Payer Claims List

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Community Choice Health Plan of Westchester (Yonkers, No. 26231. Community Claims .... CDOK1. Delta Dental of Oklahoma(Oklahoma City, OK). No. CDOR1.
Payer Claims List

Payer ID

Payer Name

Req. Enroll.

20413 20446 CX044 39640 CXADN 75240 37283 AARP1 61425 61474 72468 61473 72468 10003 CX052 CX085 CX052 FX036 58066 52080 91136 80705 LX140 LX122 59140 13545 80705 16140 CXARC 63240 38265 ASRM1 ATPA1 ATPA1 PHP01 AHP01 43178 CX097 64071 87815 38255 22384 CX098 CX076 93524 52133 CPPSA 83077 43168 60054 95340 75261 54763 60054 57604 68246

3P Administrators (Onalaska, WI) 6 Degrees Health Inc. (Beaverton, OR) A & I Benefit Plan Admin, Portland Oregon A&D Charitable Foundations (Eden Prairie, MN) A.D.N. Administrators (Southfield, MI) AAG Benefit Plan Administrators (Dallas, TX) AAG-American Administrative Group (Lubbock,TX) AARP Dental Insurance Plan (Mechanicsburg, PA) ACEC-Healthplan ACS Benefit Service (PO Box 2400 Winston, NC only) ACS Benefit Services (Salem Winston, NC) ACS Benefit Solutions ACS Consulting, Salem Winston, NC ACS Hawaii (Honolulu, HI) AD-Medicaid (Atlantic Dental, Inc)(Mequon, WI) ADI (Atlantic Dental) PPO (Coral Gables, FL ADI -Medicaid (Atlantic Dental, Inc)(Coral Gables, FL ADN (Southfield, MI) AFLAC of GA (Columbus, GA) AFLAC of NY (1932 Wynnton Road, Columbus GA) AGC- I.U.O.E Local 701 trust Funds AH & L (Anthem Health & Life Ins of NJ)(Kennett, MO) AHCCCS (Phoenix, AZ) AHL (Richardson TX) AIG (Las Vegas, NV & Seattle, WA & Tampa, FL) AIG American General (US Life) (Neptune, NJ & Beattyvil ALTA Health & Life Ins. Co. (Kennett, MO) APA Partners, Inc. - Latham, NY ARC Administrators (Lexington, KY) ARM (Alternative Risk Management (Eagan, MN) ASR Corporation (Grand Rapids, MI) ASRM (Moorestown, NJ) ATPA (Associated Third Party Admin) ATPA (San Diego, CA & Tualatin, OR) Abrazo HealthCare (Phoenix, AZ) Abri Health Plan (Thiensville, WI) Acceptius (Benefit Management Inc of MO, Joplin, MO) Access Dental (Salem, OR) Acclaim (Tupelo, MS) Accordia National (Charleston, WV) Activa Benefit Services, LLC - Grand Rapids, MI Administrative Concepts (Wayne, PA) Administrative D.C. No 1 Welfare Fund (Des Plaines, IL) Administrative Services Only (PO Box 9005,9007,9010 Ly Advantage Dental Plan - Roseburg, OR Advantage Health Solutions (Salt Lake City, UT) Advantage by Superior (PO Box 537030, Sacramento, CA Advantek Benefit Admin (Fresno, CA) Advantica Administrative Svcs (St. Louis, MO) Adventis Risk Management Inc Adventist Health Claims (Roseville, CA) Adventist Risk Management (Grapevine, TX) Old PO Box Adventist Risk Management (Horsham, PA) Old PO Box 4 Aetna Aetna (SRC)(Blue Bell, PA & Columbia, SC) Aetna US Healthcare Encounters (PO Box 14530, Lexingt

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

95426 91136 92600 91136 91136 91136 91136 44423 CXALC 81040 CX016 LX139 65074 51037 94177 37308 22155 63240 50503 STR01 13343 86048 86002 86003 86047 Call 75137 42112 74223 CX084 34187 52133 LX016 ADP01 AHG01 660650587 CX001 44444 41178 86001 GP133 LX010 54763 47009 38255 53085 34192 84103 47198 80705 84105 84105 84105 CB923 LX074 ARGUS

Affordable Benefits Admin (Burbank, CA) Alaska Children's Services, Inc. Alaska Electric Health & Welfare Fund (Anchorage, AK) Alaska Hotel Restaurant and camp Alaska Laborers Construction Industry Trust (Seattle, WA Alaska Pipe Trades Local 375 (Seattle, WA) Alaska United Food & Comm. Workers Health & Welfare Alexian Brothers Community Services of TN (Chattanoog AllCare CCO Dental (Salem, OR) Allegiance Benefit Plan (Missoula, MT) Allen Medical Claims Administrator (Fort Valley, GA) Alliant (Chesire, CT) Allianz (Miami, FL) Allied Administrators (Eagan, MN) Allied Administrators (San Francisco, CA) Allied Benefit Systems (Chicago, IL) Allied National (Eagan, MN) Alternative Risk Management (ARM) Eagan, MN) Altus Dental - Providence, RI AlwaysCare Benefits (Baton Rouge, LA) Amalgamated Life - PA Alicare (New York, NY) (King of P AmeriChoice - New York Medicaid (Salt Lake City, UT) AmeriChoice - New York Medicare (Salt Lake City, UT) AmeriChoice - Pennsylvania Medicare (Salt Lake City, UT AmeriChoice of NJ Medicaid (salt Lake City, UT) AmeriHealth Mercy Health Plan Ameriben Solutions (Boise, ID) American Admin (West Des Moines, IA) American Administrative Group, Inc (AAG)(San Antonio, American Benefit Corporation (Huntington, WV) American Benefits Management of (N Canton, OH) American Choice (Thiensville, WI) American Dental Network (ADN)(PO Box 610, Southfield, American Dental Payers of WI American Health (Maumee, OH) American Health Medicare American Medical Security (Green Bay, WI) American Postal Workers Union Health Plan (Silver Sprin Americas TPA (Minneapolis, MN) Americhoice - New Jersey Medicare (Salt Lake City, UT) Americhoice NJ(Thiensville, Milwaukee WI) Amerihealth (720 Blair, Horsham, PA) Amerihealth Administrators (Horsham, PA) Ameritas Life Insurance Corp. (Lincoln, NE) Amway Corporation (East Ada, MI) Anchor Benefit Consulting (Maitland, FL & Davenport, LA Antares Management Solutions (Westlake, OH) Anthem (PO Box 1115, Minneapolis, MN) Anthem CA (Po Box 1115, MPLS MN) Anthem Health & Life Insurance Co of New Jersey/AH&L Anthem of CT (PO Box 547 North Haven, CT) Anthem of CT (PO Box 9274, Oxnard, CA) Anthem of TX (Po box 659444, texas) Anthem of Virginia (Richmond, VA) Argus (Tampa Fl) Argus (Tampa, FL & Eagan, MN)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

75278 81883 LX035 38416 CX072 16180 25133 50266 ATPA1 ATPA1 70408 LX088 39065 75068 ASHC1 74240 93221 95691 CX085 CX052 LX081 37280 91136 CX022 LX019 86098 999999 77078 LX070 53021 LX108 49153 CXBMD 44219 43471 74227 SX145 CHSBA CHSBD 68241 BNMK1 23210 33192 36149 41205 25145 56139 LX087 43178 FX012 56139 37212 48611 36459 LX086 37118

Arkansas Best Corp-Choice Benefits-Fort Smith, AR Arkansas Municipal Health Benefit (N Little Rock AR) Arm LTD Midwest (Brookfield, WI) Arm, LTD (Spencer Stuart) (Eagan, MN) Ascent Benefits (Phoenix, AZ) Aspen (Redwood City, CA) Associated Benefit Plan (London, KY) Associated Benefits (Des Moines, IA) Associated Third Party Admin (ATPA)(San Diego, CA) Associated Third Party Admin (ATPA)(Tualatin, OR) Assurant (PO Box 2940 Clinton, IA) Assurant Health (Fort Mill SC) Assurant Health (PO Box 2806, Clinton, IA) Assurant Health Self Funded (Chicago, IL) Assurant Supplemental (PO Box 2829 Clinton, IA) Assured Benefits Administrators (El Paso, TX) Asuris Northwest Health(PO Box 30271 SLC, UT) Athens Area Health Plan Select (Athens, GA) Atlantic Dental Inc - PPO (ADI) (Coral Gables, FL) Atlantic Dental Inc-Medicaid (Coral Gables, FL) Aultra ( Canton, OH) Automated Group Admin (Fort Wayne, IN) Automotive Machinists Local 289 Health & Welfare Trust Auxiant (Cedar Rapids, IA) Auxiant (PO Box 90991, Milwaukee, WI) Avesis (PO Box 7777 Phoenix, AZ) BAD CARRIER BAnner - Medisun (Mesa, AZ) BCBS KS (Tokepa, KS) BCBS of LA AdvantagePlans Network BCBS of WA - FEP (Po Box 31207,SLC, UT) BCI Administrators Inc (West Bloomfield, MI) BEAM Dental (Columbus, OH) BHP Unity (PO Box 456, Arnold, MD) BMA (Tampa, FL) Bankers United Life/Student Insurance (Lincoln, NE) Banner Health Systems (Mesa, AZ) Bay Area Automotive Group (Livermore, CA) Bay Area Delivery Drivers (Livermore, CA) Bell Atlantic BenMark (Mississippi) BeneCare Dental Plan - Philadelphia, PA Benecomp National Corporation (St. Petersburg, FL) Benefit Admin Systems (PO Box 2920 Milwaukee, WI) Benefit Administration Services (Eagan, MN) Benefit Coordinators Corporation (Pittsburgh, PA) Benefit Management (Matthews, NC) Benefit Management (San Antonio TX) Benefit Management Inc of MO (Joplin, MO) Benefit Management Services (PO Box 1178, Matthews, Benefit Management Services, Inc (Charlotte, NC) Benefit Management Systems (Madison, MS) Benefit Management, Inc. (Great Bend, KS) Benefit Mangement Group NV (Las Vegas, NV) Benefit Plan Adm (Fargo ND) Benefit Plan Admin (Roanoke, VA)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

39081 74223 36342 R7003 58102 FX022 36149 BMX01 37248 95604 32006 CX025 54763 83470 CBC01 53589 CBAL1 47570 83470 47198 52133 84099 00700 84105 53287 FX046 76031 CBGA1 LX138 84105 CBID1 CB621 84105 CBIA1 CBIA2 CBKS1 47171 84105 89070 23739 FX136 89070 FX017 BCAFD LX021 BME01 CBMA1 CBMI1 CBMS1 CBMT1 52133 61474 00800 55093 CBNY1 CBNE1

Benefit Plan Administrators Co. Eau Claire, WI Benefit Planners, Inc )San Antonio, TX) Benefit Systems & Services, Inc. (Westmont, IN) Benefit, Inc. (Roseville, MN) BenefitStream (Po Box 1990, Jasper GA) Benefits (PO Box 1175, Maple Grove, MN) Benefits Admin Systems (Homewood, IL) Benemax (Medfield, MA) Benesys, Inc (LaFayette, LA) Best Life & Health Ins Co. - Irvine CA Better health Plans of South Carolina Big Lots Associates Benefit Plan (EMBC) Dublin, OH Blue Cross (Po box 1002, Horsham PA) Blue Cross AR (Harrisburg, PA) Blue Cross Dental (Po Box 1126, Elk Grove IL) Blue Cross of AZ (Phoenix, AZ) Blue Cross of Alabama (Birmingham, AL) Blue Cross of Alaska & Washington (Anchorage, AK) Blue Cross of Arkansas (PO Box 1206 Elk Grove Village, I Blue Cross of CA (Oxnard, CA) Blue Cross of CA (PO Box 272590 & 272540, Chico, CA) Blue Cross of Colorado/Anthem - Colorado Springs, CO Blue Cross of Connecticut (Blue Care Family Plan) (North Blue Cross of Connecticut (PO Box 547 North Haven, CT) Blue Cross of Delaware (Wilmington, DE) Blue Cross of FL (Jacksonville, FL) Blue Cross of Florida (Florida Combined Life)(PO Box 100 Blue Cross of GA (Columbus, GA) Blue Cross of ID - FEP (PO Box 7408, Boise, ID) Blue Cross of IN (PO Box 188, Mpls., MN) Blue Cross of Idaho (PO Box 7408, Boise, ID) Blue Cross of Illinois (Oak Brooke Terrace, IL) Blue Cross of Indiana Anthem (Louisville, KY) Blue Cross of Iowa (FEP claims only) (Des Moines) Blue Cross of Iowa (Po Box 935 Des Moines, IA) Blue Cross of Kansas (Topeka, KS) Blue Cross of Kansas City (MO) Blue Cross of Kentucky/Indiana/Ohio Anthem - Louisville, Blue Cross of LA Advantage Plan (PO Box 69441) Blue Cross of Louisiana (Baton Rouge, LA) Blue Cross of MD (14111-14116, Lexington, KY) Blue Cross of MN (Harrisburg, PA) Blue Cross of MN (PO Box 64338, St. Paul, MN) Blue Cross of MN (PO Box 75, Minneapolis, MN) Blue Cross of MS (Po box 1043, Jackson MS) Blue Cross of Maine Blue Cross of Massachusettes (North Quincy, MA) Blue Cross of Michigan (Detroit, MI) Blue Cross of Mississippi (Jackson, MS) Blue Cross of Montana (Helena, MT) Blue Cross of NC (Mailed to Salt Lake City, UT) Blue Cross of NC (PO Box 2400 Winston, NC only) Blue Cross of NE Nork York (Buffalo, NY) Blue Cross of NY (Empire) Claims sent to MN Blue Cross of NY - Empire Blue Cross of Nebraska (Omaha, NE)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

84101 BNH01 22099 CBNM1 84100 CBNYW CBNYE CBNYR 61473 61472 CX004 00840 LX097 LX034 84105 CB850 LX052 54771 CB870 CBSD1 CBSD1 38520 CBTN1 CB900 CBUT1 CBUTF 84103 CB923 LX090 CMS01 CB950 47570 93200 47198 94036 CBID2 36609 74237 14168 04210 20381 CX028 BRIDG B2129 51037 CX032 59069 47009 61492 42150 LX124 CX075 CPPCA 55438 41124 88019

Blue Cross of Nevada - Colorado Springs, CO Blue Cross of New Hampshire Blue Cross of New Jersey (Horizon) (Newark, NJ) Blue Cross of New Mexico (Belleville, IL) Blue Cross of New Mexico Dental Blue Cross of New York (1901 Main St. Buffalo, NY) Blue Cross of New York (NorthEast)(Albany NY Only) Blue Cross of New York - Par (PO Box 22999, Rochester, Blue Cross of North Carlonia (Winston Salem, NC) Blue Cross of North Carolina Federal Employee Claims (D Blue Cross of North Dakota (ND Dental Services) (Fargo, Blue Cross of OK (PO Box 23100 Belleville, IL) Blue Cross of OK (Tulsa OK) Blue Cross of OK (Tulsa. OK) Blue Cross of Ohio Anthem (Louisville, KY) Blue Cross of Oregon (Portland, OR & SLC, UT) Blue Cross of Oregon - FEP (Po Box 31105, SLC, UT) Blue Cross of PA - Highmark Blue Cross of Rhode Island (providence, RI) Blue Cross of SD (PO Box 9291 Des Moines, IA) Blue Cross of SD (Sioux Falls, SD) Blue Cross of South Carolina (Columbia/Charleston SC)(P Blue Cross of Tennessee (Chattanooga, TN) Blue Cross of Texas (Dallas, TX) Blue Cross of UT BCBS (PO Box 30270, Salt Lake City, U Blue Cross of UT-FEP (PO Box 30272, Salt Lake City, UT) Blue Cross of VA - Trigon (Colorado Springs, CO) Blue Cross of VA / Anthem (Richmond, VA) Blue Cross of WA (550 12th St, Washington DC) Blue Cross of WI (PO Box 10888, Greenbay, WI) Blue Cross of WI (United) Blue Cross of Washington & Alaska(Anchorage, AK) Blue Cross of Washington (PO Box 30271 SLC UT)(PO Bo Blue Cross/Trust Fund (San Antonio, TX) Blue Shield CA - NON-FEP (Salt Lake City, UT) Blue Shield of Idaho(PO Box 31603 Salt Lake City, UT) Boilermakers Natl Health & Welfare Fund/International B Boon Chapman Benefit Administrators (Austin, TX) Boston Mutual Life Ins (Latham, NY) Boston Mutual Life Ins Co. (80 East Concord St., Boston, Boulder Admin Services (Boulder, MT) Bridgeport LLC of Missouri - St Charles, MO Bridgespan (Lewiston, ID) Brighter Administrators Brokerage Concepts (King of Prussia, PA) Brokers National (Houston TX) Brown & Brown United Benefits Fringe (PO Box 2480, Da Businessmen Assurance (NE) Businessmen's Assurance Butler Benefits (Davenport, IA, Eagan, MN) Butler Company C.L. Frates (Oklahoma City, OK) CA Health Families (Sacramento, CA) CBCA Administrators (TX,NY,KY,GA,MN) CBSA (Mpls, MN) CCEA Teachers Health Trust (Las Vegas, NV)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

00720 88022 84147 10000 62310 71063 37227 CPPTX CX054 42141 33192 33192 CPPCA LX131 CX061 71057 37105 CBC01 CX037 68011 CX095 CAPHP FX136 93975 WVCS1 INCS1 DX215 KYCS1 CKOH2 56195 CX101 25125 LX091 LX118 37060 91136 66698 75177 34097 LX103 36215 55731 DX215 34154 EM205 68241 48123 61271 38308 62308 10050 59225 CX071 CX054 CMS01 11752

CCSTpa (Comprehensive Care Services PO Box 64008, 6 CDS Group Health (Sparks, NV) CHAMPVA - HAC - Denver, CO CIGNA (DHMO) (PO Box 188046, Chattanooga, TN) CIGNA Flex Care/Lovelace (New Mexico Only) CNA Health Partners of Arkansas CNIC Healthcare Services (Englewood/Colorado Springs, CPP Texas Chip (PO Box 537014 Sacramento, CA) CSEA (Civil Service Employes Assoc.) (Latham, NY) CTI Administrators (Des Moines, IA) Cadent Administrators (St. Petersburg, FL) Cadent Underwriters (St. Petersburg, FL) California State Gov. Programs California Water Service (San Jose CA) Canada Life Assurance Company(Atlanta, GA) Cannon Cochran Mgmt Services, Inc. (Metairie, LA) Cannon Cochran Mngmt Services, Inc - Danville, IL Capital Blue Cross (Harrisburg, PA) Capital Dental - Houston, TX Capitol Administrators (Rancho Cordova, CA) Capitol Dental (Performance Health Tech) (Salem, OR) Caprock Health Plans (Eagan, MN) CareFirst (PO Box 14111 - 14116) (Lexington, KY)) CareOregon (Portland, OR) CareSource West Virginia (Dayton, OH) CareSource of IN (JustME)(Dayton, OH) Careington Benefit Solutions (Frisco, TX Caresource KY (Dayton, OH) Caresource- Dayton OH Carolina Summit HealthCare (Cincinnati, OH) Carpenters Health & Welfare of PA (Philadelphia, PA) Carpenters Health Welfare (St. Louis, Hazelwood, MO) Carpenters Welfare Fund (Chicago IL) CarringtonWellMed (Kansas City MO) Caterpillar Inc. Cement Masons & Plasters Health & Welfare Trust (Seatt CentraCare (Battle Creek, MI) Central & Southwest Services Central Reserve Life (Eagan, MN) Central Reserve Life (Winston Salem NC) Central States (Rosemont, IL & PO Box 5104 Des Plaines Centraol Susquehanna HealthCare (PO Box 668, Arnold, Chesapeake Life Ins (Frisco, TX) Chesterfield Resources (Akron, OH) Childrens Medical Services (CMS) Po Box 917833 El Paso Choice Plus (TRW) Christi Hope (Wichita, KS) Christian Brothers Services (Colorado Springs, CO) Christian Brothers Services (Romeoville, IL) Cigna Cigna DHMO Cigna Voluntary (Phoeniz, AZ) Citizens Security Life Ins. (Louisville, KY) Civil Service Employees Association (CSEA) (Latham, NY) Claims Management Services (Greenbay, WI) ClaimsBridge HPN (Arnold, MD)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

33192 CCS01 WDENC 14829 37310 37310 77052 LX073 34181 37237 61948 26231 PHP01 27905 75261 34177 CX021 77828 CX029 CX021 34177 03036 00720 CHCP1 66698 74234 37307 62308 37135 61305 45321 62308 CPPCC CPPCH 35149 52132 58231 DX215 35182 41045 FX048 LX048 35180 35183 35183 75136 35182 41045 56116 56116 41124 56116 58102 CX049 25133 25133

Clarendon's Healthy Kids (St. Petersburg, FL) Clayton County Self Funded Dental Plan (Jonesboro, GA) Clear Plan Co-Ordinated Benefit Plans (Eagan, MN) Coast Benefits/Coast Hotels and Casinos (Las Vegas, NV) Coast Hotels and Casinos, Inc./DBA Coast Benefits (Las Coastal Admin Services (Salinas, CA) Combined Insurance (Ocala, FL) Comerce Benefits Group (Elyria, OH) Commenwealth Admin, LLC (Lexington, KY) Community Choice Health Plan of Westchester (Yonkers, Community Claims Administration (Orange, CA) Community Connection (Phoenix, AZ) Community Health Alliance (Knoxville, TN) Community Health Electronic Claims Comp - Ohio - 33 Fitch Blvd., Austintown OH CompBenefits - (Chicago, IL & Roswell, GA) Companion Life (PO Box 100102, Columbia, SC) Companion Permier (9201 Watson, St Louis) Compdent - (Chicago, IL & Roswell, GA) Compensation Programs of Ohio, Inc. Comprehensive Benefits Admin - Burlington, VT Comprehensive Care Services (CCSTpa) PO Box 64008, 6 Comprehensive HealthCare Options (Centennial, CO) Comprehensive Senior Care Corp. (Battle Creek, MI) CompuSys/Erisa Group (Austin, TX) Connecticut Carpenters Health Fund (Hamden, CT) Connecticut General (Bloomfield, CT) Consociate Dansig, Inc. (Decatur, IL) Consolidated Group Dental (Nashua, NH) Consumers Choice Health Plan (North Charleston, SC) Continental Dental (Plantation, FL) Cook Children's Dental (PO Box 537010, Sacramento, CA Cook Children's Health Plan (PO Box 537014 Sacramento Cook Group Health Plan (Bloomington, IN) Cooperative Benefit Administrators (CBA) (Lincoln, NE) Core Administrative Services (Macon, GA) Core Five Solutions (Frisco, TX) Core Source (Po Box 2920, Clinton IA) CoreSource (AZ, MN) CoreSource (Mailed to IA) CoreSource (Mailed to IA) CoreSource (NC, IN) (Charlotte, NC) CoreSource (Po Box 279, SHeldon IA) CoreSource OH - mailed to OH CoreSource of Little Rock (Little Rock, AR) CoreSource of PA MD IL (Lancaster, PA)(Clinton, IA) CoreStar (Minneapolis,MN) Corporate Benefit Services (Charlotte, NC) Corporate Benefit Services (Eagan, MN) Corporate Benefit Services (Mpls, MN) Corporate Benefit Services(El Paso, TX) Covenant Admin, Inc - (PO Box 105738 Atlanta, GA) Coventry (Po Box 7402, London KY) Coventry Health Coventry Health & Life OK

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

25133 25133 25133 25133 25148 25133 37320 CX074 56213 20572 39170 68241 82056 LX082 DEW01 00001 CX065 06172 07035 07035 39113 CDIAM 66043 CPPTM DDCA2 94276 94276 86027 CDAR1 DDCA2 DDCA3 CDCAP 77777 CDCA1 84056 22189 51022 94276 94276 10002 82029 IDIND 05030 CDIN1 CDIA1 CDKS1 CDKY1 94276 02027 23166 04614 CDMI0 CDMN1 94276 43090 94276

Coventry Health (241508 Charlotte, NC) Coventry Health (PO Box 241508 Charlotte, NC) Coventry Health (PO Box 8403,8400,8402, London, KY) Coventry Health (PO box 8403,8400,8402, London, KY) Coventry Health Care of Georgia (PO Box 7711,7715 Lon Coventry Health Care of KS Creative Plan Administrators (Hartford, CT) Crescent Dental (Amherst, NY & Richardson, TX) Crescent Health (Asheville, NC) Crowe Paradis Service Corp (North Reading, MA) Custom Benefit Adminstrators(Lacrosse, WI) Custom Care Custom Design Benefits (3737 West Fork Road, Cincinna Cypress (Appleton WI) D. Edward Wright TPA( DDCA2 Test DH Evans (Harrisburg, PA) Dart Management Corp. (Mason, MI) DeCare (PO Box 1348, Mpls., MN) Northwest Employees DeCare (Po Box 709, MPLS MN) Dean Health Plan (Madison, WI) Delta Dental IA - Dental Wellness Plan (Johnston, IA) Delta Dental Peurto Rico (San Juan, PR) Delta Dental TX Medicaid-Childrens(PO Box 537014, Sacr Delta Dental USA (Cerritos, CA) Delta Dental of Alabama ( Irving, TX) Delta Dental of Alaska (Irving, TX) Delta Dental of Arizona Delta Dental of Arkansas Delta Dental of CA (Cerritos, CA) Delta Dental of CA (Encounter, CAP)(Cerritos, CA) Delta Dental of CA (PMI) (12898 Towne Center Drive, Ce Delta Dental of California (PO Box 997330, Sacramento, Delta Dental of California(Tricare) - PO Box 537007-537 Delta Dental of Colorado (Denver, Co) Delta Dental of Connecticut (Parsipanny, NJ) Delta Dental of Delaware (Mailed to Mechanicsburg, PA) Delta Dental of Florida (Irving, TX) Delta Dental of Georgia (Alpharetta, GA) Delta Dental of HI (Honolulu, HI) Delta Dental of Idaho (Boise, ID) Delta Dental of Illinois (Individual Plans Only) (PO Box 5 Delta Dental of Illinois (Lisle, IL) Delta Dental of Indiana (Farmington Hills, MI) Delta Dental of Iowa (Ankeny, IA) Delta Dental of Kansas(Whichita, KS) Delta Dental of Kentucky(Lousiville, KY) Delta Dental of Louisiana(Irving, TX) Delta Dental of Maine (Northeast) Delta Dental of Maryland(Mechanicsburg, PA) Delta Dental of Massachusetts (Boston, MA, Milwaukee, Delta Dental of Michigan(Farmington Hills, MI) Delta Dental of Minnesota(Minneapolis, MN) Delta Dental of Mississippi (Irving, TX) Delta Dental of Missouri Delta Dental of Montana (Sacramento, CA)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

CDNE1 94276 02027 22189 85022 11198 56101 CDND1 CDOH1 CDOK1 CDOR1 23166 660436769 05029 43091 54097 CDTN1 94276 94276 02027 CDVA1 52147 91062 31096 39069 CDWY1 07025 CPPCA 94235 CDMN1 WDENC LX077 LX038 CX036 CX049 CX014 04356 CX014 EMBDQ 52133 GP133 52133 52133 CX035 58102 64246 46278 46278 81264 CX094 CX034 DNOA1 DSL01 DSL01 DSL01 CX004

Delta Dental of Nebraska(Minneapolis, MN) Delta Dental of Nevada (Irving TX) Delta Dental of New Hampshire (Northeast) Delta Dental of New Jersey (Parsipanny, NJ) Delta Dental of New Mexico(Albuquerque, NM) Delta Dental of New York (Mechanicsburg, PA) Delta Dental of North Carolina(Farmington Hills, MI & Sa Delta Dental of North Dakota(Bismark ND) Delta Dental of Ohio(Farmington Hills,MI) Delta Dental of Oklahoma(Oklahoma City, OK) Delta Dental of Oregon (Oregon Dental Service)(Portland Delta Dental of Pennsylvania(Mechanicsburg, PA) Delta Dental of Peurto Rico Delta Dental of Rhode Island (Providence, RI) Delta Dental of South Carolina(Columbia SC) Delta Dental of South Dakota( Pierre, SD) Delta Dental of Tennesse (Nashville, TN) Delta Dental of Texas(Irving TX) Delta Dental of Utah (Irving TX) Delta Dental of Vermont (Northeast) Delta Dental of Virginia (Roanoak, VA) Delta Dental of Washington DC (Mechanicsburg, PA) Delta Dental of Washington-State Delta Dental of West Virginia Delta Dental of Wisconsin Stevens Point, WI) Delta Dental of Wyoming Delta Dental of Wyoming (Cheyenne, WY) Delta Dental-Health Families (Sacramento, CA) Delta Health Systems (Stockton, CA) Delta of MN ( Po Box 9120, Farmington Hills, MI) Delta of WI (PO Box 103 Stevens Point) Deltacare (Lansing MI) Dencap (Detroit, MI) Denex (Houston, TX & Rockville, MD) Denex/SG (PO Box 2767, Houston, TX) DentaQuest DentaQuest (Boston, MA) DentaQuest (WI) DentaQuest-Emblem(Emblem Health)(Milwaukee, WI) Dental Benefit Providers (CA) (San Fransico, CA) Dental Benefit Providers (PO Box 427 Thiensville, Milwau Dental Benefit Providers (Thiensville, WI) Dental Benefit Providers\United Health - Bethesda, MD,U Dental Care Plus - (Cincinnati, OH & Sharonville, OH) Dental Decisions (2600 McCormick) Clearwater, FL) Dental Guard Preferred (Spokane, WA) Dental Health & Wellness (St. Louis, MO & Milwaukee, W Dental Health & Wellness (Tampa, FL) Dental Health Alliance (Shawnee Mission, KS) Dental Health Services of America (Long Beach, CA) Dental Network - Towson, MD Dental Network of America (IL) Dental Select (Murray,Draper, UT) Dental Select (Richardson, TX) Dental Select (SLC, UT) Dental Service Corp (Fargo, ND)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

CX017 67814 88888 43168 22384 94146 DESAZ CX089 A1004 38238 96400 33192 58102 LX129 37272 HSP01 CX040 25160 DOM01 LX002 DOM01 DOM01 25145 CX014 CX014 CX014 CX014 CX014 CKKY3 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CX014

Dentalcomp - Harrisburg, PA DenteMax (Wellesley Hills) Dentegra (Alpharetta, GA) Dentemax (St. Louis, MO) DentexMax (Wayne, PA) Denti-Cal (Medicaid of California) (Sacramento, CA) Department of Economic Security (Phoenix, AZ) Desert Mutual Benefit Admin (Salt Lake City, UT) Detroit Laborers (Metropolitan) (Landing, MI) Detroit Tower Trades( Po Box 99490, Troy MI) Diego PACE (Eden Prairie, MN) Direct Assignment Benefit Plan (St. Petersburg, FL) Direct Assignment Benefits (PO Box 9077 Clearwater, FL Direct Dental (San Anselmo CA) Direct Reimbursement Benefits (Newnan, GA) District Council 37 Health & Welfare Fund Diversified Admin Corp. - Marlborough, CT Diversified Group (Maryland) (Harrisburg, PA) Dominion Dental (115 S Union Ste 300, Alexandria, VA Dominion Dental (Alexandria, VA) Dominion Dental (Elk Grove Village, IL) Dominion Dental (PO Box 1920, Boie, MD) Dominion Dental Benefit Coordinators Corp. - Pittsburgh, Doral Dental of Arizona Doral Dental of Arizona--CIGNA Doral Dental of Connecticut Doral Dental of Illinois Doral Dental of Illinois Doral Dental of Kentucky / Region 3 (Mequon , WI) Doral Dental of Maryland Helix Doral Dental of Maryland Physicians Care Doral Dental of Maryland Priority partners Doral Dental of Minnesota Doral Dental of Minnesota Medicare Doral Dental of Missouri St. Louis Doral Dental of Missouri- Kansas City Doral Dental of Nebraska Doral Dental of New Jersey Amerigroup Doral Dental of New Jersey HealthNet Doral Dental of New Mexico Doral Dental of New York Doral Dental of New York Non global Budget Doral Dental of Ohio Doral Dental of Oklahoma Community Care Doral Dental of Oklahoma Heartland Doral Dental of Oklahoma Non Global Budget Doral Dental of Oklahoma Unicare Doral Dental of Oklahoma Unicare non global Doral Dental of Pennsylvania- Keystone Doral Dental of Pennysylvania Pittsburgh Doral Dental of Pennysylvania- AmeriHealth Doral Dental of Pennysylvania- Healthmate Doral Dental of Pennysylvania-Philadelphia Doral Dental of Tennessee Tenn Care Doral Dental of Virginia (M) Doral Dental of Virginia- Commercial

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

CX014 CX014 CX014 CX014 CX014 LX067 35186 34159 LX112 38241 81039 41198 LX107 CX043 EBSRM 73288 36364 CX079 73288 62308 FX044 34108 08754 CX079 03964 LX136 A4681 A4681 EMBDQ 55093 41198 38241 37257 37257 37257 37257 37257 37257 CX025 03036 03036 41198 CX012 47009 42149 EDHP1 CX022 35112 29979 CX031 LX042 75232 73288 36659 59297 WDENC

Doral Dental of Virginia- Premier Doral Dental of Virginia- Sentara Doral Dental of Virginia- Unicare Doral Dental of Virginia-Commercial Doral Dental of kansas Dr Admin Services (Plainview NY) Dunn and Associates Benefits Administrators, Inc E-V Benefits Management, Inc. (Columbus, OH) EBA M Corp (Westlake Village CA) EBC (Farmington Hills, MI) EBMS (Emp Benefit Mngmt Serv, Inc.) Billings, MT & Salt EBS (Employee Benefit Services of Lousiana, Inc) Shreve EBS (San Antonio TX) EBS Benefit Solutions (PO Box 4863, Syracuse, NY) EBS-RMSCO (NY) EHI Employers Health of Wisconsin (Lexington, KY) EHN Medical Group IPA (Rockford, IL) EMIA-Educators Mutual (Murray, UT) EMPHESYS Employers Health of Wisconsin EQUICOR ERISA (Austin, TX) ES Beveridge & Associates (Mansfield, OH) Eddy SeniorCare (Newton Square, PA) Educators Mutual Ins. Assoc. (Murray, UT) Elderwood Health (Eden Prairie, MN) Electrical (2002 London, Duluth, MN) Electrical Workers (Indianapolis, IN) Electrical Workers (Indianpolis, IN) Emblem Health Medicaid-DentaQuest(Milwaukee, WI) Empire BCBS of NY (Minneapolis, MN) Employee Benefit (Lubbock, TX) Employee Benefit Consultants (Farmington Hills, MI) Employee Benefit Consultants(Albuquerque, NM) Employee Benefit Consultants(Appleton, WI) Employee Benefit Consultants(Broadview Hts, OH) Employee Benefit Consultants(Findlay, OH) Employee Benefit Consultants(Louisville, KY) Employee Benefit Consultants(Milwaukee, WI) Employee Benefit Mngmt (EBMC) - Dublin, OH Employee Benefit Plan Admin (Burlington, VT) Employee Benefit Plan Administration, Inc (PO Box 2000, Employee Benefit Services of Louisiana, Inc (EBS) Shrev Employee Benefit Systems - Pembroke, MA Employee Benefits Services (Lincoln, NE) Employee Benefits Systems of IA (Burlington, IA) Employee Direct Health Plans (PO Box 211003, Eagan, M Employee Group Services (EGS) PO Box 75008 Cedar Ra Employee Plans, LLC - PO Box 2362, Fort Wayne, IN Employee Resource Management (Phoenix, AZ) Employer Plan Services, Inc - Houston, TX Employers Direct Health Employers Direct Health (Dallas, TX) Employers Health of Wisconsin (EHIC) (EMPHESYS) (Lexi Employers Midwest Health Benefits (Park Ridge, IL) Employers Mutual, Inc (Stuart and Jacksonville, FL) Encara (Stevens Point, WI)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

91136 36878 37331 73126 CX046 74234 43168 35605 93240 22344 71412 91136 33033 48117 LX120 CXFMC CX096 89070 LX055 71056 41041 FDIC1 FX007 72630 CX050 LX117 75138 64246 CX090 CX086 70408 25133 25133 660537624 FP66053762 13317 LX101 ENDVR 74223 39026 FX061 95266 FX061 90328 11244 FX135 LX058 R7004 68241 76031 48116 LX134 68241 25133 25059 391225059

Enstar Natural Gas (Detroit, MI) Entrust (Eagan, MN) Epoch (St. Louis, MO) Equitable Plan Services, PO Box 720460, Oklahoma City, Erin Group Administrators (Lancaster, PA) Erisa Group/CompuSys (Austin, TX) Essex Dental Benefits (St Louis, MO) Everence (Goshen, IN) Evergreen Health Co-Op (Clinton, IA) Exceedent (Milwaukee, WI) ExclusiCare (Charlotte , NC) FBX North Star Borough/ School District FCE Benefit Administrators (Eagan, MN & San Antonio, T FMH Benefit Services, Inc. of KS (Overland Park, KS) FMRSD Dental Plan (Walpole NH) Family Care CCO (Salem, OR) Family Dental (Salem, OR) Family Members Dental Plan (Harrisburg, PA) Fara Benefits (PO Box 8770, Metairie, LA) Fed Ex Freight East, Inc (Harrison, AR) Federated Insurance - Owatonna, MN Fidelio Dental insurance (Glenside, PA) Fidelio Laborers (2826 Mt Carmel, Glenside, PA) First Ameritas Life Ins Corp of New York (Lincoln, NE) First Care / Southwest Life and Health (Austin, TX) First Choice (Beloit WI) First Choice of the Midwest, Inc (Sioux Falls, SD) First CommonWealth(Spokane, WA & Chicago, IL) First Continental Life & Accident Insurance (SugarLand, First Dental Health (San Diego, CA) First Fortis Life Insurance (Clinton, IA) First Health (Tucson, AZ - London, KY) First Health - Tucson, AZ - London, KY, Coraoplis, PA) First Medical (International) First Plus First Reliance Standard (Lincoln, NE) First Service Administrators (Lakeland FL) First Source (Endeavor) (Lake Katrine, NY) Fiserv (Benefit Planners) (San Antonio, TX) Fiserv (Wausau, WI & Pueblo, CO) Fiserv - Harrington (PO Box 2697, Wichita, KS) Fiserv - Harrington Benefit (Columbus, OH) Fiserv-Harrington Health (PO box 30544, Salt Lake City, Fiserv-Lovelace Health (Westerville, OH) FitzHarris & Company, Inc(Farmingdale, NY) FlagShip DeltaCare (Parsppany, NU) FlagShip Dental Care (PO Box 369) (Parsippany, NJ) Flex Compensation (Mpls, MN) FlexCare Florida Combined Life(Blue Cross of FL)(PO Box 100135, Florida Hospital Waterman (Tavares,, FL) Florida League of Cities (Orlando FL) Florida Power & Light Foreign Service Benefit Plan (London, KY) Forest County Potawatomi Ins. Forest County Potawatomi Ins. (Crandon, WI)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

LX050 DNOA1 70408 39065 BOONG 64069 LX084 CX041 31478 LX057 59069 45289 59204 80241 GCU01 06143 75238 67814 57254 44054 LX071 13551 80314 37283 96938 67814 63665 LX047 67814 67814 CX064 07205 91136 LX008 GWD01 GWD01 44054 LX098 80705 39640 LX040 75256 36338 72153 80241 CX011 CB951 CX036 10006 89070 95192 13551 38194 37276 CX015 LX020

Formula Corporation (3265 Northwood Circles, Eagan, M Fort Dearborn Life Ins Fortis Benefits/Protective Life - Birmingham, AL Fortis Insurance Company - WI Foundation Benefit Admin (FBA) (Austin, TX) Fox Everett, Inc (Ridgeland & Jackson, MS) Frank M Vaccaro Asso Mount Laurel NJ) Fraternal Order of Police - Philadelphia, PA Freedom Network (Po box 25938) Shawnee, KS) Freedom of Choice (MHHNP)(PO Box 742567 Houston, T Fringe Benefit Management (Fl) Fringe Benefits (Austin, TX) Fringe Benefits Coorinators of FL (Daytona Beach, Ormo GBS (Eagan, MN) GCU Local 8-M & 96B Health & Welfare Fund GEGA - GE Group Administrators, South Carolina (South GEGA - GE Group Administrators, Texas GEGLAC (Genworth Life & Health) GE Group GEHA - All Plans except PO Box 4665 (Independence, M GEHA Only (PO Box 4665, Independence, MO) GEM Group (Claymont, DE) GHI - New York (Group Health, Inc)(New York, NY) GIC-Idemnity Plan Gallagher Benefit Administrators (Lisle, IL) Gateway Health Plan (Milwaukee, WI) Ge Group Life Assurance Co. Phoenix American Life (Gre General American Life (Kennett, MO) Genworth (PO Box 40011, Lynchburg, VA) Genworth Dental (PO Box 40011, Lynchburg, VA) Genworth Life & Health (GEGLAC)(GE Group LIfe) Gettysburg (Frederick, MD) Gilsbar, Inc - Covington, LA & Jackson, MS (Covington, L Glassworkers Health & Welfare Fund (Seattle, WA) Golden (Warren MI) Golden West Dental (21555 Oxnard S, Woodhills, CA) Golden West Dental (PO Box 5347, Oxnard, CA) Government Employees Hospital Assoc (GEHA) Only (PO Great Cornerstone Life & Health (Edmond OK) Great-West Life and Annuity Ins. Co. (Kennett, MO) GreatLakes PACE (Eden Prairie, MN) Group Admin (San Antonio, TX) Group Administrators (PO Box 780159, San Antonio, TX) Group Administrators Ltd. - Schaumburg, IL Group Benefit Administrators (Henderson, TN) Group Benefit Services (Eagan, MN) Group Benefit Services (East Lansing, MI) Group Benefit Services (Luterville, MD) Group Dental Services(Houston, TX & Rockville, MD) Group Health (Madison, WI) Group Health Coop. Ind. and Family (PO box 69443) Group Health Cooperative (Eau Clairie, WI) Group Health Insurance (New York, NY) Group Health Managers - Redford, MI Group Insurance Service Center (Pembroke, MA) Group Link of Indiana (Indianapolis, IN) Group Pension Admin (PO Box 830248, Richardson, TX)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

LX066 48143 CX061 64246 60389 60652 LX059 LX093 48330 10004 10001 51037 41170 47738 97258 95266 22521 59142 75243 75196 06131 59143 FX061 10002 86066 25160 LX105 62179 22521 59142 46221 22100 82018 62111 LX114 16112 CX039 CPPCA 30946 HND1 20199 51037 69821 CX010 CX009 62157 22521 59142 47009 59140 76342 CX055 CX019 25133 41170 37283

Group Resources (Dallas, Houston, Atlanta, Pheonix) Group and Pension Admin (Richardson, TX) Guarantee Life Insurance Guardian Life Insurance Company of America (Spokane, Gulf Coast (UCS) Phoenix, AZ) Gulf South Risk Services (Phoenix, AZ) H & A Administrators (Plymouth, MN) HCH Administration Inc (Peoria IL) HMAA (Hawaii) HMSA Federal Program HMSA-Hawaii Medical Services Assoc (Honolulu, HI) HNAS (Eagan, MN) HRM Claim Management (Kalamazoo,MI) Hamaspik Choice (Monsey, NY) Hammerman and Gainer (Irving, TX) Harrington Benefit Services (Columbus, OH) Harrington Benefit Services (Oklahoma City, OK) Harrington Benefit Services (Oklahoma City, OK) Harrington Benefit Services (Seattle, WA) Harrington Benefit Services (Westerville, OH) Harrington Benefit Services, Inc (Tampa, FL) Harrington Health Colonial Dental (Salt Lake City, UT) Harrington Health-Fiserv (PO Box 520, Pueblo, CO) Hawaii Dental Service Assoc (Honululu(, HI) Hawaii-Mainland Admim (Tempe, AZ) Health Aspex (Maryland) Health Care Solutions Group (Muskogee OK) Health Choice (Medicaid) (Phoenix, Tempe, AZ) Health Choice (Oklahoma City, OK) Health Choice (Oklahoma City, OK) Health Choice Insurance (Phoenix, AZ) Health Choice Integrated Care (Flagstaff, AZ) Health Claims Services (Boise, ID) Health Cost Solutions (Hendersonville, TX 37077) Health EOS by Multiplan Health Economics (Rochester, NY) Health Economics Group Inc - Rochester, NY Health Families (Sacramento, CA) Health Future, LLC Medford, OR Health Net - Commercial (Van Nuys, CA) Health Network of America (Ft. Worth, TX) Health Now (Eagan, MN) Health Partners - Next Level (Birmingham, AL) Health Partners of Minnesota (Medicaid) (Minneapolis, M Health Partners of Minnesota - Commercial (Minneapolis, Health Partners of Tennessee- Jackson, TN Health Plan SErvices of OK (Oklahoma City, OK Health Plan Servces of OK- Oklahoma City, OK Health Plan Services (Lincoln, NE) Health Plan Services (Tampa, FL) Health Plan of NV (Las Vegas, NV) Health Plans, Inc (Westborough, MA) Health Resources Incorporated (HRI) - IN (Evansville, IN Health Right of CT (Medicaid Claims) Health Risk Management, Inc. (HRM)(Kalamazoo, MI) Health Smart ( Po Box 93670, Lubbock TX)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

37283 31172 85729 20356 95213 34185 75234 75234 25125 HND2 25133 71063 71063 CXHSC 37256 75237 HMA01 75289 11271 LX041 68195 CARRS 22148 LX037 95378 CX013 89070 88023 34150 CX015 22099 22099 22099 91136 LX136 61101 73288 22175 IAT01 A1117 A1317 A1461 A4681 LX079 64246 LX075 41124 CXIBT LX141 LX111 41600 FX056 17882 26879 40585 91136

Health Smart Benefit (PO Box 167768, Irving TX) Health Trans (Innovative Benefit Admin)(Greenwood Vill HealthComp TPA (PO Box 45018, Fresno, CA) HealthE Exchange (Kansas City, MO) HealthEdge Administrators (Bakersfield, CA) HealthFirst Houston (Houston, TX) HealthFirst TPA (Eagan, MN) HealthFirst TPA (Tyler, TX) HealthLink (St. Louis) HealthNet - Gov't Program HealthRight of CT (Medicaid claims to First Health Strata HealthSCOPE Benefits, Inc (Little Rock, AR) HealthScope Benefits (Po Box 619055, Dallas, TX) HealthShare CCO (Salem, OR) HealthSmart (Oklahoma City, OK) HealthSmart Accel (Lubbock & Irving, TX) Healthcare Management Administrators, Inc (Bellevue, Healthfirst of Austin (Dallas, TX) Healthplex, Inc. (Uniondale, NY) Healthscape (Bend, OR) Healthsource/Provident Insurance Co.(Chattanooga, TN) Healthy MI Dental (Detroit, MI) Heavy and General Labors Fund of New Jersey (Newark, Heritage Consultants (Auburndale, FL) Heritage National Healthplan/John Deere Health Care Hershey Healthsmile Highmark/HHIC (PO Box 69433 Harrisbury, PA) Hometown Health (Reno, NV) Hometown Health Network (Saint Clairsville, OH) Hoosier Dental (Indianapolis, IN) Horizon (Blue Cross of New Jersey) (Indianapolis, IN) Horizon BCBS NJ ( Po box 1311, MPLS) Horizon NJ Health (PO Box 299, Milwaukee, WI) Hotel Employees & Restraunt Employess Health Trust(Se Hotel Restaurant (2002 London, Duluth, MN) Humana Medicare/Humana Gold Humana/Employers Health of WI (Lexington, KY) I.E. Shaffer (West Trenton, NJ) IATSE - Atlanta Health & Welfare Fund IBEW Local 117(Carmel, IN) IBEW Local 38(Carmel, IN) IBEW Local 461(Carmel, IN) IBEW Local 481 (Carmel, IN) IBEW Local Union 577 (Madison WI) IBEW Welfare Trust Fund (Decatur, IL) IBEW Welfare Trust NECA (Decatur IL) IBI ( Minneapolis, MN) IBT - Local 145 Health Services & Ins Plan (Statford, CT) IHC Admin Services (Eagan, MN) IMA (Bossier City LA) IMCare (Grand Rapids, MN & Birmingham, AL) IMS (Amarillo, TX) IMS TPA: Parton Lumber (UCS) (Phoenix, AZ) IMS TPA: Walker White (USC)(Phoenix, AZ) INDECS Corp. (Lyndhurst, NJ) Idaho Pipe Trades

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

36600 CDOK1 ICW01 CX070 35107 43471 52196 31172 40025 37279 13315 15688 88006 11889 74385 86304 51020 23229 84137 IAT01 660537624 IAHFI 36609 A1317 A1461 A4681 41124 41600 61271 14168 79480 34136 14168 LX096 CX061 JEN01 CXJAS LX119 41099 95378 80314 38310 CHSJT J1410 CX073 40137 57038 KBT01 CX058 CX058 95279 73100 29979 73100 77894 37323

Illinois Central Hospital Association Indian Health Services (Oklahoma City, OK) Indiana Carpenters Welfare Fund( Indianapolis, IN) Indiana Childrens Special HealthCare (Indianapolis, IN) Indiana Teamsters Health Benefit Funds (Indianapolis, I Inetico (Tampa, FL) Informed, LLC Innovative Benefit Admin (Health Trans)(Greenwood Vill Innovative Health (PO Box 14094, Lexington, KY) Insurance Admin of America (Mount Laurel, NJ) Insurance Design Administrators - Oakland, NJ Insurance Management Services (Elko, NV) Insurance Management Services, Elko, NV Insurance Systems (PO Box 211006, Eagan, MN) Insurance Systems Inc. (Monroe, LA) Insurers Administrative Corporation (Phoenix, AZ) Integra Adminstrative Group - Seaford, DE Integral Quality Care (Phoenix, AZ) InterWest Health (Eagan, MN) Interantional Association of Theatrical State Employees ( International (First Medical) International Assoc. of Health & Frost (Tinley Park, IL) International Brotherhood of Boilermakers (Kansas City, International Brotherhood of Electrical Workers (IBEW) L International Brotherhood of Electrical Workers (IBEW), International Brotherhood of Electrical Workers (IBEW), Iowa Benefits, Inc( Minneapolis, MN) Itasca Medical Care (Grand Rapids, MN & Birmingham, A J.F. Molloy and Associates, Inc.(Colorado Spring, CO) JLT Services Corporation (Latham, NY) JMS-MSA (Po Box 679, Farmington MI) JP Farley Corporation(West Lake, OH) Jardine Group Services (Latham, NY) Jefferson Federation Jefferson Pilot (Omaha, NE) Jenkins & Associates (1299 BattleCreek Rd, Ste 200 & P Jensen Administrative Services (SLC, UT) Jerrys Home Improvement (Portland OR) John Alden Life Ins. (501 W Michigan, Milwaukee, WI) John Deere Health Care/Heritage National Healthpla(Moli John Hanncock John Morrell Co. AHBPA (Birmingham, AL) Joint Benefit Trust (Dublin, CA) Jopari Careworks (Columbus, OH) Kaiser Permanente (PO Box 4360, Rockville, MD) Kalos Health (Niagara Falls, NY) Kanawha Ins Co. - Lancaster, Greenville, SC Kansas Building Trades (Topeka, KS) Kansas City Life (PO Box 9040 Austin, TX) Kansas City Life Insurance Company (Kansas City, MO) Keenan Associates (Torrance, CA) Kempton Company - OK (Oklahoma City,OK) Kempton Group (UCS) (Phoenix, AZ) Kempton Group Administrators (Oklahoma City, OK) Kentucky Health Co-Op (Fort Mill, SC) Key Solution (Fort Mill, SC)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

KEY01 LX043 34145 52193 25922 25924 25923 59847 76184 A1004 LSH01 90096 CX083 33LGC 78140 71498 RLH01 CX047 37294 27005 93093 CX061 73288 LCB01 NYT01 NYT01 35107 84041 IAHFI LX092 NYT01 NYT01 NYT01 NYT01 NYT01 NYT01 LX125 NYT01 NYT01 NYT01 NYT01 05030 NYT01 GCU01 LX079 91136 CB752 LX100 45289 45289 FX045 LX045 23223 62310 90328 62310

Keystone Mercy Health Plan (Milwaukee, WI) Klais Company (Akron, OH) Klais and Company (Fairlawn, OH) LBA HealthPlans, Inc (Timonium, MD)(El Paso, TX) LIFE Armstrong (Eden Prairie, MN) LIFE Beaver & Lawrence (Eden Prairie, MN) LIFE Butler (Eden Prairie, MN) LIFE St. Joseph of the Pines (Eden Prairie, MN) LIFE St. Mary (Eden Prairie, MN) Laborers Metropolitan Detroit HealthCare Fund (Langsing Laborers Southeast Health & Welfare Plan Land of Lincoln (Chicago, IL) Liberty Dental Plan (Santa Ana, CA & Tampa, FL) Life Gift Cards (Woodland Park, CO) Life Insurance Company of Boston & New York LifeCircles PACE (Muskegon, MI) LifeMap (PO Box 1271, Portland, OR & Milwaukee, WI) LifeRe (San Antonio, TX) LifeWise/Washington Employers Trust (Seattle, WA) Lifestyle Dental (Witcha, KS) Lifewise Health Plan or Oregon (Bend, OR) Lincoln National (Omaho, NE & Orlando, FL) Lincoln National of Wisconsin (Madison or Green Bay) Line Construction Benefit (Lombard, IL) Local 1149 Baldwinsville NY Local 118 Rochester NY Local 135 Health Benefits - Indianapolis, IN Local 137 Operating Engineers (Hopatchung, NJ) Local 17 Fund-Int. Assoc. of Heath & Frost(Tinley Park, I Local 174 (Joliet IL) Local 182 Utica NY Local 264 Cheektowaga NY Local 294 Albany NY Local 317 Syracuse NY Local 375 Buffalo NY Local 449 Buffalo NY Local 513 (Bridgeton MO) Local 529 Elmira NY Local 669 Albany NY Local 687 Potsdam NY Local 693 Binghamton NY Local 731 (Burr Ridge, IL) Local 791 Rochester NY Local 8-M & 96B Health & Welfare Local Union 577 IBEW (Madison WI) Locals 302 and 612 of the I.U.O.E Lockard & Williams (Pascaqoula, MS) Logistics Health Inc (LaCrosse WI) LoneStar (Eagan, MN) LoneStar TPA via ECOM (Tyler, TX) Loomis (Reading, PA) Loomis (Reading, PA) Loomis Company (Wyomissing, PA) Lovelace Insurance Lovelace Sandia Health Plan (Westerville, OH) Lovelace Senior Options(LSO) and Lovelace Senior Plan(L

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

52133 CX033 MBAAZ 83028 87065 87065 56205 65030 660396197P 41101 59226 LX057 94276 27401 LX133 10317 41154 89070 R7005 37233 20572 LX130 10317 91136 CX042 25133 25160 GI813 35162 65030 64246 CX014 98010 4600012 FX032 LX032 LX025 CX098 CX014 92805 41154 37287 31149 LX049 EM284 EM843 EM205 EM039 EM522 74323 56205 57016 CX026 CX026 CKMEH CX014

M-Plan Dental (Salt Lake City, UT) MAMSI - (Frederick, MD) MBA (El Paso, TX) MBA Benefit Admin (Salt Lake & Murray, UT) MBA Benefit Administrators (Salt Lake City, UT) MBA of Wyoming (Worland, WY) MBS (MedCost Benefit Services(MBS))Winston Salem, NC MCNA (Managed Care of North America) Fort Lauderdale MCS / MCS Classic Care MDB (1335 Industrial Blvd., Ste 100, St. Paul, MN) MEGA Life & Health Insurance Company (North Richland MHHNP (Memorial Herman Health)(PO Box 742567 Hous MHHNP (Po Box 742567, Houston TX) MI UFCW Union (Madison Heights, MI) MMA (Goshen IN) MMEHT (Augusta, ME) MMSI-Mayo Clinic Health Solutions (Rochester, MN) MMSO (Military Medical Support) (Po Box 886999) MN Power (Duluth, MN) MPEEBT / MPE Services, Inc (Jackson, MS) MSA Careguard (North Reading, MA) MVP Medical (Schenectady NY) Machigonne Benefit Administators (Portland, ME) Machinists Health Mahoney Benefit Admin, LLC of TX(Ft. Lauderdale, FL) Mail Handlers Benefit Plan (Jacksonville, FL) Manage Care of America (Pittsburgh, PA) Manage Dental Guard (Sacramento, CA) Managed Care Services (Fort Wayne, IN) Managed Care of North Ameica (MCNA) Fort Lauderdale, Managed Dental Guard(Woodland Hills, CA) Managed Health Services - WI State Employees Manulife, W.J. Sutton Co. - Toronto Ontario, Canada MapFre Maritime Association (Houston, TX) Maritime Association (Houston, TX) Marsh Advantage (po box 4542, Iowa CIty IA) Masonry Institute (Des Plaines, IL) Mass Health (Doral Dental) Hingham, MA Maxor (Amarillo, TX) Mayo Clinic Health Solutions-MMSI (Rocehster, MN) McCrew Care (Columbia, SC) McGregor PACE (Eden Prairie, MN) McPrime West (1335 Industrial Blvd. Ste 150, Mpls, MN) Med3000 CMS Safety Net Med3000 CMS Title 19 Med3000 CMS Title 21 Med3000 Pedicare Title 19 Med3000 Pedicare Title 21 MedBen (Newark, OH) MedCost Benefit Services (MBS)- Winston Salem, NC Medi-Cal (PO Box 15559, Sacramento, CA Medica of MN - PO Box 1328, Mpls, MN Medica of MN - PO Box 1519, Mpls, MN Medicaid - Maine for FQHC Medicaid Pennysylvania Best Health Care Pittsburgh (Do

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

CX014 CX014 CX014 CKAZ1 CKAL1 CKAK1 CKAR1 94146 CKCO1 CKCT1 CKDE1 CKDC1 CKFL1 CKGA1 CX014 CKIL1 CKID1 CX014 CKIN1 CKIA1 CKKS1 CKKY1 CKKY3 CX014 CKLA2 CKLA1 CKME1 CX014 CKMA1 CKMI1 CKMN1 CKMS1 CKMO1 CX014 CX014 CX014 CX014 CX014 CX014 CX014 CKMT1 CKNE1 CKNV1 CKNH1 86047 CKNJ1 CKNM1 CX014 CX014 CX014 CKNY1 86048 CKNY2 CKNC1 CKND1 CKOH1

Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid Medicaid

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Pennysylvania Gateway Health Plan (Doral Den Pennysylvania Health Partners Pittsburgh (Dor Pennysylvania Oaktree (Doral Dental of WI) of AZ of Alabama of Alaska of Arkansas of California (Denti-Cal) of Colorado of Connecticut (New Britton, CT) of Delaware - New Castle, DE of Disctrict of Columbia (Washington, DC) of Florida of Georgia of Georgia Grady Healthcare Inc (Doral Dental of IL - Doral Dental of WI (Admin by Doral) of Idaho (Boise, ID) of Illinois (Doral Dental of WI) of Indiana (Boise, ID) of Iowa (Des Moines, IA) of Kansas (Mequon, WI) of Kentucky (Mequon , WI) of Kentucky Region #2 (Doral Dental Services) of Kentucky Region #3 (Doral Dental of WI) of Louisiana (Adult Dental) of Louisiana (EPSDT) (Baton Rouge, LA) of Maine of Maryland-Dept of Health and Ment of Massachusetts of Michigan of Minnesota of Mississippi of Missouri (Jefferson City, MO) of Missouri Blue Advantage (Doral Dental of WI of Missouri Community Care Plus- St Louis (Dor of Missouri Community Health PLan (Doral Den of Missouri First Guard Health Plan (Doral Dent of Missouri Health Net (Doral Dental of WI) of Missouri Truman Care- Family Health Partner of Missouri health Care USA- St.Louis (Doral De of Montana of Nebraska (Lincoln, NE) of Nevada (San Antonio, TX) of New Hampshire of New Jersey (Admin by Americhoice)(Salt Lak of New Jersey (Trenton, NJ) of New Mexico of New Mexico Cimmaron Health Plan (Doral D of New Mexico Loveplace Community health pla of New Mexico Presbyterian Salud (Doral Denta of New York of New York (Administrated by AmeriChoice) of New York (Dental Clinics Only) of North Carolina (Raleigh, NC) of North Dakota (Bismark, ND) of Ohio (Administrated by Quadax) (Columbus,

Payer Claims List

Payer ID

Payer Name

Req. Enroll.

CX014 CX014 CX014 CKOK1 CX014 CX014 CKOR1 CKPA1 CX014 CKRI1 CKSD1 CKSC1 CX014 CKTX1 CKUT1 CKVA1 CKVT1 CX014 CKWA1 CKWV1 CKWI1 CX014 CX014 CKWY1 CX014 MAHC1 LX019 CX024 74323 60221 CB833 84600 660663351 973 23160 LX057 MNM01 LX133 MBAAZ 37264 86052 63002 33628 CX074 41124 23550 65978 A1004 CDMI0 LX116 A1432 38238 A1404 27401 LX078 37281

Medicaid of Ohio Emerald HMO and Medicare INC. (Dora Medicaid of Ohio Health Power HMO Cincinatti (Doral De Medicaid of Ohio Personal Physicians Care Cleveland (Do Medicaid of Oklahoma (Oklahoma City, OK) Medicaid of Oklahoma Heartland Health PLan (Doral Den Medicaid of Oklahoma Unicare Health PLan (Doral Dental Medicaid of Oregon Medicaid of Pennsylvania (Harrisburg, PA) Medicaid of Pennysylvania (Doral Dental of WI) Medicaid of Rhode Island Medicaid of SD Medicaid of South Carolina Medicaid of Tennessee (Doral Dental of WI) Medicaid of Texas Medicaid of Utah Medicaid of VA - Richmond, VA Medicaid of Vermont Medicaid of Virginia HealthKeepers Plus (Doral Dental of Medicaid of Washington Medicaid of West Virginia (Charelston, WY) Medicaid of Wisconsin (Madison. WI) Medicaid of Wisconsin Humana/ TDC (Doral Dental of W Medicaid of Wisconsin PrimeCare (Doral Dental of WI) Medicaid of Wyoming (Cheyenne, WY) Medicaid of ohio United Health Care Inc. Medicare COm Medical Associate Health Plan (Dubuque, IA) Medical Benefit Admin (PO Box 90991, Milwaukee, WI) Medical Benefit Administrators - Madison, WI Medical Benefits Mutual - Newark, OH Medical Bridge and Dental Claims (Jackson, MS) Medical Mutual of Ohio (MMO) Medical Network of Colorado Springs(Colorado Springs, C Medicare Dental Network (MDN) Medicare Optimun / Triple S Medico Insurance (IA, NE, MN) Memorial Hermann (MHHNP)(PO Box 742567, Houston, Mennonite Mutual Aid (Goshen, IN) Mennonite Mutual Aid (Goshen, IN) Merchants Benefit (MultiFlex Dental)(Scottsdale, AZ) Mercy Benefit Admin (Springfield, MO) Mercy Care Plan (Phoenix, AZ) Mercy Life of Alabama (Livonia, MI) Mercy Maricopa Integrated Care (Phoenix, AZ) Meritain Health (Amherst, NY & Richardson, TX) Meritain Health (Minneapolis, MN) Methodist First Choice (Rockford, IL) Metlife (El Paso, TX) Metropolitan Detroit Laborers (Landing, MI) Michigan Conference of Teamsters (Farmingotn Hills, MI) Michigan Dental Plan (Clawson MI) Michigan Laborers (Carmel, IN) Michigan Regional Council of Carpenters Employee(Troy, Michigan State Painters (Carmel, IN) Michigan UFCW (Madison Heights, MI) Michigan UFCW (Madsion Heights, MI) Mid America Associates, Inc (Madison Heights, MI)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

22823 59226 12251 LX085 CX033 74227 41101 61146 51233 79480 89070 A1402 R7005 64088 37275 25133 31415 52133 35092 35092 36111 89070 86040 MBAAZ 37256 CX087 71412 91136 91136 91136 91136 65085 34159 58182 23166 75191 75190 LX075 38225 38225 CKTX1 66055 38238 91136 41045 91136 14142 23166 56175 56176 CX045 CX057 71412 52120 MBAAZ 314RV

Mid America Benefits (Po Box 685, Arnold MD) Mid West National Life Insurance (MEGALIFE) (N Richlan Mid-American AAI, Inc (UCS) Phoenix, AZ Mid-American Benefits In (Omaha NE) Mid-Atlantic Medical Services, Inc (MAMSI) PO Box 940 F Mid-West National Life Ins. Co. of TN-Student Ins Midwest Dental Benefits (1335 Industrial Blvd. Ste 100 S Midwest Group Benefits, Inc. (Decorah, IA) Midwest Security Administrators, Inc Midwest Security of WI (Onalaska, WI) Military Medical Support (MMSO) (Po Box 886999) Millwright Local 1102 Health & Welfare Fund (Lansing, M Minnesota Power (Duluth, MN) Mississippi Select Healthcare (Gulfport, MS) Missoula County Benefits Plan Missouri Department of Transportation/MODot * St Louis Momentum Ins. Plans (Madison, WI) Morgan White (Salt Lake City, UT) Morris Associates (PO Box 50440, Indianapolis, IN) Morris Associates (PO Box 619058 Dallas, TX) Motorola (Phoenix, AZ) Mountain State BCBS (MSBCBS(PO Box 69434, Harrisbur Mountain States Admin Services, Tucson, AZ MultiFlex Dental (Merchants Benefit)(Scottsdale, AZ) Mutual Assurance Admin (Oklahoma City, OK & Addison, Mutual of Omaha (Sherwood, AR & Indianapolis, IN) Mutual of Omaha/National Rural Letter Carrier (Charlotte N.W. Int Assoc of machinists & Aerospace Eng Benefits N.W. Iron Workers Health & Security Trust Fund (Seattle N.W. Roofers & Employers Health & Security Trust Fund N.W. Textile Processors (Seattle, WA) NAA (TN) North America Administrators, LP - Nashville, NABN (North American Benefits Network) Cleveland, OH NAPHCARE (Birmingham, AL) NAS (Nat'l Auto Sprinklers (Landover, MD) NCAS - Charlotte NCAS - Fairfax, VA NECA (Decatur IL) NGS American (Lake Forest, IL) NGS American (St Claire Shores & Clinton Township, MI) NHIC (Medicaid of TX) NLH (Netcare Life & Health Ins) NNEBT Northern NE Benefit Trust (Manchester, NH) NW Benefit ( Po Box 34176) NW National Life (MN, AZ) NW Plumbing and Pipfitting Industry NY State Dept of Health (Albany, NY) Nat'l Auto Sprinklers (NAS)(Landover, MD) Nathional Benefit Adminsitrators (Parsippany, NJ) National Benefit Administrators, (Charlotte, NC) National Elevator Industry Benefit Plan (NEIB) (Newtown National Pacific of TX (TX) National Rural Letter Carrier (Charlotte, NC) National Telecommunications Cooperative Association (A Nationwide (El Paso, TX) Nationwide Employee Benefits (Columbus, OH)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

31417 19191 95123 66055 84600 90091 NDB01 43351 66893 LX080 NYT01 69821 81264 65085 34159 LX027 61472 47570 02027 CBNYE CX099 36347 LX062 LX106 38238 88027 91060 93525 91136 36346 91136 16644 37299 CDOR1 22521 80705 80705 80705 80705 80705 80705 80705 80705 80705 80705 80705 80705 80705 80705 80705 80705 80705 80705 80705 80705 80705

Nationwide Health Plan (Dublin, OH) Native Care Health, LLC (Quapaw, OK) Neighborhood Health Netcare Life and Health Insurance (NLH) Network Claims (Colorado Springs, CO) Nevada Health Co Op (Las Vegas, NV) Neveda Dental Benefits (Las Vegas, NV) New England Dental Administrators - Concord, NH New England Financial (Kennet, MO) New Southland Natl Ins Co (Tuscaloosa AL) New York State Teamsters Union (Syracuse, NY) Next Level Health Partners (Birmingham, AL) Nippon Life Insurance Company of America North America Administrators, LP - Nashville, TN North American Benefits Network (NABN), Cleveland, OH North American Health ( Amherst, NY) North Carolina Health Choice for Children North Star Administrators NorthEast Delta Dental NorthEast NY Blue Shield (Albany, NY) Northern California Pipe Trades (Concord, CA) Northern Illinois Health Plan (Freeport, IL) Northern MN Dental (Duluth, MN) Northern NE Benefit Trust (Manchester NH) Northern NE Benefit Trust NNEBT (Manchester, NH) Northern Nevada Trust Fund - Reno, NV Northwest Administrators (Seattle, WA) Northwest Dental Services - Roseburg, OR Northwest Iron Workers (PO box 34464) Seattle,WA Northwest Suburban IPA (Rockford, IL) Nothwest I.A.M. Benefit Trust Nova Health Administrators, Inc. (Grand Island, NY) Nyhart (Indianapolis, IN) ODS Healthplans (Oregon Dental Services/Delta Dental o OK State Employees & Educators (Oklahoma City, OK) ONE Health Plan Inc of California ONE Health Plan Inc of Colorado ONE Health Plan Inc of Florida ONE Health Plan Inc of Georgia ONE Health Plan Inc of Idaho ONE Health Plan Inc of Indiana ONE Health Plan Inc of Iowa ONE Health Plan Inc of Kentucky ONE Health Plan Inc of Mississippi ONE Health Plan Inc of New Jersey ONE Health Plan Inc of New York ONE Health Plan Inc of North Carolina ONE Health Plan Inc of Oklahoma ONE Health Plan Inc of Texas ONE Health Plan Inc of The District of Columbia ONE Health Plan Inc of Vermont ONE Health Plan Inc of Virginia ONE Health Plan Inc of Washington ONE Health Plan Inc of Wisconsin ONE Health Plan Inc. of Alaska ONE Health Plan Inc. of Arizona

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

OAC01 74431 65074 80705 FX026 91136 LX023 LX065 GP133 25449 27267 27277 26224 CDOR1 73624 83926 84104 DX106 87068 CX066 70454 86711 37287 27277 68241 CX080 LX030 67466 CDCAP 16111 67466 CX056 93031 CXPSC 93029 CX060 CX053 LX054 04218 06126 58174 58174 PBGSM 23213 CX091 CB733 10525 32069 47009 PRW01 52133 37121 67814 PHP01 67814 38265

Ohio AFSCME Care Plan Ohio PPO Connect (PO Box 828, Arnold, MD) Olympus Managed Health Care (Miami, FL) One Health Plan Inc of Wyoming Operating Engineers (Pewaukee, WI) Operating Engineers Locals 302 & 612 Health & Security Optima (4417 Corporation Lane, Virignia Beach) Optima (Troy, MI) Optum Specialty Svcs (Thiensville, Milwaukee WI) Oregon Alaska Industrial Hardware (Phoenix, AZ) Oregon Alaska Rubber & Supply (Phoenix, AZ) Oregon Cascade Rubber Products (Phoenix, AZ) Oregon Construction Machinery Industrial (Phoenix, AZ) Oregon Dental Services & ODS Healthplans (Portland, O Oregon Peninsula Airways (Phoenix, AZ) Oregon TDX Corp. (Phoenix, AZ) Oxford Health Plans P.R.I.M.E Benefit Systems(PO Box 2239 CedarRapids, IA P5 Health Plan Solutions (Salt Lake City & West Valley, U PA Faculty Health & Welfare (Arnold, MO) PACE CNY (Syracuse, NY) PACE Southest Michigan (Eden Prairie, MN) PAI (Columbia, SC) PBS - Oregon Cascade Rubber Products (Phoenix, AZ) PDO PEHP (Public Employees Health Program)(Salt Lake City, PLUMBERS AND PIPEFITTERS (OKLAHOMA, OK) PM Group (Phoenix, AZ) PMI (Delta Dental of CA) (12898 Towne Center Drive Ce POMCO ( Syracuse, NY) Pacific Life & Annuity - Phoenix, AZ Pacific Union Dental Benefits (LasVegas, NV) PacificSource Admin (Portland, OR) PacificSource Community (Salem, OR) PacificSource Health Plans - Eugene, OR Pacificare Dental and Vision (HMO Claims Only) (PO Box Pacificare Dental and vision (PDVA) (Santa Ana, CA) Paid Dental (PO Box 9150, Austin, TX) Pan American Life Ins. (El Paso, TX) Paper Claims Paragon Benefits, Inc. (Columbus, GA) Paragon Benefits, Inc. (Po Box 981600, El Paso TX) Partners Benefit Group (Southborough, MA) Partners Health Plan (Philadelphia, PA) Passport Health (London, KY & Fort Lauderdale, FL) Patient Services (Midlothian, VA) Patients Advocates, LLC (Portland & Gray, ME) Patriot Mutual Dental Programs(PO Box 192, MPLS, MN) Paul Revere / Provident Pavers and Road Builders Welfare Fund Peoples Benefit Life Ins. Co. (Salt Lake City, UT) Pequot Plus Health (PO Box 3559 Manshantucket, CT) Phoenix American (Greenfield, MA) Phoenix Health Plan (PHP) (AZ) (Richardson, TX) Phoenix Home Life (Greenfield, MA) Physicians Care (Grand Rapids, MI)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

36345 37136 12399 CX068 CX014 24735 PIP01 PIP02 LX099 37224 37287 PCM01 PCU01 PCU02 32680 36373 41147 16112 59291 56178 68241 LX083 CX090 CB404 31478 LX132 47570 CX078 CX029 56144 LX049 PCA01 CX014 61271 38217 LX095 36331 LX001 41163 37137 88029 70408 PAS01 68195 68241 CX080 91136 39197 89461 CX077 46571 95266 91176 16117 93200 93200

Physicians Care Network (Rockford, IL) Physicians Health Assoc. (Rockford, IL) Physicians Health Plan of Northern IN(Fort Wayne, IN) Physicians Mutual (Lincoln, NE) Physicians Plus Insurance Co., Wisconsin State Employee Pinnacle Claims Management (Fresno, CA) Pipe Trades Industry Health & Welfare Fund Pipefitters 597 (45 N Ogden Ave. Chicago, IL 60607) Pipestone Industry Benefit Trust (Tulsa OK) Pittman & Associates (Memphis, TN) Planned Administrators, Inc. Plasters & Cement mason Local 148 Health & Welfare Fu Point Comfort Underwriters (Indianapolis, IN) Point Comfort Underwriters (PO Box 211745, Eagan, MN Poly America Medical & Dental Benefits-Grand Prairie, TX Prairie States Enterprises, Inc ( Sheboygan, WI) Preferred (PO Box 59212) Mpls, MN Preferred Care (Rochester, NY) Preferred Care FL (Tampa, FL) Preferred Care NC (Tampa, FL) Preferred Dental Organization Preferred Group Plans Inc (Albany NY) Preferred Health (PO Box 436987 Louisville, KY) Preferred Health Plan of the Carolinas (Charlotte, NC) Preferred Health Professionals (Freedom Dental)(Overlan Preferred One Auxiant (Cedar Rapids IA) Premera Blue Cross (Seattle, WA) Premier Access Insurance (PO Box 659010 Sacramento, Premier Dental Group - MN (Plymouth, MN) Primary Physician Care, Inc. - Charlotte, NC Prime West (1335 Industrial Blvd., Ste 150, MPls, MN) PrimeCare Admin (Las Vegas, NV) PrimeCare, Wisconsin State and Federal Employees and Principal (Coloradp Springs, CO& DesMoines, IA) Priority Health (Grand Rapids, MI) Pro Claim Plus Inc (Fort Wayne IN) Professional Benefit Administrators, Inc. (Oak Brook, IL) Professional Claims (10560 Wayzata, Minnetonka, MN) Professional claims Administrators (Minnetonka, MN) Progressive Benefits Services (Peoria, IL) Prominence Health Plan (Reno & Henderson, NV) Protective Life/Fortis (Birmingham, AL) Providence Admin Services (Eagan, MN) Provident\Healthsource (Memphis TN) Prudential (Blue Bell, PA) Public Employees Health Program (PEHP)(Salt Lake City, Puget Sound Benefits Trust (Seattle, WA) QuadMed (West Alis, WI) Quality Care Partners (PO Box 595, Arnold, MD) Quality Plan Admin (Washington, DC) Quartz ASO (Sauk City, WI) R.E. Harrington Inc (Colombus, OH) RBMS, LLC (Anchorage, AK) RMSCO (Syracuse, NY) Regence Blue Shield (PO Box 30271 SLC UT)(PO Box 21 Regence Blue Shield WA- FEP(PO Box 30271 SLC, UT)(P

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

38221 47076 80314 36088 41045 41045 41045 RLHA1 73066 CB695 LX094 999998 37331 50664 41625 84102 RR001 25133 31441 37259 SCION 38610 03699 LX128 CPPSH CX030 CX048 CX030 37137 91184 37288 77024 73172 20460 LX089 SDCOM CX023 86057 28530 93742 35202 LX126 LX053 CX092 77024 CX109 64088 42137 CX107 68241 DX215 59111 CX076 36404 CX020 34131

Regency Employee Benefits - Port Huron, MI Regional Care Inc. (Scottsbluff, NE) ReliaStar Reliance Standard Life (Lincoln, NE) Reliastar (146 Industrial Park Rd, Jackson, MN) Reliastar (7830 East Broadway, Tucson, AZ) Reliastar (PO Box 1195, Mpls, MN) Renaissance Life and Health (Indianpolis, IN) Reserve National Insurance Company Resolve (Solarte Health, Inc)(Arnold, MD) Resource One Admin (Buckeystown MD) Returned Claims RightChoice Benefit Admin (Troy, MI) Riverside San Bernardino Cty Indian Health, (Banning, C Rochester Public Schools (Rochester, MN) Rocky Mountain Life Dental (Colorado Springs, CO) Royale Resources (Perham, MN) Rural Carrier Benefit Plan (Charlotte, NC) S & S Health (Cincinnati, OH) SAMBA (Rockville, MD) SCION Dental (Thiensville, WI) SET SEG (Lansing, MI) SIEBA (Endicott, NY) SIHO Member Services (Columbus IN) STAR Health (PO Box 537030, Sacramento, CA) Safeguard (Po Box 981987, El Paso, TX) Safeguard HMO (PO Box 30920 Laguna Hills, CA) Safeguard PPO -(PO box 30930 Laguna Hills & Aliso Viej Sage Technologies (Peoria, IL) Sanford Health Plan (Sioux Falls, SD) Santa Barbara Cottage Hospital (Santa Barbara, CA) Sante Health System (SeeChange)(Fresno, CA) Scan Health Plan Arizona (PO Box 61450 Phoenix, AZ) Scan Long Term Care (PO Box 61450 Phoenix, AZ) School Claims Service LLC (New Cumberland PA) Scion Dental (Milwaukee, WI) Seabury & Smith - Iowa City, IA Secure Care (Phoenix, AZ) Secure Health Plan of GA (Macon, GA) Securian Dental Plans (PO Box 9385, MPLS, MN) Delta of Security Adminstrative Services (Marshfield, WI) Security Health Fund (Marshfield WI) Security Life (NY) Security Life Insurance (Schenectady, NY) SeeChange (Sante Health System)(Fresno, CA) Sele-Dent (Lynbrook, NY) Select Administrative Services (Gulfport, MS) Select Benefit Admin (PO Box 8339, Des Moines, IA) Select Health (Salt Lake City, UT) SelectCare (Coca Cola) SelectCare (Frisco, TX) Self Insured Benefit Admin - (Clearwater, FL) Self Insured Dental Services (PO Box 9005,9007,9010 Ly Self Insured Plans LLC (Naples, FL) Self Insured Services Company (SISCO) - Dubuque, IA Self-Funded Plans (St. Charles, IL)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

34131 36426 LX135 39033 39033 39033 CX038 75280 LX024 FX024 LX127 SMW01 41143 81434 CX067 76342 CX046 58102 41101 84076 CB695 76578 91136 23266 35227 CX051 39148 SEI01 37318 SEF01 56131 77153 CX050 CX100 68241 23253 38416 84147 37116 13411 69019 93024 CPPSP 59225 STR01 46450 57254 31121 58128 64246 LX014 74227 R7003 LX142 86083 37301

Self-Funded Plans of OH - Cleveland, OH Sendero Health Plans (Austin, TX) Sentry Insurance (Roanoke, VA) Sentry Insurance A Mutual Company (Stevens Point, WI) Sentry Insurance Company (Stevens Point, WI) Sentry Life of NY (Stevens Point, WI) Serentas Dental Care Solutions - Louisville, KY Shasta Admin Services (Redmond, OR) Sheet Metal Workers (PO Box 1449, Goodlettsville TN) Sheet Metal Workers (PO Box 1449, Goodlettsville, TN) Sheet Metal Workers Local 265 (Carol Stream IL) Sheet Metal Workers Local 91 (West Burlington, IA) Sheffield, Olson & McQueen (2145 Ford Pkwy, St. Paul, Shelte Point Life (Great Neck, NY) Shenandoah Life Insurance (Roanoke, VA) Sierra Health Services (Las Vegas, NV) Significa Benefits Services Simple (1745 N Brown Rd, Lawrencevill GA) Simple Benefits- (Duluth, GA) Sinclair Health Plan (Salt Lake City, UT) Solarte Health, Inc (Resolve)(Arnold, MN) Solstice Benefits South Bay H.E.R.E. Funds South Central Preferred (Hingham, MA) South Point Hotel & Casino (LasVegas, NV) SouthWest Benefits Southeast Dental Associates (Milwaukee, WI) Southeaster Service Employees International (SEIU) Southern Benefits Services (Lafayette, LA) Southern Electrical Health Fund (Chattanooga, TN) Southern Group Admin - Winston-Salem, NC Southern Indiana Health (Columbus, IN) Southwest Life and Health / First Care (Austin, TX) Southwest Service Admin (Phoenix, AZ) Southwestern Bell Exec Spectrum Admin (Allentown, PA) Spencer Stuart (Arm LTD) (Eagan, MN) Spina Bifida - VA HAC St Therese Physician Assoc. (Rockford, IL) Standard Ins Co. of New York (PO Box 82520, Lincoln, N Standard Insurance ( Lincoln, NE) Standard Insurance of Oregon (Lincoln, NE) Star + Plus Value Added (PO Box 537014, Sacramento, StarHRG (Phoenix, AZ) Starmount Life Insurance Company (Baton Rouge, LA) State Auto (Columbus, OH) State of TX Dental Plan - All Plans except PO Box 4665 ( Stoner and Associates - Cincinnati, OH Stowe Associates of GA (Atlanta, GA) Strategic Ourtsourcing Inc. (SOI) (Charolotte, NC) Strategic Resouce (PO Box 23759, Columbia, SC) Student Insurance (Lincoln, NE) Sturm & Associates (Edina, MN) Stylmark (Mpls.-Fridley, MN) Summit Admin Services, Inc. (Scottsdale, AZ) Summit America Insurance Services (Overland Park, KS)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

67814 47009 47009 67814 31117 CPPSW CX088 98010 73288 TIC01 60054 73288 CPPTM 88067 LX102 LX113 41147 CDMI0 TXABA LX013 79480 CPPTX 68423 74227 73288 73288 TDN01 LX110 CRIHB 23223 74227 59226 68423 13142 CHSTS 06131 25175 CMS01 ASHC1 37314 TCS01 CX112 CX112 84076 69493 37284 CX069 65978 25348 36397 CHSWT 31144 73288 89070 CDCA1 84103

Sun Life (Po Box 81633, Wellesley Hills) Sun Life Canada Sun Life Financial Sun Life and Health (Formerly Genworth) Superior Dental Care SuperiorSTAR Pregnant Women (Sacramento, CA) Surency Life and Health (Wichita, KS) Sutton Special Risk (Buffalo, NY) TDC (PO Box 1100 Employers Blvd, Green Bay, WI) TIC International, Inc (Carmel, IN) TRW TSRDP Dental Claims (PO Box 1100 Employers Blvd, Gre TX Medicaid - Delta CA - Childrens (PO Box 537014, Sacr Tall Tree Administrators (Salt Lake City, UT) Taylor Benefit Resource (Thomasville GA) Teamster Local 463 (Pennsauken NJ) Teamsters (Po Box 7078) Duluth MN Teamsters Welfare Fund (Farmington Hills, MI) Texas Ag Benefit Admin (PO Box 211575, Eagan, MN) Texas Municipal League (TML) (PO Box 149190, Austin, Texas Municipal League (TML) Austin, TX Texas-CHIP Dental Services (Sacramento, CA) The Care Network (PO Box 788, Arnold, MD) The Chesapeake Life Insurance Co.-Student Ins. The Dental Companies (PO Box 1100 Employers Blvd, Gr The Dental Concern (PO Box 1100 Employers Blvd, Gree The Dental Network (7400 York Raod, Suite 200, Towso The Dental Shop (Amherst NY) The Humboldt-DelNorte (Eureka, CA) The Loomins Company (Wyomissing, PA) The MEGA Life & Health Ins. Co.-Student Ins. The MEGA Life & Health Insurance Co. (North Richlands The Savannah Business Group (PO Box 788, Arnoold, M The Union Labor Life Insurance Co. (King of Prussia, PA) Theatrical and Stage Local 16 (Dublin, CA) Third Party Claims Management (Tampa, FL) Three Rivers Health Plan - (Monroeville, PA) Three Rivers Health Plan, Inc. (WI Time Ins (WI) Total Claims Admin. Inc/North Broward Hospital District Total Claims Solutions (Green Bay, WI) Total Dental Admin (Elk Grove, IL) Total Dental Admin (PO Box 44035 Phoenix, AZ) Total Dental Admin (Salt Lake City, UT) Tower Life Insurance (San Antonio, TX) TransChoice Key Benefit Administrators TransSmile (Sherwood, AR) Travelers (El Paso, TX) Travis County Map-Mediview Trellis Health Partners (Rolling Meadows, IL) Tri-Counties Welfare Trust Fund (Dublin, CA) TriState Benefit Solutions (Cincinnati, OH) Tricare Active Reservists (PO Box 1100 Employers Blvd, Tricare Dental Plan (UCCI) Harris burg, PA) Tricare Retiree Dental-Delta Dental of CA - PO Box 5370 Trigon - Blue Cross and Blue Shield (Colorado Springs, C

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

CB923 973 ILDTA 91078 61425 97802 89070 36659 LX078 LX029 A5205 CX111 62308 87726 74223 LX104 74223 33108 37237 95266 79480 74223 39026 39026 75196 52180 65099 23281 93092 CX110 41206 80314 47009 35198 75243 52133 13142 70408 52133 25175 97802 59069 20090 89070 70408 UFC01 UFC02 36659 UGP19 GP133 52133 95378 87726 84132 33108 36362

Trigon Blue Cross of Virginia (Now Anthem BCBS of Virgi Triple S / Medicare Optimun TruAssure (Lisle, IL) Trusteed Plan Service Corporation (Tacoma, WA) Trustmark Insurance - Lake Forest, IL UABT - United Ag-Superior Insurance (Irvine, CA) UCCI (United Concordia) UFCW (United Food & Commerical Workers)(Park Ridge, UFCW Dentemax (Madison Hgts MI) UFCW LOCAL 56 ( PENNSAUKEN, NJ) UFCW Local 400-5205 (Carmel, IN) UFCW Local 655 (Manchester, MO) UFT Welfare Fund UHC/Medica Po Box 30990 SLC UT UICI - Administrators - State of Nevada (San Antonio, TX UMC Dental Reimbursement Plan (Lubbock TX) UMR (PO Box 2838 Clinton, IA) UMR - Cincinnati (Cincinatti, OH) UMR - Lexington (Lexington, KY) UMR-Harrington Benefits (PO Box 30530,33,34,40, Salt L UMR-Onalaska (Onalaska, WI) UMR-San Antonio (San Antonio, TX) UMR-Wausau (Salt Lake City, UT) UMR-Wausau (Wausau, WI & Pueblo, Co) UMR-Westerville (Westerville, OH) UMWA Health & Retirement (Lubbock, TX) UNICARE Special Accounts UPMC Health Plan (Pittsburg, PA) US Benefits, Inc. (Portland, OR) UT Chips (Salt Lake City, UT) UltraBenefits, Inc (Westborough, MA) Unicare Unifi Companies (Lincoln, NE) Unified Group Services (Anderson, IN) Uniform Medical Plan/Harrington Benefit Services (Seattl Unimerica Dental (Salt Lake City, UT) Union Labor Life Insurance Co - King of Prussia, PA Union Security (Clinton, IA) Unique DentaCare (Salt Lake City, UT) Unison - (Monroeville, PA) United Ag - Superior Insurance Services (Irvine, CA) United Benefits (Ormond Beach, FL) United Claim Solutions (Phoenix, AZ) United Concordia (UCCI) United Dental - Texas (Clinton, IA) United Food & Commerical Workers Union of Central Ohi United Food & Commerical Workers Union of Cleveland( United Food & Commerical Workers(UFCW) (Park Ridge, United Group Program United Health Care (Milwaukee, WI) United Health Care - MD, UT (Salt Lake City, UT) United Health Care of River Valley (Moline, IL) United Health Care, GA, PA United Medical Alliance (Fort Collins, CO) United Medical Resources (Cincinatti, OH) United Security Life & Health (Clinton, IA)

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Payer Claims List

Payer ID

Payer Name

Req. Enroll.

FX028 LX028 13545 71412 UNITY 16105 91136 89070 37324 12116 64009 89070 VHP01 72128 68241 72187 75256 48123 LX139 LX123 59266 39151 91062 37294 91136 73155 39026 59332 75261 10050 47198 87815 87815 37272 91136 90560 24735 93200 CXWVC 93050 98010 R7002 R7006 FX031 LX006 20333 CX014 LX063 LX060 R7001 33884

United South Central Workers (Dallas, TX) United South Central Workers (Dallas, TX) United States Life - Neptune, NJ United of Omaha (Charlotte, NC) Unity Health Plans-Dental Health (Fairfield, NJ) Univera of New York (Baldwinsville, NY) University of Washington Students & Graduate Appts.(Se Unum Upper Peninsula Health Group (Marquette, MI) VA Fee Basis Programs (St Paul, MN) Valir PACE (Oklahoma City, OK) Valley Baptist Health Plan (PO Box 69442) Valley Health Plan (GreenBay, WI) Vantage Health Plan (Monroe, LA) Varian Health Care Plan Varipro (Eagan, MN) Verity National Group (San Antonio, TX) Via Christi Hope (Wichita, KS) Voluntary Benefits Plan (Chesire, CT) Volunteer Benefits (Waterbury CN) Volusia Health Network (Daytona Beach, FL) WEA Insurance Group (Madison, WI) Washington Dental Service (Seattle, WA) Washington Employers Trust (Seattle, WA) Washington State Council of County & City Employees D Waterstone Benefit Administrators (Oklahoma City, OK) Wausau Insurance Companies, Wausau, WI Web TPA, Inc. (Grand Prairie, TX) WebTPA/Community Health Electronic Claims/CHEC (Gra Webster Dental Wellpoint (CA) (Oxnard, CA) Wells Fargo (Anchorage, AK) Wells Fargo (Charleston, WV) Wells Fargo TPA (JSL Administrators) (Newnan, GA) West Coast Stationary Engineers health & Security Trust WestLake Financial Group (Buffalo Grove, IL) Western Growers Insurance (Newton Beach, CA) Whatcom Medical Bureau (Bellingham, WA) Willamette Valley (Salem, OR) William C Earhart (Portland, OR) William J Sutton & Co. Ltd (Buffalo, NY & Toronto, CA) Wilson, McShane (Mpls, MN) Wisconsin Auto & Truck (WATDA) (Madison, WI) Wisconsin Carpenters (Eau Claire, WI) Wisconsin Electric (2730 Dairy, 2802 Coho St, Madison, Worksite Benefit Services (PO Box 707 Tifton, GA) Xantus Health PLan- Tennessee Zenith Admin (AZ,CA,CO,NV,WA) Zenith Admin (MD,IL,IN,KY,LA,MA,MI,MO,OK,TX,WI) Zenith Administrators (Mpls, MN) iCircle Care of NY (Webster, NY)

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