LX140 Claims Payer 837 List

User Manual: LX140

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Payer Claims List

Payer ID Payer Name Req. Enroll.

59069 21st Century Health (MedsavUSA)(NJ) No

20413 3P Administrators (Onalaska, WI) No

20446 6 Degrees Health Inc. (Beaverton, OR) No

CX044 A & I Benefit Plan Admin, Portland Oregon No

39640 A&D Charitable Foundations (Eden Prairie, MN) No

CXADN A.D.N. Administrators (Southfield, MI) No

75240 AAG Benefit Plan Administrators (Dallas, TX) No

37283 AAG-American Administrative Group (Lubbock,TX) No

AARP1 AARP Dental Insurance Plan (Mechanicsburg, PA) No

LX144 ABS - US Health (Oak Park, MI) No

52133 ACEC Health Plans (SLC, UT) No

61425 ACEC-Healthplan No

61474 ACS Benefit Service (PO Box 2400 Winston, NC only) No

72468 ACS Benefit Services (Salem Winston, NC) No

61473 ACS Benefit Solutions No

72468 ACS Consulting, Salem Winston, NC No

10003 ACS Hawaii (Honolulu, HI) Yes

CX052 AD-Medicaid (Atlantic Dental, Inc)(Mequon, WI) No

CX085 ADI (Atlantic Dental) PPO (Coral Gables, FL No

CX052 ADI -Medicaid (Atlantic Dental, Inc)(Coral Gables, FL No

FX036 ADN (Southfield, MI) No

58066 AFLAC of GA (Columbus, GA) No

52080 AFLAC of NY (1932 Wynnton Road, Columbus GA) No

AFSDC AFS Insurance Service (PO Box 30430 SLC, UT No

37280 AGA (Automated Group Admin (Fort Wayne, IN) No

91136 AGC- I.U.O.E Local 701 trust Funds No

80705 AH & L (Anthem Health & Life Ins of NJ)(Kennett, MO) No

LX140 AHCCCS (Phoenix, AZ) No

LX122 AHL (Richardson TX) No

59140 AIG (Las Vegas, NV & Seattle, WA & Tampa, FL) No

13545 AIG American General (US Life) (Neptune, NJ & Beattyvil No

80705 ALTA Health & Life Ins. Co. (Kennett, MO) No

16140 APA Partners, Inc. - Latham, NY No

44444 APWU (American Postal Workers (Silver Springs, MD) No

CXARC ARC Administrators (Lexington, KY) No

63240 ARM (Alternative Risk Management (Eagan, MN) No

TLX61 ASEA (AFSCME) Local 52 (Spokane, WA) No

38265 ASR Corporation (Grand Rapids, MI) No

ASRM1 ASRM (Moorestown, NJ) No

ATPA1 ATPA (Associated Third Party Admin) No

ATPA1 ATPA (San Diego, CA & Tualatin, OR) No

75261 AXA (Web-TPA) Grapevine, TX No

PHP01 Abrazo HealthCare (Phoenix, AZ) No

AHP01 Abri Health Plan (Thiensville, WI) No

43178 Acceptius (Benefit Management Inc of MO, Joplin, MO) No

CX078 Access Administrators (PO Box 659010 Sacramento, CA) No

CX097 Access Dental (Salem, OR) No

64071 Acclaim (Tupelo, MS) No

87815 Accordia National (Charleston, WV) No

38255 Activa Benefit Services, LLC - Grand Rapids, MI No

38265 Administration Systems Research Corp. (Grand Rapids, No

22384 Administrative Concepts (Wayne, PA) No

CX098 Administrative D.C. No 1 Welfare Fund (Des Plaines, IL) No

CX076 Administrative Services Only (PO Box 9005,9007,9010 Ly No

93524 Advantage Dental Plan - Roseburg, OR No

52133 Advantage Health Solutions (Salt Lake City, UT) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

CPPSA Advantage by Superior (PO Box 537030, Sacramento, CA Yes

83077 Advantek Benefit Admin (Fresno, CA) No

43168 Advantica Administrative Svcs (St. Louis, MO) No

60054 Adventis Risk Management Inc No

95340 Adventist Health Claims (Roseville, CA) No

75261 Adventist Risk Management (Grapevine, TX) Old PO Box No

54763 Adventist Risk Management (Horsham, PA) Old PO Box 4 No

60054 Aetna No

57604 Aetna (SRC)(Blue Bell, PA & Columbia, SC) No

57604 Aetna Affordable Health Choices (SRC)(Columbia, SC) No

128WV Aetna Better Health of WV (Phoenix, AZ) No

68246 Aetna US Healthcare Encounters (PO Box 14530, Lexingt No

95426 Affordable Benefits Admin (Burbank, CA) No

91136 Alaska Children's Services, Inc. No

92600 Alaska Electric Health & Welfare Fund (Anchorage, AK) No

91136 Alaska Hotel Restaurant and camp No

91136 Alaska Laborers Construction Industry Trust (Seattle, WA No

91136 Alaska Pipe Trades Local 375 (Seattle, WA) No

91136 Alaska United Food & Comm. Workers Health & Welfare No

44423 Alexian Brothers Community Services of TN (Chattanoog No

13343 AliCare (Amalgamated Life (New York, NY) No

CXALC AllCare CCO Dental (Salem, OR) No

81040 Allegiance Benefit Plan (Missoula, MT) No

CX016 Allen Medical Claims Administrator (Fort Valley, GA) No

LX139 Alliant (Chesire, CT) No

65074 Allianz (Miami, FL) No

51037 Allied Administrators (Eagan, MN) No

94177 Allied Administrators (San Francisco, CA) No

37308 Allied Benefit Systems (Chicago, IL) No

22155 Allied National (Eagan, MN) No

63240 Alternative Risk Management (ARM) Eagan, MN) No

50503 Altus Dental - Providence, RI No

STR01 AlwaysCare Benefits (Baton Rouge, LA) No

13343 Amalgamated Life - PA Alicare (New York, NY) (King of P No

86048 AmeriChoice - New York Medicaid (Salt Lake City, UT) No

86002 AmeriChoice - New York Medicare (Salt Lake City, UT) No

86003 AmeriChoice - Pennsylvania Medicare (Salt Lake City, UT No

86047 AmeriChoice of NJ Medicaid (salt Lake City, UT) No

Call AmeriHealth Mercy Health Plan

75137 Ameriben Solutions (Boise, ID) No

42112 American Admin (West Des Moines, IA) No

75240 American Admin Group (AAG)(Dallas, TX) No

37283 American Admin Group (PO Box 93670, Lubbock, TX) No

74223 American Administrative Group, Inc (AAG)(San Antonio, No

CX084 American Benefit Corporation (Huntington, WV) No

34187 American Benefits Management of (N Canton, OH) No

52133 American Choice (Thiensville, WI) No

LX016 American Dental Network (ADN)(PO Box 610, Southfield, No

ADP01 American Dental Payers of WI No

AHG01 American Health (Maumee, OH) No

660650587 American Health Medicare No

CX001 American Medical Security (Green Bay, WI) No

44444 American Postal Workers Union Health Plan (Silver Sprin No

41178 Americas TPA (Minneapolis, MN) No

86001 Americhoice - New Jersey Medicare (Salt Lake City, UT) No

GP133 Americhoice NJ(Thiensville, Milwaukee WI) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

LX010 Amerihealth (720 Blair, Horsham, PA) No

54763 Amerihealth Administrators (Horsham, PA) No

47009 Ameritas Life Insurance Corp. (Lincoln, NE) No

38255 Amway Corporation (East Ada, MI) No

53085 Anchor Benefit Consulting (Maitland, FL & Davenport, LA No

34192 Antares Management Solutions (Westlake, OH) No

84103 Anthem (PO Box 1115, Minneapolis, MN) No

47198 Anthem CA (Po Box 1115, MPLS MN) No

80705 Anthem Health & Life Insurance Co of New Jersey/AH&L No

84105 Anthem of CT (PO Box 547 North Haven, CT) No

84105 Anthem of CT (PO Box 9274, Oxnard, CA) No

84105 Anthem of TX (Po box 659444, texas) No

CB923 Anthem of Virginia (Richmond, VA) No

34196 Apex Benefits (Akron, OH) No

LX074 Argus (Tampa Fl) No

ARGUS Argus (Tampa, FL & Eagan, MN) No

75278 Arkansas Best Corp-Choice Benefits-Fort Smith, AR No

81883 Arkansas Municipal Health Benefit (N Little Rock AR) No

LX035 Arm LTD Midwest (Brookfield, WI) No

38416 Arm, LTD (Spencer Stuart) (Eagan, MN) No

CX072 Ascent Benefits (Phoenix, AZ) No

16180 Aspen (Redwood City, CA) No

25133 Associated Benefit Plan (London, KY) No

50266 Associated Benefits (Des Moines, IA) No

AFSDC Associated Foods Service (AFS)(PO Box 30430, SLC, UT) No

ATPA1 Associated Third Party Admin (ATPA)(San Diego, CA) No

ATPA1 Associated Third Party Admin (ATPA)(Tualatin, OR) No

70408 Assurant (PO Box 2940 Clinton, IA) No

LX088 Assurant Health (Fort Mill SC) No

39065 Assurant Health (PO Box 2806, Clinton, IA) No

75068 Assurant Health Self Funded (Chicago, IL) No

ASHC1 Assurant Supplemental (PO Box 2829 Clinton, IA) No

74240 Assured Benefits Administrators (El Paso, TX) No

93221 Asuris Northwest Health(PO Box 30271 SLC, UT) No

95691 Athens Area Health Plan Select (Athens, GA) No

CX085 Atlantic Dental Inc - PPO (ADI) (Coral Gables, FL) No

CX052 Atlantic Dental Inc-Medicaid (Coral Gables, FL) No

LX081 Aultra ( Canton, OH) No

38259 Automated Benefit Services (Oak Park, MI) No

37280 Automated Group Admin (Fort Wayne, IN) No

91136 Automotive Machinists Local 289 Health & Welfare Trust No

CX022 Auxiant (Cedar Rapids, IA) No

LX019 Auxiant (PO Box 90991, Milwaukee, WI) No

86098 Avesis (PO Box 7777 Phoenix, AZ) No

LX169 BAC (PO Box 107, Reynoldsburg, OH) No

999999 BAD CARRIER No

36149 BAS (Benefit Admin Systems (Farmington Hill, MI) No

36149 BAS (Benefit Admin Systems (Homeward, IL) No

36149 BAS (Benefit Admin Systems (Milwaukee, WI) No

36149 BAS (Benefit Admin Systems)(St. Louis, MO) No

77078 BAnner - Medisun (Mesa, AZ) No

LX070 BCBS KS (Tokepa, KS) No

53021 BCBS of LA AdvantagePlans Network No

LX108 BCBS of WA - FEP (Po Box 31207,SLC, UT) No

49153 BCI Administrators Inc (West Bloomfield, MI) No

CXBMD BEAM Dental (Columbus, OH) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

BEAM1 BEAM Insurance Adminsitrators (Burlington, KY) No

44219 BHP Unity (PO Box 456, Arnold, MD) No

43471 BMA (Tampa, FL) No

36342 BSSI (Benefit System & Services (Westmont, IN) No

74227 Bankers United Life/Student Insurance (Lincoln, NE) No

SX145 Banner Health Systems (Mesa, AZ) No

CB369 Barinet (Arnold, MD) No

CHSBA Bay Area Automotive Group (Livermore, CA) No

CHSBD Bay Area Delivery Drivers (Livermore, CA) No

68241 Bell Atlantic No

LX154 Ben-e-lect (Visalia, CA) No

BNMK1 BenMark (Mississippi) No

23210 BeneCare Dental Plan - Philadelphia, PA No

33192 Benecomp National Corporation (St. Petersburg, FL) No

LX165 Benefit & Risk Mgmt Services - BRMS (Folsom, CA) No

36149 Benefit Admin Systems (BAS) (PO Box 2920 Milwaukee, No

36149 Benefit Admin Systems (BAS)(Farmington Hill, MNI) No

36149 Benefit Admin Systems (BAS)(St. Louis, MO) No

36149 Benefit Admin Systems(BAS) (Homewood, IL) No

41205 Benefit Administration Services (Eagan, MN) No

25145 Benefit Coordinators Corporation (Pittsburgh, PA) No

LX156 Benefit Coordinators Corporation (Pittsburgh, PA) No

56139 Benefit Management (Matthews, NC) No

LX087 Benefit Management (San Antonio TX) No

43471 Benefit Management Admin (BMS-Inetico)(Tampa, FL) No

43178 Benefit Management Inc of MO (Joplin, MO) No

FX012 Benefit Management Services (PO Box 1178, Matthews, No

56139 Benefit Management Services, Inc (Charlotte, NC) No

37212 Benefit Management Systems (Madison, MS) No

48611 Benefit Management, Inc. (Great Bend, KS) No

36459 Benefit Mangement Group NV (Las Vegas, NV) No

LX086 Benefit Plan Adm (Fargo ND) No

37118 Benefit Plan Admin (Roanoke, VA) No

39081 Benefit Plan Administrators Co. Eau Claire, WI No

74223 Benefit Planners, Inc )San Antonio, TX) No

36342 Benefit Systems & Services, Inc. (Westmont, IN) No

R7003 Benefit, Inc. (Roseville, MN) No

58102 BenefitStream (Po Box 1990, Jasper GA) No

FX022 Benefits (PO Box 1175, Maple Grove, MN) No

BMX01 Benemax (Medfield, MA) No

37248 Benesys, Inc (LaFayette, LA) No

LX152 Benicomp, Inc. (Fort Wayne, IN) No

95604 Best Life & Health Ins Co. - (Irvine CA) No

95604 Best Life & Health Ins. Co (Overland Park, KS) No

32006 Better health Plans of South Carolina No

CX025 Big Lots Associates Benefit Plan (EMBC) Dublin, OH No

83470 Blue Advantage (BCBS of AR)(Harrisburg, PA) No

BBMDQ Blue Care Network (BCBSM MA/BNCA - Medicare Advant No

54763 Blue Cross (Po box 1002, Horsham PA) No

83470 Blue Cross AR (Harrisburg, PA) No

CBC01 Blue Cross Dental (Po Box 1126, Elk Grove IL) No

53589 Blue Cross of AZ (Phoenix, AZ) No

CBAL1 Blue Cross of Alabama (Birmingham, AL) No

47570 Blue Cross of Alaska & Washington (Anchorage, AK) No

83470 Blue Cross of Arkansas (PO Box 1206 Elk Grove Village, I No

BSCA2 Blue Cross of CA (Fed Only)(Chico, CA) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

47198 Blue Cross of CA (Oxnard, CA) No

52133 Blue Cross of CA (PO Box 272590 & 272540, Chico, CA) No

84099 Blue Cross of Colorado/Anthem - Colorado Springs, CO No

00700 Blue Cross of Connecticut (Blue Care Family Plan) (North No

84105 Blue Cross of Connecticut (PO Box 547 North Haven, CT) No

53287 Blue Cross of Delaware (Wilmington, DE) No

FX046 Blue Cross of FL (Jacksonville, FL) No

76031 Blue Cross of Florida (Florida Combined Life)(PO Box 100 No

CBGA1 Blue Cross of GA (Columbus, GA) No

LX138 Blue Cross of ID - FEP (PO Box 7408, Boise, ID) No

84105 Blue Cross of IN (PO Box 188, Mpls., MN) No

CBID1 Blue Cross of Idaho (PO Box 7408, Boise, ID) Yes

CB621 Blue Cross of Illinois (Oak Brooke Terrace, IL) No

84105 Blue Cross of Indiana Anthem (Louisville, KY) No

CBIA1 Blue Cross of Iowa (FEP claims only) (Des Moines) Yes

CBIA2 Blue Cross of Iowa (Po Box 935 Des Moines, IA) Yes

CBKS1 Blue Cross of Kansas (Topeka, KS) No

47171 Blue Cross of Kansas City (MO) No

84105 Blue Cross of Kentucky/Indiana/Ohio Anthem - Louisville, No

89070 Blue Cross of LA Advantage Plan (PO Box 69441) No

23739 Blue Cross of Louisiana (Baton Rouge, LA) Yes

FX136 Blue Cross of MD (14111-14116, Lexington, KY) No

BBMDQ Blue Cross of MI - Medicare Advantage(Milwaukee, WI) No

89070 Blue Cross of MN (Harrisburg, PA) No

FX017 Blue Cross of MN (PO Box 64338, St. Paul, MN) No

BCAFD Blue Cross of MN (PO Box 75, Minneapolis, MN) No

LX021 Blue Cross of MS (Po box 1043, Jackson MS) No

BME01 Blue Cross of Maine No

CBMA1 Blue Cross of Massachusettes (North Quincy, MA) No

CBMI1 Blue Cross of Michigan (Detroit, MI) No

CBMS1 Blue Cross of Mississippi (Jackson, MS) Yes

CBMT1 Blue Cross of Montana (Helena, MT) No

52133 Blue Cross of NC (Mailed to Salt Lake City, UT) No

61474 Blue Cross of NC (PO Box 2400 Winston, NC only) No

00800 Blue Cross of NE Nork York (Buffalo, NY) Yes

55093 Blue Cross of NY (Empire) Claims sent to MN No

CBNY1 Blue Cross of NY - Empire No

55204 Blue Cross of NY(Western)(PO Box 80, Buffalo, NY) No

CBNE1 Blue Cross of Nebraska (Omaha, NE) No

84101 Blue Cross of Nevada - Colorado Springs, CO No

BNH01 Blue Cross of New Hampshire No

22099 Blue Cross of New Jersey (Horizon) (Newark, NJ) No

CBNM1 Blue Cross of New Mexico (Belleville, IL) No

84100 Blue Cross of New Mexico Dental No

CBNYW Blue Cross of New York (1901 Main St. Buffalo, NY) No

CBNYE Blue Cross of New York (NorthEast)(Albany NY Only) No

CBNYR Blue Cross of New York - Par (PO Box 22999, Rochester, No

61473 Blue Cross of North Carlonia (Winston Salem, NC) No

61472 Blue Cross of North Carolina Federal Employee Claims (D No

CX004 Blue Cross of North Dakota (ND Dental Services) (Fargo, Yes

00840 Blue Cross of OK (PO Box 23100 Belleville, IL) No

LX097 Blue Cross of OK (Tulsa OK) No

LX034 Blue Cross of OK (Tulsa. OK) No

84105 Blue Cross of Ohio Anthem (Louisville, KY) No

CB850 Blue Cross of Oregon (Portland, OR & SLC, UT) No

LX052 Blue Cross of Oregon - FEP (Po Box 31105, SLC, UT) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

54771 Blue Cross of PA - Highmark No

CB870 Blue Cross of Rhode Island (providence, RI) No

CBSD1 Blue Cross of SD (PO Box 9291 Des Moines, IA) No

CBSD1 Blue Cross of SD (Sioux Falls, SD) No

38520 Blue Cross of South Carolina (Columbia/Charleston SC)(P No

CBTN1 Blue Cross of Tennessee (Chattanooga, TN) Yes

CB900 Blue Cross of Texas (Dallas, TX) No

CBUT1 Blue Cross of UT BCBS (PO Box 30270, Salt Lake City, U No

CBUTF Blue Cross of UT-FEP (PO Box 30272, Salt Lake City, UT) No

84103 Blue Cross of VA - Trigon (Colorado Springs, CO) No

CB923 Blue Cross of VA / Anthem (Richmond, VA) No

LX090 Blue Cross of WA (550 12th St, Washington DC) No

CMS01 Blue Cross of WI (PO Box 10888, Greenbay, WI) No

CB950 Blue Cross of WI (United) No

47570 Blue Cross of Washington & Alaska(Anchorage, AK) No

93200 Blue Cross of Washington (PO Box 30271 SLC UT)(PO Bo No

47198 Blue Cross/Trust Fund (San Antonio, TX) No

BSCA1 Blue Shield CA No

94036 Blue Shield CA - NON-FEP (Salt Lake City, UT) No

52133 Blue Shield of CA (SLC, UT) No

CBID2 Blue Shield of Idaho(PO Box 31603 Salt Lake City, UT) No

36609 Boilermakers Natl Health & Welfare Fund/International B No

TLX71 Bollinger Insurance (PO Box 804, Short Hills, NJ) No

74237 Boon Chapman Benefit Administrators (Austin, TX) No

14168 Boston Mutual Life Ins (Latham, NY) No

04210 Boston Mutual Life Ins Co. (80 East Concord St., Boston, No

04210 Boston University Dental Health Plans (80 East Concord No

20381 Boulder Admin Services (Boulder, MT) No

CX028 Bridgeport LLC of Missouri - St Charles, MO No

BRIDG Bridgespan (Lewiston, ID) No

B2129 Brighter Administrators No

51037 Brokerage Concepts (King of Prussia, PA) No

CX032 Brokers National (Houston TX) No

59069 Brown & Brown United Benefits Fringe (PO Box 2480, Da No

LX169 Business Admin Consultants(BAC)(PO Box 107, Rynoldsb No

47009 Businessmen Assurance (NE) No

61492 Businessmen's Assurance No

42150 Butler Benefits (Davenport, IA, Eagan, MN) No

LX124 Butler Company No

CPPCA CA Health Families (Sacramento, CA) No

CAS89 CAS Benefits Plans (PO Box 3070, Bellingham, WA) No

03036 CBA Blue (Comprehensive Benefits Admin (Burlington, V No

55438 CBCA Administrators (TX,NY,KY,GA,MN) No

41124 CBSA (Mpls, MN) No

88019 CCEA Teachers Health Trust (Las Vegas, NV) No

37105 CCMSI (Cannon Cochran Mngmt Serv)(Danville, IL) No

LX170 CCPOA Benefit Trust Fund (2515 Venture Oaks, Sacrame No

00720 CCSTpa (Comprehensive Care Services PO Box 64008, 6 No

88022 CDS Group Health (Sparks, NV) No

84147 CHAMPVA - HAC - Denver, CO No

10000 CIGNA (DHMO) (PO Box 188046, Chattanooga, TN) No

LX182 CIGNA (Heritage Consultant) (Lake Alfred, FL) No

62310 CIGNA Flex Care/Lovelace (New Mexico Only) No

CX075 CL Frates (Oklahoma City, OK) No

DESAZ CMDP (Comprehensive Medical and Dental (Phoenix, AZ) No

71063 CNA Health Partners of Arkansas No

Payer Claims List

Payer ID Payer Name Req. Enroll.

37227 CNIC Healthcare Services (Englewood/Colorado Springs, No

DX215 CORE (Frisco, TX) No

58231 CORE Administrative Services (Macon, GA) No

CPPTX CPP Texas Chip (PO Box 537014 Sacramento, CA) No

CX054 CSEA (Civil Service Employes Assoc.) (Latham, NY) No

42141 CTI Administrators (Des Moines, IA) No

LX167 CWI Benefits (Greenville, SC) No

33192 Cadent Administrators (St. Petersburg, FL) No

33192 Cadent Underwriters (St. Petersburg, FL) No

CPPCA California State Gov. Programs No

LX131 California Water Service (San Jose CA) No

CX061 Canada Life Assurance Company(Atlanta, GA) No

71057 Cannon Cochran Mgmt Services, Inc. (Metairie, LA) No

37105 Cannon Cochran Mngmt Services, Inc - Danville, IL No

CBC01 Capital Blue Cross (Harrisburg, PA) No

CX037 Capital Dental - Houston, TX No

68011 Capitol Administrators (Rancho Cordova, CA) No

CX095 Capitol Dental (Performance Health Tech) (Salem, OR) No

CAPHP Caprock Health Plans (Eagan, MN) No

FX136 CareFirst (PO Box 14111 - 14116) (Lexington, KY)) No

93975 CareOregon (Portland, OR) No

WVCS1 CareSource West Virginia (Dayton, OH) No

INCS1 CareSource of IN (JustME)(Dayton, OH) No

DX215 Careington (Frisco, TX) No

GACS1 Caresource GA (Dayton, OH) No

KYCS1 Caresource KY (Dayton, OH) No

CKOH2 Caresource- Dayton OH No

56195 Carolina Summit HealthCare (Cincinnati, OH) No

CX101 Carpenters Health & Welfare of PA (Philadelphia, PA) No

25125 Carpenters Health Welfare (St. Louis, Hazelwood, MO) No

LX091 Carpenters Welfare Fund (Chicago IL) No

LX118 CarringtonWellMed (Kansas City MO) No

37060 Caterpillar Inc. No

91136 Cement Masons & Plasters Health & Welfare Trust (Seatt No

66698 CentraCare (Battle Creek, MI) No

75177 Central & Southwest Services No

LX150 Central Dta Services Downtown (Pittsburgh, PA) No

34097 Central Reserve Life (Eagan, MN) No

LX103 Central Reserve Life (Winston Salem NC) No

36215 Central States (Rosemont, IL & PO Box 5104 Des Plaines No

55731 Centraol Susquehanna HealthCare (PO Box 668, Arnold, No

DX215 Chesapeake Life Ins (Frisco, TX) No

34154 Chesterfield Resources (Akron, OH) No

84147 Children of Women Vietnam Veterans No

EM205 Childrens Medical Services (CMS) Po Box 917833 El Paso No

68241 Choice Plus (TRW) No

48123 Christi Hope (Wichita, KS) No

61271 Christian Brothers Services (Colorado Springs, CO) No

38308 Christian Brothers Services (Romeoville, IL) No

62308 Cigna No

10050 Cigna DHMO No

59225 Cigna Voluntary (Phoeniz, AZ) No

CX071 Citizens Security Life Ins. (Louisville, KY) No

CX054 Civil Service Employees Association (CSEA) (Latham, NY) No

CMS01 Claims Management Services (Greenbay, WI) No

11752 ClaimsBridge HPN (Arnold, MD) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

33192 Clarendon's Healthy Kids (St. Petersburg, FL) No

CCS01 Clayton County Self Funded Dental Plan (Jonesboro, GA) No

WDENC Clear Plan No

14829 Co-Ordinated Benefit Plans (Eagan, MN) No

37310 Coast Benefits/Coast Hotels and Casinos (Las Vegas, NV) No

37310 Coast Hotels and Casinos, Inc./DBA Coast Benefits (Las No

CAS89 Coastal Admin Serv (CAS) (PO Box 3070, Bellingham, W No

77052 Coastal Admin Services (Salinas, CA) No

59143 Colonial Dental(Harrington Health)(Salt Lake City,. UT) No

LX073 Combined Insurance (Ocala, FL) No

34181 Comerce Benefits Group (Elyria, OH) No

37237 Commenwealth Admin, LLC (Lexington, KY) No

LX166 Commercial Travelers (Utica, NY) No

61948 Community Choice Health Plan of Westchester (Yonkers, No

26231 Community Claims Administration (Orange, CA) No

PHP01 Community Connection (Phoenix, AZ) No

27905 Community Health Alliance (Knoxville, TN) No

75261 Community Health Electronic Claims No

34177 Comp - Ohio - 33 Fitch Blvd., Austintown OH No

CX021 CompBenefits - (Chicago, IL & Roswell, GA) No

77828 Companion Life (PO Box 100102, Columbia, SC) No

CX029 Companion Permier (9201 Watson, St Louis) No

CX021 Compdent - (Chicago, IL & Roswell, GA) No

34177 Compensation Programs of Ohio, Inc. No

03036 Comprehensive Benefits Admin - Burlington, VT No

00720 Comprehensive Care Services (CCSTpa) PO Box 64008, 6 No

CHCP1 Comprehensive HealthCare Options (Centennial, CO) No

DESAZ Comprehensive Medical and Dental Program (CMDP)(Pho No

66698 Comprehensive Senior Care Corp. (Battle Creek, MI) No

74234 CompuSys/Erisa Group (Austin, TX) No

37307 Connecticut Carpenters Health Fund (Hamden, CT) No

62308 Connecticut General (Bloomfield, CT) No

37135 Consociate Dansig, Inc. (Decatur, IL) No

61305 Consolidated Group Dental (Nashua, NH) No

LX146 Consolidated Health Plans (Springfiled, MA) No

45321 Consumers Choice Health Plan (North Charleston, SC) No

35245 Continental Benefits (Brandon, FL) No

62308 Continental Dental (Plantation, FL) No

CPPCC Cook Children's Dental (PO Box 537010, Sacramento, CA No

CPPCH Cook Children's Health Plan (PO Box 537014 Sacramento No

35149 Cook Group Health Plan (Bloomington, IN) No

82347 Cook Group Solutions (Eagan, MN) No

52132 Cooperative Benefit Administrators (CBA) (Lincoln, NE) No

35182 Core Source (Po Box 2920, Clinton IA) No

41045 CoreSource (AZ, MN) No

FX048 CoreSource (Mailed to IA) No

LX048 CoreSource (Mailed to IA) No

35180 CoreSource (NC, IN) (Charlotte, NC) No

35183 CoreSource (Po Box 279, SHeldon IA) No

48117 CoreSource KC(FMH Benefit)(Overland Park, KS) No

35183 CoreSource OH - mailed to OH No

75136 CoreSource of Little Rock (Little Rock, AR) No

35182 CoreSource of PA MD IL (Lancaster, PA)(Clinton, IA) No

41045 CoreStar (Minneapolis,MN) No

56116 Corporate Benefit Services (Charlotte, NC) No

56116 Corporate Benefit Services (Eagan, MN) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

41124 Corporate Benefit Services (Mpls, MN) No

56116 Corporate Benefit Services(El Paso, TX) No

58102 Covenant Admin, Inc - (PO Box 105738 Atlanta, GA) No

CX049 Coventry (Po Box 7402, London KY) No

25133 Coventry Health No

25133 Coventry Health & Life OK No

25133 Coventry Health (241508 Charlotte, NC) No

25133 Coventry Health (PO Box 241508 Charlotte, NC) No

25133 Coventry Health (PO Box 8403,8400,8402, London, KY) No

25133 Coventry Health (PO box 8403,8400,8402, London, KY) No

25148 Coventry Health Care of Georgia (PO Box 7711,7715 Lon No

25133 Coventry Health Care of KS No

37320 Creative Plan Administrators (Hartford, CT) No

CX074 Crescent Dental (Amherst, NY & Richardson, TX) No

56213 Crescent Health (Asheville, NC) No

20572 Crowe Paradis Service Corp (North Reading, MA) No

39170 Custom Benefit Adminstrators(Lacrosse, WI) No

68241 Custom Care No

82056 Custom Design Benefits (3737 West Fork Road, Cincinna No

LX082 Cypress (Appleton WI) No

DEW01 D. Edward Wright TPA( No

00001 DDCA2 Test No

CX065 DH Evans (Harrisburg, PA) No

06172 Dart Management Corp. (Mason, MI) No

07035 DeCare (PO Box 1348, Mpls., MN) Northwest Employees No

07035 DeCare (Po Box 709, MPLS MN) No

39113 Dean Health Plan (Madison, WI) No

CDIAM Delta Dental IA - Dental Wellness Plan (Johnston, IA) No

CDIAM Delta Dental IA - Government Programs (Johnston, IA) No

66043 Delta Dental Peurto Rico (San Juan, PR) No

CPPTM Delta Dental TX Medicaid-Childrens(PO Box 537014, Sacr No

DDCA2 Delta Dental USA (Cerritos, CA) No

94276 Delta Dental of Alabama ( Irving, TX) No

94276 Delta Dental of Alaska (Irving, TX) No

86027 Delta Dental of Arizona No

CDAR1 Delta Dental of Arkansas No

DDCA2 Delta Dental of CA (Cerritos, CA) No

DDCA3 Delta Dental of CA (Encounter, CAP)(Cerritos, CA) No

CDCAP Delta Dental of CA (PMI) (12898 Towne Center Drive, Ce No

77777 Delta Dental of California (PO Box 997330, Sacramento, No

CDCA1 Delta Dental of California(Tricare) - PO Box 537007-537 No

84056 Delta Dental of Colorado (Denver, Co) No

22189 Delta Dental of Connecticut (Parsipanny, NJ) No

51022 Delta Dental of Delaware (Mailed to Mechanicsburg, PA) No

94276 Delta Dental of Florida (Irving, TX) No

94276 Delta Dental of Georgia (Alpharetta, GA) No

10002 Delta Dental of HI (Honolulu, HI) No

82029 Delta Dental of Idaho (Boise, ID) No

IDIND Delta Dental of Illinois (Individual Plans Only) (PO Box 5 No

05030 Delta Dental of Illinois (Lisle, IL) No

CDIN1 Delta Dental of Indiana (Farmington Hills, MI) No

CDIA1 Delta Dental of Iowa (Ankeny, IA) No

CDKS1 Delta Dental of Kansas(Whichita, KS) No

CDKY1 Delta Dental of Kentucky(Lousiville, KY) No

94276 Delta Dental of Louisiana(Irving, TX) No

02027 Delta Dental of Maine (Northeast) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

23166 Delta Dental of Maryland(Mechanicsburg, PA) No

04614 Delta Dental of Massachusetts (Boston, MA, Milwaukee, No

CDMI0 Delta Dental of Michigan(Farmington Hills, MI) No

CDMN1 Delta Dental of Minnesota(Minneapolis, MN) No

94276 Delta Dental of Mississippi (Irving, TX) No

43090 Delta Dental of Missouri No

94276 Delta Dental of Montana (Sacramento, CA) No

CDNE1 Delta Dental of Nebraska(Minneapolis, MN) No

94276 Delta Dental of Nevada (Irving TX) No

02027 Delta Dental of New Hampshire (Northeast) No

22189 Delta Dental of New Jersey (Parsipanny, NJ) No

85022 Delta Dental of New Mexico(Albuquerque, NM) No

11198 Delta Dental of New York (Mechanicsburg, PA) No

56101 Delta Dental of North Carolina(Farmington Hills, MI & Sa No

CDND1 Delta Dental of North Dakota(Bismark ND) No

CDOH1 Delta Dental of Ohio(Farmington Hills,MI) No

CDOK1 Delta Dental of Oklahoma(Oklahoma City, OK) No

CDOR1 Delta Dental of Oregon (Oregon Dental Service)(Portland No

23166 Delta Dental of Pennsylvania(Mechanicsburg, PA) No

660436769 Delta Dental of Peurto Rico No

05029 Delta Dental of Rhode Island (Providence, RI) No

43091 Delta Dental of South Carolina(Columbia SC) No

54097 Delta Dental of South Dakota( Pierre, SD) No

CDTN1 Delta Dental of Tennesse (Nashville, TN) No

94276 Delta Dental of Texas(Irving TX) No

94276 Delta Dental of Utah (Irving TX) No

02027 Delta Dental of Vermont (Northeast) No

CDVA1 Delta Dental of Virginia (Roanoak, VA) No

52147 Delta Dental of Washington DC (Mechanicsburg, PA) No

91062 Delta Dental of Washington-State No

31096 Delta Dental of West Virginia No

39069 Delta Dental of Wisconsin Stevens Point, WI) No

CDWY1 Delta Dental of Wyoming No

07025 Delta Dental of Wyoming (Cheyenne, WY) No

CPPCA Delta Dental-Healthy Families (Sacramento, CA) No

94235 Delta Health Systems (Stockton, CA) No

WIMAN Delta of MI (PO Box 30416, Lansing, MI) No

CDMN1 Delta of MN ( Po Box 9120, Farmington Hills, MI) No

WDENC Delta of WI (PO Box 103 Stevens Point) No

DDCA2 DeltaCare (Cerritos, CA) No

CDCAP DeltaCare USA - Encounters Only (12898 Town Center, C No

LX077 Deltacare (Lansing MI) No

LX038 Dencap (Detroit, MI) No

CX036 Denex (Houston, TX & Rockville, MD) No

CX049 Denex/SG (PO Box 2767, Houston, TX) No

CX014 DentaQuest No

04356 DentaQuest (Boston, MA) No

CX014 DentaQuest (WI) No

EMBDQ DentaQuest-Emblem(Emblem Health)(Milwaukee, WI) No

52133 Dental Benefit Providers (CA) (San Fransico, CA) No

GP133 Dental Benefit Providers (PO Box 427 Thiensville, Milwau No

52133 Dental Benefit Providers (Thiensville, WI) No

52133 Dental Benefit Providers\United Health - Bethesda, MD,U No

CX035 Dental Care Plus - (Cincinnati, OH & Sharonville, OH) No

58102 Dental Decisions (2600 McCormick) Clearwater, FL) No

64246 Dental Guard Preferred (Spokane, WA) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

46278 Dental Health & Wellness (St. Louis, MO & Milwaukee, W No

46278 Dental Health & Wellness (Tampa, FL) No

81264 Dental Health Alliance (Shawnee Mission, KS) No

CX094 Dental Health Services of America (Long Beach, CA) No

CX034 Dental Network - Towson, MD No

DNOA1 Dental Network of America (IL) No

39148 Dental Professional of WI (Southeast Dental)(Milwaukee, No

DSL01 Dental Select (Murray,Draper, UT) No

DSL01 Dental Select (Richardson, TX) No

DSL01 Dental Select (SLC, UT) No

CX004 Dental Service Corp (Fargo, ND) Yes

DTCA7 Dental Transformation Initiative (DTI) No

CX017 Dentalcomp - Harrisburg, PA No

67814 DenteMax (Wellesley Hills) No

88888 Dentegra (Alpharetta, GA) No

43168 Dentemax (St. Louis, MO) No

22384 DentexMax (Wayne, PA) No

94146 Denti-Cal (Medicaid of California) (Sacramento, CA) No

DESAZ Department of Economic Security (Phoenix, AZ) No

CX089 Desert Mutual Benefit Admin (Salt Lake City, UT) Yes

A1004 Detroit Laborers (Metropolitan) (Landing, MI) No

38238 Detroit Tower Trades( Po Box 99490, Troy MI) No

96400 Diego PACE (Eden Prairie, MN) No

33192 Direct Assignment Benefit Plan (St. Petersburg, FL) No

58102 Direct Assignment Benefits (PO Box 9077 Clearwater, FL No

LX129 Direct Dental (San Anselmo CA) No

37272 Direct Reimbursement Benefits (Newnan, GA) No

HSP01 District Council 37 Health & Welfare Fund No

CX040 Diversified Admin Corp. - Marlborough, CT No

25160 Diversified Group (Maryland) (Harrisburg, PA) No

DOM01 Dominion Dental (115 S Union Ste 300, Alexandria, VA No

LX002 Dominion Dental (Alexandria, VA) No

DOM01 Dominion Dental (Elk Grove Village, IL) No

DOM01 Dominion Dental (PO Box 1920, Boie, MD) No

25145 Dominion Dental Benefit Coordinators Corp. - Pittsburgh, No

CX014 Doral Dental of Arizona No

CX014 Doral Dental of Arizona--CIGNA No

CX014 Doral Dental of Connecticut No

CX014 Doral Dental of Illinois No

CKKY3 Doral Dental of Kentucky / Region 3 (Mequon , WI) No

CX014 Doral Dental of Maryland Helix No

CX014 Doral Dental of Maryland Physicians Care No

CX014 Doral Dental of Maryland Priority partners No

CX014 Doral Dental of Minnesota No

CX014 Doral Dental of Minnesota Medicare No

CX014 Doral Dental of Missouri St. Louis No

CX014 Doral Dental of Missouri- Kansas City No

CX014 Doral Dental of Nebraska No

CX014 Doral Dental of New Jersey Amerigroup No

CX014 Doral Dental of New Jersey HealthNet No

CX014 Doral Dental of New Mexico No

CX014 Doral Dental of New York No

CX014 Doral Dental of New York Non global Budget No

CX014 Doral Dental of Ohio No

CX014 Doral Dental of Oklahoma Community Care No

Payer Claims List

Payer ID Payer Name Req. Enroll.

CX014 Doral Dental of Oklahoma Heartland No

CX014 Doral Dental of Oklahoma Non Global Budget No

CX014 Doral Dental of Oklahoma Unicare No

CX014 Doral Dental of Oklahoma Unicare non global No

CX014 Doral Dental of Pennsylvania- Keystone No

CX014 Doral Dental of Pennysylvania Pittsburgh No

CX014 Doral Dental of Pennysylvania- AmeriHealth No

CX014 Doral Dental of Pennysylvania- Healthmate No

CX014 Doral Dental of Pennysylvania-Philadelphia No

CX014 Doral Dental of Tennessee Tenn Care No

CX014 Doral Dental of Virginia (M) No

CX014 Doral Dental of Virginia- Commercial No

CX014 Doral Dental of Virginia- Premier No

CX014 Doral Dental of Virginia- Sentara No

CX014 Doral Dental of Virginia- Unicare No

CX014 Doral Dental of Virginia-Commercial No

CX014 Doral Dental of kansas No

LX067 Dr Admin Services (Plainview NY) No

35186 Dunn and Associates Benefits Administrators, Inc No

34159 E-V Benefits Management, Inc. (Columbus, OH) No

LX112 EBA M Corp (Westlake Village CA) No

38241 EBC (Farmington Hills, MI) No

81039 EBMS (Emp Benefit Mngmt Serv, Inc.) Billings, MT & Salt No

41198 EBS (Employee Benefit Services of Lousiana, Inc) Shreve No

16117 EBS (RMSCO)(Syracuse or Liverpool, NY) No

LX107 EBS (San Antonio TX) No

CX043 EBS Benefit Solutions (PO Box 4863, Syracuse, NY) No

EBSRM EBS-RMSCO (NY) No

73288 EHI Employers Health of Wisconsin (Lexington, KY) No

36364 EHN Medical Group IPA (Rockford, IL) No

CX079 EMIA-Educators Mutual (Murray, UT) No

73288 EMPHESYS Employers Health of Wisconsin No

CX037 EPSI Dental II (Capital Dental) No

62308 EQUICOR No

FX044 ERISA (Austin, TX) No

34108 ES Beveridge & Associates (Mansfield, OH) No

55069 Ebix Health Admin Exchange (PO Box 211288 Eagan, M No

08754 Eddy SeniorCare (Newton Square, PA) No

CX079 Educators Mutual Ins. Assoc. (Murray, UT) No

03964 Elderwood Health (Eden Prairie, MN) No

LX136 Electrical (2002 London, Duluth, MN) No

LX168 Electrical Welfare Trust (Lanham, MD) No

A4681 Electrical Workers (Indianapolis, IN) No

A4681 Electrical Workers (Indianpolis, IN) No

13551 Emblem Health (Group Health)(New York, NY) No

EMBDQ Emblem Health Medicaid-DentaQuest(Milwaukee, WI) No

55093 Empire BCBS of NY (Minneapolis, MN) No

41198 Employee Benefit (Lubbock, TX) No

38241 Employee Benefit Consultants (Farmington Hills, MI) No

37257 Employee Benefit Consultants(Albuquerque, NM) No

37257 Employee Benefit Consultants(Appleton, WI) No

37257 Employee Benefit Consultants(Broadview Hts, OH) No

37257 Employee Benefit Consultants(Findlay, OH) No

37257 Employee Benefit Consultants(Louisville, KY) No

37257 Employee Benefit Consultants(Milwaukee, WI) No

CX025 Employee Benefit Mngmt (EBMC) - Dublin, OH No

Payer Claims List

Payer ID Payer Name Req. Enroll.

81039 Employee Benefit Mngmt Serv (EBMS)(Billings, MT) No

03036 Employee Benefit Plan Admin (Burlington, VT) No

03036 Employee Benefit Plan Administration, Inc (PO Box 2000, No

41198 Employee Benefit Services of Louisiana, Inc (EBS) Shrev No

CX012 Employee Benefit Systems - Pembroke, MA No

47009 Employee Benefits Services (Lincoln, NE) No

42149 Employee Benefits Systems of IA (Burlington, IA) No

EDHP1 Employee Direct Health Plans (PO Box 211003, Eagan, M No

CX022 Employee Group Services (EGS) PO Box 75008 Cedar Ra No

35112 Employee Plans, LLC - PO Box 2362, Fort Wayne, IN No

29979 Employee Resource Management (Phoenix, AZ) No

CX031 Employer Plan Services, Inc - Houston, TX No

LX042 Employers Direct Health No

75232 Employers Direct Health (Dallas, TX) No

73288 Employers Health of Wisconsin (EHIC) (EMPHESYS) (Lexi No

36659 Employers Midwest Health Benefits (Park Ridge, IL) No

59297 Employers Mutual, Inc (Stuart and Jacksonville, FL) No

WDENC Encara (Stevens Point, WI) No

91136 Enstar Natural Gas (Detroit, MI) No

36878 Entrust (Eagan, MN) No

46278 Envolve (Dental Health & Wellness) No

37331 Epoch (St. Louis, MO) No

73126 Equitable Plan Services, PO Box 720460, Oklahoma City, No

CX046 Erin Group Administrators (Lancaster, PA) No

74234 Erisa Group/CompuSys (Austin, TX) No

43168 Essex Dental Benefits (St Louis, MO) No

35605 Everence (Goshen, IN) No

MNM01 Everence (Mennonite Mutual Aid)(Goshen, IN) No

93240 Evergreen Health Co-Op (Clinton, IA) No

22344 Exceedent (Milwaukee, WI) No

LX183 Excellus (BCBS)(Eagan, MN) No

CBNYR Excellus (PO Box 22999, Rochester, NY) No

71412 ExclusiCare (Charlotte , NC) No

91136 FBX North Star Borough/ School District No

33033 FCE Benefit Administrators (Eagan, MN & San Antonio, T No

95411 FL MCO PHC / PHP (La Verne, CA) No

48117 FMH Benefit Services, Inc. of KS (Overland Park, KS) No

LX120 FMRSD Dental Plan (Walpole NH) No

CXFMC Family Care CCO (Salem, OR) No

CX096 Family Dental (Salem, OR) No

89070 Family Members Dental Plan (Harrisburg, PA) No

LX055 Fara Benefits (PO Box 8770, Metairie, LA) No

71056 FedEx Freight East, Inc (Harrison, AR) No

41041 Federated Insurance - Owatonna, MN No

FDIC1 Fidelio Dental insurance (Glenside, PA) No

FX007 Fidelio Laborers (2826 Mt Carmel, Glenside, PA) No

72630 First Ameritas Life Ins Corp of New York (Lincoln, NE) No

LX162 First Benefit Admin (Largo, FL) No

CX050 First Care / Southwest Life and Health (Austin, TX) Yes

LX117 First Choice (Beloit WI) No

75138 First Choice of the Midwest, Inc (Sioux Falls, SD) No

64246 First CommonWealth(Spokane, WA & Chicago, IL) No

CX090 First Continental Life & Accident Insurance (SugarLand, No

CX086 First Dental Health (San Diego, CA) No

70408 First Fortis Life Insurance (Clinton, IA) No

25133 First Health (Tucson, AZ - London, KY) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

25133 First Health - Tucson, AZ - London, KY, Coraoplis, PA) No

660537624 First Medical (International) No

FP66053762 First Plus No

13317 First Reliance Standard (Lincoln, NE) No

LX101 First Service Administrators (Lakeland FL) No

ENDVR First Source (Endeavor) (Lake Katrine, NY) No

74223 Fiserv (Benefit Planners) (San Antonio, TX) No

39026 Fiserv (Wausau, WI & Pueblo, CO) No

FX061 Fiserv - Harrington (PO Box 2697, Wichita, KS) No

95266 Fiserv - Harrington Benefit (Columbus, OH) No

FX061 Fiserv-Harrington Health (PO box 30544, Salt Lake City, No

90328 Fiserv-Lovelace Health (Westerville, OH) No

11244 FitzHarris & Company, Inc(Farmingdale, NY) No

FX135 FlagShip DeltaCare (Parsppany, NU) No

LX058 FlagShip Dental Care (PO Box 369) (Parsippany, NJ) No

R7004 Flex Compensation (Mpls, MN) No

68241 FlexCare No

76031 Florida Combined Life(Blue Cross of FL)(PO Box 100135, No

48116 Florida Hospital Waterman (Tavares,, FL) No

LX134 Florida League of Cities (Orlando FL) No

68241 Florida Power & Light No

25133 Foreign Service Benefit Plan (London, KY) No

60054 Foreign Service Benefit(Washgington, WA) No

25059 Forest County Potawatomi Ins. No

LX050 Formula Corporation (3265 Northwood Circles, Eagan, M No

DNOA1 Fort Dearborn Life Ins No

70408 Fortis Benefits/Protective Life - Birmingham, AL No

39065 Fortis Insurance Company - WI No

BOONG Foundation Benefit Admin (FBA) (Austin, TX) No

64069 Fox Everett, Inc (Ridgeland & Jackson, MS) No

LX084 Frank M Vaccaro Asso Mount Laurel NJ) No

CX041 Fraternal Order of Police - Philadelphia, PA No

LX184 Freedom Life (Ft Worth, TX) No

31478 Freedom Network (Po box 25938) Shawnee, KS) No

LX057 Freedom of Choice (MHHNP)(PO Box 742567 Houston, T No

59069 Fringe Benefit Management (Fl) No

45289 Fringe Benefits (Austin, TX) No

59204 Fringe Benefits Coorinators of FL (Daytona Beach, Ormo No

80241 GBS (Eagan, MN) No

GCU01 GCU Local 8-M & 96B Health & Welfare Fund No

06143 GEGA - GE Group Administrators, South Carolina (South No

75238 GEGA - GE Group Administrators, Texas No

67814 GEGLAC (Genworth Life & Health) GE Group No

57254 GEHA - All Plans except PO Box 4665 (Independence, M No

44054 GEHA Only (PO Box 4665, Independence, MO) No

LX071 GEM Group (Claymont, DE) No

13551 GHI - New York (Group Health, Inc)(New York, NY) No

80314 GIC-Idemnity Plan No

48143 GPA (Group Pension Admin)(Richardson, TX) No

37283 Gallagher Benefit Administrators (Lisle, IL) No

96938 Gateway Health Plan (Milwaukee, WI) No

67814 Ge Group Life Assurance Co. Phoenix American Life (Gre No

LX161 Gem Group (Pittsburgh, PA) No

63665 General American Life (Kennett, MO) No

LX047 Genworth (PO Box 40011, Lynchburg, VA) No

67814 Genworth Dental (PO Box 40011, Lynchburg, VA) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

67814 Genworth Life & Health (GEGLAC)(GE Group LIfe) No

CX064 Gettysburg (Frederick, MD) No

07205 Gilsbar, Inc - Covington, LA & Jackson, MS (Covington, L No

91136 Glassworkers Health & Welfare Fund (Seattle, WA) No

LX008 Golden (Warren MI) No

52133 Golden Rule (SLC, UT) No

GWD01 Golden West Dental (21555 Oxnard S, Woodhills, CA) No

GWD01 Golden West Dental (PO Box 5347, Oxnard, CA) No

57254 Government Employees Health Assoc. (GEHA)(All Plans e No

44054 Government Employees Hospital Assoc (GEHA) Only (PO No

LX098 Great Cornerstone Life & Health (Edmond OK) No

80705 Great-West Life and Annuity Ins. Co. (Kennett, MO) No

39640 GreatLakes PACE (Eden Prairie, MN) No

LX040 Group Admin (San Antonio, TX) No

75256 Group Administrators (PO Box 780159, San Antonio, TX) No

36338 Group Administrators Ltd. - Schaumburg, IL No

72153 Group Benefit Administrators (Henderson, TN) No

LX151 Group Benefit Administrators (SLC, UT) No

80241 Group Benefit Services (Eagan, MN) No

CX011 Group Benefit Services (East Lansing, MI) No

CB951 Group Benefit Services (Luterville, MD) No

CX036 Group Dental Services(Houston, TX & Rockville, MD) No

10006 Group Health (Madison, WI) No

89070 Group Health Coop. Ind. and Family (PO box 69443) No

95192 Group Health Cooperative (Eau Clairie, WI) No

13551 Group Health Insurance (New York, NY) No

38194 Group Health Managers - Redford, MI No

37276 Group Insurance Service Center (Pembroke, MA) No

CX015 Group Link of Indiana (Indianapolis, IN) No

48143 Group Pension Admin (GPA)(Richardson, TX) No

LX020 Group Pension Admin (PO Box 830248, Richardson, TX) No

LX066 Group Resources (Dallas, Houston, Atlanta, Pheonix) No

48143 Group and Pension Admin (GPA)(Richardson, TX) No

CX061 Guarantee Life Insurance No

64246 Guardian Life Insurance Company of America (Spokane, No

GI813 Guardian Managed DentalGuard (Sacramento, CA) No

60389 Gulf Coast (UCS) Phoenix, AZ) No

60652 Gulf South Risk Services (Phoenix, AZ) No

LX059 H & A Administrators (Plymouth, MN) No

LX093 HCH Administration Inc (Peoria IL) No

82018 HCS (Health Claims Services)(Boise, ID) No

48330 HMAA (Hawaii) No

10004 HMSA Federal Program Yes

10001 HMSA-Hawaii Medical Services Assoc (Honolulu, HI) No

51037 HNAS (Eagan, MN) No

41170 HRM Claim Management (Kalamazoo,MI) No

37224 HSBS (Health Smart Benefit Solutions (Memphis, TN) No

37256 HSBS Oklahoma City (Oklahoma City, OK) No

47738 Hamaspik Choice (Monsey, NY) No

97258 Hammerman and Gainer (Irving, TX) No

95266 Harrington Benefit Services (Columbus, OH) No

22521 Harrington Benefit Services (Oklahoma City, OK) No

59142 Harrington Benefit Services (Oklahoma City, OK) No

75243 Harrington Benefit Services (Seattle, WA) No

75196 Harrington Benefit Services (Westerville, OH) No

06131 Harrington Benefit Services, Inc (Tampa, FL) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

59143 Harrington Health Colonial Dental (Salt Lake City, UT) No

FX061 Harrington Health-Fiserv (PO Box 520, Pueblo, CO) No

10002 Hawaii Dental Service Assoc (Honululu(, HI) No

86066 Hawaii-Mainland Admim (Tempe, AZ) No

25160 Health Aspex (Maryland) No

71056 Health Benefit Claims Dept (Harrison, AR) No

LX105 Health Care Solutions Group (Muskogee OK) No

62179 Health Choice (Medicaid) (Phoenix, Tempe, AZ) No

22521 Health Choice (Oklahoma City, OK) No

59142 Health Choice (Oklahoma City, OK) No

46221 Health Choice Insurance (Phoenix, AZ) No

22100 Health Choice Integrated Care (Flagstaff, AZ) No

82018 Health Claims Services (Boise, ID) No

62111 Health Cost Solutions (Hendersonville, TX 37077) No

LX114 Health EOS by Multiplan No

41178 Health EZ (Americas TPA)(Minneapolis, MN) No

16112 Health Economics (Rochester, NY) No

CX039 Health Economics Group Inc - Rochester, NY No

75234 Health First TPA (Eagan, MN & Tyler, TX) No

30946 Health Future, LLC Medford, OR No

CX083 Health Net (Liberty Dental) (Santa Ana, CA & Tamp, FL) No

HND1 Health Net - Commercial (Van Nuys, CA) No

20199 Health Network of America (Ft. Worth, TX) No

51037 Health Now (Eagan, MN) No

69821 Health Partners - Next Level (Birmingham, AL) No

CX010 Health Partners of Minnesota (Medicaid) (Minneapolis, M No

CX009 Health Partners of Minnesota - Commercial (Minneapolis, No

62157 Health Partners of Tennessee- Jackson, TN No

22521 Health Plan SErvices of OK (Oklahoma City, OK No

59142 Health Plan Servces of OK- Oklahoma City, OK No

47009 Health Plan Services (Lincoln, NE) No

59140 Health Plan Services (Tampa, FL) No

76342 Health Plan of NV (Las Vegas, NV) No

CX055 Health Plans, Inc (Westborough, MA) No

CX019 Health Resources Incorporated (HRI) - IN (Evansville, IN No

25133 Health Right of CT (Medicaid Claims) No

41170 Health Risk Management, Inc. (HRM)(Kalamazoo, MI) No

37283 Health Smart ( Po Box 93670, Lubbock TX) No

37283 Health Smart Benefit (PO Box 167768, Irving TX) No

37224 Health Smart Benefit Solutions (HSBS)(Memphis, TN) No

41154 Health Traditions (MMSI)(Rochester, MN) No

71064 HealthChoice (Lubbock, TX) No

85729 HealthComp TPA (PO Box 45018, Fresno, CA) No

20356 HealthE Exchange (Kansas City, MO) No

95213 HealthEdge Administrators (Bakersfield, CA) No

34185 HealthFirst Houston (Houston, TX) No

75234 HealthFirst TPA (Eagan, MN) No

75234 HealthFirst TPA (Tyler, TX) No

25125 HealthLink (St. Louis) No

59226 HealthMarkets (MEGA Life)(TX) No

52133 HealthNet (SLC, UT) No

HND2 HealthNet - Gov't Program No

55204 HealthNow NY (PO Box 80, Buffalo, NY) No

25133 HealthRight of CT (Medicaid claims to First Health Strata No

71063 HealthSCOPE Benefits, Inc (Little Rock, AR) No

71063 HealthScope Benefits (Po Box 619055, Dallas, TX) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

CXHSC HealthShare CCO (Salem, OR) No

37256 HealthSmart (Oklahoma City, OK) No

87815 HealthSmart (PO Box 91608, Lubbock, TX) No

75237 HealthSmart Accel (Lubbock & Irving, TX) No

87815 HealthSmart Benefits(Charleston, WV) No

31172 HealthTrans (Innovative Benefit Admin)(Greenwood Villa No

HMA01 Healthcare Management Administrators, Inc (Bellevue, No

75289 Healthfirst of Austin (Dallas, TX) No

56144 Healthgram Inc. (Primary Physician)(Charlotte, NC) No

11271 Healthplex, Inc. (Uniondale, NY) No

LX041 Healthscape (Bend, OR) No

68195 Healthsource/Provident Insurance Co.(Chattanooga, TN) No

CPPCA Healthy Families (Sacramento, CA) No

CARRS Healthy MI Dental (Detroit, MI) No

22148 Heavy and General Labors Fund of New Jersey (Newark, No

LX037 Heritage Consultants (Auburndale, FL) No

95378 Heritage National Healthplan/John Deere Health Care No

89070 Highmark/HHIC (PO Box 69433 Harrisbury, PA) No

88023 Hometown Health (Reno, NV) No

34150 Hometown Health Network (Saint Clairsville, OH) No

CX015 Hoosier Dental (Indianapolis, IN) No

22099 Horizon (Blue Cross of New Jersey) (Indianapolis, IN) No

22099 Horizon BCBS NJ ( Po box 1311, MPLS) No

22099 Horizon NJ Health (PO Box 299, Milwaukee, WI) No

91136 Hotel Employees & Restraunt Employess Health Trust(Se No

LX136 Hotel Restaurant (2002 London, Duluth, MN) No

61101 Humana Medicare/Humana Gold No

73288 Humana/Employers Health of WI (Lexington, KY) No

22175 I.E. Shaffer (West Trenton, NJ) No

LX145 IAA (Mt Laurel, NJ) No

IAT01 IATSE - Atlanta Health & Welfare Fund No

A1117 IBEW Local 117(Carmel, IN) No

A1317 IBEW Local 38(Carmel, IN) No

A1461 IBEW Local 461(Carmel, IN) No

A4681 IBEW Local 481 (Carmel, IN) No

LX079 IBEW Local Union 577 (Madison WI) No

64246 IBEW Welfare Trust Fund (Decatur, IL) No

LX075 IBEW Welfare Trust NECA (Decatur IL) No

41124 IBI ( Minneapolis, MN) No

CXIBT IBT - Local 145 Health Services & Ins Plan (Statford, CT) No

LX141 IHC Admin Services (Eagan, MN) No

LX111 IMA (Bossier City LA) No

41600 IMCare (Grand Rapids, MN & Birmingham, AL) No

FX056 IMS (Amarillo, TX) No

17882 IMS TPA: Parton Lumber (UCS) (Phoenix, AZ) No

26879 IMS TPA: Walker White (USC)(Phoenix, AZ) No

40585 INDECS Corp. (Lyndhurst, NJ) No

91136 Idaho Pipe Trades No

36600 Illinois Central Hospital Association No

CDOK1 Indian Health Services (Oklahoma City, OK) No

ICW01 Indiana Carpenters Welfare Fund( Indianapolis, IN) No

CX070 Indiana Childrens Special HealthCare (Indianapolis, IN) Yes

35107 Indiana Teamsters Health Benefit Funds (Indianapolis, I No

43471 Inetico (Tampa, FL) No

52196 Informed, LLC No

31172 Innovative Benefit Admin (HealthTrans)(Greenwood Villa No

Payer Claims List

Payer ID Payer Name Req. Enroll.

40025 Innovative Health (PO Box 14094, Lexington, KY) No

37279 Insurance Admin of America (Mount Laurel, NJ) No

13315 Insurance Design Administrators - Oakland, NJ No

15688 Insurance Management Services (Elko, NV) No

88006 Insurance Management Services, Elko, NV No

11889 Insurance Systems (PO Box 211006, Eagan, MN) No

74385 Insurance Systems Inc. (Monroe, LA) No

86304 Insurers Administrative Corporation (Phoenix, AZ) No

51020 Integra Adminstrative Group - Seaford, DE No

23229 Integral Quality Care (Phoenix, AZ) No

84137 InterWest Health (Eagan, MN) No

87765 Interactive Medical Systems (PO Box 21145, Eagan, MN) No

LX158 Interactive Medical Systems (Wake Forest, NC) No

IAT01 Interantional Association of Theatrical State Employees ( No

660537624 International (First Medical) No

IAHFI International Assoc. of Health & Frost (Tinley Park, IL) No

36609 International Brotherhood of Boilermakers (Kansas City, No

A1317 International Brotherhood of Electrical Workers (IBEW) L No

A1461 International Brotherhood of Electrical Workers (IBEW), No

A4681 International Brotherhood of Electrical Workers (IBEW), No

41124 Iowa Benefits, Inc( Minneapolis, MN) No

41600 Itasca Medical Care (Grand Rapids, MN & Birmingham, A No

61271 J.F. Molloy and Associates, Inc.(Colorado Spring, CO) No

14168 JLT Services Corporation (Latham, NY) No

79480 JMS-MSA (Po Box 679, Farmington MI) No

34136 JP Farley Corporation(West Lake, OH) No

14168 Jardine Group Services (Latham, NY) No

LX096 Jefferson Federation No

CX061 Jefferson Pilot (Omaha, NE) No

JEN01 Jenkins & Associates (1299 BattleCreek Rd, Ste 200 & P No

CXJAS Jensen Administrative Services (SLC, UT) No

LX119 Jerrys Home Improvement (Portland OR) No

41099 John Alden Life Ins. (501 W Michigan, Milwaukee, WI) No

95378 John Deere Health Care/Heritage National Healthpla(Moli No

80314 John Hanncock No

38310 John Morrell Co. AHBPA (Birmingham, AL) No

CHSJT Joint Benefit Trust (Dublin, CA) No

J1410 Jopari Careworks (Columbus, OH) No

CX073 Kaiser Permanente (PO Box 4360, Rockville, MD) No

40137 Kalos Health (Niagara Falls, NY) No

57038 Kanawha Ins Co. - Lancaster, Greenville, SC No

KBT01 Kansas Building Trades (Topeka, KS) No

CX058 Kansas City Life (PO Box 9040 Austin, TX) No

CX058 Kansas City Life Insurance Company (Kansas City, MO) No

95279 Keenan Associates (Torrance, CA) No

61453 Kemper (Milwaukee, WI) No

73100 Kempton Company - OK (Oklahoma City,OK) No

29979 Kempton Group (UCS) (Phoenix, AZ) No

73100 Kempton Group Administrators (Oklahoma City, OK) No

77894 Kentucky Health Co-Op (Fort Mill, SC) No

37217 Key Benefit Admin (Milwaukee, WI) No

37323 Key Solution (Fort Mill, SC) No

KEY01 Keystone Mercy Health Plan (Milwaukee, WI) No

LX043 Klais Company (Akron, OH) No

34145 Klais and Company (Fairlawn, OH) No

52193 LBA HealthPlans, Inc (Timonium, MD)(El Paso, TX) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

25922 LIFE Armstrong (Eden Prairie, MN) No

25924 LIFE Beaver & Lawrence (Eden Prairie, MN) No

25923 LIFE Butler (Eden Prairie, MN) No

59847 LIFE St. Joseph of the Pines (Eden Prairie, MN) No

76184 LIFE St. Mary (Eden Prairie, MN) No

A1004 Laborers Metropolitan Detroit HealthCare Fund (Langsing No

LSH01 Laborers Southeast Health & Welfare Plan No

37116 Lake County Physicians Associaton No

90096 Land of Lincoln (Chicago, IL) No

CX083 Liberty Dental Plan (Santa Ana, CA & Tampa, FL) No

33LGC Life Gift Cards (Woodland Park, CO) No

78140 Life Insurance Company of Boston & New York No

71498 LifeCircles PACE (Muskegon, MI) No

RLH01 LifeMap (PO Box 1271, Portland, OR & Milwaukee, WI) No

CX047 LifeRe (San Antonio, TX) No

EBSRM LifeTime Benefits (EBS-RMSCO)(NY) No

37294 LifeWise/Washington Employers Trust (Seattle, WA) No

27005 Lifestyle Dental (Witcha, KS) No

93093 Lifewise Health Plan or Oregon (Bend, OR) No

CX061 Lincoln National (Omaho, NE & Orlando, FL) No

73288 Lincoln National of Wisconsin (Madison or Green Bay) No

LCB01 Line Construction Benefit (Lombard, IL) No

NYT01 Local 1149 Baldwinsville NY No

NYT01 Local 118 Rochester NY No

35107 Local 135 Health Benefits - Indianapolis, IN No

84041 Local 137 Operating Engineers (Hopatchung, NJ) No

IAHFI Local 17 Fund-Int. Assoc. of Heath & Frost(Tinley Park, I No

LX092 Local 174 (Joliet IL) No

NYT01 Local 182 Utica NY No

NYT01 Local 264 Cheektowaga NY No

NYT01 Local 294 Albany NY No

NYT01 Local 317 Syracuse NY No

NYT01 Local 375 Buffalo NY No

NYT01 Local 449 Buffalo NY No

LX125 Local 513 (Bridgeton MO) No

NYT01 Local 529 Elmira NY No

NYT01 Local 669 Albany NY No

NYT01 Local 687 Potsdam NY No

NYT01 Local 693 Binghamton NY No

05030 Local 731 (Burr Ridge, IL) No

NYT01 Local 791 Rochester NY No

GCU01 Local 8-M & 96B Health & Welfare No

LX079 Local Union 577 IBEW (Madison WI) No

91136 Locals 302 and 612 of the I.U.O.E No

CB752 Lockard & Williams (Pascaqoula, MS) No

LX100 Logistics Health Inc (LaCrosse WI) No

45289 LoneStar (Eagan, MN) No

45289 LoneStar TPA via ECOM (Tyler, TX) No

FX045 Loomis (Reading, PA) No

LX045 Loomis (Reading, PA) No

23223 Loomis Company (Wyomissing, PA) No

62310 Lovelace Insurance No

90328 Lovelace Sandia Health Plan (Westerville, OH) No

62310 Lovelace Senior Options(LSO) and Lovelace Senior Plan(L No

52133 M-Plan Dental (Salt Lake City, UT) No

CX033 MAMSI - (Frederick, MD) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

MBAAZ MBA (El Paso, TX) No

83028 MBA Benefit Admin (Salt Lake & Murray, UT) No

87065 MBA Benefit Administrators (Salt Lake City, UT) No

87065 MBA of Wyoming (Worland, WY) No

56205 MBS (MedCost Benefit Services(MBS))Winston Salem, NC No

65030 MCNA (Managed Care of North America) Fort Lauderdale No

660396197P MCS / MCS Classic Care No

41101 MDB (1335 Industrial Blvd., Ste 100, St. Paul, MN) No

59226 MEGA Life & Health Insurance Company (North Richland No

LX057 MHHNP (Memorial Herman Health)(PO Box 742567 Hous No

94276 MHHNP (Po Box 742567, Houston TX) No

27401 MI UFCW Union (Madison Heights, MI) No

LX133 MMA (Goshen IN) No

10317 MMEHT (Augusta, ME) No

41154 MMSI-Mayo Clinic Health Solutions (Rochester, MN) No

89070 MMSO (Military Medical Support) (Po Box 886999) No

R7005 MN Power (Duluth, MN) No

LX159 MPE Employee Benefit Services (Jackson, MS) No

37233 MPEEBT / MPE Services, Inc (Jackson, MS) No

20572 MSA Careguard (North Reading, MA) No

LX130 MVP Medical (Schenectady NY) No

10317 Machigonne Benefit Administators (Portland, ME) No

91136 Machinists Health No

CX042 Mahoney Benefit Admin, LLC of TX(Ft. Lauderdale, FL) No

25133 Mail Handlers Benefit Plan (Jacksonville, FL) No

25160 Manage Care of America (Pittsburgh, PA) No

GI813 Manage Dental Guard (Sacramento, CA) No

35162 Managed Care Services (Fort Wayne, IN) No

65030 Managed Care of North Ameica (MCNA) Fort Lauderdale, No

64246 Managed Dental Guard(Woodland Hills, CA) No

CX014 Managed Health Services - WI State Employees No

98010 Manulife, W.J. Sutton Co. - Toronto Ontario, Canada No

4600012 MapFre No

FX032 Maritime Association (Houston, TX) No

LX032 Maritime Association (Houston, TX) No

LX025 Marsh Advantage (po box 4542, Iowa CIty IA) No

CX098 Masonry Institute (Des Plaines, IL) No

CX014 Mass Health (Doral Dental) Hingham, MA No

LX157 Massachusetts Benefit Admin (Boston, MA) No

37217 Maverist (Milwaukee, WI) No

92805 Maxor (Amarillo, TX) No

41154 Mayo Clinic Health Solutions-MMSI (Rocehster, MN) No

37287 McCrew Care (Columbia, SC) No

31149 McGregor PACE (Eden Prairie, MN) No

LX164 McLaren Health Plan (Flint, MI) No

LX049 McPrime West (1335 Industrial Blvd. Ste 150, Mpls, MN) No

EM284 Med3000 CMS Safety Net No

EM843 Med3000 CMS Title 19 No

EM205 Med3000 CMS Title 21 No

EM039 Med3000 Pedicare Title 19 No

EM522 Med3000 Pedicare Title 21 No

74323 MedBen (Newark, OH) No

56205 MedCost Benefit Services (MBS)- Winston Salem, NC No

57016 Medi-Cal (PO Box 15559, Sacramento, CA No

CX026 Medica of MN - PO Box 1328, Mpls, MN No

CX026 Medica of MN - PO Box 1519, Mpls, MN No

Payer Claims List

Payer ID Payer Name Req. Enroll.

CKMEH Medicaid - Maine for FQHC No

CX014 Medicaid Pennysylvania Best Health Care Pittsburgh (Do No

CX014 Medicaid Pennysylvania Gateway Health Plan (Doral Den No

CX014 Medicaid Pennysylvania Health Partners Pittsburgh (Dor No

CX014 Medicaid Pennysylvania Oaktree (Doral Dental of WI) No

CKAZ1 Medicaid of AZ No

CKAL1 Medicaid of Alabama Yes

CKAK1 Medicaid of Alaska Yes

CKAR1 Medicaid of Arkansas No

94146 Medicaid of California (Denti-Cal) No

CKCO1 Medicaid of Colorado No

CKCT1 Medicaid of Connecticut (New Britton, CT) No

CKDE1 Medicaid of Delaware - New Castle, DE No

CKDC1 Medicaid of Disctrict of Columbia (Washington, DC) Yes

CKFL1 Medicaid of Florida Yes

CKGA1 Medicaid of Georgia No

CX014 Medicaid of Georgia Grady Healthcare Inc (Doral Dental No

CKIL1 Medicaid of IL - Doral Dental of WI (Admin by Doral) No

CKID1 Medicaid of Idaho (Boise, ID) No

CX014 Medicaid of Illinois (Doral Dental of WI) No

CKIN1 Medicaid of Indiana (Boise, ID) No

CKIA1 Medicaid of Iowa (Des Moines, IA) Yes

CKKS1 Medicaid of Kansas (Mequon, WI) No

CKKY1 Medicaid of Kentucky (Mequon , WI) Yes

CKKY3 Medicaid of Kentucky Region #2 (Doral Dental Services) No

CX014 Medicaid of Kentucky Region #3 (Doral Dental of WI) No

CKLA2 Medicaid of Louisiana (Adult Dental) No

CKLA1 Medicaid of Louisiana (EPSDT) (Baton Rouge, LA) No

CKME1 Medicaid of Maine Yes

CX014 Medicaid of Maryland-Dept of Health and Ment No

CKMA1 Medicaid of Massachusetts No

CKMI1 Medicaid of Michigan No

CKMN1 Medicaid of Minnesota Yes

CKMS1 Medicaid of Mississippi Yes

CKMO1 Medicaid of Missouri (Jefferson City, MO) No

CX014 Medicaid of Missouri Blue Advantage (Doral Dental of WI No

CX014 Medicaid of Missouri Community Care Plus- St Louis (Dor No

CX014 Medicaid of Missouri Community Health PLan (Doral Den No

CX014 Medicaid of Missouri First Guard Health Plan (Doral Dent No

CX014 Medicaid of Missouri Health Net (Doral Dental of WI) No

CX014 Medicaid of Missouri Truman Care- Family Health Partner No

CX014 Medicaid of Missouri health Care USA- St.Louis (Doral De No

CKMT1 Medicaid of Montana No

CKNE1 Medicaid of Nebraska (Lincoln, NE) Yes

CKNV1 Medicaid of Nevada (San Antonio, TX) Yes

CKNH1 Medicaid of New Hampshire No

86047 Medicaid of New Jersey (Admin by Americhoice)(Salt Lak No

CKNJ1 Medicaid of New Jersey (Trenton, NJ) Yes

CKNM1 Medicaid of New Mexico Yes

CX014 Medicaid of New Mexico Cimmaron Health Plan (Doral D No

CX014 Medicaid of New Mexico Loveplace Community health pla No

CX014 Medicaid of New Mexico Presbyterian Salud (Doral Denta No

CKNY1 Medicaid of New York Yes

86048 Medicaid of New York (Administrated by AmeriChoice) No

CKNY2 Medicaid of New York (Dental Clinics Only) Yes

CKNC1 Medicaid of North Carolina (Raleigh, NC) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

CKND1 Medicaid of North Dakota (Bismark, ND) No

CKOH1 Medicaid of Ohio (Administrated by Quadax) (Columbus, No

CX014 Medicaid of Ohio Emerald HMO and Medicare INC. (Dora No

CX014 Medicaid of Ohio Health Power HMO Cincinatti (Doral De No

CX014 Medicaid of Ohio Personal Physicians Care Cleveland (Do No

CKOH2 Medicaid of Ohio: Caresource (Dayton, OH) No

CKOK1 Medicaid of Oklahoma (Oklahoma City, OK) No

CX014 Medicaid of Oklahoma Heartland Health PLan (Doral Den No

CX014 Medicaid of Oklahoma Unicare Health PLan (Doral Dental No

CKOR1 Medicaid of Oregon Yes

CKPA1 Medicaid of Pennsylvania (Harrisburg, PA) No

CX014 Medicaid of Pennysylvania (Doral Dental of WI) No

CKRI1 Medicaid of Rhode Island Yes

CKSD1 Medicaid of SD No

CKSC1 Medicaid of South Carolina No

CX014 Medicaid of Tennessee (Doral Dental of WI) No

CKTX1 Medicaid of Texas No

CKUT1 Medicaid of Utah Yes

CKVA1 Medicaid of VA - Richmond, VA No

CKVT1 Medicaid of Vermont Yes

CX014 Medicaid of Virginia HealthKeepers Plus (Doral Dental of No

CKWA1 Medicaid of Washington No

CKWV1 Medicaid of West Virginia (Charelston, WY) Yes

CKWI1 Medicaid of Wisconsin (Madison. WI) No

CX014 Medicaid of Wisconsin Humana/ TDC (Doral Dental of W No

CX014 Medicaid of Wisconsin PrimeCare (Doral Dental of WI) No

CKWY1 Medicaid of Wyoming (Cheyenne, WY) Yes

CX014 Medicaid of ohio United Health Care Inc. Medicare COm No

MAHC1 Medical Associate Health Plan (Dubuque, IA) No

LX019 Medical Benefit Admin (PO Box 90991, Milwaukee, WI) No

CX024 Medical Benefit Administrators - Madison, WI No

74323 Medical Benefits Mutual - Newark, OH No

60221 Medical Bridge and Dental Claims (Jackson, MS) No

CB833 Medical Mutual of Ohio (MMO) No

84600 Medical Network of Colorado Springs(Colorado Springs, C No

660663351 Medicare Dental Network (MDN) No

973 Medicare Optimun / Triple S No

23160 Medico Insurance (IA, NE, MN) No

59069 MedsavUSA (Fringe Benefit)(FL) No

LX057 Memorial Hermann (MHHNP)(PO Box 742567, Houston, No

MNM01 Mennonite Mutual Aid (Goshen, IN) No

LX133 Mennonite Mutual Aid (Goshen, IN) No

MBAAZ Merchants Benefit (MultiFlex Dental)(Scottsdale, AZ) No

37264 Mercy Benefit Admin (Springfield, MO) No

86052 Mercy Care Plan (Phoenix, AZ) No

63002 Mercy Life of Alabama (Livonia, MI) No

33628 Mercy Maricopa Integrated Care (Phoenix, AZ) No

CX074 Meritain Health (Amherst, NY & Richardson, TX) No

41124 Meritain Health (Minneapolis, MN) No

23550 Methodist First Choice (Rockford, IL) No

65978 Metlife (El Paso, TX) No

A1004 Metropolitan Detroit Laborers (Landing, MI) No

CDMI0 Michigan Conference of Teamsters (Farmingotn Hills, MI) No

LX116 Michigan Dental Plan (Clawson MI) No

A1432 Michigan Laborers (Carmel, IN) No

38238 Michigan Regional Council of Carpenters Employee(Troy, No

Payer Claims List

Payer ID Payer Name Req. Enroll.

A1404 Michigan State Painters (Carmel, IN) No

27401 Michigan UFCW (Madison Heights, MI) No

LX078 Michigan UFCW (Madsion Heights, MI) No

37281 Mid America Associates, Inc (Madison Heights, MI) No

22823 Mid America Benefits (Po Box 685, Arnold MD) No

59226 Mid West National Life Insurance (MEGALIFE) (N Richlan No

12251 Mid-American AAI, Inc (UCS) Phoenix, AZ No

LX085 Mid-American Benefits In (Omaha NE) No

CX033 Mid-Atlantic Medical Services, Inc (MAMSI) PO Box 940 F No

74227 Mid-West National Life Ins. Co. of TN-Student Ins No

41101 Midwest Dental Benefits (1335 Industrial Blvd. Ste 100 S No

61146 Midwest Group Benefits, Inc. (Decorah, IA) No

LX171 Midwest Operating Engineers H&W (6150 Juliet Rd. Cou No

51233 Midwest Security Administrators, Inc No

79480 Midwest Security of WI (Onalaska, WI) No

89070 Military Medical Support (MMSO) (Po Box 886999) No

A1402 Millwright Local 1102 Health & Welfare Fund (Lansing, M No

R7005 Minnesota Power (Duluth, MN) No

64088 Mississippi Select Healthcare (Gulfport, MS) No

37275 Missoula County Benefits Plan No

25133 Missouri Department of Transportation/MODot * St Louis No

SKYGN Molina Health Care (Milwaukee, WI) No

CX083 Molina HealthCare(Liberty Dental) (Santa Ana, CA & Tam No

86098 Molina Medicare No

31415 Momentum Ins. Plans (Madison, WI) No

52133 Morgan White (Salt Lake City, UT) No

35092 Morris Associates (PO Box 50440, Indianapolis, IN) No

35092 Morris Associates (PO Box 619058 Dallas, TX) No

36111 Motorola (Phoenix, AZ) No

89070 Mountain State BCBS (MSBCBS(PO Box 69434, Harrisbur No

86040 Mountain States Admin Services, Tucson, AZ No

MBAAZ MultiFlex Dental (Merchants Benefit)(Scottsdale, AZ) No

37256 Mutual Assurance Admin (Oklahoma City, OK & Addison, No

CX087 Mutual of Omaha (Sherwood, AR & Indianapolis, IN) No

71412 Mutual of Omaha/National Rural Letter Carrier (Charlotte No

34192 Mututal Health Services (Antares Mgmt)(Westlake, OH) No

91136 N.W. Int Assoc of machinists & Aerospace Eng Benefits No

91136 N.W. Iron Workers Health & Security Trust Fund (Seattle No

91136 N.W. Roofers & Employers Health & Security Trust Fund No

91136 N.W. Textile Processors (Seattle, WA) No

65085 NAA (TN) North America Administrators, LP - Nashville, No

34159 NABN (North American Benefits Network) Cleveland, OH No

58182 NAPHCARE (Birmingham, AL) No

23166 NAS (Nat'l Auto Sprinklers (Landover, MD) No

LX177 NCAS (Harrisbury, PA claims only) No

75191 NCAS - Charlotte No

75190 NCAS - Fairfax, VA No

LX075 NECA (Decatur IL) No

38225 NGS (St Claire Shores & Clinton Township, MI) No

38225 NGS American (Lake Forest, IL) No

CKTX1 NHIC (Medicaid of TX) No

66055 NLH (Netcare Life & Health Ins) No

38238 NNEBT Northern NE Benefit Trust (Manchester, NH) No

91136 NW Benefit ( Po Box 34176) No

41045 NW National Life (MN, AZ) No

91136 NW Plumbing and Pipfitting Industry No

Payer Claims List

Payer ID Payer Name Req. Enroll.

14142 NY State Dept of Health (Albany, NY) No

23166 Nat'l Auto Sprinklers (NAS)(Landover, MD) No

56175 Nathional Benefit Adminsitrators (Parsippany, NJ) No

LX172 Natinoal Assoc. of Letter Carriers(NALC)(Ashbury, VA) No

LX176 National Automatic Sprinkler (Landover, MD) No

56176 National Benefit Administrators, (Charlotte, NC) No

75190 National Claims Admin Services (NCAS))(Fairfax, VA) No

CX045 National Elevator Industry Benefit Plan (NEIB) (Newtown No

CX057 National Pacific of TX (TX) No

71412 National Rural Letter Carrier (Charlotte, NC) No

52120 National Telecommunications Cooperative Association (A No

MBAAZ Nationwide (El Paso, TX) No

314RV Nationwide Employee Benefits (Columbus, OH) No

31417 Nationwide Health Plan (Dublin, OH) No

19191 Native Care Health, LLC (Quapaw, OK) No

95123 Neighborhood Health No

66055 Netcare Life and Health Insurance (NLH) No

84600 Network Claims (Colorado Springs, CO) No

90091 Nevada Health Co Op (Las Vegas, NV) No

NDB01 Neveda Dental Benefits (Las Vegas, NV) No

43351 New England Dental Administrators - Concord, NH No

66893 New England Financial (Kennet, MO) No

LX180 New Era Life (Houston, TX) No

LX181 New Era Life (Valdosta, GA) No

LX080 New Southland Natl Ins Co (Tuscaloosa AL) No

NYT01 New York State Teamsters Union (Syracuse, NY) No

LX174 Newman Company (Franklin Square , NY) No

69821 Next Level Health Partners (Birmingham, AL) No

81264 Nippon Life Insurance Company of America No

65085 North America Administrators, LP - Nashville, TN No

34159 North American Benefits Network (NABN), Cleveland, OH No

LX027 North American Health ( Amherst, NY) No

37314 North Broward Hospial District (FL) No

CKNC1 North Carolina Health Choice (Raleigh, NC) No

61472 North Carolina Health Choice for Children No

47570 North Star Administrators No

02027 NorthEast Delta Dental (ME, NH, VT) No

CBNYE NorthEast NY Blue Shield (Albany, NY) No

CX099 Northern California Pipe Trades (Concord, CA) No

36347 Northern Illinois Health Plan (Freeport, IL) No

LX062 Northern MN Dental (Duluth, MN) No

LX106 Northern NE Benefit Trust (Manchester NH) No

38238 Northern NE Benefit Trust NNEBT (Manchester, NH) No

88027 Northern Nevada Trust Fund - Reno, NV No

91060 Northwest Administrators (Seattle, WA) No

93525 Northwest Dental Services - Roseburg, OR No

91136 Northwest Iron Workers (PO box 34464) Seattle,WA No

36346 Northwest Suburban IPA (Rockford, IL) No

91136 Nothwest I.A.M. Benefit Trust No

16644 Nova Health Administrators, Inc. (Grand Island, NY) No

37299 Nyhart (Indianapolis, IN) No

CDOR1 ODS Healthplans (Oregon Dental Services/Delta Dental o No

22521 OK State Employees & Educators (Oklahoma City, OK) No

CX075 OK State Medical Assoc. (OSMA)(Oklahoma City, OK No

80705 ONE Health Plan Inc of California No

80705 ONE Health Plan Inc of Colorado No

Payer Claims List

Payer ID Payer Name Req. Enroll.

80705 ONE Health Plan Inc of Florida No

80705 ONE Health Plan Inc of Georgia No

80705 ONE Health Plan Inc of Idaho No

80705 ONE Health Plan Inc of Indiana No

80705 ONE Health Plan Inc of Iowa No

80705 ONE Health Plan Inc of Kentucky No

80705 ONE Health Plan Inc of Mississippi No

80705 ONE Health Plan Inc of New Jersey No

80705 ONE Health Plan Inc of New York No

80705 ONE Health Plan Inc of North Carolina No

80705 ONE Health Plan Inc of Oklahoma No

80705 ONE Health Plan Inc of Texas No

80705 ONE Health Plan Inc of The District of Columbia No

80705 ONE Health Plan Inc of Vermont No

80705 ONE Health Plan Inc of Virginia No

80705 ONE Health Plan Inc of Washington No

80705 ONE Health Plan Inc of Wisconsin No

80705 ONE Health Plan Inc. of Alaska No

80705 ONE Health Plan Inc. of Arizona No

CX075 OSMA (OK State Medical Assoc)(Oklahoma City, OK) No

OAC01 Ohio AFSCME Care Plan No

74431 Ohio PPO Connect (PO Box 828, Arnold, MD) No

65074 Olympus Managed Health Care (Miami, FL) No

80705 One Health Plan Inc of Wyoming No

FX026 Operating Engineers (Pewaukee, WI) No

91136 Operating Engineers Locals 302 & 612 Health & Security No

LX023 Optima (4417 Corporation Lane, Virignia Beach) No

LX065 Optima (Troy, MI) No

GP133 Optum Specialty Svcs (Thiensville, Milwaukee WI) No

25449 Oregon Alaska Industrial Hardware (Phoenix, AZ) No

27267 Oregon Alaska Rubber & Supply (Phoenix, AZ) No

27277 Oregon Cascade Rubber Products (Phoenix, AZ) No

26224 Oregon Construction Machinery Industrial (Phoenix, AZ) No

CDOR1 Oregon Dental Services & ODS Healthplans (Portland, O No

73624 Oregon Peninsula Airways (Phoenix, AZ) No

83926 Oregon TDX Corp. (Phoenix, AZ) No

84104 Oxford Health Plans No

DX106 P.R.I.M.E Benefit Systems(PO Box 2239 CedarRapids, IA No

87068 P5 Health Plan Solutions (Salt Lake City & West Valley, U No

CX066 PA Faculty Health & Welfare (Arnold, MO) No

70454 PACE CNY (Syracuse, NY) No

21614 PACE Greater New Orleans (Norlin)(NewOrleans, LA) No

86711 PACE Southest Michigan (Eden Prairie, MN) No

37287 PAI (Columbia, SC) No

CX065 PATH Administrators (Harrisburg, PA) No

27277 PBS - Oregon Cascade Rubber Products (Phoenix, AZ) No

68241 PDO No

CX080 PEHP (Public Employees Health Program)(Salt Lake City, No

LX030 PLUMBERS AND PIPEFITTERS (OKLAHOMA, OK) No

67466 PM Group (Phoenix, AZ) No

CDCAP PMI (Delta Dental of CA) (12898 Towne Center Drive Ce No

16111 POMCO ( Syracuse, NY) No

LX149 POMCO Group (Syracuse, NY) No

LX175 Pacific Dental Benefits (Concord, CA) No

67466 Pacific Life & Annuity - Phoenix, AZ No

CX056 Pacific Union Dental Benefits (LasVegas, NV) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

93031 PacificSource Admin (Portland, OR) No

CXPSC PacificSource Community (Salem, OR) No

93029 PacificSource Health Plans - Eugene, OR No

CX060 Pacificare Dental and Vision (HMO Claims Only) (PO Box No

CX053 Pacificare Dental and vision (PDVA) (Santa Ana, CA) No

LX054 Paid Dental (PO Box 9150, Austin, TX) No

LX063 Painters Trust Association (Spokane WA) No

04218 Pan American Life Ins. (El Paso, TX) No

06126 Paper Claims No

58174 Paragon Benefits, Inc. (Columbus, GA) No

58174 Paragon Benefits, Inc. (Po Box 981600, El Paso TX) No

35162 Parkview Health Plans (Fort Wayne, IN) No

PBGSM Partners Benefit Group (Southborough, MA) No

23213 Partners Health Plan (Philadelphia, PA) No

CX091 Passport Health (London, KY & Fort Lauderdale, FL) No

CB733 Patient Services (Midlothian, VA) No

10525 Patients Advocates, LLC (Portland & Gray, ME) No

32069 Patriot Mutual Dental Programs(PO Box 192, MPLS, MN) No

47009 Paul Revere / Provident No

PRW01 Pavers and Road Builders Welfare Fund No

LX148 Pekin Life Insurance (Pekin, IL) No

52133 Peoples Benefit Life Ins. Co. (Salt Lake City, UT) No

37121 Pequot Plus Health (PO Box 3559 Manshantucket, CT) No

LX163 Personal Insurance Administrators (Agoura Hills, CA) No

67814 Phoenix American (Greenfield, MA) No

PHP01 Phoenix Health Plan (PHP) (AZ) (Richardson, TX) No

67814 Phoenix Home Life (Greenfield, MA) No

38265 Physicians Care (Grand Rapids, MI) No

36345 Physicians Care Network (Rockford, IL) No

37136 Physicians Health Assoc. (Rockford, IL) No

12399 Physicians Health Plan of Northern IN(Fort Wayne, IN) No

CX068 Physicians Mutual (Lincoln, NE) No

47009 Physicians Mutual (Lincoln, NE) No

CX014 Physicians Plus Insurance Co., Wisconsin State Employee No

24735 Pinnacle Claims Management (Fresno, CA) No

PIP01 Pipe Trades Industry Health & Welfare Fund No

PIP02 Pipefitters 597 (45 N Ogden Ave. Chicago, IL 60607) No

LX099 Pipestone Industry Benefit Trust (Tulsa OK) No

37224 Pittman & Associates (Memphis, TN) No

37287 Planned Administrators, Inc. No

PCM01 Plasters & Cement mason Local 148 Health & Welfare Fu No

PCU01 Point Comfort Underwriters (Indianapolis, IN) No

PCU02 Point Comfort Underwriters (PO Box 211745, Eagan, MN No

32680 Poly America Medical & Dental Benefits-Grand Prairie, TX No

23253 Populytics (Spectrum Admin (Allentown, PA) No

36373 Prairie States Enterprises, Inc ( Sheboygan, WI) No

41147 Preferred (PO Box 59212) Mpls, MN No

16112 Preferred Care (Rochester, NY) No

59291 Preferred Care FL (Tampa, FL) No

56178 Preferred Care NC (Tampa, FL) No

68241 Preferred Dental Organization No

LX083 Preferred Group Plans Inc (Albany NY) No

CX090 Preferred Health (PO Box 436987 Louisville, KY) No

CB404 Preferred Health Plan of the Carolinas (Charlotte, NC) No

31478 Preferred Health Professionals (Freedom Dental)(Overlan No

LX132 Preferred One Auxiant (Cedar Rapids IA) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

47570 Premera Blue Cross (Seattle, WA) No

CX078 Premier Access Insurance (PO Box 659010 Sacramento, No

CX029 Premier Dental Group - MN (Plymouth, MN) No

56144 Primary Physician Care, Inc. - Charlotte, NC No

LX049 Prime West (1335 Industrial Blvd., Ste 150, MPls, MN) No

PCA01 PrimeCare Admin (Las Vegas, NV) No

CX014 PrimeCare, Wisconsin State and Federal Employees and No

61271 Principal (Coloradp Springs, CO& DesMoines, IA) No

38217 Priority Health (Grand Rapids, MI) No

LX095 Pro Claim Plus Inc (Fort Wayne IN) No

36331 Professional Benefit Administrators, Inc. (Oak Brook, IL) No

LX001 Professional Claims (10560 Wayzata, Minnetonka, MN) No

41163 Professional claims Administrators (Minnetonka, MN) No

37137 Progressive Benefits Services (Peoria, IL) No

88029 Prominence Health Plan (Reno & Henderson, NV) No

70408 Protective Life/Fortis (Birmingham, AL) No

PAS01 Providence Admin Services (Eagan, MN) No

68195 Provident\Healthsource (Memphis TN) No

60054 Prudential No

68241 Prudential (Blue Bell, PA) No

CX080 Public Employees Health Program (PEHP)(Salt Lake City, No

91136 Puget Sound Benefits Trust (Seattle, WA) No

39197 QuadMed (West Alis, WI) No

89461 Quality Care Partners (PO Box 595, Arnold, MD) No

CX077 Quality Plan Admin (Washington, DC) No

46571 Quartz ASO (Sauk City, WI) No

95266 R.E. Harrington Inc (Colombus, OH) No

91176 RBMS, LLC (Anchorage, AK) No

16117 RMSCO (Syracuse or Liverpool, NY) No

93200 Regence (FEP Po Box 857, ID) No

RLH01 Regence (PO Box 1271, Portland, OR) No

93200 Regence Blue Shield (PO Box 30271 SLC UT)(PO Box 21 No

93200 Regence Blue Shield WA- FEP(PO Box 30271 SLC, UT)(P No

38221 Regency Employee Benefits - Port Huron, MI No

47076 Regional Care Inc. (Scottsbluff, NE) No

80314 ReliaStar No

36088 Reliance Standard (PO Box 82510 Lincoln, NE) No

41045 Reliastar (146 Industrial Park Rd, Jackson, MN) No

41045 Reliastar (7830 East Broadway, Tucson, AZ) No

41045 Reliastar (PO Box 1195, Mpls, MN) No

RLHA1 Renaissance Life and Health (Indianpolis, IN) No

73066 Reserve National Insurance Company No

CB695 Resolve (Solarte Health, Inc)(Arnold, MD) No

LX094 Resource One Admin (Buckeystown MD) No

999998 Returned Claims No

37331 RightChoice Benefit Admin (Troy, MI) No

91176 Risk and Benefit Mgmt Services (Anchorage, AK) No

50664 Riverside San Bernardino Cty Indian Health, (Banning, C No

41625 Rochester Public Schools (Rochester, MN) No

84102 Rocky Mountain Life Dental (Colorado Springs, CO) No

RR001 Royale Resources (Perham, MN) No

25133 Rural Carrier Benefit Plan (Charlotte, NC) No

31441 S & S Health (Cincinnati, OH) No

37259 SAMBA (Rockville, MD) No

SCION SCION Dental (Milwaukee, WI) No

SCION SCION Dental (Thiensville, WI) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

38610 SET SEG (Lansing, MI) No

03699 SIEBA (Endicott, NY) No

LX128 SIHO Member Services (Columbus IN) No

CPPSH STAR Health (PO Box 537030, Sacramento, CA) Yes

CX030 Safeguard (Po Box 981987, El Paso, TX) No

CX048 Safeguard HMO (PO Box 30920 Laguna Hills, CA) No

CX030 Safeguard PPO -(PO box 30930 Laguna Hills & Aliso Viej No

37105 Sage Technologies (Cannon Cochran)(Danville, IL) No

37137 Sage Technologies (Peoria, IL) No

96400 San Diego PACE (Eden Prairie, MN) No

91184 Sanford Health Plan (Sioux Falls, SD) No

37288 Santa Barbara Cottage Hospital (Santa Barbara, CA) No

77024 Sante Health System (SeeChange)(Fresno, CA) No

73172 Scan Health Plan Arizona (PO Box 61450 Phoenix, AZ) No

20460 Scan Long Term Care (PO Box 61450 Phoenix, AZ) No

LX089 School Claims Service LLC (New Cumberland PA) No

SDCOM Scion Dental (Milwaukee, WI) No

CX023 Seabury & Smith - Iowa City, IA No

86057 Secure Care (Phoenix, AZ) No

28530 Secure Health Plan of GA (Macon, GA) No

93742 Securian Dental Plans (PO Box 9385, MPLS, MN) Delta of No

35202 Security Adminstrative Services (Marshfield, WI) No

LX126 Security Health Fund (Marshfield WI) No

LX053 Security Life (NY) No

CX092 Security Life Insurance (Schenectady, NY) No

77024 SeeChange (Sante Health System)(Fresno, CA) No

CX109 Sele-Dent (Lynbrook, NY) No

64088 Select Administrative Services (Gulfport, MS) No

42137 Select Benefit Admin (PO Box 8339, Des Moines, IA) No

CX107 Select Health (Salt Lake City, UT) No

68241 SelectCare (Coca Cola) No

DX215 SelectCare (Frisco, TX) No

59111 Self Insured Benefit Admin - (Clearwater, FL) No

CX076 Self Insured Dental Services (PO Box 9005,9007,9010 Ly No

36404 Self Insured Plans LLC (Naples, FL) No

CX020 Self Insured Services Company (SISCO) - Dubuque, IA No

34131 Self-Funded Plans (St. Charles, IL) No

34131 Self-Funded Plans of OH - Cleveland, OH No

LX155 Seminole Tribe of FL (Fort Lauderdale, FL) No

36426 Sendero Health Plans (Austin, TX) No

15682 Senior Network Health (Utica, NY) No

LX135 Sentry Insurance (Roanoke, VA) No

39033 Sentry Insurance A Mutual Company (Stevens Point, WI) No

39033 Sentry Insurance Company (Stevens Point, WI) No

39033 Sentry Life of NY (Stevens Point, WI) No

CX038 Serentas Dental Care Solutions - Louisville, KY No

75280 Shasta Admin Services (Redmond, OR) No

LX024 Sheet Metal Workers (PO Box 1449, Goodlettsville TN) No

FX024 Sheet Metal Workers (PO Box 1449, Goodlettsville, TN) No

LX127 Sheet Metal Workers Local 265 (Carol Stream IL) No

SMW01 Sheet Metal Workers Local 91 (West Burlington, IA) No

41143 Sheffield, Olson & McQueen (2145 Ford Pkwy, St. Paul, No

81434 Shelte Point Life (Great Neck, NY) No

CX067 Shenandoah Life Insurance (Roanoke, VA) No

76342 Sierra Health Services (Las Vegas, NV) No

CX046 Significa Benefits Services No

Payer Claims List

Payer ID Payer Name Req. Enroll.

58102 Simple (1745 N Brown Rd, Lawrencevill GA) No

41101 Simple Benefits- (Duluth, GA) No

84076 Sinclair Health Plan (Salt Lake City, UT) No

SKYGEN Skygen USA No

SKYGN Skygen USA (Milwaukee, WI) No

CB695 Solarte Health, Inc (Resolve)(Arnold, MN) No

76578 Solstice Benefits No

91136 South Bay H.E.R.E. Funds No

TPC11 South Carolina Healthy Connections No

23266 South Central Preferred (Hingham, MA) No

LX179 South Country Health Alliance ( Owatonna, MN) No

35227 South Point Hotel & Casino (LasVegas, NV) No

CX051 SouthWest Benefits No

39148 Southeast Dental Associates (Milwaukee, WI) No

SEI01 Southeaster Service Employees International (SEIU) No

37318 Southern Benefits Services (Lafayette, LA) No

SEF01 Southern Electrical Health Fund (Chattanooga, TN) No

56131 Southern Group Admin - Winston-Salem, NC No

77153 Southern Indiana Health (Columbus, IN) No

CX050 Southwest Life and Health / First Care (Austin, TX) Yes

CX100 Southwest Service Admin (Phoenix, AZ) No

68241 Southwestern Bell Exec No

23253 Spectrum Admin (Allentown, PA) No

38416 Spencer Stuart (Arm LTD) (Eagan, MN) No

84147 Spina Bifida - VA HAC No

37116 St Therese Physician Assoc. (Rockford, IL) No

13411 Standard Ins Co. of New York (PO Box 82520, Lincoln, N No

69019 Standard Insurance ( Lincoln, NE) No

93024 Standard Insurance of Oregon (PO Box 82622 Lincoln, N No

CPPSP Star + Plus Value Added (PO Box 537014, Sacramento, Yes

59225 StarHRG (Phoenix, AZ) No

STR01 Starmount Life Insurance Company (Baton Rouge, LA) No

46450 State Auto (Columbus, OH) No

57254 State of TX Dental Plan - All Plans except PO Box 4665 ( No

31121 Stoner and Associates - Cincinnati, OH No

58128 Stowe Associates of GA (Atlanta, GA) No

64246 Strategic Ourtsourcing Inc. (SOI) (Charolotte, NC) No

LX014 Strategic Resouce (PO Box 23759, Columbia, SC) No

74227 Student Insurance (Lincoln, NE) No

R7003 Sturm & Associates (Edina, MN) No

LX142 Stylmark (Mpls.-Fridley, MN) No

86083 Summit Admin Services, Inc. (Scottsdale, AZ) No

37301 Summit America Insurance Services (Overland Park, KS) No

67814 Sun Life (Po Box 81633, Wellesley Hills) No

47009 Sun Life Canada No

47009 Sun Life Financial No

67814 Sun Life and Health (Formerly Genworth) No

31117 Superior Dental Care No

CPPSW SuperiorSTAR Pregnant Women (Sacramento, CA) Yes

CX088 Surency Life and Health (Wichita, KS) No

98010 Sutton Special Risk (Buffalo, NY) No

73288 TDC (PO Box 1100 Employers Blvd, Green Bay, WI) No

TIC01 TIC International, Inc (Carmel, IN) No

LX147 TLC Benefit Solutions (Valdosta, GA) No

LX178 TR Paul (Newtown, PA) No

60054 TRW No

Payer Claims List

Payer ID Payer Name Req. Enroll.

73288 TSRDP Dental Claims (PO Box 1100 Employers Blvd, Gre No

CPPTM TX Medicaid - Delta CA - Childrens (PO Box 537014, Sacr No

88067 Tall Tree Administrators (Salt Lake City, UT) No

LX102 Taylor Benefit Resource (Thomasville GA) No

88019 Teachers Health Trust (CCEA)(Las Vegas, NV) No

LX113 Teamster Local 463 (Pennsauken NJ) No

41147 Teamsters (Po Box 7078) Duluth MN No

CDMI0 Teamsters Welfare Fund (Farmington Hills, MI) No

TXABA Texas Ag Benefit Admin (PO Box 211575, Eagan, MN) No

LX013 Texas Municipal League (TML) (PO Box 149190, Austin, No

79480 Texas Municipal League (TML) Austin, TX No

CPPTX Texas-CHIP Dental Services (Sacramento, CA) No

68423 The Care Network (PO Box 788, Arnold, MD) No

74227 The Chesapeake Life Insurance Co.-Student Ins. No

73288 The Dental Companies (PO Box 1100 Employers Blvd, Gr No

73288 The Dental Concern (PO Box 1100 Employers Blvd, Gree No

TDN01 The Dental Network (7400 York Raod, Suite 200, Towso No

LX173 The Dental Network of MD(Out of state dentists, NOT in No

LX110 The Dental Shop (Amherst NY) No

34150 The Health Plan Upper Ohio Valley (Saint Clairsville, OH) No

CRIHB The Humboldt-DelNorte (Eureka, CA) No

23223 The Loomins Company (Wyomissing, PA) No

74227 The MEGA Life & Health Ins. Co.-Student Ins. No

59226 The MEGA Life & Health Insurance Co. (North Richlands No

68423 The Savannah Business Group (PO Box 788, Arnoold, M No

13142 The Union Labor Life Insurance Co. (King of Prussia, PA) No

CHSTS Theatrical and Stage Local 16 (Dublin, CA) No

06131 Third Party Claims Management (Tampa, FL) No

25175 Three Rivers Health Plan - (Monroeville, PA) No

CMS01 Three Rivers Health Plan, Inc. (WI No

ASHC1 Time Ins (Milwaukee, WI) No

37314 Total Claims Admin. Inc/North Broward Hospital District No

TCS01 Total Claims Solutions (Green Bay, WI) No

CX112 Total Dental Admin (Elk Grove, IL) No

CX112 Total Dental Admin (PO Box 44035 Phoenix, AZ) No

84076 Total Dental Admin (Salt Lake City, UT) No

LX153 Total Plan Services, Inc. (Addison, TX) No

69493 Tower Life Insurance (San Antonio, TX) No

37284 TransChoice Key Benefit Admin (Milwaukee, WI) No

CX069 TransSmile (Sherwood, AR) No

65978 Travelers (El Paso, TX) No

25348 Travis County Map-Mediview No

36397 Trellis Health Partners (Rolling Meadows, IL) No

CHSWT Tri-Counties Welfare Trust Fund (Dublin, CA) No

31144 TriState Benefit Solutions (Cincinnati, OH) No

31144 TriState Benefit Solutions (Eagan, MN) No

73288 Tricare Active Reservists (PO Box 1100 Employers Blvd, No

89070 Tricare Dental Plan (UCCI) Harris burg, PA) No

CDCA1 Tricare Retiree Dental-Delta Dental of CA - PO Box 5370 No

84103 Trigon - Blue Cross and Blue Shield (Colorado Springs, C No

CB923 Trigon Blue Cross of Virginia (Now Anthem BCBS of Virgi No

973 Triple S / Medicare Optimun No

ILDTA TruAssure (Lisle, IL) No

91078 Trusteed Plan Service Corporation (Tacoma, WA) No

61425 Trustmark Insurance - Lake Forest, IL No

97802 UABT - United Ag-Superior Insurance (Irvine, CA) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

89789 UC Health Plan Administrators (Englewood, CO) No

89070 UCCI (United Concordia) No

80085 UCS International Medical Group: FBOP Honolula (Phoeni No

36659 UFCW (United Food & Commerical Workers)(Park Ridge, No

LX078 UFCW Dentemax (Madison Hgts MI) No

LX029 UFCW LOCAL 56 ( PENNSAUKEN, NJ) No

A5205 UFCW Local 400-5205 (Carmel, IN) No

CX111 UFCW Locals (400, 534, 655, 881)(Manchester, MO) No

UFC01 UFCW of Central Ohio No

UFC02 UFCW of Cleveland No

62308 UFT Welfare Fund No

GP133 UHC (United HealthCare)(Milwaukee, WI) No

87726 UHC/Medica Po Box 30990 SLC UT No

74223 UICI - Administrators - State of Nevada (San Antonio, TX No

LX104 UMC Dental Reimbursement Plan (Lubbock TX) No

74223 UMR (PO Box 2838 Clinton, IA) No

33108 UMR - Cincinnati (Cincinatti, OH) No

37237 UMR - Lexington (Lexington, KY) No

95266 UMR-Harrington Benefits (PO Box 30530,33,34,40, Salt L No

79480 UMR-Onalaska (Onalaska, WI) No

74223 UMR-San Antonio (San Antonio, TX) No

39026 UMR-Wausau (Salt Lake City, UT) No

39026 UMR-Wausau (Wausau, WI & Pueblo, Co) No

75196 UMR-Westerville (Westerville, OH) No

52180 UMWA Health & Retirement (Lubbock, TX) No

65099 UNICARE Special Accounts No

23281 UPMC Health Plan (Pittsburg, PA) No

93092 US Benefits, Inc. (Portland, OR) No

CX110 UT Chips (Salt Lake City, UT) No

41206 UltraBenefits, Inc (Westborough, MA) No

80314 Unicare No

47009 Unifi Companies (Lincoln, NE) No

35198 Unified Group Services (Anderson, IN) No

75243 Uniform Medical Plan/Harrington Benefit Services (Seattl No

52133 Unimerica Dental (Salt Lake City, UT) No

13142 Union Labor Life Insurance Co - King of Prussia, PA No

70408 Union Security (Clinton, IA) No

52133 Unique DentaCare (Salt Lake City, UT) No

25175 Unison - (Monroeville, PA) No

97802 United Ag - Superior Insurance Services (Irvine, CA) No

59069 United Benefits (Ormond Beach, FL) No

20090 United Claim Solutions (Phoenix, AZ) No

89070 United Concordia (UCCI) No

70408 United Dental - Texas (Clinton, IA) No

UFC01 United Food & Commerical Workers Union of Central Ohi No

UFC02 United Food & Commerical Workers Union of Cleveland( No

36659 United Food & Commerical Workers(UFCW) (Park Ridge, No

UGP19 United Group Program No

GP133 United Health Care (Milwaukee, WI) No

52133 United Health Care - MD, UT (Salt Lake City, UT) No

95378 United Health Care of River Valley (Moline, IL) No

87726 United Health Care, GA, PA No

84132 United Medical Alliance (Fort Collins, CO) No

33108 United Medical Resources (Cincinatti, OH) No

36362 United Security Life & Health (Clinton, IA) No

FX028 United South Central Workers (Dallas, TX) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

LX028 United South Central Workers (Dallas, TX) No

13545 United States Life - Neptune, NJ No

71412 United of Omaha (Charlotte, NC) No

UNITY Unity Health Plans-Dental Health (Fairfield, NJ) No

16105 Univera of New York (Baldwinsville, NY) No

91136 University of Washington Students & Graduate Appts.(Se No

89070 Unum No

37324 Upper Peninsula Health Group (Marquette, MI) No

LX151 Utah Idaho Teamsters (SLC, UT) No

12116 VA Fee Basis Programs (St Paul, MN) No

64009 Valir PACE (Oklahoma City, OK) No

89070 Valley Baptist Health Plan (PO Box 69442) No

VHP01 Valley Health Plan (GreenBay, WI) No

72128 Vantage Health Plan (Monroe, LA) No

68241 Varian Health Care Plan No

72187 Varipro (Eagan, MN) No

75256 Verity National Group (San Antonio, TX) No

48123 Via Christi Hope (Wichita, KS) No

LX139 Voluntary Benefits Plan (Chesire, CT) No

LX123 Volunteer Benefits (Waterbury CN) No

59266 Volusia Health Network (Daytona Beach, FL) No

39151 WEA Insurance Group (Madison, WI) No

LX160 WMI Mutual Insurance Company (Brownville, NY) No

LX150 WPEE Insurance Trust Fund (Pittsburgh, PA) No

91062 Washington Dental Service (Seattle, WA) No

37294 Washington Employers Trust (Seattle, WA) No

91136 Washington State Council of County & City Employees D No

73155 Waterstone Benefit Administrators (Oklahoma City, OK) No

39026 Wausau Insurance Companies, Wausau, WI No

59332 Web TPA, Inc. (Grand Prairie, TX) No

75261 WebTPA/Community Health Electronic Claims/CHEC (Gra No

10050 Webster Dental No

CX083 WellCare(Liberty Dental)(Santa Ana, CA & Tampa, FL) No

47198 Wellpoint (CA) (Oxnard, CA) No

87815 Wells Fargo (Anchorage, AK) No

87815 Wells Fargo (Charleston, WV) No

37272 Wells Fargo TPA (JSL Administrators) (Newnan, GA) No

91136 West Coast Stationary Engineers health & Security Trust No

90560 WestLake Financial Group (Buffalo Grove, IL) No

93128 Western Grocers Employee Benefit (PO Box 22166, Portl No

24735 Western Growers Insurance (Newton Beach, CA) No

TLW33 Western PA Teamsters Fund (50 Penn, Pittsburgh, PA) No

LX150 Western Pennsylvania Electric (Pittsburgh, PA) No

91060 Western Teamsters (Seattle, WA) No

93200 Whatcom Medical Bureau (Bellingham, WA) No

CXWVC Willamette Valley (Salem, OR) No

93050 William C Earhart (Portland, OR) No

98010 William J Sutton & Co. Ltd (Buffalo, NY & Toronto, CA) No

R7002 Wilson, McShane (Mpls, MN) No

R7006 Wisconsin Auto & Truck (WATDA) (Madison, WI) No

FX031 Wisconsin Carpenters (Eau Claire, WI) No

LX006 Wisconsin Electric (2730 Dairy, 2802 Coho St, Madison, No

20333 Worksite Benefit Services (PO Box 707 Tifton, GA) No

CX014 Xantus Health PLan- Tennessee No

LX143 Zelis Payments No

LX063 Zenith Admin (AZ,CA,CO,NV,WA) No

Payer Claims List

Payer ID Payer Name Req. Enroll.

LX060 Zenith Admin (MD,IL,IN,KY,LA,MA,MI,MO,OK,TX,WI) No

R7001 Zenith Administrators (Mpls, MN) No

33884 iCircle Care of NY (Webster, NY) No

LX140 Claims Payer 837 List

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