $366 $714 $1,159

of 114




Billing

Provider


RAM K MITTAL, MD Physician $101 $101

RAMON A AGOR, MD Physician $183 $89 $272

RAVI GUPTA, MD Physician $86 $86

RAYMOND W MOY MD SC Physician Group $55 $55

RENEE SINOPOLI, MD Physician $42 $42

RETINA & VITREOUS CONSULTANT Physician Group $48 $48

RHEUMATIC DISEASE Physician Group $11 $11

RICARDO R SINENSE, MD Physician $55 $55

RICHARD A STELIGA, MD Physician $55 $55

RICHARD D DAVENPORT MDAND AS Physician Group $242 $242

RICHARD N EVANS JR, MD Physician $109 $79 $189

RISING PHOENIX HEART INSTITU Physician Group $101 $101

RIVERBEND SERV U PHARMACY Pharmacy $93 $93

RIZWANULLAH ARAIN, MD Physician $1,483 $95 $1,579

ROBERT J FRITZ, MD Physician $290 $480 $526 $676 $1,972

ROESCHENS OMNICARE PHARMACY Pharmacy $100 $100

ROSEANN GUMINA, MD Physician $30 $30

SAMI A ROUMANI, MD Physician $303 $1,225 $1,528

SAMIR MULLICK MD SC Physician Group $191 $363 $468 $946 $1,967

SAM'S PHARMACY 10-6303 Pharmacy $592 $338 $873 $1,803

SAM'S PHARMACY 10-6324 Pharmacy $264 $264


SARBJEET S SANDHU, MD Physician $36 $193 $229

SEAN P KEANE, MD Physician $90 $82 $173 $345

SETON PHARMACY Pharmacy $93 $37 $356 $399 $884

SHAFI MEDICAL CENTER SC Physician Group $10,771 $9,983 $7,724 $11,419 $39,896

SHAHIDA R MUNIM, MD Physician $252 $252

SHEEBA A PANNU, MD Physician $58 $58

SHOREVIEW PEDIATRICS SC Physician Group $59 $59

of 114




Billing

Provider


SIDNEY HERSZENSON, MD Physician $152 $152

SIXTEENTH STREET COMMUNITY

Federally Qualified


SIXTEENTH STREET COMMUNITY HEALTH CENTER

Federally Qualified

Health Clinic (FQHC) $8,059 $5,303 $13,362

SKYWALK PHARMACY Pharmacy $15 $15

SOUTHEAST SURGICAL SC Physician Group $30 $61 $91

SOUTHEASTERN WI ANESTHESIOLOGY Physician Group $47 $47

SOUTHEASTERNWI INFECTIOUS Physician Group $48 $48

SOUTHSIDE PEDIATRIC ASSOCIAT Physician Group $206 $237 $78 $30 $550

SPORTS MEDICINE AND ORTHOPED Physician Group $289 $289

SRINIVAS R BRAMHADEVI, MD Physician $171 $1,395 $161 $1,727

ST MARYS HOSPITAL OZAUKEE Physician Group $12,049 $12,049

STEPHEN C HINKLE, MD Physician $48 $48

STEPHEN T BAKER, MD Physician $109 $109

STEVEN B GREENMAN, MD Physician $101 $571 $672

STEVEN H GOLDBERG, MD Physician $55 $55

SUHAS K SHELGIKAR, MD Physician $30 $30

SUMMIT ANESTHESIOLOGY LTD Physician Group $176 $326 $501

SUSAN J RIEGG, MD Physician $22 $22

SUSON EYE SPECIALISTS MD SC Physician Group $256 $256

SWAN SERV U PHARMACY Pharmacy $132 $1,056 $697 $1,885

SYED N HASNAIN, MD Physician $467 $114 $219 $799

TAHA MEDICAL CENTER SC Physician Group $412 $412

TAKE CARE HEALTH WISCONSIN SC Nurse Practitioner $1,455 $1,455

TARGET STORE T-0223 PHARMACY Pharmacy $296 $2,252 $3,322 $4,936 $10,806


TARGET STORE T-1925 PHARMACY Pharmacy $344 $482 $1,321 $2,980 $5,127

TARGET STORE T-2199 PHARMACY Pharmacy $731 $416 $314 $1,545 $3,006

of 114




Billing

Provider


TARGET STORE T-2388 PHARMACY Pharmacy $81 $81

TARGET STORE T-2586 PHARMACY Pharmacy $47 $460 $645 $1,152

TARGET T-0024 PHARMACY Pharmacy $523 $191 $123 $743 $1,581

TARGET T-0057 PHARMACY Pharmacy $61 $100 $53 $966 $1,180

THE BOARD OFREGENTS OF THE Family Planning Clinic $645 $1,929 $1,907 $4,971 $9,452

THE MEDICAL COLLEGE OF WISCONSIN INCPhysician Group $48,127 $35,357 $47,587 $87,727 $218,799

THE MEDICAL COLLEGE OFWI IN Family Planning Clinic $1,941 $1,078 $786 $1,301 $5,106

THE MEDICAL COLLEGE OFWISCO Family Planning Clinic $947 $230 $709 $29 $1,915

THE PHARMACYSHOPPE Pharmacy $145 $145

THE SLEEP WELLNESS INSTITUTE Physician Group $61 $408 $469

THERESA PARDOE, DO Physician $52 $52

THOMAS SLOTA, MD Physician $48 $48 $95

THOMPSON'S SERV-U PHARMACY Pharmacy $936 $605 $1,541

THULASIRAMA P RAVICHANDRAN, MD Physician $47 $101 $148

TNT TRANSIT, Transportation $800 $800

TODD J POREMSKI, MD Physician $135 $135

TODD W BURNER, MD Physician $178 $178

TOSA PHARMACY Pharmacy $170 $170

TRINH TRUONG, MD Physician $269 $269

UNION SERV U PHARMACY Pharmacy $44 $44

UNITED DYNACARE LLC Independent Lab $73,188 $77,407 $155,499 $195,393 $501,487

UNITED OCCUPATIONAL MEDICINE & WALK IN SERVICES, LPhysician Group $108 $108

URSULA STAR ADAMCZYK, MD Physician $88 $88

UWM SILVER SPRING NURSING CTR Physician Group $172 $172

VILLARD PRIMARY & SPECIALTY Physician Group $4,256 $3,132 $1,949 $5,377 $14,713

VINCENT G LUBSEY MD SC Physician Group $1,311 $478 $11,119 $4,906 $17,814

VIOLETA A SINGSON, MD Physician $68 $68

WALEED S NAJEEB, MD Physician $22 $22


of 114




Billing

Provider



WALGREENS #01460 Pharmacy $859 $242 $998 $3,824 $5,923



WALGREENS #03125 Pharmacy $701 $596 $1,820 $1,101 $4,217




















WALGREENS 03509 Pharmacy $1,513 $203 $2,603 $5,113 $9,432





of 114




Billing

Provider




WALGREENS 04556 Pharmacy $346 $119 $268 $1,417 $2,150






WALGREENS 05459 Pharmacy $663 $1,116 $576 $2,317 $4,672


WALGREENS 05884 Pharmacy $799 $518 $1,727 $954 $3,998


WALGREENS 07661 Pharmacy $195 $506 $1,016 $1,477 $3,194

WALGREENS 09839 Pharmacy $179 $739 $1,540 $3,125 $5,583









WALGREENS#07568 Pharmacy $747 $2,671 $2,372 $2,651 $8,440



WALGREENS01979 Pharmacy $1,406 $1,406


WALMART PHARMACY Pharmacy $3,758 $2,861 $2,414 $7,860 $16,892

WAL-MART PHARMACY 10-1394 Pharmacy $1,244 $1,999 $2,635 $5,877

of 114




Billing

Provider


WAL-MART PHARMACY 10-1551 Pharmacy $413 $215 $378 $928 $1,935

WAL-MART PHARMACY 10-2828 Pharmacy $47 $146 $531 $738 $1,463



WALTER A FUHR, MD Physician $58 $58

WALTER BRUMMUND, MD Physician $109 $30 $140

WALTER I MELNYCZENKO, MD Physician $47 $77 $279 $568 $971

WALTER K T WONG, MD Physician $286 $286

WATERTOWER PAIN CONSULTANTS SC Physician Group $78 $78

WAUWATOSA CHILDRENS CLINIC Physician Group $91 $91

WEST ALLIS ORTHOPEDIC CLINIC Physician Group $44 $44

WHEATON FRANCISCAN HEALTHCARE FRANKLIN, INC.Hospital $1,405 $22,945 $24,351

WHEATON FRANCISCAN HEALTHCARE ST FRANCIS INCHospital $376 $786 $52,513 $83,057 $136,731

WHEATON FRANCISCAN HELATHCAR Hospital $145 $30,887 $31,031

WHEATON FRANCISCAN INC - ST JOSEPHHospital $2,909 $10,678 $173,217 $225,692 $412,495

WHEATON FRANCISCAN LABORATOR Independent Lab $4,283 $527 $4,278 $22,065 $31,153

WHEATON FRANCISCAN MEDICAL Physician Group $7,807 $29,467 $45,069 $116,034 $198,378

WHEATON FRANCISCAN PHARMACY Pharmacy $537 $1,048 $530 $627 $2,741

WHEATON FRANCISCAN-THE WISCONSIN HEART HOSPITALHospital $2,540 $2,057 $4,597

WILKES VILLAGE PHARMACY Pharmacy $13 $13 $26

WILLIAM T MCCULLOUGH, MD Physician $30 $30

WISCONSIN AVE MED CLINIC SC Physician Group $412 $412

WISCONSIN BONE & JOINTSC Physician Group $110 $183 $243 $375 $910

WISCONSIN NEUROLOGY CLINIC LLC Physician Group $780 $780

WISCONSIN SURGERY CENTER LLC

Ambulatory Surgical

Center (ASC) $1,447 $1,447

WOMENS CARE CENTER S C Physician Group $259 $295 $555

Minnesota ABBOTT NORTHWESTERN HOSPITAL Hospital $262 $65 $327

ALLINA MEDICAL CLINIC Physician Group $503 $715 $1,217

of 114




Billing

Provider


ALLINA MEDICAL CLINIC HASTIN Physician Group $143 $219 $253 $615

BRIDGET P BAHNEMAN, CNM Nurse Practitioner $30 $30

CENTRAL REGIONAL PATHOLOGY Independent Lab $1,816 $1,946 $770 $1,575 $6,107

CHILDRENS HOSPITALS & CLINIC Physician Group $12 $12

CHILDRENS RESPIRATORY & CRITICAL CARE SPECIALISTSPhysician Group $48 $48

CONSULTING RADIOLOGISTS LTD Physician Group $25 $136 $241 $401

CORNER MEDICAL CENTER PHARMACYPharmacy $22 $76 $99

DC WEST Physician Group $772 $694 $363 $666 $2,495

DENFELD MEDICAL CENTER Physician Group $30 $30

DULUTH CLINIC HERMANTOWN Physician Group $27 $108 $136

DULUTH CLINIC LAKESIDE Physician Group $58 $58 $115

DULUTH CLINIC LTD Physician Group $10,032 $11,808 $11,796 $13,874 $47,510

DULUTH CLINIC PHARMACY Pharmacy $1,314 $513 $700 $815 $3,343

DULUTH CLINICHERMANTOWNPHARM Pharmacy $135 $135

DULUTH CLINICWEST PHARM Pharmacy $121 $210 $180 $511

DULUTH FAMILY PRACTICECENTE Physician Group $155 $155

ECONOFOODS PHARMACY #328 Pharmacy $125 $125

ESSENTIA HEALTH DULUTH Hospital $3,359 $1,822 $2,054 $7,234

ESSENTIA HEALTH ST MARYS MEDICAL CENTERHospital $28 $412 $1,651 $11 $2,102

FAIRVIEW ELLSWORTH CLINIC Physician Group $184 $184

FAIRVIEW LAKES REGIONAL Hospital $24 $24

FAIRVIEW RED WING HOSPITAL Hospital $11 $1,808 $1,819

FAIRVIEW REDWING HEALTH Physician Group $40 $40 $80

FAIRVIEW UNIVERSITY DISCHARGE PHARMACYPharmacy $96 $96

FAMILY MEDICINE OF WINONA PA Physician Group $86 $48 $134

FOND DU LAC CAIR PHARMACY Pharmacy $37 $332 $369

GROUP HEALTHPLAN INC Physician Group $326 $119 $27 $220 $693

HEALTHEAST MEDICAL LABORATOR Independent Lab $49 $85 $775 $909

HEALTHEAST ST JOHNS HOSPITAL Hospital $112 $112

of 114




Billing

Provider


HEALTHEAST WOODWINDS HOSPITA Hospital $23 $24 $47

HENNEPIN FACULTY ASSOCIATES Physician Group $68 $68

HENRY K BONG, MD Physician $143 $143

HOSPITAL PATHOLOGY ASSOC PA Physician Group $341 $359 $22 $332 $1,053

INDEPENDENT LAB DULUTH Independent Lab $8,251 $12,891 $19,277 $24,921 $65,340

JULIE S CRONK, MD Physician $54 $54

KMART PHARMACY 7214 Pharmacy $396 $733 $1,129

LABORATORY MEDICINE SPECIALI Physician Group $551 $787 $928 $1,531 $3,798

LAKE SUPERIOR COMMUNITY HLTH

Federally Qualified


LAKEVIEW COMMUNITY PHARMACY Pharmacy $107 $107

LAKEVIEW HOSPITAL PHARMACY Pharmacy $682 $646 $608 $1,936

LAKEVIEW MEMORIAL HOSPITAL Hospital $12 $51 $140 $39 $243

LCM PATHOLOGISTS PC Independent Lab $1,772 $28 $1,800

MAYO CLINIC Physician Group $60 $213 $108 $1,692 $2,073

MAYO CLINIC HEALTH SYSTEM LAKE CITY-WABASHA CLINICPhysician Group $122 $193 $219 $305 $839

MAYO CLINIC PHARMACY Pharmacy $192 $192

MAYO CLINIC PHARMACY BALDWIN Pharmacy $46 $46

MAYO CLINIC PHARMACY EISENBE Pharmacy $115 $115

MAYO CLINIC PHARMACY NORTHWE Pharmacy $96 $96

MAYO MEDICALLABORATORIES Independent Lab $2,359 $2,110 $2,944 $2,038 $9,451

MEDTOX LABORATORIES INC Independent Lab $196 $771 $967

METROPOLITAN UROLOGIC SPECIALISTS, P.A.Physician Group $30 $41 $71

MIDWEST SPINE INSTITUTE Physician Group $139 $123 $30 $292

MILLER CREEK MEDICAL CLINIC Physician Group $225 $225

MINNESOTA ONCOLOGY HEMATOLOGY PAPhysician Group $47 $88 $136

NADEEM IQBAL, MD Physician $77 $77

NORTHLAND FAMILY PHYSICIANS Physician Group $30 $30

NORTHLAND NEUROLOGY & MYOLOG Physician Group $30 $30

of 114




Billing

Provider


NORTHLAND OBGYN ASSOC PA Physician Group $1,545 $1,205 $2,364 $3,891 $9,006

ORTHOPAEDIC ASSC OF DULUTH Physician Group $164 $164

PARK NICOLLET METHODIST HOSP Hospital $120 $120

PARKVIEW PHARMACY Pharmacy $257 $257

PETER F BORNSTEIN, MD Physician $48 $48

PHILLIPS EYE INSTITUTE Hospital $368 $368

PS RUDIE MD AND ASSOCIATES Physician Group $135 $86 $220

PS RUDIE MEDICAL CLINIC Physician Group $30 $672 $703

QUEST DIAGNOSTICS LLC IL Independent Lab $2,012 $2,335 $3,038 $2,980 $10,366

RADIOLOGISTS ASSOC IN DULUTH Physician Group $104 $280 $384

RED WING CORNER DRUG Pharmacy $564 $564

REDPHARM DRUG INC Pharmacy $255 $148 $353 $689 $1,445

REGINA MEDICAL CENTER Hospital $29 $672 $701

REGINA MEDICAL GROUP Physician Group $217 $176 $393

REGIONS HOSPITAL Hospital $166 $166

RIVER FALLS AREA HOSPITAL Independent Lab $43 $43

ROBERT O HILDEBRANDT, MD Physician $85 $85

ROCHESTER METHODIST HOSP Hospital $66 $66

SHOPKO PHARMACY #2114 Pharmacy $214 $897 $551 $1,662

ST CROIX ORTHOPAEDICS PA Physician Group $69 $30 $61 $192 $352

ST ELIZABETHHOSPITAL Hospital $82 $82

ST LUKES ANESTHESIA ASSOCIATES Physician Group $94 $94

ST LUKES CARDIOLOGY ASSOCIATES Physician Group $48 $48

ST LUKES DERMATOLOGY ASSOCIATESPhysician Group $136 $136

ST LUKES EMERGENCY SERVICES Physician Group $22 $22 $43

ST LUKES ENDOCRINOLOGY ASSOCIATESPhysician Group $152 $152

ST LUKES GASTROENTEROLOGY ASSOCIATESPhysician Group $79 $48 $127

ST LUKES HOSPITAL Hospital $76 $4,702 $3,149 $325 $8,253

ST LUKES HOSPITAL CRNA Anesthetist $202 $105 $308

of 114




Billing

Provider


ST LUKES HOSPITAL OF DULUTH Independent Lab $2,433 $2,972 $2,181 $4,881 $12,467

ST LUKES INTERNAL MEDICINE ASSOCIATESPhysician Group $30 $30 $60

ST LUKES RHEUMATOLOGY ASSOCIATESPhysician Group $27 $30 $57

ST LUKES URGENT CARE Physician Group $838 $946 $363 $776 $2,922

ST MARYS HOSPITAL Hospital $12 $27 $39

ST PAUL RADIOLOGY PA Physician Group $273 $243 $516

STILLWATER MEDICAL GROUP Physician Group $1,027 $627 $2,957 $2,098 $6,710

SUBURBAN RADIOLOGIC CONSULTA Physician Group $12 $12



TARGET STORE T-1096 PHARMACY Pharmacy $90 $63 $132 $285


THE CHILDRENS HEART CLINIC Physician Group $47 $47

THOMAS A WEBER, MD Physician $22 $22

THREE RIVERSPATHOLOGYPA Physician Group $5,418 $3,696 $1,888 $1,248 $12,250

THRIFTY WHITE DRUG #726 Pharmacy $177 $177

TWIN CITIES DERMATOPATHOLOGY Independent Lab $130 $130

UNITED HOSPITALS INCORPORATE Hospital $160 $160

UNIVERSITY OF MINNESOTA MEDI Hospital $12 $196 $207

UNIVERSITY OFMINNESOTAPHYSIC Physician Group $222 $222

WABASHA PHARMACY Pharmacy $178 $1,504 $58 $1,739

WAL MART PHARMACY 10 1971 Pharmacy $163 $163

WAL MART PHARMACY 10 2367 Pharmacy $393 $13 $406




WALGREENS 06916 Pharmacy $386 $1,749 $1,241 $3,376



of 114




Billing

Provider


WAL-MART PHARMACY 10-1472 Pharmacy $377 $377

WAL-MART PHARMACY 10-1861 Pharmacy $211 $435 $114 $761



WILLIAM K SCHWARTAU, MD Physician $12 $12

WINONA CLINIC LTD Physician Group $111 $142 $254

WINONA CLINIC PHARMACY Pharmacy $346 $413 $759

WINONA HEALTH SERVICES Hospital $50 $436 $486


Monroe GUNDERSEN CLINIC LTD Physician Group $1,820 $1,164 $1,853 $36 $4,873

JACKSON DRUGCO INC Pharmacy $473 $473

JOEL D ERICKSON, MD Physician $100 $100

LYNNE H POLODNA, NP Nurse Practitioner $57 $22 $79

MAYO CLINIC HEALTH SYSTEM FRANCISCAN HEALTHCARERural Health Clinic $30 $58 $88

MAYO CLINIC HEALTH SYSTEM FRANCISCAN HEALTHCARE-SPHospital $221 $2,641 $2,861

MEDICINE SHOPPE 1798 Pharmacy $2,119 $2,291 $1,023 $5,432

PHILLIPS TOMAH PHARMACY Pharmacy $307 $349 $511 $1,281 $2,447

SCENIC BLUFFS COMMUNITYHEALT

Federally Qualified

Health Clinic (FQHC) $155 $60 $168 $165 $547

SCENIC BLUFFS HEALTH CENTER Pharmacy $291 $221 $87 $599

SPARTA PHARMACY LLC Pharmacy $227 $182 $282 $691

THE MEDICINE SHOPPE #1798 Pharmacy $1,183 $1,551 $2,734

TOMAH MEMORIAL HOSPITAL Physician Group $158 $158

TOMAH MEMORIAL HOSPITAL INC Hospital $202 $903 $5,108 $6,212




Oconto BARBARA A PESOLA, NP Nurse Practitioner $128 $128

CMH CENTER FOR WOMENS CARE Physician Group $679 $1,886 $5,592 $8,157

of 114




Billing

Provider


COMMUNITY MEMORIAL HOSPITAL Hospital $3,662 $5,863 $20,187 $20,283 $49,994

Pharmacy $96 $292 $549 $1,687 $2,624

Physician Group $1,362 $1,361 $1,726 $5,577 $10,026

FMC OCONTO Physician Group $611 $611

Rural Health Clinic $51 $116 $43 $210

FMC OCONTO FALLS Rural Health Clinic $244 $103 $52 $405 $803

FMC SURING Physician Group $57 $58 $133 $248

JUDITH E BOWERS, DO Physician $483 $1,149 $1,632

MEGAN E TEMP, MD Physician $173 $173

NEW WOMENS HEALTHCARE ASSOC Physician Group $327 $95 $421

NEWCAP WHS Family Planning Clinic $251,394 $399,225 $452,780 $751,768 $1,855,167

NICOLET HEALTH CLINIC

Federally Qualified


NICOLET PHARMACY INC Pharmacy $1,735 $1,437 $1,044 $2,446 $6,662

OCONTO FALLS PHARMACY Pharmacy $3,719 $2,910 $3,266 $3,073 $12,968

OCONTO HOSPITAL & MEDICAL CE Hospital $292 $422 $7,004 $7,718

OCONTO HOSPITAL & MEDICAL CENTERIndependent Lab $401 $401

OCONTO HOSPITAL AND MEDICAL CLINICPhysician Group $91 $91

OCONTO PHARMACY BF Pharmacy $3,497 $2,234 $1,184 $731 $7,646

PAMIDA PHARMACY 833 Pharmacy $1,259 $561 $867 $1,165 $3,852

PREVEA HEALTH Independent Lab $369 $369

RENATE G MUNARI, MD Physician $132 $132

SUSAN A PATERSON, CNM Nurse Practitioner $818 $818

Oneida ARLENE V KELLETT, NP Nurse Practitioner $188 $188

ASPIRUS RHINELANDER CLINIC Physician Group $84 $762 $1,264 $2,110

ASPIRUS THREE LAKES CLINIC Physician Group $37 $78 $276 $391

BACKES APOTHECARY PHARMACY Pharmacy $730 $871 $567 $427 $2,595

DAVID A KNUFF, MD Physician $49 $49

FAMILY HEALTHSERVICES SC Physician Group $1,153 $1,014 $469 $474 $3,110

of 114




Billing

Provider


HOWARD YOUNGMEDICAL CENTER Independent Lab $318 $845 $1,163

HOWARD YOUNGMEDICAL CENTER INCHospital $1,643 $3,611 $25,112 $23,756 $54,121

JANET R BOWEN, NP Nurse Practitioner $229 $252 $317 $233 $1,031

JON W POTTER, DO Physician $52 $55 $108

JOSEPH P KIM, MD Physician $55 $22 $77

MARSHFIELD CLINIC MINOCQUA A

Ambulatory Surgical

Center (ASC) $724 $1,447 $2,171

MARSHFIELD CLINIC MINOCQUA C Independent Lab $526 $778 $561 $119 $1,984

Physician Group $2,049 $2,025 $4,074


MINISTRY MEDICAL GROUP Physician Group $149 $149

NADINE B BOND, NP Nurse Practitioner $2,819 $1,049 $3,868

NORTHERN WISCONSIN BONE& JOI Physician Group $86 $86

NORTHLAND ORTHOPEDIC ASSOC Physician Group $237 $237

ONEIDA COUNTYHEALTH DEPARTME Family Planning Clinic $157,060 $162,293 $150,765 $163,585 $633,703

PREMIER PHYSICAL MEDICINE AND WELLNESS CLINICPhysician Group $373 $267 $640

REDMAN & GELINAS SC Physician Group $48 $48

ROBERT J AYLESWORTH, MD Physician $22 $22

SACRED HEART ST MARYS HOSPITAL Physician Group $15,575 $18,656 $16,841 $42,108 $93,180

SACRED HEARTST MARYS HOSPIT Independent Lab $1,035 $11 $235 $1,069 $2,350


SMH MINISTRYMED GRP RIVERSI Physician Group $43 $43

ST MARYS HOSPITAL Hospital $867 $4,905 $21,875 $39,142 $66,790


STOXEN PROFESSIONAL PHARMACY Pharmacy $3,110 $4,401 $2,885 $2,516 $12,913

THREE LAKES PHARMACY Pharmacy $500 $401 $182 $192 $1,275

TRIGS PHARMACY Pharmacy $4,723 $3,572 $3,795 $6,004 $18,093



of 114




Billing

Provider




Other Border ASSOCIATED REGIONAL & UNIVER Independent Lab $49 $49

BOSTWICK LABORATORIES INC Independent Lab $1,568 $1,674 $3,242

DYNACARE NORTHWEST INC Independent Lab $119 $119

GENZYME GENETICS Independent Lab $21 $21

LABONE INC Independent Lab $814 $814

LABORATORY CORPORATIONOF Independent Lab $3,782 $1,472 $1,978 $4,463 $11,695

LABORATORY CORPORATIONOF AM Independent Lab $44 $126 $170

NATIONAL HEALTH LABORATORY Independent Lab $2,242 $830 $3,071

QUEST DIAGNOSTICS Independent Lab $98 $98

QUEST DIAGNOSTICS INC Independent Lab $264 $97 $134 $69 $564

QUEST DIAGNOSTICS NICHOLS INSTITUTE OF VALENCIA INIndependent Lab $49 $49

SANFORD SM USD CLINICAL VIRO Independent Lab $243 $49 $291

Outagamie AASCEND PAIN INSTITUTE SC Physician Group $152 $152

APPLETON AREA ANESTHESIA & PAIN SERVICES, SCPhysician Group $124 $124

ASSOCIATES IN GASTROENTEROLOGY, SCPhysician Group $48 $125 $172

AURORA PHARMACY INC Pharmacy $193 $558 $504 $856 $2,110

BRIAN KIESNOWSKI, MD Physician $90 $90

BRIAN L LOHRBACH, MD Physician $121 $121

BRIAN L VANHOOZEN, DO Physician $103 $58 $152 $312

BUTTE DES MORTS PATHOLOGY SC Physician Group $3,040 $3,108 $3,617 $6,336 $16,101

COMPREHENSIVE PAIN MANAGEMENT OF FOX VALLEYPhysician Group $205 $205

CONSUMER PRESCRIPTION CENTER Pharmacy $2,071 $47 $505 $216 $2,839



CUB PHARMACY#673 Pharmacy $29 $29

CVS PHARMACY #08525 Pharmacy $2,325 $5,822 $2,107 $3,002 $13,256

DANIEL F WENDELBORN, MD Physician $30 $30

of 114




Billing

Provider


DAVID J BROOKS, MD Physician $47 $47

DERMATOLOGY ASSOCIATES OF WISCONSIN SCPhysician Group $186 $186

DOUGLAS S YEATMAN, MD Physician $30 $30

FAMILY CARE OF THE FOXCITIES Physician Group $30 $87 $86 $203

FMC SEYMOUR Physician Group $121 $121

FORD PHARMACY Pharmacy $159 $159

FORD PHARMACY NORTH Pharmacy $114 $38 $152

FOX CITIES EYE CLINIC SC Physician Group $134 $134

FOX VALLEY HEMATOLOGY & ONCO Physician Group $121 $48 $536 $704

FOX VALLEY NEPHROLOGY PARTNE Physician Group $149 $149

FOX VALLEY PULMONARY MEDICIN Physician Group $48 $48

FOX VALLEY REPRODUCTIVE MEDICINEPhysician Group $2,671 $2,483 $5,154

FOX VALLEY SURGICAL ASSOCIAT Physician Group $133 $133

HAND AND UPPER EXTREMITY CTR Physician Group $55 $55

IHC-ST ELIZABETH EMERGENCY PHYSICIANS, LLCPhysician Group $22 $27 $49

INTEGRITY MEDICAL GROUP SC Physician Group $83 $83

JERNEGANS HEALTH MART Pharmacy $2,607 $4,573 $1,732 $1,883 $10,795

JON J CHERNEY MD, MD Physician $55 $55

KAGEN ALLERGYCLINIC SC Physician Group $236 $236

KAUKAUNA CLINIC SC Physician Group $249 $339 $678 $676 $1,941

KENT C SCHAEFER, MD Physician $37 $37

KIMBERLY PHARMACY INC Pharmacy $400 $391 $79 $870

LYNN K DAHLKE, NP Nurse Practitioner $74 $74

MICHAEL S FAUDREE, MD Physician $43 $43

MORTON PHARMACY Pharmacy $2,763 $1,203 $1,093 $2,390 $7,448

NEUROSPINE CENTER OF WI SC Physician Group $171 $171

NEW ANESTHESIOLOGY SC Physician Group $79 $79

NEW LONDON FAMILY MEDICAL Hospital $230 $459 $4,748 $10,428 $15,865

Independent Lab $95 $111 $247 $846 $1,298

of 114




Billing

Provider


NORTH THEDACARE FAMILY MEDICINEPhysician Group $1,654 $1,644 $4,692 $22,497 $30,487

ONEIDA COMMUNITY HEALTH

Federally Qualified



OSTEOPATHIC MEDICINE &PHYSIC Physician Group $236 $30 $266


PRIMARY CARE ASSOCIATES OF APPLETON, LTDPhysician Group $455 $901 $864 $2,187 $4,407

RADIATION ONCOLOGY SPECIALISTS Physician Group $48 $48

RADIOLOGY ASSOCIATES OF APPLETONPhysician Group $12 $168 $253 $433


SEYMOUR PHARMACY TLSMEINC Pharmacy $832 $1,149 $2,328 $1,313 $5,623



SHOPKO PHARMACY #504 Pharmacy $753 $996 $1,749

SHOPKO PHARMACY #505 Pharmacy $1,619 $1,182 $2,801

ST ELIZABETH HOSPITAL INC Independent Lab $5,636 $7,017 $9,951 $18,660 $41,263

ST ELIZABETHHOSPITAL Hospital $358 $2,243 $15,743 $26,073 $44,417

STEPHEN C DUNGAR, MD Physician $158 $158


TCP INTERNAL MED ECH Physician Group $43 $153 $591 $97 $884

THEDA CARE PHYSICIANS Physician Group $739 $1,319 $1,381 $3,439

THEDACARE ORTHOPEDICS PLUS Physician Group $356 $356

THEDACARE PHYSICIANS- BLACK CREEKPhysician Group $101 $101

THEDACARE PHYSICIANS KIMBERLY Physician Group $2,144 $434 $75 $2,652

THEDACARE PHYSICIANS- WEST Physician Group $294 $297 $130 $721

TIMOTHY B RASOR, MD Physician $12 $52 $64

UW MEDICAL FOUNDATION FOX VA Physician Group $1,003 $766 $1,769

UW SYSTEMS Physician Group $252 $186 $47 $485

VALLEY EYE ASSOCIATES Physician Group $99 $99

of 114




Billing

Provider


VALLEY ORTHOPEDIC CLINIC SC Physician Group $85 $85

VALLEY UROLOGIC ASSOCIATES Physician Group $30 $22 $86 $137










WOMENS CARE OF WISCONSIN Physician Group $1,559 $6,718 $1,377 $1,393 $11,045

WOMENS HEALTH SPECIALISTS SC Physician Group $11,404 $12,485 $13,539 $16,888 $54,316

Out-of-State ALEXIAN BROTHERS MED CTR Hospital $80 $80

AMERIPATH FLORIDA LLC Independent Lab $146 $146

ASCEND CLINICAL LLC Independent Lab $52 $52

AUBURN REGIONAL MEDICAL CENTER Hospital $22 $22

BANNER THUNDERBIRD MEDICAL Hospital $123 $123

BAPTIST MEMORIAL HOSPITAL Hospital $56 $56

BARAGA COUNTY MEMORIAL HOSPITALHospital $13 $13

BAYLOR MEDICAL CENTER AT GRAPEVINEHospital $35 $35

BUFFALO HOSPITAL Hospital $41 $41

CAMBRIDGE MEDICAL CENTER Hospital $433 $433

CENTEGRA HOSPITAL MCHENRY Hospital $11 $11

CGH MEDICAL CENTER Hospital $60 $60

CVS PHARMACY# 05600 Pharmacy $62 $910 $972

FLORIDA HOSPITAL MEDICAL Hospital $121 $121

HALIFAX MEDICAL CENTER Hospital $12 $12

HARDIN MEMORIAL HOSPITAL Hospital $16 $16

of 114




Billing

Provider


IOWA METHODIST MEDICALCENTE Hospital $11 $11

JACKSON MADISON COUNTY GENERAL HOSPHospital $100 $120 $220

LABORATORY CORPORATIONOF Independent Lab $14 $14

LEESBURG REGIONAL MEDICAL Hospital $2,006 $2,006

MEDICAL DIAGNOSTIC LABORATORIES LLCIndependent Lab $194 $1,175 $7,936 $9,305

MEMORIAL HOSPITAL Hospital $112 $112

MEMORIAL MEDICAL CENTER Hospital $646 $646

MERCY HOSPITAL OF FRANCISCAN Hospital $12 $12

METHODIST HEALTHCARE MEMPHIS Hospital $11 $71 $81

METROSOUTH MEDICAL CENTER Hospital $128 $128

MIDWESTERN REGIONAL Hospital $11 $11

MOUNTAINVIEWHOSPITAL Hospital $310 $310

OUR LAB Independent Lab $107 $107

PORTAGE HOSPITAL Hospital $12 $12

RANDALL S VOLLERTSEN, MD Physician $78 $78

ROSELAND COMMUNITY HOSPITAL Hospital $66 $66

RUSH UNIVERSITY MEDICAL CENT Hospital $61 $61

ST ANTHONY NORTH HOSPITAL Hospital $23 $23

ST FRANCIS HOSPITAL Hospital $31 $31

ST FRANCIS REGIONAL MEDICAL Hospital $12 $20 $32

ST LUKES METHODIST HOSPITAL Hospital $10 $10

ST MICHAELS HOSPITAL Hospital $3,945 $3,945

ST ROSE DOMINICAN DI LIMA Hospital $12 $12

ST VINCENT HOSPITAL HEALTH Hospital $336 $336

SUMMIT MEDICAL CENTER Hospital $12 $12

THE MEDICINE SHOPPE #1855 Pharmacy $618 $1,405 $2,023

THE METHODIST HOSPITALS INC Hospital $12 $12

THE TOLEDO HOSPITAL Hospital $117 $117

TRINITY HOSPITAL Hospital $35 $24 $59

of 114




Billing

Provider


UNITY HOSPITAL Hospital $100 $100

UNIVERSITY HOSPITAL Hospital $100 $100

VERNON MEMORIAL HEALTHCARE Independent Lab $107 $237 $327 $671

VISTA MEDICAL CENTER EAST Hospital $22 $22

VISTA MEDICAL CENTER WEST Hospital $11 $11

WEST SUBURBAN HOSPITALMED Hospital $12 $12

Ozaukee AURORA MEDICAL GROUP WEST BEND Physician Group $5,770 $1,717 $1,827 $5,391 $14,706

AURORA PHARMACY INC Pharmacy $122 $977 $1,099

CAROL J ESTILL, MD Physician $30 $30

COLUMBIA CENTER INC Hospital $418 $418

CVS PHARMACY#08775 Pharmacy $69 $83 $425 $577

DONALD J MEYER, DO Physician $95 $95

INDIRA MAMMEN, MD Physician $790 $1,136 $794 $2,720

INTERPEDIA SC Physician Group $86 $86

JAIME D CABATINGAN, MD Physician $30 $30

JANICE ALEXANDER RN MD SC Physician Group $20 $322 $342

JANICE H ALEXANDER, MD Physician $47 $57 $104

JOHN F LESKO, MD Physician $109 $109

JULIE A CHICKS, MD Physician $95 $1,667 $1,762

MILWAUKEE ENT CLINIC LTD Physician Group $66 $66

NORTH SHORE DERMATOLOGY SC Physician Group $55 $111 $166

NORTHEAST OB GYN SC Physician Group $112 $32 $144

NORTHSHORE GYNECOLOGY Physician Group $1,826 $1,826

ORTHOPAEDIC ASSOCIATES OF MILWAUKEE, S.C.Physician Group $22 $22


OZAUKEE MEDICAL CENTER Physician Group $30 $30

ROBERT R STUMPF, MD Physician $43 $43

ROYAL MEDICAL TRANSPORTATION Transportation $304 $304

SALVADOR V DELROSARIO, MD Physician $60 $60

of 114




Billing

Provider


SHOPKO EXPRESS #503 Pharmacy $199 $155 $87 $1,634 $2,075


SMO PHYSICIANS Physician Group $30 $30

ST MARYS HOSPITAL OZAUKEE Hospital $945 $533 $11,110 $10,632 $23,220

Physician Group $762 $602 $918 $2,282

TARGET STORE T-1212 PHARMACY Pharmacy $249 $1,145 $635 $2,029

THIENSVILLE FAMILY HEALTH Physician Group $149 $198 $103 $450

THUROW PRIMARY PREVENTIVE HEALTHCARE SCNurse Practitioner $191 $191

TNJ TRANSPORT LLC Transportation $45 $45

UNITED OCCUPATIONAL MEDICINE & WALK IN SERVICES, LPhysician Group $115 $115

VICTORIA J MONDLOCH, MD Physician $57 $57

WALGREENS Pharmacy $1,656 $2,550 $1,540 $3,863 $9,609

WALGREENS #01988 Pharmacy $774 $828 $427 $3,665 $5,695





WISCONSIN RADIOLOGY SPECIALISTS SCPhysician Group $155 $717 $748 $1,619

YE OLDE PHARMACY & WELLNESS Pharmacy $244 $394 $638

Pepin CASTLEBERG CLINIC SC Physician Group $263 $151 $180 $86 $679

CHIPPEWA VALLEY HOSPITAL Hospital $1,554 $292 $1,218 $3,064

ECONOFOODS PHARMACY 323 Pharmacy $1,899 $1,403 $1,224 $796 $5,322

HEIKE PHARMACY INC Pharmacy $2,147 $2,686 $2,478 $1,936 $9,246

JANE M POESCHEL, NP Nurse Practitioner $39 $140 $440 $848 $1,466

KENNETH M RUCKER, MD Physician $30 $30

MICHELLE L BANDY, MD Physician $112 $215 $328

PEPIN COUNTYNURSING SERVICE Family Planning Clinic $11,312 $10,704 $11,466 $18,677 $52,159

Pierce ALLINA MEDICAL CLINIC PRESCO Physician Group $308 $308

ECONOFOODS PHARMACY #322 Pharmacy $2,240 $2,464 $3,567 $1,955 $10,226

of 114




Billing

Provider


ELLSWORTH MEDICAL CLINIC Physician Group $60 $305 $365

FAIRVIEW ELLSWORTH CLINIC Physician Group $1,040 $598 $2,668 $2,840 $7,146

FREEMAN DRUGINC Pharmacy $643 $1,161 $1,980 $2,977 $6,760

MOST PHARMACY Pharmacy $1,755 $643 $953 $452 $3,802

PAMIDA PHARMACY #654 Pharmacy $84 $609 $938 $1,630

PIERCE CO REPRODUCTIVE HEALTH Family Planning Clinic $342,034 $301,354 $344,000 $436,680 $1,424,068

RIVER FALLS AREA HOSPITAL Hospital $661 $4,420 $6,218 $9,512 $20,810

RIVER FALLS MEDICAL CLINIC Physician Group $4,716 $5,284 $8,824 $13,349 $32,173

SPRING VALLEY DRUG Pharmacy $381 $1,146 $1,113 $559 $3,198

SPRING VALLEYMEDICAL CLINIC Physician Group $103 $100 $203

VILLAGE PHARMACY Pharmacy $134 $506 $640

Polk AMERY REGIONAL MEDICALCENTE Independent Lab $23 $23

AMERY REGIONAL MEDICALCENTER Hospital $100 $1,296 $2,573 $7,177 $11,147

Physician Group $7,988 $7,801 $4,389 $4,121 $24,299

BALSAM LAKE PHARMACY INC Pharmacy $3,873 $1,289 $14 $1,105 $6,281

BRADLEY S HARLANDER, DDS Dentist $262 $262

CHET JOHNSON& SONS DRUG Pharmacy $2,670 $686 $1,538 $2,328 $7,222

CLINIC PHARMACY OSCEOLA Pharmacy $733 $1,257 $2,993 $3,274 $8,257

JOHNSON DRUGAT ARMC Pharmacy $948 $385 $410 $1,423 $3,165

LADD MEMORIAL HOSPITAL Hospital $1,092 $3,290 $16,433 $10,696 $31,511


LUCK MEDICAL CLINIC Rural Health Clinic $87 $178 $185 $1,070 $1,520

LUCK MEDICALCLINIC SC Physician Group $127 $348 $313 $172 $960

LUCK PHARMACY INC Pharmacy $1,057 $475 $76 $50 $1,658

OSCEOLA MEDICAL CENTER Independent Lab $169 $169

Physician Group $2,052 $825 $1,542 $2,195 $6,615

OSCEOLA PHARMACY Pharmacy $37 $79 $105 $220

PAMIDA PHARMACY 228 Pharmacy $636 $515 $1,151

PAUL A HAUGEDDS LTD Dentist $236 $236

of 114




Billing

Provider


POLK CO HEALTH DEPARTMENT Family Planning Clinic $96,091 $99,018 $110,173 $151,339 $456,621

RENE B MILNER, MD Physician $22 $55 $77

RIVER VALLEYPHARMACY Pharmacy $1,557 $2,187 $1,227 $2,764 $7,734

ST CROIX REGIONAL MEDICAL Physician Group $7,574 $4,556 $7,751 $13,856 $33,737

ST CROIX REGIONAL MEDICAL CE Independent Lab $12 $68 $420 $613 $1,113

ST CROIX REGIONAL MEDICAL CENTER Hospital $1,597 $2,526 $7,539 $12,230 $23,892

ST CROIX VALLEY SURGICAL ASC Physician Group $22 $22

TANGEN DRUG INC Pharmacy $2,181 $1,377 $1,293 $2,143 $6,994

THE MEDICINE SHOPPE #1855 Pharmacy $271 $271

THE MEDICINESHOPPE Pharmacy $2,179 $1,981 $1,950 $6,110


Portage ASPIRUS ROSHOLT FAMILY Physician Group $30 $30

ASPIRUS STEVENS POINT CLINIC Physician Group $348 $1,088 $2,375 $5,811 $9,622

ASPIRUS STEVENS POINT SENTRY Physician Group $30 $30 $60


CENTRAL WISCRADIOLOGISTS SC Physician Group $285 $450 $762 $1,497


COPPS FOOD CENTER PHARMACY #8107Pharmacy $1,331 $1,331


JUAN B LOPEZ, MD Physician $22 $22


KLASINSKI CLINIC SC Physician Group $78 $78

MINISTRY MEDICAL GROUP

Mental Health and

Substance Abuse

Services $95 $936 $1,031

Physician Group $408 $795 $1,203

MINISTRY MEDICAL GROUP PLOVER FAMILY PRACTICEPhysician Group $1,760 $8,179 $9,939

SAINT MICHAELS HOSPITAL Independent Lab $7,213 $3,905 $2,704 $849 $14,670


of 114




Billing

Provider



ST MICHAELS HOSPITAL Hospital $6,867 $36,297 $136,592 $138,273 $318,029

Physician Group $18,843 $21,819 $21,552 $26,660 $88,875

ST MICHAELS HOSPITAL OF STEVENS POINT INCPhysician Group $6,114 $5,309 $4,465 $5,565 $21,453

STEVENS POINT SURGICAL SERVICES SCPhysician Group $472 $472 $943

TRIGS COUNTY MARKET PHARMACY Pharmacy $3,407 $4,176 $2,173 $4,413 $14,168

UNIVERSITY HEALTH SERVICE PH Pharmacy $42,903 $86,581 $116,745 $97,925 $344,154

UWSP STUDENTHEALTH SERVICE Family Planning Clinic $42,318 $64,964 $39,361 $17,175 $163,818





Price AURORA PHARMACY Pharmacy $450 $1,782 $2,151 $999 $5,381

COPPS FOOD CENTER PHARMACY #8127Pharmacy $1,100 $1,100

FLAMBEAU HOSPITAL Independent Lab $19 $19 $37

FLAMBEAU HOSPITAL INC Anesthetist $245 $245

Hospital $228 $2,249 $4,636 $7,538 $14,651

LAKEVIEW PHARMACY Pharmacy $1,121 $2,099 $2,997 $1,573 $7,791

MEMORIAL HEALTH CENTER CLINICS PRENTICEPhysician Group $778 $1,748 $173 $554 $3,254

PAMIDA PHARMACY 319 Pharmacy $771 $85 $1,145 $1,014 $3,015

PARK FALLS REGIONAL MEDICAL CLINIC SCPhysician Group $218 $34 $456 $708

PARK PHARMACYINC Pharmacy $3,754 $2,580 $2,855 $2,606 $11,795

PRICE COUNTYHEALTH Family Planning Clinic $93,342 $74,280 $88,997 $100,421 $357,040

Racine ADVANCED MEDICAL IMAGING LLC Physician Group $28 $28

ALL SAINTS MEDICAL GROUP Physician Group $15,967 $5,853 $21,820

AURORA HEALTH CENTER RACINE Physician Group $3,049 $1,492 $3,456 $11,017 $19,014


AURORA MEMORIAL HOSPITAL OF Hospital $176 $4,577 $4,990 $9,744


of 114




Billing

Provider



D J KONTRA MD AND ASSOCIATES Physician Group $52 $52

DANA R TROTTER MD SC Physician Group $196 $196

EYE CENTER OFRACINE LTD Optometrist $290 $290

EYE CLINIC OFRACINE LTD Physician Group $283 $283

GREAT LAKES DERMATOLOGY Physician Group $454 $454

HAUPER PHARMACY Pharmacy $357 $357

K & S MEDICAL TRANSPORT INC Transportation $54 $54

K MART PHARMACY #9713 Pharmacy $638 $608 $925 $615 $2,786


K MART PHARMACY 3851 Pharmacy $387 $1,616 $2,003

LAKEVIEW PHARMACY OF RACINE Pharmacy $281 $748 $1,363 $1,639 $4,032

MICHAEL A GANZ, MD Physician $22 $22

NORTHWESTERN MEDICAL CENTER SC Physician Group $55 $198 $1,479 $1,732

NUTRITIONAL DESIGNS & PHARMACY Pharmacy $44 $476 $2,361 $2,881



PATRICIO L ILADA IV, MD Physician $173 $173



PLANNED PARENTHOOD OF WISCONSIN, INC.Family Planning Clinic $2,275,131 $6,679,236 $8,954,367

RACINE COMMUNITY HEALTH CENTER

Federally Qualified

Health Clinic (FQHC) $55 $55 $460 $3,514 $4,083

RACINE COUNTY PATHOLOGY ASC Physician Group $975 $1,258 $2,924 $4,271 $9,427


SOUTHEAST ANESTHESIA CONSULT Physician Group $176 $176 $175 $527


SWIFT CARE SC Physician Group $55 $606 $661

THE PHARMACY STATION BURLINGTONPharmacy $1,995 $1,515 $1,201 $1,978 $6,690

of 114




Billing

Provider


THE PHARMACYSTATION Pharmacy $1,244 $857 $337 $327 $2,765










WAL-MART PHARMACY 10-3488 Pharmacy $1,697 $1,117 $848 $1,016 $4,677

WHEATON FRANCISCAN HEALTHCAR Hospital $2,942 $12,205 $173,227 $209,293 $397,668

Independent Lab $1,408 $2,829 $5,581 $12,024 $21,841

WHEATON FRANCISCAN PHARMACY Pharmacy $2,812 $1,243 $1,875 $3,420 $9,349

Richland JOHN M WENTZ, MD Physician $60 $60

RICHLAND FAMILY PRESCRIPTION Pharmacy $1,249 $1,948 $1,467 $3,399 $8,063

RICHLAND HOSPITAL Independent Lab $98 $576 $674

RICHLAND HOSPITAL INC Hospital $11 $606 $1,170 $6,863 $8,650

RICHLAND MEDICAL CENTER LTD Physician Group $365 $1,537 $928 $3,642 $6,473

THRIFTY WHITE PHARMACY Pharmacy $2,201 $2,403 $3,023 $1,978 $9,604


Rock AURORA PHARMACY INC Pharmacy $31,296 $17,338 $12,079 $11,775 $72,488

BELOIT AREA COMMUNITY HEALTH CENTER

Federally Qualified


BELOIT CLINIC Physician Group $15,108 $12,493 $12,211 $9,192 $49,004

BELOIT MEMORIAL HOSPITAL Hospital $104 $32,991 $83,170 $116,265

BELOIT MEMORIAL HOSPITAL INC Independent Lab $19 $17 $29 $64

BELOIT RADIOLOGY LTD Physician Group $37 $156 $508 $701

CUB PHARMACY Pharmacy $1,162 $2,161 $187 $3,510

of 114




Billing

Provider


CVS PHARMACY #08534 Pharmacy $4,632 $7,488 $3,267 $3,738 $19,125

CVS PHARMACY#08550 Pharmacy $523 $935 $1,631 $3,090


DEAN PHARMACY Pharmacy $880 $377 $426 $172 $1,855

EDGERTON HOSPITAL & HEALTH Hospital $303 $1,087 $1,050 $2,440

EDGERTON HOSPITAL & HEALTH S Physician Group $52 $30 $95 $177

EDGERTON HOSPITAL MILTON CLINIC Physician Group $30 $30

EDGERTON PHARMACY Pharmacy $1,362 $472 $1,167 $1,246 $4,246

EVANSVILLE HOMETOWN PHARMACY Pharmacy $625 $2,187 $3,025 $1,472 $7,309

FIRST CHOICEWOMENS HEALTH CENTERFamily Planning Clinic $398,223 $393,236 $350,072 $472,959 $1,614,490

HART ROAD PATHOLOGY SC Physician Group $1,024 $709 $1,056 $2,303 $5,091

HOMECARE PHARMACY LLC Pharmacy $1,413 $490 $1,428 $1,057 $4,387

HOMECARES BELOIT CLINIC Pharmacy $731 $474 $16 $1,221

JANESVILLE COMMUNITY HEALTH CENTER

Federally Qualified

Health Clinic (FQHC) $37 $256 $58 $350

JANESVILLE MEDICAL CENTER Physician Group $170 $115 $180 $465

JONAS J Y LEE, MD Physician $194 $194


KEALEY PHARMACY & HOMECARE Pharmacy $1,958 $1,381 $371 $1,631 $5,342

KENNETH R BETTS, MD Physician $137 $57 $194

MERCY EAST PHARMACY Pharmacy $758 $670 $433 $419 $2,279

MERCY HEALTH SYSTEM CORP Hospital $318 $913 $7,296 $22,031 $30,558

MERCY HOSPITAL PHYSICIANS Physician Group $502 $502

MERCY MALL PHARMACY Pharmacy $218 $34 $245 $497

MERCY OPTIONS BEHAVIORAL HEALTH CLINIC JANESVILLE

Mental Health and

Substance Abuse

Services $48 $48

MERCY WEST PHARMACY Pharmacy $1,770 $1,770 $921 $624 $5,084

MHS PHYSICIAN SERVICES Physician Group $15,973 $13,632 $22,386 $50,564 $102,554

of 114




Billing

Provider


MILTON PHARMACY Pharmacy $880 $1,542 $498 $587 $3,507


OSCO DRUG 5089 Pharmacy $147 $147


RIVERVIEW SURGERY CENTER

Ambulatory Surgical

Center (ASC) $1,447 $731 $2,178

ROCK COUNTY HEALTH DEPARTMENT Family Planning Clinic $16 $33 $164 $214

SAM'S PHARMACY 10-4840 Pharmacy $119 $120 $294 $151 $684

SCHNUCKS PHARMACY 758 Pharmacy $954 $2,571 $2,200 $1,851 $7,577


SHOPKO PHARMACY 2026 Pharmacy $5,431 $4,561 $5,130 $4,959 $20,080

ST MARYS DEAN VENTURES INC Physician Group $489 $1,114 $788 $2,071 $4,463

STATELINE ANESTHESIOLOGISTS Physician Group $172 $172











WEST SIDE MEDICAL CENTER Physician Group $322 $498 $454 $2,706 $3,980

Rusk FLAMBEAU PHARMACY Pharmacy $2,995 $2,573 $1,259 $6,827

MARSHFIELD CLINIC LADYSMITH Independent Lab $105 $105


Federally Qualified



of 114




Billing

Provider


RUSK CO CLINIC PHCY Pharmacy $1,603 $1,115 $410 $1,698 $4,826

RUSK CO DEPT HEALTH & HUMAN SERVICESFamily Planning Clinic $15,504 $11,105 $12,022 $15,114 $53,746

RUSK COUNTY MEMORIAL HOSP Hospital $183 $520 $2,022 $2,726

RUSK COUNTY MEMORIAL HOSPITA Physician Group $22 $22


Sauk BALLWEG FAMILY PHARMACY INC Pharmacy $316 $560 $756 $511 $2,143

CORNER DRUG Pharmacy $2,564 $3,369 $1,829 $2,543 $10,305

DEAN PHARMACY Pharmacy $1,263 $655 $1,775 $1,999 $5,693

DELTON FAMILY MEDICAL CENTER Physician Group $220 $628 $741 $1,011 $2,600

DIANA L KRUSE, MD Physician $60 $60

EANNELLI PHARMACY Pharmacy $953 $793 $335 $1,485 $3,567

HALL PHARMACYINC Pharmacy $1,046 $994 $2,040

HISHAM A OSMAN, MD Physician $149 $144 $293

HOCHUNK NATION WELLNESS

Federally Qualified

Health Clinic (FQHC) $345 $236 $79 $130 $790

HOUSE OF WELLNESS PHARMACY Pharmacy $149 $154 $302

K MART PHARMACY 7650 Pharmacy $1,034 $1,592 $524 $688 $3,838

MAIN STREET PHARMACY INC Pharmacy $84 $93 $178

MEDICAL ARTS PHARMACY Pharmacy $5,179 $2,949 $4,335 $4,355 $16,817

MICHAEL D PLOOSTER, MD Physician $340 $340

ORTHOPEDIC ASSOCIATES OF Physician Group $90 $225 $315

PAMIDA PHARMACY 175 Pharmacy $403 $613 $298 $1,313

PLAIN MEDICAL CLINIC Physician Group $11 $11

Rural Health Clinic $73 $73

PRAIRIE CLINIC SC Physician Group $3,542 $1,941 $1,819 $3,331 $10,632

REEDSBURG AREA MEDICAL Anesthetist $269 $171 $440

Hospital $1,205 $2,896 $13,058 $12,854 $30,014

REEDSBURG AREA MEDICALCENTE Independent Lab $208 $238 $297 $640 $1,384

REEDSBURG AREA MEDICALCENTER Physician Group $60 $73 $181 $414 $729

of 114




Billing

Provider


REEDSBURG FAMILY PRESCRIPTION CENTERPharmacy $364 $287 $713 $981 $2,344

REEDSBURG MEMORIAL HOSPITAL Physician Group $30 $30

REEDSBURG PHYSICIANS GROUPSC Physician Group $5,910 $7,766 $4,610 $6,669 $24,955

RIVER VALLEY MEDICAL CLINIC Physician Group $10 $10

RIVER VALLEYMEDICAL CLINIC Rural Health Clinic $97 $43 $70 $210

SAUK CITY PHARMACY Pharmacy $462 $265 $112 $441 $1,280

SAUK PRAIRIE MEMORIAL HOSPITAL Physician Group $431 $464 $30 $121 $1,046

SAUK PRAIRIEMEMORIAL HOSP Hospital $433 $1,842 $5,846 $8,121

SPRING GREENMEDICAL CENTER Rural Health Clinic $78 $463 $117 $658

Therapy Group $92 $92

SPRING GREENPHARMACY INC Pharmacy $2,297 $2,032 $354 $689 $5,371

SPRING MEDICAL ASSOCIATES LL Physician Group $155 $30 $185

ST CLARE HOSPITAL AND HEALTH Hospital $90 $268 $5,345 $11,819 $17,521

Physician Group $261 $81 $61 $1,147 $1,549

ST CLARE LABORATORY Independent Lab $192 $228 $238 $630 $1,288


SURGICAL ASSOCIATES Physician Group $112 $22 $37 $171

SURGICAL PARTNERS SC Physician Group $22 $30 $55 $111 $218

TIMOTHY J MCREATH, DDS Dentist $1,166 $1,166






WAL-MART PHARMACY 10-3505 Pharmacy $1,340 $790 $1,293 $3,232 $6,655

Sawyer CO OP PHARMACY Pharmacy $621 $1,959 $190 $2,769

DULUTH CLINIC HAYWARD PHARMA Pharmacy $2,956 $2,272 $2,031 $1,868 $9,127

ESSENTIA HEALTH HAYWARD CLINIC Physician Group $6,917 $7,467 $7,961 $10,066 $32,411

FOGARTY SURGICAL SERVICES & FAMILY CAREPhysician Group $246 $678 $175 $580 $1,679

of 114




Billing

Provider


HAYWARD AREAMEMORIAL HOSP Hospital $169 $163 $1,244 $2,177 $3,752


HAYWARD AREAMEMORIAL HOSPIT Independent Lab $60 $34 $53 $147

INHOFF HEALTH MART PHARMACY Pharmacy $2,032 $1,761 $1,601 $5,394

LAC COURTE OREILLES

Federally Qualified


LAC COURTE OREILLES COMMUNIT

Mental Health and

Substance Abuse

Services $318 $318


SAWYER COUNTY HEALTH & HUMAN SERVICES SAWYER COUNTFamily Planning Clinic $15,587 $13,928 $10,583 $11,449 $51,547

STONE LAKE RURAL HEALTH CLIN Rural Health Clinic $122 $108 $230



Shawano ASPIRUS GENERAL CLINIC Physician Group $71 $71

ASPIRUS WAUSAU HOSPITAL INC WITTENBERG CLINICPhysician Group $135 $135

ASPIRUS WITTENBERG CLINIC Physician Group $37 $228 $265

DREIER PHARMACY & GIFTSHOPP Pharmacy $950 $1,290 $862 $972 $4,074

FMC BONDUEL Physician Group $166 $166

GWIDT PHARMACY INC Pharmacy $1,950 $3,480 $2,721 $1,948 $10,100


LANGLADE MEMORIAL HOSPGENERA Physician Group $284 $560 $69 $332 $1,246

MARSHFIELD CLINIC WITTENBERG Independent Lab $21 $21


SHAWANO MEDICAL CENTER Hospital $252 $505 $5,129 $10,984 $16,870


SHAWANO MEDICAL CENTER CLINIC Physician Group $66 $55 $554 $1,218 $1,892

STOCKBRIDGE MUNSEE HEALTH & WELLNESSPharmacy $281 $353 $635

of 114




Billing

Provider


STOCKBRIDGE MUNSEE HEALTH & WELLNESS CTR

Federally Qualified


THEDACARE PHARMACY Pharmacy $1,580 $1,495 $771 $916 $4,762

THEDACARE PHYSICIANS SHAWANO Physician Group $3,786 $6,693 $2,292 $12,770

THEDACARE PHYSICIANS TIGERTON Physician Group $481 $481



Sheboygan AURORA MEDICAL GROUP Physician Group $15,821 $9,955 $11,442 $25,676 $62,894

AURORA MEDICAL GROUP INC

Mental Health and

Substance Abuse

Services $11 $11


AURORA SHEBOYGAN MEMORIAL Hospital $163 $484 $5,021 $2,881 $8,549

AURORA VALLEY VIEW CAMPUS OF Physician Group $189 $189

COULIS CARDIOLOGY Physician Group $59 $61 $120

DEAN A MANCHESKI, MD Physician $115 $115

GARY R SCHERR, MD Physician $79 $79

GEORGE S SCHROEDER, MD Physician $57 $57

GLANDER PRESCRIPTIONS PLUS Pharmacy $88 $183 $115 $598 $983

JAMES R PAWLAK, MD Physician $60 $60

K MART PHARMACY 3831 Pharmacy $518 $589 $1,004 $427 $2,537


KATHERINE C CLEVELAND, MD Physician $48 $48

KATHRYN A GREEN, MD Physician $102 $102

LOUIE COULIS, MD Physician $127 $127

MARSHO FAMILY MEDICAL GROUP Physician Group $2,136 $30 $2,166

MARY E ARENBERG, MD Physician $648 $22 $670

MARY J GENTINE, MD Physician $30 $30

NAN C BROWNE, NP Nurse Practitioner $37 $37

of 114




Billing

Provider



PLYMOUTH FAMILY PHYSICIANS Physician Group $79 $79

PREVEA SHEBOYGAN HEALTH CENT Physician Group $1,214 $2,649 $3,862

SCOTT M STILLWELL, MD Physician $73 $73

SHEBOYGAN INTERNAL MEDICINE ASSOCIATESPhysician Group $88 $511 $599

SHEBOYGAN ORTHOPAEDIC ASSOCIATES SCPhysician Group $67 $454 $521

SHEBOYGAN WOMENS HEALTH SC Physician Group $2,558 $2,084 $4,642

SHOPKO PHARMACY #2116 Pharmacy $676 $227 $1,488 $2,391

SHORELINE SKIN SPECIALISTS Physician Group $153 $153

ST MARYS HOSPITAL OZAUKEE Physician Group $421 $30 $451

ST NICHOLAS HOSPITAL Hospital $183 $260 $3,536 $19,586 $23,565

Independent Lab $951 $793 $484 $573 $2,801

STEVEN J STAEHLING, MD Physician $65 $65


THOMAS J ZWEIFEL, DO Physician $122 $122

WALGREEN 06097 Pharmacy $3,838 $2,767 $1,651 $4,212 $12,468

WALGREENS #12020 Pharmacy $1,889 $953 $1,995 $5,910 $10,748






St. Croix BALDWIN AREA MEDICAL CENTER INC Hospital $315 $631 $3,951 $5,970 $10,867

BALDWIN AREAMEDICAL CENTER Independent Lab $22 $87 $109


BALDWIN CLINIC Rural Health Clinic $1,604 $868 $4,642 $4,873 $11,987

COMMUNITY PHARMACY AT HUDSON Pharmacy $1,308 $1,048 $868 $1,340 $4,565

COUNTY MARKET PHARMACY Pharmacy $536 $773 $452 $183 $1,944

ECONOFOODS PHARMACY #320 Pharmacy $135 $135

of 114




Billing

Provider


ECONOFOODS PHARMACY #321 Pharmacy $5,186 $4,720 $3,415 $3,877 $17,198

ECONOFOODS PHARMACY 344 Pharmacy $1,052 $405 $169 $1,792 $3,419

EILEEN M REARDON, MD Physician $47 $475 $130 $652

HUDSON HOSPITAL & CLINICS Physician Group $37 $37

HUDSON HOSPITAL INC Hospital $715 $4,050 $14,888 $17,405 $37,057

HUDSON MEMORIAL HOSPITAL Anesthetist $143 $143

HUDSON PHYSICIANS Physician Group $2,386 $3,902 $4,953 $6,062 $17,304

MARJORIE J BELISLE, NP Nurse Practitioner $77 $60 $55 $192

MICKLESEN DRUG INC Pharmacy $940 $682 $119 $496 $2,237

NEW RICHMONDCLINIC Physician Group $2,621 $3,309 $3,329 $4,074 $13,332

PAMIDA PHARMACY 315 Pharmacy $2,603 $485 $3,088

SHOPKO PHARMACY #2130 Pharmacy $2,117 $1,873 $872 $2,233 $7,095

SOMERSET DRUG LLC Pharmacy $394 $960 $1,354

ST CROIX CO HEALTH & HUMAN Family Planning Clinic $134,347 $122,823 $134,667 $252,243 $644,080

STEPHANIE L JOHNSON, CNM Nurse Practitioner $338 $223 $560

STILLWATER MEDICAL GROUP Physician Group $114 $290 $436 $1,199 $2,039


VILLAGE PHARMACY Pharmacy $2,715 $4,606 $7,148 $8,923 $23,393




WESTERN WISCONSIN OB GYN Physician Group $881 $755 $1,636

WESTFIELDS HOSPITAL Hospital $1,665 $4,035 $9,079 $14,779

WESTFIELDS HOSPITAL INC Physician Group $58 $257 $314

Taylor K MART PHARMCY 7656 Pharmacy $2,073 $2,601 $1,250 $1,020 $6,944

MEDFORD VALURITE DRUGS Pharmacy $3,553 $2,987 $1,822 $1,421 $9,783

MEDICAL CENTER PHARMACY Pharmacy $4,637 $3,486 $3,980 $5,416 $17,518

MEMORIAL HEALTH CENTER CLINIC RIB LAKEPhysician Group $415 $157 $297 $869

MEMORIAL HEALTH CENTER CLINICS GILMANPhysician Group $100 $147 $1,414 $344 $2,005

of 114




Billing

Provider


MEMORIAL HEALTH CENTER CLINICS MEDFORD BEHAVIORAL

Mental Health and

Substance Abuse

Services $115 $115

MEMORIAL HEALTH CENTERCLINI Physician Group $4,091 $3,262 $3,881 $5,652 $16,885

MEMORIAL HEALTH CENTERINC Hospital $2,572 $746 $10,933 $11,399 $25,650

Independent Lab $716 $825 $1,186 $861 $3,587

Physician Group $276 $143 $35 $65 $518


Trempealeau COLBY HEALTHMART PHARMACY Pharmacy $492 $599 $793 $1,335 $3,218

FRANCISCAN SKEMP ARCADIA Hospital $165 $110 $2,759 $3,034

GALESVILLE PHARMACY Pharmacy $140 $818 $1,664 $1,109 $3,731

GUNDERSEN CLINIC BLAIR Rural Health Clinic $83 $201 $284

GUNDERSEN CLINIC INDEPENDENC Rural Health Clinic $39 $32 $166 $148 $386

GUNDERSEN CLINIC LTD Physician Group $82 $240 $321

GUNDERSEN CLINIC WHITEHALL Rural Health Clinic $441 $313 $37 $248 $1,038

MAYO CLINIC HEALTH SYSTEM OAKRIDGE INCHospital $255 $255

MAYO CLINIC HEALTH SYSTEM OAKRIDGE- OSSEO CLINICPhysician Group $85 $75 $383 $1,081 $1,624

MAYO CLINIC HEALTH SYSTEM PHARMACY & HOME MEDICALPharmacy $223 $497 $231 $553 $1,504

PAMIDA PHARMACY 834 Pharmacy $674 $430 $359 $268 $1,731

STRUM PHARMACY INC Pharmacy $246 $155 $304 $298 $1,003

THE BLAIR PHARMACY Pharmacy $508 $288 $745 $59 $1,600

TRI COUNTY MEMORIAL Physician Group $30 $30

TRI COUNTY MEMORIAL HOSPITAL Hospital $99 $199 $204 $3,356 $3,858


WESTERN DAIRYLAND ECONOMIC OPPORTUNITY COUNCIL INCFamily Planning Clinic $34,675 $62,308 $74,787 $93,500 $265,271

Vernon BLAND CLINICVMH Rural Health Clinic $139 $238 $108 $486

GUNDERSEN CLINIC HILLSBORO Rural Health Clinic $109 $109

GUNDERSEN CLINIC LTD Physician Group $986 $916 $1,003 $33 $2,937

HIRSCH CLINIC VMH Physician Group $548 $10 $134 $406 $1,098

of 114




Billing

Provider


HIRSCH CLINICVMH Rural Health Clinic $2,916 $1,195 $763 $1,627 $6,501

LAFARGE MEDICAL CLINIC Rural Health Clinic $246 $503 $121 $870

PETERSON PHARMACY INC Pharmacy $823 $1,746 $760 $477 $3,806

ST JOSEPHS HEALTH SERVICES INC Physician Group $360 $235 $436 $431 $1,462

ST JOSEPHS MEMORIAL HOSPITAL Hospital $740 $459 $5,397 $6,596

VERNON MEMORIAL HOSPITAL Hospital $155 $918 $3,883 $3,348 $8,304

VERNON MEMORIAL PHARMACY Pharmacy $42 $42



WESTBY PHARMACY Pharmacy $134 $134

Vilas ASPIRUS LAND O LAKES CLINIC Physician Group $83 $69 $48 $118 $318

ASPIRUS PHARMACY Pharmacy $128 $154 $282

ASPIRUS PHELPS CLINIC Physician Group $24 $22 $46

EAGLE RIVER MEMORIAL HOSPITAL Hospital $678 $802 $4,712 $6,192

LAND O LAKESHEALTH CARE PHARMACYPharmacy $1,155 $155 $664 $769 $2,742

MARSHFIELD CLINIC EAGLE RIVE Independent Lab $11 $11

PETER CHRISTENSEN HEALTH CENTER

Federally Qualified


PETER CHRISTENSEN HLTHCTR Pharmacy $370 $1,308 $1,678

RIVER NORTH PHARMACY Pharmacy $800 $705 $351 $1,856

ST GERMAIN HEALTH CAREPHARMA Pharmacy $513 $304 $119 $700 $1,636

TERRANCE D MOE, MD Physician $469 $120 $550 $1,139

TRIGS PHARMACY Pharmacy $3,105 $2,893 $1,567 $2,329 $9,895

VILAS COUNTYHEALTH Family Planning Clinic $18,145 $18,145


WALL STREET HEALTH CARE PHAR Pharmacy $1,512 $389 $306 $552 $2,759

Walworth ALTERNATIVE HEALTHCAREFAMIL Physician Group $148 $775 $924

AURORA LAKELAND MEDICAL CTR Hospital $169 $368 $5,328 $5,733 $11,599


of 114




Billing

Provider


AURORA PHARMACY INC Pharmacy $623 $352 $203 $2,825 $4,003

CLIFFORD R POPLAR, MD Physician $30 $55 $85

DARIEN MEDICAL CENTER Physician Group $201 $201

E A MCCULLOUGH INC Pharmacy $149 $149

FORT HEALTHCARE INC Physician Group $58 $58

JOHN P HOWLAND, DDS Dentist $310 $186 $496

JULIE R OSBORNE, DO Physician $279 $30 $41 $350

KAMAL S MUZAFFAR, MD Physician $209 $209

MC 5 INC Pharmacy $254 $1,849 $1,541 $820 $4,464

MCCULLOUGH PHARMACY INC Pharmacy $633 $199 $578 $148 $1,558

MERCY WALWORTH HOSPITAL AND MEDICAL CENTERHospital $51 $12 $10,766 $10,829

MERCY WALWORTH PHARMACY Pharmacy $727 $416 $764 $1,078 $2,984

NEIL J RENNICK, DO Physician $57 $30 $87

PHARMACY STATION Pharmacy $2,207 $670 $1,581 $2,674 $7,132

PLANNED PARENTHOOD OF WISCONSIN, INCFamily Planning Clinic $2,466 $37,088 $39,554

PLAZA PHARMACY Pharmacy $431 $1,000 $365 $1,796

REYNOLDS PHARMACY INC Pharmacy $188 $1,263 $2,897 $1,683 $6,031



UNIVERSITY HEALTH & COUNSELING Family Planning Clinic $2,870 $62,285 $107,318 $92,188 $264,660

WALGREENS #09210 Pharmacy $1,907 $1,202 $949 $2,829 $6,886






Washburn ESSENTIA HEALTH SPOONER CLINIC Physician Group $5,203 $6,687 $7,849 $17,471 $37,209

INDIANHEAD MEDICAL CENTER Hospital $244 $624 $4,104 $323 $5,295

KATHERINE E PARKINSON, MD Physician $30 $30

of 114




Billing

Provider


NORTH WOODS COMMUNITY HEALTH

Federally Qualified



PARKINSON DERMATOLOGY SC Physician Group $149 $149

RED CROSS PHARMACY Pharmacy $6,919 $7,706 $6,435 $11,094 $32,154

SCHMITZS ECONOMART Pharmacy $1,172 $1,835 $2,121 $1,330 $6,457

SHELL LAKE CLINIC LTD Physician Group $2,941 $3,462 $2,817 $2,340 $11,560

SHELL LAKE PHARMACY Pharmacy $1,384 $2,032 $2,398 $3,825 $9,639

SPOONER HEALTH SYSTEM Hospital $962 $2,554 $4,282 $7,798

WASHBURN COUNTY HEALTHDEPT Family Planning Clinic $45,133 $29,543 $17,258 $30,279 $122,212

Washington AURORA HEALTH CENTER HARTFOR Physician Group $3,965 $6,885 $3,136 $8,753 $22,739

AURORA MEDICAL CENTER OF Hospital $455 $2,413 $3,299 $6,168


DIAGNOSTIC SERVICES OFWASHINGTON CTYPhysician Group $1,790 $783 $1,603 $1,235 $5,410

DIRK H STEINERT, MD Physician $49 $49

EARL W NEPPLE, MD Physician $48 $48

JEWEL OSCO 3625 Pharmacy $128 $128

K MART PHARMACY 3534 Pharmacy $2,081 $629 $237 $442 $3,389


KETTLE MORAINE ANESTHESIOLOG Physician Group $29 $98 $127

PAUL V BULLIS, MD Physician $30 $30


PICK N SAVE PHARMACY #6430 Pharmacy $995 $581 $775 $445 $2,795

PICK N SAVE PHARMACY 6357 Pharmacy $316 $357 $162 $366 $1,201



ST JOSEPHS COMMUNITY HOSP Hospital $1,424 $2,184 $12,496 $20,170 $36,274

ST JOSEPHS COMMUNITY HOSPITA Independent Lab $1,459 $1,886 $3,322 $4,063 $10,730

ST MARYS HOSPITAL OZAUKEE Physician Group $138 $330 $174 $642

of 114




Billing

Provider


WAL MART PHARMACY 10 1515 Pharmacy $419 $1,564 $1,283 $4,031 $7,296

WAL MART PHARMACY 10 2658 Pharmacy $3,654 $5,489 $2,850 $5,041 $17,035





WEST BEND CLINIC INC Physician Group $9,095 $13,658 $17,675 $38,763 $79,192

WEST BEND PHARMACY Pharmacy $174 $445 $495 $1,457 $2,570

Waukesha AFFILIATED DERMATOLOGISTS Physician Group $98 $673 $770

ALEXANDER A ROMASHKO MD SC Physician Group $141 $141

AMERIPATH MILWAUKEE SC Physician Group $11 $205 $40 $256

ANEX SC Physician Group $193 $55 $55 $304

ANN M TOUSIGNANT, MD Physician $58 $58

ANNE M RIENDL, MD Physician $476 $476

ANTHONY HOANG, MD Physician $57 $57

ARNAVAZ DUA, MD Physician $48 $48

AURORA HEALTH CENTER Physician Group $20 $60 $210 $1,423 $1,714

AURORA MEDICAL GROUP Physician Group $276 $909 $189 $3,517 $4,891

AURORA PHARMACY Pharmacy $360 $914 $28 $1,427 $2,730


AURORA QUICKCARE LLC Nurse Practitioner $505 $715 $1,565 $2,785

AURORA ST LUKES NEW BERLIN Physician Group $60 $22 $596 $678

AURORA WILKINSON MEDICAL CLINIC Physician Group $1,905 $2,570 $1,052 $12,505 $18,032

BELLIN ANESTHESIA ASSOCIATES SC Physician Group $37 $111 $55 $203

BRIAN A CHAPMAN, MD Physician $182 $182

BROOKFIELD SURGICAL ASSOC Physician Group $266 $266

CENTER FOR NEUROLOGICAL DISORDERSPhysician Group $78 $48 $126

CHERRI A SCHLEICHER, FNP Nurse Practitioner $148 $148


of 114




Billing

Provider


CHRISTINA TINGUELY, MD Physician $55 $272 $327

CHRISTOPH KING, DO Physician $30 $30

CHRISTOPHER J HUSSUSSIAN, MD Physician $30 $30

COMMUNITY MEMORIAL HOSPITAL Hospital $129 $762 $7,165 $22,723 $30,780

CVS PHARMACY # 06855 Pharmacy $59 $59

CVS PHARMACY #08947 Pharmacy $26 $26

CVS PHARMACY#08764 Pharmacy $283 $296 $579

DANA J AKIYA, MD Physician $325 $325

DARRYL M PRINCE, MD Physician $114 $61 $175

DERMATOPATHOLOGY OF WISC Independent Lab $195 $155 $66 $2,599 $3,014

DIGESTIVE DISEASE SPECIALIST Physician Group $91 $61 $152

DONALD J LANDGRAF, DO Physician $47 $60 $217 $324

DR ARNAVAZ DUA MD SC Physician Group $143 $143

ELAINE M LIVERMAN, MD Physician $115 $115

ELDON J SWENSON, MD Physician $158 $158

ELIZABETH M DAVIES, MD Physician $30 $78 $125 $513 $747

ELMBROOK INTERNAL MED ASSOC Physician Group $521 $521

EMILY E STODDARD, MD Physician $24 $203 $227

FALLS ANESTHESIA ASSOCIATES SC Physician Group $193 $149 $312 $655

GASTROENTEROLOGY SPECIALISTS Physician Group $101 $101

GENEVIEVE M JONES, MD Physician $48 $48

GREAT LAKES RADIOLOGISTS Physician Group $10 $84 $94

GREATER MILWAUKEE PLASTIC SU Physician Group $12 $101 $113

GREG HEAL, MD Physician $30 $60 $211 $30 $332

GUILLERMO D VARONA, MD Physician $30 $30

HEALTH CENTER PHARMACYWEST Pharmacy $331 $350 $391 $1,072

JAMES A STADLER II, MD Physician $165 $20 $205 $390

JEROME DRUGS BIG BEND Pharmacy $120 $279 $399

JEROME DRUGS INC Pharmacy $242 $306 $547

of 114




Billing

Provider


JOHN E KELLY, MD Physician $129 $163 $296 $588

JOHN R PHILLIPS, MD Physician $22 $22

JOHN S CANTIERI, MD Physician $99 $59 $158

JOSE S AGPOON, MD Physician $98 $98

JUAN T BIAGTAN, MD Physician $126 $126

K MART PHARMACY 3692 Pharmacy $524 $1,190 $502 $2,216


KATHY HARTKE, MD Physician $19 $57 $75

KENNETH G CONDON, MD Physician $55 $55

KENNETH W REICHERT II, MD Physician $22 $22

LABORATORY PATHOLOGY Physician Group $104 $104

LABWORKS INC Physician Group $12 $12

LAKE AREA PHYSICAL MEDICINE Physician Group $30 $90 $43 $273 $436

LAKE COUNTRY PATHOLOGISTS SC Physician Group $39 $721 $1,260 $3,725 $5,745

LAKE COUNTRYINSTITUTIONAL Pharmacy $29 $29

LAKESHORE MEDICAL CLINIC Physician Group $87 $57 $457 $2,932 $3,532

LAURA EPPERSON, MD Physician $218 $257 $475

LEIF E ESBENSEN, MD Physician $410 $410

LIFETIME OB GYN LTD Physician Group $1,457 $981 $2,782 $7,571 $12,791

LYNN K DIULIO, MD Physician $58 $58

MARK A WEBER, MD Physician $176 $176

MARK D GROSSKLAUS, MD Physician $43 $43

MARY C FOX, MD Physician $30 $30

MARY M MILBRATH, MD Physician $22 $22

MATTHEW A MEYER, MD Physician $290 $354 $645

MEDICAL ASSOCIATES INC Physician Group $3,961 $2,987 $1,949 $9,337 $18,233

MEDICAL CENTER PHARMACY Pharmacy $323 $65 $388

MEDICAL EYE ASSOC S C Physician Group $153 $153

of 114




Billing

Provider


MENOMONEE FALLS ASC

Ambulatory Surgical

Center (ASC) $724 $731 $1,455

MENOMONEE FALLS MEDICAL Pharmacy $166 $111 $276

METROPOLITAN ANESTHESIOLOGISTS SCPhysician Group $157 $176 $332

MICHAEL LUNDE, MD Physician $48 $48

MIDWEST PHYS ANES SRVCS SC Physician Group $30 $30

MILLER PHARMACY INC Pharmacy $1,362 $627 $487 $433 $2,908

MILWAUKEE ANESTHESIA CONSULTANTS LTDPhysician Group $153 $153

MOHAMMED R SETHI, MD Physician $78 $78

MORELAND MEDICAL CENTER LAB Independent Lab $11 $220 $329 $309 $869

MORELAND OB/GYN ASSOCIATES, S.C. Physician Group $1,359 $2,345 $2,231 $3,851 $9,785

MORELAND PLAZA PHARMACY INC Pharmacy $34 $34

NEURO ASSOC WAUKESHA LTD Physician Group $164 $164

NEW BERLIN PHARMACY INC Pharmacy $370 $259 $629

NEZIH Z HASANOGLU, DO Physician $113 $113

NICOLE L STERNITZKY, MD Physician $1,032 $299 $378 $291 $2,000

NORTHWOODS ANESTHESIA SERVICES SCPhysician Group $37 $196 $233

OB GYN AFFILIATES SC Physician Group $57 $129 $103 $280 $569

OCONOMOWOC MEM HOSP Hospital $298 $904 $4,979 $11,548 $17,730

OCONOMOWOC MEMORIAL HOSPITAL Independent Lab $520 $561 $554 $984 $2,619

ORTHOPAEDIC ASSOCIATES OF WI Physician Group $73 $430 $504


PADMAJA DONIPARTHI MD SC Physician Group $171 $171

PAMELA R HANSON, DDS Dentist $680 $383 $1,063

PATRICIO F VIERNES, MD Physician $48 $48





of 114




Billing

Provider







PICK N SAVE PHARMACY 6308 Pharmacy $100 $56 $126 $282

PICK N SAVE PHARMACY 6388 Pharmacy $1,235 $1,585 $2,317 $2,916 $8,053


PRACTICE MANAGEMENT GROUP Physician Group $115 $112 $113 $1,827 $2,167

PRESCRIPTIONCENTER Pharmacy $32 $1,651 $1,683

PROHEALTH CARE MEDICAL ASSOCIATESPhysician Group $3,582 $4,401 $5,900 $18,754 $32,638

PROHEALTH CARE MEDICALCTRS Physician Group $231 $231

RADIOLOGY WAUKESHA SC Physician Group $157 $136 $785 $1,077

RALPH T COMPTON III, MD Physician $13 $13

RENEU WOMENSHEALTH ANDMEDIS Physician Group $246 $44 $380 $670

RICHARD J POLLACK, DO Physician $257 $257

RIESCH SURGICAL SCIENCE LLC Physician Group $61 $61

ROBERT E SCHELLINGER, MD Physician $67 $678 $744

ROGER A LALICH, DO Physician $37 $273 $310

SAM'S PHARMACY 10-8164 Pharmacy $160 $89 $298 $547

SEAN A JOCHIMS, MD Physician $30 $30

SHEKHAR A DAGAM, MD Physician $48 $48

SHERRY L PROWATZKE, MD Physician $58 $58


SOUTHEASTERN WI ANESTHESIOLOGY Physician Group $223 $176 $186 $585

STANYA SMITH, MD Physician $170 $170

STONES PHARMACY INC Pharmacy $167 $167

SUSSEX FAMILY PRACTICESC Physician Group $137 $468 $605

TARGET STORE T-0863 Pharmacy $393 $181 $1,007 $773 $2,355

of 114




Billing

Provider


TARGET STORE T-0864 PHARMACY Pharmacy $22 $1,692 $1,714



TARGET T-0082 PHARMACY Pharmacy $313 $297 $274 $885

THEODORE G GREEN, DO Physician $22 $22

THOMAS G KORKOS MD SC Physician Group $48 $48

THOMAS G KORKOS, MD Physician $55 $55

THOMAS G WITTMANN, MD Physician $22 $169 $190

TIMOTHY G MCAVOY, MD Physician $55 $30 $85

TOBIN DRUG OCONOMOWOC INC Pharmacy $144 $144

UROLOGY ASSOCIATES LTD SC Physician Group $55 $55

VERRE YOUNG EYE CLINICSC Physician Group $48 $48

VICTORIA J MONDLOCH, MD Physician $173 $173

WAL MART PHARMACY 10 1515 Pharmacy $626 $626

WALGREEN 07259 Pharmacy $1,006 $1,109 $1,532 $2,609 $6,255

WALGREENS #03615 Pharmacy $971 $926 $619 $756 $3,272

WALGREENS #05309 Pharmacy $1,484 $1,489 $709 $1,702 $5,384





WALGREENS 04888 Pharmacy $1,357 $1,149 $1,208 $821 $4,536








of 114




Billing

Provider





WALGREENS#07797 Pharmacy $340 $391 $779 $852 $2,361


WAL-MART PHARMACY 10-1571 Pharmacy $860 $1,218 $2,518 $2,333 $6,929

WAL-MART PHARMACY 10-1635 Pharmacy $1,167 $599 $492 $1,926 $4,185


WAL-MART PHARMACY 10-3322 Pharmacy $862 $274 $1,058 $507 $2,701

WAL-MART PHARMACY 10-5438 Pharmacy $288 $787 $1,107 $2,181

WAUKESHA COUNTY HEALTH& Physician Group $101 $101

WAUKESHA FAMILY PRACTICE CEN Physician Group $70 $159 $686 $3,455 $4,370

WAUKESHA HEART INSTITUTE Physician Group $30 $30

WAUKESHA MEMORIAL HOSPITAL INC Hospital $446 $2,252 $30,323 $74,153 $107,174

WAUKESHA MEMORIAL HOSPITAL L Independent Lab $2,362 $3,170 $3,692 $15,848 $25,072

WAUKESHA PEDIATRIC ASSOCIATE Physician Group $30 $77 $57 $164

WAUKESHA PHARMACY Pharmacy $75 $75

WAUKESHA SURGICAL SPECIALIST Physician Group $74 $74

WEST SUBURBAN CENTER FOR Physician Group $101 $101

WESTWOOD MEDICAL GROUP Physician Group $193 $193

WHEATON FRANCISCAN INC Hospital $254 $4,393 $14,364 $19,010

WHEATON FRANCISCAN MEDICAL Physician Group $91 $91

WHEATON FRANCISCAN PHARMACY Pharmacy $48 $14 $62

WILLIAM A DARLING, MD Physician $30 $30

WISCONSIN EATING DISORDER Physician Group $94 $94

WISCONSIN HEART GROUP SC Physician Group $101 $101

WISCONSIN NEUROSURGERY SC Physician Group $60 $60

WOMENS HEALTHCARE SC Physician Group $909 $314 $1,223

Waupaca AFFINITY MEDICAL GROUPRHC Rural Health Clinic $337 $143 $88 $505 $1,073

of 114




Billing

Provider


ELIZABETH A BARON-KUHN, MD Physician $628 $628

JOHN G HOFFMANN, MD Physician $301 $301


KOEPPENS MEDICAL TRANSPORTS Transportation $88 $88

MINISTRY MEDICAL GROUP Physician Group $394 $1,516 $1,910

MINITSTRY MEDICAL GROUP Physician Group $30 $465 $495


PRESCRIPTIONS PLUS Pharmacy $680 $486 $310 $368 $1,845

RICHARD S VEIGA MD SC Physician Group $358 $358

RICHARD S VEIGA, MD Physician $630 $433 $1,063

RIVERSIDE CLINIC PHARMACY Pharmacy $1,212 $1,926 $1,852 $914 $5,905

RIVERSIDE MEDICAL CENTER Hospital $571 $2,891 $18,721 $11,164 $33,348

Independent Lab $661 $322 $293 $827 $2,103

Physician Group $112 $52 $201 $256 $620

ROBERT L PETERSON, MD Physician $22 $22

STRATTON DRUGINC Pharmacy $1,460 $948 $1,644 $2,461 $6,514

THE MEDICINESHOPPE Pharmacy $223 $32 $255

THEDACARE PHYSICIANS CLINTONVILLEPhysician Group $114 $114

THEDACARE PHYSICIANS IOLA Physician Group $1,870 $59 $1,929

THEDACARE PHYSICIANS WAUPACA Physician Group $1,881 $1,872 $1,611 $6,753 $12,117

TIMOTHY B RASOR, MD Physician $87 $87




WAUPACA COUNTY DHHS Family Planning Clinic $55,993 $26,868 $80,446 $66,804 $230,112

WAUPACA WOODS PHARMACY Pharmacy $858 $855 $1,288 $982 $3,983

Waushara AURORA PHARMACY INC Pharmacy $764 $794 $3,888 $1,813 $7,259

CHN MEDICAL CENTER REDGRANITE Physician Group $30 $86 $216 $332

CHN MEDICAL CENTER WAUTOMA Physician Group $342 $342

of 114




Billing

Provider


CHN PHARMACY #1 Pharmacy $3,343 $2,014 $645 $3,829 $9,831

LA CLINICA DE LOS CAMPESINOS

Federally Qualified



WAUSHARA FAMILY PHYSICIANS Physician Group $973 $949 $694 $2,760 $5,375

WILD ROSE COMMUNITY MEM HOSP Hospital $335 $157 $3,400 $6,303 $10,194

WILD ROSE COMMUNITY MEMORIAL Independent Lab $97 $159 $317 $573

Winnebago AFFINITY MEDICAL GROUP Physician Group $24,722 $21,663 $26,545 $50,412 $123,342

ALBERT L FISHER, MD Physician $30 $151 $181

ANESTHESIA SERVICES OF THE FOX VALLEY,SCPhysician Group $158 $66 $372 $596

ASSOCIATION OF HOSPITAL ANESTHESIOLOGISTSPhysician Group $182 $182

AURORA MEDICAL CTR OF OSHKOS Hospital $123 $6,644 $3,087 $9,854

AURORA MEDICAL GROU P OSHKOS Physician Group $9,911 $9,920 $11,852 $17,282 $48,964


CHILDRENS HOSPITAL OF Hospital $400 $351 $751

CVS PHARMACY #05186 Pharmacy $367 $379 $746

DAVID J SCHULTZ, MD Physician $22 $22 $44


DIGESTIVE HEALTHCARE SPECIALISTS, SCPhysician Group $22 $22

DILIP K TANNAN, MD Physician $217 $333 $550

EAR NOSE & THROAT SPECIALIST Physician Group $236 $236

FOX CITIES COMMUNITY HEALTH CENTER INC

Federally Qualified


Mental Health and

Substance Abuse

Services $22 $22

FOX VALLEY PATHOLOGISTS SC Physician Group $2,008 $3,603 $4,954 $7,284 $17,849

FOX VALLEY PLASTIC SURGERY Physician Group $55 $55

FOX VALLEY WOMENS HEALTH SERVICESPhysician Group $1,826 $1,826

of 114




Billing

Provider


INTERGRATIVE PAIN MANAGEMENT SCPhysician Group $231 $231

JOHN S PUJALS, MD Physician $37 $37

K MART PHARMACY 4254 Pharmacy $1,908 $657 $2,565

KAMALJIT S PAUL, MD Physician $48 $48

KEVIN E WASCO, MD Physician $22 $22

KIRTIDA N RINGWALA, MD Physician $135 $60 $146 $123 $464

LAKESIDE NEUROCARE Physician Group $22 $30 $52

MARY MCDONALDMD SC Physician Group $55 $55

MERCY MEDICAL CENTER OF OSHK Independent Lab $3,097 $3,803 $6,679 $11,254 $24,834

MERCY MEDICAL CENTER OF OSHKOSH INCHospital $1,020 $1,514 $10,427 $23,814 $36,775

MORTON PHARMACY Pharmacy $6,514 $5,511 $4,362 $5,000 $21,387

NEUROSCIENCE GROUP OF NE WI Physician Group $30 $73 $418 $521

NORTHEAST WISCONSIN VISION CENTER, LTDPhysician Group $55 $55

OMRO PHARMACY Pharmacy $1,265 $1,140 $978 $1,950 $5,333

ORTHOPAEDIC SPECIALISTS SC Physician Group $22 $22

PATRICK J BRENNAN, MD Physician $22 $22

PAUL A BOEDER, MD Physician $329 $216 $1,917 $2,463



RADIOLOGY ASSOCIATES OF THE Physician Group $159 $370 $1,029 $1,558

RAYMOND F GEORGEN, MD Physician $22 $22 $44

ROBERT F MANN, MD Physician $101 $101

ROBERT J HOLLY, MD Physician $22 $22

SHEILA M ANDERSON, MD Physician $225 $225



SHOPKO PHARMACY #2100 Pharmacy $1,766 $1,906 $1,353 $533 $5,558

ST ELIZABETHSURGERY CENTER

Ambulatory Surgical

Center (ASC) $930 $209 $1,139

of 114




Billing

Provider


STUDENT HEALTH CENTER Family Planning Clinic $188,521 $205,246 $143,624 $120,453 $657,844

TARGET STORE T-0807 PHARMACY Pharmacy $277 $946 $250 $2,508 $3,981

THEDA CARE PHYSICIANS MENASH Physician Group $1,791 $992 $1,710 $4,493

THEDA CLARK MEDICAL CENTER Hospital $3,843 $2,407 $26,816 $21,651 $54,716

Independent Lab $6,741 $13,816 $16,784 $20,550 $57,892

THEDACARE PHYSICIANS NEENAH- EASTPhysician Group $451 $129 $759 $3,172 $4,512

THEDACARE PHYSICIANS NEENAH- WESTPhysician Group $750 $301 $188 $1,240

THEDACARE PHYSICIANS OSHKOSH Physician Group $575 $656 $251 $1,483

THEDACARE PHYSICIANS PEDIATRICS APPLETONPhysician Group $58 $58

THEDACARE PHYSICIANS- PEDIATRICS NEENAHPhysician Group $155 $155

UROLOGY ASSOC OF WI SC Physician Group $27 $262 $289

VALLEY NEUROLOGY CLINIC SC Physician Group $94 $320 $414









WOMENS CARE OF WISCONSIN Physician Group $980 $5,356 $8,817 $15,153

Wood ASPIRUS DOCTORS CLINIC Physician Group $7,584 $8,238 $6,910 $10,140 $32,872

AURORA PHARMACY INC Pharmacy $1,019 $738 $688 $645 $3,091


DALY DRUG INC Pharmacy $197 $160 $358

DOCTORS CLINIC OF WIS RAPIDS Physician Group $1,976 $1,976

FAMILY HEALTH CENTER OF MARS Pharmacy $3,940 $5,138 $867 $758 $10,703

HOSPITALIST MEDICINE PHYSICIANS OF WISCONSIN RAPIDPhysician Group $143 $143

JOEL M CARLSON, MD Physician $61 $61

of 114




Billing

Provider


MARSHFIELD CLINIC

Federally Qualified


Physician Group $77,173 $108,422 $93,117 $128,007 $406,719

MARSHFIELD CLINIC MARSHFIELD

Ambulatory Surgical

Center (ASC) $3,618 $724 $4,342

MARSHFIELD CLINIC MENTAL

Mental Health and

Substance Abuse

Services $134 $48 $581 $763


Federally Qualified


MARSHFIELD CLINIC WISCONSIN Independent Lab $118 $42 $110 $357 $627

MARSHFIELD LAB OUTREACH TRUS Independent Lab $8,170 $13,177 $9,511 $18,601 $49,459

MARSHFIELD MEDICAL CENTER LABORATORYIndependent Lab $125 $256 $340 $544 $1,266

MCDONOUGH ORTHOPAEDIC & SPOR Physician Group $55 $55

PARK AND ASSOCIATES SC Physician Group $394 $433 $827

PHILLIPS NEKOOSA PHARMACY Pharmacy $777 $777


RIVERVIEW FAMILY CLINIC Physician Group $2,159 $1,875 $1,754 $2,363 $8,151

RIVERVIEW HOSPITAL Independent Lab $3,377 $3,094 $5,280 $4,006 $15,758

RIVERVIEW HOSPITAL OC Physician Group $403 $403

RIVERVIEW HOSPITAL ASSOCIATION Hospital $8,415 $15,750 $81,397 $82,230 $187,793

ROBERT A KAY, DDS Dentist $1,433 $2,894 $1,318 $5,645



ST JOSEPHS HOSP OUTPATIENT Pharmacy $339 $1,460 $2,636 $2,363 $6,798

ST JOSEPHS HOSPITAL Hospital $260 $4,351 $14,982 $19,593

SURGICAL ASSOCIATES OFWISCO Physician Group $55 $55



of 114




Billing

Provider



WISCONSIN RIVER ORTHOPAEDICS Physician Group $233 $233

(blank) ACCESS COMMUNITY HEALTH CENTERS

Federally Qualified

Health Clinic (FQHC) $99 $99

ACL SERVICESINC Independent Lab $218 $218

ADVANCED HEALTHCARE SC Physician Group $172 $172

ALFREDO C MILLAN MD SC Physician Group $30 $30

ALL SAINTS MEDICAL GROUP Physician Group $521 $521

ALLAHYAR JAZAYERI, MD Physician $57 $57

AMERIPATH MILWAUKEE SC Physician Group $936 $936

AMERY REGIONAL MEDICALCENTER Physician Group $467 $467

ANNE M DAYER, MD Physician $22 $22

ASHLAND PATHOLOGY SERVICES Physician Group $39 $39

ASPIRUS DOCTORS CLINIC Physician Group $188 $188

ASPIRUS GENERAL CLINIC Physician Group $125 $125

ASPIRUS KRONENWETTER CLINIC Physician Group $114 $114

ASPIRUS LAND O LAKES CLINIC Physician Group $30 $30

ASPIRUS OB GYN ASSOCIATES Physician Group $486 $486

ASSOCIATES IN PATHOLOGYSC Independent Lab $655 $655

AURORA BAYCARE MEDICALCTR Hospital $6,360 $6,360

AURORA HEALTH CARE INC Physician Group $83 $83

AURORA HEALTH CARE METRO INC Physician Group $72 $72

AURORA HEALTH CENTER Physician Group $481 $481

AURORA HEALTH CENTER HARTFOR Physician Group $22 $22

AURORA HEALTH CENTER KENOSHA Physician Group $2,122 $2,122

AURORA HEALTH CENTER RACINE Physician Group $385 $385

AURORA HEALTHCENTER Rural Health Clinic $165 $165

AURORA MEDICAL GROU P OSHKOS Physician Group $87 $87

AURORA MEDICAL GROUP Physician Group $4,360 $4,360

of 114




Billing

Provider


AURORA MEDICAL GROUP INC Physician Group $87 $87

AURORA MEDICAL GROUP MILWAUKEEPhysician Group $77 $77

AURORA MEDICAL GROUP WEST BEND Physician Group $44 $44

AURORA NOR DOOR CLINIC Rural Health Clinic $108 $108

AURORA VALLEY VIEW CAMPUS OF Physician Group $22 $22

AURORA WILKINSON MEDICAL CLINIC Physician Group $296 $296

AURORA WISELIVES CLINIC Physician Group $114 $114

BALDWIN CLINIC Rural Health Clinic $131 $131

BELOIT AREA COMMUNITY HEALTH CENTER

Federally Qualified


BELOIT CLINIC Physician Group $120 $120

BOARD OF REGENTS UNIV OF WI Independent Lab $1,484 $1,484

BUTTE DES MORTS PATHOLOGY SC Physician Group $610 $610

CHEQUAMEGON CLINIC Physician Group $30 $30

CHN MEDICAL CENTER BERLIN Physician Group $57 $57

CHN MEDICAL CENTER GREEN LAKE Physician Group $24 $24

CHN MEDICAL CENTER REDGRANITE Physician Group $60 $60

CHN MEDICAL CTR EASTRIDGE Physician Group $11 $11

CHN OB/GYN Physician Group $147 $147

CLARK CO FAMILY PLANNING Family Planning Clinic $1,624 $1,624

CLARK W STEVENS MD, MD Physician $177 $177

CLINIC PHARMACY OF WEST SALEM INCPharmacy $54 $54

COLUMBIA CENTER INC Hospital $4,518 $4,518

CONSULTANTS LABORATORYOF Independent Lab $153 $153

COUNTY OF BURNETT Family Planning Clinic $49 $49

CSM HOSPITAL MILWAUKEE Physician Group $22 $22

DANE CO CYTOLOGY CENTERINC Independent Lab $578 $578

DC WEST Physician Group $30 $30

DEAN HEALTH SYSTEMS INC Physician Group $852 $852

of 114




Billing

Provider


DIAGNOSTIC RADIOLOGY ASSOC Physician Group $110 $110

DIAGNOSTIC SERVICES OFWASHINGTON CTYPhysician Group $239 $239

DOCTORS CLINIC OF WIS RAPIDS Physician Group $499 $499

DOOR CO MEMORIAL HOSPITAL Hospital $30 $30

DOUGLAS CO COMMUNITY HLTH Family Planning Clinic $882 $882

DULUTH CLINIC LTD Physician Group $436 $436

DUNN COUNTY PUBLIC HLTH Family Planning Clinic $125 $125

ESSENTIA HEALTH DULUTH Hospital $1,408 $1,408

ESSENTIA HEALTH HAYWARD CLINIC Physician Group $47 $47

FAMILY HEALTH OF LAFAYETTE COUNTYPhysician Group $77 $77

FAMILY HEALTHSERVICES SC Physician Group $566 $566

FAMILY PLANNING HEALTHSERVI Family Planning Clinic $6,822 $6,822

FIRST CHOICEWOMENS HEALTH CENTERFamily Planning Clinic $7,757 $7,757

FOND DU LAC PATHOLOGY CONSUL Physician Group $501 $501

FOND DU LAC REGIONAL CLINIC Physician Group $99 $99

GARY R SCHERR, MD Physician $39 $39

GEORGE A NORRIS, MD Physician $79 $79

GRAND VIEW CLINIC Physician Group $57 $57

GRAND VIEW HOSPITAL Hospital $44 $44

GREAT LAKES Physician Group $867 $867

GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WIPhysician Group $207 $207

GUNDERSEN CLINIC LTD Physician Group $898 $898

HAYWARD AREAMEMORIAL HOSP Physician Group $190 $190

HEART CARE ASSOC Physician Group $60 $60

HESS MEMORIAL HOSPITALINC Physician Group $32 $32

HFM WOMENS HEALTH Physician Group $22 $22

HIRSCH CLINICVMH Rural Health Clinic $308 $308

HOCHUNK NATION WELLNESS

Federally Qualified


of 114




Billing

Provider


HOLY FAMILY MEMORIAL INC Physician Group $261 $261

HOSPITAL PATHOLOGY ASSOC PA Physician Group $44 $44

HUDSON PHYSICIANS Physician Group $512 $512

IRON COUNTY HEALTH DEPARTMENT Family Planning Clinic $138 $138

JEFFREY J ANDEREGG, MD Physician $84 $84

KAREN B HIMMEL, MD Physician $27 $27

KETTLE MORAINE ANESTHESIOLOG Physician Group $222 $222

LABORATORY CORPORATIONOF Independent Lab $346 $346

LABORATORY CORPORATIONOF AM Independent Lab $845 $845

LABWORKS INC Physician Group $101 $101

LAKESHORE MEDICAL CLINIC Physician Group $208 $208

LCM PATHOLOGISTS PC Independent Lab $347 $347

MARINER MEDICAL CLINIC Physician Group $71 $71

MARSHFIELD CLINIC

Federally Qualified

Health Clinic (FQHC) $44,481 $44,481



MARSHFIELD CLINIC EAU Independent Lab $281 $281

MARSHFIELD CLINIC MENOMONIE Independent Lab $31 $31

MARSHFIELD CLINIC MERCER Independent Lab $21 $21

MARSHFIELD CLINIC MERRILL CENTER LABIndependent Lab $21 $21

MARSHFIELD CLINIC MINOCQUA C Independent Lab $227 $227


MARSHFIELD CLINIC OAKWOOD Independent Lab $21 $21

MARSHFIELD CLINIC RICE LAKE CENTERIndependent Lab $174 $174

MARSHFIELD CLINIC RIVERVIEW CENTER LABIndependent Lab $42 $42

MARSHFIELD CLINIC WAUSAU Independent Lab $268 $268

MARSHFIELD CLINIC WAUSAU AMB

Ambulatory Surgical


of 114




Billing

Provider


MARSHFIELD CLINIC WISCONSIN Independent Lab $21 $21

MARSHFIELD LAB OUTREACH TRUS Independent Lab $1,359 $1,359

MARSHFIELD MEDICAL CENTER LABORATORYIndependent Lab $71 $71

MARSHO FAMILY MEDICAL GROUP Physician Group $90 $90

MAYO CLINIC HEALTH SYSTEM EAU CLAIRE CLINIC INCPhysician Group $413 $413

MAYO CLINIC HEALTH SYSTEM FRANCISCAN MEDICAL CENTEPhysician Group $1,550 $1,550

MAYO MEDICALLABORATORIES Independent Lab $50 $50

MEDPOINT FAMILY CARE CENTER Physician Group $82 $82

MEMORIAL HEALTH CENTERCLINI Physician Group $57 $57

MEMORIAL MEDICAL CENTER INC Hospital $23 $23

MEMORIAL MEDICAL CTR Rural Health Clinic $119 $119

MHS PHYSICIAN SERVICES Physician Group $678 $678

MILWAUKEE HEALTH SERVICES

Federally Qualified


MINISTRY MEDICAL GROUP Physician Group $69 $69

NARAYAN BALIGA, MD Physician $193 $193

NATIONAL HEALTH LABORATORY Independent Lab $414 $414

NEW RICHMONDCLINIC Physician Group $51 $51

NEWCAP WHS Family Planning Clinic $535 $535

NORTH SHORE PATHOLOGISTS Physician Group $152 $152

NORTH WOODS COMMUNITY HEALTH

Federally Qualified


NORTHREACH HEALTHCARE LLC Physician Group $90 $90

NORTHWOODS ANESTHESIA SERVICES SCPhysician Group $77 $77

OAKLEAF SURGICAL HOSPITAL Hospital $35,034 $35,034

ONEIDA COMMUNITY HEALTH

Federally Qualified


ONEIDA COUNTYHEALTH DEPARTME Family Planning Clinic $57 $57

OPTIONS IN REPRODUCTIVECARE Family Planning Clinic $16,397 $16,397

of 114




Billing

Provider


PATHOLOGY CONSULTANTS OF GREEN BAY, SCPhysician Group $968 $968

PATHOLOGY PHYSICIANS LTD Physician Group $22 $22

PETER S KAROFSKY, MD Physician $88 $88

PIERCE CO REPRODUCTIVE HEALTH Family Planning Clinic $1,173 $1,173

PLANNED PARENTHHOOD OF WISCONSIN, INC.Family Planning Clinic $2,160 $2,160

PLANNED PARENTHOOD Family Planning Clinic $8,424 $8,424

PLANNED PARENTHOOD OF WI Family Planning Clinic $1,806 $1,806

PLANNED PARENTHOOD OF WISC Family Planning Clinic $17,280 $17,280

PLANNED PARENTHOOD OF WISCONSIN, INCFamily Planning Clinic $7,935 $7,935

PLANNED PARENTHOOD OF WISCONSIN, INC.Family Planning Clinic $20,847 $20,847

POLK CO HEALTH DEPARTMENT Family Planning Clinic $43 $43

PREVEA CLINIC Independent Lab $650 $650


PRICE COUNTYHEALTH Family Planning Clinic $6,957 $6,957

PROCARE MEDICAL GROUP Physician Group $36 $36

PROGRESSIVE COMMUNITY HEALTH CENTERS

Federally Qualified


QUEST DIAGNOSTICS LLC IL Independent Lab $1,713 $1,713

SACRED HEART ST MARYS HOSPITAL Physician Group $522 $522

SHAFI MEDICAL CENTER SC Physician Group $108 $108

SHEBOYGAN WOMENS HEALTH SC Physician Group $130 $130



SOUTHWEST COMMUNITY ACTION Family Planning Clinic $3,002 $3,002

ST ELIZABETHSURGERY CENTER

Ambulatory Surgical

Center (ASC) $2,895 $2,895

ST JOSEPHS HEALTH SERVICES INC Physician Group $57 $57

ST LUKES HOSPITAL Hospital $4,850 $4,850

ST LUKES URGENT CARE Physician Group $22 $22

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Billing

Provider


ST MARYS DEAN VENTURES INC Physician Group $164 $164

ST MARYS DEAN VENTURESINC Rural Health Clinic $22 $22

ST MICHAELS HOSPITAL Hospital $257 $257


ST MICHAELS HOSPITAL OF STEVENS POINT INCPhysician Group $107 $107

STEVEN D STENZEL, MD Physician $57 $57

STUDENT HEALTH CENTER Family Planning Clinic $232 $232

SURGERY & CARE CENTER ST MAR

Ambulatory Surgical


THE APOTHECARY Pharmacy $37 $37

THE DIAGNOSTIC & TREATMENT Independent Lab $320 $320

THE MEDICAL COLLEGE OF WISCONSIN INCPhysician Group $3,546 $3,546

THE MEDICAL COLLEGE OFWI IN Family Planning Clinic $175 $175

THE MEDICAL COLLEGE OFWISCO Family Planning Clinic $112 $112

THREE RIVERSPATHOLOGYPA Physician Group $2,432 $2,432

U OF WISCONSIN EAU CLAIRE Family Planning Clinic $928 $928

UHS PHYSICIAN CLINIC Physician Group $30 $30

UNITED DYNACARE LLC Independent Lab $85 $85

UNIVERSITY HEALTH SERVICE PH Pharmacy $98 $98

UNIVERSITY OF WISCONSIN MEDICAL FOUNDATIONPhysician Group $408 $408

UW HEALTH OUTPATIENT PHARMAC Pharmacy $381 $381

UW MEDICAL FOUNDATION INC Physician Group $57 $57

UW MEDICAL FOUNDTION EAU CLA Physician Group $100 $100

VALLEY ORTHOPEDIC CLINIC SC Physician Group $22 $22

VILAS COUNTYHEALTH Family Planning Clinic $127 $127

VINCENT G LUBSEY MD SC Physician Group $47 $47




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Billing

Provider












WASHBURN COUNTY HEALTHDEPT Family Planning Clinic $1,786 $1,786

WATERTOWN FAMILY PRACTICE Physician Group $12 $12

WELLNESS CENTER OF DOOR COUNTY Family Planning Clinic $352 $352

WEST BEND CLINIC INC Physician Group $51 $51

WESTERN DAIRYLAND ECONOMIC OPPORTUNITY COUNCIL INCFamily Planning Clinic $10,497 $10,497

WHEATON FRANCISCAN LABORATOR Independent Lab $142 $142

WOMENS HEALTH & RESOURCE CEN Family Planning Clinic $431 $431

YOON W CHUN MD, MD Physician $155 $155

Grand Total $15,822,365 $16,707,743 $20,248,201 $28,804,876 $81,583,185

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Wisconsin - Claims Paid - FPW - 2007-2010

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