phicure professional payer list updated 08.30 · 2018. 10. 25. · ambhn ambay health network n...

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Confidential Updated 08.30.2017

PHIcure Professional Payer List Updated 08.30.2017

Payer ID Payer Name Enrollment Required

13162 1199 SEIU NATIONAL BENEFIT FUND N

51028 21ST CENTURY INSURANCE AND FINANCIAL SERVICES N

07205 360 ALLIANCE PPO GILSBAR N

20413 3P ADMIN N

20446 6 DEGREES HEALTH INCORPORATED N

74234 8TH DISTRIC ELECTRICAL N

93044 A & I BENEFIT PLAN ADMINISTRATORS N

36273

AARP MEDICARE SUPPLEMENT/FIXED INDEMITY BY

UNITEDHEALTHCARE (UNITEDHEALTHCARE) N

87726

AARP MEDICARECOMPLETE (AARP MEDICARECOMPLETE FROM

SECUREHORIZONS) N

36273

AARP UNITEDHEALTHCARE INSURANCE CO. (SPECIAL DATA

REQUIREMENTS LOCATED IN VENDOR DOWNLOAD TOOLS OR

PROVIDER TRAINING MATERIALS.) N

A0701 ABMG N

03443 ABRAZO ADVANTAGE HEALTH PLAN N

ABRI1 ABRI HEALTHPLAN N

A0003 ACCELERATED CLAIMS INCORPORATED N

AHS01 ACCESS ADMINISTRATORS N

COACC ACCESS BEHAVIORAL CARE N

ACCOM ACCESS COMMUNITY HEALTH NETWORK N

95424 ACCESS MEDICAL GROUP N

AMG01 ACCESS MEDICAL GROUP N

64071 ACCLAIM N

MHIPA ACCLAIM IPA N

MHIPA ACCLAIM IPA (MHCAC) N

21356 ACCLAIM REPRICING N

Confidential Updated 08.30.2017

AHIPA ACCOUNTABLE IPA N

MPM23 ACCOUNTABLE IPA (MPM) N

41160 ACNIPA N

87815 ACORDIA NATIONAL (NOW KNOWN AS WELLS FARGO TPA) N

72467 ACS BENEFIT SERVICES, INC. N

PA331 ACS BENEFITS PAYER COMPASS N

38254

ACTIVA BENEFITS SERVICES, LLC (FORMERLY AMWAY

CORPORATION) N

75678 ACTIVE CARE UCS N

AHC01 ACTIVHEALTHCARE N

J1241 ADMINISTAFF N

59141 ADMINISTRATIVE SERVICES, INC. N

37278 ADMINONE N

22384 ADMINSTRATIVE CONCEPTS, INC. N

58202 ADVANCED DATA SOLUTIONS N

74234 ADVANSTAFF, INC. N

ACIPA ADVANTAGE CARE IPA N

35219 ADVANTAGE HEALTH SOLUTIONS MEDICARE ADVANTAGE N

35209 ADVANTAGE HEALTH SOLUTIONS, INC. N

77070 ADVANTAGE PREFERR N

83077 ADVANTEK BENEFIT ADMINISTRATORS N

59374 ADVANTICA BENEFITS N

95340 ADVENTIST HEALTH SYSTEM N

45423 ADVICARE N

J1896 ADVOCARE MCO INCORPORATED N

36320 ADVOCATE HEALTH CENTERS (AHC) N

65093 ADVOCATE PHYSICIANS PARTNERS (PHO) N

CB637 AEGIS ADMIN SERVICES N

Confidential Updated 08.30.2017

57604 AETNA AFFORDABLE HEALTH CHOICES (SM) - SRC N

58730 AETNA ASA PPO/ASSURANT HEALTH (SIGNATURE ADMIN) N

23225 AETNA BETTER HEAL N

23228 AETNA BETTER HEALTH - PA MEDICAID N

128LA AETNA BETTER HEALTH LA N

26337 AETNA BETTER HEALTH MEDICAID IL N

128MO AETNA BETTER HEALTH MO N

46320 AETNA BETTER HEALTH NJ N

34734 AETNA BETTER HEALTH NY N

128KY AETNA BETTER HEALTH OF KY N

128MI AETNA BETTER HEALTH OF MICHIGAN N

42130 AETNA BETTER HEALTH OF NEBRASKA N

50023 AETNA BETTER HEALTH OF OHIO N

128VA AETNA BETTER HEALTH OF VIRGINIA N

128WV AETNA BETTER HEALTH WV N

60054 AETNA HEALTH PLAN - PPO N

60054 AETNA LIFE & CASUALTY COMPANY N

38692 AETNA TX MEDICAID & CHIP N

ADOCS AFFILIATED DOCTORS OF ORANGE COUNTY N

APG01 AFFILIATED PHYSICIANS GROUP N

POP06 AFFILIATED PHYSICIANS IPA N

23334 AFFINITY ESSENTIALS N

13334

AFFINITY HEALTH PLANS (CONTACT AFFINITY EDI COORDINATOR

BEFORE SUBMITTING CLAIMS ELECTRONICALLY AT

EDI@AFFINITYPLAN.ORG OR CALL 718-794-7592.) N

13333

AFFINITY HEALTH PLANS (TMG HEALTH) (EFFECTIVE FOR

MEDICARE CLAIMS WITH DOS ON OR AFTER 01/01/2010) N

46594 AFFINITY MEDICAL GROUP N

Confidential Updated 08.30.2017

95426

AFFORDABLE BENEFIT ADMINISTRATORS, INC. (CLAIMS WITH THE

FOLLOWING ADDRESS SHOULD ONLY BE SENT TO THIS PAYERID:

ABA, PO BOX 10787, BURBANK, CA 91510-0787) N

AWNY6 AGE WELL NY N

ARA01 AGERIGHT ADVANTAGE N

95241 AGIA INC (CLAIMS ARE PRINTED AND MAILED TO THE PAYER.) N

AGUA1 AGUA CALIENTE N

80705 AH & L N

36320MA AHC MISDIRECTED CLAIMS N

31138 AHPO (CLEVELAND, OH) N

22195 AIG (MAKSIN MANAGEMENT CORPORATION) N

IP080 AKM MEDICAL GROUP N

95327

ALAMEDA ALLIANCE FOR HEALTH (PROVIDER MUST CONTACT

PAYER TO BE APPROVED. CONTACT AT ALAMEDA IS ANET

QUIAMBAO AT 510-747-6153 OR

AQUIAMBAO@ALAMEDAALLIANCE.COM) N

AIPAZ ALAMITOS IPA N

91136 ALASKA CHILDRENS SERVICES, INC N

92600 ALASKA ELECTRICAL HEALTH & WELFARE FUND N

91136 ALASKA LABORERS CONSTRUCTION INDUSTRY TRUST N

91136 ALASKA PIPE TRADES LOCAL 375 N

91136

ALASKA UNITED FOOD & COMMERCIAL WORKERS HEALTH &

WELFARE TRUST N

85600 ALBUQUERQUE PUBLIC SCHOOLS N

44423 ALEXIAN BROTHERS COMMUNITY SERVICES TENNESSEE N

CCHPC ALIGNMENT HEALTH CARE N

81400 ALL SAVERS INSURANCE (UNITEDHEALTHONE) N

37602 ALL SAVERS INSURANCE CO. N

MRIPA ALLCARE HEALTHPLAN N

26158 ALLCARE PEBB N

Confidential Updated 08.30.2017

MRPEBB ALLCARE PEBB N

82238 ALLEGIAN ADVANTAGE N

55649 ALLEGIAN CHOICE N

81040 ALLEGIANCE BENEFIT PLAN MANAGEMENT, INC. N

99588 ALLEGIANCE HEALTH MANAGEMENT N

J1740 ALLEN CANNING N

23071 ALLIANCE BEHAVIORAL HEALTHCARE N

88461 ALLIANCE HEALTHPLANS OF WI N

22417 ALLIANCE PHYSICIANS HIGH DESESTT N

52149 ALLIANCE PPO INC.(NOW KNOWN AS ONENET PPO, LLC.) N

CALL

ALLIANCE, THE (ONLY FOR ID CARDS SHOWING PO BOX 44365

MADISON WI 53744 AS MAILING ADDRESS. CALL 608-210-6656

FOR PAYER ID.) N

58234 ALLIANT HEALTH PLANS OF GEORGIA N

94177 ALLIED ADMINISTRA N

37308 ALLIED BENEFIT SYSTEMS N

99030 ALOHA CARE N

ALOHA ALOHACARE Y

ACMG1 ALPHA CARE MEDICAL GROUP N

ALPHA ALPHACARE N

A0701 ALTA BATES MEDICAL GROUP N

80705 ALTA HEALTH AND LIFE INSURANCE COMPANY N

AMC11 AM CAPITOL INSURA N

AMAIA AMA INSURANCE AGENCY N

AMAIA AMA INSURANCE AGENCY, INC N

TH071 AMA INSURANCE AGENCY, INC N

13343 AMALGAMATED LIFE - PA/ALICARE N

13550 AMALGAMATED LIFE INSURANCE CO. N

Confidential Updated 08.30.2017

COMPU

AMALGAMATED TRANSIT UNION DIVISION 1001 HEALTH &

WELFARE FUND N

AMBHN AMBAY HEALTH NETWORK N

76061 AMCARE HEALTH PLA N

38219 AMERAPLAN (CLAIMS ARE PRINTED AND MAILED TO THE PAYER.) N

97661 AMERIBEN IEC GROUP N

75137 AMERIBEN SOLUTIONS N

F75137 AMERIBEN SOLUTIONS N

26078 AMERICA 1STCHO NC N

27515 AMERICAID COMMUNITY CARE (HOUSTON) N

27517 AMERICAID COMMUNITY CARE (MARYLAND) N

27516 AMERICAID COMMUNITY CARE (NEW JERSEY) N

42112 AMERICAN ADMINIST N

75240

AMERICAN ADMINISTRATIVE GROUP - AAG (FORMERLY KNOWN

AS UICI ADMINISTRATORS N

37283

AMERICAN ADMINISTRATIVE GROUP (FORMERLY GALLAGHER

BENEFIT) N

63103 AMERICAN BEHAVIOR N

34187 AMERICAN BENE MGT N

59140 AMERICAN BENEFITS PLAN ADMINISTRATORS (LAS VEGAS, NV) N

ACN01 AMERICAN CHIROPRACTIC NETWORK N

41161 AMERICAN CHIROPRACTIC NETWORK (PAN) N

ACN01 AMERICAN CHIROPRACTIC NETWORK IPA OF NY N

ACN01 AMERICAN CHIROPRACTIC NETWORK, INC. N

J1236 AMERICAN CLAIMS MANAGEMENT (ACM) N

60305 AMERICAN COMMUNIT N

ACN01 AMERICAN COMPLIMENTARY CARE NETWORK, INC. N

56071 AMERICAN FAMILY (ADMINISTERED BY AMERICAN REPUBLIC) N

IP080 AMERICAN FAMILY HEALTH PROVIDERS N

Confidential Updated 08.30.2017

TH095 AMERICAN FAMILY INSURANCE N

AMF11 AMERICAN FAMILY INSURANCE COMPANY N

60801 AMERICAN FIDELITY INSURANCE COMPANY N

62030 AMERICAN GENERAL N

66065 AMERICAN HEALTH MEDICARE N

01066 AMERICAN HEALTHCARE ALLIANCE N

77083 AMERICAN HERITAGE N

81949 AMERICAN INSURANCE COMPANY OF TX N

87726 AMERICAN INTERNATIONAL GROUP, INC. N

72099

AMERICAN LIFECARE (GROUP NUMBER REQUIRED. VALID ONLY

FOR CLAIMS WITH A BILLING ADDRESS OF 1100 POYDRAS ST.

#2600, NEW ORLEANS, LA 70163) N

81400 AMERICAN MEDICAL SECURITY N

81400 AMERICAN MEDICAL SECURITY (UNITEDHEALTHONE) N

74048 AMERICAN NATIONAL INSURANCE CO N

60739 AMERICAN NATIONAL INSURANCE COMPANY N

44444 AMERICAN POSTAL WORKERS UNION HEALTH PLAN N

42011 AMERICAN REPUBLIC INSURANCE COMPANY N

17965 AMERICAN SENTINEL INSURANCE COMPANY N

ASH01 AMERICAN SPECIALTY HEALTH Y

ATHAL AMERICAN THERAPY ADMINISTRATORS N

TH117 AMERICAN WHOLE NETWORK N

37322 AMERICAN WORKER HEALTH PLAN N

20553 AMERICAS 1ST CHOICE HEALTH PLANS OF SOUTH CAROLINA N

55349 AMERICAS 1ST CHOICE OF SC N

20029 AMERICA'S CHOICE NMA N

21810 AMERICA'S HEALTH CHOICE N

16120 AMERICA'S PPO (FORMERLY KNOWN AS ARAZ.) N

Confidential Updated 08.30.2017

41178 AMERICA'S PPO / AMERICA'S TPA N

87726

AMERICHOICE - CT, FL, MD, RI, TX, WI (UNITEDHEALTHCARE

COMMUNITY PLAN) N

87726

AMERICHOICE BY UNITEDHEALTHCARE (NYU)

(UNITEDHEALTHCARE COMMUNITY PLAN) N

87726

AMERICHOICE MS - CHIP & CAN (UNITEDHEALTHCARE

COMMUNITY PLAN) N

86047

AMERICHOICE NJ, MEDICAID, NJ FAMILY CARE

(UNITEDHEALTHCARE COMMUNITY PLAN) N

86048

AMERICHOICE NY MEDICAID & CHILD HEALTH PLUS

(UNITEDHEALTHCARE COMMUNITY PLAN) - USE PAYERID 87726 N

87726 AMERICHOICE OF FLORIDA N

87726 AMERICHOICE OF ILLINOIS N

87726 AMERICHOICE OF MARYLAND N

87726 AMERICHOICE OF NEBRASKA N

87726

AMERICHOICE OF NEBRASKA (UNITEDHEALTHCARE COMMUNITY

PLAN) N

86047 AMERICHOICE OF NJ MEDICAID & FAMILY CARE N

86048 AMERICHOICE OF NY MEDICAID & CHILD HEALTH PLUS N

86049

AMERICHOICE OF PA CHILDREN'S HEALTH INSURANCE PROGRAM

(KIDSCHOICE) N

86049 AMERICHOICE OF PA MEDICAID N

86003

AMERICHOICE OF PENNSYLVANIA PERSONAL CARE PLUS(ALL

CLAIMS SUBMITTED REQUIRE YOUR AMERICHOICE ASSIGNED

PROVIDER ID #. CONTACT THEM AT 888-362-3368 FOR YOUR ID#.) N

87726 AMERICHOICE OF RHODE ISLAND N

95378 AMERICHOICE OF TN N

86049

AMERICHOICE PA MEDICAID & CHIP (UNITEDHEALTHCARE

COMMUNITY PLAN) N

25175

AMERICHOICE PERSONAL CARE PLUS PA (UNITEDHEALTHCARE

COMMUNITY PLAN) N

Confidential Updated 08.30.2017

95378

AMERICHOICE TN: TENNCARE, SECURE PLUS COMPLETE

(UNITEDHEALTHCARE COMMUNITY PLAN) N

28804 AMERIGROUP N

28807

AMERIGROUP - MARYLAND, VIRGINIA AND DISTRICT OF

COLUMBIA N

28806 AMERIGROUP - NEW JERSEY N

28805 AMERIGROUP / AMERICAID - HOUSTON N

27514 AMERIGROUP GEORGIA N

27518 AMERIGROUP IL N

28804 AMERIGROUP IL N

28808 AMERIGROUP IL N

26375 AMERIGROUP IOWA N

26378 AMERIGROUP MULTIPLE STATES N

28809 AMERIGROUP OF FLORIDA N

27514 AMERIGROUP TENNESSEE N

93688 AMERIHEALTH - DE (PPO) Y

60061 AMERIHEALTH - NEW JERSEY (NON-HMO CLAIMS) Y

SX075 AMERIHEALTH - NJ (NON-HMO) N

54763 AMERIHEALTH ADMINISTRATORS N

27357 AMERIHEALTH CARITAS N

77075 AMERIHEALTH CARITAS IOWA N

77013 AMERIHEALTH CARITUS VIP MICHIGAN N

77051 AMERIHEALTH CONNECT N

77002 AMERIHEALTH DISTRICT OF COLUMBIA N

23037 AMERIHEALTH HMO N

95044 AMERIHEALTH HMO NEW JERSEY AND DELAWARE Y

22248 AMERIHEALTH MERCY HEALTH PLAN N

77001 AMERIHEALTH NORTHEAST N

Confidential Updated 08.30.2017

77007 AMERIHEALTH VIP CARE - DC N

22355

AMERIHEALTH VIP CARE (MEDICARE ADVANTAGE PLAN PART OF

THE AMERIHEALTH MERCY FAMILY OF COMPANIES) N

26374 AMERIKIDS-DALLAS/FT. WORTH N

26375 AMERIVANTAGE N

64090 AMFIRST INSURANCE COMPANY N

01757 AM-FIRST INSURANCE MORGAN WHITE N

24818 AMIDA CARE (FORMERLY VIDA CARE.) N

79966 AMIDA CARE MEDICARE N

IP080 AMVI N

38254 AMWAY CORPORATION N

MHIPA ANAHEIM MEMORIAL IPA (MHCAN) N

53085 ANCHOR BENEFIT CONSULTING N

J1919 ANCHOR CLAIMS MANAGEMENT N

86062 ANCILLARY BENEFIT SYSTEMS ARIZONA N

AZFMC ANCILLARY BENEFITS/ARIZONA FOUNDATION FOR MEDICAL CARE N

98205 ANERICAN FOUNDERS LIFE INS CO (NFL PLANS ONLY) N

75299 ANGELES IPA (SYNERMED) N

43101 ANPAC N

34192 ANTARES MANAGEMENT SOLUTIONS N

80705 ANTHEM HEALTH AND LIFE INSURANCE COMPANY OF NEW JERSEY N

00050 ANTHEM OF COLORADO N

34196

APEX BENEFIT SERVICES (CLAIMS MUST CONTAIN THE RENDERING

PROVIDER ID OR THE CLAIM WILL REJECT.) N

16120 ARAZ (NOW KNOWN AS AMERICA'S PPO.) N

52312 ARBOR HEALTH N

77045

ARCADIAN MANAGEMENT SERVICES, INC (GROUP NUMBER

SHOULD BE ENTERED IF AVAILABLE. ) N

ARGUS ARGUS DENTAL AND VISION N

Confidential Updated 08.30.2017

AZFMC ARIZONA FOUNDATION FOR MEDICAL CARE N

03432 ARIZONA PHYSICIANS IPA N

03432

ARIZONA PHYSICIANS IPA (APIPA) (UNITEDHEALTHCARE ARIZONA

PHYSICIANS IPA) N

74234

ARIZONA PIPE TRADES HEALTH AND WELFARE TRUST FUND LOCAL

UNION NOS. 469 & 741 METAL TRADES HEALTH PLAN N

74234

ARIZONA PIPE TRADES HEALTH AND WELFARE TRUST FUND LOCAL

UNION NOS. 469 & 741 PIPE TRADES HEALTH PLAN N

27154 ARIZONA PRIORITY CARE PLUS N

75278 ARKANSAS BEST CORPORATION N

62176 ARKANSAS MANAGED CARE ORGANIZATION (AMCO) N

95440 ARNETT HEALTH PLA N

43905 ARNOT OGDEN MEDICAL CENTER (UCS) N

WMM01 ARTA HEALTH NETWORK N

06603 ASAGEHA N

AAMG1 ASIAN AMERICAN MEDICAL GROUP N

94027 ASOCIACION DE MAESTROS N

16180 ASPEN N

46156 ASPIRE HEALTH PLAN N

38265 ASR CORPORATION N

ASRM1 ASRM CORPORATION N

FAABC ASSOCIATED BENEFITS CORP N

ATPA1 ASSOCIATED THIRD PARTY ADMINISTRATION (ATPA) N

36326 ASSOCIATES FOR HEALTHCARE N

39065 ASSURANT EMPLOYEE BENEFITS (FORMERLY FORTIS INSURANCE) N

41099 ASSURANT HEALTH - JOHN ALDEN LIFE INS. N

ASNTH ASSURANT HEALTH RE-PRICING VIA HEALTHSPAN N

37313

ASSURANT HEALTH SELF FUND (VERIFY THAT CLAIMS SHOULD GO

TO FT. MILL, SC) N

Confidential Updated 08.30.2017

75068 ASSURANT HEALTH SELF FUNDED N

75068 ASSURANT HEALTH SELF FUNDED N

88035 ASSURECARE, INC. N

74240 ASSURED BENEFITS ADMINISTRATORS N

SX179

ASURIS NORTHWEST/MEDADVANTAGE (REF*1B*PROVIDER ID IN

BILLING AND RENDERING REQUIRED EVEN WHEN NPI IS

SUBMITTED.) N

93221 ASURIS NW HEALTH N

J1914 ATHENS N

22285 ATLANTIC MEDICAL N

22304 ATLANTICARE ADMIN N

AEC01 ATLANTIS EYECARE N

ATLAD ATLAS ADMIN USAMC N

90956 ATLAS LIFE INS CO (NFIC PLAN ONLY) N

37231 ATR N

MPCHA ATRIO HEALTH PLAN (MARION POLK HEALTH PLAN ADVANTAGE) N

ATRIO ATRIO HEALTH PLANS N

MNAUL AULTCARE Y

10016 AULTCOMP MCO N

38259 AUTOMATED BENEFIT SERVICES (ABS) N

37280 AUTOMATED GROUP ADMINISTRATION, INC. N

91136

AUTOMOTIVE MACHINISTS LOCAL 289 HEALTH & WELFARE TRUST

- GRP#F32 N

AVA01 AVALON HEALTHCARE SOLUTIONS N

IP080 AVALON IPA N

AH001 AVANTE HEALTH (CUSTOMER SERVICE 559-261-9060) N

MP001 AVECTUS HEALTHCARE SOLUTIONS (CALL 855-AVECTUS) N

46045 AVERA HEALTH PLANS N

87098 AVESIS THIRD PART ADMINISTRATORS N

Confidential Updated 08.30.2017

59274 AVMED N

58204 AVMED-PARITY HEALTHCARE (OB/GYN ONLY) N

AXM01 AXMINISTER MEDICAL GROUP N

NCHON AZ INTEGRATED PHYSICIANS N

95964 AZ PACIFICARE CLA N

BKRFM BAKERSFIELD FAMILY MEDICAL CENTER N

74227 BANKERS UNITED LIFE (STUDENT DIVISION) N

SX145

BANNER HEALTH CO. (ALL BANNER HEALTH PLANS WERE

CONSOLIDATED TO THE PAYERID OF SX145.) Y

77078 BANNER MEDISUN N

65026 BAPTIST HEALTH SOUTH FLORIDA N

41204 BASIC PLUS N

84041 BASIL CASTROVINCI ASSOCIATES N

06941 BAY BRIDGE ADMINISTRATORS LLC N

59279 BAYCARE LIFE MANAGEMENT N

32002 BC MICHIGAN COMPLETE N

CALL

BCBS BLUECARE FAMILY PLAN (CONNECTICUT) TO BE USED ON ALL

CT BLUECARE CLAIMS WITH DATES OF SERVICE ON OR AFTER

7/01/06 Y

SB570 BCBS DELAWARE N

SB700 BCBS MASSACHUSETTS N

00220 BCBS MINNESOTA N

00222 BCBS MINNESOTA N

00722 BCBS MINNESOTA N

SB810 BCBS NORTH CAROLINA N

SB690 BCBS OF MARYLAND N

66001 BCBS TEXAS MEDICAID STAR CHIP N

43324

BEACON HEALTH STRATEGIES (BLOCK 11 ON THE HCFA 1500 FORM

MUST USE PLAN SPECIFIC IDS.) N

Confidential Updated 08.30.2017

95377

BEECH STREET CORP. (PAYER REQUIRES THAT PAYER AND

EMPLOYER INFORMATION IN BOX11 BE ATTACHED.) N

63100 BEHAVIORAL HEALTH SYSTEMS N

BHI00 BEHAVIORAL HEALTHCARE, INC. N

MPM10 BELLA VISTA MED GRP IPA N

37286 BENE PLAN ADMINIS N

99320

BENEFIT & RISK MANAGEMENT SERVICES (COMMERCIAL

MEDICARE UNDER MED3000) N

99320 BENEFIT & RISK MGTM SVCS N

41205 BENEFIT ADMINISTRATION SERVICES N

36149 BENEFIT ADMINISTRATIVE SYSTEMS N

51037 BENEFIT CONCEPTS N

25145 BENEFIT COORDINATORS CORPORATION N

56139 BENEFIT MANAGAEMENT SVCS N

BMATP BENEFIT MANAGEMENT ADMIN N

88092 BENEFIT MANAGEMENT LLC (VBA) N

56139

BENEFIT MANAGEMENT SERVICES (PLEASE CONTACT CHRIS BURAK

AT 704-321-3156 FOR PAYERID INFORMATION.) N

37212 BENEFIT MANAGEMENT SYSTEMS, INC OF MISSISSIPPI N

48611

BENEFIT MANAGEMENT, INC. OF KS (ONLY ACCEPTS CLAIMS FOR

THESE GROUPS

BMI187,BMI219,BMI234,BMI236,BMI214,BMI241,BMI617

BMI246,BMI246.) N

19753 BENEFIT PLAN ADMINISTRATORS N

39081

BENEFIT PLAN ADMINISTRATORS CO. (PAYER ID VALID ONLY FOR

CLAIMS WITH A BILLING SUBMISSION ADDRESS OF PO BOX 1128,

EAU CLAIRE, WI 54702-1128) N

37118 BENEFIT PLAN ADMINISTRATORS, INC N

34178 BENEFIT SERVICES (AKRON OH) N

34192

BENEFIT SERVICES, INC. (AKRON, OH) (PAYER NAME IS NOW

ANTARES MANAGEMENT SOLUTIONS) N

Confidential Updated 08.30.2017

36342 BENEFIT SYSTEMS AND SERVICES, INC. N

61425 BENEFIT TRUST LIFE INSURANCE COMPANY N

87265 BENESIGHT (FORMERLY THE TPA) N

37248 BENESYS LHP CLAIM N

38238

BENESYS, INC. (LOCATED IN TROY, MI) (NOW KNOWN AS SHEET

METAL WORKERS LOCAL 104) N

BNMK1 BENMARK N

23243 BERKSHIRE HEALTH PARTNERS N

95606 BERKSHIRE LEHIGH PARTNERS N

95604 BEST LIFE & HEALTH INSURANCE CO. N

01508 BETTER HEALTH FLORIDA N

20488

BETTER HEALTH PLAN OF FLORIDA (FOR CLAIMS REJECTIONS,

CONTACT PAYER AT 800-514-4561 AND SELECT PROVIDER

SERVICES OPTION.) N

62183 BETTER HEALTH PLANS INCORPORATED N

32006 BETTER HEALTH PLANS SOUTH CAROLINA N

POP05 BEVERLY ALIANZA IPA N

44219 BHP-UNITY N

67668 BHSF INTERNATIONAL N

BSHS1 BIENVIVIR N

CX025 BIG LOTS ASSOCIATES BENEFIT PLANS N

BVTX1 BLOCK VISION OF TEXAS N

BV001 BLOCK VISION, INC. N

ARBLS BLUE ADVANTAGE OF ARKANSAS N

ECIBB BLUE BELL BENEFITS N

CALL BLUE CARE PPO Y

00870 BLUE CHIP OF RHODE ISLAND Y

RICHP BLUE CHIP OF RHODE ISLAND N

00403 BLUE CHOICE MEDICAID N

Confidential Updated 08.30.2017

00804 BLUE CHOICE OF ROCHESTER NY Y

N6BLS BLUE CHOICE OF ROCHESTER NY N

00922 BLUE CHOICE OF SOUTH CAROLINA N

BCSAL BLUE CROSS BLUE SHIELD ALABAMA Y

53589 BLUE CROSS BLUE SHIELD OF ARIZONA Y

MC721 BLUE CROSS COMMUNITY CENTENNIAL N

MCDIL BLUE CROSS COMMUNITY OPTIONS N

66006 BLUE CROSS MEDICARE ADVANTAGE N

47198 BLUE CROSS OF CALIFORNIA N

00610 BLUE CROSS OF IDAHO Y

IDBLC BLUE CROSS OF IDAHO N

15754 BLUE GRASS FAMILY HEALTH (SRRIPA) N

IP061 BLUE LAKE RANCHERIA N

00580 BLUE SHIELD OF ALABAMA Y

00822 BLUE SHIELD OF ALASKA Y

00520 BLUE SHIELD OF ARKANSAS Y

BS001 BLUE SHIELD OF CALIFORNIA N

00805 BLUE SHIELD OF CENTRAL NY HMO/PPO Y

00060

BLUE SHIELD OF CONNECTICUT (NOTE: THE DOS IN REPORTS IS

PROGRAMMATICALLY CALCULATED AND IS NOT ACTUAL CLAIM'S

DATA. SOME VARIANCES MAY EXIST.) N

00570 BLUE SHIELD OF DELAWARE Y

00590 BLUE SHIELD OF FLORIDA N

00601 BLUE SHIELD OF GEORGIA (STATE HEALTH OF GA) Y

HIBCS BLUE SHIELD OF HAWAII Y

00611 BLUE SHIELD OF IDAHO-REGENCE Y

00621 BLUE SHIELD OF ILLINOIS N

00630 BLUE SHIELD OF INDIANA N

Confidential Updated 08.30.2017

88848 BLUE SHIELD OF IOWA Y

47163 BLUE SHIELD OF KANSAS Y

47171 BLUE SHIELD OF KANSAS CITY Y

00660 BLUE SHIELD OF KENTUCKY N

53120 BLUE SHIELD OF LOUISIANA Y

00680 BLUE SHIELD OF MAINE N

00200 BLUE SHIELD OF MASSACHUSETTS Y

00710 BLUE SHIELD OF MICHIGAN Y

00720 BLUE SHIELD OF MINNESOTA Y

00230 BLUE SHIELD OF MISSISSIPPI Y

00241 BLUE SHIELD OF MISSOURI N

BCSMT BLUE SHIELD OF MONTANA N

NCABS BLUE SHIELD OF NATIONAL CAPITAL AREA Y

77780 BLUE SHIELD OF NEBRASKA Y

00265 BLUE SHIELD OF NEVADA Y

00770 BLUE SHIELD OF NEW HAMPSHIRE N

22099 BLUE SHIELD OF NEW JERSEY Y

00790 BLUE SHIELD OF NEW MEXICO Y

00803 BLUE SHIELD OF NEW YORK (EMPIRE) N

05536 BLUE SHIELD OF NORTH CAROLINA N

00820 BLUE SHIELD OF NORTH DAKOTA Y

00800 BLUE SHIELD OF NORTHEAST NY Y

00834 BLUE SHIELD OF OHIO N

00840 BLUE SHIELD OF OKLAHOMA Y

00851 BLUE SHIELD OF OREGON Y

54771 BLUE SHIELD OF PENNSYLVANIA Y

CALL BLUE SHIELD OF PUERTO RICO (TRIPLE S) Y

Confidential Updated 08.30.2017

00870 BLUE SHIELD OF RHODE ISLAND Y

00804 BLUE SHIELD OF ROCHESTER NY (EXCELLUS) Y

SCBCS BLUE SHIELD OF SOUTH CAROLINA Y

88848 BLUE SHIELD OF SOUTH DAKOTA Y

00390 BLUE SHIELD OF TENNESSEE Y

84980 BLUE SHIELD OF TEXAS Y

TXBLS BLUE SHIELD OF TEXAS N

84980 BLUE SHIELD OF TX HCSC INSURANCE SERVICES COMPANY N

00910 BLUE SHIELD OF UTAH Y

00806 BLUE SHIELD OF UTICA NY Y

VTBCS BLUE SHIELD OF VERMONT Y

VTBLS BLUE SHIELD OF VERMONT N

00923 BLUE SHIELD OF VIRGINIA N

54828 BLUE SHIELD OF WEST VIRGINIA Y

00801 BLUE SHIELD OF WESTERN NEW YORK Y

00950 BLUE SHIELD OF WISCONSIN Y

00960 BLUE SHIELD OF WYOMING Y

WYBLS BLUE SHIELD OF WYOMING N

37121 BLUEBONNET ADMINISTRATORS N

A0016 BLUECARE FAMILY PLAN N

61124 BLUEGRASS FAMILY HEALTH N

36609 BOILERMAKERS NATIONAL HEALTH & WELFARE FUND N

BOLL1 BOLLINGER, INC. N

74238 BOON-CHAPMAN BENEFIT ADMINISTRATORS, INC. N

13337 BOSTON MEDICAL CENTER HEALTHNET N

20381 BOULDER ADMIN SVC N

48964 BPS INC N

Confidential Updated 08.30.2017

52192

BRAVO HEALTH (FORMERLY KNOWN AS ELDER HEALTH INC.

SERVING MEMBERS IN PA, MD, DE, TX AND WASHINGTON DC.) N

J1761 BRICKSTREET N

BRIDG BRIDGESPAN N

88033 BRIDGESTONE FIRES N

68069 BRIDGEWAY ARIZONA (ALSO 68054) N

BHP01 BRIGHT HEALTH PHYSICIANS N

CB186 BRIGHT HEALTH PLAN N

22286 BRITCAY N

51037 BROCKERAGE CONCEPTS, INC (BENEFIT CONCEPTS) N

59069 BROWN & BROWN BENEFITS N

94316 BROWN & TOLAND MEDICAL GROUP N

BTSS1 BROWN & TOLAND SUTTER N

BTSS1 BROWN & TOLAND SUTTERSELECT N

BTHS1 BROWN AND TOLAND HEALTH SERVICES N

68069 BUCKEYE COMMUNITY HEALTH (ALSO 32004) N

J1391 BUILDERS GROUP OF MINNESOTA N

42150 BUTLER BENEFITS N

23708 C & O EMPLOYEES HOSPITAL ASSOCIATION N

A1680 C3 HEALTH (FKA ACCESS HEALTH INC.) N

KS003 CA KAISER PERMANENTE (NORTHERN CALIFORNIA ONLY) N

CWS99 CAL WATER N

68069 CALIFORNIA HEALTH AND WELLNESS N

AMM14 CALIFORNIA IPA N

94056 CALIFORNIA PACIFIC MEDICAL CENTER N

CALOP CAL-OPTIMA DIRECT N

J1819 CAMBRIDGE INTEGRATED SERVICES N

25831 CAMERON MANUFACTURING AND DESIGN INCORPORATED (UCS) N

Confidential Updated 08.30.2017

71057

CANNON COCHRAN MANAGEMENT SERVICES, INC. LA (CLAIMS

FOR PAYER ADDRESS OF METAIRIE, LA ONLY.) N

95399 CAP MANAGEMENT N

IP080 CAP MANAGEMENT SYSTEMS N

23045

CAPITAL ADVANTAGE INSURANCE COMPANY (CAIC)

PROFESSIONAL (BCBS PROVIDERID AND PERFORMING PROVIDERID

REQUIRED. CALL 800-874-8433) N

24705 CAPITAL BC PENNSYLVANIA N

23045

CAPITAL BLUE CROSS PROFESSIONAL (BCBS PROVIDERID AND

PERFORMING PROVIDERID REQUIRED. CALL 800-874-8433) Y

SX065 CAPITAL DISTRICT PHP N

95112 CAPITAL HEALTH PLAN N

65067 CAPITAL INTERNATIONAL MANAGEMENT SERVICES N

68011 CAPITOL ADMINISTRATORS N

CAPHP CAPROCK HEALTH PLAN N

CAPH2 CAPROCK HEALTH PLANS VERITY N

86044 CAPSTONE HEALTH P N

GCVCP CARDIOVASCULAR CARE PROVIDERS N

57116 CARE 1ST HEALTH PLAN OF ARIZONA N

57115 CARE 1ST HEALTH PLAN OF CA N

HM037 CARE CHOICES HMO N

14182 CARE CORE NATIONAL N

77082 CARE IMPROVEMENT PLUS N

37228 CARE N CARE N

65031 CARE PLUS N

41222 CARE TO CARE N

27004 CARE WISCONSIN HEALTH PLAN (TRIZETTO) N

57721 CAREATC N

11345 CARECENTRIX Y

Confidential Updated 08.30.2017

14188 CARECORE NATIONAL WELLCARE N

14179 CARECORE NATIONAL, LLC (AETNA RADIOLOGY CLAIMS) N

14180

CARECORE NATIONAL, LLC (RADIOLOGY CHARGES FOR OXFORD)

(PROVIDER MUST CALL ANTHONY SAMPSON AT 845-298-8155 FOR

PROVIDER CODE.) N

SB580 CAREFIRST BCBS - DC, NATIONAL CAPITAL AREA Y

25139 CARELINK N

25140 CARELINK MEDICAID N

CM001 CAREMORE N

CARMO CAREMORE IPA N

CARMO CAREMORE VALUE PLUS (CVP) N

25142

CARENET OF VIRGINIA (PREPARE TO USE CONSOLIDATED

COVENTRY PAYERID OF 25133.) N

93975 CAREOREGON, INC. N

95092 CAREPLUS N

NCH04 CAREPLUS CARDIOLOGY - NEW CENTURY HEALTH N

77023 CAREPOINT HEALTH PLAN N

26160 CARESOURCE N

31114 CARESOURCE N

MRCHP CARESOURCE HEALTH PLAN OF OREGON N

INCS1 CARESOURCE IN N

KYCS1 CARESOURCE KY N

37311 CARESOURCE OF IND N

WVCS1 CARESOURCE WEST VIRGINIA N

10010 CAREWORKS N

J1866

CAREWORKS CONSULTANTS INCORPORATED (CAREWORKS USA

AND CCI) N

29076

CAROLINA CARE PLAN (PART OF THE MEDICAL MUTUAL FAMILY OF

COMPANIES. FORMER PAYERID WAS 57105.) N

Confidential Updated 08.30.2017

SX191 CAROLINA CRESCENT N

68069 CAROLINA CRESCENT (ALSO 68055) N

56195 CAROLINA SUMMIT HEALTHCARE, INC N

COMPU CARPENTERS' AND MILLWRIGHTS' HEALTH BENEFIT TRUST FUND N

CX101 CARPENTERS HEALTH AND WELFARE FUND OF PHILADELPHIA N

COMPU

CARPET, LINOLEUM AND RESILIENT TILE LAYERS HEALTH AND

WELFARE FUND N

CAS01 CASCADE EAST HEALTH PLAN N

37060 CATERPILLAR INCORPORATED N

03036 CBA BLUE N

52132 CBA, INC. (COOPERATIVE BENEFITS ADMINISTRATORS, INC.) N

55438 CBCA FORT WORTH N

56215 CBHA CAROLINA BEHAVIORAL HEALTH ALLIANCE N

31158 CBIZ BENEFITS N

65391 CBNHP HEALTH CHOICES N

41124 CBSA (CORPORATION BENEFIT SERVICES OF AMERICA) N

J1900 CC DEVELOPMENT GROUP INCORPORATED N

06541 CCHS N

CCMC1 CCMC - COMPREHENSIVE CARE MANAGEMENT CORP N

CALL CCS (AKA COMPREHENSIVE CARE SYSTEMS) Y

MNBLS CCS (AKA COMPREHENSIVE CARE SYSTEMS) N

CCStpa CCSTPA COMPREHENSIVE CARE SERVICES N

87065 CDO TECHNOLOGIES N

88022 CDS GROUP HEALTH N

SISCO CEDAR VALLEY COMMUNITY HEALTH PLAN N

95166 CEDARS-SINAI MEDICAL NETWORK SERVICES CLAIMS N

95167 CEDARS-SINAI MEDICAL NETWORK SERVICES ENCOUNTERS N

68063 CELTIC INSURANCE N

Confidential Updated 08.30.2017

CELTC CELTIC INSURANCE N

68069 CELTICARE N

91136

CEMENT MASONS & PLASTERERS HEALTH & WELFARE TRUST -

GRP#F16 N

95386 CENCAL HEALTH N

68068 CENPATICO - MULTIPLE STATES N

68048

CENPATICO BEHAVIORAL HEALTH AZ (PRIOR TO SUBMISSION,

CONTACT 866-495-6748 TO VERIFY PROVIDER ID.) N

68068 CENPATICO KANSAS N

36474 CENTEGRA HEALTH SYSTEM N

68069 CENTENE ADVANTAGE PLANS (ALSO 68056) N

94312 CENTER FOR ELDERS INDEPENDENCE N

POP01 CENTER IPA N

13357 CENTERCARE N

13360 CENTERLIGHT HEALTHCARE INC. N

56122 CENTERPOINT HUMAN SERVICES N

IP080 CENTINELA IPA N

MPM03 CENTINELA VALLEY IPA N

66698 CENTRACARE N

31118 CENTRAL BENEFIT NATIONAL N

31118 CENTRAL BENEFITS LIFE AKA HEALTHSCOPE BENEFITS N

31118 CENTRAL BENEFITS MUTUAL N

CALL

CENTRAL CALIFORNIA ALLIANCE (CALL THE EDI SUPPORT UNIT AT

800-700-3874 X5510 TO OBTAIN PAYERID.) N

SX169 CENTRAL CALIFORNIA ALLIANCE FOR HEALTH N

NWADM

CENTRAL CALIFORNIA ELECTRICIAL WORKERS HEALTH AND

WELFARE TRUST N

WH001 CENTRAL CALIFORNIA WOMENS HEALTH N

CHCPI CENTRAL HEALTH MEDICARE N

Confidential Updated 08.30.2017

34097 CENTRAL RESERVE LIFE N

62218 CENTRAL SENIOR CARE N

CIPA1 CENTRAL SENIOR CARE N

36215

CENTRAL STATES SOUTHEAST AND SOUTHWEST AREAS HEALTH

AND WELFARE AND PENSIONS FUNDS N

55731 CENTRAL SUSQUEHANNA HEALTHCARE PROVIDERS (CSHP) N

42140 CENTURION N

36393 CENTURY PHO N

23171 CHA - COMMONWEALTH HEALTH ALLIANCE N

99795 CHAMPION CHEVROLET N

84146

CHAMPVA-HAC (CHAMPVA-HAC IS NOT ASSOCIATED WITH AND

DOES NOT PROCESS CLAIMS FOR TRICARE (FORMERLY

CHAMPUS.)) N

95748 CHARTERED HEALTH PLAN (DC CHARTERED HEALTH PLAN) N

CHAT1 CHATWINS HEALTHCARE ADMINISTRATORS C N

16600 CHAUTAUQUA COUNTY HEALTH PLAN (MAYVILLE,NY) N

J1908 CHESAPEAKE INSURANCE N

94321

CHILDREN FIRST MEDICAL GROUP (FOR QUESTIONS REGARDING

CLAIM STATUS, PROVIDERS WILL NEED TO CONTACT PAYER: CFMG

PROVIDER CUSTOMER SERVICE 510-428-3154) N

39113 CHILDREN'S COMMUNITY HEALTH PLAN N

251CC CHILDRENS COMMUNITY HEALTH PLAN WISCONSIN N

CMCHP CHILDRENS MEDICAL CENTER HEALTH PLAN N

CSSD2 CHILDRENS SPECIALIST OF SAN DIEGO II N

94302

CHINESE COMMUNITY HEALTH PLAN (UNIQUE PROVIDER ID MUST

BE ON CLAIM.) N

CHIPA CHIPA - COLLEGE HEALTH IPA N

ACN01 CHIROCARE N

33070 CHIROMETRICS INCORPORATED N

CASD1 CHIROPRACTIC ASSOCIATION OF SOUTH DAKOTA N

Confidential Updated 08.30.2017

DAKCH CHIROPRACTIC ASSOCIATION OF SOUTH DAKOTA N

LNDMK

CHIROPRACTIC CARE OF MINNESOTA, INC. (FOR DATES OF SERVICE

BEFORE 1-01-08, CONTINUE TO USE PAYERID OF ACN01.) N

ACN01 CHIROPRACTIC CARE OF WISCONSIN, INC. N

U1439 CHIROPRACTIC HEALTH PLAN (CHP) N

33065

CHOC - CHILDRENS HOSPITAL OF ORANGE COUNTY HEALTH

ALLIANCE N

CPNFC CHOICE PHYSICIANS NET FIRST CHOICE N

POP03 CHOICEONE IPA N

39112

CHP/RPU (FABOH) (FACILITY PHYSICAL ADDRESS REQUIRED ON

CLAIM.) N

UH138 CHP/WISE N

38308 CHRISTIAN BROTHERS SERVICES N

59355 CHRISTIAN CARE MINISTRIES N

75544 CHRISTIE STUDENT HEALTH PLANS N

10629 CHRISTUS HEALTH MEDICARE ADVANTAGE N

21062 CHRISTUS HEALTH NEW MEXICO HIX N

45210 CHRISTUS HEALTH PLAN MEDICAID N

52106 CHRISTUS HEALTH PLAN TEXAS HIX N

SPOHN CHRISTUS SPOHN HEALTH NETWORK N

C1052 CHUBB AND SON N

62308 CIGNA - PPO N

MCCBV

CIGNA BEHAVIORAL HEALTH (WE WILL ALSO ACCEPT PID SX071

FOR THESE CLAIMS: USE OF EITHER ID ACCOMPLISHES THE SAME

ROUTING.) Y

62308 CIGNA HEALTH PLAN - HMO N

86033 CIGNA HEALTHCARE FOR SENIORS - ARIZONA MEDICARE N

62308 CIGNA PREMIER PLUS N

46871 CINNCINNATI FINANCIAL CORPORATION N

Confidential Updated 08.30.2017

10207 CITRUS HEALTH CARE N

IP055 CITRUS VALLEY PHYSICIANS GROUP N

J1885 CITY AND COUNTY OF SAN FRANCISCO (CCSF) N

74234 CITY OF AUSTIN N

J1928 CITY OF CHARLOTTE N

J1901 CITY OF RIALTO CALIFORNIA N

CLFR2 CL FRATES N

CCMMH CLACKAMAS COUNTY MENTAL HEALTH N

43056 CLAIMS DEVELOPMENT CORPORATION N

11752 CLAIMSBRIDGE HPN N

57080 CLAIMSWARE, INC. DBA MANAGEMED N

95444 CLARIAN HEALTH PLANS N

77201 CLEARCHOICE HEALT N

41201 CLIENT FIRST N

24585 CLIFTON HEALTH SYSTEMS DBA ACTIN CARE GROUPS N

CDCR1 CLINCAS DEL CAMINO REAL N

CRGMN CLINICAL RESOURCE GROUP N

CSI001 CLINICAL SPECIALTIES INCORPORATED N

CSI01 CLINICAL SPECIALTIES INCORPORATED N

M3FL0012 CMS MMA SPECIALTY PLAN N

CHCNT CNIC HEALTH SOLUTIONS, INC. N

COFHP CO SECURE HORIZON N

J1902 COACHELLA VALLEY WATER DISTRICT (CALIFORNIA) N

77052 COASTAL ADMINISTRATIVE SERVICES N

A0004 COASTAL CARE N

CCPN1 COASTAL COMMUNITIES PHYSICIAN NETWORK (CCPN) N

LIPAZ COASTAL HEALTHCARE MANAGEMENT N

Confidential Updated 08.30.2017

43141 COASTALCARE (DOS PRIOR TO 7 1 2015) N

38335 COFINITY (FORMERLY SLOANS LAKE) N

SLOAN COFINITY (FORMERLY SLOANS LAKE) N

37123 COLONIAL HEALTHCA N

22284 COLONIAL MEDICAL N

84129 COLORADO ACCESS N

COACC COLORADO ACCESS HMO N

H0657 COLORADO CHOICE HEALTH N

49718 COLORADO HEALTH INSURANCE COOPERATIVE N

COKSR COLORADO KAISER PERMANENTE (COLORADO PLANS ONLY) Y

COMPU COLORADO LABORERS HEALTH AND WELFARE FUND N

CHP02 COLUMBINE HEALTH PLAN N

CHP02 COLUMBINE HEALTH PLAN N

62149 COMM HEALTHNET CT N

32481 COMM PREMIER PLUS N

34181 COMMERCE BENEFITS GROUP N

88091 COMMERCIAL TRAVELERS N

77170 COMMON GROUND HEALTHCARE COOPERATIVE N

37237 COMMONWEALTH ADMINISTRATIVE GROUP N

14315 COMMONWEALTH CARE ALLIANCE N

17902 COMMUNITY CARE ASSOCIATES N

25179

COMMUNITY CARE BEHAVIORAL HEALTH ORG. (FOR DATES OF

SERVICE PRIOR TO OCTOBER 1, 2007) N

23282

COMMUNITY CARE BHO (FOR DATES OF SERVICE AFTER OCTOBER

1, 2007) N

AMM12 COMMUNITY CARE IPA N

73143

COMMUNITY CARE MANAGED HEALTH CARE PLANS OF

OKLAHOMA N

39126 COMMUNITY CARE ORGANIZATION N

Confidential Updated 08.30.2017

00330 COMMUNITY CARE PL N

95192 COMMUNITY CONNECT MEDICAID N

CECVP COMMUNITY EYE CARE N

COMMF COMMUNITY FIRST N

35193 COMMUNITY HEALTH ALLIANCE N

27905 COMMUNITY HEALTH ALLLIANCE TN N

CHCN1 COMMUNITY HEALTH CENTER NETWORK N

48145

COMMUNITY HEALTH CHOICE (PLEASE INCLUDE TPI NUMBER

(TEXAS MEDICAID NUMBER) IN FIELD FA0-23) N

75261 COMMUNITY HEALTH ELECTRONIC CLAIMS/CHEC/WEBTPA N

66170 COMMUNITY HEALTH GROUP N

95376 COMMUNITY HEALTH GROUP N

60495 COMMUNITY HEALTH PLAN INCORPORATED N

CHPWA COMMUNITY HEALTH PLAN OF WA N

SB613 COMMUNITY HEALTH PLAN OF WASHINGTON N

CMGWV COMMUNITY MEDICAL GROUP OF THE WEST VALLEY N

66121

COMMUNITY MEDICAL GROUP OF THE WEST VALLEY

INCORPORATED N

J1925 COMP WEST N

J1829 COMPANION PROPERTY AND CASUALTY INSURANCE COMPANY N

37297 COMPBENEFITS CORP N

34177 COMPENSATION PROGRAMS OF OHIO, INC. N

23296 COMPFIRST, LLC N

CHP01 COMPLEMENTARY HEALTHCARE PLAN N

93101 COMPLEMENTARY HEALTHCARE PLANS N

15243 COMPMANAGEMENT HEALTH N

10005 COMPMGMT HEALTH SYSTEMS N

59314 COMPREHENSIVE BEH N

Confidential Updated 08.30.2017

03036

COMPREHENSIVE BENEFITS ADMINISTRATOR, INC. (NOW KNOWN

AS CBA BLUE.) N

00720 COMPREHENSIVE CARE SERVICES (BCBSMN) N

M0166 COMPREHENSIVE MEDICAL/VISION PROGRAM AZ N

37363 COMPSYCH N

74234 COMPUSYS INCORPORATED (NEW MEXICO) N

74234 COMPUSYS INCORPORATED OF ARIZONA N

COMPU COMPUSYS INCORPORATED OF COLORADO N

74234 COMPUSYS INCORPORATED OF UTAH N

COMPU COMPUSYS OF COLORADO N

74234 COMPUSYS/ERISA GROUP, INCORPORATED (AZ) N

74234 COMPUSYS/ERISA GROUP, INCORPORATED (NM) N

74234 COMPUSYS/ERISA GROUP, INCORPORATED (TX) N

33632 CONCORDIA CARE INC N

CB268 CONERSTONE PREFERRED RESOURCES N

80705 CONFEDERATION ADMIN SERVICES N

80705 CONFEDERATION LIFE INSURANCE N

78375 CONNECTICARE - MEDICARE N

06105 CONNECTICARE, INC. N

37307 CONNECTICUT CARPENTERS HEALTH FUND N

37135 CONSOCIATE GROUP N

75284 CONSOLIDATED ASSOCIATES RAILROAD N

59140 CONSOLIDATED GROUP N

87843 CONSOLIDATED HEALTH PLANS N

L0260 CONSTELLATION HEALTH N

19046 CONSTITUTION STATE / TRAVELERS N

58112 CONSUMER MUTUAL OF MICHIGAN N

45321 CONSUMERS CHOICE HEALTH SC N

Confidential Updated 08.30.2017

08680 CONTAINER GRAPHICS CORPORATION N

CH101 CONTESSA HEALTH SECURITY HEALTH PLAN N

71404 CONTINENTAL GENERAL INSURANCE CO. N

35315 CONTINENTAL KEY N

55544 CONVERSION PLAN APWU N

CCHP1 COOK CHILDREN'S HEALTH PLAN N

CCHP9 COOK CHILDREN'S STAR PLAN N

35149 COOK GROUP HEALTH PLAN N

35199 COOPERATIVE MANAGED CARE SERVICES N

HPAMN COOPORTUNITY HEALTH N

14829 COORDINATED BENEFIT PLAN N

58204 COORDINATED MEDICAL SPECIALISTS (CMS) N

58231 CORE ADMINISTRATIVE SERVICES N

47165 CORE BENEFITS MULTIMATIC TENNESSEE LLC N

23274 CORE VALUE (PART OF GETTYSBURG HEALTH.) N

35187 CORESOURCE N

75136

CORESOURCE LITTLE ROCK (FOR CLAIMS WHERE THE 'SUBMIT

CLAIMS TO ADDRESS' ON THE MEDICAL ID CARD IS AN ADDRESS IN

LITTLE ROCK. FOR ASSISTANCE, CALL 800-689-0106) N

35182 CORESOURCE OF ILLINOIS Y

35182 CORESOURCE OF IOWA Y

35182 CORESOURCE OF MARYLAND Y

35180

CORESOURCE OF NORTH CAROLINA (START USING NEW PAYERID

OF 35182. OLD PAYERID WILL START REJECTING SOON.) N

35183 CORESOURCE OF OH N

35182 CORESOURCE OF PENNSYLVANIA Y

41045

CORESTAR AZ MN (START USING NEW PAYERID OF 35182. OLD

PAYERID WILL START REJECTING SOON.) N

Confidential Updated 08.30.2017

CORIZ

CORIZON HEALTH INC.(CLAIMS WITH ADDRESS OF

BRENTWOOD,TN SHOULD BE SUBMITTED TO THIS PAYER ID.) N

35202 CORNERSTONE BENEFIT ADMINISTRATORS N

64270 CORPORATE PLAN MANAGEMENT INCORPORATED N

CCIHC

CORRECTCARE INTEGRATED HEALTH (CA PRISON HEALTH CARE

SERVICES) N

CCIH

CORRECTCARE INTEGRATED HEALTH (CALIFORNIA PRISON

HEALTHCARE) N

CCIHJAIL CORRECTCARE INTEGRATED HEALTH (NON-LOUISIANA JAILS) N

PHPMC CORRECTION HEALTH PARTNERS N

43160 CORRECTIONAL MEDICAL SERVICES N

62553 COUNTRY LIFE N

42139 COUNTY CARE N

60827 COUNTY CARE (USE PAYERID 42139) N

42138 COUNTY CARE BEHAVIORAL HEALTH TPA N

A0005 COUNTY MEDICAL SERVICES PROGRAM N

CALL COVA (COMMONWEALTH OF VA) Y

58102 COVENANT ADMINISTRATORS, INC. N

CMSEB COVENANT MANAGEMENT SYSTEMS EMPLOYEE BENEFIT PLAN N

25133

COVENTRY HEALTH CARE (COVENTRY OLD LEGACY PAYER ID'S ARE

STILL ACCEPTED.) N

25132 COVENTRY HEALTH CARE IOWA N

25135 COVENTRY HEALTH CARE LOUISIANA N

25136 COVENTRY HEALTH CARE LOUISIANA N

25127 COVENTRY HEALTHCARE GEORGIA N

128FL COVENTRY HEALTHCARE OF FL N

CHCNT COVERCOLORADO N

00019

COX HEALTH PLAN (REQUIRES PROVIDER ID IN BOX 33A. CONTACT

COX HEALTH PLAN FOR ID.) N

Confidential Updated 08.30.2017

10014 CRA MANAGED CARE N

64068 CREATIVE MEDICAL SYSTEMS N

37320 CREATIVE PLAN ADMINISTRATORS N

56213 CRESCENT HEALTH SOLUTIONS N

CALL

CRESCENT PPO HEALTH SOLUTIONS.(PLEASE REGISTER AT

WWW.CRESCENTHS.COM PRIOR TO SUBMISSION. SELECT CLAIMS

BELOW THE CRESCENT LOGO. THEY WILL SUPPLY THE PAYID.) N

80705 CROWN LIFE N

46120 CRYSTAL RUN HEALTH PLANS N

34186 CSI NETWORK SERVICES N

27136 CSI OF MICHIGAN N

42141 CTI ADMINISTRATORS INC N

59140 CULINARY HEALTH & WELFARE FUND (LAS VEGAS, NV) N

82056 CUSTOME DESIGN BENEFITS, INC. N

25172

D. H. EVANS AND ASSOCIATES (CALL JESSICA PICARDE @ 410-349-

3222 BEFORE SENDING THIS PAYERID.) Y

DAK01 DAKOTACARE N

06172 DART CONTAINER CO N

CB897 DART MEMBER CARE N

CB987 DART MEMBER CARE N

00157 DAVIS VISION N

DCHSF DCHS MEDICAL FOUNDATION N

VMF01 DCHS MEDICAL FOUNDATION N

DEAN1 DEAN HEALTH PLAN Y

64159 DEFINITY HEALTH N

87726 DEFINITY HEALTH PLAN (UNITEDHEALTHCARE) N

87726 DEFINITY SERVICES N

77124 DELANO IPA N

63081 DELAWARE HEALTH PLAN CONSORT N

Confidential Updated 08.30.2017

DCHPMCAID DELL CHILDRENS HEALTH PLAN N

74272 DELL CHILDREN'S HEALTH PLAN N

94235 DELTA HEALTH N

DHS01 DELTA HEALTH SYSTEMS N

AMS01 DENTEMAX N

AMS01 DENTEMAX/DPI (MI) N

84134 DENVER HEALTH - INDIGENT N

84133 DENVER HEALTH AND HOSPITAL AUTHORITY N

84135 DENVER HEALTH MEDICAL PLAN N

84131 DENVER HEALTH MEDICAL PLAN, INC. - MEDICARE CHOICE N

J1438 DEPARTMENT OF LABOR N

58204

DERMATOLOGY NETWORK SOLUTIONS BCBS FOR THE HEALTH

OPTIONS HMO (PAYER REQUIRES 11 DIGIT MEMBER ID NUMBER) N

58204

DERMATOLOGY NETWORK SOLUTIONS, LLC BCBS (PAYER

REQUIRES 11 DIGIT MEMBER ID NUMBER) N

58204

DERMATOLOGY NETWORK SOLUTIONS, LLC HUMANA (PAYER

REQUIRES 11 DIGIT MEMBER ID NUMBER) N

58204

DERMATOLOGY NETWORK SOLUTIONS, LLC VISTA (PAYER

REQUIRES 11 DIGIT MEMBER ID NUMBER) N

SX105 DESERET MUTUAL Y

PPM01 DESERT FAMILY PRACTICE ASSOCIATION N

DVMC1 DESERT VALLEY MEDICAL GROUP N

56240 DETROIT MEDICAL CENTER N

DWMH0 DETROIT WAYNE MENTAL HEALTH AUTHORITY N

25160 DGA - DIVERSIFIED GROUP ADMINISTRATORS N

23706 DGA PRODUCER HP N

36439 DIATRI LLC N

PROH4 DIGNITY HEALTH INLAND EMPIRE N

HOSH4 DIGNITY HEALTH INLAND EMPIRE HIGH RISK N

Confidential Updated 08.30.2017

HOSH1 DIGNITY HEALTH SACRAMENTO HOSPITAL SHOP FOR MERCY MED N

PROH2 DIGNITY HEALTH SEQUOIA PHYS N

PROH1 DIGNITY HEALTH WOODLAND CLINIC N

DCA62 DIRECT CARE ADMINISTRATORS N

BC001 DIRECTORS GUILD OF AMERICA N

06102 DIVERSIFIED GROUP BROKERAGE N

SX105 DMBA AKA MISSIONARY MEDICAL Y

16003

DMERC REGION A (TESTING IS REQUIRED FOR CLAIMS REQUIRING

CMNS.) Y

17003

DMERC REGION B (TESTING IS REQUIRED FOR CLAIMS REQUIRING

CMNS.) Y

18003

DMERC REGION C (TESTING IS REQUIRED FOR CLAIMS REQUIRING

CMNS.) Y

19003

DMERC REGION D (TESTING IS REQUIRED FOR CLAIMS REQUIRING

CMNS.) Y

77044 DOLABOR BLACK LUN N

DOLMG DOLTON MEDICAL GROUP N

DNLY1 DONLEY & COMPANY N

APP01 DOWNEY SELECT IPA (APPLECARE MEDICAL MGMT) N

DREYR DREYER MEDICAL N

74284 DRISCOLL CHILDRENS HEALTH PLAN N

74284 DRISCOLL CHILDRENS HEALTH PLAN (CHIP) N

35186 DUNN AND ASSOCIATES BENEFITS N

34108 E.S. BEVERIDGE AND ASSOCIATES N

75232 E3 HEALTH, INC (FORMERLY FIRST INTEGRATED HEALTH) N

36434 EARLY INTERVENTION CENTRAL BILLING N

IP130 EAST BAY MEDICAL NETWORK N

56089 EAST CAROLINA BEHAVIORAL HEALTH N

23861 EASTERN IOWA COMMUNITY HEALTHCARE (EICH) N

Confidential Updated 08.30.2017

66122 EASTLAND MEDICAL GROUP N

EMG11 EASTLAND MEDICAL GROUP N

J1903 EASTMAN KODAK COMPANY N

08044 EASTPOINTE N

24770 EASY CHOICE HEALTH PLAN OF NY N

CALL EBC INC. (TO OBTAIN THE PAYERID, PLEASE CALL (440) 262-1160) N

EV001 EBERLE VIVIAN N

CX025 EBMC N

81039 EBMS (EMPLOYEE BENEFIT MANAGEMENT SERVICES, INC) N

22521 EDS HEALTHCHOICE N

SX110

EDUCATORS MUTUAL (EMIA) (ENROLLMENT REQUIRED, CONTACT

EMIA TO ENROLL 800-362-0533, OPT. 2) Y

73288 EHI (EMPLOYERS HEALTH INSURANCE) N

EPF03 EL PASO FIRST - CHIP N

MPM04 EL PROYECTO DEL BARRIO IPA N

52192

ELDER HEALTH MARYLAND HMO INC. (NOW KNOWN AS BRAVO

HEALTH.) N

04326 ELDER SERVICE PLAN OF THE NORTH SHORE. N

31625

ELDERPLAN, INC. (ELDERPLAN PROVIDER ID NECESSARY ON ALL

CLAIMS. CONTACT (718)921-7979 FOR PROVIDER ID.) N

ECISF ELLIS CONSULTANTS N

NAELM ELMCARE N

NAELM ELMCARE L.L.C. N

37253 ELMCO N

22120 ELMIRA SAVINGS BANK (UCS) N

34167 EMERALD HEALTH NETWORK N

34167 EMERALD HEALTH NETWORK, INC. (ALL HMO BUSINESS) N

34555 EMERALD HMO N

Confidential Updated 08.30.2017

95600

EMERGENCY MEDICAL SERVICES FUND (ORANGE COUNTY

CALIFORNIA) N

65062 EMI (EYE MANAGEMENT INC) N

59299 EMI KP AMBULANCE CLAIMS N

41198 EMP BENE SVCS LA N

EMP01 EMPIRE PHYSICIAN'S MEDICAL GROUP N

87726 EMPIRE PLAN (UNITEDHEALTHCARE) N

95288 EMPLOYEE BENEFIT ADMINISTRATION & MANAGEMENT (EBA&M) N

38241 EMPLOYEE BENEFIT CONCEPTS N

CALL

EMPLOYEE BENEFIT CONSULTANTS, INC. (CALL (440) 262-1160 FOR

PAYERID.) N

37215 EMPLOYEE BENEFIT CORPORATION N

31074 EMPLOYEE BENEFIT MANAGEMENT CORP. N

SX182 EMPLOYEE BENEFIT MANAGEMENT SYSTEM (EBMS) N

SC446 EMPLOYEE BENEFIT SERVICES DBA KEY BENEFIT ADMINISTRATORS Y

60221 EMPLOYEE BENEFIT SERVICES INCORPORATED (EBSI) N

EBSSA EMPLOYEE BENEFIT SVCS (EBS) OF SAN ANTONIO N

42149 EMPLOYEE BENEFIT SYSTEM N

37216 EMPLOYEE BENEFIT SYSTEMS N

03036

EMPLOYEE BENEFITS PLAN ADMINISTRATION, INC. (EBPA) (NOW

KNOWN AS CBA BLUE.) N

75184 EMPLOYEE CLAIM ADJUDICATION SERVICES N

92135 EMPLOYEE LOGISTICS N

35112 EMPLOYEE PLANS, LLC N

21415 EMPLOYEES MUTUAL (EMC) N

48888 EMPLOYER DIRECT HEALTHCARE N

74212 EMPLOYER PLAN SERVICES, INC. N

27008 EMPLOYERS COALITION ON HEALTH (ECOH) N

75236 EMPLOYERS DIRECT HEALTH - EMPLOYEE PLAN N

Confidential Updated 08.30.2017

75235 EMPLOYERS DIRECT HEALTH - FI N

75233 EMPLOYERS DIRECT HEALTH - SF N

27008 EMPLOYERS HEALTH COOPERATIVE (EHC) N

J1912 EMPLOYERS INSURANCE (BUNCH) N

37249 EMPLOYERS LIFE IN N

59298 EMPLOYERS MUTUAL, INC. (FLORIDA PROVIDERS ONLY) N

35206

ENCORE HEALTH NETWORK (NOTE: GROUP POLICY NUMBER IN

HCFA BOX 11 IS REQUIRED.) N

36364 ENH MEDICAL GROUP IPA N

91136 ENSTAR NATURAL GAS - GRP# P61 N

36878 ENTRUST N

EPNSH EPN - SETON HEALTH PLAN EXCLUSIVE (PROVIDER ID REQUIRED) N

62308 EQUICOR N

62308 EQUICOR - PPO N

73126 EQUITABLE PLAN SERVICES N

23250

ERIN GROUP ADMINISTRATORS (NOW KNOWN AS SIGNIFICA

BENEFIT SERVICES, INC.) N

74234 ERISA ADMINISTRATIVE SERVICES INCORPORATED N

74234 ERISA ADMINISTRATIVE SERVICES, INC. N

57082 ESSENCE HEALTHCARE N

87726 EVERCARE SPECIAL NEEDS (EVERCARE BY UNITEDHEALTHCARE) N

87726 EVERCARE STAR PLUS N

35605 EVERENCE N

93240 EVERGREEN HEALTH COOPERATIVE N

58233 EVERGREEN HLTH PL N

59313 EVOLUTIONS HEALTHCARE N

22344 EXCEEDENT LLC N

IP080 EXCEPTIONAL CARE MEDICAL N

Confidential Updated 08.30.2017

EC999 EXCLUSIVE CARE - COUNTY OF RIVERSIDE N

BVES1

EYE SPECIALISTS (PROVIDER ID NUMBER REQUIRED IN BOX33A OR

BOX24J) N

31165 EYEMED N

63740 EYEQUEST N

95432 FACEY MEDICAL FOUNDATION N

37300 FACS GROUP N

J1884 FAIRFAX COUNTY GOVERNMENT N

FT254 FALLON (TRANSPLANT CLAIMS) N

22254 FALLON COMMUNITY HEALTH N

45559 FALLON TOTAL CARE N

60995 FAMILY CARE - MILWAUKEE WI N

PHD01

FAMILY CARE CCO (ADMIN BY PH TECH. USE FOR CLAIMS WITH

DOS OF 08/01/2012 AND LATER.) N

FCD01

FAMILY CARE MEDICAID (ADMIN BY PH TECH USE FOR CLAIMS

WITH DOS OF 07/31/2012 AND PRIOR.) N

FCM01 FAMILY CARE MEDICAID MENTAL HEALTH N

PHR01

FAMILY CARE MEDICARE (ADMIN BY PH TECH. USE FOR CLAIMS

WITH DOS OF 01/01/2013 AND LATER.) N

IP080 FAMILY CHOICE MEDICAL N

IP080 FAMILY HEALTH ALLIANCE N

85468 FAMILY HEALTH NETWORK N

43173 FAMILY HEALTH PARTNERS/MC+MISSOURI N

36396 FAMILY MEDICAL NETWORK N

93121 FAMILYCARE COORDINATED CARE ORGANIZATION N

FCS01 FAMILYCARE SPECIALIST MEDICAL GROUP N

14140 FARM FAMILY N

J1830 FCCI N

33033 FCE BENEFIT ADMINISTRATORS N

Confidential Updated 08.30.2017

C2BLS FEDERAL EMPLOYEE PROGRAM (CONNECTICUT) N

CALL FEDERAL EMPLOYEE PROGRAM (CONNECTICUT) N

41041 FEDERATED MUTUAL INSURANCE N

J1909 FFVA MUTUAL INSURANCE N

11315 FIDELIS CARE NEW YORK N

77054 FIDELIS SECURE CARE N

FDNYP FIRE DEPT CITY NEW YORK WORLD TRADE CENTER HEALTH PLAN N

FAMR1 FIRST ADMIN SD N

88055 FIRST AGENCY N

FSTAG FIRST AGENCY N

56196 FIRST CAROLINA CARE N

91131 FIRST CHOICE HEALTH NETWORK N

FCMG1 FIRST CHOICE MEDICAL GROUP N

75138 FIRST CHOICE OF MIDWEST (PPO) N

37510 FIRST CHOICE VIP CARE N

77009 FIRST CHOICE VIP CARE PLUS SC. N

80705 FIRST GREAT-WEST LIFE & ANNUITY N

87043 FIRST HEALTH N

73159 FIRST HEALTH NETWORK N

23241 FIRST PRIORITY N

87726 FIRST SENIORITY FREEDOM N

59276 FIRST SERVICE ADMINISTRATORS N

MC104 FIRST SERVICES MEDICAID N

FS802 FIRST SOLUTION Y

63080 FIRST STATE HEALT N

94999 FIRSTCARE N

94998 FIRSTCARE STAR MEDICAID N

Confidential Updated 08.30.2017

11244 FITZHARRIS & COMPANY N

95411 FL MCO PHC/PHP N

95411 FL MCO PHC/PHP N

95411 FL MCO PHC/PHP N

59276 FLORIDA 1ST - WINTERHAVEN, FLORIDA N

J1910 FLORIDA FRUIT AND VEGETABLE ASSOCIATION N

59322 FLORIDA HEALTH PLAN N

81044 FLORIDA HEALTH SOLUTION HMO COMPANY N

VB001 FLORIDA HOSPITAL N

48116 FLORIDA HOSPITAL WATERMAN N

65063 FLORIDA NETPASS N

APBPN FLORIDIANCARE N

48117 FMH BENEFIT SERVICES N

25059 FOREST COUNTY POTAWATOMI INSURANCE DEPARTMENT N

87066 FORMAX, INC. N

39065 FORTIS (FORMERLY TIME INSURANCE) N

39065 FORTIS (WESTERN LIFE INS. BENEFIT PLAN) N

70408 FORTIS BENEFITS (KANSAS CITY) N

39065 FORTIS BENEFITS, INC. (WOODBURY) PHCS NETWORK CLAIMS N

41124 FORTIS SELF FUNDED ADMINISTRATIVE SERVICES N

39065 FORTIS WESTERN N

FH001 FOUNDATION HEALTH OF CA N

FHFLE FOUNDATION HEALTH OF FLORIDA-ENCOUNTERS N

FVMCH FOX VALLEY MEDICINE SITE 199 N

FVMC1 FOX VALLEY MEDICINE SITE 451 N

64067 FOXEVERETT INGALL N

64069 FOX-EVERETT, INC. N

Confidential Updated 08.30.2017

J1883 FRANCISCAN ALLIANCE N

31313 FREEDOM FIRST N

41212 FREEDOM HEALTH PLAN N

62324 FREEDOM LIFE INSURANCE COMPANY N

71768 FREEDOMBLUE HHIC Y

IP080 FREEMAN IPA N

43197 FRESENIUS HEALTH PARTNERS N

TH118 FRESENIUS MEDICAL CARE N

99660 FRESNO PACE N

59204 FRINGE BENEFIT COORDINATORS N

34171 FRONTPATH HEALTH COALITION N

30005 GALVESTON COUNTY INDIGENT HEALTH CARE N

10009 GATES MCDONALD HEALTH PLUS N

25169 GATEWAY HEALTH PLAN N

05506 GATEWAY HEALTH PLAN N

60550

GATEWAY HEALTH PLAN ((YELLOW CARD). CHECK THE ID CARD TO

VERIFY THE PAYER ID BEFORE SUBMITTING) N

25169 GATEWAY HEALTH PLAN MEDICAID PA N

91741 GATEWAY HEALTH PLAN MEDICARE OHIO ASSURED N

76028 GATEWAY HEALTH PLAN OF OHIO, INC. N

4317M GATEWAY TO BETTER HEALTH Y

431YM GATEWAY TO BETTER HEALTH N

CB951 GBS GLOBAL BENEFITS N

80241 GBS GROUP BENEFIT SERVICES INCORPORATED N

GEHA9 GEHA HEALTH GROUP (NEVADA) N

75273 GEISINGER HEALTH PLAN Y

MCS01 GEMCARE (GOLDEN EMPIRE MANAGED CARE SYSTEM) N

20376 GEMCARE HEALTH PLAN N

Confidential Updated 08.30.2017

MCS03 GEMCARE HEALTH PLAN N

27133 GEMCARE IPA N

63665 GENCARE HEALTH (ST. LOUIS ONLY) N

63665 GENCARE HEALTH (ST. LOUIS) N

63665 GENELCO (ST. LOUIS ONLY) N

63665 GENELCO (ST. LOUIS ONLY) N

63665 GENERAL AMERICAN (SANUS - EAST) N

63665 GENERAL AMERICAN LIFE INS. CO. (SANUS, ST. LOUIS) N

63665 GENERAL AMERICAN LIFE INSURANCE COMPANY N

GHEDI GENERATIONS GLOBALHEALTH N

46050 GENERATIONS HEALTH N

46051 GENERATIONS HILLCREST N

IP105 GENESIS HEALTH CARE N

J1895 GENEX CARE FOR OHIO N

58207 GEORGIA HEALTH PL N

61271 GEORGIA POWER MEDICAL BENEFITS PLAN N

00601 GEORGIA STATE HEALTH BENEFIT PLAN (PROCESSED BY GA BC/BS) Y

CHCNT GETTINGUSCOVERED N

23274 GETTYSBURG HEALTH (INCLUDING CORE VALUE.) N

25531 GHI HMO SELECT N

GHMCR GHI MEDICARE PART B OF NEW YORK N

22937 GHI MEDICARE PPFS N

58204 GI INNOVATIVE MANAGEMENT N

J1927 GILLETTE CHILDRENS SPECIALTY HEALTHCARE N

07205 GILSBAR, INC N

COMPU

GLASSWORKERS AND GLAZIERS HEALTH AND WELFARE FUND

TRUST N

91136 GLASSWORKERS HEALTH & WELFARE FUND - GRP# F29 N

Confidential Updated 08.30.2017

07689 GLOBAL CARE INC N

MPM05 GLOBAL CARE MED GRP IPA N

GEM01 GLOBAL EXCEL MANAGEMENT N

GHOKC GLOBAL HEALTH Y

75246 GM SOUTHWEST N

47083 GMS, INC. N

77160 GOLD COAST N

A0006 GOLDEN EMPIRE MANAGED CARE N

37602 GOLDEN RULE INSURANCE N

GTPA1 GOLDEN TRIANGLE PHYSICIAN ALLIANCE N

GSMPA GOOD SAMARITAN IPA (COASTAL HEALTHCARE MANAGEMENT) N

IP086 GOOD SAMARITAN MEDICAL PRACTICE ASSOCIATION (GSMPA) N

76923 GOOD SHEPHERD HOSPICE N

44054 GOVERNMENT EMPLOYEES HOSPITAL ASSOCIATION,INC. (GEHA) N

57254 GOVERNMENT EMPLOYEES HOSPITAL ASSOCIATION,INC. (GEHA) N

95453 GRAND VALLEY HEALTH PLAN N

95467 GREAT LAKES HEALTH PLAN N

95467

GREAT LAKES HEALTH PLAN (UNITEDHEALTHCARE GREAT LAKES

HEALTH PLAN) N

39640 GREAT LAKES PACE N

80705 GREAT WEST (SF) N

80705 GREAT WEST (WA) N

80705 GREAT WEST CARE N

80705 GREAT WEST DENVER N

63665

GREAT WEST LIFE & ANNUITY (CLAIMS FOR KENNETT, MISSOURI

ONLY) N

80705 GREAT WEST LIFE ASSURANCE N

80705 GREAT WEST LIFE ASSURANCE COMPANY OF AMERICA N

Confidential Updated 08.30.2017

99284 GREATER COVINA MEDICAL GROUP N

GCMG1 GREATER COVINA MEDICAL GROUP N

IP080 GREATER L. A. HEALTH N

GNPMG GREATER NEWPORT PHYSICIANS N

NMM01 GREATER ORANGE MEDICAL GROUP N

GOBHI GREATER OREGON BEHAVIORAL HEALTH INCORPORATED N

IP080 GREATER SAN GABRIEL N

PDT01 GREATER TRICITIES IPA (NOBLE AMA SELECT) N

80705 GREAT-WEST BELLEVUE N

78521 GREENTREE N

78521 GREENTREE ADMINISTRATORS N

36338 GROUP ADMINISTRATORS LTD. N

GASA1 GROUP ADMINISTRATORS SELF-FUNDED ALTERNATIVE N

48143 GROUP AND PENSION ADMINISTRATORS N

91051 GROUP HEALTH COOPERATIVE (WA) N

95192 GROUP HEALTH COOPERATIVE OF EAU CLAIRE N

39167

GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN

CLAIMS N

39168

GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN

ENCOUNTERS N

13551 GROUP HEALTH INCORPORATED (GHI) (NEW YORK) N

61101 GROUP HEALTH INSURANCE - DE N

91121

GROUP HEALTH NORTHWEST (CALL PAYER AT 888-767-4670 PRIOR

TO SUBMITTING ELECTRONIC CLAIMS.) N

37276 GROUP INSURANCE SERVICE CENTER, INC N

OBA16 GROUP MANAGEMENT SERVICES INCORPORATED N

CX015 GROUPLINK N

64246 GUARDIAN LIFE INSURANCE COMPANY OF AMERICA N

60652 GULF SOUTH RISK SERVICES N

Confidential Updated 08.30.2017

CB624 GULF STREAM GENERAL DYNAMICS N

39180 GUNDERSON LUTHERAN HEALTH PLAN N

80705 GWL N

80705 GWL & A N

37114 H.E.R.E.I.U. WELFARE PENSION FUNDS N

65101 HAA PREFERRED PARTNERS N

HALCY HALCYON BEHAVIORAL HEALTH N

47738 HAMASPIK CHOICE N

97258 HAMMERMAN & GAINER N

58305 HARBOR ADVANTAGE N

43313 HARKEN HEALTH N

36406

HARMONY HEALTH PLAN OF ILLINOIS (WELLCARE PROVIDER ID

REQUIRED, CALL (800) 960-2530 OPT. 2 THEN 5) N

36405

HARMONY HEALTH PLAN OF INDIANA (ONLY CLAIMS FOR INDIANA

HOOSIER HEALTHWISE MEMBERS CAN BE SENT TO THIS PAYER

ELECTRONICALLY.) N

75126 HARPETH IPA AMERIVANTAGE N

59143 HARRINGTON HEALTH BPO Y

04245 HARVARD COMMUNITY HEALTH PLAN N

04271 HARVARD PILGRIM HEALTH CARE N

87726 HARVARD PILGRIM PASSPORT CONNECT N

48330 HAWAII MANAGEMENT ALLIANCE ASSOCIATION (HMAA) N

99208 HAWAII WESTERN MANAGEMENT (HWMG) N

86068 HAWKI (PROVIDER ID REQUIRED) N

HCCMI HCC LIFE INSURANCE N

37111 HCH ADMINISTRATION N

37329 HCHA ALBQ - SELF FUNDED N

20501 HCP NEVADA N

HDMCO HDM BENEFIT SOLUTIONS N

Confidential Updated 08.30.2017

90023 HDPC - PREMIER HEALTHCARE N

CALL HEALTH ADVANTAGE OF ARKANSAS Y

23172 HEALTH ALLIANCE EXCLUSIVE & PLUS N

77950 HEALTH ALLIANCE MEDICAL PLANS OF ILLINOIS N

38224 HEALTH ALLIANCE PLAN OF MICHIGAN N

25126

HEALTH AMERICA INCORPORATED HEALTH ASSURANCE

ADVANTRA N

CALL

HEALTH CARE DISTRICT PALM BEACH (PLEASE CONTACT HCDPBC

TO ENROLL AND TO OBTAIN PAYER ID 866-930-1002.) N

42102 HEALTH CARE NETWORK OF WI (HCN) N

42102 HEALTH CARE NETWORK OF WISCONSIN (HCN) N

HCP02 HEALTH CARE PARTNERS - AZ N

62180 HEALTH CHOICE GENERATIONS N

46221 HEALTH CHOICE INSURANCE N

22100 HEALTH CHOICE INTEGRATED CARE N

62179 HEALTH CHOICE OF AZ N

45399 HEALTH CHOICE UTAH N

82018 HEALTH CLAIMS SERVICE N

62111 HEALTH COST SOLUTIONS N

34158 HEALTH DESIGN PLUS N

66004 HEALTH ECONOMIC LIVELIHOOD PARTNERSHIP (HELP) N

16120 HEALTH EZ N

95019 HEALTH FIRST HEALTH PLANS N

75234 HEALTH FIRST-TYLER, TX N

59087 HEALTH HELP NETWORKS, INC. N

86066

HEALTH MANAGEMENT ASSOCIATES (HMA, SERVICING

SOUTHEASTERN AND SOUTHWESTERN REGIONS) (PROVIDER ID

REQUIRED) N

10006 HEALTH MGMT SOLUTIONS N

Confidential Updated 08.30.2017

68021 HEALTH NET - VA N

HM001 HEALTH NET (CALIFORNIA ENCOUNTERS ONLY.) N

95567 HEALTH NET (OF CALIFORNIA) N

AZHNT HEALTH NET OF ARIZONA N

22340 HEALTH NET OREGON N

65062 HEALTH NETWORK ONE N

04286 HEALTH NEW ENGLAND N

FLHLT HEALTH OPTIONS OF FLORIDA (BLUE SHIELD HMO) N

FLENC

HEALTH OPTIONS OF FLORIDA (BLUE SHIELD HMO) ENCOUNTERS

ONLY!! Y

NAHOI HEALTH OPTIONS OF ILLINOIS N

62157 HEALTH PARTNERS - JACKSON,TN N

80142 HEALTH PARTNERS, PA N

20270 HEALTH PAYMENT SYSTEMS N

37221 HEALTH PLAN MANAG N

52563 HEALTH PLAN OF MICHIGAN N

83253 HEALTH PLAN OF MICHIGAN N

76343 HEALTH PLAN OF NEVADA (ENCOUNTER CLAIMS) N

76342 HEALTH PLAN OF NEVADA (FFS CLAIMS) N

68035 HEALTH PLAN OF SAN JOAQUIN N

HPSM1 HEALTH PLAN OF SAN MATEO N

59140 HEALTH PLAN SERVICES, TAMPA OFFICE N

44273 HEALTH PLANS INC. N

95435 HEALTH PLEDGE HMO N

38216 HEALTH PLUS OF MICHIGAN N

HPPO HEALTH PLUS PHYSICIAN ORGANIZATION N

63363 HEALTH PLUS PHYSICIANS ORGANIZATION N

41170 HEALTH RISK MANAGEMENT (HRM) N

Confidential Updated 08.30.2017

00995

HEALTH SAFETY NETWORK - MASS. HEALTH MEDICAL (PROF

0ONLY) N

M3IL1

HEALTH SELECT IPA (ENROLLMENT REQUIRED. CONTACT 866-703-

1444.) N

37290 HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS (HSCSN) N

41150 HEALTH SERVICES MANAGEMENT N

HSM01

HEALTH SERVICES MANAGEMENT, INC. (NOTE: ANSI SUBMITTERS

CAN ALSO SUBMIT TO PLANS AHP, CMS, ONP, PCI, PHP AND VHP

WITH PROPER VALUE IN SBR04.) N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR AHS N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR BPA N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR ECOH N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR EHC N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR ENCR N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR FCM N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR HF N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR HT N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR MMSI N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR MSHO N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR PNET N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR PONE N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR SC N

HSM01 HEALTH SERVICES MANAGEMENT, INC. FOR WEA N

65449 HEALTH SPECIAL RISK INCORPORATED N

HTHTX HEALTH TEXAS MEDICAL GROUP N

95828 HEALTHCARE DISTRICT PALM BEACH COUNTY N

MPM06 HEALTHCARE LA, IPA N

TH049 HEALTHCARE MANAGEMENT ADMIN N

Confidential Updated 08.30.2017

HMA01

HEALTHCARE MANAGEMENT ADMINISTRATORS, INC. (ALSO

KNOWN AS HMA, SERVICING WESTERN REGION) N

EPF37 HEALTHCARE OPTIONS N

HCP01 HEALTHCARE PARTNERS N

11328 HEALTHCARE PARTNERS, IPA N

56731 HEALTHCARE RESOURCES NW N

73147 HEALTHCARE SOLUTIONS GROUP N

25133 HEALTHCARE USA N

25143 HEALTHCARE USA N

85729 HEALTHCOMP N

HCA77 HEALTHCOMP N

HCOMP HEALTHCOMP (COMMUNITY FIRST STAR HEALTH PLAN) N

59608 HEALTHEASE N

95213

HEALTHEDGE ADMINISTRATORS (PAYERID VALID FOR CLAIMS

WITH A SUBMISSION ADDRESS OF PO BOX 11210, BAKERSFIELD,

CA 93389) N

41178 HEALTHEZ N

75289 HEALTHFIRST OF AUSTIN TPA N

80141 HEALTHFIRST, INC. (NY) N

56144 HEALTHGRAM N

CALL HEALTHKEEPER HMO Y

96475 HEALTHLINK HMO N

90001 HEALTHLINK PPO N

38309 HEALTHNET OF AZ N

55204 HEALTHNOW NY Y

07003 HEALTHPARTNERS N

55764 HEALTHPARTNERS OF MINNESOTA N

27514 HEALTHPLUS AMERIGROUP N

68195 HEALTHPOINT CORPORATION N

Confidential Updated 08.30.2017

52429 HEALTHSCOPE BENEFITS EHC REPRICING N

71063 HEALTHSCOPE BENEFITS, INC N

HSHAR HEALTHSHARE N

75237 HEALTHSMART ACCEL N

75250 HEALTHSMART PREFERRED CARE N

HSPC1 HEALTHSMART PREFERRED CARE (HSPC) N

CALL

HEALTHSOURCE \ HUDSON HEALTH PLAN (PROVIDER

ENROLLMENT IS REQUIRED BY THE PAYER. MUST CALL (914) 372-

2291 TO OBTAIN PAYERID) N

71074

HEALTHSOURCE ARKANSAS - CLAIMS MUST CONTAIN

HEALTHSOURCE SPECIFIC VENDOR ID & SPECIFIC RENDERING

PROVIDER ID N

HS001 HEALTHSOURCE INC. N

61127

HEALTHSOURCE KENTUCKY - CLAIMS MUST CONTAIN

HEALTHSOURCE SPECIFIC VENDOR ID & SPECIFIC RENDERING

PROVIDER ID N

01041

HEALTHSOURCE MAINE - CLAIMS MUST CONTAIN HEALTHSOURCE

SPECIFIC VENDOR ID & SPECIFIC RENDERING PROVIDER ID N

02038

HEALTHSOURCE NEW HAMPSHIRE - CLAIMS MUST CONTAIN

HEALTHSOURCE SPECIFIC VENDOR ID & SPECIFIC RENDERING

PROVIDER ID N

56147

HEALTHSOURCE NORTH CAROLINA - CLAIMS MUST CONTAIN

HEALTHSOURCE SPECIFIC VENDOR ID & SPECIFIC RENDERING

PROVIDER ID N

75255

HEALTHSOURCE NORTH TEXAS - CLAIMS MUST CONTAIN

HEALTHSOURCE SPECIFIC VENDOR ID & SPECIFIC RENDERING

PROVIDER ID N

68195 HEALTHSOURCE PROVIDENT INS. CO. N

06119 HEALTHSOURCE SOUTH CAROLINA N

71075 HEALTHSOURCE, AR (MED) (CIGNA) N

58210 HEALTHSOURCE, GA (CIGNA) N

02041 HEALTHSOURCE, MASS N

Confidential Updated 08.30.2017

31141 HEALTHSOURCE, OH N

62129 HEALTHSOURCE, TN (CIGNA) N

34092 HEALTHSPAN N

RH007 HEALTHSPAN N

HSPAN HEALTHSPAN NETWORK REPRICING N

HT001

HEALTHSPRING HMO (NO PPO CLAIMS ACCEPTED VIA THIS

PAYERID.) Y

63092 HEALTHSPRING HMO/HEALTHSPRING MEDICARE+CHOICE N

HESUN HEALTHSUN N

58213 HEALTHWAYS WHOLEHEALTH NETWORKS N

95827 HEALTHY PALM BEACHES, INC. N

HSF01 HEALTHY SAN FRANCISCO N

68064 HEALTHY TEXAS N

68064 HEALTHY TEXAS N

22251 HEALTHY YORK NETWORK N

77180 HEALTHYCT N

45336 HEALTHYCT INCORPORATED N

00243 HELIX FAMILY CHOICE N

59230

HERITAGE CONSULTANTS (MUST USE 9-DIGIT SUBSCRIBER ID ON

ALL CLAIMS) N

HER01 HERITAGE IPA N

M3FL5 HFN HEALTHEASE N

36335 HFN, INC. N

20552 HHH CHOICES GOLD N

95393 HIGH DESERT MEDICAL GROUP N

HDMDG HIGH DESERT MEDICAL GROUP (REGAL) N

33069 HIGH DESERT PRIMARY CARE N

91164 HIGHLINE MEDICAL SERVICES MOLINA N

Confidential Updated 08.30.2017

91161 HIGHLINE PSHP N

35145 HIGHMARK - KEY FAMILY N

47181 HIGHMARK BCBSD HEALTH OPTIONS N

00046 HILL PHYSICIANS MEDICAL GROUP N

HIL01 HILL PHYSICIANS MEDICAL GROUP N

80520 HILLIARD CORPORATION (UCS) N

NAHIN HINSDALE PHYS N

55247 HIP-HEALTH INSURANCE PLAN OF GREATER NY N

HPFFS HISPANIC PHYSICIANS IPA N

86066 HMA (SERVICING HI, AZ AND NV) N

75318 HMC HEALTHWORKS N

COHMO HMO COLORADO N

84555 HMO LOUISIANA BLUE ADVANTAGE N

IP080 HOLLYWOOD PRESBYTERIAN N

NAHLX HOLY CROSS HEALTH PARTNERS N

68069 HOME STATE HEALTH PLAN N

VAICE HOMELAND SECURITY (ATTN: DEPORTATION) N

50701 HOMELINK N

88023 HOMETOWN HEALTH PLAN NEVADA N

30757

HOMETOWN HEALTH PLAN OF OHIO (NOW KNOWN AS THE

HEALTH PLAN) N

88537 HOMETOWN HLTH PRO N

82234 HOMEWOOD RESORTS (UCS) N

66003 HOPKINS HEALTH ADVANTAGE N

HMLIC HORACE MANN LIFE INSURANCE N

HVMG1 HORIZON VALLEY MEDICAL GROUP N

91136

HOTEL EMPLOYEES & RESTAURANT EMPLOYEES HEALTH TRUST -

GRP#F19 N

Confidential Updated 08.30.2017

J1888 HOWARD COUNTY GOVERNMENT (MARYLAND) N

CARD

HPMS (SEND CLAIMS TO PAYERID LISTED ON PATIENT'S

INSURANCE CARD.) N

94254 HPR N

13335

HUDSON HEALTH PLAN (PROVIDER MUST BE LOCATED IN

DUCHESS, ORANGE, ROCKLAND, SULLIVAN OR WESTCHESTER

COUNTY, NY) Y

HBI01 HUMAN BEHAVIORAL INSTITUTE N

61104 HUMANA BEHAVIORAL HEALTH N

95348 HUMANA HEALTH PLANS OHIO N

61115 HUMANA LONG TERM CARE N

61125 HUMANA MILITARY TRICARE N

L0200 HUMANA PUERTO RICO N

61160 HUMANA VA HERO PR N

61120 HUMANA VETERANS HEALTHCARE SERVICES N

61101 HUMANA, CLAIMS ONLY N

61102 HUMANA, ENCOUNTERS ONLY N

94154 HUMBOLDT DEL NORTE FOUNDATION FOR MEDICAL CARE N

37260 HUNT INSURANCE GR N

IP080 HUNTINGTON PARK MEDICAL GROUP N

IP080 HUNTINGTON PARK MISSION N

38234 IBA SELF FUNDED GROUP N

74234

IBEW LOCAL 640 & ARIZONA CHAPTER NECA HEALTH & WELFARE

TRUST N

74234 IBEW WESTERN UTILITIES OR LOCAL 57 N

81810 IBG ADMINISTRATORS, LLC N

41124 IBI N

19028 IBM BUSINESS TOISC N

11695 ICARE (INDEPENDENT CARE HEALTH PLAN) N

Confidential Updated 08.30.2017

26054 ICARE HEALTH OPTIONS TPA N

33884 ICIRCLE OF NEW YORK N

75185 ICON BENEFIT ADMINISTRATORS N

TRUEB IDAHO TRUE BLUE N

YESB IDAHO YES BLUE N

22175 IE SHAFFER N

75274 IHG DIRECT N

68069 ILLINICARE GROUP HEALTH (ALSO 68066) N

DMG01 ILLINOIS HEALTH PLAN (IHP) N

86069 ILLINOIS HEALTH SOLUTIONS ( PROVIDERID REQUIRED) N

IPA99 ILLINOIS PHYSICIANS ALLIANCE IPA N

72091 IMA OF LOUSIANA INC. N

43123 IMAGINE HEALTH N

41600 IMCARE N

40585 INDECS CORPORATION N

TA720 INDEPENDENCE ADMINISTRATORS N

CB231 INDEPENDENCE AMERICAN INSURANCE COMPANY N

64284 INDEPENDENCE CARE SYSTEM N

MHM01 INDEPENDENCE MEDICAL GROUP N

IMG01 INDEPENDENCE MEDICAL GROUP KERN COUNTY N

IMG02 INDEPENDENCE MEDICAL GROUP TULARE COUNTY N

54704

INDEPENDENT BLC OF PA (ALSO KNOWN AS PERSONAL CHOICE

PPO OF PENNSYLVANIA.) Y

95308

INDEPENDENT HEALTH (ENROLLMENT AND TESTING REQUIRED,

CONTACT (716) 635-3911) Y

SX073 INDEPENDENT HEALTH OF NEW JERSEY. N

45048 INDEPENDENT LIVING SYSTEMS N

INDPM INDEPENDENT PHYSICIAN AT MERCY N

Confidential Updated 08.30.2017

04412 INDIAN HEALTH SERVICE/TRIBAL ORGANIZATIONS Y

00290 INDIAN HEALTH SERVICES N

35600 INDIANA DEPARTMENT OF HEALTH CHILDREN'S HEALTH N

35161 INDIANA PROHEALTH NETWORK N

35107

INDIANA TEAMSTERS HEALTH BENEFITS FUND (FORMERLY

KNOWN AS LOCAL 135 HEALTH BENEFITS FUND) N

77153 INDIANA UNIVERSITY (SOUTHEASTERN INDIANA HEALTH) N

COMPU INDUSTRIAL MACHINE SPECIALTIES N

43471 INETICO, INC. N

96490 INFORMED LLC N

52196 INFORMED, LLC N

85578 INGALLS PROVIDER GROUP N

38343 INGHAM HEALTH PLAN CORPORATION N

J1907 INGLES MARKETS N

IEHP1 INLAND EMPIRE HEALTH PLAN N

MVMM1 INLAND FACULTY MEDICAL GROUP N

OSFC9 INNOV_OSF HEALTHCARE CENTRAL N

31172 INNOVANTE BENEFIT ADMINISTRATORS N

40025 INNOVATION HEALTH N

80087 INNOVATIVE PHYSICIAN ASSOCIATES N

VAICE INS HEALTH SERVICES N

37279 INSURANCE ADMINISTRATOR OF AMERICA N

13315 INSURANCE DESIGN ADMINISTRATORS N

72091 INSURANCE MANAGEMENT ADMINISTRATORS N

15688 INSURANCE MANAGEMENT SERVICES N

IMSMS INSURANCE MANAGEMENT SERVICES OF TEXAS N

ISL11 INSURANCE SERVICE OF LUBBOCK N

IAC01 INSURER'S ADMINISTRATION CORPORATION N

Confidential Updated 08.30.2017

86304 INSURERS ADMINISTRATIVE CORP N

51020 INTEGRA ADMINISTRATIVE GROUP, INC. N

31129 INTEGRA GROUP - CHA N

31127

INTEGRA GROUP (ALSO KNOWN AS REHAB PROVIDER NETWORK,

BUT NOT THE SAME AS COLORADO PAYER OF SAME NAME.) N

45302 INTEGRA MANAGED LONG TERM CARE N

23229 INTEGRAL QUALITY CARE N

10001 INTEGRATED COMP N

IHCS1 INTEGRATED HOMECARE SERVICES N

20050 INTEGRATED MEDICAL SOLUTIONS N

68068 INTEGRATED MENTAL HEALTH SERVICES N

68031 INTEGRITY DENTAL ONLY N

56132 INTERACTIVE MEDICAL SYSTEMS N

92649 INTER-AMERICAS INSURANCE N

37227 INTERCARE HEALTH PLANS N

INCHN INTERCOMMUNITY HEALTH NET Y

60280 INTERFACE EAP N

23287 INTERGROUP SERVICES CORPORATION N

SX107 INTERMOUNTAIN HEALTHCARE N

74234 INTERMOUNTAIN IRONWORKERS TRUST FUND N

48603

INTERNATIONAL BROTHERHOOD OF BOILERMAKERS EMPLOYEE

HEALTH CARE PLAN (IBBEHC) N

39182 INTERNATIONAL FUNDING INC. N

IMGIN INTERNATIONAL MEDICAL GROUP, INC N

37269 INTERNATIONAL UNION OPERATING ENGINEERS N

84137 INTERWEST HEALTH PPO (MONTANA) N

35115 INTOTAL HEALTH N

41124 IOWA BENEFITS, INC. N

Confidential Updated 08.30.2017

86068 IOWA HEALTH SOLUTIONS (PROVIDER ID REQUIRED) N

IPAK1 IPA OF KANE COUNTY N

J1887 IPMG CLAIMS MANAGEMENT N

J1911 ISURITY N

SX172 IU MEDICAL GROUP PRIMARY CARE N

JCC01 JACKSON CARE CONNECT N

05014 JACKSON MEMORIAL N

JAI01 JAI MEDICAL SYSTEMS N

JCARE JENCARE MEDICAL N

61271 JF MOLLOY N

87726

JOHN DEERE HEALTHCARE, NOW KNOW AS UNITEDHEALTHCARE

RIVER VALLEY Y

52189

JOHN HOPKINS HEALTHCARE (EHP/PP) (SUBMIT BILLING NPI AND

RENDERING/SERVICING NPI) N

38310 JOHN MORRELL COMPANY - AHPBA N

JMH01 JOHN MUIR HEALTH NETWORK N

68036 JOHN MUIR MT. DIABLO HEALTH SYSTEM N

68013 JOHN MUIR TRAUMA PHYSICIANS N

CALL

JOHN MUIR TRAUMA PHYSICIANS (PLEASE CALL 925-947-5288 FOR

PAYER ID INFORMATION.) N

37215 JOHN P PEARL AND ASSOCIATES N

52123

JOHNS HOPKINS (USFHP) (NEW SUBMITTER SHOULD SEND IN

THEIR BILLING NPI & RENDERING SERVICING NPI) N

43178 JOPLIN CLAIMS N

34136 JP FARLEY CORPORATION N

MWP01 JPS PREFERRED CARE N

37272 JSL ADMINISTRATORS N

91617 KAISER FOUNDATION HEALTH PLAN COLORADO N

52095 KAISER FOUNDATION HEALTH PLAN MID ATLANTIC N

Confidential Updated 08.30.2017

NG010 KAISER FOUNDATION HEALTH PLAN OF GEORGIA N

94135 KAISER FOUNDATION HEALTH PLAN OF NORTHERN CA REGION N

NG007 KAISER FOUNDATION HEALTH PLAN OF OHIO N

94134 KAISER FOUNDATION HEALTH PLAN OF SOUTHERN CA REGION N

93079 KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST N

NG009 KAISER FOUNDATION HEALTH PLAN OF THE NW N

NG008 KAISER MID-ATLANTIC N

KS007 KAISER NORTHWEST REGION N

KS001 KAISER PERMANENTE (SOUTHERN CALIFORNIA ONLY) N

KSRCS KAISER PERMANENTE COLORADO SPRINGS N

21313 KAISER PERMANENTE GEORGIA N

RH011 KAISER PERMANENTE HAWAII N

94123 KAISER PERMANENTE HEALTH PLAN HAWAII N

94320 KAISER PPO N

40137 KALOS HEALTH N

57038 KANAWHA HEALTHCARE SOLUTIONS N

KCIPA KANE COUNTY IPA N

81812 KATY MEDICAL CLAIMS N

KMG11 KATY MEDICAL GROUP N

KEE01 KEENAN & ASSOCIATES N

KELSE KELSEY SEYBOLD N

61453 KEMPER BENEFITS N

73100 KEMPTON GROUP N

KENT1 KENT COUNTY HEALTH PLAN N

27215 KENTUCKY HEALTH ADMINISTRATORS, INC. N

77894 KENTUCKY HEALTH COOPERATIVE N

68069 KENTUCKY SPIRIT HEALTH PLAN (ALSO 68067) N

Confidential Updated 08.30.2017

28021 KERN COUNTY CDCR N

22149 KERN HEALTH CARE NETWORK N

77039 KERN HEALTH SYSTEMS N

89890 KERN LEGACY HEALTH PLAN N

37217 KEY BENEFIT ADMINISTRATORS N

35317 KEY GAP N

95460 KEY HEALTH MEDICAL SOLUTIONS N

KHMSI KEY HEALTH MEDICAL SOLUTIONS INCORPORATED N

KEYIP KEY INSURANCE GROUP N

IP082

KEY MEDICAL GROUP (PROVIDERS PLEASE CONTACT BRANDI

GUINN @ 559-735-3892 X233 FOR AUTHORIZATION.) N

37321 KEY SELECT N

37323 KEY SOLUTION N

CALL KEYCARE PPO Y

23284 KEYSTONE MERCY HEALTH PLAN N

84223 KEYSTONE VIP CHOICE N

KGA15 KG ADMINISTRATIVE SERVICES N

3414A

KLAIS & COMPANY (REPRICING FOR HEALTHSPAN NETWORK

ONLY.) N

34145 KLAIS AND COMPANY N

KAMG1 KOREAN MEDICAL N

KPIC1

KPIC - KAISER PERMANENTE (VALID IN THE STATES OF CACO DC GA

HI MD OH AND OR) N

57610 KUSPUK SCHOOL DISTRICT N

27357 LA CARE N

LACAR LA CARE HEALTH PLAN N

LADOC LA DEPT OF CORRECTIONS N

MPM19 LACH HEALTHNET BY MEDPOINT N

71037 LAFAYETTE CONSOLIDATED GOVERNMENT N

Confidential Updated 08.30.2017

SISCO LAKE AREA COMMUNITY HEALTH PLAN N

SISCO LAKE REGION COMMUNITY HEALTH PLAN N

66127 LAKESIDE COMPREHENSIVE HEALTHCARE N

95415 LAKESIDE HEALTH SERVICES N

66125 LAKESIDE MEDICAL GROUP N

LMG11 LAKESIDE MEDICAL GROUP INC. N

CALL

LANCASTER GENERAL HEALTH GROUP (CONTACT SHERRY

WOLGEMUTH VP OF CLAIMS OPERATIONS AT 717-560-9290 EXT

124 FOR APPROVAL AND PAYERID.) N

90096 LAND OF LINCOLN HEALTH N

LNDMK LANDMARK HEALTHCARE INC. Y

J1889 LANDRYS N

NWADM LAS VEGAS FIRE FIGHTERS LOCAL NO 1285 SECURITY FUND N

NMM02 LASALLE MEDICAL ASSOCIATES N

53122 LASSEN MUNICIPAL UTILITY DISTRICT N

36333 LAWNDALE CHRISTIAN HEALTH CENTER N

LAWND LAWNDALE CHRISTIAN HEALTH CENTER N

52193 LBA HEALTHPLANS N

LWMC1 LEISURE WORLD MANAGED CARE N

37316 LEON MEDICAL CENTER HEALTH PLAN N

65055 LEON MEDICAL CENTER HEALTH PLAN N

11328 LIBERTY HEALTH ADVANTAGE N

87071 LIBERTY HEALTH ADVANTAGE N

98205 LIFE & HEALTH INS CO OF AMERICA (NFL PLAN ONLY) N

33LGC LIFE GIFT CARDS N

LIICA

LIFE INVESTORS INS CO OF AMERICA (SPECIALIZED CLAIMS ONLY.

CALL 866-745-3545 WITH CLAIM ROUTING QUESTIONS.) N

59847 LIFE ST JOSEPH OF THE PINES N

41136 LIFE TRAC N

Confidential Updated 08.30.2017

71498 LIFECIRCLES PACE N

RLH01 LIFEMAP N

76870 LIFEPATH HOSPICE INC. N

LIFE1 LIFEPRINT N

27005 LIFESTYLE HEALTH PLANS N

EBSRM LIFETIME BENEFIT SOLUTIONS N

EBSRM LIFETIME BENEFITS SOLUTIONS N

93093 LIFEWISE A PREMIER HEALTH PLAN Y

93093 LIFEWISE HEALTH PLAN OF OREGON A PREMIER HEALTH PLAN Y

91049

LIFEWISE HEALTH PLAN OF WASHINGTON A PREMIER HEALTH

PLAN Y

LWA01 LIFEWORKS ADVANTAGE N

LOBH1 LINDEN OAKS BEH H N

75283 LINN COUNTY N

LIPA1 LIPA/AGATE RESOURCES N

LCM1 LITTLE COMPANY OF MARY N

4725P LITTLE COMPANY OF MARY HEALTH Y

CALL LOCAL CHOICE Y

CB752 LOCKARD & WILLIAMS N

37267 LOMA LINDA UNIVERSITY ADVENTIST N

33036 LOMA LINDA UNIVERSITY HEALTH CARE N

37226 LONDON HEALTH ADM N

45289 LONE STAR TPA N

MHIPA LONG BEACH MEMORIAL IPA (MHCLB) N

73236 LOREN COOK N

67202 LOUISIANA HEALTH COOPERATIVE N

68069 LOUSIANA HEALTHCARE CONNECTIONS N

Confidential Updated 08.30.2017

NMBLS

LOVELACE SANDIA HEALTH PLAN (ACQUIRED BY BS OF NEW

MEXICO) N

56756 LOWER KUSKOKWIM SCHOOL DISTRICT N

13193 LOYAL AMERICAN N

39198 LUTHERAN PREFERRED N

37292 MACHINIST DISTRICT 9 WELFARE N

J1343 MACKINAW ADMINISTRATORS N

36334

MACNEAL HEALTH PROVIDERS - CHS (CONTACT 708-783-7100

PRIOR TO FIRST SUBMISSION.) N

60054

MAGELLAN BEHAVIORAL HEALTH (FOR DATES OF SERVICE

1/1/2006 AND AFTER - PROVIDER ID REQUIRED - AETNA

SUBSCRIBERS ONLY.) N

01260

MAGELLAN HEALTH (ALL NON-AETNA SUBSCRIBERS - PROVIDER ID

REQUIRED) N

11303 MAGNACARE N

68069 MAGNOLIA MISSISSIPPI (ALSO 68062) N

87726

MAHP (MD IPA, OPTUMUN CHOICE AND MLH)

UNITEDHEALTHCARE N

62413 MAILHANDLERS N

45341 MAINE COMMUNITY HEALTH OPTIONS N

35162 MANAGED CARE SERVICES, LLC N

MCS04 MANAGED CARE SYSTEMS N

MCS02 MANAGED CARE SYSTEMS (DELANGO REGIONAL MEDICAL) N

MHCA1 MANAGED HEALTH CARE ADMIN EPS N

22771 MANAGED HEALTH NETWORKS (MHN) N

68069 MANAGED HEALTH SERVICES INDIANA (ALSO 39186) N

68069

MANAGED HEALTH SERVICES OF WISCONSIN (PLEASE CONTACT

THE PAYER @ 800-225-2573, EXT 25525 TO GET SETUP TO SUBMIT

ELECTRONIC CLAIMS.) Y

MHCA2 MANAGED HEALTHCARE ADMINISTRATION INC- BLUE CHOICE Y

Confidential Updated 08.30.2017

36312 MANAGED HEALTHCARE ASSOC (MHCA) N

41555 MANATEE SERVICES N

46012 MAPFRE LIFE COMMERCIAL N

52461 MARCH VISION CARE INCORPORATED N

5246M MARCH VISION HEALTH PLAN N

A0008 MARICOPA HEALTH PLAN N

IP097 MARIN IPA N

MPCHP MARION POLK HEALTH PLAN Y

20805 MARRICK MEDICAL FINANCE LLC N

46478 MARRICK WRX N

53275 MARTINS POINT HEALTH CARE N

MPHC2 MARTIN'S POINT HEALTH CARE USFHP/GENERATIONS ADVANTAGE N

22348 MARYLAND PHYSICIANS CARE N

00247 MARYLAND PHYSICIANS CARE N

77063

MARYLAND PMHS VALUEOPTIONS (USE FOR ALL DATES OF

SERVICE) Y

37121 MASHANTUCKET PEQUOT TRIBAL NATION N

MMPHB MASTERS, MATES AND PILOTS PLAN N

27320 MAX SPECIALTY BENEFITS N

92805 MAXOR N

88090 MAYO CLINIC FL/GA N

41154 MAYO MANAGEMENT SERVICES, INC. N

83028 MBA BENEFIT ADMINISTRATORS N

87065 MBA OF WYOMING N

CSMED MCARE OF COLORADO SPRINGS Y

MCCBV

MCC BEHAVIORAL CARE (WE WILL ALSO ACCEPT PID SX071 FOR

THESE CLAIMS: USE OF EITHER ID ACCOMPLISHES THE SAME

ROUTING.) Y

59331 MCCREARY CORPORATION N

Confidential Updated 08.30.2017

31149 MCGREGOR PACE N

3833N MCLAREN ABW-NHP N

3833T MCLAREN ABW-THPC N

3833R MCLAREN ADVANTAGE SNP N

3833A MCLAREN HEALTH ADVANTAGE N

38338 MCLAREN HEALTH PLAN N

3833C MCLAREN MEDICAID N

6197P MCS N

66039 MCS LIFE N

MDC01 MD CARE HEALTH PLAN N

MDXHI MD HAWAII N

87726

MD-INDIVIDUAL PRACTICE ASSOCIATION, INC. (M.D. IPA)

(PREVIOUSLY PAYER ID 52148) N

MDWIS MDWIS HIP N

91313 MDWISE HOOSIER CARE CONNECT N

35191 MDWISE HOOSIER HEALTHWISE N

31354 MDWISE HOOSIER INDIANA PLAN N

45627 MDWISE MARKETPLACE N

MWSHN MDWISE SELECT HEALTH NETWORK N

MLINK MECKLINK N

80026 MED PARTNERS AMER N

88058 MED PAY N

88058 MED PAY N

M3CA0001 MED3000 CALIFORNIA N

EM350 MED3000 CMS EARLY STEPS N

M3FL0010 MED3000 CMS EARLY STEPS N

EM284 MED3000 CMS SAFETY NET N

M3FL0011 MED3000 CMS SAFETY NET N

Confidential Updated 08.30.2017

EM843 MED3000 CMS TITLE 19 REFORM N

EM205 MED3000 CMS TITLE 21 N

M3FL0014 MED3000 CMS TITLE 21 N

EM216 MED3000 HEALTHSPRING N

58204 MEDADMIN SOL INC N

59231 MEDCOM N

68037 MEDCORE MEDICAL GROUP (OMNI IPA) N

90753 MEDCOST / LIBERTY HEALTH SHARE N

56205 MEDCOST BENEFIT SERVICES N

56162 MEDCOST, INC. N

95321 MEDFOCUS N

94265 MEDICA N

78857 MEDICA HEALTH CARE PLAN, INC. N

12422 MEDICA2 N

EPF02

MEDICAID - TX PREMIER PLAN (CONTACT PROVIDER RELATIONS @

(915)532-2778, X1068) Y

ALMCD MEDICAID OF ALABAMA Y

AKMCD MEDICAID OF ALASKA Y

AZMCD MEDICAID OF ARIZONA (AHCCCS) Y

ARMCD MEDICAID OF ARKANSAS Y

COMCD MEDICAID OF COLORADO Y

CTMCD MEDICAID OF CONNECTICUT Y

DEMCD MEDICAID OF DELAWARE Y

FLMCD MEDICAID OF FLORIDA Y

GAMCD MEDICAID OF GA Y

HIMCD MEDICAID OF HAWAII Y

IDMCD MEDICAID OF IDAHO Y

ILMCD MEDICAID OF ILLINOIS Y

Confidential Updated 08.30.2017

INMCD MEDICAID OF INDIANA Y

IAMCD MEDICAID OF IOWA Y

KSMCD MEDICAID OF KANSAS Y

KYMCD MEDICAID OF KENTUCKY Y

LAMCD MEDICAID OF LOUSIANA (INCLUDES KIDMED CLAIMS.) Y

MEMCD MEDICAID OF MAINE Y

MDMCD MEDICAID OF MARYLAND Y

MAMCD MEDICAID OF MASSACHUSETTS Y

MIMCD MEDICAID OF MICHIGAN Y

MNMCD MEDICAID OF MINNESOTA Y

MSMCD MEDICAID OF MISSISSIPPI Y

MOMCD MEDICAID OF MISSOURI Y

MTMCD MEDICAID OF MONTANA N

NEMCD MEDICAID OF NEBRASKA Y

NVMCD MEDICAID OF NEVADA Y

NHMCD MEDICAID OF NEW HAMPSHIRE Y

NJMCD MEDICAID OF NEW JERSEY Y

NMMCD MEDICAID OF NEW MEXICO Y

NYMCD MEDICAID OF NEW YORK Y

NCMCD MEDICAID OF NORTH CAROLINA Y

NDMCD MEDICAID OF NORTH DAKOTA Y

OHMCD MEDICAID OF OHIO Y

OKMCD MEDICAID OF OKLAHOMA Y

ORMCD MEDICAID OF OREGON Y

PAMCD MEDICAID OF PENNSYLVANIA Y

RIMCD MEDICAID OF RHODE ISLAND Y

SCMCD MEDICAID OF SOUTH CAROLINA Y

Confidential Updated 08.30.2017

SDMCD MEDICAID OF SOUTH DAKOTA Y

TNMCD MEDICAID OF TENNESSEE (TENNCARE) Y

TXMCD MEDICAID OF TEXAS N

UTMCD MEDICAID OF UTAH Y

VTMCD MEDICAID OF VERMONT Y

VAMCD MEDICAID OF VIRGINIA Y

DCMCD MEDICAID OF WASHINGTON DC Y

WAMCD MEDICAID OF WASHINGTON STATE Y

WVMCD MEDICAID OF WEST VIRGINIA Y

WIMCD MEDICAID OF WISCONSIN Y

WYMCD MEDICAID OF WYOMING Y

86916 MEDICAID TEXAS HEALTH STEPS & CSHCN N

SKTX1 MEDICAID TEXAS LTC N

SKVI0 MEDICAID UNITED STATES VIRGIN ISLANDS N

MAHC1 MEDICAL ASSOCIATES HEALTH PLAN N

MAHP1 MEDICAL ASSOCIATES HEALTH PLAN N

68041 MEDICAL BENEFIT ADMINISTRATION, INC. N

74323 MEDICAL BENEFITS MUTUAL N

MPM18 MEDI-CAL BY MEDPOINT N

9043P MEDICAL CONTROL N

29076

MEDICAL MUTUAL OF OHIO (PAYER REQUIRES A 12 DIGIT

RENDERING PROVIDER ID#, WHICH NEEDS TO BE OBTAINED FROM

PAYER BY CALLING 800-321-7223) N

CSMED MEDICAL NETWORK OF COLORADO SPRINGS Y

CAMCD MEDICAL OF CALIFORNIA Y

MHIPA MEDICAL ORANGE COAST MEMORIAL IPA N

62177 MEDICAL REIMBURSEMENTS OF AMERICA N

58203 MEDICAL RESOURCE NETWORK (MRN, INC) N

Confidential Updated 08.30.2017

80019 MEDICAL SERVICE COMPANY GROUP INCORPORATED (MSC) N

12057 MEDICAL SERVICES INITIATIVE N

38224 MEDICAL VALUE PLAN - OHIO (MVP) N

VIMCR MEDICARE OF THE VIRGIN ISLANDS Y

ALMCR MEDICARE PART A/B OF ALABAMA Y

AKMCR MEDICARE PART A/B OF ALASKA Y

AZMCR MEDICARE PART A/B OF ARIZONA Y

ARMCR MEDICARE PART A/B OF ARKANSAS Y

COMCR MEDICARE PART A/B OF COLORADO Y

CTMCR MEDICARE PART A/B OF CONNECTICUT Y

DCMCR MEDICARE PART A/B OF DC Y

DEMCR MEDICARE PART A/B OF DELAWARE Y

FLMCR MEDICARE PART A/B OF FLORIDA Y

GAMCR MEDICARE PART A/B OF GEORGIA Y

HIMCR MEDICARE PART A/B OF HAWAII Y

IDMCR MEDICARE PART A/B OF IDAHO Y

ILMCR MEDICARE PART A/B OF ILLINOIS Y

INMCR MEDICARE PART A/B OF INDIANA Y

IAMCR MEDICARE PART A/B OF IOWA Y

KSMCR MEDICARE PART A/B OF KANSAS Y

KYMCR MEDICARE PART A/B OF KENTUCKY Y

LAMCR MEDICARE PART A/B OF LOUISIANA Y

MEMCR MEDICARE PART A/B OF MAINE Y

MDMCR MEDICARE PART A/B OF MARYLAND Y

MAMCR MEDICARE PART A/B OF MASSACHUSETTS Y

MIMCR MEDICARE PART A/B OF MICHIGAN Y

MNMCR MEDICARE PART A/B OF MINNESOTA Y

Confidential Updated 08.30.2017

MSMCR MEDICARE PART A/B OF MISSISSIPPI Y

MOMCR

MEDICARE PART A/B OF MISSOURI (EASTERN) (SPECIALTY TESTING

REQUIRED) Y

MTMCR MEDICARE PART A/B OF MONTANA Y

NEMCR MEDICARE PART A/B OF NEBRASKA Y

NVMCR MEDICARE PART A/B OF NEVADA Y

NHMCR MEDICARE PART A/B OF NEW HAMPSHIRE Y

NMMCR MEDICARE PART A/B OF NEW MEXICO Y

ENMCR MEDICARE PART A/B OF NEW YORK (EMPIRE) Y

NYMCR MEDICARE PART A/B OF NEW YORK (UPSTATE) Y

NJMCR MEDICARE PART A/B OF NJ (SPECIALTY TESTING REQUIRED) Y

NCMCR MEDICARE PART A/B OF NORTH CAROLINA Y

NDMCR MEDICARE PART A/B OF NORTH DAKOTA Y

CNMCR MEDICARE PART A/B OF NORTHERN CALIFORNIA Y

OHMCR MEDICARE PART A/B OF OHIO Y

OKMCR MEDICARE PART A/B OF OKLAHOMA Y

ORMCR MEDICARE PART A/B OF OREGON Y

PAMCR MEDICARE PART A/B OF PA (SPECIALTY TESTING REQUIRED) Y

RIMCR MEDICARE PART A/B OF RHODE ISLAND Y

SCMCR MEDICARE PART A/B OF SOUTH CAROLINA Y

SDMCR MEDICARE PART A/B OF SOUTH DAKOTA Y

CSMCR MEDICARE PART A/B OF SOUTHERN CALIFORNIA Y

TNMCR MEDICARE PART A/B OF TENNESSEE Y

TXMCR MEDICARE PART A/B OF TEXAS Y

UTMCR MEDICARE PART A/B OF UTAH Y

VTMCR MEDICARE PART A/B OF VERMONT Y

VAMCR MEDICARE PART A/B OF VIRGINIA Y

WAMCR MEDICARE PART A/B OF WASHINGTON Y

Confidential Updated 08.30.2017

WVMCR MEDICARE PART A/B OF WEST VIRGINIA Y

MWMCR MEDICARE PART A/B OF WESTERN MISSOURI Y

WIMCR MEDICARE PART A/B OF WISCONSIN Y

WYMCR MEDICARE PART A/B OF WYOMING Y

ASMCR MEDICARE PART B OF AMERICAN SAMOA Y

GUMCR MEDICARE PART B OF GUAM Y

QUMCR MEDICARE PART B OF NEW YORK GHI Y

PRMCR MEDICARE PART B OF PUERTO RICO (IN TEST) Y

CALL MEDICARE SUPPLEMENTAL Y

AMM11 MEDICHOICE IPA N

23160 MEDICO INSURANCE COMPANY N

95655 MEDIGOLD N

94254 MEDIPRIME N

20039 MEDITURE N

V360H MEDIVIEW VISTA 360 HEALTH N

441MP MEDPARTNERS N

35205 MEDPARTNERS ADMIN N

412MP MEDPARTNERS ADMIN SERVICES N

00130 MEDPAY N

MPM20 MEDPOINT N

62160 MEDSOLUTIONS, INC. N

39190 MEDSTAR FAMILY CHOICE N

00243 MEDSTAR PHYSICIAN PARTNERS N

251MS MEDSTAR SELECT N

MX001 MEDXOOM N

74227 MEGA LIFE & HEALTH INS. CO. (STUDENT DIVISION) N

MMFMC MEMORIAL CARE MEDICAL FOUNDATION N

Confidential Updated 08.30.2017

MCA11 MEMORIAL CLINICAL ASSOCIATES N

62181 MEMORIAL CLINICAL ASSOCIATES SELECTCARE TEXAS N

MHIPA MEMORIAL HEALTHCARE IPA N

MHHNP MEMORIAL HERMANN HEALTH NETWORK N

59065 MEMORIAL INTEGRATED HC N

59064 MEMORIAL INTEGRATED HEALTHCARE N

CALL

MEMORIAL INTEGRATED HEALTHCARE (PLEASE EMAIL TRACY

HARSWICK AT THARSWICK@MHS.NET FOR PAYER ID

INFORMATION.) N

IP080 MENDICINA FAMILIAR MEDICAL GROUP N

74289

MENTAL HEALTH NETWORK (ONLY CLAIMS FOR PO BOX 209010

AUSTIN TX 78720) N

CALL MERCY CARE (PLEASE CALL 608-758-7739 FOR PAYERID.) N

86052 MERCY HEALTH PLAN (AHCCCS) N

86052 MERCY HEALTH PLAN OF AZ N

22326

MERCY HEALTH PLAN OF NEW JERSEY (PROVIDER ID REQUIRED IN

BOX33A - CONTACT (800) 682-9091 TO OBTAIN ID) N

MER11 MERCY HEALTH PLANS N

63002 MERCY LIFE ALABAMA N

33628 MERCY MARICOPA INTEGRATED CARE N

43185 MERCY PROVIDER NETWORK N

39114 MERCYCARE N

13189 MERIDIAN HEALTH PLAN N

64157 MERITAIN HEALTH (NORTH AMERICAN HEALTH PLAN.) N

64158 MERITAIN HEALTH / AGENCY SERVICES N

41124 MERITAIN HEALTH MINNEAPOLIS N

45150 MERITUS HEALTH N

65113 METCARE HEALTH PLANS N

13265 METRO PLUS HEALTH PLAN N

Confidential Updated 08.30.2017

10850 METROPOLITAN HEALTH PLAN N

38325 MI COMMUNITY CHOI N

MIBCN MICHIGAN BLUE CARE HMO (BCN OF MICHIGAN) Y

MIFEP MICHIGAN FEP Y

MIMPB MICHIGAN MEDICARE PLUSBLUE Y

96598 MICRON TECH N

52149 MID ATLANTIC PSYCHIATRIC SERVICES, INC. (MAPSI) N

MVBCN MID VALLEY BEHAVIORAL HEALTH NETWORK N

37281 MID-AMERICA ASSOCIATES N

22823 MID-AMERICAN BENEFITS N

77012 MIDCOAST IPA N

23550 MIDLAND MANAGEMENT/MFC N

90956 MIDLAND NATIONAL LIFE INS CO (NFIC PLAN ONLY) N

47078 MIDLANDS CHOICE N

47080 MIDLANDS CHOICE N

47080 MIDLANDS HEALTH PARTNERS N

C1051 MIDWEST FAMILY MUTUAL INSURANCE COMPANY N

61146 MIDWEST GROUP BENEFITS N

76079 MIDWEST HEALTH PARTNERS N

MHP77 MIDWEST HEALTH PLANS, INC. N

66727 MIDWEST PHYSICIAN ADMINISTRATIVE SERVICES N

TH088 MIDWEST PHYSICIAN ADMINISTRATIVE SERVICES N

74227 MID-WEST UNITED LIFE (STUDENT DIVISION) N

01776 MINUTEMAN N

PHM10 MISSION COMMUNITY IPA & PACIFIC HEALTH MSO N

MPM07 MISSION COMMUNITY IPA MED GRP N

STJOE MISSION HOSPITAL AFFILIATES N

Confidential Updated 08.30.2017

SX105 MISSIONARY MEDICAL Y

64084 MISSISSIPPI PHYSICIANS CARE NETWORK N

64088

MISSISSIPPI SELECT HEALTHCARE (MISSISSIPPI SELECT HEALTH

CARE) N

37275 MISSOULA COUNTY MEDICAL BENEFITS N

00530 MISSOURI CARE N

MMS01 MISSOURI MEDICARE SELECT N

26097 ML HEALTHCARE N

35316 MMA N

88600 MMM (MEDICARE Y MUCHO MAS) N

13350 MODA HEALTH - FORMERLY ODS HEALTH PLAN N

71079 MOLINA HC MISSOUR N

04423 MOLINA HEALCARE OF NEW MEXICO - SCI N

33373 MOLINA HEALTHCARE OF CA - ENCOUNTERS ONLY. N

38333

MOLINA HEALTHCARE OF CALIFORNIA (RENDERING PROVIDER

MUST USE MEDI-CAL ID NUMBER OR STATE LICENSE NUMBER.

BILLING PROVIDER SHOULD USE FEDERAL TAXID ONLY.) N

51062 MOLINA HEALTHCARE OF FLORIDA N

20934 MOLINA HEALTHCARE OF ILLINOIS N

38334 MOLINA HEALTHCARE OF MICHIGAN N

20676 MOLINA HEALTHCARE OF NEVADA N

NM505 MOLINA HEALTHCARE OF NEW MEXICO N

09824 MOLINA HEALTHCARE OF NEW MEXICO SALUD N

20149 MOLINA HEALTHCARE OF OHIO N

46299 MOLINA HEALTHCARE OF SOUTH CAROLINA N

20554 MOLINA HEALTHCARE OF TEXAS N

38336

MOLINA HEALTHCARE OF WASHINGTON (RENDERING PROVIDERS

USE DSHS MEDICAID ID OR STATE LICENCE NUMBER.) N

43174 MOLINA HEALTHCARE OF WASHINGTON ENCOUNTERS ONLY N

Confidential Updated 08.30.2017

SX109 MOLINA HEALTHCARE UTAH N

72135 MOMENTUM HEALTH SERVICES N

IP095

MONARCH HEALTHCARE IPA (RENDERING PROVIDER ID#

REQUIRED ON ALL CLAIMS.) N

50749 MONDIAL ASSISTANCE N

01759

MONITOR LIFE (PAYER ACCEPTS SECONDARY CLAIMS ONLY AND

MEDICARE CANNOT BE PRIMARY PAYER.) N

13174

MONTEFIORE CONTRACT MANAGEMENT ORGANIZATION

(PROVIDER ID REQUIRED, CALL 914-377-4400 FOR ID PRIOR TO

FIRST CLAIMS SUBMISSIONS.) N

MBIPA MONTEREY BAY IPA N

J1890

MONTGOMERY COUNTRY GOVERNMENT SELF INS PROGRAM

(MCSIP) N

46161 MONTIFORE HMO N

MMLIC

MONUMENTAL LIFE INS CO. (SPECIALIZED CLAIMS ONLY. CALL 501-

277-1284 FOR INFORMATION.) N

MMLI6 MONUMENTAL LIFE INSURANCE COMPANY BALTIMORE N

MMLI7 MONUMENTAL LIFE INSURANCE COMPANY BALTIMORE N

MMLI9 MONUMENTAL LIFE INSURANCE COMPANY PLANO N

MMLI5 MONUMENTAL LIFE INSURANCE COMPANY SCRANTON N

MMLI4 MONUMENTAL LIFE INSURANCE COMPANY VALLEY FORGE N

35092 MORRIS ASSOCIATES AKA HEALTHSCOPE BENEFITS N

IP083

MOSAIC IPA MEDICAL GROUP (PROVIDERS PLEASE CONTACT

BRANDI GUINN @ 559-735-3892 X233 FOR AUTHORIZATION.) N

99282 MOTION PICTURE INDUSTRY N

MPI01 MOTION PICTURE INDUSTRY HEALTH PLAN N

COMMA MOUNTAIN MEDICAL - MMA N

MTNST MOUNTAIN STATES ADMINISTRATORS (COLORADO ONLY) N

80900 MPA - CUSTOM PROVIDER NETWORK N

37233 MPE EMPLOYEE BENEFIT SERVICES N

Confidential Updated 08.30.2017

95444 MPLAN INC. HEALTHCARE GROUP N

MPM16 MPM PROSPECT N

26161 MRIPA ALLCARE CCO N

SB731 MS BCBS STATE EMPLOYEES N

20572 MSA CARE GUARD N

95655 MT. CARMEL N

86040 MTN STATES ADMINI N

9048P MULTIPLAN INCORPORATED N

34080 MULTIPLAN WISCONSIN PREFERRED PROVIDER NETWORK Y

MLTOT MULTNOMAH COUNTY N

81883 MUNICIPAL HEALTH BENEFITS FUND N

A1681 MUSKEGON CARE N

37256 MUTUAL ASSURANCE ADMINISTRATORS N

39065 MUTUAL BENEFIT N

39065 MUTUAL BENEFIT LIFE N

71412 MUTUAL OF OMAHA INSURANCE COMPANY N

71412 MUTUALLY PREFERRED N

14165 MVP HEALTH PLAN OF NY N

MIDSC MWEST SECURITIES N

33020 MY FAMILY MEDICAL GROUP N

32043 MYNEXUS INCORPORATED N

91136 N.W. IRONWORKERS HEALTH & SECURITY TRUST FUND - GRP#F15 N

91136

N.W. ROOFERS & EMPLOYERS HEALTH & SECURITY TRUST FUND -

GRP#F14 N

91136 N.W. TEXTILE PROCESSORS - GRP#F14 N

65085 NAA (NORTH AMERICA ADMINISTRATORS) N

L0110 NAMCI GLOBAL CARE N

NHCA1 NAPERVILLE HEALTH CARE ASSOCIATES N

Confidential Updated 08.30.2017

58182 NAPHCARE INC N

67788

NATIONAL ACCIDENT AND HEALTH GENERAL AGENCY

INCORPORATED N

CB148 NATIONAL ALLIED WU LOCAL 831 N

53011 NATIONAL ASSOCIATION OF LETTER CARRIERS N

NCABS NATIONAL CAPITAL AREA Y

90001

NATIONAL CAPITAL PREFERRED PROVIDER ORGANIZATION

(NCPPO) (TO OBTAIN YOUR PROVIDER ID NUMBER, PLEASE CALL

THE NCPPO CUSTOMER SERVICE DEPARTMENT AT (800) 272-5911 N

90956 NATIONAL FINANCIAL INSURANCE COMPANY N

98205 NATIONAL FOUNDATION LIFE INSURANCE COMPANY N

NHC01 NATIONAL HEALTCHARE CORPORATION ADVANTAGE N

NHAIN NATIONAL HEALTH ADMINISTRATORS INC. N

88057 NATIONAL HEALTH BENEFIT N

88050 NATIONAL HEALTH BENEFITS CORPORATION - NHBC02 N

52132 NATIONAL RURAL ELECTRIC N

NTA11 NATIONAL TEACHERS ASSOCIATION (NTA) N

52103

NATIONAL TELECOMMUNICATIONS COOPERATIVE ASSOCIATION

(NTCA) N

52104

NATIONAL TELLECOMMUNICATIONS COOPERATIVE ASSOCIATION

(NTCS STAFF) N

NVADM NATIONAL VISION N

31417 NATIONWIDE GROUP N

31417 NATIONWIDE INSURANCE N

31417 NATIONWIDE LIFE AND HEALTH N

31417 NATIONWIDE MUTUAL INSURANCE N

31417

NATIONWIDE SPECIALTY HEALTH (FORMERLY NATIONWIDE

HEALTH PLANS N

19191 NATIVE CARE HEALTH N

75191 NCAS - CHARLOTTE, VA N

Confidential Updated 08.30.2017

75190 NCAS - FAIRFAX, VA N

19988 NEA GROUP INSURAN N

51909 NEIGHBORHOOD DOCTORS ORGANIZATION N

95123 NEIGHBORHOOD HEALTH PARTNERSHIP (NHP) N

96107 NEIGHBORHOOD HEALTH PARTNERSHIP (NHP) N

05047

NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND (CONTACT

NHPRI 401-459-6030 TO VERIFY PROVIDER AND VENDOR

NUMBER.) N

96240 NEIGHBORHOOD HEALTH PLAN OF RI - INTEGRITY N

96240 NEIGHBORHOOD HEALTH RI EXCHANGE, UNITY, INTEGRITY PLANS N

04293 NEIGHBORHOOD PLAN (BOSTON, MA) N

66055 NETCARE LIFE AND HEALTH INSURANCE N

04332

NETWORK HEALTH (BEFORE INITIATING SUBMISSIONS, PLEASE

CALL PROVIDER RELATIONS AT (617)806-8104 OR

WWW.NETWORK-HEALTH.ORG FOR AN EDI STARTUP PLAN.) N

77076 NETWORK HEALTH INSURANCE CORP - MEDICARE N

04332 NETWORK HEALTH MASSACHUSETTS N

39144

NETWORK HEALTH PLAN OF WISCONSIN, INC.(PRIOR TO INITIAL

CLAIMS SUBMISSION, PLEASE CONTACT NETWORK HEALTH PLAN

EDI SPECIALIST AT 920-720-1506.) N

AMS01 NETWORK HEALTH PPO N

NSIPA NETWORK SOLUTIONS IPA N

90091 NEVADA HEALTH COOP N

86067 NEVADA HEALTH SOLUTIONS (PROVIDER ID REQUIRED) N

86067 NEVADACARE (PROVIDER ID REQUIRED) N

86067 NEVADACARE KIDS (PROVIDER ID REQUIRED) N

95998 NEW AVENUES INC. N

NCH09 NEW CENTURY HEALTH - VISTA CARDIOLOGY N

NCHOR NEW CENTURY HEALTH ARIZONA INTEGRATED PHYSICIANS N

NCHCA NEW CENTURY HEALTH CENTERS N

Confidential Updated 08.30.2017

NCH03 NEW CENTURY HEALTH UROLOGY N

66893 NEW ENGLAND, THE N

66893 NEW ENGLAND, THE N

75281 NEW ERA LIFE N

76031 NEW ERA WELFARE BENEFIT PLAN TRUST N

68069 NEW HAMPSHIRE HEALTHY FAMILY N

74234 NEW MEXICO DISTRICT COUNCIL OF CARPENTERS N

45129 NEW MEXICO HEALTH CONNECTIONS N

74234 NEW MEXICO PAINTERS AND ALLIED TRADES LOCAL NO 823 N

85036 NEW MEXICO PUBLIC SCHOOLS INSURANCE AUTHORITY N

74234

NEW MEXICO-WEST TEXAS MULTI-CRAFT (LSO KNOWN AS NEW

MEXICO LABORERS) N

84141 NEW WEST HEALTH PLAN N

NYL11 NEW YORK LIFE - LONG TERM CARE N

14179 NEW YORK MEDICAL IMAGING-MVP N

11334 NEW YORK NETWORK MANAGEMENT N

ADSL1 NEXCALIBER N

69821 NEXT LEVEL HEALTH N

38225 NGS AMERICAN, INC. N

81264 NIPPON LIFE INSURANCE COMPANY N

22603 NJ CARPENTERS HEALTH FUND N

NMPPO NM BLUE MCARE PPO N

IP080 NOBLE COMMUNITY N

64157 NORTH AMERICAN ADMINISTRATORS, INC. N

34159 NORTH AMERICAN BENEFITS NETWORK (NABN) N

76112 NORTH AMERICAN INSURANCE COMPANY N

IP079

NORTH AMERICAN MEDICAL MANAGEMENT (PROVIDER NUMBER

MUST BE IN BOX 33A) N

Confidential Updated 08.30.2017

37314 NORTH BROWARD HOSPITAL DISTRICT N

78353 NORTH IOWA COMMUNITY HEALTHCARE (NICH) N

46227 NORTH SHORE - LIJ CARECONNECT INSURANCE COMPANY N

17516 NORTH SHORE - LU MLTCP N

36392 NORTH SUBURBAN ASSOCIATED PHYSICIANS N

35212 NORTH TEXAS HEALTHCARE NETWORK N

PH018 NORTH WEST LIFE N

58169 NORTHEAST GEORGIA HEALTH SERVICES N

72690 NORTHEAST IOWA AREA AGENCY N

SISCO NORTHEAST IOWA COMMUNITY HEALTH PLAN N

NCA01 NORTHERN CALIFORNIA ADVANTAGE MEDICAL GROUP N

J1923 NORTHERN CLAIMS MANAGEMENT N

36347 NORTHERN ILLINOIS HEALTH PLAN N

88027

NORTHERN NEVADA TRUST FUNDS (CALL 775-826-7200 PRIOR TO

SUBMITTING CLAIMS.) N

NMG01 NORTHRIDGE MEDICAL GROUP N

48026 NORTHSHORE PHYSICIANS ASSOCIATES N

60058 NORTHSTAR ADVANTAGE N

52627 NORTHSTAR ADVANTAGE (MHP) N

NWDC1 NORTHWEST DIAGNOSTIC CLINIC N

NPN11 NORTHWEST PHYSICIANS NETWORK N

36346 NORTHWEST SUBURBAN IPA (IL) N

PH018 NORTHWESTERN NATIONAL LIFE N

16114 NOVA CASUALTY COMPANY N

16644 NOVA HEALTHCARE ADMINISTRATORS, INC. (GRAND ISLAND, NY) N

62119 NW DIAGNOSTIC CLINIC SELECTCARE OF TX (NWDC) N

N2FEP NY CENTRAL FEP (FEDERAL EMPLOYEE PROGRAM) BLUE SHIELD N

24819 NY PRESBYTERIAN S N

Confidential Updated 08.30.2017

37299 NYHART N

14142 NYS DOH UCP N

OAKST OAK STREET HEALTH N

36400 OAK WEST PHYSICIAN ASSOCIATION N

36402

OAK WEST PRIMARY PHYSICIAN ASSOCIATION (CLAIMS AFTER

6.01.2015) N

NAOAK

OAK WEST PRIMARY PHYSICIAN ASSOCIATION (CLAIMS PRIOR TO

6.01.2015) N

NAOAK

OAK WEST PRIMARY PHYSICIAN ASSOCIATION (CLAIMS PRIOR TO

6.01.2015) N

OCFMC OC FOUNDATION MED N

L0140 OCCULAR BENEFITS N

50653 OCCUPATIONAL EYEWEAR NETWORK INCORPORATED N

72127 OCHSNER HEALTH PLAN N

OBA18 OGDEN BENEFITS ADMINISTRATION N

31147 OH WORKERS COMP N

34189 OHIO HEALTH CHOICE PPO N

74431 OHIO PPO CONNECT N

OLRMC OLOLRMC UNINSURED PATIENT SERVICES PROGRAM N

65074 OLYMPUS MANAGEMENT HEALTHCARE N

25150

OMNICARE (FOR CLAIMS WITH DATES OF SERVICE AFTER

10/01/04) N

OMN02 OMNICARE IPA N

IP088 OMNICARE MEDICAL GROUP N

99485 ON LOK SENIOR HEALTH SERVICES INCORPORATED N

ONOCI ONCOLOGY NETWORK OF ORANGE COUNTY N

22321 ONE CALL MEDICAL N

80705 ONE HEALTH PLAN INC. N

80705 ONE HEALTH PLAN MICHIGAN, INC. N

Confidential Updated 08.30.2017

80705 ONE HEALTH PLAN NEW YORK, INC. N

80705 ONE HEALTH PLAN OF ALASKA N

80705 ONE HEALTH PLAN OF ARIZONA, INC. N

95379 ONE HEALTH PLAN OF CALIFORNIA N

95412 ONE HEALTH PLAN OF COLORADO N

80705 ONE HEALTH PLAN OF DC INC, N

80705 ONE HEALTH PLAN OF FLORIDA N

95569 ONE HEALTH PLAN OF GEORGIA N

95388 ONE HEALTH PLAN OF ILLINOIS N

80705 ONE HEALTH PLAN OF INDIANA, INC. N

80705 ONE HEALTH PLAN OF KANSAS AND MISSOURI N

80705 ONE HEALTH PLAN OF MAINE, INC. N

80705 ONE HEALTH PLAN OF MASSACHUSETTS, INC. N

80705 ONE HEALTH PLAN OF MINNESOTA, INC. N

80705 ONE HEALTH PLAN OF NEVADA, INC. N

80705 ONE HEALTH PLAN OF NEW JERSEY N

80705 ONE HEALTH PLAN OF NORTH CAROLINA N

80705 ONE HEALTH PLAN OF OHIO N

80705 ONE HEALTH PLAN OF PENNSYLVANIA N

80705 ONE HEALTH PLAN OF SOUTH CAROLINA N

80705 ONE HEALTH PLAN OF TENNESSEE N

80705 ONE HEALTH PLAN OF TEXAS N

80705 ONE HEALTH PLAN OF VIRGINIA, INC. N

80705 ONE HEALTH PLAN OF WASHINGTON N

80705 ONE HEALTH PLAN OF WISCONSIN, INC. N

80705 ONE HEALTH PLAN OF WYOMING N

ONEHC ONE HOMECARE SOLUTIONS N

Confidential Updated 08.30.2017

52149 ONENET PPO, LLC. (FORMERLY KNOWN AS ALLIANCE PPO, INC.) N

BPA01 OPEIU LOCALS 30 & 537 N

66771 OPERATING ENGINEERS LOCAL 139 HEALTH BENEFIT FUND N

74234 OPERATING ENGINEERS LOCAL NO 53 N

91136

OPERATING ENGINEERS LOCALS 302 & 612 HEALTH & SECURITY

FUND - GRP#F12 N

56190 OPTICARE EYE HEALTH NETWORK N

OPCAU OPTICARE OF UTAH N

54154 OPTIMA INSURANCE COMPANY N

52152 OPTIMUM CHOICE OF THE CAROLINA'S (MAMSI) N

87726 OPTIMUM CHOICE, INC. (OCI) (PREVIOUSLY PAYER ID 52148) N

20133 OPTIMUM HEALTHCARE, INC. N

U6885 OPTUM BEHAVIORAL HEALTH SLCO N

41161

OPTUM HEALTH - PHYSICAL HEALTH (INCLUDES OXFORD)

(OPTUMHEALTH) N

87726 OPTUMHEALTH BEHAVIOR SOLUTIONS N

87726 OPTUMHEALTH BEHAVIORAL SOLUTIONS OF NM (OPTUMHEALTH) N

41194 OPTUMHEALTH CARE SOLUTIONS (FORMERLY U.R.N.) N

41194

OPTUMHEALTH CARE SOLUTIONS (FORMERLY UNITED RESOURCES

NETWORKS)(OPTUMHEALTH) N

87726 OPTUMHEALTH NEW MEXICO N

00773 OPTUMHEALTH VISION N

MHIPA ORANGE COAST MEMORIAL IPA N

65021 ORANGE COUNTY HEALTHCARE AGENCY N

OHMS OREGON HEALTH MANAGEMENT SERVICES (OHMS) N

OHMSP

OREGON HEALTH MGMT OHMS AKA PRIMARY HEALTH OF

JOSEPHINE N

45332 OREGONS HEALTH CO-OP N

Confidential Updated 08.30.2017

21455

OREGON'S HEALTH CO-OP (DOS 1/1/15 AND AFTER PAYERID

45332) N

13383 ORTHONET - AETNA N

13381 ORTHONET CORPORATION N

25681 ORTHONET-HEALTHNET N

OSCAR OSCAR HEALTH N

OSFMC OSF CARE ADVANTAGE N

62171 OSF HEALTH PLAN N

61101 OSF HEALTH PLANS Y

OSFE9 OSF HEALTHCARE EAST N

37127 OSG-MICHAEL REESE N

J1904 OSI GROUP LLC N

73071 OSMA HEALTH CL FRATES N

06111 OXFORD (UNITEDHEALTHCARE/OXFORD) N

06111 OXFORD HEALTH PLANS N

87068 P5 HEALTH PLAN SOLUTIONS OF UTAH N

15460 PA CARE ADVANTAGE HIGHMARK SENIOR HEALTH Y

CALL

PA PREFERRED HEALTH (CALL PPHN CLAIMS OPERATIONS AT 410-

349-3222) N

72436 PACE CENTRAL IOWA N

70454 PACE CNY N

35416 PACE NEBRASKA N

45114 PACE OF SOUTHWEST MICHIGAN INCORPORATED N

86711 PACE SOUTHEAST MICHIGAN N

53534 PACE SOUTHWEST IOWA N

99486 PACEPARTNER SOLUTIONS N

J1913 PACIFIC COMPENSATION INSURANCE COMPANY N

J1916 PACIFIC GAS AND ELECTRIC 115 N

Confidential Updated 08.30.2017

75309 PACIFIC SOUTHWEST ADMININSTRATORS (PSWA) N

33053 PACIFICARE BEHAV N

81400 PACIFICARE INDIVIDUAL BUSINESS PLAN (UNITEDHEALTHONE) N

95958 PACIFICARE OF CA ENCOUNTERS N

95958 PACIFICARE OF OK ENCOUNTERS N

95958 PACIFICARE OF OR ENCOUNTERS N

95958 PACIFICARE OF TX ENCOUNTERS N

95958 PACIFICARE OF WA ENCOUNTERS N

95999 PACIFICARE PPO N

20416 PACIFICSOURCE COMMUNITY SOLUTIONS N

93029 PACIFICSOURCE HEALTH PLANS N

20377 PACIFICSOURCE MEDICARE N

COIHS PACIFICSOURCE OHP N

81240 PALIC / PAN-AMERICAN HEALTH Y

37268

PALLADIAN MUSCULAR SKELETAL HEALTH (FORMERLY PRISM

HEALTH NETWORKS) N

38520

PALMETTO TRICARE (REGIONS 1-6) NORTHERN AND SOUTHERN

REGION N

94115 PALO ALTO MEDICAL FOUNDATION N

IP132 PALO ALTO MEDICAL FOUNDATION N

04218 PAN AMERICAN LIFE INSURANCE N

PAPER PAPER CLAIMS N

PRINT PAPER CLAIMS N

58174 PARAGON BENEFITS N

SX158 PARAMOUNT HEALTH N

58204 PARITY HEALTHCARE, INC. N

66917 PARKLAND COMMUNITY HEALTH PLAN N

PARTH PARTNERS IN HEALTH N

Confidential Updated 08.30.2017

56152 PARTNERS NAT HPNC N

PHP02

PARTNERSHIP HEALTH PLAN (OPTUMINSIGHT FOR ENROLL

FORMS) N

IP080 PASADENA PRIMARY CARE PHYSICIANS N

97652 PASSPORT ADVANTAGE N

61129 PASSPORT HEALTH PLAN N

76569 PASSPORTADVANTAGE N

PAN01 PATIENT ACCESS N

10525 PATIENT ADVOCATES, LLC N

26335 PATIENTPAY N

20907 PAUL MUELLER N

26048 PAYER FUSION N

27048 PAYER FUSION N

25449 PBS OREGON ALASKA INDUSTRIAL HARDWARE N

27267 PBS OREGON ALASKA RUBBER AND SUPPLY N

27277 PBS OREGON CASCADE RUBBER PRODUCTS N

26224 PBS OREGON CONSTRUCTION MACHINERY INDUSTRIAL N

73624 PBS OREGON PENINSULA AIRWAYS N

83926 PBS OREGON TDX CORPORATION N

95885 PCA HEALTHPLANS TEXAS N

68069 PEACH STATE HEALTH PLAN (BEHAVIORAL HEALTH) N

68069

PEACH STATE HEALTH PLAN (MEDICAID) (CALL 800-225-2573 EXT

25525 PRIOR TO SUBMITTING CLAIMS.) (ALSO 39187) N

27034 PEAK PACE SOLUTIONS N

20472 PEDIATRIC ASSOCIATES OF BROWARD N

M3FL8 PEDICARE TITLE 19 N

M3FL6 PEDICARE TITLE 21 N

PEF01 PEF CLINIC N

Confidential Updated 08.30.2017

J1924 PEGASUS RISK MANAGEMENT CALIFORNIA N

CALL PEHP - UTAH PUBLIC EMPLOYEE HEALTH PLAN Y

SX106

PEHP - UTAH PUBLIC EMPLOYEE HEALTH PLAN (ENROLLMENT

REQUIRED, PLEASE CONTACT PROVIDER RELATIONS 800-765-7347) N

UH136 PEHP CHIROHLTHPLA N

37086 PEKIN INSURANCE N

CALL PENINSULA HEALTHCARE Y

53226 PENN BEHAVIORAL HEALTH N

95056 PENNSYLVANIA KEYSTONE HEALTH PLAN EAST (CLAIMS ONLY) Y

PCBLS PENNSYLVANIA KEYSTONE HEALTH PLAN EAST (CLAIMS ONLY) N

95056

PENNSYLVANIA KEYSTONE HEALTH PLAN EAST (ENCOUNTERS

ONLY) Y

PEBLS

PENNSYLVANIA KEYSTONE HEALTH PLAN EAST (ENCOUNTERS

ONLY) N

23130 PENNSYLVANIA LIFE INSURANCE N

20172 PENNSYLVANIA PACE N

06161 PENNSYLVANIA PREFERRED HEALTH NETWORK (PPHN) N

72126

PEOPLES HEALTH NETWORK (TENET) (NETWORK ID MUST BE ON

CLAIM. CONTACT PHN.PROVIDER@TENETHEALTH.COM) N

54704

PERSONAL CHOICE PPO OF PENNSYLVANIA (ALSO KNOW AS

INDEPENDENT BLC) Y

95397 PERSONAL INSURANCE ADMINISTRATORS N

25146 PERSONALCARE N

45275 PHCS GEHA N

13306 PHCS SAVILITY (ONLY FOR SAVILITY CARD MEMBERS.) N

PHIF4 PHIFER WIRE INS N

75238 PHOENIX GROUP SER N

03440 PHOENIX HEALTH PLAN N

22729 PHOENIX HEALTH PLAN (MEDICARE) N

Confidential Updated 08.30.2017

PHYCR PHYCOR (FT COLLINS OFFICE ONLY) Y

EXC01 PHYS MED GROUP OF SAN JOSE N

PA513 PHYSICIAN ASSOCIATES OF GREATER SAN GABRIEL VALLEY Y

58204 PHYSICIAN ASSOCIATES OF LOUSIANA (PAL) N

57549 PHYSICIAN HEALTH COOPERATIVE/SRRIPA N

PHPMC PHYSICIAN HEALTH PARTNERS N

PPRT1 PHYSICIAN PARTNERS IPA N

28943 PHYSICIANS ACCOUNTABLE CARE ORGANIZATION N

38265 PHYSICIANS CARE NETWORK N

36345

PHYSICIANS CARE NETWORK (ROCKFORD, IL ONLY) PAYERID VALID

ONLY FOR CLAIMS WITH BILLING SUBMISSION NAME, CITY AND

STATE OF PHYSICIANS CARE NETWORK, ROCKFORD, IL. N

PCN12 PHYSICIANS CARE NETWORK/THE POLYCLINIC N

MCI01 PHYSICIANS CHOICE MEDICAL SANTA MARIA N

SLOS1 PHYSICIANS CHOICE MEDICAL SLO N

65018 PHYSICIANS CORPORATION OF AMERICA (FLORIDA PLAN ONLY) N

37136 PHYSICIANS HEALTH ASSOCIATION OF ILLINOIS N

PHCS1

PHYSICIANS HEALTH CHOICE - CLAIMS (ADMINISTERED BY

WELLMED) N

PHCEN

PHYSICIANS HEALTH CHOICE - ENCOUNTERS (ADMINISTERED BY

WELLMED) N

20398 PHYSICIANS HEALTH COLLABORATIVE N

MHCM2 PHYSICIANS HEALTH NETWORK N

37330 PHYSICIANS HEALTH PLAN (PHP) MID-MICHIGAN N

09173 PHYSICIANS HEALTH PLAN (PHP-SC) N

12399 PHYSICIANS HEALTH PLAN OF NORTHERN INDIANA N

PHIPA PHYSICIANS HEALTHWAYS IPA N

PMGSC PHYSICIANS MEDICAL OF SANTA CRUZ N

47027 PHYSICIANS MUTUAL INSURANCE COMPANY N

Confidential Updated 08.30.2017

91171 PHYSICIANS OF SOUTHWEST WASHINGTON N

39156 PHYSICIANS PLUS INSURANCE CORP. N

TH131 PHYSICIANS UNITED PLAN N

95397 PIA N

87056 PIASC N

251PD PIEDMOND WELLSTAR HEALTH PLAN N

56151 PIEDMONT ADMINISTRATORS N

06607 PIEDMONT BEHAVIORAL HEALTH N

PMA86 PIMA HEALTH SYSTE N

45985 PINNACLE PHYSICIAN MANAGEMENT ORGANIZATION N

CCIA1 PINNACOL ASSURANCE N

PPNZZ PIONEER PROVIDER NETWORK N

COMPU PIPE INDUSTRY HEALTH & WELFARE FUND OF COLORADO N

59700 PIPEFITTERS L 597 N

37224 PITTMAN AND ASSOCIATES N

23283 PITTSBURGH CARE PARTNERSHIP N

37287 PLANNED ADMINISTRATORS, INC. (PAI) N

CLFRS PLICO N

PMGSJ PMG OF SAN JOSE Y

POD1S PODIATRY FIRST N

POD1ST PODIATRY FIRST INC N

59324 PODIATRY NETWORK FL N

PCU01 POINT COMFORT UNDERWRITERS N

PCU02 POINT COMFORT UNDERWRITERS N

32680 POLY AMERICA MEDICAL & DENTAL BENEFIT PLAN N

16111 POMCO N

IP057 POMONA VALLEY MEDICAL GROUP (PVMG) PROMED N

Confidential Updated 08.30.2017

73159 PPO OKLAHOMA (WINTERBROOK HEALTHCARE MANAGEMENT) N

UHNDC PPO ONE N

59333 PPO PLUS N

72148 PPO PLUS, LLC N

A0009 PPOM LLC N

PPOM1 PPOM LLC N

36332 PPONEXT N

04334 PRACTICARE N

36373 PRAIRIE STATES ENTERPRISES, INC. N

TCC13 PRE MED DEFENDER N

EPF10

PREFERRED ADMINISTRATOR (CONTACT PROVIDER RELATIONS @

(915)532-2778, X1068) N

EPF11 PREFERRED ADMINISTRATORS CHILDRENS HOSPITAL N

53476 PREFERRED BENEFIT ADMINISTRATORS N

SC481 PREFERRED BLUE SC Y

SX089 PREFERRED CARE NY N

CALL

PREFERRED CARE PARTNERS (ENCOUNTERS FROM DELEGATED

ENTITIES ONLY. TO GET PAYERID, CALL JEFF NEHMS AT 305-670-

8440.) N

65088 PREFERRED CARE PARTNERS (MIAMI,FLORIDA) N

73145 PREFERRED COMMUNITY CHOICE N

CALL

PREFERRED HEALTH CARE - PPO LANCASTER, PA (IHS GATEWAY

PAYER) - CONTACT SHERRY WOLGEMUTH AT (717)560-9290 EXT.

124 FOR APPROVAL AND THE PAYER ID. N

33898 PREFERRED HEALTH CARE (PHC) N

61106 PREFERRED HEALTH PLAN (LOUISVILLE, KY) N

CB404 PREFERRED HEALTH PLAN OF CAROLINAS (PHPC) N

31478 PREFERRED HEALTH PROFESSIONALS N

00036 PREFERRED HEALTH PROFESSIONALS KANSAS CITY N

Confidential Updated 08.30.2017

61665 PREFERRED HEALTH SYSTEMS INSURANCE CO (PPO) N

60110 PREFERRED HEALTH SYSTEMS, INC. N

PFIPA PREFERRED IPA N

L0250 PREFERRED MEDICARE N

36401 PREFERRED NETWORK ACCESS N

41147 PREFERRED ONE N

00430 PREMERA Y

PCI01 PREMIER CARE IPA N

PCL01 PREMIER CARE IPA N

65054 PREMIER EYE CARE N

43166 PREMIER HEALTH PL N

251PR PREMIER HEALTH PLAN N

88051 PREMIER HEALTHCARE EXCHANGE N

88056 PREMIER HEALTHCARE EXCHANGE (CYPRESS) N

CAPMN PREMIER PHYSICIANS NETWORK N

MPM22 PREMIER PHYSICIANS NETWORK N

PREHP

PRESBYTERIAN HEALTH PLAN (COMMERCIAL) (PROVIDER ID IS

REQUIRED. CONTACT (888) 923-5757, #6 THEN #2 TO OBTAIN ID.

NEW MEXICO PROVIDERS ONLY.) N

PRESA

PRESBYTERIAN SALUD (PLEASE ADD PROVIDER NUMBER IN

2010AA REF02 OR 2310B REF02 NUMBER IS 11 DIGITS OR LESS.

CONTACT 888-923-5757, #6,#2 TO OBTAIN ID.) N

05003 PRESBYTERIAN(NM) N

77003 PRESTIGE HEALTH CHOICE N

39185 PREVEA HEALTH INSURANCE PLAN / ARISE HEALTH PLAN N

PCACZ

PRIMARY CARE ASSOC OF CALIFORNIA (CUSTOMER SERVICE

PHONE NUMBER 877-602-1563) N

PCJOL PRIMARY CARE OF JOLIET N

PCSNCHD PRIMARY CARE SERVICES NCHD N

Confidential Updated 08.30.2017

60054 PRIMARY CHOICE (AETNA HP-NY/NJ) N

73288 PRIMARY DELIVERY SYSTEMS N

82048 PRIMARY HEALTH NETWORK N

56144 PRIMARY PHYSICIANCARE, INC. N

E3510 PRIME CARE N

MVCV1 PRIME COMMUNITY CARE CENTRAL VALLEY N

61604 PRIME WEST HEALTH PLAN N

IP079 PRIMECARE HEALTH PLAN N

04320 PRIMESOURCE HEALTH NETWORK N

J1891 PRINCE GEORGES COUNTY GOVERNMENT MARYLAND N

PRI01 PRINCETON PREMIER IPA N

61271 PRINCIPAL FINANCIAL GROUP N

61271 PRINCIPAL MUTUAL LIFE INSURANCE COMPANY N

38217

PRIORITY HEALTH (PLEASE CONTACT PRIORITY HEALTH EDI DEPT

AT 616-464-8686 OR EMAIL EDISETUP@PRIORITY-HEALTH.COM) N

CALL PRIORITY HEALTHCARE Y

37268

PRISM HEALTH NETWORKS (NOW KNOWN AS PALLADIAN

MUSCULAR SKELETAL HEALTH ) N

37315 PRISM UNIVERA N

PRNLK PRNLINK MLK N

70259 PROCARE HEALTH PLAN MEDICAID N

13396 PRODUCTIVE PROCESSING N

36331 PROFESSIONAL BENEFIT ADMINISTRATORS, INC. (OAK BROOK, IL) N

37242 PROFESSIONAL CLAIMS MANAGEMENT N

56001 PROFESSIONAL CLAIMS MANAGEMENT N

J1821 PROFESSIONAL CLAIMS MANAGEMENT N

WK476 PROGRESSIVE INSURANCE N

93082 PROMINENCE HEALTH PLAN OF NEVADA N

Confidential Updated 08.30.2017

80095 PROMINENCE HEALTH PLAN OF TEXAS N

88082 PROMINENCE-ST. MARY'S HEALTH PLAN ENCOUNTERS N

PROSP PROSPECT MEDICAL GROUP N

37309 PROTECTIVE LIFE INSURANCE COMPANY N

SX187 PROVIDENCE N

PHP01 PROVIDENCE CHOICE OPTION Y

PHP01 PROVIDENCE GOOD HEALTH PLAN Y

PAS01 PROVIDENCE INSURANCE AND ADMINISTRATIVE SERVICES N

SX133 PROVIDENCE OF OREGON HEALTH PLAN N

PHP00

PROVIDENCE PREFERRED (PPO) (PROVIDERID AND ENROLLMENT

REQUIRED.) Y

68195 PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY N

68195 PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY OF AMERICA N

68195 PROVIDENT LIFE & CASUALTY INSURANCE COMPANY N

48100 PROVIDRS CARE NETWORK N

HM015 PRUCARE HMO (ENCOUNTERS ONLY) N

MPM25 PRUDENT MEDICAL GROUP N

HM015 PRUDENTIAL ENCOUNTERS N

PH001 PRUITT HEALTH PREMIER N

PSKW0 PSKW N

J1897 PUBLIX SUPER MARKETS INCORPORATED N

CALL PUERTO RICO TRIPLE S (BCBS) Y

91136 PUGET SOUND BENEFITS TRUST - GRP#F25 N

91136 PUGET SOUND ELECTRICAL WORKERS TRUST - GRP#33 N

44827 QUAD CITIES COMMUNITY HEALTH PLAN N

40437 QUAD CITY COMMUNITY HEALTHCARE (QCCH) N

35172 QUAL CHOICE NC N

35174 QUAL CHOICE OF ARKANSAS N

Confidential Updated 08.30.2017

01250 QUAL CHOICE OF OHIO N

QMDCE QUAL MEDICAL COLORADO N

QUANM QUAL MEDICAL NEW MEXICO N

QMDPO QUAL MEDICAL PORTLAND N

23342 QUALCARE N

22312 QUALCARE ALLIANCE NETWORKS INC. (QANI) N

89461 QUALITY CARE PARTNERS N

QCTPA QUANTUMCARE (WE CARE HEALTH PLAN) N

QUARTZASO QUARTZ ADMINISTRATIVE SERVICES ORGANIZATION (ASO) N

84562 QUESTCARE MEDICAL N

73067 QUICKTRIP CORPORATION N

57117 QVI RISK SOLUTIONS, INC. N

CALL

RADCON, INC. (PLEASE CONTACT KATHY KING @ 856-608-1350

FOR PAYER ID INFORMATION.) N

RCHN1 RADY CHILDRENS HEALTH NETWORK N

RRMCR RAILROAD MEDICARE Y

J1894 RAM MUTUAL INSURANCE COMPANY N

RPAWC RAVENSWOOD PHYSICIAN ASSOCIATES N

91176 RBMS, LLC N

SYMED REDLANDS IPA (SYNERMED) N

REGAL REGAL MEDICAL GROUP N

00932 REGENCE BLUE SHIELD OF WASHINGTON N

RGA01 REGENCE GROUP ADMINISTRATORS N

38221 REGENCY EMPLOYEE BENEFITS N

47076 REGIONAL CARE, INC. N

REHNA REHN AND ASSOCIATES N

PH018 RELIASTAR (FORMERLY NWNL) N

76066 RENAISSANCE PHYSICIANS ORGANIZATION N

Confidential Updated 08.30.2017

73066

RESERVE NATIONAL INSURANCE (FOR CLAIMS REJECTIONS, PLEASE

CONTACT RESERVE NATIONAL CUSTOMER SERVICE AT (405)848-

7931.) N

20481

RESOLVE HEALTH PLAN ADMINISTRATORS (AUTHORIZATION

NUMBER REQUIRED: BEGINS WITH THE NUMBER 5 AND IS 13

CHARACTERS IN LENGTH.) N

RHA01 RESOLVE HEALTH PLAN ADMINISTRATORS LLC N

RPPG1 RESURRECTION PHYSICIAN PROVIDER GROUP N

26316 RETIREE HEALTH TRUST N

RVC01 REVCLAIMS N

A0010 REVCLAIMS LLC N

74205 RIGHT CARE FROM SCOTT & WHITE N

37331 RIGHTCHOICE BENEFITS ADMINISTRATORS N

RCMG1 RIVER CITY MEDICAL GROUP N

42172 RIVERLINK HEALTH N

45281 RIVERSIDE HEALTH INC N

RMC01 RIVERSIDE MEDICAL CLINIC N

RMSCO RMSCO N

SX141 ROCKY MOUNTAIN HEALTH PLAN GRAND JUNCTION N

RMHMO ROCKY MOUNTAIN HMO Y

37602 ROONEY LIFE INS. N

46166

ROYAL HEALTH ON BEHALF OF EXTENDED CARE MLTC (FOR

CLAIMS WITH SERVICE DATES/STATEMENT DATES AFTER

12/1/2013.) N

36389 RUSH PRUDENTIAL HEALTH PLANS (HMO ONLY) N

31441 S & S HEALTHCARE STRATEGIES N

35164 SAGAMORE HEALTH NETWORK, INC. N

MNDH1 SAGE N

MNDH1 SAGE PLUS N

37137 SAGE TECHNOLOGIES - PBS N

Confidential Updated 08.30.2017

37105

SAGE TECHNOLOGIES (FORMERLY CCMSI) (CLAIMS FOR PAYER

ADDRESS OF ROCKFORD, IL ONLY.) N

STA01 SAINT ANTHONY PHO N

88029 SAINT MARYS HEALTH PLAN N

SAMAD SAMARITAN ADVANTAGE Y

SAMCP SAMARITAN CHOICE PLAN Y

SAM00 SAMARITAN COMMERCIAL PLAN N

CP001 SAMARITAN HEALTH PLANS N

MSO77

SAN DIEGO COUNTY LOW INCOME HEALTH PROGRAM/COVERAGE

INITIATIVE N

MSO11 SAN DIEGO COUNTY MEDICAL SERVICES (CMS) N

MSO22 SAN DIEGO COUNTY PHYSICIAN EMERGENCY SERVICES N

MSO44 SAN DIEGO COUNTY PRIMARY CARE SERVICES N

MSO33 SAN DIEGO COUNTY RYAN WHITE PRIMARY CARE PROGRAM N

MSO55 SAN DIEGO COUNTY SHERIFFS DEPARTMENT N

96400 SAN DIEGO PACE N

J1886 SAN FRANCISCO MUNICIPAL TRANSPORTATION AGENCY N

33072 SAN LUIS OBISPO SELECT IPA N

SHC30 SANDHILLS CENTER N

SHC303 SANDHILLS CENTER N

91184 SANFORD HEALTH PLAN N

MNSHP SANFORD HEALTH PLAN N

SCACO SANTA CLARA COUNTY IPA N

24077 SANTA CLARA FAMILY HEALTH PLANS N

SNTMC SANTE COMMUNITY PHYSICIANS MEDICAL GROUP CORP N

77038 SANTE HEALTH SYSTEMS N

63665 SANUS HMO-ST. LOUIS (GENERAL AMERICA) N

63665 SANUS PPO (GENERAL AMERICA) N

Confidential Updated 08.30.2017

45552 SATELLITE HEALTH PLAN N

SC922 SC BCBS COMPANION HEALTH Y

SC886 SC BCBS PLANNED ADMINISTRATORS Y

SC400 SC BCBS STATE EMPLOYEE HEALTH PLAN Y

SCAN1 SCAN CA N

99157 SCAN ENCOUNTERS (DIVERSIFIED DATA DESIGN (DDD)) N

72261 SCAN HEALTH PLAN N

73172 SCAN HEALTH PLAN ARIZONA N

20460 SCAN LONG TERM CARE N

SCH01 SCHALLER ANDERSON CHOC HEALTH ALLIANCE N

16146 SCHC TOTAL CARE N

88030 SCOTT & WHITE HEALTH CARE N

SHPM1 SCRIPPS HEALTH PLAN MANAGEMENT SERVICES ORGANIZATION N

SHPS1 SCRIPPS HEALTH PLAN SERVICES N

46187 SEASIDE HEALTH PLAN (STARTING WITH DOS 9/1/2013) N

SVIPA SEAVIEW IPA N

28530 SECURE HEALTH OF GEORGIA N

42142 SECURECARE OF IOWA N

87726

SECUREHORIZONS MEDICARECOMPLETE (SECUREHORIZONS BY

UNITEDHEALTHCARE) N

87726

SECUREHORIZONS MEDICAREDIRECT (SECUREHORIXONS BY

UNITEDHEALTHCARE) N

39045 SECURITY HEALTH PLAN N

TP097 SEDGWICK N

77024 SEECHANGE N

35098 SEECHANGE HEALTH INSURANCE N

SCHP1 SEECHANGE HEALTHPLAN N

20618 SEIU LOCAL 1 CLEVELAND WELFARE FUND N

Confidential Updated 08.30.2017

42137

SELECT BENEFIT ADMINISTRATORS (PAYERID VALID FOR CLAIMS

SUBMISSION ADDRESS OF PO BOX 8339, DES MOINES, IA 50301) N

37282 SELECT BENEFIT ADMINISTRATORS OF AMERICA N

93031 SELECT BENEFIT ADMINISTRATORS, INC. N

60054 SELECT CHOICE N

23285

SELECT HEALTH OF SOUTH CAROLINA (PROVIDER ID REQUIRED IN

BOX33A.) N

SSC11 SELECT SENIOR CLINIC N

00014 SELECTCARE N

76045 SELECTCARE OF TEXAS (HPN) HERITAGE PHYSICIANS NETWORK N

GTPA1

SELECTCARE OF TX (BEAUMONT) (PROVIDER ID REQUIRED -

CONTACT (713) 843-6780 TO OBTAIN ID.) N

HPN11

SELECTCARE OF TX (HOUSTON) (PROVIDER ID REQUIRED -

CONTACT (713) 843-6780 TO OBTAIN ID.) N

KLSY1

SELECTCARE OF TX (KELSEY-SEYBOLD) (PROVIDER ID REQUIRED -

CONTACT (713) 843-6780 TO OBTAIN ID.) N

61225 SELECTCARE TEXAS (KELSEY SEYBOLD) N

72189 SELECTCARE TEXAS BEAUMONT & GOLDEN TRIANGLE N

36404 SELF INSURED PLANS, LLC N

34131 SELF-FUNDED PLANS (IL, PA, OH) N

TRSEL SELMAN TRICARE SUPP N

J1915 SEMPRA ENERGY EMPLOYEE CARE SERVICES N

36426 SENDERO HEALTH N

60054 SENIOR CHOICE (AETNA HP-NY/NJ) N

95444 SENIOR SMART CHOICE N

83035 SENIOR WHOLE HEALTH N

54154 SENTARA FAMILY PLAN N

54154 SENTARA HEALTH MANAGEMENT N

5415M SENTARA MENTAL HEALTH PROFESSIONAL N

Confidential Updated 08.30.2017

23249 SENTINEL MANAGEMENT SERVICES N

AMM07 SEOUL MEDICAL GROUP N

IP080 SEOUL MEDICAL GROUP N

SHPCH SETON CHIP (PROVIDER ID REQUIRED.) N

SHEBP SETON EMPLOYEE PLAN N

SHMAP SETON MAP PROGRAM - MEDIVIEW (PROVIDER ID REQUIRED) N

STAR1 SETON STAR N

25404 SEVEN CORNERS N

SCMG1 SHARP COMMUNITY MEDICAL GROUP N

SHP01 SHARP HEALTH PLAN N

SRS83 SHARP REES STEALY MEDICAL GROUP N

75280 SHASTA ADMINISTRATIVE SERVICES, (JELD-WEN CLAIMS ONLY) N

10002 SHEAKLEY UNICOMP (OH BWC) N

38238

SHEET METAL WORKERS LOCAL 104 (PAYERID VALID FOR

SUBMISSION ADD OF PO BOX 1138, SAN RAMON, CA 94583.) N

41143 SHEFFIELD OLSON AND MCQUEEN INCORPORATED N

SC359 SHERMAN CHOICE N

03699 SIEBA LTD N

76343

SIERRA HEALTH AND LIFE (ENCOUNTER CLAIMS)

(SECUREHORIZONS BY UNITEDHEALTHCARE) N

76342

SIERRA HEALTH AND LIFE (FFS CLAIMS) (SECUREHORIZONS BY

UNITEDHEALTHCARE) N

76342 SIERRA HEALTH SERVICES N

76343 SIERRA HEALTH SERVICES ENCOUNTERS N

SMG01 SIERRA MEDICAL GROUP N

SA001 SIGNATURE ADVANTAGE N

62159 SIGNATURE HEALTH N

23250 SIGNIFICA BENEFIT SERVICES, INC. N

NTWKS SIHO N

Confidential Updated 08.30.2017

77871 SIHRTE N

NASCR SILVER CROSS MANAGED CARE ORGANIZATION N

97691 SILVER STAR PACE N

37228 SILVERBACK TPA N

27094 SIMPLY HEALTHCARE PLANS N

84076 SINCLAIR HEALTH PLAN N

00540 SISCO N

25125 SL CARPENTERS FUN N

84096 SLOANS LAKE MANAGED CARE N

72112 SMA N

72112 SMA 65 N

72112 SMA HEALTH PLAN N

72112 SMA HMO N

J1824 SMART AND FINAL N

72112 SMARTPLAN N

72112 SMARTPLAN 65 N

02057 SMITH ADMINISTRATORS N

SMITH SMITH ADMINISTRATORS N

13010 SMOKEY MOUNTAIN CENTER Y

CB695 SOLARTE HEALTH INCORPORATED N

91131 SOUND HEALTH N

42172

SOUNDPATH HEALTH (FORMERLY KNOWN AS PUGET SOUND

HEALTH PARTNERS, INC.) N

SAMG1 SOUTH ATLANTIC MEDICAL GROUP N

42406 SOUTH CAROLINA SOLUTIONS N

23266

SOUTH CENTRAL PREFERRED - PPO YORK, PA (IHS GATEWAY

PAYER) ( CONTACT JANE GROVE FOR SOUTH CENTRAL PREFERRED

(717) 851-6715.) N

CASD2 SOUTH DAKOTA CHIROPRACTIC (SANFORD HEALTH PLAN) N

Confidential Updated 08.30.2017

59065 SOUTH FLORIDA COMMON SERVICES N

06294 SOUTH FLORIDA MUSCULOSKELETAL CARE N

SX142 SOUTH INDIANA HEALTH OPTIONS - HMO N

35227 SOUTH POINT HOTEL AND CASINO N

28580 SOUTH TAHOE REFUSE N

25147 SOUTHCARE / HEALTHCARE PREFERRED N

86068 SOUTHEAST IOWA HEALTH PLAN (PROVIDER ID REQUIRED) N

72112 SOUTHEAST MEDICAL ALLIANCE N

90448 SOUTHEASTERN INDIANA HEALTH ORGANIZATION SIHO N

77153 SOUTHEASTERN INDIANA HEALTH SIHO N

37318 SOUTHERN BENEFIT SERVICES N

SCP01 SOUTHERN CAL PHYSICIANS MANAGED CARE SERVICES N

NWADM SOUTHERN CALIFORNIA BAKERY DRIVERS SECURITY FUND N

25128 SOUTHERN HEALTH SERVICES INCORPORATED N

SIHCA SOUTHERN ILLINOIS HEALTHCARE ASSOCIATION N

SIPA1 SOUTHLAND IPA N

PHM11 SOUTHLAND SAN GABRIEL VALLEY N

SWPG1 SOUTHWEST PHYSICIANS GROUP N

CX100 SOUTHWEST SERVICE ADMINISTRATORS N

37266 SOUTHWEST SERVICE LIFE N

00773 SPECTERA N

23253 SPECTRUM ADMINISTRATORS N

38416 SPENCER STUART (ARM LTD) N

J1922 SPRINGFIELD INSURANCE COMPANY N

52190 SRI URN MGD TRANS N

IP062 ST JOSEPH HEALTH N

SLCH1 ST LAWRENCE COUNTY HEALTHCARE PLAN N

Confidential Updated 08.30.2017

SMIPA ST MARY'S IPA Y

J1926 ST PAUL INSURANCE N

STM01 ST THOMAS MEDICAL NETWORK N

22240 ST. BARNABAS SYSTEM HEALTH PLAN N

JOEHD ST. JOE HIGH DESERT N

37264 ST. JOHN'S CLAIMS ADMINISTRATION N

IP106 ST. JOSEPH HERITAGE HEALTHCARE N

IP059 ST. JOSEPH HUMBOLT COUNTY N

37116 ST. THERESE PHYSICIAN ASSOCIATION N

01758 STANDARD LIFE & ACCIDENT N

73099 STANDARD LIFE & ACCIDENT INSUR CO N

61425 STARMARK N

06057 STARMARK 4MOST N

46450 STATE AUTO INSURANCE COMPANIES N

72087 STATE EMPLOYEES GROUP BENEFITS N

LABLS STATE EMPLOYEES GROUP BENEFITS N

31059 STATE FARM (CASUALTY AND PROPERTY) N

31053

STATE FARM GROUP MEDICAL & IND HEALTH INS CO (NOTE THAT

PAYER REQUIRES INSURED'S ID OF 11 OR 12 DIGITS AND EXACT

STRUCTURE. OTHERWISE CLAIMS WILL REJECT.) N

00601 STATE MERIT GA Y

GABLS STATE MERIT GA N

75087 STATES GENERAL LIFE INSURANCE N

67829 STERLING MEDICARE ADVANTAGE N

06089 STIRLING AND STIR N

SLIC2 STONEBRIDGE LIFE INS COMPANY (CEDAR RAPIDS IOWA) N

SLIC1 STONEBRIDGE LIFE INS COMPANY (VALLEY FORGE PENNSYLVANIA) N

31121 STONER & ASSOCIATES N

Confidential Updated 08.30.2017

57492 STONES RIVER IPA AMERIVANTAGE N

15752 STONES RIVER REGIONAL IPA - WINDSOR N

74227 STUDENT INSURANCE N

74227

STUDENT INSURANCE - BOSTON MUTUAL LIFE INSURANCE

COMPANY N

74227

STUDENT INSURANCE - LIFE INSURANCE COMPANY OF BOSTON

AND NEW YORK N

74227

STUDENT INSURANCE - MEGA LIFE & HEALTH INSURANCE

COMPANY N

74227

STUDENT INSURANCE - MID-WEST NATIONAL LIFE INSURANCE

COMPANY OF TENNESSEE N

74227 STUDENT INSURANCE - RELIANCE INSURANCE COMPANY N

74227

STUDENT INSURANCE - RELIANCE NATIONAL INSURANCE

COMPANY N

74227 STUDENT INSURANCE DIVISION N

74227 STUDENT RESOURCES INTERNATIONAL (UNITEDHEALTHCARE) N

95202 SUMMACARE HEALTH PLAN N

86071 SUMMERLIN LIFE AND HEALTH N

86083 SUMMIT ADMINISTRATION SERVICES, INC. N

37301

SUMMIT AMERICA INSURANCE SERVICES, INC. (STUDENT

ACCIDENT AND SICKNESS, COLLEGE SPORTS AND NASCC CLAIMS

ONLY.) N

SX186 SUN HEALTH CORPOR N

90956 SUNAMERICA LIFE INS CO (NFIC PLAN ONLY) N

68069 SUNFLOWER STATE HEALTHCARE PLAN N

68057 SUNSHINE HEALTH PLAN N

68069 SUNSHINE HEALTH PLAN (ALSO 68057) N

23218 SUPERIOR ADMINISTRATORS, INC. N

68069 SUPERIOR HEALTH PLAN (ALSO 39188) N

SHP11 SUPERIOR HEALTH/CENTENE CORP N

Confidential Updated 08.30.2017

97802 SUPERIOR INSURANCE SERVICES N

77035 SUTTER CONNECT - CENTRAL VALLEY MED GROUP (CLAIMS) N

IP100 SUTTER CONNECT - DELTA - CLAIMS N

HM059 SUTTER CONNECT - SIP, SMG, SWMG - ENCOUNTERS ONLY N

IP099 SUTTER CONNECT - SOLANO REGIONAL MEDICAL GROUP - CLAIMS N

IP091

SUTTER CONNECT - SUTTER GOULD MEDICAL FOUNDATION -

CLAIMS N

IP130 SUTTER CONNECT EAST BAY MED FOUNDATION Y

HM065 SUTTER CONNECT EAST BAY MEDICAL N

HM069 SUTTER CONNECT EAST BAY REGIONAL AFFINITY ENCOUNTERS N

HM068

SUTTER CONNECT EAST BAY REGIONAL BROWN & TOLAND

ENCOUNTERS. N

IP092

SUTTER CONNECT SUTTER MEDICAL GROUP (SMG,SWMG,SIP)

(PLEASE CONTACT SUTTER TO GET SET UP TO SEND CLAIMS, 800-

611-5191) PER PROVIDER TESTING REQUIRED N

SC050 SUTTER CONNECT-PALO ALTO MEDICAL FOUNDATION N

77318 SUTTER DELTA MEDICAL GROUP N

94269 SUTTER EAST BAY MEDICAL FOUNDATION N

SC052 SUTTER EAST BAY REGIONAL HOSP-AFFINITY CLAIMS N

HM057

SUTTER MEDICAL GROUP OF THE REDWOODS (SMGR) (PLEASE

CONTACT SUTTER TO GET SETUP TO SEND ENCOUNTERS, 800-611-

5191) N

SC028 SUTTER SENIOR CARE N

53589 SW SERVICE ADMINISTRATORS N

36411 SWEDISH COVENANT HOSPITAL N

NASWD SWEDISH COVENANT HOSPITAL N

07040 SWIFT GLASS CORPORATION N

98022 TAKECARE INSURANCE COMPANY N

TALMG TALBERT MEDICAL GROUP N

88067 TALL TREES ADMINISTRATORS N

Confidential Updated 08.30.2017

COMPU TATTERED COVER, INC. N

TAYLR TAYLER BENEFITS N

39157 TBG ADM SERVICES N

88019 TEACHERS HEALTH TRUST N

75133 TEAM CHOICE PNS N

36215 TEAMCARE N

NWADM TEAMSTERS LOCAL 631 SECURITY FUND FOR SOUTHERN NEVADA N

NWADM TEAMSTERS MISCELLANEOUS SECURITY TRUST FUND N

74234 TECH-STEEL, INC. N

22483 TELAMON N

20212 TETHYS HEALTH VENTURES N

TXABA TEXAS AGRICULTURAL COOPERATIVE TRUST N

TXCSN TEXAS CHILDREN PLAN FOR TEXAS MEDICAID N

76048 TEXAS CHILDREN'S HEALTH PLAN N

75228 TEXAS CHILDREN'S HEALTH PLAN (MEDICAID) N

TXCSM

TEXAS CHILDRENS STAR MEDICAID (ENROLLMENT VERIFICATION

CALLS SHOULD BE DIRECTED TO 800-990-TCHP (8247)) Y

76046 TEXAS FIRST HEALTH PLAN (TOPA) N

TX1ST TEXAS FIRST HEALTH PLANS N

THS01 TEXAS HEALTHSPRING N

74214 TEXAS MUNICIPAL LEAGUE GROUP BENEFITS RISK POOL N

J1921 TEXAS POLITICAL SUBDIVISIONS JSIF N

TTCEC TEXAS TRUE CHOICE N

13185 TEXASFIRST HEALTH PLAN N

TBGNE THE BENEFIT GROUP INCORPORATED N

BOONG THE BOON GROUP N

68423 THE CARE NETWORK N

34154 THE CHESTERFIELD COMPANIES N

Confidential Updated 08.30.2017

COA01 THE CITY OF AMARILLO N

75600 THE CITY OF ODESSA N

87726 THE EMPIRE PLAN N

20356 THE HEALTH EXCHANGE (CERNER CORPORATION) N

30757

THE HEALTH PLAN (FORMERLY KNOWN AS HOMETOWN HEALTH

PLAN OF OHIO.) N

34150 THE HEALTH PLAN (UPPER OHIO VALLEY) N

29018 THE HEALTH PLAN OF WESTERN ILLINOIS (HOWI) N

35206 THE HEALTHCARE GROUP (THCG) N

58200 THE INTEGRITY BENEFIT NETWORK, INC. N

23223

THE LOOMIS COMPANY (CALL PROVIDER RELATIONS AT 610-374-

4040 EXT. 2438 FOR PROCEDURES PRIOR TO SUBMITTING

ELECTRONICALLY.) N

59227

THE MEGA LIFE AND HEALTH INSURANCE COMPANY-OKC (VALID IF

PO BOX 548801 OKLAHOMA CITY OK 73154.) N

70491 THE MUTUAL GROUP N

63092

THE OATH - HEALTH PARTNERS OF ALABAMA (NOW KNOWN AS

HEALTHSPRING HMO/HEALTHSPRING MEDICARE+CHOICE) N

THERA THERAPHYSICS N

COTHE THERAPHYSICS COLORADO ONLY N

J1831 THERAPY DIRECT NETWORK N

75305 THERAPY REVIEW SY N

SC315

THOMAS COOPER (PROVIDER MUST BE ENROLLED WITH SC BLUE

SHIELD.) Y

MP340 THREE RIVERS PREFERRED N

25175

THREE RIVERS PROVIDER NETWORK (NOW KNOWN AS UNISON

HEALTH PLAN.) N

THRIV THRIVENT FINANCIAL N

58600 TIFT REGIONAL N

39065 TIME INSURANCE (A FORTIS COMPANY) N

Confidential Updated 08.30.2017

TLC01 TLC ADVANTAGE IN SIOUX FALLS N

TLC79 TLC BENEFIT SOLUTIONS N

WITH1 TODAYS HEALTH N

48055 TODAYS OPTION (AMERICAN PROGRESSIVE AND PYRAMID LIFE) N

92620 TONGASS TIMBER TRUST N

61425 TOOLING & MANUFACTURING ASSOC. N

THIPA TORRANCE HOSPITAL IPA N

TMMC1 TORRANCE MEMORIAL N

TCARE TOTAL CARE OF NY N

68069 TOTAL CAROLINA CARE (ALSO 68055) N

31182 TOTAL COMMUNITY CARE N

38201 TOTAL HEALTHCARE, INC. N

41202 TOTAL PLAN SERVICES N

87726 TOUCHPOINT N

TPS01 TOUCHPOINT SOLUTIONS TOUCHPOINT CRM N

23856 TOUCHSTONE HEALTH PSO N

13402 TOUCHSTONE HEALTH/HEALTH NET SMART N

69493 TOWER LIFE INSURA N

37230 TR PAUL INC. N

TFLI4 TRANSAMERICA FINANCIAL LIFE INSURANCE BALTIMORE N

TFLI6 TRANSAMERICA FINANCIAL LIFE INSURANCE CEDAR RAPIDS N

TFLI2 TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY N

TFLI3 TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY N

TFLI5 TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY N

TRCLF TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY N

TRLTC TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY N

TRP1P TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY N

Confidential Updated 08.30.2017

TFLIC

TRANSAMERICA FINANCIAL LIFE INSURANCE COMPANY HURST

TEXAS N

TLIN7 TRANSAMERICA FINANCIAL LIFE INSURANCE PLANO N

TLINS

TRANSAMERICA LIFE INS. CO.(SPECIALIZED CLAIMS ONLY. CALL

501-277-1284 FOR INFORMATION.) N

TRP1E TRANSAMERICA LIFE INSURANCE COMPANY N

MMLI3

TRANSAMERICA PREMIER LIFE INSURANCE COMPANY

(MONUMENTAL) N

37284 TRANSCHOICE - KEY BENEFIT ADMIN N

74234 TRANSWESTERN GENERAL AGENCY N

TRAN1 TRANSWESTERN INSURANCE ADMINISTRATORS, INC. N

TCMAP TRAVIS COUNTY MAP MEDIVIEW N

36397 TRELLIS HEALTH PARTNERS N

J1905 TRI CITY HEALTHCARE DISTRICT N

39181 TRIAD HEALTHCARE INC N

TDDIR TRICARE FOR LIFE (ALL REGIONS 1-12) Y

57106 TRICARE NORTH Y

FOREN TRICARE OVERSEAS Y

38520

TRICARE PALMETTO (REGIONS 1-6) NORTHERN AND SOUTHERN

REGION N

57106 TRICARE SOUTH Y

99726 TRICARE WEST Y

WESTR TRICARE WEST N

31144 TRIHEALTH PHYSICIAN SOLUTIONS Y

31143 TRIHEALTH PHYSICIAN SOLUTIONS CONCERN N

A0011 TRILLIUM HEALTHCARE RESOURCES N

98514 TRILOGY HEALTH N

97300 TRIPLE S Y

64300 TRIPLEFIN LLC N

Confidential Updated 08.30.2017

64300 TRIPLEFIN LLC N

62777 TRLHN/EB N

TCUSA TRUE CHOICE USA N

TCUCH TRUE CHOICE USA - CHRISTUS HEALTHPLAN N

L0230 TRUSTED HEALTH PLAN N

91078 TRUSTEED PLANS SERVICE CORPORATION N

61425 TRUSTMARK (INCLUDES STARMARK & TMA) N

THA01 TUALITY HEALTH N

THASC TUALITY HEALTH SELECT N

04298 TUFTS ASSOCIATED HEALTH N

TH055 TX TRUE CHOICE N

87726 UBH EMPLOYER DIVISION N

87726 UBH RIOS N

UCDMG UC DAVIS HEALTH SYSTEMS N

52629 UCARE OF MINNESOTA N

94603 UC-DAVIS HEALTH N

USMBP UCLA MEDICAL GROUP N

93235 UCS N

97041 UCS HEWITT COLEMAN N

59573 UCS HOCKENBERGOS EQUIPMENT N

60230 UCS MASONRY INDUSTRY TRUST N

52323 UCS NEBRASKA PLASTICS GROUP N

08354 UCS NX HEALTH NETWORK N

97736 UCS RTG MEDICAL GROUP N

20452 UCS WINSTON HOSPITALITY N

BS001

UFCW LOCAL 400-5205 (SUBMITTERS TO UFCW MUST REGISTER

WITH CA BLUE SHIELD AT WWW.BLUESHIELDCA.COM/PROVIDER.

IF REGISTRATION NOT COMPLETED, CLAIMS WILL REJECT.) N

Confidential Updated 08.30.2017

95375 UHC COMMUNITY IA N

86001 UHC COMMUNITY NJ2 N

86002 UHC COMMUNITY NY2 N

39026

UHIS-UNITEDHEALTHCARE INTEGRATED SERVICES

(UNITEDHEALTHCARE) N

75245 UICI ADMINISTRATORS - STATE OF NEVADA N

ULLIC ULLICO INCORPORATED (VALLEY FORGE PENNSYLVANIA) N

77022 ULTIMATE HEALTH PLAN N

41206 ULTRA BENEFITS INC N

UMHCJ

UMASS MEDICAL SCHOOL HEALTH AND CRIMINAL JUSTICE

PROGRAM N

75130 UMC HEALTH PLAN N

31107 UMR CINCINNATI N

UMRC1 UMR CINCINNATI HS N

62061 UMR KANSAS (FORMERLY FISERV HEALTH - KANSAS) N

79480 UMR ONALASKA (FORMERLY MIDWEST SECURITY) N

74223 UMR SAN ANTONIO N

39026 UMR WAUSAU/UHIS N

79480 UMR-MIDWEST SECURITIES N

95266 UMRWESTERVILLE 95 N

52180 UMWA HEALTH & RETIREMENT FUNDS N

80314 UNICARE LIFE & HEALTH N

35198 UNIFIED GROUP SERVICES N

62170 UNIFIED HEALTH SERVICES N

51368 UNIFIED IPA N

34638

UNIFIED PHYSICIANS NETWORK (FOR CLAIMS REJECTIONS, PLEASE

CONTACT UNIFIED PHYSICIANS CLAIM DEPARTMENT AT 847-763-

1700) N

01691 UNIFIED PHYSICIANS NETWORK (UPN) N

Confidential Updated 08.30.2017

13407 UNIFORMED SERVICE FAMILY HEALTH PLAN N

87042 UNION PACIFIC RAILROAD EMPLOYEES HEALTH SYSTEMS N

25175

UNISON DC, DE, NJ, OH, PA, SC, TN (UNITEDHEALTHCARE

COMMUNITY PLAN) N

25175

UNISON HEALTH PLAN (FORMERLY THREE RIVERS PROVIDER

NETWORK.) N

UABT1 UNITED AGRICULTURE BENEFIT TRUST N

87726 UNITED BEHAVIORAL HEALTH N

59069 UNITED BENEFITS, INC (A BROWN & BROWN COMPANY) N

ADCUC UNITED CARE MEDICAL GROUP N

20090 UNITED CLAIM SOLUTIONS N

A0047 UNITED CLAIM SOLUTIONS N

36659 UNITED FOOD AND COMMERCIAL WORKERS MIDWEST UNIONS N

21850 UNITED FOOD AND COMMERCIAL WORKERS UFCW LOCAL 1529 N

UFWIF UNITED FURNITURE WORKERS N

UGP19 UNITED GROUP PROGRAMS N

96385 UNITED HEALTHCARE COMMUNITY PLAN KANSAS N

84132 UNITED MEDICAL ALLIANCE (UMA) Y

31107

UNITED MEDICAL RESOURCES, INC. (SOME OF UMR'S NEW

MEMBER CARDS NO LONGER PRINT THE FULL SSN. WHEN

SUBMITTING ELECTRONICALLY, THE FULL SSN MUST BE ENTERED.) N

71412 UNITED OF OMAHA N

ECMSO UNITED PHYSICIANS INTERNATIONAL (UPI) N

84132 UNITED PHYSICIANS OF NORTHERN COLORADO Y

87726 UNITEDHEALTHCARE N

87726

UNITEDHEALTHCARE / MAMSI LIFE AND HEALTH INSURANCE CO.

(MLH) (PREVIOUSLY PAYER ID 52148) N

86050 UNITEDHEALTHCARE COMMUNITY PLAN MISSOURI N

87726 UNITEDHEALTHCARE GROUP MEDICARE ADVANTAGE N

Confidential Updated 08.30.2017

87726

UNITEDHEALTHCARE HAWK-I (UNITEDHEALTHCARE COMMUNITY

PLAN) N

52148

UNITEDHEALTHCARE MAHP MARYLAND IPA OPTIMUM CHOICE

MAMSI N

87726

UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY

(UNITEDHEALTHCARE COMMUNIT PLAN) N

87726

UNITEDHEALTHCARE RIVER VALLEY (FORMERLY KNOWN AS JOHN

DEERE HEALTHCARE Y

00773 UNITEDHEALTHCARE VISION N

87726

UNITEDHEALTHCARE WEST (FORMERLY KNOW AS PACIFICARE)

(UNITEDHEALTHCARE) N

95958

UNITEDHEALTHCARE WEST ENCOUNTERS(FORMERLY KNOW AS

PACIFICARE) (UNITEDHEALTHCARE) N

66705

UNITY HEALTH INSURANCE (BEFORE SUBMITTING CLAIMS, PLEASE

CALL JOE BOERBOOM AT 608-643-1531 FOR EDI SIGNUP.) N

A0012 UNITY HEALTH PLAN N

81108 UNITY SECURITY LIFE AND HEALTH N

SX087 UNIVERA HEALTH CARE PLAN/CHOICECARE BUFFALO N

HC001 UNIVERA HEALTHCARE - CNY N

SX091 UNIVERA HEALTHCARE (SSA) Y

UNINW UNIVERA TRADITIONAL PPO N

UNBCI UNIVERSAL BENEFITS CORPORATION N

UNBC2 UNIVERSAL BENEFITS CORPORATION CEDAR RAPIDS N

33001 UNIVERSAL CARE - CALIFORNIA (PROVIDERID REQUIRED.) N

93220 UNIVERSAL FIDELITY ADMINISTRATORS COMPANY N

50528 UNIVERSAL HEALTH N

38298 UNIVERSALSTANDARD N

09830 UNIVERSITY FAMILY CARE N

07503 UNIVERSITY FAMILY CARE - HEALTHCARE GROUP N

09908 UNIVERSITY FAMILY CARE - MARICOPA HEALTH PLAN N

Confidential Updated 08.30.2017

09908 UNIVERSITY FAMILY CARE - MARICOPA HEALTH PLAN N

99026 UNIVERSITY HEALTH ALLIANCE Y

46407 UNIVERSITY HEALTH CARE ADVANTAGE N

45437 UNIVERSITY HEALTHCARE MARKETPLACE N

UIC67 UNIVERSITY OF ILLINOIS N

37601 UNIVERSITY OF ILLINOIS AT CHICAGO DIV OF SPECIALIZED CARE N

45282 UNIVERSITY OF MARYLAND HEALTH ADVANTAGE N

92579 UNIVERSITY OF MIAMI BEHAVIORAL HEALTH N

SX155 UNIVERSITY OF UTAH HEALTH PLANS N

91136

UNIVERSITY OF WASHINGTON STUDENTS & GRADUATE APPTS. -

GRP#P67 N

A0013 UNIVERSITY PHYSICIANS HEALTHCARE N

IP056

UPLAND MEDICAL GROUP (CUSTOMER SERVICE PHONE NUMBER

(909) 291-4400) N

23281 UPMC HEALTH PLAN N

25184 UPMC VISION ADVANTAGE N

37324 UPPER PENINSULA HEALTH GROUP (TPA) N

38337 UPPER PENINSULA HEALTH PLAN N

93092 US BENEFITS N

90551 US FAMILY HEALTH PLAN N

USFHP US FAMILY HEALTH PLAN (USFHP) N

50383 US IMAGING NETWORK (NEW YORK) N

74095 USAA N

J1822 USAA N

9047P USC HEALTH SERVICES N

74234 UTAH CARPENTERS N

74234 UTAH LABORERS N

74234 UTAH PIPE TRADES N

Confidential Updated 08.30.2017

N4FEP UTICA NY FEP BLUE SHIELD N

UT3F UTMB 3 SHARE PROGRAM N

12115 VA FEE BASIS PROGRAMS N

55912

VA PATIENT CENTERED COMMNITY CARE PROGRAM (VAPCCC

REGION 3) N

55915

VA PATIENT CENTERED COMMNITY CARE PROGRAM (VAPCCC

REGION 5A) N

55917

VA PATIENT CENTERED COMMNITY CARE PROGRAM (VAPCCC

REGION 6) N

55917 VA PATIENT CENTERED COMMUNITY CARE REGION 6 N

VAP33 VA PATIENT CENTERED REGION 3 N

VAPC3 VA PATIENT CENTERED REGION 5A Y

VAPC6 VA PATIENT CENTERED REGION 6 N

VABLS VA PLANS N

CALL VA STATE EMPLOYER FUNDS Y

64009 VALIR PACE N

82420 VALLEY BAPTIST HEALTH N

VCIPA VALLEY CARE IPA N

VHA11 VALLEY HEALTH ADMINISTRATORS N

94293 VALLEY MENTAL HEALTH N

00814 VALUE OPTIONS AZ MEDICAID N

00815 VALUE OPTIONS COLORADO MEDICAID Y

00813 VALUE OPTIONS COMMERCIAL CLAIMS Y

00823 VALUE OPTIONS MARYLAND N

00816

VALUE OPTIONS MASSACHUSETTS BEHAVIORAL HEALTH

PARTNERSHIP Y

00817 VALUE OPTIONS PENNSYLVANIA MEDICAID Y

00818 VALUE OPTIONS TEXAS NORTHSTAR Y

Confidential Updated 08.30.2017

43307

VALUEOPTIONS/MBHP (FOR CLAIM REJECTIONS PLEASE CONTACT

E-SUPPORTSERVICES@VALUEOPTIONS.COM OR 888-247-9311) Y

72128 VANTAGE HEALTH PLAN, INC. N

PPM01 VANTAGE MEDICAL GROUP N

VAP5A VAPCCC REGION 5A N

55916 VAPCCC REGION 5B N

VPA18 VARIABLE PROTECTION ADMINISTRATORS (VPA) N

73288 VENCOR N

VCHCP VENTURA COUNTY HEALTHCARE PLAN N

66126 VERDUGO HILLS MEDICAL GROUP N

VMMH1 VERITY N

75256 VERITY NATIONAL GROUP N

VMMH2 VERITY PLUS N

48123 VIA CHRISTI HOPE N

54182 VICARE ADMIN SVCS N

24818 VIDA CARE (NOW KNOWN AS AMIDA CARE.) N

25924 VIECARE LIFE BEAVER AND LIFE LAWRENCE COUNTIES N

73743 VILLAGE FAMILY PHYSICIAN N

VFP11 VILLAGE FAMILY PRACTICE N

VLGMD VILLAGE MD N

26545 VILLAGECAREMAX N

84806 VIRGINIA COORDINATED CARE VCC N

CALL

VIRGINIA HEALTH NETWORK,INC (TO GET THE PAYERID, CALL

PAYER AT (804)320-3837) N

VPCCP VIRGINIA PREMIER COMPLETE CARE Y

VPELT VIRGINIA PREMIER ELITE N

54176 VIRGINIA PREMIER HEALTH PLAN Y

M3FL2 VISTA - TALLAHASSEE N

Confidential Updated 08.30.2017

55248 VISTA HEALTH PLAN & FOUNDATION HEALTH PLAN N

NCH08 VISTA ONCOLOGY NEW CENTURY INFUSION SOLUTIONS N

VESTA VISTACARE/RH ADMIN N

63114 VIVA HEALTH PLAN N

31626 VNA HOMECARE OPTIONS N

77073 VNS CHOICE MEDICARE (FORMERLY VISITING NURSE SERVICE) N

59266 VOLUSIA HEALTH NETWORK N

23173 VPH COMMUNITY CAR N

22264

VYTRA HEALTHCARE (PROVIDER ID NUMBER REQUIRED. PLEASE

CALL 1-631-420-4100, OPT 4, OPT 4 FOR PAYER SET-UP AND PAYER

ASSIGNED PROVIDER ID NUMBER.) N

91062 WA DENTAL SERVICE N

85256 WABASH MEMORIAL HOSPITAL ASSOCIATION N

31650 WAGNER MEINERT N

WCHHS WASHINGTON COUNTY HEALTH AND HUMAN SERVICES N

WALAI WASHINGTON STATE DEPT OF LABOR & INDUSTRIES Y

00934 WASHINGTON STATE PREMERA BLUE CROSS Y

WABLC WASHINGTON STATE PREMERA BLUE CROSS N

73155 WATERSTONE BENEFIT ADMINISTRATORS N

23051 WATERSTONE BENEFIT ADMINISTRATORS (OUTSIDE OKLAHOMA) N

MPM09 WATTS HEALTHCARE CORP IPA N

39026

WAUSAU INSURANCE COMPANIES (NOW KNOWN AS UMR

WAUSAU/UHIS.) N

77072 WCARE PRI FEE SER N

39151 WEA INSURANCE GROUP N

36337 WEISS HEALTH PROVIDERS N

A0014 WELL SENSE HEALTH PLAN N

59354 WELLCARE HEALTH PLAN, INC. (ENCOUNTERS ONLY) N

14163 WELLCARE HMO, INC. N

Confidential Updated 08.30.2017

14164 WELLCARE OF CT N

14164 WELLCARE OF NY N

WELM2 WELLMED N

WELMD WELLMED MEDICAL MANAGEMENT ENC N

25711 WELLNET HEALTH PLANS N

87815 WELLS FARGO TPA N

CB457 WELLSPAN EMPLOYEE ASSISTANCE PROGRAM N

35245 WELLSYSTEMS LLC N

91064 WENATCHEE VALLEY MEDICAL CENTER N

91136

WEST COAST STATIONARY ENGINEERS HEALTH & SECURITY TRUST

FUND - GRP#F13 N

66124 WEST COVINA MEDICAL GROUP N

80942 WEST SUBURBAN HEALTH PROVIDERS N

45276 WEST VIRGINIA FAMILY HEALTH PLAN N

WVS01 WEST VIRGINIA SENIOR CHOICE N

75196 WEST VIRGINIA STA N

77025 WEST VIRGINIA WORKERS COMP N

39065 WESTERN N

39065 WESTERN CARE N

24735 WESTERN GROWER'S ASSURANCE TRUST N

24735 WESTERN GROWER'S INSURANCE COMPANY N

68039 WESTERN HEALTH ADVANTAGE N

39065 WESTERN LIFE INS. BENEFIT PLAN (FORTIS) N

37247 WESTERN MUTUAL INSURANCE N

DOCSO WESTERN OREGON ADVANCED HEALTH (CCO) N

WOAHM WESTERN OREGON ADVANCED HEALTH (CCO) N

31048 WESTERN SOUTHERN FINANCIAL GROUP N

90560 WESTLAKE FINANCIAL GROUP, INC. N

Confidential Updated 08.30.2017

38232 WEYCO INC. N

33711 WILLAMETTE VALLEY COMMUNITY N

WVCH5 WILLAMETTE VALLEY COMMUNITY HEALTH N

93050 WILLIAM C. EARHART CO, INC. N

98010 WILLIAM J SUTTON & CO. LTD. N

62061

WILLIS ADMINISTRATIVE SERVICES CORPORATION (NOW UMR

KANSAS) N

WHLTH WILLOW HEALTH N

J1893 WILSON MUTUAL INSURANCE N

41095 WILSON-MCSHANE N

13413 WIN HEALTHCARE (WOMAN'S INTEGRATED NETWORK, INC.) N

27327 WINHEALTH PARTNERS/WYOMING HEALTH SOLUTIONS N

WPS01 WISCONSIN COMMERCIAL N

74101 WISCONSIN DEPARTMENT OF CORRECTIONS N

VEST1 WISCONSIN DEPT OF CORRECTIONS N

81949 WOODMAN ACCIDENT AND LIFE CO (AICT PLANS ONLY) N

20333 WORKSITE BENEFIT SERVICES N

77080 WPP ELDERCARE WISCONSIN N

WP481 WPPA-PROVIDRS CARE NETWORK N

OOWPS WPS COMMERCIAL Y

SX022 WPS HEALTH INSURANCE N

23710 WRITERS' GUILD - INDUSTRY HEALTH PLAN N

15459 WV CARE ADVANTAGE HIGHMARK SENIOR HEALTH Y

WYSCH WYOMING SCHOOL BOARDS ASSOCIATION INSURANCE TRUST N

60646 YALE UNIVERSITY HEALTH PLAN N

YAMHL YAMHILL COMMUNITY CARE ORGANIZATION (CCO) N

09829 YAVAPAI COUNTY N

51350 YERINGTON PAIUTE TRIBE N

Confidential Updated 08.30.2017

88858 ZEBRAHEALTH N

ZNTHW ZENITH ADMINISTRATORS N

ZOOM1 ZOOMCARE N

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