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All States Payer ListProfessional Claims (HCFA 1500)

ALL STATES *****Requires Pre-EnrollmentPre.Enr. Payer ID Name Claims Type State

131621199 Local Benefit Fund (Provider should submit claims with assigned Plan Provider ID, as 2 digit suffix is no longer required. Call Renaud Dufresne at (646) 473-6960 for a list of Network ID's.)

Comm

59069 21st Century Health and Benefits Comm 51028 21st Century Insurance and Financial Services (For Minnesota only) Comm MN20413 3P Admin Comm74234 8th District Elec Comm UT93044 A & I Benefit Plan Administrators Comm75240 AAG Benefit Plan Administrators, Inc. Comm37283 AAG-American Administrative Group (Formerly Gallagher Benefit Admin) Comm75185 AAG-American Administrative Group (Formerly Icon Benefit Admin) Comm

87726 AARP - Payer ID valid only for claims with a billing submission address of PO Box 30968 Salt Lake City, UT 84130 Comm



IP079 ABMA Medical Corporation Comm CA03443 ABRAZO Advantage Health Plan CommAHS01 Access Administrators CommCOACC Access Behavioral Care Comm COCARMO Access IPA (CareMore) Comm64071 Acclaim Comm21356 Acclaim Repricing CommAHP01 Accountable Health Plan - Wisconsin & Iowa Comm

***** AHIPA Accountable IPA (California) CommHPSVC ACEC Comm NV72467 ACS Benefit Services Inc. Comm36112 ACS Rewards Administration Center Comm

AHC01 ActivHealthCare Comm22384 Administration Concepts Inc. Comm38265 Administration Systems Research Corp Comm59141 Administrative Services Inc. Comm37278 AdminOne Comm

ADOCS ADOC (Affiliated Doctor's of Orange County) Comm & HMO CA

TMG01 Advanced Medical Associates (Testing of each provider is required by payer and done automatically by Office Ally

t t b itti l i f thi ) CommTMG01 once you start submitting claims for this payer.) Comm

AMM01 Advanced Medical Management Comm & HMO CAAMM02 Advanced Medical Management MSI Comm & HMO CA74234 Advanstaff, Inc. Comm68056 Advantage by Bridgeway Health Solutions Comm 68056 Advantage by Buckeye Community Health Plan Comm 68056 Advantage by Managed Health Services Comm 68056 Advantage by Superior HealthPlan Comm 35209 Advantage Health Solutions Comm

NMM01 Advantage Medical Group CommADVTK Advantek Benefit Administrators Comm25133 Advantra - Kansas City Medicare - Coventry Comm25152 Advantra Freedom Comm25126 Advantra/ Health Assurance/ Health America, Inc. Comm95340 Adventist Health System West - Roseville, CA Comm36320 Advocate Health Centers Comm IL65093 Advocate Health Partners Comm IL60054 Aetna Comm57604 Aetna Affordable Health Choices (SM) - SRC Comm23225 Aetna Better Health Comm23225 Aetna Better Health - Connecticut Medicaid Comm60054 Aetna Student Health Comm38692 Aetna TX Medicaid Comm TX

ADOCS Affiliated Doctor's of Orange County (ADOC) Comm & HMO CAAPG01 Affiliated Physicians Group - APG Comm IL

13334Affinity Health PlanPlease contact Affinitys EDI Coordinator before submitting claims electronically at [email protected] or call (718)794-7592.

Comm

34444 AFL-CIO Food & Beverage Dealer’s Trust Fund Comm OH13346 AFTRA Health Fund Comm NY37280 AGA Comm64158 Agency Services Inc. (Now known as Meritain Health) CommMAP01 AIA- American Insurance Administrators (PO Box 2501 Bassett, CA and City of Industry addresses only) CommCAPMN AKM Medical Group (Cap Managements Systems) Comm CA06311 Alabama Medical Surgical Associates Comm

Revised 8/28/2009

Send to Any Payer on this List Free of Charge through Office Ally**** Indicates Pre-Enrollment - Approval from Office Ally and Payer Required Prior to Claim Submission

www.officeally.com (866) 575-4120 of 31

Pre.Enr. Payer ID Name Claims Type State91136 Alaska Children's Services, Inc. Group #P68 Comm92600 Alaska Electrical Health & Welfare Fund Comm AK91136 Alaska Laborers Construction Industry Trust Group # F23 Comm91136 Alaska Pipe Trades Local 375 Group # F24 Comm91136 Alaska UFCW Health & Welfare Trust Group # F45 Comm13550 ALICARE Comm58213 Alignis Comm37602 All Savers Insurance Co. Comm81040 Allegiance Benefit Plan Management Inc13079 Alliance Healthcare - Stones River Regional IPA CommHCP01 Alliance IPA Comm & HMO CA20257 Alliance Physicians (High Desert Primary Care Alliance) Hesperia, CA Comm CA52149 Alliance PPO Comm88461 Alliance, The (A Wisconsin provider network) (Call Dave Sell at 608-210-6656 to pre-enroll) Comm91131 Alliant Health Plan (FCHN) Comm WA58234 Alliant Health Plans of Georgia Comm GA94177 Allied Administrators (San Francisco) Comm37308 Allied Benefit Systems, Inc. Comm

NMM01 Allied Physicians Medical Group CommSYMED Alpha Care Medical Group Comm & HMO CA80705 ALTA Health & Life Insurance CommIP079 Alta Senior Care Comm CAAMAIA Ama Insurance Agency Inc Comm13550 Amalgamated Life Comm CO13343 Amalgamated Life IPA Alicare Comm

COMPU Amalgamated Transit Union Division 1001 Health & Welfare Fund Comm75137 Ameriben Solutions, Inc. Comm27517 Americaid Community Care (Maryland) Comm MD27516 Americaid Community Care (New Jersey) Comm NJ75240 American Administrative Group Comm37283 American Administrative Group - AAG - (Formerly Gallagher Benefit Admin) Comm42112 American Administrators (West Des Moines, IA) Comm63103 American Behavioral Comm

HPSVC American Benefit Plan Administrators (HealthPlan Services Inc.) Comm & HMO34187 American Benefits Management (North Canton, OH) Comm OH37128 American Commercial Barge Lines Comm60305 American Community Mutual Insurance CommACN01 American Complimentary Care Network CommCAPMN American Family Health Providers (Cap Managements Systems) Comm CAAMF11 American Family Insurance Comm62030 American General Comm62030 American General Comm01066 American Healthcare Alliance Comm36369 American Imaging Management, Inc. Comm87726 American International Group, Inc. (AIG) (Plan of United Healthcare) Comm72099 American LIFECARE Comm81400 American Medical Security Comm74048 American National Ins. Co. (ANICO) Comm

APBPN American Pioneer Brevard PHY Net CommAPSFL American Pioneer South Fl Hcfa Comm44444 American Postal Workers Union Comm14190 American PPO Comm48055 American Progressive Life and Health Insurance Co. Comm 42011 American Republic Insurance Company (ARIC) CommASHP1 American Specialty Health Plan Comm37322 American Worker Health Plan Comm41161 American Chiropractic Network (ACN) Comm41160 American Chiropractic Network IPA of NY (ACNIPA) Comm NY21810 Americas Health Choice Comm87726 AmeriChoice of Florida Comm FL87726 AmeriChoice of IL Comm IL87726 AmeriChoice of MD Comm MD87726 AmeriChoice of NE Comm NE

86001 AmeriChoice of New Jersey Personal Care Plus (Medicare) (All claims require AmeriChoice provider id - call 888-362-3368 to obtain.) Comm NJ

86047 AmeriChoice of New Jersey, Inc. - Medicaid NJ Comm NJ86048 AmeriChoice of New York Medicaid and Child Health Plus Comm NY

86002 AmeriChoice of New York Personal Care Plus (Medicare) (All claims require AmeriChoice provider id - call 888-362-3368 to obtain.) Comm NY

86049 AmeriChoice of Pennsylvania Medicaid Comm PA

86003 AmeriChoice of Pennsylvania Personal Care Plus (Medicare) (All claims require AmeriChoice provider id - call 888-345-3627 to obtain.) Comm PA

87726 AmeriChoice of RI Comm RI95378 AmeriChoice of TN Comm TN

ASRM1 AmeriCorp Comm27519 Amerigroup - Florida Comm FL

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State27514 Amerigroup Community Care of New Mexico Comm NM27514 Amerigroup Community Care Comm27514 Amerigroup Corporation (Fort Worth) Comm TX27515 Amerigroup Corporation (Houston) Comm TX27514 Amerigroup Georgia Comm GA27518 Amerigroup Illinois / Amerigroup Ohio Comm

***** 54763 AmeriHealth Administrator *Must also be a Highmark provider****** 93688 Amerihealth Delaware Non-HMO (Highmark) *Must also be a Highmark provider* Comm DE***** 95044 Amerihealth Delware -New Jersey HMO (Highmark) *Must also be a Highmark provider* Comm

22248 Amerihealth Mercy Health Plan Comm***** 60061 Amerihealth New Jersey Non-HMO (Highmark) *Must also be a Highmark provider* Comm NJ

PPM01 Ameri-West Health Associates Comm AMILR AMIL/ARIA - Via Mediview Comm TXCAPMN AMVI (Cap Managements Systems) Comm CAPROSP AMVI/Prospect Health Network (Prospect Medical Group) Comm & HMO CA53085 Anchor Benefit Consulting, Inc. Comm86062 Ancillary Benefit Systems/ Arizona Foundation for Medical Care Comm AZ

HSM01 Angel Medical Group, dba Superior Choice Medical Group CommSYMED Angeles IPA Comm & HMO CA34192 Antares Management Solutions Comm

HDMDG Antelope Valley Medical Associates Comm & HMO CA80705 Anthem Health and Life Insurance Company of New Jersey Comm & HMO NJ16140 APA Partners Inc. Comm

PROSP APAC (Pinnacle Health Resources) (Prospect Medical Group) Comm & HMO CA34196 Apex Benefit Services CommAPP01 AppleCare Medical Management Comm & HMO CA54160 APS Healthcare, Inc. Comm44444 APWU / Affordable Network Comm16120 ARAZ Comm AZAMS11 Arcadian Community Care Comm LAAMS11 Arcadian Health Plan Comm OKAMS11 Arcadian Management Services Comm CAAMS11 Arcadian of Washington (Arcadian Mgmt Serv) Comm WA36356 Argus Health Systems Comm86062 Arizona Foundation for Medical Care Comm & HMO AZ03432 Arizona Physicians IPA (APIPA) Comm74234 Arizona pipe Trades Health & Welfare Trust Fund Local Unions #469 & 741 Pipe Trades Health Plan Comm AZ75278 Arkansas Best Corporation CommAMS11 Arkansas Community Care Comm AR95440 Arnett Health Plans Comm

NMM01 Arroyo Vista Family Health Center CommNMM01 Arroyo Vista Family Health Center CommHSM01 Asian Community Medical Group, Inc. CommASRM1 ASRM Corp CommFAABC ASSOCIATED BENEFITS CORPORATION CommHSM01 Associated Physicians Medical Group, Inc. CommATPA1 Associated Third Party Admin Comm36326 Associates for Health Care, Inc. (AHC) Comm39065 Assurant Health Comm37313 Assurant Health Self-Funded (Ft. Mill, SC) Comm SC37323 Assurant MiniMed-Key Family Comm74240 Assured Benefits Administrators Comm00932 Asuris Northwest Health Comm WA95691 Athens Area Health Plan Select Comm22304 Atlanticare also known as Horizon HealthCare Admin (HHA) Comm13853 Atlantis Health Plan Comm NY38259 Automated Benefit Services Comm37280 Automated Group Administration, Inc. Comm

CAPMN Avalon IPA (Cap Managements Systems) Comm CACAPMN Avalon Medical Group (Cap Managements Systems) Comm CAAH001 Avante Health Comm46045 Avera Health Plans CommAV001 AVMED Healthplan Comm FLBKRFM Bakersfield Family Medical Center (Regal) Comm & HMO CASX145 Banner Health Co. Comm37248 Bass Administrators, Inc. Comm49153 BCI Administrators, Inc. Comm

43324Beacon Health Strategies - Please use the following Plan IDs for block 11 on the 1500 form. Neighborhood Health Plan of MA=001; Hudson Health Plan=004;Fallon Community Plan=005; Neighborhood Health Plan of RI=006; Affinity Health Plan=009; DC Chartered Health Plan=013

Comm

95377 Beech Street Comm63100 Behavioral Health Systems Comm

MPMOA Bella Vista Medical Group IPA Comm CASYMED Bellflower Medical Center (Synermed) Comm & HMO33192 Bencomp National Corporation 36149 Benefit Administrative Systems Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State25145 Benefit Coordinators Corporation (Pittsburgh, PA) Comm PA

BMATP Benefit Management Admin (BMA) Comm00999 Benefit Management Services, Inc. (BCBS LA) (BCBS ID required, 5 or 10 characters long) Comm LA37212 Benefit Management Systems, Inc Comm39081 Benefit Plan Administrators Co. (Eau Claire, WI) Comm WI37118 Benefit Plan Administrators, Inc. (Roanoke, VA) Comm VA37222 Benefit Plan Management, Inc. Comm74223 Benefit Planners Comm34178 Benefit Services Comm OHBSI01 Benefit Solutions Inc Comm FL38257 Benefit Source, Inc. Comm36342 Benefit Systems & Services, Inc. (BSSI) Comm74223 Benefits Planners, Inc. Comm87265 Benesight (formerly The TPA) Comm37248 Benesys Inc. Comm

BNMK1 BenMark (Mississippi) Comm MS95604 Best Life & Health Insurance Co. Comm32006 Better Health Plans of South Carolina Comm SC62183 Better Health Plans, Inc. CommBC001 Blue Cross - California Comm CABC001 Blue Cross (Cal-Optima - Medi-Cal) Comm CA

***** 00520 Blue Cross Blue Shield Arkansas - (Health Advantage, Blue Advantage, FEP, ITS and First Source) Comm53589 Blue Cross Blue Shield of Arizona Comm AZ00050 Blue Cross Blue Shield of Colorado Comm CO00060 Blue Cross Blue Shield of Connecticut Comm CTSB580 Blue Cross Blue Shield of DC (Carefirst) DCBS590 Blue Cross Blue Shield of Florida Comm FL00601 Blue Cross Blue Shield of Georgia Comm GA

***** HMSA1 Blue Cross Blue Shield of Hawaii Comm HI00621 Blue Cross Blue Shield of Illinois Comm IL00630 Blue Cross Blue Shield of Indiana Comm IN

00630 Blue Cross Blue Shield of Indiana - 12 provider number required. Please contact BCBS customer service at 800-205-5870 option 9 if unknown. Comm IN

***** BCSIA Blue Cross Blue Shield of Iowa Comm IA***** 47163 Blue Cross Blue Shield of Kansas Comm KS***** 47171 Blue Cross Blue Shield of Kansas City Comm MO

00660 Blue Cross Blue Shield of Kentucky - 12 provider number required. Please contact BCBS customer service at 800-205-5870 option 9 if unknown. Comm KY

***** 23738 Blue Cross Blue Shield of Louisiana Comm LA00680 Blue Cross Blue Shield of Maine Comm MESB690 Blue Cross Blue Shield of Maryland (CareFirst ) Comm MDSB690 Blue Cross Blue Shield of Maryland (CareFirst ) Comm MDSB700 Blue Cross Blue Shield of Massachusetts Comm MA

***** 00710 Blue Cross Blue Shield of Michigan Comm MI***** 00720 Blue Cross Blue Shield of Minnesota Comm MN***** 00230 Blue Cross Blue Shield of Mississippi Comm MS

00241 Blue Cross Blue Shield of Missouri Comm MO***** BCSMT Blue Cross Blue Shield of Montana Comm MT

SB580 Blue Cross Blue Shield of NCA Region – DC (Care First ) Comm DC

***** 23241Blue Cross Blue Shield of NE Pennsylvania - - All new providers must enroll with First Priority Health/Blue Cross of Northeastern PA prior to submitting electronic claims. Enrollment form available at: http://www.bcnepa.com/EDI/registrationForm.aspx

Comm PA

***** 77780 Blue Cross Blue Shield of Nebraska00265 Blue Cross Blue Shield of Nevada Comm NV00770 Blue Cross Blue Shield of New Hampshire Comm NH00790 Blue Cross Blue Shield of New Mexico Comm NM22099 Blue Cross Blue Shield of New York & New Jersey Horizon Comm NY, NJ

***** SB810 Blue Cross Blue Shield of North Carolina (State Health Plan) Comm NC***** 00800 Blue Cross Blue Shield of North East New York (HealthNow) (not the same as Empire BCBS) Comm NY***** 00801 Blue Cross Blue Shield of North West New York (HealthNow) (not the same as Empire BCBS) Comm NY

00834 Blue Cross Blue Shield of Ohio - 12 provider number required. Please contact BCBS customer service at 800-205-5870 option 9 if unknown. Comm OH

00840 Blue Cross Blue Shield of Oklahoma Comm OK00851 Blue Cross Blue Shield of Oregon (Regence) Comm OR

***** 54771 Blue Cross Blue Shield of Pennsylvania (Highmark) Comm PA***** 00870 Blue Cross Blue Shield of Rhode Island Comm RI

BCSSC Blue Cross Blue Shield of South Carolina Comm***** 88848 Blue Cross Blue Shield of South Dakota Comm SD***** 00390 Blue Cross Blue Shield of Tennessee Comm TN

84980 Blue Cross Blue Shield of Texas Comm TX***** BCSVT Blue Cross Blue Shield of Vermont

00923 Blue Cross Blue Shield of Virginia Comm VA00950 Blue Cross Blue Shield of Wisconsin Comm WI23045 Blue Cross of Pennsylvania (Capital / CAIC) Comm PA

***** BC099 Blue Cross of Washington State (Premera) Comm WA***** BC099 Blue Cross/Blue Shield of Alaska (Premera ) Comm AK

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type StateBS001 Blue Shield - California / Blue Shield (FEP) Comm CA00611 Blue Shield of Idaho (Regence) Comm ID00932 Blue Shield of Washington State (Regence) Comm WA61124 Bluegrass Family Health Comm KY13337 BMC HealthNet Plan Comm20018 BMGI - Benefit Management Group Inc. Comm36609 Boilermakers National Health & Welfare Fund CommBOLL1 Bollinger Inc. Comm74238 Boon – Chapman Administrators, Inc. Comm13337 Boston Medical Center Health Plan, Inc. Comm MA38324 Botsford Health Plan (Farmington Hills, MI) Comm MI37273 BoydCare Comm37286 BPA/Benefit Plan Administrators (North Dakota) Comm ND13310 BPS Inc. Comm52192 Bravo Health (PA, MD, DE, TX and DC) Comm38365 Bridge Benefits Comm37285 Bridgestone Claims Services Comm68054 Bridgeway Arizona CommBHP01 Bright Health Physicians Comm35182 Brodart Comm51037 Brokerage Concepts Comm94316 Brown & Toland Comm CA84980 Bryan Indep school district Comm32004 Buckeye Community Health Comm42150 Butler Benefit Comm23708 C & O Employees' Hospital Association Comm62413 CAC (Mailhandlers Benefit Plan) Comm33192 Cadent Aministrators Comm33192 Cadent Underwriters Comm

REGAL Caduceus Medical Group (Regal) Comm & HMO CAHDNFC California Care (Humboldt Del Norte) Comm CAHSM01 California Pacific Physicians medical Group, Inc. CommAMS11 Cal-Net Physicians IPA CommCALOP Cal-Optima Direct Comm & HMO CACAMAA Cameron and Associates Comm71057 Cannon Cochran Management Services - Metairie, LA (PO Box 6794, Metairie, LA 70009) Comm37105 Cannon Cochran Management Services Inc Comm

CAPMN Cap Management Systems Comm CA38245 Cape Health Plan Comm23045 Capital BlueCross / CAIC Comm PASX065 Capital District Physicians Health Plan CDPHP CommSX065 Capital District Physicians Health Plan -CDPHP Comm95112 Capital Health Plan Comm65067 Capital International Management Services Comm68011 Capitol Administrators Comm

GCVCP Cardiovascular Care Providers Comm57116 Care 1st Health Plan of Arizona Comm AZ

HPSM1 Care Advantage77082 Care Improvement Plus Comm00344 Care Management Resources Comm

38269 Carechoices Michigan - Mercy Healthplans (Enrollment required; please contact Noreen at (248) 489-5281) Comm

14182 CareCore National Comm14184 CareCore National - Healthnet Comm14185 CareCore National, LLC - Health Net New Jersey Comm14179 CareCore National, LLC (Aetna Radiology Claims) Comm14180 CareCore National, LLC (Oxford Radiology Claims) CommSB580 CareFirst BCBS - DC, National Capital Area Comm DCSB690 CareFirst BCBS - Maryland Region Comm MD16147 CareGuide Comm25139 Carelink Advantra Comm25139 Carelink Health Plan Comm25140 Carelink Medicaid Comm

CLUHS Carelink University Health System CommCARMO CareMore IPA Comm & HMO CACARMO CareMore Value Plus (CVP) Comm 25142 Carenet Comm39280 CareOne Health Plan Comm FL93975 CareOregon, Inc. Comm OR22248 CarePartners Comm MO95092 Careplus Comm95093 Careplus (Encounters) Comm37311 CareSource of Indiana Comm IN31114 CareSource OH Comm OH35167 Carewise Comm10010 Careworks Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State62073 Cariten Healthcare Comm62072 Cariten Senior Health Comm37245 Carolina Benefit Administrators Inc. Comm57105 Carolina Care Plan Inc. Comm56195 Carolina Summit Healthcare, Inc. Comm

COMPU Carpenters' and Millwrights' Health Benefit Trust Fund Comm & HMO CO91131 Carpenters Health & Welfare (FCHN) Comm WA25125 Carpenter's Health and Welfare Trust Fund of St. Louis Comm MO91131 Carpenters Trust (FCHN) WA Only Comm WA

COMPU Carpet, Linoleum and Resilient Tile Layers Health and Welfare Fund Comm & HMO CO37060 Caterpillar, Inc. CommSX183 Catholic Healthcare West Comm41170 CBCA Administrators (HRM) Comm73159 CCN Managed Care, Inc. (Now Part of First Health Network) Comm87065 CDO Technologies CommSX065 CDPHP - Capital District Physicians Health Plan Comm88022 CDS Group Health CommHPIPA Cedars Towers Surgical Medical Group Comm95167 Cedars-Sinai Medical Group - Non - Payable Claims (Capitated) HMO CA95166 Cedars-Sinai Medical Group - Payable Claims Comm CA

CELTC Celtic Comm37250 Cemara Administrators Comm91136 Cement Masons & Plasterers Health & Welfare Trust Group #F16 Comm

68048Cenpatico Behavioral Health - Arizona (Prior to submitting claims, please call Provider Relations Dept at 866-495-6748) Comm

68050 Cenpatico Behavioral Health - Georgia (Prior to submitting claims, please call Provider Relations Dept at 800-947-0633)

Comm

68052Cenpatico Behavioral Health - Indiana (Prior to submitting claims, please call Provider Relations Dept at 877-647-4848) Comm

68047Cenpatico Behavioral Health - Kansas (Prior to submitting claims, please contact Provider Relations Dept at 866-896-7293) Comm

68056 Centene Advantage Plans Comm USC02 Center Care (For Safety Claims) CommUNC01 Center Care (For Unicare Claims) CommMER04 Centercare PPO (Meritain) Comm13357 CenterCare CommAMS11 Centinela Valley IPA Comm CA75243 Centra Comm75196 Centra Benefits (Houston) Comm TX31118 C t l B fit Lif C31118 Central Benefits Life Comm31118 Central Benefits Mutual Comm31118 Central Benefits National Comm

***** CCA01 Central California Alliance for Health Comm

***** CCA01 Central Coast Alliance for Health (Before submitting claims please email [email protected], include your Tax ID, NPI and MediCal Legacy ID)

Comm

02041 Central Mass. Health Care (CMHC) Comm34097 Central Reserve Life Comm62218 Central SeniorCare Comm36215 Central States Health & Welfare Funds Comm37214 Central States Joint Board Health & Welfare Trust Fund Comm IL

***** SC027 Central Valley Medical Group (pre-enrollment under Sutter Connect) Comm CASCP01 Centre for Health Care Comm CA48120 Century Health Solutions Comm23171 CHA Health Comm

***** CH002CHAMPUS / TRICARE NORTH (Health Net Federal) : Connecticut, Delaware, Illinois, Indiana, Kentucky, Massachusetts, Maryland, Maine, Michigan, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia, Wash D.C., West Virginia and Wisconsin.

Govn't

***** CH002CHAMPUS / TRICARE SOUTH (Humana Military) : Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina, Tennessee and Texas. Govn't

***** WPSTC

CHAMPUS / TRIWEST (WPS): Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa(Except for the Rock Island

Arsenal Area), Kansas, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon

South Dakota, The Extreme Western Portion of Texas, Utah, Washington and Wyoming.

Govn't

84146 CHAMPVA Govn't16600 Chautauqua County Healthcare Plan (Mayville, NY) Comm NY25151 CHCcares of South Carolina Comm SCCHCN1 CHCN - Community Health Center Network CommCHECS CHEC - A Subsidiary of Sprint Comm59223 Chesapeake Life Insurance Company Comm34154 Chesterfield Technologies Comm

AMM03 Child Health and Disabillity Prevention Treatment (Advanced Medical Management) Comm & HMO CA86048 Child Health Plus and Americhoice of New York Medicaid Comm94321 Children First Medical Group Comm84146 Children of Women Vietnam Veterans-VA HAC Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type StateCPMG1 Children’s Physicians Medical Group CommCSSD2 Children's Specialists of San Diego II Comm94302 Chinese Community Health Plan Comm38692 CHIP CommCHIPA CHIPA- College Health IPA Comm ACN01 ChiroCare CommLNDMK Chiropractic Care of MN CommACN01 Chiropractic Care of Wisconsin CommSCH01 CHOC Health Alliance (Schaller Anderson) Comm & HMO CA76049 Choice One/UTMB CHIP Health Plan (Please contact payer before sending claims-1-877-238-8543) Comm61271 Christian Brothers Services CommSPOHN Christus Spohn Health Plan CommCIGNA CIGNA - Former Payer ID (62308) CommCIGNA CIGNA - PPO - Former Payer ID (62308) CommCIGBH CIGNA Behavioral Health Comm62310 CIGNA Flex Care (New Mexico Only) Comm NM86033 CIGNA For Seniors CommCIGNA CIGNA Health Plan - Former Payer ID (62308) CommCIGNA CIGNA Premier Plus - Former Payer ID (62308) Comm10207 Citrus Health Plan Comm

AMS11 Citrus Valley Physician's Group Comm & HMO CACOA01 City of Amarillo Group Health Plan Comm74234 City of Austin Comm TX75600 City of Odessa, The Comm

TKFMC City of Visalia Comm & HMO CA62413 Claims Administration Corp. Comm57080 Claimsware, Inc., DBA ManageMed Comm33192 Clarendons Healthy Kids CommHPSVC Clark County NV77201 Clark County Comm

AMM03 CMS - Custody Medical Services (c/o Advanced Medical Management) Comm71063 CNA Health Partners Comm71063 CNA Health Partners (Formerly Coresource, AR) Comm AR37310 Coast Hotels & Casino, Inc. / DBA Coast Benefits Comm

CCPN1 Coastal Communities Physician Network (CCPN) Comm & HMO CACOAST Coastal TPA Comm38335 Cofinity Comm37123 Colonial Healthcare Comm84129 Colorado Access Comm CO

COKSR Colorado Kaiser Permanente (Colorado plans only **EXCEPT COLORADO SPRINGS**) Comm & HMO COCOMPU Colorado Laboreres Health & Welfare Fund Comm & HMO COCOMPU Colorado Laboreres Health & Welfare Fund Comm & HMO COAMS11 Columbia Community Care Comm WA25351 Columbia Cornell Care Comm91162 Columbia United Providers Comm37271 Combined Benefits, Inc. CommCIGNA CoMed - CIGNA - Former Payer ID (62308) Comm34181 Commerce Benefits Group Comm37237 Commonwealth Administrators, LLC. Comm14315 Commonwealth Care Alliance Comm23171 Commonwealth Health Alliance (CHA) Comm23282 Community Care BHO Comm73143 Community Care Managed Health Care Plans of OK Comm OK39126 Community Care Organization Comm71079 Community Care Plus Comm MO61948 Community Choice Health Plan of Westchester Comm38325 Community Choice of Michigan Comm MI26231 Community Claims Administration Comm

SYMED Community Family Care and CFC San Fernando Valley Comm & HMO CACOMMF Community First Comm35193 Community Health Alliance Comm

CHCN1 Community Health Center Network - CHCN Comm48145 Community Health Choice Comm75261 Community Health Electronic Claims/CHEC/webTPA Comm62149 Community Health Network of Connecticut Comm CT

90010 Community Health Plan (located in St. Joseph, MO. Service Area includes NW Missiouri, NE Kansas, SW Iowa, SE Nebraska) Comm

CHPWA Community Health Plan of Wash CommCMGWV Community Medical Group of the West Valley Comm & HMO CA

32481 Community Premier Plus for Neighborhood Health Providers Comm34177 Comp - Ohio (Austintown, OH) Comm OH37297 CompBenefits Corporation CommCHP01 Complementary Healthcare Plan Comm59314 Comprehensive Behavioral Care Comm03036 Comprehensive Benefits Administrator, Inc. Comm VT

CCMC1 Comprehensive Care Management Comm NY

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type StateCOMPU CompuSys (Incorporated) of Colorado Comm & HMO CO74234 CompuSys / Erisa Group Comm TX74234 CompuSys Inc Comm NM74234 CompuSys Inc Comm AZ74234 CompuSys Inc Comm UT80705 Confederation Admin. Services & Life Insurance Comm06105 Connecticare, Inc. Comm37307 Connecticut Carpenters Health Fund Comm CT62308 Connecticut General Comm63208 Connecticut PRI Comm37135 Consociate Group Comm75284 Consolidated Associates Railroad Comm37295 Consumer Health Solutions Comm

71404 Continental General Insurance Company Comm55544 Conversion Plan-APWU Comm

CCHP1 Cook Childrens Health Plan CommCCHP9 Cook Childrens Star Plan Comm TX35149 Cook Group Heath Plan Comm52132 Cooperative Benefit Administrators (CBA) Comm35199 Cooperative Managed Care Services Comm58204 Coordinated Medical Specialists Comm41045 CoreSource AZ MN Comm75136 CoreSource Little Rock Comm AR35182 CoreSource MD PA IL IA Comm35180 CoreSource NC IN Comm35183 CoreSource OH Comm OH35202 Cornerstone Benefit Adminstrators Comm

41124 Corp. Benefit Services/CBSA/Fortis Self Funded Admin (Now known as Meritain. Payer ID valid only for claims with a billing submission address of P.O. Box 27267, Minneapolis, MN 55427-0267)

Comm

56116 Corporate Benefits Service, Inc. (NC) Comm NC37246 Corporate Systems Administration Comm43160 Correctional Medical Services, Inc. Comm62553 Country Life Insurance Company Comm58102 Covenant Administrators, Inc. (Atlanta, GA) Comm

CMSEB Covenant Mgnt Sys Employ Ben Comm25133 Coventry - Kansas City Medicare (Advantra) Comm KS25152 Coventry Advantra (Texas, New Mexico, Arizona) Comm25133 Coventry Health & Life – Oklahoma Comm25141 Coventry Health and Life Insurance (Tennessee) Comm25149 Coventry Health Care Nevada Comm25149 Coventry Health Care - Nevada Comm87043 Coventry Health Care National Network Comm25130 Coventry Health Care of Delaware, Inc. Comm DE25127 Coventry Health Care of Georgia, Inc. Comm GA25136 Coventry Health Care of Nebraska, Inc. Comm NE25132 Coventry Healthcare of Iowa Comm IA25133 Coventry Healthcare of Kansas, Inc. - Wichita Comm KS25135 Coventry Healthcare of Louisiana Comm LA87043 Coventry Missouri Comm64068 Creative Medical Systems Comm37320 Creative Plan Administrators Comm80705 Crown Life (Great West) Comm37266 Croy-Hall Mgmt. Inc. Comm

HPSVC Culinary Workers Union NVAMM03 Custody Medical Services - CMS (c/o Advanced Medical Management) Comm39170 Custom Benefit Administrators Comm82056 Custom Design Benefits Comm57080 CWIBENEFITS, INC. Comm06172 Dart Container Corporation CommAMS11 Daughters of Charity Robert F. Kennedy Med Ctr (DCRFK) (Arcadian Mgmt Serv) Comm CAAMS11 Daughters of Charity St Francis Med Ctr (Arcadian Mgmt Serv) Comm CAAMS11 Daughters of Charity St. Vincent Med Ctr (Arcadian Mgmt Serv) Comm CA95748 DC Chartered Health Plan, Inc. (Medicaid & Alliance) Comm39113 Dean Health Plan Comm WI87726 Definity Health Comm63081 Delaware Health Plan Consortium Comm27009 Delaware Physicians Care, Inc. CommDHS01 Delta Health Systems Comm CA84134 Denver Health - Indigent Comm CO84133 Denver Health and Hospital Authority Comm CO84135 Denver Health Medical Plan Comm CO84131 Denver Health Medical Plan, Inc. - Medicare Choice Comm

***** MC006 Department of Social and Health Services - DSHS (Medicaid of WA) Govn't WADNS22 Dermatology Network Solutions, LLC BCBS (Payer requires 11 digit member ID Number) CommDNS77 Dermatology Network Solutions, LLC Humana (Payer requires 11 digit member ID Number) Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type StateDNS44 Dermatology Network Solutions, LLC Vista (Payer requires 11 digit member ID Number) CommAMS11 Desert Canyon Community Care Comm AZDESRT Desert Medical Group (Regal) Comm & HMO CA36436 Destiny Health Comm56240 Detroit Medical Center Comm MI25131 Diamond Plan Comm23706 Director's Guild of America - Producer Health Plans Comm25160 Diversified Group Administrators Comm PA06102 Diversified Group Brokerage (Marlb, CT) Comm CT06102 Diversified Group Brokerage/Healthplan Services Comm

***** 16003 DMERC Region A Medicare Govn't***** 17003 DMERC Region B Medicare Govn't***** 00885 DMERC Region C Medicare Govn't***** 05655 DMERC Region D Medicare Govn't

AMS11 Downey Regional Medical Center (Arcadian Mgmt Serv) Comm CAAPP01 Downey Select IPA (NOW KNOWN AS Applecare Medical Managment) Comm & HMO CA74284 DRISCOLL CHILDRENS HEALTH PLAN Comm37600 DSCC DIV Special Care Children Comm

***** MC006 DSHS - Department of Social and Health Services (Medicaid of WA) Govn't WA35186 Dunn and Associates Benefits Administrators, Inc. Comm75232 E3 Health Inc. Comm36434 Early Intervention Central Billing Comm

DHS01 East Bay Drainage Drivers Security Fund CommSYMED East LA Doctors Hospital CommEMG11 Eastland Medical Group IPA Comm & HMO CA62308 Eaton Benefits, OH Comm OH22262 EBA&M Employee Beneifts Administration and Management Corp Comm CA34166 EBS of Ohio (PO Box 2568, Mansfield, OH 44906) CommEPF08 El Paso First Group Health CommEPF03 El Paso First-CHIP Comm

MPMOA El Proyecto del Barrio Comm CA52192 Elder Health HMO of Pennsylvania Comm PA52192 Elder Health Maryland HMO Inc. Comm MD

31625 ElderPlan, Inc. Elderplan Provider ID is necessary on all claim submissions. If you do not know your provider Id, contact (718) 921-7979. Comm

NAELM ElmCare LLC Comm37253 Elmco Comm34167 Emerald Health Network, Inc. (All PPO Business) Comm

AMM03 Emergency Medical Service Fund (EMSF) (Advanced Medical Management) Comm & HMO CA59299 EMI-KP Ambulance Claims Comm73288 Emphesys Comm73288 Emphesys Comm

***** 13202 Empire Medicare New York Govn't NYEMP01 Empire Physicians Medical Group Comm87726 Empire Plan- United Healthcare Comm

EBSSA Employee Bene Srvcs (EBS) San Antonio Comm TX38241 Employee Benefit Concepts Comm37215 Employee Benefit Corporation Comm81039 Employee Benefit Management Services Comm03036 Employee Benefit Plan Administration (E.B.P.A.) Comm VT37216 Employee Benefit Services (Ft. Mill, SC) Comm41198 Employee Benefit Services of Louisiana, Inc (EBS) Comm22262 Employee Beneifts Administration and Management Corp (EBA&M) Comm CA75184 Employee Claim ADJ Comm

SYMED Employee Health Systems Comm & HMO CA35112 Employee Plans, LLC Comm74212 Employer Plan Services CommMIDSC Employers Coalition on Health (ECOH) Comm75232 Employers Direct Health Comm75236 Employer's Direct Health - Employee Plan Comm75235 Employer's Direct Health - FI Comm75233 Employer's Direct Health - SF CommMIDSC Employers Health Cooperative (EHC) Comm73288 Employers Health Insurance Comm37249 Employers Life Insurance Corporation Comm59297 Employers Mutual Inc Hcfa Comm59298 Employers Mutual, Inc. (Jacksonville, Florida) Comm FL59331 Employers Mutual, Inc. (Stuart, Florida) Comm FL

AMM03 EMSF (Emergency Medical Service Fund) (Advanced Medical Management) Comm & HMO CA35206 Encircle PPO Comm37110 Encompass Comm35206 Encore Health Network Comm36364 ENH Medical Group IPA Comm91136 Enstar Natural Gas, Group # P61 Comm

EPNSH EPN (Seton Health Plan) Comm28777 EPOCH Group, The Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State62308 Equicor Comm62308 Equicor - PPO Comm62308 Equicor/Equitable Comm75196 Equifax Healthcare Admin Svc. (EHAS) Comm73126 Equitable Plan Services (Oklahoma City, OK) Comm OK23250 Erin Group Administrators Comm74234 Erisa Administrative Services Comm34108 ES Beveridge & Associates Comm34159 E-V Benefits Management, Inc (Columbus, OH) - Now known as Meritain Health Comm OH87726 Evercare Comm07501 Evercare Star Plus Comm58233 Evergreen Health Plan Comm59313 Evolutions Healthcare Systems (New Port Richey, FL) CommEXC01 Excel MSO Comm & HMO CACAPMN Exceptional Care Medical (Cap Managements Systems) Comm & HMO CA71412 Exclusicare Comm37289 F.A. Richard & Associates, Inc. Comm91136 F40 Alaska Carpenters Trust Comm95432 Facey Medical Foundation Comm37300 FACS Group CommSX072 Fallon Community Health CommFCM01 Family Care Medicaid Mental Health Comm OR

FCD01 Family Care Medicaid Comm OR FCR01 Family Care Medicare Comm ORAMS11 Family Care Specialists (Arcadian Mgmt Serv) Comm CACAPMN Family Choice Medical Comm CACAPMN Family Health Alliance (Cap Managements Systems) Comm CA31472 Family Health Partners Healthcare of Kansas Comm43173 Family Health Partners/MC + Missouri Comm MO96865 Family Health Plan OH & MI37289 FARA Benefit Services, Inc. Comm14140 Farm Family Life Comm33033 FCE Benefit Administrators Comm37300 Federated Benefits Comm37300 Federated HR Services Comm41041 Federated Mutual Health Insurance Company Comm MN

COFHP FHP of Colorado HMO Claims only Trading Partner Number Required HMO CO11315 Fidelis Care New York Comm NY

FAMR1 First Administrators Comm56196 First Carolina Care Comm NC56196 First Carolina Care Comm56196 First Carolina Care Comm14162 First Choice (CT) Comm91131 First Choice Health Network Comm75138 First Choice of Midwest (PPO) Comm80705 First Great West Life & Annuity Ins. Co. Comm73159 First Health Network (CCN Managed Care and PPO for OK) Comm87043 First Health Network (Coventry) Comm58203 First Medical Network (FMN) Atlanta, GA Comm GA

06108 First Option Health Plan PHS HealthNet of the NE (Please call the EDI Team at 866-334-4638 to verify Provider ID) Comm

***** 23241 First Priority - All new providers must enroll with First Priority Health/Blue Cross of Northeastern PA prior to submitting electronic claims. Enrollment form available at: http://www.bcnepa.com/EDI/registrationForm.aspx Comm PA

87726 First Seniority Freedom/Harvard Pilgrim Comm63080 First State Health Plan Comm94999 Firstcare Comm94998 Firstcare – Medicaid Comm90061 FirstGuard Missouri Comm MO62061 Fiserv Health - Kansas & Tennessee Comm95266 Fiserv Health Harrington Comm11244 Fitzharris & Company, Inc. Comm60054 Flexcare Comm59276 Florida 1st - Winterhaven, FL Comm FL68058 Florida Cenpatico Behavioral Health Comm59276 Florida First Comm59321 Florida Hospital Healthcare Systems Comm FL48116 Florida Hospital Waterman Comm FL48116 Florida Hospital Waterman Employee Benefit Plan Comm FL59698 Florida League of Cities Comm65063 Florida NetPass Comm60054 Florida Power & Light (Prudential) Comm FLAPJAX Floridian Care - Jacksonville Comm FL48117 FMH Benefit Services, Inc. Comm37305 Ford Meter Box Company, Inc., The Comm62413 Foreign Service Benefit Plan Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State87066 Formax, Inc. Comm

TKFMC Foundation for Medical Care of Tulare & Kings County Comm & HMO CA64069 Fox Everett-- Ingalls Ship Building Comm

FVMCH Fox Valley Medicine Site 199 CommFVMC1 Fox Valley Medicine Site 451 Comm64069 Fox-Everett, Inc. Comm41212 Freedom Health Plan Comm

FMCHP Fresenius Med Care HTH Plan CommDHS01 Fresno Unified Comm & HMO CATKFMC Friant Water Users Comm & HMO CA59069 Fringe Benefit Management Comm 59204 Fringe Benefits Coordinators Comm34171 FrontPath Health Coalition Comm37283 Gallagher Benefit Administrators, Inc (now AAG-American Administrative Group) Comm30005 Galveston County Indigent Health Care Comm60550 Gateway Health Plan - Medicare Assrd Comm25169 Gateway Health Plan Medicaid PA Comm91741 Gateway Health Plan of Ohio - Medicare Assured Comm76028 Gateway Health Plan of Ohio Inc Comm

PROSP Gateway IPA (Pinnacle Health Resources) (Prospect Medical Group) Comm & HMO CA06143 GEGA - Group Administrators, South Carolina Comm SC67815 GEGLAC - G.E. Group Life Assurance Company Comm44054 GEHA Comm44054 GEHA Ins. No. 372 Comm

75273 Geisinger Health Plans (Prior enrollment required. Please contact Geisinger Health Plan at 888-281-5338, option 3, to obtain an enrollment form; or download a PDF enrollment form at www.thehealthplan.com) Comm

MCS01 GEMCare (Golden Empire Managed Care System) Comm & HMO CAMCS03 GemCare Health Plan, Kern County EPO Comm63665 Gencare Health (St. Louis) Comm MO63665 Genelco (St. Louis Only) Comm MO63665 General American (Sanus- East) Comm MO63665 General American Life Ins. Co. (Sanus, St. Louis) Comm MO

HDNFC General Hospital (Humboldt Del Norte) Comm CAPROSP Genesis Healthcare (EMG) (Prospect Medical Group) Comm CA11345 Gentiva Health Service Comm61271 Georgia Power Med. Benefits Pln (Health Care Services) Comm GA61271 Georgia Power Med. Benefits Pln (Hlth Care Srvcs) Comm GA23212 Gettysburg Health Comm 59041 GEVB - PIC (GE Voluntary Benefits Professional Insurance Company) Comm22937 GHI M di P i t F f S i C22937 GHI - Medicare Private Fee for Service Comm13551 GHI - New York (Group Health Inc.) Comm25531 GHI HMO Comm25141 GHP (Group Health Plan) Comm58204 GI Innovative Management Comm07205 Gilsbar Inc. Comm

COMPU Glassworkers and Glaziers Health and Welfare Fund Trust Comm & HMO CO

AMM02Glendale Physicians Alliance (GPA Medi-Cal and GPA Healthy Families claims only) (GPA Senior and GPA Commercial claims should be sent through REGAL) Comm

REGALGlendale Physicians Alliance (GPA Senior and GPA Commercial claims only) (GPA Medi-Cal and GPA Healthy Families claims should be sent through AMM01) Comm

07689 Global Care Inc. CommMPMOA Global Care Medical Group IPA Comm CA47083 GMS, Inc. Comm37602 Golden Rule Insurance Company CommMBA01 Golden State Medical Group Comm & HMO CAGTPA1 Golden Triangle Physican All CommAMM01 Good Samaritan Medical Practice Association (GSMPA) Comm CA44054 Government Employees Hospital Association Comm37234 Grant Physicians Practice Association Comm95467 Great Lakes Health Plan Comm80705 Great West Health Care Comm

CAPMN Greater L.A. Health (Cap Managements Systems) Comm CANMM01 Greater Orange Medical Group CommNMM01 Greater San Gabriel Medical Group CommCAPMN Greater San Gabriel Valley Physicians (Cap Managements Systems) Comm & HMO CAHCP01 Greater Valley Comm & HMO CA80705 Great-West Life & Annuity Insurance Company Comm78521 GREENTREE ADMINISTRATORS Comm36338 Group Administrators Ltd. Comm48143 Group and Pension Administrators Comm72153 Group Benefit Administrators (Hendersonville, TN) Comm TN72087 Group Benefits - Louisiana Comm LA91051 Group Health Cooperative - East Comm39167 Group Health Cooperative of South Central Wisconsin Comm WI

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State39168 Group Health Cooperative of South Central Wisconsin Comm WI91051 Group Health Cooperative Healthy Options Comm91051 Group Health Cooperative Medicare Plus Choice Comm91051 Group Health Cooperative Washington State Comm61101 Group Health Insurance Comm DE61101 Group Health Insurance (Humana) Comm38194 Group Health Managers Comm91051 Group Health Options, Alliant Comm91051 Group Health Options, Washington State Comm25141 Group Health Plan (GHP) Comm

13551 Group Health, Inc. (GHI) Comm

37276 Group Insurance Service Center, Inc. Comm68046 Group Practice Affiliates Comm64246 Guardian Life (The Guardian) CommRENBL GULF QUEST IPA HMO BLUE CommRENGQ Gulf Quest Renassaince Comm91131 H.E.R.E Health Trust Comm WA37114 H.E.R.E.I.U Welfare Pension Funds Comm36406 Harmony Health Plan of Illinois Comm IL36405 Harmony Health Plan of Indiana Comm INHCP01 Harrimon Jones Comm & HMO CA75196 Harrington Benefit Services - Centra Comm95266 Harrington Benefit Services, Inc. Comm59142 Harrington Benefit Services, Inc. (Oklahoma) Comm OK95959 Harris Methodist Health Plan Comm04271 Harvard Pilgrim Health Care Comm99208 Hawaii Management Alliance Association (HMAA) Comm37111 HCH Administration (Illinois) Comm IL37215 HCH Administration, Inc. Comm37329 HCHA Albq-Self Funded Comm82018 HCS - Health Claims Service (Boise, ID) Comm ID

HDMCO HDM Benefit Solutions Comm20257 HDPC / Alliance Physicians (High Desert Primary Care Alliance) Comm CA33069 HDPC / High Desert Primary Care Comm CA90023 HDPC / Premier Care(High Desert Primary Care Premier) Comm CA34654 Health & Welfare fund of the Plumbers & Pipefitters Local Union#396 Comm OH23173 Health 1,2,3, Inc. Comm, , ,77950 Health Alliance Medical Plan Comm38224 Health Alliance Plan of Michigan Comm MI25126 Health America, Inc./ Health Assurance/ Advantra Comm25126 Health Assurance/ Health America, Inc./ Advantra Comm60054 Health Care Alliance (Sears) Comm

HCDPB Health Care District Palm Beach CommMPMOA Health Care LA, IPA Comm CA42102 Health Care Network of Wisconsin (HCN) Comm WIHCP01 Health Care Partners Comm34193 Health Care Payer's Coalition (HCPC) Comm OH56142 Health Care Savings Comm61271 Health Care Services, Georgia Power Comm GA62180 Health Choice Generations Comm34158 Health Design Plus (Hudson, Ohio) Comm OH75196 Health Economics Corporation Comm20356 Health Exchange (Cerner Corp) Comm16120 Health EZ Comm30946 Health Future LLC Comm59087 Health Help Network Inc. (HHNI) Comm

55247Health Insurance Plan of Greater NY (provider enrollment is required. Please call HIP Provider Relations to obtain the enrollment form at (800) 447-8386 or e-mail at [email protected])

Comm NY

62295 Health Market Care Assured Comm***** CH002 Health Net Federal Services (TRICARE for North Region) Govn't

SX185 Health Net Pearl Comm20199 Health Network America Comm65062 Health Network One Comm

***** 55204 Health Now New York Comm NY62157 Health Partners (Tennessee) Comm TN

***** HPAMN Health Partners of Minnesota, Inc. Comm MN

80142 Health Partners, PA (All claims submitted require a valid Health Partners, PA, provider ID in the Rendering Provider Network ID field) Comm PA

37221 Health Plan Management Comm83253 Health Plan of Michigan Comm MI

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State76342 Health Plan of Nevada Comm & HMO CA, NV

HPSM1 Health Plan of San Mateo Comm & HMO CA94254 Health Plan of the Redwoods (Mediprime) Comm CA

HPSVC Health Plan Services - Oklahoma Comm44273 Health Plans, Inc. Comm95435 Health Pledge HMO Comm11324 Health Plus PHSP (Brooklyn, NY) Comm NY55438 Health Risk Management Comm20896 Health Services Consulting Group Comm37290 Health Services for Children with Special Needs Comm34167 Health Services Preferred (HSP) by Emerald Health Comm37290 Health Servs for Children w-Special Needs Comm27008 Health Systems International - ECOH Comm61101 Health Value Management - DE (Humana) Comm DE35206 Healthcare Group, The CommHCP01 HealthCare Partners in CA Comm & HMO11328 HealthCare Partners, IPA (NY) (Formerly Heritage NY Medical Group) Comm NY56731 Healthcare Resources NW Comm73147 Healthcare Solutions Group Comm25143 Healthcare USA Comm36335 Healthcare's Finest Network, Inc. (HFN) Comm62179 HealthChoice of Arizona Comm AZ95376 HealthChoice of Connecticut Comm CT85729 HealthComp Comm CANAHOI Healthe Options of Illinois Comm

HCPHM HealthFirst (HMO) Comm TX80141 Healthfirst Health Plan of New Jersey Comm75234 Healthfirst Tyler, TX Comm TX80141 Healthfirst, Inc. Comm NY23226 HealthGuard of Lancaster Comm59087 HealthHelp Network, Inc. (HHNI) Comm FL61101 Healthhelp Networks, Inc. (HNNI) Comm96475 Healthlink HMO (Please call Provider Relations Dept at (800) 624-2356 for unique provider number. ) Comm90001 Healthlink PPO (Please call Provider Relations Dept at (800) 624-2356 for unique provider number. ) Comm95567 HealthNet of CA, OR, and WA Comm38309 HealthNet of Arizona Comm AZ06108 HealthNet of the Northeast Comm

80142 HealthPartners, PA (All claims submitted require a valid Health Partners, PA, provider ID in the Rendering Provider Network ID field) Comm PA

59140 HealthPlan Services (Tampa only) Comm FL59140 HealthPlan Services (Tampa only) Comm FLHPSVC HealthPlan Services, Inc. (American Benefit) Comm & HMO59256 Healthplan Southeast HPSE Comm FL71063 HealthSCOPE Benefits Inc CommM3IL1 HealthSelect BCBS of Florida Comm FL75250 HealthSmart Preferred Care Comm02041 Healthsource CMHC Comm02041 Healthsource Massachusetts, Inc. Comm68195 Healthsource Provident Comm71075 Healthsource, AR (Med) (CIGNA) Comm58210 Healthsource, GA (CIGNA) Comm GA61127 Healthsource, KY Comm KY01041 Healthsource, ME (Payer requires unique provider ID;please contact (800) 909-2227, ext.5760) Comm75255 Healthsource, N. TX (CIGNA) Comm56147 Healthsource, NC (CIGNA) Comm

02038 Healthsource, NH (Payer requires unique provider ID for new providers; please contact Donna Wilson at (603) 268-7439.) Comm

31141 Healthsource, OH Comm OH06119 Healthsource, SC Comm62129 Healthsource, TN (CIGNA) Comm13335 HealthSource/ Hudson Health Plan (Please contact payer before sending claims- 914-631-1611) Comm63092 HealthSpring HMO/HealthSpring Medicare+Choice Comm36332 HealthStar, Inc. Comm58213 Healthways WholeHealth Network Comm

HLTHQ Healthy Equation Comm95827 Healthy Palm Beaches Inc Comm FL22148 Heavy & General Labors Fund of NJ Comm59230 Heritage Consultants Comm11328 Heritage NY Medical Group Comm NYREGAL Heritage Provider Network Comm & HMO CA36335 HFN, Inc. (Healthcare's Finest Network) Comm

HDMDG High Desert Medical Group (Lancaster, CA) Comm & HMO CA33069 High Desert Primary Care (Hesperia CA) Comm91161 Highline Medical Service Organization - PSHP Comm91164 Highline Medical Service Organization – Molina Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State35145 Highmark - Key Family CommHIL01 Hill Physicians Medical Group Comm CA59347 Hillcrest Benefit Administrators Comm36385 Hinsdale Physicians Healthcare CommHPIPA Hispanic Physicians IPA Comm61101 HMPK, INC. (Humana) Comm

SYMED Hollywood Presbyterian Medical Group CommNAHLX Holy Cross Health Partners Comm31147 Hometown Health Network (Ohio BWC) Claims For Ohio Workers Comp Claims ONLY Comm & HMO OH88023 Hometown Health Plan Nevada Comm22099 Horizon Blue Cross Blue Shield of New York & New Jersey Comm NY, NJ22326 Horizon NJ Health Comm37274 Hospital Benefits, Inc. Comm91136 Hotel Employees & Restaurant Employees Health Trust, Group # F19 Comm61101 HPLAN, INC. (Humana) Comm94254 HPR Comm58227 HPS Paradigm, INC Comm41170 HRM Claim Management Comm41150 HSM (Health Services Management) Comm MN13335 Hudson Health Plan (Please contact payer before sending claims- 914-631-1611) CommHBI01 Human Behavior Institute Comm61101 Humana Care Plan Comm61101 Humana Gold Plus Comm61101 Humana Health Comm61101 Humana Health Chicago Inc. Comm61101 Humana Health Chicago Ins. Co. Comm61101 Humana Health Plan Comm61101 Humana Health Plan - HMO Comm95348 Humana Health Plans of Ohio OH61101 Humana Insurance Agency Comm61101 Humana Insurance Co. Comm61101 Humana Medical Plan - CA Comm CA61101 Humana Medical Plan - KY Comm KY

***** CH002 Humana Military Healthcare Services (TRICARE for South Region) Govn'tZ0005 Humana Ohio 2 Comm OH61160 Humana Veterans Healthcare Services Comm61101 Humana Wisconsin Health Organization (Formerly Carenetwork/Wisconsin Health Organization) Comm WI

HDNFC Humboldt-Del Norte Foundation IPA Comm CA37260 Hunt Insurance Group Comm

CAPMN Huntington Park Mission Medical Group (Cap Managements Systems) Comm CA13335 Husdon Health Plan (Please contact payer before sending claims 914 631 1611) Comm13335 Husdon Health Plan (Please contact payer before sending claims- 914-631-1611) CommSX172 I U Medical Group Primary Care CommSX172 I U Medical Group Primary Care Comm22175 I. E. Shaffer (West Trenton, NJ) Comm NJ37279 IAA (Insurance Administrator of America, Inc.) Comm38234 IBA Self Funded Group Comm

BS001 IBEW Local 6 - San Francisco Electrical Workers *They will all have a prefix code of "XEL" as their member ID on the BSC card. Comm

74234 IBEW Local 640 & AZ Chapter NECA Health & Welfare Trust Comm74234 IBEW Western Utilities or Local 57 Comm60054 IBM Medical Plans Comm11695 iCARE (Independent Care Health Plan) Comm WI37296 ICM Comm75185 ICON Benefit Administrators Comm75274 IHG Direct CommIHORG IHO (Inland Health Organization) Comm36600 Illinois Central Hospital Association (Tinley Park, IL) Comm IL91131 ILWU Local 21 (FCHN) Comm WA41600 IMCARE Comm41600 I'Mcare CommSCP01 Imperial County Physicians Med Group (SCPMCS) Comm40585 INDECS Corporation Comm

***** 54704 Independence Blue Cross (Highmark) *Must also be a Highmark provider* Comm PAIMG01 Independence Medical Group –Kern County CommIMG02 Independence Medical Group- Tulare County Comm35204 Indiana Health Network Comm IN35161 Indiana ProHealth Network Comm35107 Indiana Teamsters Health Benefits Fund (Indianapolis, IN) Comm IN31053 Individual Health Insurance Companies Comm

COMPU Industrial Machine Specialties Comm & HMO CO52196 Informed CommNAING Ingalls Provider Group Comm91131 Inland Empire Electrical Trust (FCHN) Comm & HMO WAIEHP1 Inland Empire Health Plan Comm CAIHORG Inland Health Organization (IHO) Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State04320 Innovative Healthware Solutions Comm93112 Inpronet, Portland, OR Comm OR60054 Institutes of Quality Comm37279 Insurance Administrator of America, Inc. (IAA) Comm63082 Insurance Claims Services, Inc. (Birmingham, AL) Comm AL13315 Insurance Design Administrators CommIMSMS Insurance Management Services Comm TX88006 Insurance Management Services (Elko, NV) Comm NVISL11 Insurance Service of Lubbock CommIAC01 Insurers Administrative Corp. Comm51020 Integra Administrative Group (Seaford, DE) Comm DE31127 Integra Group Comm31129 Integra Group-CHA CommINET1 Integranet Comm37124 Integrated Benefit Services, IL Comm IL34167 Integrated Care Network (ICN) by Emerald Health Comm

68053 Integrated Mental Health Service (Prior to submitting claims, please call Provider Relations Dept at 1-800-716-5650 to verify your provider info is on file in the claim system) Comm

58200 Integrity Benefit Group, Inc., The Comm92649 Inter-Americas Insurance Comm37227 InterCare Health Plans Comm60280 Interface EAP (IEAP) Comm23287 Intergroup Services Corporation Comm74234 Intermountain Ironworkers Trust Fund Comm36609 International Brotherhood of Boilermakers CommIMGIN International Medica Group Inc Comm37269 International Union of Operating Engineers ~ Local 15, 15A, 15C & 15D Comm37241 International Union of Operating Engineers, Local 4 Health & Welfare Fund (Located in Lexington, MA) Comm84137 Interwest Health (Acceptius Gateway Payer) Comm20435 Intgritas Benefit Group Comm41124 Iowa Benefits Comm37272 J. Smith Lanier & Co. Administrators Comm61271 J.F. Molloy & Associates, Inc. Comm05014 Jackson Memorial Health Plan (FL) Comm FLJAI01 Jai Medical Systems Comm MDJISSP Ji Specjality Services, Inc Comm41099 John Alden Life Comm

68036 John Muir Mt. Diablo Health System (If you have never submitted claims to John Muir before, please fax your W-9 with contact name and # to Patty Kan 925-941-2026) Comm

68013 John Muir Trauma Physicians37215 John P Pearl & Associates Ltd Comm37215 John P. Pearl & Associates, Ltd. Comm52189 Johns Hopkins Healthcare Comm43178 Joplin Claims Comm34136 JP Farley Corporation Comm37272 JSL Administrators Comm94320 Kaiser CSI-California Select for Individuals (formerly known as Kaiser PPO) Comm94135 Kaiser Foundation Health Plan of Northern CA Region Comm CA34092 Kaiser Foundation Health Plan of Ohio Comm OH52095 Kaiser Foundation Health Plan of the Mid-Atlantic States (MD, VA and DC) Comm91617 Kaiser Foundation HealthPlan of CO Comm & HMO CO93079 Kaiser Foundation of the Northwest Comm94134 Kaiser Permanente (Southern California Only) Comm CA21313 Kaiser Permanente of Georgia Comm GA57038 Kanawha Healthcare Solutions, Inc. Comm57038 Kanawha Insurance Company Comm44030 Kansas City Life Insurance Company Comm25133 Kansas City Medicare - Coventry (Advantra) CommHSM01 Karing Physicians Medical Group, Inc. Comm81812 Katy Medical Claims Comm

TKFMC Kaweah Delta Comm & HMO CAKELSE Kelsey Seybold Comm73100 Kempton Group Administrators Comm63077 Kentucky Health Select Comm KY61101 Kentucky Kare (Humana) Comm37124 Kepple & Co. (Formerly Integrated Benefit Svcs.) Comm ILMCS03 Kern County EPO, (GemCare Health Plan) Comm77039 Kern Health Systems Comm CA37217 Key Benefit Administrators (Indianapolis, IN) CommIP082 Key Medical Group Comm CA37321 Key Select Comm23239 Keystone Health Plan Central Comm

***** 95056 Keystone Health Plan East (KHP) (Highmark) *Must also be a Highmark provider* Comm23284 Keystone Mercy Health Plan Comm PA86049 KidsChoice Medicaid and AmeriChoice of Pennsylvania Comm PA86049 KidsChoice via Information Network Corp. Comm PA

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State34145 Klais and Company Comm

KAMG1 Korean American Medical Group Comm & HMO CAKPS01 KPS - Kitsap Physicians Services Comm WAKPS01 KPS Health Plan Comm WALACAR L.A. Care Health Plan Comm & HMO CALVCV1 La Vida Central Valley CommLVIPA La Vida IPA Comm CA71037 Lafayette Consolidated Government Comm LA

LCHC1 Lakeside Comprehensive Healthcare CommLMG11 Lakeside Medical Group Comm CALNDMK Landmark CommBPA01 Laundry Workers Comm36333 Lawndale Christian Health Center Comm52193 LBA Health Plans Comm75279 Leggett and Platt Comm37316 Leon Medical Center Health Plan Comm37248 LHP Claims Unit Comm87071 Liberty Health Advantage Comm37281 Liberty Union Comm37281 Life Assurance Company CommLIIC3 Life Investors Inc Co America L3 CommLIICA Life Investors Inc Co America LA CommLIIC2 Life Investors Inc Co of America Comm41136 Life Trac Comm

LFGRD Lifeguard Comm***** 91155 LifeWise (of Arizona), A Premera Healthplan Comm AZ***** 93093 LifeWise (of Oregon), A Premera Healthplan Comm OR***** 91049 LifeWise (of Washington), A Premera Healthplan Comm WA

61101 Lincoln National - Phoenix, AZ (Humana) Comm AZ73288 Lincoln National (EMPHESYS) CommLOBH1 Linden Oaks Behavioral Health Comm75283 Linn County CommLIPA1 Lipa-Agate Resources Hcfa Comm35107 Local 135 Health Benefits (Indianapolis, IN) Comm IN37267 Loma Linda University Adventist Health Sciences Center Employee Health Plan Comm37267 Loma Linda University Adventist Health Sciences Centers Comm37267 Loma Linda University Behavioral Medicine Center Employee Health Plan Comm37267 Loma Linda University Employee Health Plan Comm37267 Loma Linda University Health Care Employee Health Plan Comm33036 Loma Linda University Healthcare - ManagedCare Claims Comm37226 London Health Administrators Comm37226 London Health Administrators Comm23223 Loomis Company, The - TPA Wyomissing, PA (IHS Gateway Payer) CommPPM01 Los Angeles Medical Center (LAMC) Comm SX159 Lovelace Medicaid NMSX159 Lovelace Salud (NM Medicaid) NM90328 Lovelace Sandia Health Plan52148 M.D. Individual Practice Assoc. (M.D.IPA) Comm

CAPMN Mabuhay Medical Group (Cap Managements Systems) Comm & HMO CA37292 Machinist District 9 Welfare Comm36334 MacNeal Health Providers-CHS CommHCP01 Magan Medical Clinic Comm & HMO CA01260 Magellan Health Services (formerly known as Magellan Behavioral Health) Comm11303 Magnacare Comm62413 Mailhandlers Benefit Plan (CAC) Comm22195 Maksin Management Corporation Comm52148 MAMSI Life & Health Ins. Co. (MLH) CommMCS03 Managed Care GemCare Health Plan Comm CA35162 Managed Care Services, LLC CommMCS02 Managed Care Systems (Delano Regional Med. Grp.) Comm CAMCS01 Managed Care Systems (GEMCARE) Comm CA22771 Managed Health Network (MHN) Comm

39186 Managed Health Services Indiana (Medicaid HMO) (Prior to submitting claims, please call Provider Relations Dept at 800-944-9661 to verify your provider info is on file.) Comm IN

39187 Managed Health Services Wisconsin Comm WI41159 Managed Physical Network Comm93900 Managed Physical Network Comm41555 Manatee Service Center -Bradenton, FL Comm75258 Mapco, Inc. Comm09908 Maricopa Health Plan – University Family Care Comm13310 MARSH ADVANTAGE Comm22347 Maryland Health Insurance Plan Comm MD22348 Maryland Physicians Care Comm MD37121 Mashantucket Pequot Tribal Nation Comm80314 Mass Mutual Comm

MMPHB Masters Mates and Pilots Plan Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State41154 Mayo Management Services, Inc. Comm

87065 MBA Benefit Administrators (Payer ID valid for claims with a submission address of PO Box 651109, Salt Lake City, UT 84115) Comm UT

87065 MBA of Wyoming (Payer ID valid for claims with a submission address of PO Box 98, Worland, WY 82401) Comm WY

VALOP MBHP – Mass Behavioral Health Partnership (through Value Options) Comm 56205 MBS (Formerly MedCost Benefit Services) Comm

CSMED Mcare of Colorado Springs Comm & HMO CO59331 McCreary Corporation Comm

MHM02 McKinley Medical Group (Magnolia Healthcare Mgmt) CommMDAPN MD Anderson Physician Network CommMDC01 MD Care Health Plan Comm52148 MD - Individual Practice Association, Inc. (M.D. IPA) Comm20475 Mdwise Hoosier Alliance Comm58204 MedAdmin Solutions - Capitated claims- FL only Comm58202 MedAdmin Solutions - self funded plans Comm74323 MedBen (Newark, OH) Comm OH59231 MedCom Comm60054 Medconnection (Marriot) Comm

MDCOR MedCore Comm56162 MedCost, Inc. Comm38353 MedDirect Comm95321 Medfocus Comm94265 Medica (MN) Comm MN78857 Medica Health Care Plan, Inc Comm 78857 Medica Health Care Plan, INC. Comm

***** MCDAK Medicaid - AK Comm***** 77027 Medicaid - FL Comm FL***** MCDID Medicaid - ID Govn't ID***** MCDIL Medicaid - IL Govn't IL***** MCDMN Medicaid - MN Comm MN

NCXIX Medicaid - NC Govn't NC***** MCDNJ Medicaid - NJ Govn't NJ

NMMAD Medicaid - NM Govn't NM***** MC008 Medicaid - NV Govn't NV

MCDOK Medicaid - OK Govn't OK***** ORDHS Medicaid - OR Govn't OR

TMHP1 Medicaid - TX Govn't TXMCDWI Medicaid - WI Comm

***** 77016 Medicaid of Colorado***** MC006 Medicaid of WA - DSHS - Department of Social and Health Services Govn't WA

MCDVA Medicaid VA Comm VA37298 Medical Benefits Admin of Maryland Comm MD

MBA01 Medical Benefits Administrators Comm & HMO CA74323 Medical Benefits Administrators, Inc. (Newark, OH) Comm OH74323 Medical Benefits Companies (Newark, OH) Comm OH74323 Medical Benefits Mutual Comm04258 Medical Claims Service, Inc. Comm75229 Medical Control Inc Comm52181 MEDICAL DEVELOPMENT INTERNATIONAL Comm

CSMED Medical Network of Colorado Springs Comm & HMO CO61101 Medical Plan of Kansas City - MO (Humana) Comm MO58203 Medical Resource Network (MRN) Comm

AMM02 Medical Services For Indigents (MSI) (Advanced Medical Management) Comm & HMO CA***** MC051 MediCal Type 05 CA

38224 Medical Value Plan-MVP-OH Comm OH***** MR010 Medicare - AK Govn't AK***** MR086 Medicare - AR***** MR008 Medicare - AZ Govn't AZ***** MR001 Medicare - CA (Northern California) Govn't CA***** MR002 Medicare - CA (Southern California) Govn't CA***** MR004 Medicare - CO Govn't CO***** 13102 Medicare - CT Govn't CT***** 00903 Medicare - DC (Highmark) Govn't DC***** 00902 Medicare - DE (Highmark) Govn't DE***** 00885 Medicare - DMERC Region C Govn't***** 05655 Medicare - DMERC Region D Govn't***** MR025 Medicare - FL Govn't FL***** 10202 Medicare - GA Govn't GA***** MR057 Medicare - HI Govn't HI***** 05102 Medicare - IA Govn't IA***** MR003 Medicare - ID Govn't ID***** 00952 Medicare - IL Govn't IL***** MR089 Medicare - IN Govn't IN***** 05202 Medicare - KS Govn't KS

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State***** 00660 Medicare - KY Govn't KY***** 14202 Medicare - MA Govn't MA***** 00901 Medicare - MD (Highmark) Govn't MD***** 14102 Medicare - ME Govn't ME***** 00953 Medicare - MI Govn't MI***** 00954 Medicare - MN Govn't MN***** 05302 Medicare - MO (East and West) Govn't MO***** 03202 Medicare - MT Govn't MT***** MR020 Medicare - NC Govn't NC***** MR083 Medicare - ND Govn't ND***** 00655 Medicare - NE Govn't NE***** 14302 Medicare - NH Govn't NH***** 12402 Medicare - NJ Govn't NJ***** 04202 Medicare - NM Govn't NM***** MR007 Medicare - NV Govn't NV***** 13292 Medicare - NY - Queens Govn't NY***** 13282 Medicare - NY - Upstate Govn't NY***** 13202 Medicare - NY (Downstate-Empire) (Payer ID is required) Govn't NY***** 00883 Medicare - OH Govn't OH***** 04302 Medicare - OK (Trailblazers) Govn't OK***** MR011 Medicare - OR Govn't OR***** 12502 Medicare - PA Govn't PA***** MR018 Medicare - Railroad Govn't***** MR084 Medicare - SD Govn't SD***** MR034 Medicare - TN Govn't TN***** MR085 Medicare - TX (Trailblazers) Govn't TX***** MR046 Medicare - UT Govn't UT***** 00904 Medicare - VA Govn't VA***** 14502 Medicare - VT Govn't VT***** MR006 Medicare - WA Govn't WA***** 00951 Medicare - WI Govn't MI***** 00884 Medicare - WV Govn't WV***** MR074 Medicare - WY Govn't WY***** 00880 Medicare SC Govn't SC

CAPMN Medicina Familiar Medical Group (Cap Managements Systems) Comm CA94254 MediPrime Comm

37304 Mediversal Comm62160 MedSolutions, Inc. of Georgia Comm GA82160 Medspan, Inc. Comm

59221 Mega Life & Health Insurance Company - Insurance CenterP O Box 982009 North Richland Hills TX 76182 Comm P.O. Box 982009, North Richland Hills, TX 76182

59227 MEGA Life & Health Insurance Company - OKC P.O. Box 548801, Oklahoma City, OK 73154 Comm OK

01047 MEMIC Comm62181 Memorial Clinical Associates / SelectCare of Texas (MCA) Comm

MHHNP Memorial Herman Hlth Net Comm

***** 59065 MEMORIAL INTEGRATED HEALTHCARE (Please email Tracy Harswick at [email protected] before submitting claims.) Comm

HCP01 Memorial Medical Group Comm & HMO CA***** 59065 Memorial PSN/CMS (Please email Tracy Harswick at [email protected] before submitting claims.) Comm

74289 Mental Health Network (MHNet) Comm86052 Mercy Care Plan (AHCCCS) Comm AZ71079 Mercy Care Plus Comm MO43166 Mercy Health Plan Comm

38269 Mercy Healthplans - Carechoices Michigan (Enrollment required; please contact Noreen at (248) 489-5281.) Comm MI

IP079 Mercy Physicians Medical Group (MPMG) (NAMM Southern CA) Comm

38232 Meritain Health (Formerly know was Weyco) – Payer ID valid for claims with billing submission address of 2370 Science Parkway Okemos, Michigan 48864 Comm

41124 Meritain Health (Formerly known as Corp. Benefit Services/CBSA/Fortis Self Funded Admin and Performax, Inc. Payer ID valid only for claims with a billing submission address of P.O. Box 27267, Minneapolis, MN 55427-0267)

Comm

34159 Meritain Health (Formerly known as E-V Benefits Management, Inc, Columbus, OH). Comm

34159 Meritain Health (Formerly known as NABN, Columbus, OH. Payer ID valid only for claims with billing submission address of P.O. Box 94928, Cleveland, OH 44101-4928 or P.O. Box 89476, Cleveland, OH 44101-5476.

Comm

34159 Meritain Health (Formerly known as North American Benefits Network, Cleveland, OH). Payer ID valid only for claims with billing submission address of P.O. Box 94928, Cleveland, OH 44101-4928 or P.O. Box 89476, Cleveland, OH 44101-5476

Comm

64157 Meritain Health (Formerly known as North American Administrators, Inc.) Comm64158 Meritain Health/Agency Services (Formaly known as Agency Services Inc.) Comm64157 Meritain Health (Formerly know as North American Administrators, Inc.) Comm64157 Meritain Health/North American Administrators Comm64157 Meritain Health/North American Administrators Comm85035 Mesa Mental Health Comm NM

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State65113 Metcare Health Plans, Inc. Comm23550 Methodist First Choice Comm95420 MethodistCare Comm87726 Metrahealth Network (HMO & Care Option:A United HealthCare Co.) Comm87726 Metrahealth Plan Administrators (A United HealthCare Co.) Comm87726 Metrahealth/Metrahealth Railroad (A United HealthCare Co.) Comm

82135 Metro Alliance Comm

13265 Metro Plus Health Plan CommMHP01 Metropolitan Health Plan Comm MN22771 MHN (Managed Health Network) Comm61101 Michael Reese HMO Plan - IL Comm IL61101 Michael Reese HMO Plan - IN Comm IN37127 Michael Reese Physicians Group Comm63079 Mid Atlantic Health Plan Comm52148 Mid Atlantic Psychiatric Services, Inc. (MAPSI) Comm52149 Mid Atlantic Psychiatric Services, Inc. (MAPSI) Comm37281 Mid-America Associates, Inc. Comm63079 Mid-Atlantic Health Plan Comm

CAPMN MidCities IPA (Cap Managements Systems) Comm & HMO CAAMS11 Midcoast Care Inc. (Arcadian) Comm & HMO CASYMED Mid-County Physicians Medical Group (San Diego) Comm & HMO47080 Midlands Choice, Inc. Comm62168 Midsouth Administrative Group Comm76079 Midwest Health Partners CommMHP77 Midwest Health Plans Inc Comm59224 Mid-West National Life Insurance Company of Tennessee CommMIDSC Midwest Preferred Comm79480 Midwest Security CommMSI01 Midwester Preferred Comm

MPHS1 Mills Peninsula Health Services Comm CAMPMG1 Mills Peninsula Medical Group Comm CA05018 MIPS CommSTJOE Mission (St. Joseph Heritage Healthcare) Comm & HMO CAMPMOA Mission Community IPA Medical Group Comm CA37233 Mississippi Public Entity Employee Benefit Trust Comm MS64088 Mississippi Select Health Care Comm MS64088 Mississippi Select Health Care (Gulfport, MS) Comm MS37275 Missoula County Medical Benefits Plan Comm43179 Missouri Care/MC Comm37265 MLink Comm37265 MLink Comm62178 MMS, LLC. Comm51062 Molina Healthcare of Florida Comm00076 Molina Healthcare of Indiana Comm IN38334 Molina Healthcare of Michigan Comm MI20676 Molina Healthcare of Nevada Comm NV09824 Molina Healthcare of New Mexico Comm NM20149 Molina Healthcare of Ohio Comm OH20554 Molina Healthcare of Texas Comm TX38336 Molina Healthcare of Washington (formerly Qualmed WA) Comm WA82119 Molina Healthcare of Washington ASO - Encounters Claims Comm WA91128 Molina Healthcare Washington ASO Comm WAIP095 Monarch Healthcare IPA Comm CAMMLI2 Monumental Life Ins MMLI2 - Kentucky Comm KYMMLI3 Monumental Life Ins MMLI3 - Texas Comm TXMMLIC Monumental Life Ins MMLIC - Arkansas Comm AK35092 Morris Associates CommIP083 Mosaic IPA Medical Group Comm CAMPI01 Motion Picture Industry Health Plan Comm CA36111 Motorola, Inc. Comm84095 Mountain Medical Affiliates Comm86040 Mountain States Administrative Services (Tucson, AZ) Comm

MTNST Mountain States Administrators (CO only) Comm37233 MPE Services Inc. Comm MS37233 MPEEBT Comm MS95444 MPLAN, Inc./HealthCare Group, LLC CommIP079 MPMG (Mercy Physicians Medical Group) (NAMM Southern CA) Comm

AMM02 MSI (Medical Services For Indigents) (Advanced Medical Management) Comm & HMO CASYMED Multicultural Primary Care Medical Group (San Diego) Comm & HMO CA39634 Multiplan Inc for American Family Comm34080 Multiplan Wisconsin Preferred Network Comm37256 Mutual Assurance Comm OK59140 Mutual Group (The) (US) Comm71412 Mutual of Omaha Comm71412 Mutually Preferred Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State14165 MVP Health Care of NY (For your MVP Provider number, call 800-684-9286) Comm NY91136 N.W. Ironworkers Health & Security Trust Fund, Group # F15 Comm91136 N.W. Roofers & Employers Health & Security Trust Fund, Group# F26 Comm91136 N.W. Textile Processors Group # F14 Comm65085 NAA (North America Administrators, L.P.) (Nashville, TN) Comm TN

34159 NABN (Cleveland, OH) Now known as Meritain Health. Payer ID valid only for claims with billing submission address of P.O. Box 94928, Cleveland, OH 44101-4928 or P.O. Box 89476, Cleveland, OH 44101-5476 Comm OH

NOD01 Nacel Open Door – (Minnesota providers only) Comm53011 NALC/Affordable Health Benefits Comm36398 NAMM of Illinois Comm ILNHCA1 Naperville Health Care NHCA1 Comm53011 National Association of Letter Carriers Comm56175 National Benefit Administrators - New Jersey Comm NJ56176 National Benefit Administrators - North Carolina Comm56175 National Benefit Administrators of NJ Comm NJ

90001 National Capital Preferred Provider Organization (NCPPO) (To obtain your provider ID number, please call the NCPPO Customer Service Department at (800) 272-5911. ) Comm

75275 National Health Insurance Company Comm37231 National Healthcare Exchange CommSX190 National Imaging Association Comm59087 National Radiology Network, The Comm52132 National Rural Electric Cooperative Assoc. Comm71412 National Rural Letter Carrier Assoc. Comm52103 National Telecom Coop Assoc (NTCA) Comm52104 National Telecs Coop Assoc Comm31417 Nationwide Insurance Comm75190 NCAS - Fairfax, VA Comm CA52118 NCAS - Owingsmill, Maryland (Formerly Care First Administators) Comm MD75191 NCAS-Charlotte Comm NC

96107 Neighborhood Health Partnership of Florida (Only valid for PO Box 025680, Miami, FL 33102-5680 address) Comm FL

04293 Neighborhood Health Plan (Boston, MA) Comm MA05047 Neighborhood Health Plan of Rhode Island (NHPRI) Comm

11325 Neighborhood Health Providers (NHP/SHP (Neighborhood Health Providers and Suffolk Health Plan) (Please call (631) 360-3102 for your unique NHP/SHP provider number.) Comm

37255 Nesika Health Group Comm66055 Netcare Life and Health Insurance (Hagatna, Guam) Comm

04332 Network Health (please contact Provider Relations at (617) 806-8104 or [email protected] for an EDI setup form) Comm

77076 Network Health Insurance Corp Medicare Comm77076 Network Health Insurance Corp-Medicare Comm39144 Network Health Plan of Wisconsin, Inc. Comm WI

NMM01 Network Medical Management Comm58204 Network TPA, LLC CommNCH06 New Century Health - Bascom Palmer Eye Care Network Comm FLNCH05 New Century Health - California Eye Care Comm CANCH04 New Century Health - CarePlus Cardiology Comm FLNCH01 New Century Health - CarePlus Dermatology Comm FLNCH03 New Century Health - CarePlus Urology Comm FLNCH11 New Century Health – Humana Cardiology Comm CANCH02 New Century Health - Humana Dermatology Comm FLNCH10 New Century Health - Humana Oncology Comm FLNCH09 New Century Health – Vista Cardiology CommNCH07 New Century Infusion Solutions - CarePlus Oncology Comm FLNCH08 New Century Infusion Solutions - Vista Oncology Comm66893 New England, The Comm76031 New Era Employee Welfare Benefit Comm75281 New Era Life Insurance Company CommHSM01 New Life Medical Group, Inc. dba Healthy New Life Medical Corp. Comm65056 New Market Dimensions Comm74234 New Mexico District Council of Carpenters Comm NM74234 New Mexico Painters & Allied Trades Local #823 Comm UT74234 New Mexico West Texas Multi-Craft Comm37312 New Source Benefits, LLC Comm84141 New West Health Plan CommNYL11 New York Life Long Term Care Comm48186 New York Presbyterian Community Health Plan Comm NY24819 New York Presbyterian System Select Health Comm NY38225 NGS American Comm62124 NHC Health Benefit Plan Comm11325 NHP/SHP (Neighborhood Health Providers and Suffolk Health Plan) Comm81264 Nippon Life Insurance Co. Comm22603 NJ Carpernters Health Fund CommPDT01 Noble AMA Select IPA Comm & HMO CACAPMN Noble Community Medical Associates LA (Cap Managements Systems) Comm & HMO CA

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type StateHSM01 Noble Mid OC Orange County (Health Smart) Comm & HMO CA

34159North American Benefits Network (Cleveland, OH). Now known as Meritain Health. Payer ID valid only for claims with billing submission address of P.O. Box 94928, Cleveland, OH 44101-4928 or P.O. Box 89476, Cleveland, OH 44101-5476

Comm OH

64157 North American Health Plan (Now known as Meritain Health) Comm64157 North American Health Plan (Now known as Meritain Health) Comm36398 North American Medical Management - IL Comm ILE3510 North American Medical Management - Northern California Comm CAIP079 North American Medical Management - Southern California Comm CA64157 North American Preferred (Now known as Meritain Health) Comm64157 North AmeriCare Comm37314 North Broward Hospital District Comm FLSCP01 North County Health Services Comm CANSA01 North Star Advantage Comm MN35212 North Texas Healthcare Network Comm TX91131 North West Administrators (FCHN) Comm WA

PROSP North West Orange County Medical Group Comm & HMO CA91131 North West Sheet Metal Workers (FCHN) Comm WA64157 North American Administrators (Now known as Meritain Health) Comm

AMS11 Northeast Community Care Comm ME,NY

38238 Northern California Sheet Metal Workers Health Care Plan Comm CA36347 Northern Illinois Health Plan Comm IL88027 Northern Nevada Trust Fund Comm

NMG01 Northridge Medical Group Comm CANANWC Northwest Community Health Partners Comm62119 Northwest Diagnostic Clinic / SelectCare of Texas (NWDC) Comm36346 Northwest Suburban IPA (Illinois) Comm IL16644 Nova Healthcare Administrators, Inc. (Grand Island, NY) Comm06226 Novanet Comm71080 Novasys Health Network Comm

PROSP Nuestra Familia Medical Group (Prospect Medical Group) Comm & HMO CA41045 NW National Life (Reliastar) Comm37299 Nyhart Comm

NAOAK Oak West Primary Physician Assoc Comm95358 Oaktree Health Plan CommDESRT Oasis IPA Comm & HMO CA72112 Oath For Louisiana, Inc., The (formerly, Southeast Medical Alliance) Comm

72127 Ochsner Health Plan (Payor requires unique provider ID for each practitioner/provider; please contact Jill Brant at (504) 219-6682 or [email protected]) Comm

13350 ODS Health Plan Comm72087 Office of Group Benefits - Louisiana Comm LA13310 Office of the Administrator (Seabury and Smith) Comm DC14163 Ohana Health Plan Comm HI34189 Ohio Health Choice, PPO Comm OH95435 Ohio Health Group Comm OHAMS11 Ojai Dual Risk (Arcadian Mgmt Serv) Comm CAAMS11 Ojai Valley Community Med. Group (Arcadian Mgmt Serv) Comm CA22521 OK State Employees & Educators (EDS) Comm

HDNFC OMNI Healthcare (Humboldt Del Norte) Comm CAMDCOR Omni IPA/Medcore HP CommOMN02 Omnicare Medical Group (OMNI) Comm CA25150 Omnicare, A Coventry Health Plan Comm22321 One Call Medical CommONECR One Care Comm95379 One Health Plan Comm CA95412 One Health Plan Comm CO80705 One Health Plan (Except CA, CO, GA, IL, or TX) Comm95569 One Health Plan of Georgia, Inc. Comm95388 One Health Plan of Illinois, Inc. Comm95379 One Healthplan Comm52149 OneNet PPO, LLC Comm

BPA01 OPEIU Locals 30& 537 Comm74234 Operating Engineers Local #53 Comm UT

BPA01 Operating Engineers Local 501 Comm91136 Operating Engineers Locals 302 & 612 Health & Security Fund, Group # F12 Comm52152 Optimum Choice of the Carolina’s (OCCI) Comm52148 Optimum Choice, Inc. (OCI) Comm37125 Option Services Group Comm91131 Options Health Plan Comm WA87726 OptumHealth Behavioral Solutions Comm41160 OptumHealth Care Solutions (ACN of NY) Comm41161 OptumHealth Care Solutions (ACN) Comm

HSM01 Orange County Advantage Medical Group CommOCFMC Orange County Foundation for Medical Care Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State87043 ORNDA Health D296Corp (First Health)+D312 Comm13383 Orthonet - Aetna Comm13382 Orthonet - Uniformed Services Family Health Plan Comm13381 Orthonet Corporation - CIGNA Comm25681 Orthonet-HealthNet Comm62171 OSF Health Plans Comm36365 Our Lady of the Resurrection Physician Association Comm06111 Oxford Health Comm91131 P.S.E.W. Trust Comm87068 P5 Health Plan Solutions of Utah Comm UT

SYMED Pacific Alliance Medical Group Comm & HMO CAHSM01 Pacific Healthcare IPA Medical Associates, Inc. CommPCFCI Pacific IPA Comm CA93029 Pacific Source Comm OR95999 Pacificare (PPO claims only) Comm95959 Pacificare - Secure Horizon/HMO claims only Comm CA33053 Pacificare Behavioral Health Comm95964 Pacificare of Arizona - For payable PacifiCare/Secure Horizons HMO claims only. Not for PPO claims Comm AZ

COFHP PacifiCare of Colorado - Claims Comm CO95959 Pacificare of Oregon -Secure Horizon/HMO claims only Comm OR95959 Pacificare of TX (OK & TX)-Secure Horizon/HMO claims only Comm TX95959 Pacificare of Washington-Secure Horizon/HMO claims only Comm WA37287 PAI (Planned Administrators, Inc.) CommAMS11 Palomar Pomerado Health (Arcadian Mgmt Serv) Comm CA58174 Paragon Benefits, Inc. Comm58204 Parity Healthcare LLC Comm66917 Parkland Community Health Plan Comm

***** Partners National Health Plans of North Carolina (Contracted providers only. Please call Partners National Health Plan of NC provider services department at (888) 296-9790; option 2 for electronic claims set-up and payer id.) Comm NC

CAPMN Pasadena Primary Care Physicians (Cap Managements Systems) Comm CA61129 Passport Health Plan Comm10525 Patient Advocates, LLC Comm65018 PCA Health Plan of Florida Comm FL65018 PCA Health Plan of Florida Comm95885 PCA Health Plans of Texas (Humana) Comm TX61101 PCA Star (Humana) Comm68049 Peach State Health Plan Comm20472 Pediatric Associates Comm

HDMDG Pegasus Medical Group Comm & HMO CAPBLIC Peoples Benefit Life Ins Co CommPBLIC Peoples Benefit Life Ins Co Comm72126 Peoples Health Network Comm13522 Perfect Health Insurance Company Comm

41124 Performax, Inc. (Now known as Meritain. Payer ID valid only for claims with a billing submission address of P.O. Box 27267, Minneapolis, MN 55427-0267) Comm MN

34173 Personal Physician Care Comm25146 PersonalCare Comm60054 PG&E (Pacific Gas & Electric) Comm95183 PHA Insurance Services (Orlando, FL) Comm FL13306 PHCS Savility Payers Comm75238 Phoenix Group Services, TX Comm TX03440 Phoenix Health Plan Comm62155 PHP TennCare Comm

PHYCR Phycor Comm COPA513 Physician Associates of Greater San Gabriel Valley Comm CA58204 Physician Associates of Louisiana Comm58204 Physician Care Network Comm

PHPMC Physician Health Partners Comm COPHPMC Physician Health Partners Comm CO15749 Physicians Alliance - SRR IPA CommHSM01 Physicians Alliance Network Comm38265 Physicians Care Comm57098 Physicians Care Network (North Carolina) Comm NC36345 Physicians Care Network (Rockford, IL only) Comm ILPDT01 Physician's Data Trust Comm & HMO CA75297 Physicians Direct Comm37136 Physicians Health Association of Illinois Comm

PHCEN Physicians Health Choice - Encounters CommPHCS1 Physicians Health Choice- Hcfa Claims Comm20398 Physicians Health Collaborative Comm

MHM03 Physicians Health Network (PHN) Comm CA37330 Physicians Health Plan (PHP) - Mid-Michigan Comm MI09173 Physicians Health Plan (PHP) - SC Comm SC37330 Physicians Health Plan (PHP) - South-Michigan Comm MI12399 Physicians Health Plan of Northern Indiana Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State65031 Physicians Healthcare Plans Comm

CPMG1 Physicians Management Group CommEXC01 Physicians Medical Group of San Jose Comm CA47027 Physicians Mutual Insurance Company Comm39156 Physicians Plus Insurance Corporation Comm10775 Physicians United Plan Comm56151 Piedmont Administrators Comm06607 Piedmont Behavioral Health Comm

PGLTC Pinal / Gila Long Term Care Comm AZ24735 Pinnacle Claims Management, Inc. Comm

PROSP Pinnacle Health Resources (Prospect Medical Group) Comm & HMO CA45985 Pinnacle Physician Management ORG Comm84109 Pinnacol Assurance Comm CO

COMPU Pipe Industry Health & Welfare Comm & HMO CO37224 Pittman and Associates Comm64160 Pivotal Plan Comm37287 Planned Administrators, Inc. Comm

HPSVC Plumbers and Pipefitters NV58204 Podi Care Managed Care Comm

POD1S Podiatry First59324 Podiatry Network FL Comm32680 Poly America Medical & Dental Benefits Plan Comm16111 POMCO CommIP057 Pomona Valley Medical Group (PVMG) ProMed Comm73159 PPO Oklahoma Comm72148 PPO Plus LLC Comm38335 PPOM Comm04334 Practicare Inc CommLVIPA Prairie Medical Group (La Vida) Comm CA36373 Prairie States Enterprises, Inc. CommEPF10 Prefered Administrator Comm53476 Preferred Benefit Administrators Comm61665 Preferred Benefits Administrator Comm59291 Preferred Care FL Comm56178 Preferred Care NC Comm65088 Preferred Care Partners (Miami, Florida) Comm FL73145 Preferred Community Choice Comm73145 Preferred Community Choice/PCCSelect/CompMed Comm35173 Preferred Health Network (PHN) Comm61106 Preferred Health Plan, Inc. (Louisville, KY) Comm KY31478 Preferred Health Professionals Comm31478 Preferred Health Professionals Comm60110 Preferred Health Systems Insurance Co. (PHSIC) Comm04320 Preferred Healthcare System - PPO CommPFIPA Preferred IPA Comm CA36401 Preferred Network Access, Inc. Comm14162 Preferred One (CT), a Division of First Choice Comm60110 Preferred Plus of Kansas Comm KS41147 PreferredOne Comm MN

***** BC099 Premera Blue Cross of Washington State Comm WA***** BC099 Premera Blue Cross/Blue Shield of Alaska Comm AK***** 91155 Premera LifeWise of Arizona Comm AZ***** 93093 Premera LifeWise of Oregon Comm OR

43166 Premier Benefits Inc. Comm61101 Premier Benefits, Inc. Comm90023 Premier Care (High Desert Primary Care Premier) Hesperia, CA Comm CAAMS11 Premier Care of Northern California (Arcadian Mgmt Serv) Comm CAPREYE Premier Eye Care Comm & HMO43166 Premier Health Plans Comm90440 Premier Health Systems Comm

CAPMN Premier Physicians Network & Valley Division (PPN) (Cap Managements Systems) Comm CA05003 Presbyterian Health Plan Comm

PRESA Presbyterian Salud Comm45056 Prestige Health Choice Comm39185 Prevea Health Plan CommIP096 Prima Health IPA Comm NC

CAPMN Primary Care & Pediatrics IPA (PCPIPA) CommPCAMG Primary Care Associates Medical Group (PCAMG) ( for DOS 1-1-09 and beyond) Comm73288 Primary Delivery System Comm82048 Primary Health Network CommPRIME Primary Health Plan Comm56144 Primary Physician Care Inc. CommPPM01 Primary Provider Management Comm & HMO CA61101 Prime Benefits Systems Inc. - MO (Humana) Comm MO63088 Prime Health Comm61101 Prime Health Kansas City Inc. - MO (Humana) Comm MO

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State61101 Prime Health Mgmt. Services - MO (Humana) Comm MO61101 Prime Health of Kansas City - MO (Humana) Comm MO56190 Prime Vision Health Comm

PWHS1 Prime West Health System Comm MNIP079 PrimeCare Medical Network - Chino Comm & HMO CAIP079 PrimeCare Medical Network - Citrus Valley Comm & HMO CAIP079 PrimeCare Medical Network - Corona Comm & HMO CAIP079 PrimeCare Medical Network - Hemet Comm & HMO CAIP079 PrimeCare Medical Network - Inland Valley Comm & HMO CAIP079 PrimeCare Medical Network - Moreno Comm & HMO CAIP079 PrimeCare Medical Network - Redlands Comm & HMO CAIP079 PrimeCare Medical Network - Riverside Comm & HMO CAIP079 Primecare Medical Network - San Bernardino Comm & HMO CAIP079 PrimeCare Medical Network - Sun City Comm & HMO CAIP079 PrimeCare Medical Network - Temecula Comm & HMO CA04320 PrimeSource Health Network CommPRI01 Princeton Premier Ipa Comm61271 Principal Life Insurance Company (Principal Financial Group) Comm61271 Principal Mutual Life Insurance Company (Principal Mutual Life Assurance) Comm38217 Priority Health Comm37303 Prism - First Health Comm37268 Prism Network, Inc. Comm37315 Prism-Univera Comm38329 Pro Care Health Plan, Inc. (Detroit, MI) Comm MI31132 Pro Health Comp Care Comm

PROSP ProCare (Prospect) Comm & HMO CA59296 Professional Benefit Administrators (Winter Park, FL) Comm FL36331 Professional Benefit Administrators, Inc. (Oak Brook, IL ONLY) Comm IL34176 Professional Benefits Administrators (Cuyahoga Falls, OH) Comm OH41163 Professional Claim Administrators Comm37242 Professional Claims Management (Canton, OH) Comm34134 Professional Risk Management CommPADC1 Project Access of Durham County CommIP057 ProMed Health Care Administrators Comm61101 Promina Comm

PROSP Prospect Medical Group Comm & HMO CAPROSP Prospect Sherman Oaks Medical Group (Prospect Medical Group) Comm & HMO CA37309 Protective Life Insurance CommCIGNA Provident Healthsource (Cigna) - Former Payer ID (62308) Comm62308 Provident Life & Accident Comm62308 Provident Life & Casualty Comm62308 Provident Life & Casualty Comm62308 Provident Preferred Network Comm51032 Provider Network of America (Pro-Net) CommPF101 Providers First PPO CommHM015 PruCare HMO (Encounters Only) Comm & HMOSYMED Prudent Care Medical Group Comm & HMO CA09822 PSN - Florida Medicaid (JMH Comm FL

AMM03 Public Health Medical Services (Advanced Medical Management) Comm & HMO CA91136 Puget Sound Benefits Trust, Group# F25 Comm91136 Puget Sound Electrical Workers Trust, Group# F33 Comm42172 Puget Sound Health Partners Comm48055 Pyramid Life Insurance Company Comm51052 Pyschcare LLC Comm39197 Quad Med LLC (Pewaukee, WI) Comm WI35174 Qual Choice of Arkansas Comm AR23342 QualCare, Inc. (New Providers must enroll with QualCare at (800) 992-6613, option 5.) Comm61101 Qualicare CommQHP01 Quality Health Plans Comm37129 Quincy Health Care Management Inc. Comm

57117 QVI Risk Solutions Inc CommTKFMC R&N Market Comm & HMO CA95266 R.E. Harrington, Inc. Comm

***** MR018 Railroad Medicare Govn't91176 RBMS, LLC Comm

SYMED Redlands IPA (San Bernardino) Comm & HMO CAREGAL Regal Comm & HMO CA00611 Regence Blue Shield of Idaho Comm ID00932 Regence Blue Shield of Washington State Comm WA00851 Regence BlueCross BlueShield of Oregon Comm OR38221 Regency Employee Benefits CommHSM01 Regent Medical Group, Inc. (Regent Family Practice of Glendale) Comm47076 Regional Care, Inc. CommREH55 Rehab Network, LLC Humana (Payer requires 11 digit member ID Number) Comm & HMO41045 Reliastar Employee Ben. (Northwestern Nat Life) Comm

RENGQ Renaissance Gulf Quest Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type StateRENRB RENASSAINCE RIVEROAKS BLUE CommRENRO RENASSAINCE-RIVER OAKS Comm37278 ResourceOne Administrators Comm

36396Resurrection Health Care Preferred/AKA Family Medical Network *Please call (773) 572-8311 or ( 773) 572-8309 prior to your first submission of claims. Comm

RPPG1 Resurrection Physicians Group Comm37270 Reynolds & Reynolds Comm

MPMOA Riverside Family Health Medical Group Comm CA16117 RMSCO Inc Comm75196 Rockwell International Comm

***** RMHMO Rocky Mountain Health Plan - Grand Junction Comm37602 Rooney Life Inc. Comm36215 Rosemont of Des Plaines, IL Comm36339 Rush Health Association Comm60054 Rush Prudential Comm36389 Rush Prudential Health Plans (HMO Only) Comm63070 RWDSU Benefit Fund Comm

AMM03 Ryan White Network (Advanced Medical Management) Comm & HMO CA31441 S & S Healthcare Strategies Comm35164 Sagamore Health Network Comm INHSM01 Saigon Medical Group, Inc. Comm88029 Saint Mary's Health Plan Comm NV62308 SAMBA Comm74234 same as above - Metal Trades Health Plan CommSCP01 San Diego Physicians Med Group (SCPMCS) Comm

BS001 San Francisco Electrical Workers – IBEW Local 6 *They will all have a prefix code of "XEL" as their member ID on the BSC card. Comm

HSM01 San Judas Medical Group IPA CommAMS11 San Luis Obispo Select IPA (Arcadian Mgmt Serv) Comm CA60054 Sandia Triple Option Plan (Sandia Top) Comm91184 Sanford Health Plan CommAMS11 Santa Barbara Select IPA (Arcadian Mgmt Serv) Comm CA10378 Santa Clara County IPA (SCCIPA) Comm

SANTE SANTE Comm CA63665 Sanus HMO - St. Louis (General American) Comm MO63665 Sanus PPO (General American) - Sanus East CommAMS11 SBSI Appeals (Arcadian Mgmt Serv) Comm CASCAN1 SCAN Health Plan Comm & HMO CASCH01 Schaller Anderson (CHOC Health Alliance) Comm & HMO CA16146 SCHC Total Care Inc. (Acceptius Gateway payer) Comm88030 Scott & White Health Care Plan Comm88030 Scott & White Health Care Plan Comm60054 Scripps Medical Plan Comm13310 Seabury & Smith Comm91131 Seattle Area Plumbing Comm WASVIPA Seaview IPA Comm & HMO CA28530 Secure Health Plans of Georgia, LLC Comm95959 Secure Horizon CA - Pacificare Comm CA87726 Secure Horizon Direct Comm

COFHP Secure Horizons of CO * Comm & HMO CO42142 SecureCare of Iowa Comm IA42142 Securecare of Iowa-Infotrust Comm39045 Security Health Plan Comm64088 Select Administrative Services (SAS) Comm MS42137 Select Benefit Administrators (Des Moines, Iowa) Comm IA73117 Select Care of Oklahoma-Tribute Comm23285 Select Health of South Carolina Comm SC20415 Select Senior Clinic Comm00014 SelectCare Comm59111 Self Insured Benefit Administrators (Clearwater, FL) Comm36404 Self Insured Plans (Naples, FL) Comm FL34131 Self-Funded Plans, Inc. Comm83035 Senior Whole Health Comm60054 SeniorCare Comm23249 Sentinel Management Services Comm39033 Sentry Insurance a Mutual Company Comm39033 Sentry Life Insurance Company Comm39033 Sentry Life of New York Comm

CAPMN Seoul Medical Group (Cap Managements Systems) Comm CATKFMC Sequoia Beverage Comm & HMO CA38610 SET SEG Comm76056 Seton CHIP Comm

SHEBP Seton Employee Plan CommSHPCH Seton Health PlanSHMAP Seton Map Program (Mediview) Comm87726 Share Health Plan - ILL/PPO Comm IL

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State87726 Share Health Plan - ILX/HMO Comm IL

***** SCMG1 Sharp Healthcare Comm75280 Shasta Administrative Services Comm38238 Sheet Metal Workers Local 104 Health Care Plan (San Ramon, CA) Comm CA

PROSP Sierra Family Network (Prospect Medical Group) Comm & HMO CA76342 Sierra Health Services Comm & HMO CA, NV76343 Sierra Health Services (encounters) Comm

HDMDG Sierra Medical Group Comm & HMO CAMBA01 Sierra Nevada Medical Associates Comm & HMO CA62159 Signature Health Alliance Comm

NASCR Silver Cross Managed Care Org Comm84076 Sinclair Health Plan Comm84096 Sloans Lake Managed Care Comm02057 Smith Administrators CommAMS11 Sonoma County Primary Care (Arcadian Mgmt Serv) Comm CA91131 Sound Health Comm ID91131 Sound Health Comm MT91131 Sound Health (Sisters of Providence) Comm ID91131 Sound Health (Sisters of Providence) Comm MT91131 Sound Health (Sisters of Providence) Comm91131 Sound Health Wellness Trust Comm WA23266 South Central Preferred Comm PA25147 SouthCare/Healthcare Preferred CommAMS11 Southeast Community Care Comm GA,SC,NC72112 Southeast Medical Allience (The Oath For Louisiana, Inc.) CommSTGEB Southeast Texas Govt Emps Ben Comm37318 Southern Benefit Services Comm

SYMED Southern California Children's Healthcare Network Comm & HMO CABPA01 Southern California Lumber CommSCP01 Southern California Physicians Managed Care Services Comm56131 Southern Group Administrators Comm25128 Southern Health Services Inc. CommHSM01 Southland Advantage Medical Group, Inc. CommHSM01 Southland San Gabriel Valley Medical Group, Inc. Comm35227 SouthPoint Hotel and Casino Comm

SWSTA Southwest Administrators (CA) Comm CASWSTA Southwest Administrators (NV) Comm NVM3IL2 Southwest BCBS of Florida CommSPA98 Southwest Physicians Associates Comm TX37266 Southwest Service Life Comm TX37259 Special Agents Mutual Benefit Association Comm37259 Special Agents Mutual Benefit Association Comm52190 Special Risk International Comm23253 Spectrum Admin Inc TPA Comm84146 Spina Bifida - VA HAC CommSPOHN Spohn Health CommAMS11 Spokane Community Care Comm WA95286 SSM Exclusive Choice Comm22240 St. Barnabas System Health Plan CommAPP01 St. Francis IPA (NOW KNOWN AS Applecare Medical Management) Comm & HMO CA37264 St. John's Claim Administration CommSTJOE St. Joseph Heritage Healthcare Comm & HMO CASTJOE St. Joseph IPA (St. Joseph Heritage Healthcare) Comm & HMO CASTJOE St. Jude (St. Joseph Heritage Healthcare) Comm & HMO CAHSM01 St. Peter Medical Group, Inc. Comm37116 St. Therese Physician Associates Comm ILSTM01 ST. THOMAS MED NTWK GULFQUEST CommPDT01 St. Vincent IPA Comm & HMO CA59225 Star HRG Comm31053 State Farm Insurance Companies Comm

***** SB810 State Health Plan of North Carolina Comm NC75087 States General Life Insurance Comm14163 Staywell Health Plan Comm

91151 Sterling Option One Comm WA

31121 Stoner and Associates (Cincinnati, OH) Comm OH58128 Stowe Associates Comm74227 Student Resources Comm88331 Suffolk Health Plan of New York Comm NY95202 Summacare Health Plan (HMO) Comm37301 Summit America Insurance Services, Inc. CommSX186 Sun Health Corp Comm68057 Sunshine State Health Plan Comm23218 Superior Administrators, Inc (Santa Ana, CA) Comm CASHP11 Superior Health Centene Corp Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State

39188 Superior Health Plan Texas (Prior to submitting claims, please call Provider Relations Dept at 1-800-218-7453) Comm TX

***** SC006 Sutter Connect - Alta Bates Medical Group, Alta Bates Network (ABMG/ABN) (Claims/Encounters) Comm CA***** SC016 Sutter Connect - Solano Regional Medical Foundation, (SRMF) (Claims/Encounters) Comm CA***** SC018 Sutter Connect - Sutter Delta Medical Group Comm CA***** SC003 Sutter Connect - Sutter Gould Medical Foundation (Claims/Encounters) Comm CA

***** SC004 Sutter Connect - Sutter Independent Physicians, Sutter Medical Group, Sutter West Medical Group (SIP/SMF/SWMG) (Claims/Encounters) Comm CA

***** SC008 Sutter Connect - Sutter Medical Group of the Redwoods, Santa Rosa Network (SMGR/SRN) (Claims/Encounters) Comm CA

***** SC025 Sutter Connect - Sutter Select Comm CA***** SC020 Sutter East Bay Medical Foundation Comm CA

NASWD Swedish Covenant Managed Care CommSYMED SynerMed Comm & HMO CA

TMG01 Talbert Medical Group (Testing of each provider is required by payer and done automatically by Office Ally once you start submitting claims for this payer. ) Comm & HMO CA

88067 Tall Tree Administrators Comm37228 Tarrant Health Services Comm TX

TKFMC TASEBA Comm & HMO CACOMPU Tattered Cover, Inc. Comm & HMO CO39157 TBG Administrative Services Comm

BPA01 TCU-LA MTA Comm88019 Teachers Health Trust CommADSL1 Team Choice - Alpha Care Gold Comm36215 Teamcare Comm36612 Teamsters Local Union #301 Comm91131 Teamsters Welfare Trust Comm WA74234 Tech-Steel, Inc Comm37293 Tennessee Benefit Administrators, LLC CommKLSY1 Texan Plusslctcare TX Kelsey CommAMS11 Texarkana Community Care Comm AR,TXTTASB Texas Association of School Boards Comm TX76048 Texas Children's Health Plan Comm TX75228 Texas Childrens Health Plan (Medicaid) Comm TXAMS11 Texas Community Care Comm TX13185 Texas First Health Plans Comm TX76046 Texas First Health Plans (TIOPA) Comm TX33104 Texas HealthSpring Comm74214 Texas Municipal League TML Comm TXEPF02 Texas Premier PlanTTCEC Texas True Choice CommTTCEC Texas True Choice CommBOONG The Boon Group CommCRI01 The Chesterfield Companies Comm75600 The City of Odessa Comm28777 The EPOCH Group Comm37305 The Ford Meter Box Company, Inc. Comm34150 The Health Plan (Massillon, Ohio and St. Clairsville, Ohio only) Comm35206 The Healthcare Group Comm58200 The Integrity Benefit Group, Inc. Comm23223 The Loomis Company - TPA Wyomissing, PA (IHS Gateway Payer) Comm59227 The MEGA Life & Health Insurance Company - OKC Comm72112 The Oath For Louisiana, Inc. (formerly, Southeast Medical Alliance) Comm04320 The Preferred Healthcare System - PPO Comm38200 The Wellness Plan Comm

THERA Theraphysics (All but Colorado) Comm & HMOCOTHE Theraphysics (Colorado Only) Comm & HMO COTHIPA THIPA Comm & HMO CA06131 Third Party Claims Management Comm25175 Three Rivers Health Plans, Inc CommPH017 Time Ins. Co. Comm39065 Time Insurance (A Fortis Company) Comm & HMO74214 TML Intergovernmental Employee Benefits Pool Comm TX20081 Todays Health48055 Todays Option (American Progressive and Pyramid Life) Comm92620 Tongass Timber Trust Comm61425 Tooling and Manufacturing Assocation CommTHIPA Torrance Hospital IPA (THIPA) Comm & HMO CA

TMMC1 Torrance Memorial Medical Center Comm CA31182 Total Community Care Comm38201 Total Health Care Comm38202 Total Health Choice - Florida Comm FL38201 Total Healthcare, Inc. Comm87726 Touchpoint Comm & HMO23856 Touchstone Health PSO Comm13402 TOUCHSTONE HEALTH/HEALTH NET SMART CHOICE Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State69493 Tower Life Insurance Company Comm

TKFMC Town & Country Comm & HMO CA60054 TPA Health Plan Comm37230 TR Paul Inc. Comm

***** MR085 Trailblazer Texas (Medicare) Govn'tTLINS TransAmerica Life Insurance Co. Comm59222 TransAmerica Life Insurance Company Comm37284 TransChoice-KBA Comm37284 TransChoice-Key Benefit Administrators Comm74234 Transwestern General Agency Comm87726 Travelers Health Network - HMO (Metrahealth) Comm CA87726 Travelers/CGT-PPO Comm

TCHD1 Travis County Hospital District MAP Comm36397 Trellis Health Partners Comm

***** TDDIR TriCare for Life Govn't

***** CH002TRICARE NORTH (Health Net Federal) formerly known as CHAMPUS: Connecticut, Delaware, Illinois, Indiana, Kentucky, Massachusetts, Maryland, Maine, Michigan, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia, Wash D.C., West Virginia and Wisconsin.

Govn't

***** CH002TRICARE SOUTH (Humana Military) formerly known as CHAMPUS: Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Oklahoma, South Carolina, Tennessee and Texas. Govn't

PDT01 TriCities IPA Comm & HMO CA38269 Trinity Health (Enrollment required; please contact Noreen at (248) 489-5281) Comm34185 TriSurant (formerly Health Administration Services-HAS) Comm

***** WPSTC

TRIWEST (WPS) formerly known as CHAMPUS: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Iowa(Except

for the Rock Island Arsenal Area), Kansas, Minnesota, Missouri, Montana, Nebraska, Nevada, New Mexico, North

Dakota, Oregon South Dakota, The Extreme Western Portion of Texas, Utah, Washington and Wyoming.

Govn't

54210 True Choice USA CommTCUCH True Choice USA-CRSTS Healthplan Comm91131 Trusted Plans Service Corp. (TPSC) (FCHN) Comm WA91131 Trustee Plans (FCHN) Comm WA91131 Trusteed Insurance (FCHN) Comm WA91078 Trusteed Plans Service Corporation Comm61425 Trustmark Insurance Comm04298 Tufts Health Plan Comm

***** SX192 UAHC Health Plan of TN Comm TN87726 UBH Employer Division Comm87726 UBH Rios Comm87726 UBH Rios Comm87726 UBH United Behavioral Health (former MetraHealth - UNET) Comm60054 UC Care (University of California) Comm CA52629 UCare of Minnesota Comm22329 UHP of New Jersey Comm NJ74223 UICI - Administrators - Nevada (through Benefit Planners, Inc.) Comm NV75240 UICI Administrators Comm37292 UMMH Comm39026 UMR- Wausau/UHIS Comm31107 UMR-Cincinnati Comm52180 UMWA Health & Retirement Funds Comm80314 UNICARE Comm62170 Unified Health Services (Workman's Comp Only) CommHCP01 Unified IPA Comm & HMO CA75243 Uniform Medical Plan (Harrington Benefit Services) Comm13407 Uniformed Services Family Health Plan (USFHP) St. Vincent Catholic Medical Centers of New York Comm91131 UNIGARD (FCHN) Comm WA13142 Union Labor Life Insurance CommSCP01 Union Pacific IPA (SCPMCS) Comm87042 Union Pacific Railroad Employees Health System Comm70408 Union Security Insurance Comm62183 Unison Health Plan / Better Health Plans Comm25175 Unison Health Plan/Three Rivers Comm

UAGBT United Agriculture Benefit Trust Comm & HMO CA87726 United Behavioral Health (RIOS) Comm87726 United Behavioral Health (UBH) Comm59069 United Benefits(formerly Brown & Brown Benefits) Comm

CAPMN United Care Medical Network (formerly United St. Joseph Mission [Cap Management]) Comm & HMO CA91131 United Employee Benefit Trust (FCHN) Comm WA87726 United HealthCare Comm

87726 United HealthCare (formerly MetraHealth Care Plans, Met Life, Metropolitan Life Ins Co, MetraHealth Elect, MetraHealth Healthcare Network HMO) (no vision claims) Comm

87726 United HealthCare (formerly MetraHealth Healthcare Network PPO, New York State Employees (Empire), Travelers Ins Co, Travelers Plan Administrators) (no vision claims) Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State87726 United HealthCare (formerly The Travelers, Travelers Health Network) Comm87726 United HealthCare of Alabama Comm AL87726 United HealthCare of Arizona, Inc. Comm AZ87726 United HealthCare of Arkansas Comm AR87726 United HealthCare of California - Northern California Comm CA87726 United HealthCare of California - Southern California Comm CA87726 United HealthCare of Colorado, Inc. Comm CO87726 United HealthCare of Florida Comm FL87726 United HealthCare of Georgia Comm GA87726 United HealthCare of Illinois Comm IL87726 United HealthCare of Kentucky, Ltd. Comm KY87726 United HealthCare of Mississippi Comm MS87726 United HealthCare of New England Comm87726 United HealthCare of New York (includes New York and New Jersey) Comm NY87726 United HealthCare of North Carolina, Inc. Comm NC87726 United HealthCare of Ohio Comm OH87726 United HealthCare of Texas -Dallas Comm TX87726 United HealthCare of Texas- Houston Comm TX87726 United HealthCare of the Mid-Atlantic Comm87726 United HealthCare of the Midlands - HMO (Choice Select) Comm87726 United HealthCare of the Midlands - PPO (Choice Plus, Select Plus, Self Funded) Comm87726 United HealthCare of the Midwest - Choice, Choice Plus, Select, Select Plus Comm87726 United HealthCare of the Midwest - Medicare Complete Comm95378 United HealthCare of the River Valley (John Deere) Comm87726 United HealthCare of Upstate New York Comm NY87726 United HealthCare of Utah Comm UT87726 United HealthCare of Virginia Comm VA87726 United HealthCare Plans of Puerto Rico Comm84132 United Medical Alliance (UMA) Comm & HMO CO71412 United of Omaha Comm84132 United Physicians of Northern Colorado (UPNC) Comm41194 United Resources Network Comm

66705Unity Health Insurance -Before submitting claims, please go to http://www.unityhealth.com/Providers/EDI/index.htm and complete EDI Sign Up Form and NPI Appendix A documents. Or call Joe Boerboom at 608-643-1531 to request these forms.

Comm

UC001 Universal Care - California Comm CAUC002 Universal Care Encounters Comm50528 Universal Health Care Inc Comm38298 U i l St d d H lth C38298 Universal Standard Healthcare Comm09830 University Family Care Comm09908 University Family Care - Maricopa Health Plan Comm

***** UHA01 University Health Alliance Comm22329 University Health Plan of New Jersey Comm NJ92579 University of Miami Behavioral Health Comm87043 University of Missouri CommIP056 Upland Medical Group Comm23281 UPMC Health Plan Comm37324 Upper Peninsula Health Group (TPA) Comm38337 Upper Peninsula Health Plan Comm87726 US Behavioral Health Plan, CA Comm CA93092 US Benefits Comm

USFHP US Family Health Plan Comm60054 US Healthcare Comm74095 USAA (United States Automobile Association) Comm74234 Utah Carpenters Comm UT74234 Utah Laborers Comm UT74234 Utah Pipe Trades Comm UT12115 VA Fee Basis Programs CommVCIPA Valley Care IPA Comm & HMO CAVHP01 Valley Health Plan (Commercial) CommVHP02 Valley Health Plan (Medi-Cal) Comm77004 Valley Physician's IPA Comm CA

***** VALOP Value Options Comm 23173 Vanderbilt Health Plan Comm

SYMED Vanguard Health Systems (SynerMed) Comm & HMO72128 Vantage Health Plan, Inc. (located in Louisiana) CommPPM01 Vantage Medical Group (located in California) Comm & HMO CA60054 Varian Health Care Plan Comm73288 VENCOR Comm86062 VentureNet Healthcare Comm

VHMG1 Verdugo Hills Medical Group Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State23173 VHP Community Care Comm

VVMG1 Victor Valley IPA Comm & HMO CA24818 Vida Care Comm73743 Village Family Practice Comm91131 Virginia Mason Group Health Comm

***** 54176 Virginia Premier Health Plan Comm37297 Vison Care Incorporated Comm86079 Vista Del Sol Health Care Comm55248 Vista Health Plan Comm FL63114 Viva Health Plan Comm59266 Volusia Health Network Comm22264 Vytra Comm NY62111 W.C. Beeler & Company Comm TN91131 WA Teamster Comm WA37294 Washington Employers Trust Comm91131 Washington State Health Insurance Pool (WSHIP) Comm38356 Washtenaw Community Health Org Comm73155 Waterstone Benefit Administrators Comm58082 Watkins Associated Industries, Inc. Comm

MPMOA Watts Healthcare Corp. Comm CA75261 Web TPA Comm TX36337 Weiss Health Providers Comm59354 Wellcare Health Plans (Encounters) Comm14163 Wellcare HMO, Inc. Comm14164 Wellcare of Conneticut Comm CT59608 Wellcare of Florida Comm FL

14163 Wellcare of Georgia (Wellcare Provider ID is required. To obtain your provider ID, please call (866) 231-1821 option 2 then 4) Comm GA

14163 Wellcare of Louisiana Comm LA14164 Wellcare of New York Comm NY14163 WellCare of Ohio Comm OH14163 Wellcare of Texas Comm TX77072 Wellcare Private Fee for Service Plans Comm

WELM2 Wellmed Medical (Claims) CommWELMD Wellmed Medical Management Comm38200 Wellness Plan, The Comm25129 WellPath Comm87815 Wells Fargo 3rd Party Administrators (formerly know as Acordia National) Comm22925 WELS Benefit Plan Office Comm

WCMG1 West Covina Medical Group Comm & HMO CA75196 West Virginia State Employees (PEIA) Comm WV24735 Western Growers Assurance Trust Comm24735 Western Growers Insurance Company Comm37306 Western Health Inc Comm37247 Western Mutual Insurance Comm31048 Western Southern Financial Group (Cincinnati, OH) Comm OH74234 Western Utilities or Local 57 Comm

WESTL Westlake Financial Group - HCFA Comm

38232 Weyco, Inc. (Now know as Meritain Health) – Payer ID valid for claims with billing submission address of 2370 Science Parkway Okemos, Michigan 48864 Comm

93050 William C Earhart Comm98010 William J. Sutton & Company, LTD. (Toronto, Canada) Comm

WCMAP Williams & County Map Comm62061 Willis Administrative Services (now known as Fiserv Health- Kansas) Comm11696 Windsor Home Network Comm62153 Windsor Medicare Extra Comm

WNHLT WinHealth Comm & HMO39200 Wisconsin Auto and Truck Dealers CommSX022 Wisconsin Physicians Service Insurance Corporation Comm20333 Worksite Benefit Services, LLC Comm75276 World Insurance Company Comm91131 WPAS (FCHN) Comm WA34080 WPPN- HPO (HealthEOS) Comm

***** WPSTC WPS (TRIWEST for West Region) Govn'tWPS01 WPS Commercial Govn't23710 Writer's Guild Industry Health Plan Comm91131 WSHIP - Washington State Health Insurance Pool Comm91131 WVMC (FCNH) Comm WA

***** 09829 Yavapai County CommSTJOE Yorba Park (St. Joseph Heritage HealthCare) Comm & HMO CA75285 Young Life Comm

Revised 8/28/2009



Pre.Enr. Payer ID Name Claims Type State91131 Zenith (WA only) (FCHN) Comm WA

Revised 8/28/2009



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