PHICURE - CONFIDENTIAL - November 01, 2019 837 …PHICURE - CONFIDENTIAL - November 01, 2019 Payer ID Payer Name State Prof Claim Inst Claim 13162 1199 SEIU National Benefit Fund All

PHICURE - CONFIDENTIAL - November 01, 2019

Payer ID Payer Name State Prof Claim Inst Claim

13162 1199 SEIU National Benefit Fund All Yes Yes

51028 21st Century Insurance and Financial Services MN Yes No

07205 360 Alliance PPO Gilsbar All Yes Yes

20413 3P ADMIN All Yes No

20446 6 DEGREES HEALTH INCORPORATED All Yes No

74234 8th Distric Electrical UT Yes No

93044 A & I Benefit Plan Administrators All Yes No

36273

AARP Medicare Supplement/Fixed Indemity by

UnitedHealthcare (UnitedHealthcare) All Yes Yes

87726

AARP MedicareComplete (AARP MedicareComplete

from SecureHorizons) All Yes Yes

36273

AARP UnitedHealthcare Insurance Co. (Special Data

Requirements located in Vendor Download Tools or All Yes Yes

A0701 ABMG CA Yes No

03443 Abrazo Advantage Health Plan All Yes Yes

ABRI1 Abri Healthplan All Yes No

A0003 ACCELERATED CLAIMS INCORPORATED All Yes No

AHS01 Access Administrators All Yes Yes

COACC Access Behavioral Care CO Yes No

ACCOM ACCESS COMMUNITY HEALTH NETWORK All Yes No

AMG01 Access Medical Group All Yes No

95424 ACCESS MEDICAL GROUP All Yes No

19305 Access Medicare (Cuatro LLC) All No Yes

64071 ACCLAIM All Yes Yes

MHIPA Acclaim IPA CA Yes No

MHIPA Acclaim IPA (MHCAC) CA Yes No

21356 ACCLAIM REPRICING All Yes No

AHIPA ACCOUNTABLE IPA All Yes No

MPM23 ACCOUNTABLE IPA (MPM) All Yes No

41160 ACNIPA All Yes No

87815 Acordia National (Now known as Wells Fargo TPA) All Yes Yes

72467 ACS Benefit Services, inc. All Yes Yes

PA331 ACS BENEFITS PAYER COMPASS All Yes No

38254 Activa Benefits Services, LLC (Formerly Amway All Yes No

75678 ACTIVE CARE UCS All Yes No

AHC01 ACTIVHEALTHCARE All Yes No

J1241 ADMINISTAFF All Yes No

59141 Administrative Services, Inc. All Yes Yes

37278 Adminone All Yes Yes

22384 Adminstrative Concepts, Inc. All Yes Yes

ABMS

Advance Benefit Management Systems, USA Inc.

(ABMS) All Yes Yes

837 Payer List

58202 Advanced Data Solutions All Yes Yes

AMM01 Advanced Medical Management All Yes No

74234 Advanstaff, Inc. All Yes No

ACIPA Advantage Care IPA CA Yes No

35219 Advantage Health Solutions Medicare Advantage All Yes No

35209 Advantage Health Solutions, Inc. All Yes Yes

77070 ADVANTAGE PREFERR All Yes No

83077 Advantek Benefit Administrators All Yes No

59374 Advantica Benefits All Yes No

95340 Adventist Health System All Yes Yes

13373 ADVICA - New York Hospital Community Health Plan NY Yes No

45423 Advicare All Yes No

J1896 ADVOCARE MCO INCORPORATED All Yes No

36320 Advocate Health Centers (AHC) All Yes No

65093 Advocate Physicians Partners (PHO) All Yes No

CB637 Aegis Admin Services All Yes No

57604 Aetna Affordable Health Choices (SM) - SRC All Yes Yes

62118 Aetna American Continental All No Yes

58730 Aetna ASA PPO/Assurant Health (Signature Admin) All No No

23225 AETNA BETTER HEAL All Yes No

23228 Aetna Better Health - PA Medicaid PA Yes No

128LA Aetna Better Health LA LA Yes Yes

26337 Aetna Better Health Medicaid IL IL Yes No

128MO Aetna Better Health MO MO Yes Yes

46320 Aetna Better Health NJ NJ Yes Yes

34734 Aetna Better Health NY All Yes No

128KY Aetna Better Health of KY KY Yes No

128MD Aetna Better Health of MD MD Yes Yes

128MI Aetna Better Health of Michigan MI Yes Yes

42130 Aetna Better Health of Nebraska All Yes Yes

50023 AETNA BETTER HEALTH OF OHIO All Yes Yes

128VA Aetna Better Health of Virginia VA Yes Yes

128WV Aetna Better Health WV WV Yes Yes

60054 Aetna Health Plan - PPO All Yes Yes

60054 Aetna Life & Casualty Company All Yes Yes

38692 Aetna TX Medicaid & CHIP TX Yes Yes

ADOCS Affiliated Doctors of Orange County CA Yes Yes

APG01 AFFILIATED PHYSICIANS GROUP All Yes No

M3CA1 Affiliated Physicians Group LLC NULL No Yes

POP06 AFFILIATED PHYSICIANS IPA All Yes No

23334 Affinity Essentials All Yes Yes

13334

Affinity Health Plans (Contact Affinity EDI

Coordinator before submitting claims electronically

at [email protected] or call 718-794-7592.) All Yes Yes

13333

Affinity Health Plans (TMG Health) (Effective for

Medicare claims with DOS on or after 01/01/2010) All Yes Yes

46594 AFFINITY MEDICAL GROUP All Yes No

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) All Yes No

34444

AFL - CIO Food & Beverage Dealers Trust Fund

(Toledo, OH) OH Yes No

13346 Aftra Health Fund All Yes Yes

AWNY6 AGE WELL NY NY Yes Yes

ARA01 AGERIGHT ADVANTAGE All Yes No

95241

AGIA Inc (Claims are printed and mailed to the

payer.) All Yes No

AGUA1 AGUA CALIENTE All Yes No

80705 AH & L All Yes Yes

36320MA AHC MISDIRECTED CLAIMS All Yes No

31138 AHPO (Cleveland, OH) OH Yes Yes

22195 AIG (Maksin Management Corporation) All Yes Yes

IP080 AKM Medical Group CA Yes No

95327

Alameda Alliance for Health (Provider must contact

payer to be approved. Contact at Alameda is Anet

Quiambao at 510-747-6153 or

[email protected]) All Yes No

AIPAZ Alamitos IPA CA Yes No

91136 Alaska Childrens Services, Inc AK Yes Yes

92600 Alaska Electrical Health & Welfare Fund All Yes Yes

91136 Alaska Laborers Construction Industry Trust AK Yes Yes

91136 Alaska Pipe Trades Local 375 AK Yes Yes

91136

Alaska United Food & Commercial Workers Health &

Welfare Trust AK Yes Yes

85600 ALBUQUERQUE PUBLIC SCHOOLS All Yes No

44423

ALEXIAN BROTHERS COMMUNITY SERVICES

TENNESSEE All Yes No

ALH01 Aliera Health Care All Yes Yes

CCHPC ALIGNMENT HEALTH CARE All Yes No

81400 All Savers Insurance (UnitedHealthOne) All Yes Yes

37602 All Savers Insurance Co. All Yes Yes

MRIPA Allcare Healthplan OR Yes Yes

26158 Allcare PEBB All Yes Yes

MRPEBB ALLCARE PEBB All Yes No

82238 ALLEGIAN ADVANTAGE All Yes Yes

55649 Allegian Choice All Yes Yes

81040 Allegiance Benefit Plan Management, Inc. All Yes Yes

99588 ALLEGIANCE HEALTH MANAGEMENT All Yes No

J1740 ALLEN CANNING All Yes No

23071 ALLIANCE BEHAVIORAL HEALTHCARE All Yes No

93658 Alliance Coal Health Plan ALL Yes No

88461 Alliance Healthplans of WI WI Yes No

22417 ALLIANCE PHYSICIANS HIGH DESESTT All Yes No

52149 Alliance PPO Inc.(Now known as OneNet PPO, LLC.) All Yes Yes

CALL

Alliance, The (Only for ID Cards showing PO Box

44365 Madison WI 53744 as mailing address. Call

608-210-6656 for Payer ID.) All Yes No

58234 Alliant Health Plans of Georgia GA Yes Yes

94177 ALLIED ADMINISTRA All Yes No

37308 Allied Benefit Systems All Yes Yes

04293 Allways Health Plan (Formerly NHP Boston) All Yes Yes

99030 ALOHA CARE All Yes No

ALOHA AlohaCare HI Yes No

ACMG1 Alpha Care Medical Group CA Yes No

ALPHA ALPHACARE All Yes No

MPM32 Alphacare Medical Group ALL Yes Yes

A0701 Alta Bates Medical Group CA Yes No

80705 ALTA Health and Life Insurance Company All Yes Yes

AMC11 AM CAPITOL INSURA All Yes No

AMAIA AMA Insurance Agency All Yes No

TH071 AMA INSURANCE AGENCY, INC All Yes No

AMAIA AMA Insurance Agency, INC All Yes Yes

13343 Amalgamated Life - PA/Alicare All Yes Yes

13550 Amalgamated Life Insurance Co. All Yes No

COMPU

Amalgamated Transit Union Division 1001 Health &

Welfare Fund CO Yes No

AMBHN AMBAY HEALTH NETWORK All Yes No

76061 AMCARE HEALTH PLA All Yes No

38219

AmeraPlan (Claims are printed and mailed to the

payer.) All Yes Yes

97661 AMERIBEN IEC GROUP All Yes No

75137 Ameriben Solutions All Yes Yes

F75137 AMERIBEN SOLUTIONS All Yes No

26078 AMERICA 1STCHO NC All Yes No

27515 Americaid Community Care (Houston) TX Yes Yes

27517 Americaid Community Care (Maryland) MD Yes Yes

27516 Americaid Community Care (New Jersey) NJ Yes Yes

42112 AMERICAN ADMINIST All Yes No

75240

American Administrative Group - AAG (Formerly

known as UICI Administrators All Yes Yes

37283

American Administrative Group (formerly Gallagher

Benefit) All Yes Yes

63103 American Behavior All Yes Yes

34187 AMERICAN BENE MGT All Yes No

95170 American Benefit Plan Administrators All No Yes

59140

American Benefits Plan Administrators (Las Vegas,

NV) NV Yes Yes

ACN01 American Chiropractic Network NY Yes No

41161 American Chiropractic Network (PAN) All Yes Yes

ACN01 American Chiropractic Network IPA of NY NY Yes No

ACN01 American Chiropractic Network, Inc. NY Yes No

J1236 AMERICAN CLAIMS MANAGEMENT (ACM) All Yes No

60305 AMERICAN COMMUNIT All Yes No

ACN01 American Complimentary Care Network, Inc. All Yes No

56071

American Family (administered by American

Republic) All Yes Yes

IP080 American Family Health Providers CA Yes No

TH095 American Family Insurance All Yes No

AMF11 AMERICAN FAMILY INSURANCE COMPANY All Yes No

60801 American Fidelity Insurance Company All Yes Yes

62030 American General All Yes No

50587 American Health PR Yes No

66065 AMERICAN HEALTH MEDICARE PR Yes No

01066 American Healthcare Alliance All Yes Yes

77083 American Heritage All Yes Yes

36369

American Imaging Management, Inc. (Assigned

Group Policy Plan ID required. To obtain, call AIM at

800-252-2021) All No No

81949 American Insurance Company of TX All Yes No

87726 American International Group, Inc. All Yes Yes

72099

American LIFECARE (Group Number required. Valid

only for claims with a billing address of 1100

Poydras ST. #2600, New Orleans, LA 70163) All Yes No

23212 American Medical & Life All No Yes

81400 American Medical Security All Yes Yes

81400 American Medical Security (UnitedHealthOne) All Yes Yes

74048 American National Insurance Co All Yes Yes

60739 AMERICAN NATIONAL INSURANCE COMPANY All Yes No

44444 American Postal Workers Union Health Plan All Yes Yes

42011 American Republic Insurance Company All Yes Yes

17965 American Sentinel Insurance Company All No No

ASH01 AMERICAN SPECIALTY HEALTH All Yes No

ASHP1 American Specialty Health All Yes No

65064

American Therapy Administration of Florida aka ATA-

FL (Only PT, OT and Speech Therapy claims for FL

plans to AETNA, CarePlus, JMH HP, Sunshine St,

WellCare.) FL Yes No

ATHAL AMERICAN THERAPY ADMINISTRATORS All Yes No

TH117 American Whole Network All Yes No

37322 American Worker Health Plan All Yes Yes

20553 Americas 1st Choice Health Plans of South Carolina All Yes Yes

55349 Americas 1st Choice of SC All Yes Yes

20029 America's Choice NMA All Yes Yes

21810 America's Health Choice All Yes Yes

16120 America's PPO (Formerly known as ARAZ.) All Yes Yes

41178 America's PPO / America's TPA All Yes Yes

87726

AmeriChoice - CT, FL, MD, RI, TX, WI

(UnitedHealthcare Community Plan) CT,FL,MD,RI,TX,WIYes Yes

87726

AmeriChoice by UnitedHealthcare (NYU)

(UnitedHealthcare Community Plan) All Yes Yes

87726

AmeriChoice MS - CHIP & CAN (UnitedHealthcare

Community Plan) MS Yes Yes

86047

AmeriChoice NJ, Medicaid, NJ Family Care

(UnitedHealthcare Community Plan) NJ Yes Yes

86048

AmeriChoice NY Medicaid & Child Health Plus

(UnitedHealthcare Community Plan) - Use PayerID

87726 All Yes No

87726 AmeriChoice of Florida FL Yes Yes

87726 AmeriChoice of Illinois IL Yes Yes

87726 AmeriChoice of Maryland MD Yes Yes

87726 AmeriChoice of Nebraska NE Yes Yes

87726

AmeriChoice of Nebraska (UnitedHealthcare

Community Plan) NE Yes Yes

86047 AmeriChoice of NJ Medicaid & Family Care NJ Yes Yes

86048 AmeriChoice of NY Medicaid & Child Health Plus All Yes No

86049

AmeriChoice of PA Children's Health Insurance

Program (KidsChoice) All Yes No

86049 AmeriChoice of PA Medicaid All Yes No

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#.) All Yes Yes

87726 AmeriChoice of Rhode Island RI Yes Yes

95378 Americhoice of TN TN Yes No

86049

AmeriChoice PA Medicaid & CHIP (UnitedHealthcare

Community Plan) All Yes No

25175

Americhoice Personal Care Plus PA

(UnitedHealthcare Community Plan) All Yes Yes

95378

AmeriChoice TN: TennCare, Secure Plus Complete

(UnitedHealthcare Community Plan) TN Yes Yes

28804 Amerigroup All Yes Yes

28807

Amerigroup - Maryland, Virginia and District of

Columbia MD,DC Yes No

28806 Amerigroup - New Jersey NJ Yes Yes

28805 Amerigroup / Americaid - Houston TX Yes No

27514 AMERIGROUP Georgia GA Yes Yes

28804 Amerigroup IL TX,NM Yes Yes

27518 AMERIGROUP IL All Yes No

28808 AMERIGROUP IL All Yes No

26375 Amerigroup Iowa All Yes Yes

26378 AMERIGROUP MULTIPLE STATES All Yes Yes

28809 Amerigroup of Florida FL Yes No

27514 AMERIGROUP Tennessee TN Yes Yes

93688 AmeriHealth - DE (PPO) All Yes Yes

60061 AmeriHealth - New Jersey (Non-HMO Claims) All Yes Yes

SX075 AMERIHEALTH - NJ (NON-HMO) All Yes No

54763 AmeriHealth Administrators All Yes Yes

27357 Amerihealth Caritas LA Yes Yes

87716 Amerihealth Caritas Healthplan NH NH Yes Yes

77075 Amerihealth Caritas Iowa IA Yes Yes

77062 AmeriHealth Caritas VIP Care All Yes Yes

77013 Amerihealth Caritus VIP Michigan MI Yes Yes

77051 AmeriHealth Connect All Yes Yes

77799 Amerihealth DE DE Yes Yes

77002 Amerihealth District of Columbia All Yes Yes

23037 AMERIHEALTH HMO DE,NJ Yes Yes

95044 AmeriHealth HMO New Jersey and Delaware NJ,DE Yes Yes

22248 AmeriHealth Mercy Health Plan All Yes No

77001 AmeriHealth NorthEast All Yes Yes

77007 Amerihealth VIP Care - DC All Yes No

22355

AmeriHealth VIP Care (Medicare Advantage Plan

Part of the AmeriHealth Mercy Family of

Companies) All Yes No

77006 Amerihealth VIP Care-La All No Yes

26374 Amerikids-Dallas/Ft. Worth TX Yes Yes

26375 Amerivantage All Yes Yes

64090 Amfirst Insurance Company All Yes Yes

01757 AM-First Insurance Morgan White All Yes No

24818 Amida Care (Formerly Vida Care.) All Yes Yes

79966 Amida Care Medicare All Yes Yes

21825 AMPS ALL Yes Yes

25667 AMPS - CX ALL Yes Yes

IP080 AMVI CA Yes No

38254 Amway Corporation All Yes No

MHIPA Anaheim Memorial IPA (MHCAN) CA Yes No

53085 Anchor Benefit Consulting All Yes No

J1919 ANCHOR CLAIMS MANAGEMENT All Yes No

86062 ANCILLARY BENEFIT SYSTEMS ARIZONA All Yes No

AZFMC

Ancillary Benefits/Arizona Foundation for Medical

Care All Yes No

98205 Anerican Founders Life Ins Co (NFL Plans only) All Yes No

75299 ANGELES IPA (SYNERMED) All Yes No

34192 Antares Management Solutions All Yes Yes

AECON Anthem E Consult All Yes Yes

80705

Anthem Health and Life Insurance Company of New

Jersey NJ Yes Yes

00050 Anthem of Colorado CO Yes Yes

ATMED Anthem Telemedicine All Yes Yes

34196

Apex Benefit Services (Claims must contain the

rendering provider ID or the claim will reject.) All Yes No

81312 Apostrophe All Yes Yes

54160 APS Healthcare Inc. All Yes Yes

16120 ARAZ (Now known as America's PPO.) All Yes Yes

52312 Arbor Health All Yes Yes

77045

Arcadian Management Services, Inc (Group number

should be entered if available. ) All Yes Yes

ARGUS ARGUS DENTAL AND VISION All Yes Yes

36356 Argus Health Systems All Yes No

AZFMC Arizona Foundation for Medical Care AZ Yes No

03432 Arizona Physicians IPA AZ Yes No

03432

Arizona Physicians IPA (APIPA) (UnitedHealthcare

Arizona Physicians IPA) AZ Yes No

74234

Arizona Pipe Trades Health and Welfare Trust Fund

Local Union Nos. 469 & 741 Metal Trades Health

Plan AZ Yes No

74234

Arizona Pipe Trades Health and Welfare Trust Fund

Local Union Nos. 469 & 741 Pipe Trades Health Plan AZ Yes No

27154 Arizona Priority Care Plus All Yes Yes

75278 Arkansas Best Corporation All Yes Yes

62176 Arkansas Managed Care Organization (AMCO) AR Yes No

95440 ARNETT HEALTH PLA All Yes No

43905 ARNOT OGDEN MEDICAL CENTER (UCS) All Yes No

WMM01 Arta Health Network CA Yes No

06603 ASAGEHA All Yes Yes

AAMG1 ASIAN AMERICAN MEDICAL GROUP All Yes No

94027 Asociacion de Maestros PR Yes No

PRADM Asociacion de Maestros (PROSSAM) PR Yes Yes

16180 Aspen All Yes Yes

46156 Aspire Health Plan All Yes No

38265 ASR Corporation All Yes Yes

ASRM1 ASRM Corporation All Yes Yes

FAABC ASSOCIATED BENEFITS CORP All Yes No

ATPA1 Associated Third Party Administration (ATPA) All Yes No

36326 Associates for Healthcare All Yes Yes

39065

Assurant Employee Benefits (Formerly Fortis

Insurance) All Yes No

41099 Assurant Health - John Alden Life Ins. All Yes No

ASNTH Assurant Health Re-Pricing via HealthSpan All Yes No

37313

Assurant Health Self Fund (Verify that claims should

go to Ft. Mill, SC) All Yes No

75068 Assurant Health Self Funded All Yes Yes

75068 Assurant Health Self Funded All Yes Yes

88035 AssureCare, Inc. All Yes Yes

74240 Assured Benefits Administrators All Yes Yes

SX179

Asuris Northwest/MedAdvantage (REF*1B*Provider

ID in Billing and Rendering required even when NPI

is submitted.) All Yes No

93221 Asuris NW Health All Yes Yes

J1914 ATHENS All Yes No

95691 Athens Health Plan All Yes Yes

22285 Atlantic Medical All Yes No

22304 ATLANTICARE ADMIN All Yes No

AEC01 ATLANTIS EYECARE All Yes No

ATLAD ATLAS ADMIN USAMC All Yes No

90956 Atlas Life Ins Co (NFIC Plan only) All Yes No

37231 ATR All Yes No

MPCHA

Atrio Health Plan (Marion Polk Health Plan

Advantage) All Yes No

ATRIO ATRIO HEALTH PLANS All Yes No

MNAUL Aultcare OH Yes No

10016 AULTCOMP MCO All Yes No

38259 Automated Benefit Services (ABS) All Yes Yes

37280 Automated Group Administration, Inc. All Yes Yes

91136

Automotive Machinists Local 289 Health & Welfare

Trust - Grp#F32 All Yes Yes

AVA01 AVALON HEALTHCARE SOLUTIONS All Yes No

IP080 Avalon IPA CA Yes No

AH001 Avante Health (Customer Service 559-261-9060) All Yes No

MP001 Avectus Healthcare Solutions (Call 855-AVECTUS) All Yes No

46045 Avera Health Plans All Yes Yes

26355 Averde Health All Yes No

87098 Avesis Third Part Administrators All Yes No

59274 AVMED FL Yes Yes

58204 AVMED-Parity Healthcare (OB/GYN only) FL Yes Yes

AXM01 Axminister Medical Group All Yes No

NCHON AZ Integrated Physicians All Yes No

95964 AZ PACIFICARE CLA All Yes No

BKRFM Bakersfield Family Medical Center All Yes No

BCTF1 Bakery and Confectionary Union All Yes Yes

74227 Bankers United Life (Student Division) All Yes Yes

67895 Banner Aetna All Yes Yes

12X42 Banner Health All Yes Yes

SX145

Banner Health Co. (All Banner Health Plans were

consolidated to the payerID of SX145.) All Yes No

77078 Banner Medisun All Yes Yes

66901

Banner-University Family Care(University of Arizona

Health Plans) All Yes No

BHPMA BAPTIST HEALTH PLAN ADVANTAGE ALL Yes No

65026 Baptist Health South Florida All Yes No

41204 BASIC PLUS All Yes No

84041 BASIL CASTROVINCI ASSOCIATES All Yes No

06941 BAY BRIDGE ADMINISTRATORS LLC All Yes No

68756 Bay Bridge Administrators/Protector 360 TX Yes Yes

59279 BAYCARE LIFE MANAGEMENT All Yes No

32002 BC MICHIGAN COMPLETE All Yes No

SB570 BCBS DELAWARE All Yes No

SB700 BCBS MASSACHUSETTS All Yes No

00722 BCBS MINNESOTA All Yes No



SB810 BCBS NORTH CAROLINA All Yes No

SB690 BCBS of Maryland MD Yes Yes

66001 BCBS TEXAS MEDICAID STAR CHIP All Yes No

49153 BCI Administrators, Inc All Yes No

VALOP Beacon Health Options (Formerly Value Options) All Yes Yes

43324

Beacon Health Strategies (Block 11 on the HCFA

1500 form must use Plan specific IDs.) All Yes Yes

95962

Beacon Health Strategies (Providers need to call

Provider Relations Dept at 781-994-7576 to register

before sending claims.) Yes No

95377

Beech Street Corp. (Payer requires that payer and

employer information in box11 be attached.) All Yes Yes

63100 Behavioral Health Systems All Yes Yes

BHI00 Behavioral Healthcare, Inc. CO Yes No

68241 Bell Atlantic (Prudential) All Yes No

MPM10 Bella Vista Med Grp IPA CA Yes No

37286 BENE PLAN ADMINIS All Yes No

99320

Benefit & Risk Management Services (Commercial

Medicare under Med3000) All Yes Yes

99320 Benefit & Risk Mgtm Svcs All Yes Yes

41205 Benefit Administration Services All Yes No

36149 Benefit Administrative Systems All Yes Yes

51037 Benefit Concepts All Yes Yes

25145 Benefit Coordinators Corporation All Yes Yes

56139 Benefit Managaement Svcs All Yes Yes

BMATP Benefit Management Admin NULL Yes Yes

88092 BENEFIT MANAGEMENT LLC (VBA) All Yes No

56139

Benefit Management Services (Please contact Chris

Burak at 704-321-3156 for payerID information.) All Yes Yes

00999 Benefit Management Services, Inc of Lousiana LA Yes No

37212 Benefit Management Systems, Inc of Mississippi MS Yes Yes

48611

Benefit Management, Inc. of KS (Only accepts claims

for these groups

BMI187,BMI219,BMI234,BMI236,BMI214,BMI241,B

MI617 BMI246,BMI246.) All Yes Yes

19753 Benefit Plan Administrators All Yes Yes

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) WI Yes Yes

37118 Benefit Plan Administrators, Inc All Yes Yes

34178 Benefit Services (Akron OH) NULL Yes No

36342 Benefit Systems and Services, Inc. All Yes Yes

61425 Benefit Trust Life Insurance Company All Yes Yes

87265 Benesight (formerly The TPA) All Yes Yes

37248 BENESYS LHP CLAIM All Yes No

38238

BeneSys, Inc. (Located in Troy, MI) (Now known as

Sheet Metal Workers Local 104) All Yes Yes

BNMK1 Benmark All Yes No

23243 Berkshire Health Partners All Yes Yes

95606 BERKSHIRE LEHIGH PARTNERS All Yes No

95604 Best Life & Health Insurance Co. All Yes Yes

01508 BETTER HEALTH FLORIDA All Yes No

20488

Better Health Plan of Florida (For claims rejections,

contact payer at 800-514-4561 and select provider

services option.) All No No

62183 BETTER HEALTH PLANS INCORPORATED All Yes No

32006 BETTER HEALTH PLANS SOUTH CAROLINA All Yes No

POP05 BEVERLY ALIANZA IPA All Yes No

44219 BHP-Unity All Yes Yes

67668 BHSF INTERNATIONAL All Yes No

BSHS1 Bienvivir NULL Yes No

CX025 Big Lots Associates Benefit Plans All Yes No

BVTX1 Block Vision of Texas TX Yes No

BV001 Block Vision, Inc. All Yes No

ARBLS BLUE ADVANTAGE OF ARKANSAS AR Yes No

00521 Blue Advantage of Arkansas AR Yes No

ECIBB BLUE BELL BENEFITS All Yes No

00923 Blue Care PPO VA Yes Yes

00870 Blue Chip of Rhode Island RI Yes No

RICHP BLUE CHIP OF RHODE ISLAND RI Yes No

00403 Blue Choice Medicaid SC Yes Yes

00804 Blue Choice of Rochester NY NY Yes Yes

N6BLS BLUE CHOICE OF ROCHESTER NY NY Yes No

00922 Blue Choice of South Carolina SC Yes Yes

BCSAL Blue Cross Blue Shield Alabama AL Yes Yes

53589 Blue Cross Blue Shield of Arizona AZ Yes Yes

VIBCS Blue Cross Blue Shield of USVI VI Yes Yes

MC721 BLUE CROSS COMMUNITY CENTENNIAL All Yes No

MCDIL Blue Cross Community Options All Yes Yes

66006 Blue Cross Medicare Advantage MT,IL,TX,OK Yes Yes

47198 Blue Cross of California CA Yes No

00610 Blue Cross of Idaho ID Yes No

IDBLC BLUE CROSS OF IDAHO ID Yes No

12011 Blue Cross of Maryland ALL No Yes

15754 Blue Grass Family Health (SRRIPA) All Yes No

IP061 Blue Lake Rancheria CA Yes No

00580 Blue Shield of Alabama AL Yes No

00822 Blue Shield of Alaska AK Yes No

00520 Blue Shield of Arkansas AR Yes No

BS001 Blue Shield of California CA Yes Yes

00805 Blue Shield of Central NY HMO/PPO NY Yes Yes

00060

Blue Shield of Connecticut (NOTE: The DOS in

Reports is programmatically calculated and is not

actual claim's data. Some variances may exist.) CT Yes Yes

00570 Blue Shield of Delaware DE Yes No

00590 Blue Shield of Florida FL Yes Yes

00601 Blue Shield of Georgia (State Health of GA) GA Yes Yes

HIBCS Blue Shield of Hawaii HI Yes No

00611 Blue Shield of Idaho-Regence ID Yes Yes

00621 Blue Shield of Illinois IL Yes Yes

00630 Blue Shield of Indiana IN Yes Yes

88848 Blue Shield of Iowa IA Yes Yes

88848MC Blue Shield of Iowa Secondary to Medicare IA Yes No

47163 Blue Shield of Kansas KS Yes Yes

47171 Blue Shield of Kansas City KS,MO Yes No

00660 Blue Shield of Kentucky KY Yes Yes

53120 Blue Shield of Louisiana LA Yes No

00680 Blue Shield of Maine ME Yes Yes

00200 Blue Shield of Massachusetts MA Yes No

00710 Blue Shield of Michigan MI Yes No

00720 Blue Shield of Minnesota MN Yes Yes

00230 Blue Shield of Mississippi MS Yes No

00241 Blue Shield of Missouri MO Yes Yes

BCSMT Blue Shield of Montana MT Yes No

NCABS Blue Shield of National Capital Area DC,VA,MD Yes No

77780 Blue Shield of Nebraska NE Yes No

00265 Blue Shield of Nevada All Yes Yes

00770 Blue Shield of New Hampshire NH Yes Yes

NJBCS Blue Shield of New Jersey NJ Yes Yes

00790 Blue Shield of New Mexico NM Yes Yes

00803 Blue Shield of New York (Empire) NY Yes Yes

05536 Blue Shield of North Carolina NC Yes No

00820 Blue Shield of North Dakota ND Yes Yes

00800 Blue Shield of Northeast NY NY Yes No

00834 Blue Shield of Ohio OH Yes Yes

00840 Blue Shield of Oklahoma OK Yes No

00851 Blue Shield of Oregon OR Yes Yes

54771 Blue Shield of Pennsylvania PA Yes Yes

PRSSS Blue Shield of Puerto Rico (Triple S) PR Yes No

00870 Blue Shield of Rhode Island RI Yes No

00804 Blue Shield of Rochester NY (Excellus) NY Yes Yes

SCBCS Blue Shield of South Carolina SC Yes Yes

88848 Blue Shield of South Dakota SD Yes Yes

00390 Blue Shield of Tennessee TN Yes Yes

84980 Blue Shield of Texas TX Yes Yes

TXBLS BLUE SHIELD OF TEXAS TX Yes No

84980 Blue Shield of TX HCSC Insurance Services Company TX Yes Yes

00910 Blue Shield of Utah UT Yes Yes

00806 Blue Shield of Utica NY NY Yes No

VTBLS Blue Shield of Vermont VT Yes No

VTBCS Blue Shield of Vermont VT Yes No

00923 Blue Shield of Virginia VA Yes Yes

54828 Blue Shield of West Virginia WV Yes No

00801 Blue Shield of Western New York NY Yes No

00301 Blue Shield of Western New York NY Yes No

00950 Blue Shield of Wisconsin WI Yes Yes

00960 Blue Shield of Wyoming WY Yes Yes

WYBLS BLUE SHIELD OF WYOMING WY Yes No

37121 Bluebonnet Administrators LA Yes Yes

A0016 BLUECARE FAMILY PLAN All Yes No

A0016 BLUECARE FAMILY PLAN CT Yes No

00246 BlueCross BlueShield of Western New York Medicaid All Yes Yes

61124 Bluegrass Family Health All Yes Yes

36609 Boilermakers national Health & Welfare Fund All Yes Yes

BOLL1 Bollinger, INC. All No No

74238 Boon-Chapman Benefit Administrators, Inc. All Yes Yes

13337 Boston Medical Center Healthnet MA Yes No

18768 BOULDER ADMIN SERVICES All Yes Yes

20381 BOULDER ADMIN SVC All Yes No

48964 BPS Inc All Yes No

UC002 Brand New Day (Encounters) All Yes Yes

UC001 Brand New Day (FFS) All Yes Yes

52192

Bravo Health (Formerly known as Elder Health Inc.

Serving members in PA, MD, DE, TX and Washington

DC.) All Yes No

J1761 BRICKSTREET All Yes No

BRIDG Bridgespan All Yes Yes

88033 BRIDGESTONE FIRES All Yes No

68069 Bridgeway Arizona (Also 68054) AZ Yes Yes

68054 Bridgeway AZ AZ Yes No

BHP01 Bright Health Physicians CA Yes No

CB186 BRIGHT HEALTH PLAN All Yes No

22286 BRITCAY All Yes No

51037 Brockerage Concepts, Inc (Benefit Concepts) All Yes No

59069 Brown & Brown Benefits All Yes Yes

94316 Brown & Toland Medical Group All Yes No

BTSS1 Brown & Toland Sutter All Yes No

BTSS1 Brown & Toland SutterSelect All Yes No

BTHS1 BROWN AND TOLAND HEALTH SERVICES All Yes No

32004 Buckeye Community Health OH Yes Yes

68069 Buckeye Community Health (Also 32004) IA Yes Yes

J1391 BUILDERS GROUP OF MINNESOTA All Yes No

42150 Butler Benefits All Yes Yes

23708 C & O Employees Hospital Association All Yes No

A1680 C3 Health (fka Access Health Inc.) MI Yes No

KS003 CA Kaiser Permanente (Northern California Only) CA Yes No

CWS99 CAL WATER All Yes No

68069 California Health and Wellness CA Yes Yes

AMM14 CALIFORNIA IPA All Yes No

94056 CALIFORNIA PACIFIC MEDICAL CENTER All Yes No

CALOP Cal-Optima Direct All Yes Yes

J1819 CAMBRIDGE INTEGRATED SERVICES All Yes No

CAMAA Cameron and Associates All Yes No

25831

CAMERON MANUFACTURING AND DESIGN

INCORPORATED (UCS) All Yes No

71057

Cannon Cochran Management Services, Inc. LA

(Claims for Payer address of Metairie, LA only.) LA Yes Yes

95399 CAP Management All Yes No

IP080 Cap Management Systems CA Yes No

23045

Capital Advantage Insurance Company (CAIC)

PROFESSIONAL (BCBS ProviderID and Performing

ProviderID required. Call 800-874-8433) PA Yes No

24705 CAPITAL BC PENNSYLVANIA All Yes No

23045

Capital Blue Cross PROFESSIONAL (BCBS ProviderID

and Performing ProviderID required. Call 800-874-

8433) PA Yes No

SX065 Capital District PHP All Yes Yes

95112 Capital Health Plan All Yes Yes

65067 Capital International Management Services All Yes No

68011 Capitol Administrators All Yes Yes

CAPHP Caprock Health Plan All Yes Yes

CAPH2 CAPROCK HEALTH PLANS VERITY All Yes No

86044 CAPSTONE HEALTH P All Yes No

GCVCP Cardiovascular Care Providers NULL Yes Yes

57116 Care 1st Health Plan of Arizona AZ Yes Yes

57115 Care 1st Health Plan of CA CA Yes Yes

HM037 Care Choices HMO All Yes No

14182 Care Core National All Yes Yes

77082 Care Improvement Plus All Yes No

37228 Care N Care All Yes Yes

43172 Care Partners All Yes No

65031 Care Plus All Yes Yes

41222 Care to Care All Yes Yes

27004 Care Wisconsin Health Plan (Trizetto) All Yes Yes

57721 CAREATC All Yes No

11345 CareCentrix All Yes Yes

38269

Carechoices Michigan - Mercy Healthplans

(Enrollment required; please contact Noreen at

(248) 489-5281.) MI Yes No

14188 Carecore National Wellcare All Yes No

14185 CareCore National, LLC - Health Net New Jersey All No Yes

14179 CareCore National, LLC (Aetna Radiology Claims) All Yes Yes

14180

CareCore National, LLC (Radiology charges for

Oxford) (Provider must call Anthony Sampson at 845-

298-8155 for provider code.) NY, NJ Yes Yes

SB580 CareFirst BCBS - DC, National Capital Area MD,DC Yes No

SB691 CareFirst DELMARVA Health Plan DC Yes No

CLUHS Careklink University Health System NULL Yes No

25139 Carelink All Yes No

25140 Carelink Medicaid All Yes Yes

CM001 Caremore All Yes No

CARMO Caremore IPA All Yes No

CARMO CareMore Value Plus (CVP) All Yes No

25142

Carenet of Virginia (Prepare to use consolidated

Coventry payerID of 25133.) VA Yes Yes

93975 CareOregon, Inc. OR Yes Yes

95092 CAREPLUS All Yes Yes

NCH04 CarePlus Cardiology - New Century Health All Yes No

77023 Carepoint Health Plan All Yes Yes

31114 CareSource OH Yes Yes

26160 CARESOURCE All Yes No

MRCHP Caresource Health Plan of Oregon All No No

INCS1 CareSource IN IN Yes Yes

KYCS1 CareSource KY KY Yes Yes

GACS1 CARESOURCE OF GA All Yes Yes

37311 CARESOURCE OF IND All Yes No

WVCS1 CARESOURCE WEST VIRGINIA All Yes No

10010 Careworks All Yes Yes

CAREW Careworks (OH BWC) OH Yes No

J1866

CAREWORKS CONSULTANTS INCORPORATED

(CAREWORKS USA AND CCI) All Yes No

CAREW Careworks of Ohio (OH BWC) OH Yes No

77015 Carilion Clinic Medicare Health Plan All Yes No

62073 Cariten Commercial All No Yes

62072 Cariten Senior Health All No Yes

29076

Carolina Care Plan (Part of the Medical Mutual

Family of companies. Former payerID was 57105.) SC Yes Yes

SX191 CAROLINA CRESCENT All Yes No

68069 Carolina Crescent (Also 68055) All Yes Yes

56195 Carolina Summit Healthcare, Inc All Yes Yes

COMPU

Carpenters' and Millwrights' Health Benefit Trust

Fund CO Yes No

CX101 Carpenters Health and Welfare Fund of Philadelphia All Yes No

COMPU

Carpet, Linoleum and Resilient Tile Layers Health

and Welfare Fund CO Yes No

CAS01 Cascade East Health Plan OR Yes No

93102 Cascade Health Partners All Yes No

37060 CATERPILLAR INCORPORATED All Yes No

03036 CBA Blue All Yes Yes

52132 CBA, Inc. (Cooperative Benefits Administrators, Inc.) All Yes Yes

55438 CBCA FORT WORTH All Yes No

56215 CBHA Carolina Behavioral Health Alliance All Yes Yes

31158 CBIZ BENEFITS All Yes No

65391 CBNHP Health Choices All Yes Yes

41124 CBSA (Corporation Benefit Services of America) All Yes Yes

J1900 CC DEVELOPMENT GROUP INCORPORATED All Yes No

06541 CCHS All Yes Yes

CCMC1 CCMC - Comprehensive Care Management Corp NY Yes No

MNBLS CCS (AKA COMPREHENSIVE CARE SYSTEMS) MN Yes No

CALL CCS (aka Comprehensive Care Systems) MN Yes No

CCStpa CCSTPA COMPREHENSIVE CARE SERVICES All Yes No

87065 CDO Technologies WY,UT Yes Yes

88022 CDS Group Health All Yes No

SISCO Cedar Valley Community Health Plan All Yes Yes

33010 Cedars Sinai Medical Center All No Yes

95166 Cedars-Sinai Medical Network Services Claims All Yes No

95167 Cedars-Sinai Medical Network Services Encounters All Yes No

CELTC Celtic Insurance All Yes No

68063 CELTIC INSURANCE All Yes No

68069 CeltiCare All Yes Yes

68060 Celticare All Yes No

91136

Cement Masons & Plasterers Health & Welfare Trust

- Grp#F16 All Yes Yes

95386 CenCal Health CA Yes Yes

68050 Cenpatico - Georgia GA No Yes

68068 Cenpatico - Multiple States All Yes Yes

68059 Cenpatico - SC NULL No Yes

68046

Cenpatico Behavioral Health - Wisconsin (Call 800-

225-2573 ext 25525 prior to submitting claims.) All Yes Yes

68048

Cenpatico Behavioral Health AZ (Prior to submission,

contact 866-495-6748 to verify provider ID.) AZ Yes Yes

68058 Cenpatico Florida Behavioral Health FL Yes Yes

68047 Cenpatico Health All Yes No

68052 Cenpatico Indiana All Yes Yes

68068 Cenpatico Kansas All Yes Yes

68061 Cenpatico Massachusetts MA Yes Yes

68051 Cenpatico Ohio OH Yes Yes

68053 Cenpatico Texas All No Yes

36474 Centegra Health System All Yes Yes

68056 Centene Advantage All Yes No

68069 Centene Advantage Plans (Also 68056) All Yes Yes

94312 Center for Elders Independence All Yes Yes

POP01 CENTER IPA All Yes No

13357 CenterCare All Yes Yes

13360 Centerlight Healthcare Inc. All Yes Yes

56122 Centerpoint Human Services All Yes Yes

11442 Centers Plan for Healthy Living All No Yes

IP080 Centinela IPA CA Yes No

MPM03 CENTINELA VALLEY IPA All Yes No

45564 Centivo All Yes Yes

75243 Centra Benefit Services All No Yes

66698 CentraCare All Yes No

75177 Central & Southwest Services All Yes No

31118 Central Benefit National All Yes Yes

31118 Central Benefits Life aka HealthScope Benefits All Yes Yes

31118 Central Benefits Mutual All Yes Yes

CALL

Central California Alliance (Call the EDI Support Unit

at 800-700-3874 x5510 to obtain payerID.) CA Yes No

SX169 CENTRAL CALIFORNIA ALLIANCE FOR HEALTH CA Yes No

NWADM

Central California Electricial Workers Health and

Welfare Trust CA Yes No

WH001 CENTRAL CALIFORNIA WOMENS HEALTH All Yes No

CHCPI Central Health Medicare All Yes No

34097 Central Reserve Life All Yes Yes

CIPA1 Central Senior Care NULL Yes No

62218 CENTRAL SENIOR CARE All Yes No

37214

Central States Joint Board Health & Welfare Trust

Fund All Yes No

36215

Central States Southeast and Southwest Areas

Health and Welfare and Pensions Funds All Yes No

55731

CENTRAL SUSQUEHANNA HEALTHCARE PROVIDERS

(CSHP) All Yes No

42140 Centurion ALL Yes No

48120 Century Health Solutions All No Yes

36393 CENTURY PHO All Yes Yes

23171 CHA - Commonwealth Health Alliance All Yes Yes

99795 CHAMPION CHEVROLET All Yes No

84146

CHAMPVA-HAC (CHAMPVA-HAC is not associated

with and does not process claims for TRICARE

(formerly CHAMPUS.)) All Yes No

95748 Chartered Health Plan (DC Chartered Health Plan) DC Yes No

CHAT1

Chatwins Healthcare Administrators

C All Yes No

16600 Chautauqua County Health Plan (Mayville,NY) NY Yes No

J1908 CHESAPEAKE INSURANCE All Yes No

59223

Chesapeake Life Insurance Co. (PayerID valid for PO

BOX 982017, North Richland Hills.) All Yes No

94321

Children First Medical Group (For questions

regarding claim status, providers will need to

contact payer: CFMG Provider Customer Service 510-

428-3154) All No No

39113 Children's Community Health Plan All No No

251CC CHILDRENS COMMUNITY HEALTH PLAN WISCONSIN All Yes No

CMCHP CHILDRENS MEDICAL CENTER HEALTH PLAN All Yes No

CSSD2 CHILDRENS SPECIALIST OF SAN DIEGO II All Yes No

94302

Chinese Community Health Plan (Unique Provider ID

must be on claim.) All Yes No

CHIPA CHIPA - College Health IPA All Yes No

ACN01 ChiroCare All Yes No

33070 CHIROMETRICS INCORPORATED All Yes No

CASD1 Chiropractic Association of South Dakota SD Yes No

DAKCH CHIROPRACTIC ASSOCIATION OF SOUTH DAKOTA All Yes No

LNDMK

Chiropractic Care of Minnesota, Inc. (For Dates of

service before 1-01-08, continue to use payerID of

ACN01.) All Yes No

ACN01 Chiropractic Care of Wisconsin, Inc. WI Yes No

U1439 CHIROPRACTIC HEALTH PLAN (CHP) All Yes No

33065

CHOC - Childrens Hospital of Orange County Health

Alliance CA Yes Yes

CPNFC CHOICE PHYSICIANS NET FIRST CHOICE All Yes No

68241 Choice Plus (TRW) All Yes No

POP03 CHOICEONE IPA All Yes No

90441 CHP Direct SuperMed All Yes Yes

UH133

CHP/DMBA (Enrollment required, please contact

Provider Relations 801-352-7270)(NOTE that this

payer accepts Chiropractic claims only for Choice &

Select Plans.) UT Yes No

UH134

CHP/EMIA (Enrollment required, please contact


payer accepts Chiropractic claims only.) UT Yes No

UH135

CHP/MEDICAID (Enrollment required, please contact



39112

CHP/RPU (FABOH) (Facility physical address required

on claim.) All Yes Yes

UH137

CHP/UUHP (Enrollment required, please contact



UH138 CHP/WISE All Yes No

38308 Christian Brothers Services All Yes Yes

59355 Christian Care Ministries All Yes Yes

75544 CHRISTIE STUDENT HEALTH PLANS All Yes No

10629 Christus Health Medicare Advantage All Yes Yes

21062 Christus Health New Mexico HIX All Yes Yes

45210 CHRISTUS HEALTH PLAN MEDICAID All Yes No

52106 CHRISTUS HEALTH PLAN TEXAS HIX All Yes No

SPOHN Christus Spohn Health Network All Yes Yes

C1052 CHUBB AND SON All Yes No

62308 CIGNA - PPO All Yes Yes

MCCBV

CIGNA Behavioral Health (We will also accept PID

SX071 for these claims: use of either ID

accomplishes the same routing.) All Yes No

SX071

CIGNA Behavioral Health (We will also accept PID

SX071 for these claims: use of either ID

accomplishes the same routing.) All No No

62308 CIGNA Health Plan - HMO All Yes Yes

86033 CIGNA Healthcare for Seniors - Arizona Medicare AZ Yes Yes

62308 CIGNA Premier Plus All Yes Yes

46871 Cinncinnati Financial Corporation All Yes Yes

10207 Citrus Health Care All Yes Yes

IP055 Citrus Valley Physicians Group CA Yes No

J1885 CITY AND COUNTY OF SAN FRANCISCO (CCSF) All Yes No

ZCA01 City of Amarillo All Yes No

74234 City of Austin TX Yes No

J1928 CITY OF CHARLOTTE All Yes No

J1901 CITY OF RIALTO CALIFORNIA All Yes No

CLFR2 CL Frates All Yes Yes

CCMMH CLACKAMAS COUNTY MENTAL HEALTH OR Yes No

43056 Claims Development Corporation All Yes No

11752 ClaimsBridge HPN All Yes Yes

57080 ClaimsWare, Inc. DBA ManageMed All Yes Yes

95444 Clarian Health Plans All Yes Yes

77201 CLEARCHOICE HEALT All Yes No

41201 CLIENT FIRST All Yes No

24585

CLIFTON HEALTH SYSTEMS DBA ACTIN CARE

GROUPS All Yes No

CDCR1 CLINCAS DEL CAMINO REAL All Yes No

CRGMN Clinical Resource Group All Yes No

CSI001 CLINICAL SPECIALTIES INCORPORATED All Yes No

CSI01 CLINICAL SPECIALTIES INCORPORATED All Yes No

M3FL0012 CMS MMA SPECIALTY PLAN All Yes No

CHCNT CNIC Health Solutions, Inc. All Yes Yes

COFHP CO SECURE HORIZON All Yes No

J1902 COACHELLA VALLEY WATER DISTRICT (CALIFORNIA) All Yes No

77052 Coastal Administrative Services All Yes No

A0004 COASTAL CARE All Yes No

CCPN1 Coastal Communities Physician Network (CCPN) CA Yes No

LIPAZ Coastal Healthcare Management All Yes No

43141 COASTALCARE (DOS PRIOR TO 7 1 2015) All Yes No

SLOAN Cofinity (formerly Sloans Lake) CO Yes Yes

38335 Cofinity (formerly Sloans Lake) CO Yes Yes

37123 COLONIAL HEALTHCA All Yes No

22284 Colonial Medical All Yes Yes

84129 COLORADO ACCESS All Yes No

COACC Colorado Access HMO CO Yes No

H0657 Colorado Choice Health CO Yes No

49718 Colorado Health Insurance Cooperative CO Yes Yes

COKSR Colorado Kaiser Permanente (Colorado plans only) CO Yes No

COMPU Colorado Laborers Health and Welfare Fund CO Yes No

25351 Columbia Cornell Care All Yes No

91162 Columbia United Providers All Yes Yes

CHP02 Columbine Health Plan All Yes No

CHP02 Columbine Health Plan All Yes No

62149 COMM HEALTHNET CT All Yes No

32481 COMM PREMIER PLUS All Yes No

34181 Commerce Benefits Group All Yes No

88091 COMMERCIAL TRAVELERS All Yes No

77170 Common Ground Healthcare Cooperative All Yes No

37237 CommonWealth Administrative Group All Yes Yes

CATPA Commonwealth Administrators All Yes No

14315 Commonwealth Care Alliance All Yes No

CCAIL Community Alliance II All Yes No

17902 Community Care Associates MI Yes No

25179

Community Care Behavioral Health Org. (For Dates

of Service prior to October 1, 2007) All Yes Yes

23282

Community Care BHO (For Dates of Service after

October 1, 2007) All Yes Yes

AMM12 COMMUNITY CARE IPA All Yes No

73143

Community Care Managed Health Care Plans of

Oklahoma OK Yes Yes

39126 Community Care Organization All Yes Yes

00330 COMMUNITY CARE PL All Yes No

95192 Community Connect Medicaid All Yes Yes

CECVP COMMUNITY EYE CARE All Yes No

COMMF Community First All Yes Yes

35193 Community Health Alliance All Yes Yes

27905 Community Health Allliance TN All Yes Yes

CHCN1 Community Health Center Network NC Yes No

48145

Community Health Choice (Please include TPI

Number (Texas Medicaid Number) in Field FA0-23) All Yes No

75261 Community Health Electronic Claims/CHEC/webTPA All Yes Yes

95376 COMMUNITY HEALTH GROUP All Yes No

66170 COMMUNITY HEALTH GROUP All Yes No

60495 COMMUNITY HEALTH PLAN INCORPORATED All Yes No

CHPWA Community Health Plan of WA WA Yes Yes

SB613 Community Health Plan of Washington WA Yes Yes

CLA11 Community Health Solutions LA No No

CMGWV Community Medical Group of the West Valley CA Yes No

66121

COMMUNITY MEDICAL GROUP OF THE WEST

VALLEY INCORPORATED All Yes No

J1925 COMP WEST All Yes No

J1829

COMPANION PROPERTY AND CASUALTY INSURANCE

COMPANY All Yes No

37297 COMPBENEFITS CORP All Yes No

34177 Compensation Programs of Ohio, Inc. OH Yes Yes

23296 CompFirst, LLC All Yes No

CHP01 COMPLEMENTARY HEALTHCARE PLAN All Yes No

93101 Complementary HealthCare Plans OR,WA Yes No

15243 Compmanagement Health All Yes Yes

10005 COMPMGMT HEALTH SYSTEMS All Yes No

59314 COMPREHENSIVE BEH All Yes No

03036

Comprehensive Benefits Administrator, Inc. (Now

known as CBA Blue.) All Yes Yes

00720 Comprehensive Care Services (BCBSMN) MN Yes Yes

00562

Comprehensive Care Services (For DOS on and after

01-01- 2019) MN Yes No

M0166 Comprehensive Medical/Vision Program AZ AZ Yes Yes

37363 ComPsych All Yes Yes

74234 CompuSys Incorporated (New Mexico) NM Yes No

74234 CompuSys Incorporated of Arizona AZ Yes No

COMPU CompuSys Incorporated of Colorado CO Yes No

74234 CompuSys Incorporated of Utah UT Yes No

COMPU Compusys of Colorado CO Yes No

74234 CompuSys/Erisa Group, Incorporated (AZ) AZ Yes No

74234 CompuSys/Erisa Group, Incorporated (NM) NM Yes No

74234 CompuSys/Erisa Group, Incorporated (TX) TX Yes No

33632 Concordia Care Inc All Yes Yes

CB268 CONERSTONE PREFERRED RESOURCES All Yes No

80705 Confederation Admin Services All Yes Yes

80705 Confederation Life Insurance All Yes Yes

78375 Connecticare - Medicare All Yes No

06105 Connecticare, Inc. All Yes Yes

37307 Connecticut Carpenters Health Fund CT Yes No

37135 Consociate Group All Yes Yes

75284 Consolidated Associates Railroad All Yes No

59140 Consolidated Group All Yes Yes

87843 Consolidated Health Plans All Yes No

L0260 CONSTELLATION HEALTH All Yes No

PRCON Constellation Health PR Yes Yes

19046 CONSTITUTION STATE / TRAVELERS All Yes Yes

58112 Consumer Mutual of Michigan All Yes Yes

45321 Consumers Choice Health SC All Yes No

08680 CONTAINER GRAPHICS CORPORATION All Yes No

CH101 CONTESSA HEALTH SECURITY HEALTH PLAN All Yes No

71404 Continental General Insurance Co. All Yes No

35315 CONTINENTAL KEY All Yes No

47046 Contractors, Laborers, Teamsters & Engineers All Yes No

55544 CONVERSION PLAN APWU All Yes No

CCHP1 Cook Children's Health Plan All Yes Yes

CCHP9 Cook Children's Star Plan All Yes Yes

35149 Cook Group Health Plan All Yes Yes

82347 Cook Group Solutions ALL Yes Yes

35199 Cooperative Managed Care Services All Yes Yes

HPAMN Cooportunity Health All Yes Yes

SX009 CoOpportunity Health All Yes No

14829 Coordinated Benefit Plan All Yes Yes

58204 Coordinated Medical Specialists (CMS) All Yes Yes

58231 Core Administrative Services All Yes Yes

47165 CORE BENEFITS MULTIMATIC TENNESSEE LLC All Yes No

23274 Core Value (Part of Gettysburg Health.) All Yes No

35187 CoreSource All Yes No

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) AR Yes No

35182 CoreSource of Illinois IL Yes Yes

35182 CoreSource of Iowa IA Yes Yes

35182 CoreSource of Maryland MD Yes Yes

35180

CoreSource of North Carolina (Start using new

PayerID of 35182. Old payerID will start rejecting

soon.) NC Yes No

35183 Coresource of OH OH Yes Yes

35182 CoreSource of Pennsylvania PA Yes Yes

41045

CoreStar AZ MN (Start using new PayerID of 35182.

Old payerID will start rejecting soon.) AZ,MN Yes No

CORIZ

Corizon Health Inc.(Claims with address of

Brentwood,TN should be submitted to this Payer

ID.) All Yes Yes

35202 Cornerstone Benefit Administrators All Yes Yes

56116

Corporate Benefits Service, Inc. (NC) (Only valid for

payer address of PO Box 12953, Charlotte, NC

28220) NC Yes Yes

64270 CORPORATE PLAN MANAGEMENT INCORPORATED All Yes No

CCIHC

CorrectCare Integrated Health (CA Prison Health

Care Services) CA Yes No

CCIH

CORRECTCARE INTEGRATED HEALTH (CALIFORNIA

PRISON HEALTHCARE) All Yes No

CCIHJAIL

CORRECTCARE INTEGRATED HEALTH (NON-

LOUISIANA JAILS) All Yes No

PHPMC Correction Health Partners CO Yes Yes

43160 Correctional Medical Services All Yes Yes

48146 CorSolutions All Yes No

62553 COUNTRY LIFE All Yes No

42139 County Care All Yes No

60827 County Care (Use PayerID 42139) All Yes Yes

42138 County Care Behavioral Health TPA All Yes No

A0005 COUNTY MEDICAL SERVICES PROGRAM All Yes No

00923 COVA (Commonwealth of VA) VA Yes Yes

58102 Covenant Administrators, Inc. All Yes No

CMSEB

Covenant Management Systems Employee Benefit

plan All Yes Yes

25133

Coventry Health Care (Coventry old Legacy Payer

ID's are still accepted.) All Yes Yes

25132 COVENTRY HEALTH CARE IOWA All Yes No

25135 COVENTRY HEALTH CARE LOUISIANA All Yes No

25136 COVENTRY HEALTH CARE LOUISIANA All Yes No

25127 COVENTRY HEALTHCARE GEORGIA All Yes No

128FL Coventry Healthcare of FL FL Yes Yes

CHCNT CoverColorado CO Yes Yes

00019

Cox Health Plan (Requires Provider ID in Box 33a.

Contact Cox Health Plan for ID.) AR,MO Yes No

10014 CRA MANAGED CARE All Yes No

64068 Creative Medical Systems All Yes Yes

37320 Creative Plan Administrators All Yes Yes

56213 CRESCENT HEALTH SOLUTIONS All Yes No

56213 CRESCENT HEALTH SOLUTIONS All Yes No

80705 Crown Life All Yes Yes

46120 CRYSTAL RUN HEALTH PLANS All Yes No

46430 CRYSTAL RUN HEALTH PLANS (See Also 46120) All Yes No

34186 CSI Network Services All Yes Yes

27136 CSI OF MICHIGAN All Yes No

59225 CT General Life Insurance (Formerly STAR HRG.) All Yes Yes

42141 CTI Administrators Inc All Yes No

59140 Culinary Health & Welfare Fund (Las Vegas, NV) NV Yes Yes

68241 CustomCare All Yes No

68241 CustomCare (Southwestern Bell - Exec.) All Yes No

82056 Custome Design Benefits, Inc. All Yes No

25172

D. H. Evans and Associates (Call Jessica Picarde @

410-349-3222 before sending this payerID.) All Yes No

DAK01 DakotaCare SD Yes Yes

06172 DART CONTAINER CO All Yes No

CB987 DART MEMBER CARE All Yes Yes

CB897 DART MEMBER CARE All Yes No

00157 DAVIS VISION All Yes No

DCHSF DCHS Medical Foundation All Yes No

VMF01 DCHS MEDICAL FOUNDATION All Yes No

DEAN1 Dean Health Plan WI Yes No

64159 DEFINITY HEALTH All Yes No

87726 Definity Health Plan (UnitedHealthcare) All Yes No

87726 Definity Services All Yes No

77124 DELANO IPA All Yes No

63081 DELAWARE HEALTH PLAN CONSORT All Yes No

27009 Delaware Physicians Care, Inc. DE Yes No

25137 DelawareCare, Inc. DE Yes No

DCHPMCAID DELL CHILDRENS HEALTH PLAN All Yes No

74272 DELL CHILDREN'S HEALTH PLAN All Yes No

94235 DELTA HEALTH All Yes No

DHS01 Delta Health Systems CA No No

AMS01 Dentemax MI Yes No

AMS01 Dentemax/DPI (MI) MI Yes No

84134 Denver Health - Indigent CO No No

84133 Denver Health and Hospital Authority CO Yes No

84135 Denver Health Medical Plan CO Yes No

84131 Denver Health Medical Plan, Inc. - Medicare Choice CO No No

J1438 DEPARTMENT OF LABOR All Yes No

58204

Dermatology Network Solutions BCBS for the Health

Options HMO (Payer requires 11 digit member ID

Number) All Yes Yes

58204

Dermatology Network Solutions, LLC BCBS (Payer

requires 11 digit member ID Number) All Yes Yes

58204

Dermatology Network Solutions, LLC Humana (Payer


58204

Dermatology Network Solutions, LLC Vista (Payer


SX105 Deseret Mutual UT Yes Yes

UH105 Deseret Mutual UT Yes Yes

PPM01 Desert Family Practice Association All Yes No

DVMC1 Desert Valley Medical Group CA Yes No

56240 Detroit Medical Center All Yes Yes

DWMH0 Detroit Wayne Mental Health Authority All Yes No

25160 DGA - Diversified Group Administrators All Yes Yes

23706 DGA PRODUCER HP All Yes No

36439 DIATRI LLC All Yes No

PROH4 DIGNITY HEALTH INLAND EMPIRE All Yes No

HOSH4 DIGNITY HEALTH INLAND EMPIRE HIGH RISK All Yes No

HOSH1

DIGNITY HEALTH SACRAMENTO HOSPITAL SHOP

FOR MERCY MED All Yes No

PROH2 DIGNITY HEALTH SEQUOIA PHYS All Yes No

PROH1 DIGNITY HEALTH WOODLAND CLINIC All Yes No

DCA62 DIRECT CARE ADMINISTRATORS All Yes No

BC001 DIRECTORS GUILD OF AMERICA All Yes No

06102 Diversified Group Brokerage All Yes Yes

SX105 DMBA AKA MISSIONARY MEDICAL All Yes No

16003

DMERC Region A (Testing is required for claims

requiring CMNs.) REG A Yes No

17003

DMERC Region B (Testing is required for claims

requiring CMNs.) REG B Yes No

18003

DMERC Region C (Testing is required for claims

requiring CMNs.) REG C Yes No

19003

DMERC Region D (Testing is required for claims

requiring CMNs.) REG D Yes No

77044 DOLABOR BLACK LUN All Yes No

DOLMG DOLTON MEDICAL GROUP All Yes No

DNLY1 Donley & Company All Yes No

APP01 Downey Select IPA (Applecare Medical Mgmt) All No No

DREYR Dreyer Medical All Yes No

74284 Driscoll Childrens Health Plan All Yes Yes

74284 Driscoll Childrens Health Plan (CHIP) TX Yes Yes

37600 DSCC - Division of Specialized Care for Children All Yes No

35186 Dunn and Associates Benefits All Yes No

34108 E.S. Beveridge and Associates All Yes Yes

75232 E3 Health, Inc (Formerly First Integrated Health) All Yes Yes

36434 Early Intervention Central Billing IL Yes No

IP130 East Bay Medical Network CA Yes No

56089 EAST CAROLINA BEHAVIORAL HEALTH All Yes Yes

23861 EASTERN IOWA COMMUNITY HEALTHCARE (EICH) All Yes No

16565 Eastern Main Healthcare Systems- EMHS ALL Yes Yes

EMG11 EASTLAND MEDICAL GROUP All Yes No

66122 EASTLAND MEDICAL GROUP All Yes No

J1903 EASTMAN KODAK COMPANY All Yes No

08044 EASTPOINTE All Yes No

20532 Easy Choice Health Plan of CA CA Yes Yes

24770 Easy Choice Health Plan of NY All Yes Yes

CALL

EBC Inc. (To obtain the payerID, please call (440)

262-1160) All Yes No

EV001 EBERLE VIVIAN All Yes No

CX025 EBMC All Yes No

81039 EBMS (Employee Benefit Management Services, Inc) All Yes Yes

75277 eComPPO All Yes No

22521 EDS Healthchoice OK Yes No

SX110

Educators Mutual (EMIA) (Enrollment required,

contact EMIA to enroll 800-362-0533, Opt. 2) UT Yes Yes

73288 EHI (Employers Health Insurance) All Yes No

EPF03 El Paso First - CHIP All Yes Yes

MPM04 El Proyecto Del Barrio IPA CA No No

52192

Elder Health Maryland HMO Inc. (Now known as

Bravo Health.) All Yes Yes

04326 Elder Service Plan of the North Shore. All Yes No

31625

ElderPlan, Inc. (Elderplan Provider ID necessary on

all claims. Contact (718)921-7979 for Provider ID.) All Yes Yes

ECISF ELLIS CONSULTANTS All Yes No

NAELM Elmcare All Yes Yes

NAELM Elmcare L.L.C. IL Yes Yes

37253 Elmco NY Yes No

22120 ELMIRA SAVINGS BANK (UCS) All Yes No

34167 Emerald Health Network All Yes Yes

34167 Emerald Health Network, Inc. (All HMO Business) All Yes Yes

34555 EMERALD HMO All Yes No

95600

EMERGENCY MEDICAL SERVICES FUND (ORANGE

COUNTY CALIFORNIA) All Yes No

65062 EMI (Eye Management Inc) All No No

59299 EMI KP AMBULANCE CLAIMS All Yes No

68241 EmoryCare All Yes No

41198 EMP BENE SVCS LA All Yes No

EMP01 Empire Physician's Medical Group All No No

87726 Empire Plan (UnitedHealthcare) All Yes Yes

95288

Employee Benefit Administration & Management

(EBA&M) CA Yes No

38241 Employee Benefit Concepts All Yes Yes

37257 EMPLOYEE BENEFIT CONSULTANTS INCORPORATED All Yes No

37215 Employee Benefit Corporation All Yes Yes

31074 Employee Benefit Management Corp. OH Yes Yes

SX182 EMPLOYEE BENEFIT MANAGEMENT SYSTEM (EBMS) All Yes No

SC446

Employee Benefit Services DBA Key Benefit

Administrators SC Yes Yes

60221 EMPLOYEE BENEFIT SERVICES INCORPORATED (EBSI) All Yes No

EBSSA Employee Benefit Svcs (EBS) of San Antonio TX Yes No

42149 Employee Benefit System All Yes Yes

37216 Employee Benefit Systems All Yes Yes

03036

Employee Benefits Plan Administration, Inc. (EBPA)

(Now known as CBA Blue.) All Yes Yes

75184 EMPLOYEE CLAIM ADJUDICATION SERVICES All Yes No

92135 Employee Logistics All Yes Yes

35112 Employee Plans, LLC All Yes Yes

54098 Employee Security, Inc. All Yes No

21415 EMPLOYEES MUTUAL (EMC) All Yes No

48888 EMPLOYER DIRECT HEALTHCARE All Yes No

74212 Employer Plan Services, Inc. All No No

27008 Employers Coalition On Health (ECOH) All Yes Yes

75236 Employers Direct Health - Employee Plan All Yes No

75235 Employers Direct Health - FI All Yes Yes

75233 Employers Direct Health - SF All Yes Yes

27008 Employers Health Cooperative (EHC) All Yes Yes

J1912 EMPLOYERS INSURANCE (BUNCH) All Yes No

37249 EMPLOYERS LIFE IN All Yes No

59298 Employers Mutual, Inc. (Florida Providers only) FL Yes Yes

35206

Encore Health Network (Note: Group Policy Number

in HCFA Box 11 is required.) All Yes Yes

36364 ENH Medical Group IPA All Yes No

91136 Enstar Natural Gas - Grp# P61 All Yes Yes

36878 Entrust All Yes No

EPNSH

EPN - Seton Health Plan Exclusive (Provider ID

required) All Yes Yes

62308 EQUICOR All Yes Yes

62308 EQUICOR - PPO All Yes Yes

73126 Equitable Plan Services All Yes Yes

23250

Erin Group Administrators (Now known as Significa

Benefit Services, Inc.) All Yes Yes

74234 Erisa Administrative Services Incorporated AZ Yes No

74234 Erisa Administrative Services, Inc. All Yes No

57082 Essence Healthcare MO Yes No

87726

Evercare Special Needs (Evercare by

UnitedHealthcare) All Yes Yes

87726 Evercare Star Plus All Yes Yes

35605 Everence All Yes Yes

45319 Evergreen Health All Yes No

93240 EVERGREEN HEALTH COOPERATIVE All Yes No

58233 EVERGREEN HLTH PL All Yes No

59313 Evolutions Healthcare All Yes Yes

22344 EXCEEDENT LLC All Yes No

IP080 Exceptional Care Medical CA Yes No

EC999 Exclusive Care - County of Riverside All Yes No

37257 Expert Benefit Solutions All Yes No

BVES1

Eye Specialists (Provider ID number required in

Box33a or Box24J) CO Yes No

31165 EYEMED All Yes No

63740 EyeQuest All Yes No

95432 Facey Medical Foundation All Yes No

37300 FACS Group All Yes No

62956 Fair Price All Yes Yes

J1884 FAIRFAX COUNTY GOVERNMENT All Yes No

A0245 Fairfield All Yes Yes

FT254 FALLON (TRANSPLANT CLAIMS) All Yes No

22254 Fallon Community Health All Yes Yes

45559 Fallon Total Care All Yes Yes

60995 Family Care - Milwaukee WI WI Yes No

PHD01

Family Care CCO (Admin by PH Tech. Use for claims

with DOS of 08/01/2012 and later.) All Yes Yes

FCD01

Family Care Medicaid (Admin by PH Tech Use for

claims with DOS of 07/31/2012 and prior.) OR No Yes

FCM01 Family Care Medicaid Mental Health OR Yes Yes

FCR01 Family Care Medicare OR Yes Yes

PHR01

Family Care Medicare (Admin by PH Tech. Use for

claims with DOS of 01/01/2013 and later.) All Yes No

IP080 Family Choice Medical CA Yes No

IP080 Family Health Alliance CA Yes No

85468 Family Health Network All Yes Yes

43173 Family Health Partners/MC+Missouri MO Yes No

36396 Family Medical Network All Yes No

93121 FAMILYCARE COORDINATED CARE ORGANIZATION All Yes No

FCS01 FAMILYCARE SPECIALIST MEDICAL GROUP All Yes No

14140 Farm Family All Yes No

J1830 FCCI All Yes No

33033 FCE Benefit Administrators All Yes Yes

C2BLS FEDERAL EMPLOYEE PROGRAM (CONNECTICUT) CT Yes No

CALL Federal Employee Program (Connecticut) CT Yes No

41041 Federated Mutual Insurance All Yes Yes

J1909 FFVA MUTUAL INSURANCE All Yes No

11315 Fidelis Care New York All Yes Yes

77054 Fidelis Secure Care All Yes Yes

FDNYP

FIRE DEPT CITY NEW YORK WORLD TRADE CENTER

HEALTH PLAN All Yes No

FAMR1 FIRST ADMIN SD All Yes No

FSTAG First Agency All Yes Yes

88055 First Agency All Yes Yes

56196 First Carolina Care All Yes No

91131 First Choice Health Network WA,OR,ID,AK Yes Yes

FCMG1 First Choice Medical Group All Yes No

75138 First Choice of Midwest (PPO) All Yes Yes

37510 First Choice VIP Care All Yes No

77009 First Choice VIP Care Plus SC. All Yes Yes

80705 First Great-West Life & Annuity All Yes Yes

87043 FIRST HEALTH All Yes No

73159 First Health Network All Yes Yes

23241 First Priority All Yes No

87726 First Seniority Freedom All Yes Yes

59276 First Service Administrators FL Yes No

MC104 First Services Medicaid All Yes No

FS802 First Solution All Yes No

ENDVR First Source (Endeavor) ALL Yes Yes

63080 FIRST STATE HEALT All Yes No

94999 FirstCare All Yes Yes

94998 FirstCare Star Medicaid All Yes Yes

90060

FirstGuard Health Plan of Kansas (Contact Karen

Joslin at (816)922-7225 to verify Firstguard

ProviderID. Payer requires Insured ID of 8-11

numeric characters.) KS No Yes

90061 FirstGuard Health Plan of Missouri MO No Yes

11244 Fitzharris & Company All Yes No

95411 FL MCO PHC/PHP All Yes Yes



68241 FlexCare All Yes No

59276 Florida 1st - Winterhaven, Florida FL Yes Yes

J1910 FLORIDA FRUIT AND VEGETABLE ASSOCIATION All Yes No

59322 Florida Health Plan FL Yes No

81044 FLORIDA HEALTH SOLUTION HMO COMPANY All Yes No

12611 Florida Healthcare Plus FL Yes No

VB001 FLORIDA HOSPITAL All Yes No

59321

Florida Hospital Healthcare Systems (In network

providers must submit UP or FHHS ProviderID. Out

of network providers must contact FHHS at 407-701-

4893.) FL No Yes

48116 Florida Hospital Waterman All Yes Yes

59698 Florida League of Cities, Inc. FL Yes Yes

65063 Florida NetPass All Yes No

68241 Florida Power & Light FL Yes No

26492 Florida True Health All No Yes

APBPN FloridianCare All Yes No

84595 FMA MM Program All Yes Yes

84594 FMA USA Program All Yes Yes

48117 FMH Benefit Services All Yes Yes

25059

FOREST COUNTY POTAWATOMI INSURANCE

DEPARTMENT All Yes No

87066 Formax, Inc. All Yes No

39065 FORTIS (Formerly Time Insurance) All Yes Yes

39065 Fortis (Western Life Ins. Benefit Plan) All Yes Yes

70408 FORTIS BENEFITS (Kansas City) All Yes No

39065

Fortis Benefits, Inc. (Woodbury) PHCS Network

Claims All Yes Yes

41124 Fortis Self Funded Administrative Services All Yes Yes

39065 FORTIS Western All Yes Yes

FH001 Foundation Health of CA CA Yes No

FHFLE Foundation Health of Florida-Encounters FL Yes No

FVMCH Fox Valley Medicine Site 199 All Yes No

FVMC1 Fox Valley Medicine Site 451 All Yes No

64067 FOXEVERETT INGALL All Yes No

64069 Fox-Everett, Inc. All Yes Yes

J1883 FRANCISCAN ALLIANCE All Yes No

31313 FREEDOM FIRST All Yes No

41212 Freedom Health Plan All Yes No

62324 Freedom Life Insurance Company All Yes Yes

71768 FreedomBlue HHIC All Yes No

FDMCR FreedomCare Benefits ALL Yes No

IP080 Freeman IPA CA Yes No

43197 FRESENIUS HEALTH PARTNERS All Yes No

TH118 Fresenius Medical Care TX Yes No

FMCHP Fresenius Medical Care Health Plan NULL Yes Yes

99660 Fresno PACE All Yes No

59204 Fringe Benefit Coordinators All Yes Yes

34171 FrontPath Health Coalition All Yes No

67814 G.E. Group Life Assurance Company All Yes No

30005 GALVESTON COUNTY INDIGENT HEALTH CARE All Yes No

10009 GATES MCDONALD HEALTH PLUS All Yes No

25169 Gateway Health Plan All Yes No

05506 Gateway Health Plan All Yes No

60550

Gateway Health Plan ((Yellow Card). Check the ID

card to verify the Payer ID before submitting) All Yes No

25169 Gateway Health Plan Medicaid PA All Yes Yes

91741 GATEWAY HEALTH PLAN MEDICARE OHIO ASSURED All Yes No

76028 Gateway Health Plan of Ohio, Inc. OH Yes No

4317M Gateway to Better Health All Yes Yes

431YM GATEWAY TO BETTER HEALTH All Yes No

CB951 GBS Global Benefits All Yes No

80241 GBS GROUP BENEFIT SERVICES INCORPORATED All Yes Yes

GEHA9 GEHA HEALTH GROUP (NEVADA) All Yes No

75273 Geisinger Health Plan PA Yes Yes

MCS01 GEMCare (Golden Empire Managed Care System) All No No

20376 GEMCARE HEALTH PLAN All Yes No

MCS03 GEMCARE HEALTH PLAN All Yes No

27133 GEMCARE IPA All Yes No

63665 GenCare Health (St. Louis only) MO Yes No

63665 Gencare Health (St. Louis) MO Yes No

63665 Genelco (St. Louis only) MO Yes No

63665 General American (Sanus - East) MO Yes No

63665 General American Life Ins. Co. (Sanus, St. Louis) MO Yes No

63665 General American Life Insurance Company All Yes No

GHEDI Generations GlobalHealth NULL Yes No

46050 Generations Health All Yes No

46051 GENERATIONS HILLCREST All Yes No

IP105 GENESIS HEALTH CARE All Yes No

J1895 GENEX CARE FOR OHIO All Yes No

58207 GEORGIA HEALTH PL All Yes No

61271 Georgia Power Medical Benefits Plan GA Yes No

00601

Georgia State Health Benefit Plan (Processed by GA

BC/BS) GA Yes Yes

CHCNT GettingUsCovered CO Yes Yes

23274 Gettysburg Health (Including Core Value.) All Yes No

25531 GHI HMO Select All Yes Yes

GHMCR GHI MEDICARE PART B OF NEW YORK NY Yes No

22937 GHI MEDICARE PPFS All Yes No

25141 GHP (Group Health Plan) All Yes No

58204 GI Innovative Management All Yes Yes

J1927 GILLETTE CHILDRENS SPECIALTY HEALTHCARE All Yes No

07205 Gilsbar, Inc All Yes Yes

COMPU

Glassworkers and Glaziers Health and Welfare Fund

Trust CO Yes No

91136 Glassworkers Health & Welfare Fund - Grp# F29 All Yes Yes

07689 Global Care Inc All Yes Yes

MPM05 Global Care Med Grp IPA All No No

GEM01 Global Excel Management All Yes Yes

GHOKC Global Health All Yes Yes

75246 GM Southwest TX Yes No

47083 GMS, Inc. All Yes Yes

77160 Gold Coast All Yes No

A0006 GOLDEN EMPIRE MANAGED CARE All Yes No

37602 Golden Rule Insurance All Yes Yes

GTPA1 Golden Triangle Physician Alliance All Yes Yes

GSMPA

GOOD SAMARITAN IPA (COASTAL HEALTHCARE

MANAGEMENT) All Yes No

IP086

Good Samaritan Medical Practice Association

(GSMPA) CA Yes No

76923 Good Shepherd Hospice All Yes No

44054

Government Employees Hospital Association,Inc.

(GEHA) All Yes Yes

57254

Government Employees Hospital Association,Inc.

(GEHA) All Yes Yes

95453 Grand Valley Health Plan All Yes No

95467 Great Lakes Health Plan All Yes Yes

95467

Great Lakes Health Plan (UnitedHealthcare Great

Lakes Health Plan) All Yes Yes

39640 Great Lakes PACE All Yes No

80705 Great West (SF) CA Yes Yes

80705 Great West (WA) WA Yes Yes

80705 Great West Care All Yes Yes

80705 Great West Denver CO Yes Yes

63665

Great West Life & Annuity (Claims for Kennett,

Missouri ONLY) MO Yes No

80705 Great West Life Assurance All Yes Yes

80705 Great West Life Assurance Company of America All Yes Yes

GCMG1 Greater Covina Medical Group CA Yes No

99284 GREATER COVINA MEDICAL GROUP All Yes No

IP080 Greater L. A. Health CA Yes No

GNPMG GREATER NEWPORT PHYSICIANS All Yes Yes

NMM01 Greater Orange Medical Group All Yes Yes

GOBHI

GREATER OREGON BEHAVIORAL HEALTH

INCORPORATED All Yes No

IP080 Greater San Gabriel CA Yes No

PDT01 Greater Tricities IPA (Noble AMA Select) All Yes No

80705 Great-West Bellevue WA Yes Yes

78521 Greentree All No No

78521 Greentree Administrators All No No

36338 Group Administrators Ltd. All Yes No

GASA1 Group Administrators Self-Funded Alternative All Yes No

48143 Group and Pension Administrators All Yes Yes

91051 Group Health Cooperative (WA) WA Yes Yes

95192 Group Health Cooperative of Eau Claire All Yes No

39167

Group Health Cooperative of South Central

Wisconsin Claims WI Yes Yes

39168

Group Health Cooperative of South Central

Wisconsin Encounters WI Yes Yes

13551 Group Health Incorporated (GHI) (New York) NY Yes Yes

61101 Group Health Insurance - DE DE Yes Yes

91121

Group Health Northwest (Call Payer at 888-767-

4670 prior to submitting electronic claims.) ID,WA Yes No

37276 Group Insurance Service Center, INC All Yes Yes

OBA16 GROUP MANAGEMENT SERVICES INCORPORATED All Yes No

CX015 GROUPLINK All Yes No

64246 Guardian Life Insurance Company of America All Yes Yes

RENBL Gulf Quest IPA HMO Blue NULL Yes No

RENGQ Gulf Quest Renaissance All Yes No

60652 GULF SOUTH RISK SERVICES All Yes No

CB624 Gulf Stream General Dynamics All Yes Yes

93100 GulfQuest All Yes No

39180 Gunderson Lutheran Health Plan All Yes No

80705 GWL All Yes Yes

80705 GWL & A All Yes Yes

37114 H.E.R.E.I.U. Welfare Pension Funds All Yes Yes

65101 HAA Preferred Partners All Yes Yes

HALCY HALCYON BEHAVIORAL HEALTH All Yes No

47738 HAMASPIK CHOICE All Yes No

97258 Hammerman & Gainer All Yes No

58305 Harbor Advantage All Yes Yes

43313 Harken Health All Yes Yes

36406

Harmony Health Plan of Illinois (Wellcare Provider

ID required, call (800) 960-2530 opt. 2 then 5) IL Yes Yes

36405

Harmony Health Plan of Indiana (Only claims for

Indiana Hoosier Healthwise members can be sent to

this payer electronically.) IN Yes Yes

61067 Harmony/ILS ALL Yes Yes

14163 Harmony-Wellcare HMO, Inc. All Yes Yes

75126 HARPETH IPA AMERIVANTAGE All Yes No

59143 Harrington Health BPO All Yes Yes

95959 Harris Methodist Health Plan All Yes No

04245 Harvard Community Health Plan All Yes Yes

04271 Harvard Pilgrim Health Care All Yes No

87726 Harvard Pilgrim Passport Connect All Yes Yes

99208 Hawaii Western Management (HWMG) All Yes Yes

48330 Hawaii Management Alliance Association (HMAA) HI Yes Yes

86068 Hawki (Provider ID Required) All Yes No

HCCMI HCC Life Insurance All Yes No

37111 HCH Administration All Yes Yes

37329 HCHA Albq - Self Funded All Yes Yes

20501 HCP Nevada All Yes No

HDMCO HDM Benefit Solutions All Yes No

90023 HDPC - Premier Healthcare All Yes No

20257 HDPC Alliance Physicians All No Yes

34185 Health Administration Services, Inc All No Yes

CALL Health Advantage of Arkansas AR Yes No

23172 Health Alliance Exclusive & Plus All Yes No

77950 Health Alliance Medical Plans of Illinois IL Yes Yes

38224 Health Alliance Plan of Michigan All Yes Yes

25126

HEALTH AMERICA INCORPORATED HEALTH

ASSURANCE ADVANTRA All Yes No

68241 Health Care Alliance (Sears) All Yes No

HCDPB Health Care District Palm Beach NULL Yes No

CALL

Health Care District Palm Beach (Please contact

HCDPBC to enroll and to obtain Payer ID 866-930-

1002.) FL Yes No

42102 Health Care Network of WI (HCN) WI Yes Yes

42102 Health Care Network of Wisconsin (HCN) All Yes Yes

HCP02 Health Care Partners - AZ AZ Yes Yes

62180 Health Choice Generations All Yes Yes

46221 Health Choice Insurance All Yes Yes

22100 HEALTH CHOICE INTEGRATED CARE All Yes No

62179 Health Choice of AZ AZ Yes No

45399 Health Choice Utah UT Yes Yes

82018 Health Claims Service All Yes No

62111 Health Cost Solutions All Yes Yes

81600 Health County Health Alliance All Yes Yes

34158 Health Design Plus All Yes Yes

66004

HEALTH ECONOMIC LIVELIHOOD PARTNERSHIP

(HELP) All Yes No

16120 Health EZ All Yes Yes

95019 Health First Health Plans All Yes No

75234 Health First-Tyler, TX TX Yes Yes

59087 Health Help Networks, Inc. All Yes Yes

86066

Health Management Associates (HMA, servicing

Southeastern and Southwestern Regions) (Provider

ID Required) All Yes Yes

10006 HEALTH MGMT SOLUTIONS All Yes No

68021 Health Net - VA All Yes Yes

HM001 Health Net (California Encounters Only.) CA No No

95567 Health Net (of California) CA Yes No

AZHNT Health Net of Arizona AZ Yes No

06108

Health Net of the North East, Inc. (Health Net six

digit ID REQUIRED in B0X33a; call 866-334-4638) All Yes Yes

22340 Health Net Oregon OR Yes No

65062 Health Network One All No No

04286 Health New England All Yes Yes

FLHLT Health Options of Florida (Blue Shield HMO) FL Yes No

FLENC

Health Options of Florida (Blue Shield HMO)

ENCOUNTERS ONLY!! FL Yes No

NAHOI Health Options of Illinois IL Yes Yes

62157 Health Partners - Jackson,TN TN Yes No

94267 HEALTH PARTNERS OF MN All Yes No

80142 Health Partners, PA PA Yes Yes

20270 Health Payment Systems All Yes Yes

37221 HEALTH PLAN MANAG All Yes No

83253 Health Plan of Michigan All Yes Yes

52563 Health Plan of Michigan MI Yes No

76343 Health Plan of Nevada (Encounter claims) NV Yes Yes

76342 Health Plan of Nevada (FFS claims) CA,NV Yes Yes

68035 Health Plan of San Joaquin All Yes Yes

HPSM1 Health Plan of San Mateo CA Yes No

59140 Health Plan Services, Tampa Office All Yes Yes

44273 Health Plans Inc. All Yes Yes

95435 Health Pledge HMO All Yes No

38216 Health Plus of Michigan MI Yes Yes

HPPO HEALTH PLUS PHYSICIAN ORGANIZATION All Yes No

63363 HEALTH PLUS PHYSICIANS ORGANIZATION All Yes No

41170 HEALTH RISK MANAGEMENT (HRM) All Yes No

SKMA2 Health Safety Network - MASS. Health Medical All Yes No

00995

HEALTH SAFETY NETWORK - MASS. HEALTH

MEDICAL (PROF 0ONLY) All Yes No

M3IL1

Health Select IPA (Enrollment required. Contact 866-

703-1444.) All Yes No

37290

Health Services for Children with Special Needs

(HSCSN) All Yes Yes

41150 Health Services Management NULL Yes No

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.) All Yes No

HSM01 Health Services Management, Inc. for AHS All Yes No

HSM01 Health Services Management, Inc. for BPA All Yes No

HSM01 Health Services Management, Inc. for ECOH All Yes No

HSM01 Health Services Management, Inc. for EHC All Yes No

HSM01 Health Services Management, Inc. for ENCR All Yes No

HSM01 Health Services Management, Inc. for FCM All Yes No

HSM01 Health Services Management, Inc. for HF All Yes No

HSM01 Health Services Management, Inc. for HT All Yes No

HSM01 Health Services Management, Inc. for MMSI All Yes No

HSM01 Health Services Management, Inc. for MSHO All Yes No

HSM01 Health Services Management, Inc. for PNET All Yes No

HSM01 Health Services Management, Inc. for PONE All Yes No

HSM01 Health Services Management, Inc. for SC All Yes No

HSM01 Health Services Management, Inc. for WEA All Yes No

65449 HEALTH SPECIAL RISK INCORPORATED All Yes No

HTHTX Health Texas Medical Group All Yes No

HLTHT Health Traditions All Yes Yes

95828 HEALTHCARE DISTRICT PALM BEACH COUNTY All Yes No

HCH01 HEALTHCARE HIGHWAYS ALL Yes Yes

MPM06 Healthcare LA, IPA CA Yes No

TH049 Healthcare Management Admin All Yes No

HMA01

Healthcare Management Administrators, Inc. (also

known as HMA, servicing Western Region) WESTERN Yes Yes

EPF37 Healthcare Options NULL Yes Yes

HCP01 Healthcare Partners CA Yes No

11328 HealthCare Partners, IPA All Yes Yes

56731 Healthcare Resources NW All Yes Yes

73147 HealthCare Solutions Group All Yes Yes

25133 Healthcare USA All Yes Yes

25143 HEALTHCARE USA All Yes No

00550 Healthcare USA NULL Yes No

71064 HEALTHCHOICE ALL Yes Yes

HCA77 HealthComp All Yes No

85729 Healthcomp All Yes Yes

HCOMP

HEALTHCOMP (COMMUNITY FIRST STAR HEALTH

PLAN) All Yes No

59608 Healthease FL Yes Yes

95213

HealthEdge Administrators (PayerID valid for claims

with a submission address of PO Box 11210,

Bakersfield, CA 93389) All Yes No

41178 HealthEZ All Yes Yes

75289 Healthfirst of Austin TPA All Yes Yes

80141 Healthfirst, Inc. (NY) NY Yes Yes

56144 HealthGram All Yes Yes

23226 HealthGuard of Lancaster PA No Yes

00923 Healthkeeper HMO VA Yes Yes

96475 HEALTHLINK HMO All Yes Yes

90001 HEALTHLINK PPO All Yes Yes

38309 Healthnet of AZ AZ Yes Yes

55204 HealthNow NY NY Yes No

07003 HealthPartners All Yes Yes

55764 HealthPartners of Minnesota All Yes No

SX009 HealthPartners of MN All Yes No

27514 Healthplus Amerigroup TX Yes Yes

95009 HealthPlus of Lousiana All Yes Yes

68195 Healthpoint Corporation All Yes Yes

31106 HealthPower HMO All Yes No

52429 HEALTHSCOPE BENEFITS EHC REPRICING All Yes No

71063 HealthSCOPE Benefits, INC All Yes No

HSHAR Healthshare NULL Yes No

75237 Healthsmart Accel All Yes No

75250 HealthSmart Preferred Care All Yes Yes

HSPC1 HEALTHSMART PREFERRED CARE (HSPC) All Yes No

CALL

Healthsource \ Hudson Health Plan (Provider

enrollment is required by the payer. Must call (914)

372-2291 to obtain payerID) All Yes No

71074

Healthsource Arkansas - Claims must contain

Healthsource specific Vendor ID & specific

Rendering Provider ID AR Yes No

HS001 Healthsource Inc. All Yes No

35167

Healthsource Indiana - Claims must contain


Rendering Provider ID IN Yes No

61127

Healthsource Kentucky - Claims must contain


Rendering Provider ID KY Yes Yes

01041

Healthsource Maine - Claims must contain


Rendering Provider ID ME Yes Yes

02038

Healthsource New Hampshire - Claims must contain


Rendering Provider ID NH Yes No

56147

Healthsource North Carolina - Claims must contain


Rendering Provider ID NC Yes Yes

75255

Healthsource North Texas - Claims must contain


Rendering Provider ID TX Yes Yes

68195 Healthsource Provident Ins. Co. All Yes Yes

06119 HEALTHSOURCE SOUTH CAROLINA All Yes No

71075 Healthsource, AR (Med) (CIGNA) AR Yes Yes

58210 Healthsource, GA (CIGNA) GA Yes Yes

02041 Healthsource, Mass MA Yes Yes

31141 Healthsource, OH OH Yes Yes

62129 Healthsource, TN (CIGNA) TN Yes Yes

RH007 Healthspan All Yes Yes

34092 HEALTHSPAN All Yes No

HSPAN HealthSpan Network Repricing All No No

HT001

HealthSpring HMO (No PPO claims accepted via this

payerID.) All Yes No

63092 HealthSpring HMO/HealthSpring Medicare+Choice All Yes No

HESUN HealthSun All Yes Yes

88250 HealthTeam Advantage All Yes Yes

31472 Healthwave of Kansas KS Yes No

58213 Healthways WholeHealth Networks All No No

00661 Healthy Blue Louisiana All Yes Yes

M3FL3 Healthy Kids NULL Yes Yes

95827 Healthy Palm Beaches, Inc. FL No No

HSF01 Healthy San Francisco All Yes Yes

68064 Healthy Texas TX Yes Yes

22251 Healthy York Network All Yes No

77180 HealthyCT CT Yes No

45336 HEALTHYCT INCORPORATED All Yes No

00243 Helix Family Choice MD Yes No

59230

Heritage Consultants (Must use 9-digit subscriber ID

on all claims) All Yes No

HER01 Heritage IPA All Yes No

M3FL5 HFN Healthease NULL Yes Yes

36335 HFN, Inc. All Yes Yes

20552 HHH Choices Gold All Yes Yes

95393 HIGH DESERT MEDICAL GROUP All Yes No

HDMDG HIGH DESERT MEDICAL GROUP (REGAL) All Yes No

33069 High Desert Primary Care All Yes Yes

91164 Highline Medical Services MOLINA All Yes Yes

91161 HIGHLINE PSHP All Yes No

35145 Highmark - Key Family All Yes No

47181 Highmark BCBSD Health Options All Yes No

HIL01 Hill Physicians Medical Group All Yes No

00046 HILL PHYSICIANS MEDICAL GROUP All Yes No

59347 Hillcrest Benefits Administrators All Yes No

80520 HILLIARD CORPORATION (UCS) All Yes No

NAHIN HINSDALE PHYS All Yes No

55247 HIP-Health Insurance Plan of Greater NY NY Yes Yes

HPFFS HISPANIC PHYSICIANS IPA All Yes No

HPIPA Hispanic Physicians IPA All Yes No

86066 HMA (servicing HI, AZ and NV) All Yes Yes

75318 HMC Healthworks All Yes Yes

COHMO HMO COLORADO All Yes No

84555 HMO Louisiana Blue Advantage LA Yes Yes

IP080 Hollywood Presbyterian CA Yes No

NAHLX Holy Cross Health Partners IL Yes Yes

36412 Holy Cross Health Partners All Yes No

11001 Home Health and Hospice - J11 All Yes Yes

68069 Home State Health Plan LA Yes Yes

VAICE Homeland Security (ATTN: Deportation) All Yes Yes

50701 Homelink All Yes No

55744 Homelink HealthPartners ALL Yes No

88023 Hometown Health Plan Nevada NV Yes No

30757

Hometown Health Plan of Ohio (Now known as The

Health Plan) OH Yes No

88537 HOMETOWN HLTH PRO All Yes No

82234 HOMEWOOD RESORTS (UCS) All Yes No

66003 HOPKINS HEALTH ADVANTAGE All Yes No

HMLIC Horace Mann Life Insurance All Yes No

CALL HORIZON BCBS NEW JERSEY ALL Yes No

HVMG1 HORIZON VALLEY MEDICAL GROUP All Yes No

91136

Hotel Employees & Restaurant Employees Health

Trust - Grp#F19 All Yes Yes

J1888 HOWARD COUNTY GOVERNMENT (MARYLAND) All Yes No

CARD

HPMS (Send claims to payerID listed on patient's

insurance card.) MI Yes No

94254 HPR All Yes No

13335

Hudson Health Plan (Provider must be located in

Duchess, Orange, Rockland, Sullivan or Westchester

County, NY) NY Yes No

HBI01 Human Behavioral Institute All Yes No

61104 HUMANA BEHAVIORAL HEALTH All Yes No

95348 HUMANA HEALTH PLANS OHIO All Yes No

61115 HUMANA LONG TERM CARE All Yes Yes

61125 Humana Military Tricare All Yes Yes

L0200 Humana Puerto Rico PR Yes No

61160 HUMANA VA HERO PR All Yes No

61120 Humana Veterans Healthcare Services All Yes No

61101 HUMANA, Claims only All Yes Yes

61102 HUMANA, Encounters Only All Yes No

94154

HUMBOLDT DEL NORTE FOUNDATION FOR MEDICAL

CARE All Yes No

37260 HUNT INSURANCE GR All Yes No

IP080 Huntington Park Medical Group CA Yes No

IP080 Huntington Park Mission CA Yes No

38234 IBA Self Funded Group All Yes Yes

74234

IBEW Local 640 & Arizona Chapter NECA Health &

Welfare Trust AZ Yes No

74234 IBEW Western Utilities or Local 57 UT Yes No

81810 IBG Administrators, LLC All Yes No

41124 IBI All Yes Yes

19028 IBM BUSINESS TOISC All Yes No

68241 IBM Medical Plans All Yes No

11695 iCARE (Independent Care Health Plan) WI Yes No

26054 ICARE Health Options TPA All No No

33884 iCircle of New York All Yes No

37296 ICM All Yes No

75185 ICON Benefit Administrators All Yes No

TRUEB IDAHO TRUE BLUE ID Yes No

YESB IDAHO YES BLUE All Yes No

22175 IE SHAFFER All Yes No

75274 IHG DIRECT All Yes No

68066 Illini Care Health All Yes No

68065 Illinicare Behavioral Health All Yes Yes

68069 Illinicare Group Health (Also 68066) All Yes Yes

DMG01 Illinois Health Plan (IHP) All Yes No

86069 Illinois Health Solutions ( ProviderID Required) IL Yes No

IPA99 ILLINOIS PHYSICIANS ALLIANCE IPA All Yes No

72091 IMA of Lousiana Inc. All Yes Yes

43123 IMAGINE HEALTH All Yes No

41600 IMCARE All Yes Yes

39186 IN Managed Health Services IN Yes Yes

40585 INDECS Corporation All Yes Yes

TA720 Independence Administrators All Yes Yes

CB231 INDEPENDENCE AMERICAN INSURANCE COMPANY All Yes No

64284 Independence Care System NY Yes Yes

MHM01 Independence Medical Group All Yes No

IMG01 INDEPENDENCE MEDICAL GROUP KERN COUNTY All Yes No

IMG02 INDEPENDENCE MEDICAL GROUP TULARE COUNTY All Yes No

54704

Independent BLC of PA (Also known as Personal

Choice PPO of Pennsylvania.) PA Yes Yes

95308

Independent Health (Enrollment and Testing

Required, contact (716) 635-3911) All No No

SX073 INDEPENDENT HEALTH OF NEW JERSEY. All Yes No

45048 Independent Living Systems All Yes Yes

INDPM INDEPENDENT PHYSICIAN AT MERCY All Yes No

04411 Indian Health Service/Tribal Organizations TX No Yes

04412 Indian Health Service/Tribal Organizations TX Yes No

00290 Indian Health Services All Yes No

35600 Indiana Department of Health Children's Health IN Yes Yes

35161 Indiana ProHealth Network IN Yes Yes

35107

Indiana Teamsters Health Benefits Fund (Formerly

known as Local 135 Health Benefits Fund) IN Yes No

77153 Indiana University (Southeastern Indiana Health) All Yes Yes

95444 INDIANA UNIVERSITY HEALTH PLAN All Yes Yes

COMPU Industrial Machine Specialties CO Yes No

43471 INETICO, Inc. All Yes Yes

96490 INFORMED LLC All Yes No

50946 Informed UHC Compass Rose All Yes No

52196 InforMed, LLC All Yes Yes

85578 INGALLS PROVIDER GROUP All Yes No

NAING Ingalls Provider Group IL Yes Yes

38343 INGHAM HEALTH PLAN CORPORATION All Yes No

J1907 INGLES MARKETS All Yes No

31112 InHealth, Inc. All Yes No

IEHP1 Inland Empire Health Plan All Yes Yes

MVMM1 INLAND FACULTY MEDICAL GROUP All Yes No

OSFC9 INNOV_OSF HEALTHCARE CENTRAL All Yes No

31172 Innovante Benefit Administrators All Yes No

40025 Innovation Health All Yes No

80087 Innovative Physician Associates All Yes No

VAICE INS Health Services All Yes Yes

68241 Institutes of Quality All Yes No

37279 Insurance Administrator of America All Yes Yes

63082 Insurance Claims Services, Inc. (Birmingham, AL) AL Yes No

13315 Insurance Design Administrators All Yes Yes

72091 Insurance Management Administrators All Yes Yes

15688 Insurance Management Services All Yes Yes

IMSMS Insurance Management Services of Texas TX Yes Yes

ISL11 Insurance Service of Lubbock All Yes Yes

IAC01 Insurer's Administration Corporation All Yes No

86304 Insurers Administrative Corp All Yes No

51020 INTEGRA Administrative Group, Inc. All Yes Yes

31129 Integra Group - CHA All Yes Yes

31127

Integra Group (Also known as Rehab Provider

Network, but not the same as Colorado payer of

same name.) All Yes Yes

45302 Integra Managed Long Term Care All Yes Yes

23229 Integral Quality Care All Yes No

INET1 Integranet NULL No Yes

10001 INTEGRATED COMP All Yes No

IHCS1 INTEGRATED HOMECARE SERVICES All Yes No

20050 Integrated Medical Solutions All Yes Yes

68068 Integrated Mental Health Services All Yes Yes

68031 INTEGRITY DENTAL ONLY All Yes No

56132 Interactive Medical Systems All Yes Yes

92649 Inter-Americas Insurance NULL Yes No

37227 Intercare Health Plans All Yes Yes

INCHN Intercommunity Health Net All Yes No

60280 Interface EAP All Yes No

23287 Intergroup Services Corporation All Yes Yes

SX107 Intermountain Healthcare UT Yes Yes

74234 Intermountain Ironworkers Trust Fund AZ,ID,UT Yes No

11329 International Benefit Administration All Yes Yes

48603

International Brotherhood of Boilermakers

Employee Health Care Plan (IBBEHC) All Yes Yes

39182 International Funding Inc. All Yes Yes

IMGIN International Medical Group, INC All Yes Yes

37269 International Union Operating Engineers All Yes Yes

84137 InterWest Health PPO (Montana) MT No No

IHP02 InTotal Health All No Yes

35115 INTOTAL HEALTH All Yes No

41124 Iowa Benefits, Inc. IA Yes Yes

86068 Iowa Health Solutions (Provider ID Required) IA Yes No

IPAK1 IPA of Kane County NULL Yes No

J1887 IPMG CLAIMS MANAGEMENT All Yes No

J1911 ISURITY All Yes No

IUHPL IU HEALTH PLAN ALL Yes Yes

SX172 IU Medical Group Primary Care All Yes No

JCC01 JACKSON CARE CONNECT All Yes No

05014 JACKSON MEMORIAL All Yes No

JAI01 JAI Medical Systems All Yes No

JCARE JENCARE MEDICAL All Yes No

61271 JF Molloy All Yes No

09822 JMHP Medicaid All Yes Yes

87726

John Deere Healthcare, now know as

UnitedHealthcare River Valley All Yes Yes

52189

John Hopkins Healthcare (EHP/PP) (Submit Billing

NPI and Rendering/Servicing NPI) All Yes Yes

38310 John Morrell Company - AHPBA All No No

JMH01 John Muir Health Network CA No No

68036 John Muir Mt. Diablo Health System All Yes No

68013 JOHN MUIR TRAUMA PHYSICIANS All Yes No

CALL

John Muir Trauma Physicians (Please call 925-947-

5288 for Payer ID information.) All Yes No

37215 John P Pearl and Associates All Yes Yes

52123

Johns Hopkins (USFHP) (New submitter should send

in their Billing NPI & Rendering servicing NPI) All Yes Yes

43178 Joplin Claims All Yes Yes

34136 JP Farley Corporation All Yes Yes

MWP01 JPS Preferred Care All Yes No

37272 JSL Administrators All Yes Yes

91617 KAISER FOUNDATION HEALTH PLAN COLORADO All Yes No

52095 KAISER FOUNDATION HEALTH PLAN MID ATLANTIC All Yes No

NG010 Kaiser Foundation Health Plan of Georgia GA Yes Yes

94135

Kaiser Foundation Health Plan of Northern CA

Region CA Yes Yes

NG007 Kaiser Foundation Health Plan of Ohio OH Yes Yes

94134

Kaiser Foundation Health Plan of Southern CA

Region CA Yes Yes

93079

KAISER FOUNDATION HEALTH PLAN OF THE

NORTHWEST All Yes No

NG009 Kaiser Foundation Health Plan of the NW OR,WA Yes No

NG008 Kaiser Mid-Atlantic All Yes Yes

KS007 KAISER NORTHWEST REGION All Yes No

KS001 Kaiser Permanente (Southern California Only) CA Yes Yes

KSRCS KAISER PERMANENTE COLORADO SPRINGS All Yes No

21313 KAISER PERMANENTE GEORGIA All Yes No

RH011 Kaiser Permanente Hawaii HI Yes No

94123 KAISER PERMANENTE HEALTH PLAN HAWAII All Yes No

94320 Kaiser PPO All Yes No

40137 KALOS HEALTH All Yes No

57038 Kanawha Healthcare Solutions All Yes No

KCIPA Kane County IPA NULL Yes No

44030 Kansas City Life Insurance Company All Yes No

CX058

Kansas City Life Insurance Company And Healthy

Choices All Yes Yes

KAP01 Kapiolani Health NULL Yes No

81812 KATY MEDICAL CLAIMS All Yes No

KMG11 Katy Medical Group NULL Yes No

KEE01 Keenan & Associates CA Yes No

KELSE Kelsey Seybold All Yes No

61453 Kemper Benefits All Yes Yes

73100 Kempton Group All Yes Yes

KENT1 Kent County Health Plan MI Yes No

27215 Kentucky Health Administrators, Inc. All No No

77894 Kentucky Health Cooperative KY Yes Yes

68067 Kentucky Spirit Health All Yes No

68069 Kentucky Spirit Health Plan (Also 68067) KY Yes Yes

28021 Kern County CDCR All Yes No

22149 Kern Health Care Network All Yes No

77039 Kern Health Systems All Yes Yes

89890 KERN LEGACY HEALTH PLAN All Yes No

37217 Key Benefit Administrators All Yes No

35317 KEY GAP All Yes No

95460 Key Health Medical Solutions All Yes No

KHMSI KEY HEALTH MEDICAL SOLUTIONS INCORPORATED All Yes No

KEYIP Key Insurance Group All Yes Yes

IP082

Key Medical Group (Providers please contact Brandi

Guinn @ 559-735-3892 x233 for authorization.) CA Yes No

37321 Key Select All Yes No

37323 Key Solution All Yes No

00923 Keycare PPO VA Yes Yes

77050 Keystone Connect PA Yes No

42344 Keystone First Community HealthChoices PA Yes Yes

77741 Keystone First PA Community Health Choices All Yes Yes

23284 Keystone Mercy Health Plan All Yes Yes

84223 Keystone VIP Choice All Yes Yes

KGA15 KG ADMINISTRATIVE SERVICES All Yes No

3414A

Klais & Company (Repricing for HealthSpan Network

Only.) All No No

34145 Klais and Company All Yes Yes

KAMG1 KOREAN MEDICAL All Yes No

KPIC1

KPIC - Kaiser Permanente (Valid in the states of

CACO DC GA HI MD OH and OR) LISTED Yes No

KPS01 KPS Health Plans All No No

57610 KUSPUK SCHOOL DISTRICT All Yes No

27357 LA Care LA Yes Yes

LACAR LA Care Health Plan All Yes Yes

LADOC LA DEPT OF CORRECTIONS All Yes No

MPM19 LACH HEALTHNET BY MEDPOINT All Yes No

71037 Lafayette Consolidated Government LA No No

SISCO Lake Area Community Health Plan All Yes Yes

SISCO Lake Region Community Health Plan All Yes Yes

66127 LAKESIDE COMPREHENSIVE HEALTHCARE All Yes No

95415 Lakeside Health Services All Yes No

66125 LAKESIDE MEDICAL GROUP All Yes No

LMG11 Lakeside Medical Group Inc. All No No

16109 LANCASTER GENERAL HEALTH GROUP All Yes No

90096 Land of Lincoln Health All Yes Yes

LNDMK Landmark Healthcare Inc. All Yes No

J1889 LANDRYS All Yes No

14633 LARSON GROUP All Yes Yes

NWADM Las Vegas Fire Fighters Local No 1285 Security Fund CA Yes No

NMM02 LaSalle Medical Associates CA Yes No

53122 LASSEN MUNICIPAL UTILITY DISTRICT All Yes No

10550 Lasso Healthcare All Yes Yes

36333 Lawndale Christian Health Center All Yes No

LAWND LAWNDALE CHRISTIAN HEALTH CENTER All Yes No

52193 LBA HealthPlans All Yes Yes

LWMC1 LEISURE WORLD MANAGED CARE All Yes No

37316 Leon Medical Center Health Plan All No No

65055 Leon Medical Center Health Plan NULL Yes Yes

11328 Liberty Health Advantage All Yes Yes

87071 LIBERTY HEALTH ADVANTAGE All Yes No

98205 Life & Health Ins Co of America (NFL Plan only) All Yes No

33LGC LIFE GIFT CARDS All Yes No

LIICA

Life Investors Ins Co of America (Specialized claims

only. Call 866-745-3545 with claim routing

questions.) All Yes No

59847 LIFE ST JOSEPH OF THE PINES All Yes No

41136 Life Trac All Yes No

71498 LifeCircles PACE All Yes No

RLH01 LIFEMAP All Yes No

76870 LifePath Hospice Inc. All Yes No

LIFE1 Lifeprint All Yes No

27005 LIFESTYLE HEALTH PLANS All Yes No

EBSRM Lifetime Benefit Solutions All Yes Yes

EBSRM Lifetime Benefits Solutions All Yes Yes

93093 Lifewise A Premier Health Plan OR Yes Yes

93093

Lifewise Health Plan of Oregon A Premier Health

Plan OR Yes Yes

91049

Lifewise Health Plan of Washington A Premier

Health Plan WA Yes No

LWA01 LIFEWORKS ADVANTAGE All Yes No

LOBH1 LINDEN OAKS BEH H All Yes No

75283 Linn County All Yes No

LIPA1 Lipa/Agate Resources All No No

LCM1 LITTLE COMPANY OF MARY All Yes No

4725P Little Company of Mary Health All Yes No

00923 Local Choice VA Yes Yes

CB752 Lockard & Williams All Yes No

37267 Loma Linda University Adventist All Yes No

33036 Loma Linda University Health Care All Yes Yes

37226 LONDON HEALTH ADM All Yes No

45289 Lone Star TPA All Yes Yes

MHIPA Long Beach Memorial IPA (MHCLB) CA Yes No

73236 LOREN COOK All Yes No

67202 Louisiana Health Cooperative LA Yes Yes

28680 Louisiana Health Cooperative All Yes Yes

68069 Lousiana Healthcare Connections LA Yes Yes

SX159 Lovelace Medicaid NM Yes No

SX159 Lovelace Salud! (NM Medicaid) NM Yes No

90328 Lovelace Sandia Health Plan All Yes No

NMBLS

LOVELACE SANDIA HEALTH PLAN (ACQUIRED BY BS

OF NEW MEXICO) NM Yes No

56756 LOWER KUSKOKWIM SCHOOL DISTRICT All Yes No

13193 Loyal American All Yes Yes

39198 Lutheran Preferred All Yes No

37292 Machinist District 9 Welfare All Yes No

J1343 MACKINAW ADMINISTRATORS All Yes No

36334

MacNeal Health Providers - CHS (Contact 708-783-

7100 prior to first submission.) All No No

60054

Magellan Behavioral Health (For Dates of Service

1/1/2006 and After - Provider ID Required - AETNA

Subscribers only.) All Yes Yes

MCC01 Magellan Complete Care of AZ AZ Yes Yes

MCCVA Magellan Complete Care of VA VA Yes Yes

01260

Magellan Health (All Non-AETNA Subscribers -

Provider ID Required) All Yes No

11303 MAGNACARE All Yes Yes

68062 Magnolia All Yes No

68069 Magnolia Mississippi (Also 68062) All Yes Yes

87726

MAHP (MD IPA, Optumun Choice and MLH)

UnitedHealthcare MD Yes Yes

62413 MailHandlers All Yes Yes

45341 Maine Community Health Options All Yes Yes

26372 Majesta Care All Yes Yes

35162 Managed Care Services, LLC All Yes Yes

MCS04 Managed Care Systems CA Yes No

MCS02 Managed Care Systems (Delango Regional Medical) All No No

MHCA1 Managed Health Care Admin EPS All Yes No

22771 Managed Health Networks (MHN) All Yes Yes

68069 Managed Health Services Indiana (Also 39186) IN Yes Yes

68069

Managed Health Services of Wisconsin (Please

contact the payer @ 800-225-2573, ext 25525 to get

setup to submit electronic claims.) WI Yes Yes

39187 Managed Health Services WI All Yes Yes

MHCA2

Managed Healthcare Administration Inc- Blue

Choice AL Yes No

36312 MANAGED HEALTHCARE ASSOC (MHCA) All Yes No

41555 MANATEE SERVICES All Yes No

75258 MAPCO Inc. All Yes No

66040 Mapfre Excel PR Yes No

46012 Mapfre Life Commercial All Yes No

PRMAP Mapfre Live Insurance PR Yes Yes

52461 MARCH VISION CARE INCORPORATED All Yes No

5246M March Vision Health Plan All Yes No

A0008 MARICOPA HEALTH PLAN All Yes No

IP097 Marin IPA CA Yes No

MPCHP Marion Polk Health Plan All No No

20805 Marrick Medical Finance LLC All Yes No

46478 Marrick WRx All Yes Yes

68241 Marriott All Yes No

53275 MARTINS POINT HEALTH CARE All Yes No

MPHC2

Martin's Point Health Care USFHP/Generations

Advantage All Yes Yes

22348 Maryland Physicians Care All Yes Yes

00247 MARYLAND PHYSICIANS CARE All Yes No

77063

Maryland PMHS ValueOptions (Use for ALL Dates of

Service) MD Yes No

37121 Mashantucket Pequot Tribal Nation All Yes Yes

MMPHB Masters, Mates and Pilots Plan All Yes No

27320 Max Specialty Benefits All Yes No

92805 MAXOR All Yes Yes

88090 Mayo Clinic FL/GA All Yes Yes

41154 Mayo Management Services, Inc. All Yes Yes

83028 MBA Benefit Administrators All Yes Yes

37298 MBA of MD, Inc. MD Yes Yes

87065 MBA of Wyoming WY,UT Yes Yes

MM001

M-CARE (Payer no longer accepting electronic

claims. Claim will be printed and mailed to payer.) MI Yes No

CSMED Mcare of Colorado Springs CO Yes No

38264

Mcare of Michigan (Payer no longer accepting

electronic claims. Claim will be printed and mailed

to payer.) MI Yes No

MCCBV

MCC Behavioral Care (We will also accept PID SX071

for these claims: use of either ID accomplishes the

same routing.) All Yes Yes

59331 McCreary Corporation FL Yes No

31149 MCGREGOR PACE All Yes No

3833N McLaren ABW-NHP All Yes No

3833T McLaren ABW-THPC All Yes Yes

3833R McLaren Advantage SNP All Yes Yes

3833A McLaren Health Advantage All Yes No

38338 McLaren Health Plan All Yes No

3833C McLaren Medicaid All Yes No

6197P MCS PR Yes No

66039 MCS Life All Yes No

MDAPN MD Anderson Physician Network All Yes No

MDC01 MD CARE HEALTH PLAN All Yes No

MDXHI MD Hawaii HI Yes No

87726

MD-Individual Practice Association, Inc. (M.D. IPA)

(Previously Payer ID 52148) All Yes Yes

MDWIS MDWIS HIP All Yes No

12K81 MDWise All No Yes

3135M

MDwise Health Indiana Plan (For 2019 Claim

Submissions) All Yes Yes

20475 MDWise Hoosier Alliance All No Yes

91313 MDwise Hoosier Care Connect All Yes Yes

35191

MDwise Hoosier Healthwise (For 2018 Claim


3519M

MDwise Hoosier Healthwise (For 2019 Claim


31354

MDwise Hoosier Indiana Plan (For 2018 Claim


45627 MDWISE MARKETPLACE All Yes Yes

MWSHN MDWise Select Health Network All Yes Yes

MLINK MECKLINK All Yes No

80026 MED PARTNERS AMER All Yes No

88058 Med Pay All Yes Yes

88058 Med Pay All Yes Yes

M3CA0001 MED3000 CALIFORNIA All Yes No

EM350 Med3000 CMS Early Steps All Yes Yes

M3FL0010 MED3000 CMS EARLY STEPS All Yes No

EM284 Med3000 CMS Safety Net All Yes Yes

M3FL0011 MED3000 CMS SAFETY NET All Yes No

EM843 Med3000 CMS Title 19 Reform All Yes Yes

EM205 Med3000 CMS Title 21 All Yes Yes

M3FL0014 MED3000 CMS TITLE 21 All Yes No

EM521 Med3000 Coventry Health Kids All Yes No

EM216 Med3000 HealthSpring All Yes No

EM039 Med3000 Pedicare Title 19 All No Yes

EM522 Med3000 Pedicare Title 21 All No Yes

58204 MedAdmin Sol Inc All Yes Yes

59231 MedCom All Yes Yes

68037 MEDCORE MEDICAL GROUP (OMNI IPA) All Yes No

90753 MedCost / Liberty Health Share All Yes No

56205 MedCost Benefit Services All Yes Yes

56162 MedCost, Inc. All Yes Yes

95321 Medfocus All Yes No

94265 MEDICA All Yes Yes

78857 Medica Health Care Plan, Inc. FL Yes Yes

71890 Medica Health Plan Solutions All Yes Yes

12422 Medica2 All Yes Yes

DEMCD Medicaid of Delaware DE Yes Yes

EPF02

Medicaid - TX Premier Plan (Contact Provider

Relations @ (915)532-2778, x1068) TX Yes Yes

ALMCD Medicaid of Alabama AL Yes Yes

AKMCD Medicaid of Alaska AK Yes Yes

AZMCD Medicaid of Arizona (AHCCCS) AZ Yes Yes

ARMCD Medicaid of Arkansas AR Yes Yes

COMCD Medicaid of Colorado CO Yes Yes

CTMCD Medicaid of Connecticut CT Yes Yes

FLMCD Medicaid of Florida FL Yes Yes

GAMCD Medicaid of GA GA Yes Yes

HIMCD Medicaid of Hawaii HI Yes Yes

IDMCD Medicaid of Idaho ID Yes Yes

ILMCD Medicaid of Illinois IL Yes Yes

INMCD Medicaid of Indiana IN Yes Yes

IAMCD Medicaid of Iowa IA Yes Yes

KSMCD Medicaid of Kansas KS Yes Yes

KYMCD Medicaid of Kentucky KY Yes Yes

LAMCD Medicaid of Lousiana (Includes KidMed claims.) LA Yes Yes

LAREH

Medicaid of Lousiana Rehab (for Rehabilitation

claims) LA Yes No

MEMCD Medicaid of Maine ME Yes Yes

MDMCD Medicaid of Maryland MD Yes Yes

MAMCD Medicaid of Massachusetts MA Yes Yes

MIMCD Medicaid of Michigan MI Yes Yes

MNMCD Medicaid of Minnesota MN Yes Yes

MSMCD Medicaid of Mississippi MS Yes Yes

MOMCD Medicaid of Missouri MO Yes Yes

MTMCD Medicaid of Montana MT Yes Yes

NEMCD Medicaid of Nebraska NE Yes Yes

NVMCD Medicaid of Nevada NV Yes Yes

NHMCD Medicaid of New Hampshire NH Yes Yes

NJMCD Medicaid of New Jersey NJ Yes Yes

NMMCD Medicaid of New Mexico NM Yes Yes

NYMCD Medicaid of New York NY Yes Yes

NCMCD Medicaid of North Carolina NC Yes Yes

NDMCD Medicaid of North Dakota ND Yes Yes

OHMCD Medicaid of Ohio OH Yes Yes

OKMCD Medicaid of Oklahoma OK Yes Yes

ORMCD Medicaid of Oregon OR Yes Yes

PAMCD Medicaid of Pennsylvania PA Yes Yes

RIMCD Medicaid of Rhode Island RI Yes Yes

SCMCD Medicaid of South Carolina SC Yes Yes

SDMCD Medicaid of South Dakota SD Yes Yes

TNMCD Medicaid of Tennessee (TennCare) TN Yes Yes

TXMCD Medicaid of Texas TX Yes Yes

UTMCD Medicaid of Utah UT Yes Yes

VTMCD Medicaid of Vermont VT Yes Yes

VAMCD Medicaid of Virginia VA Yes Yes

DCMCD Medicaid of Washington DC DC Yes Yes

WAMCD Medicaid of Washington State WA Yes Yes

WVMCD Medicaid of West Virginia WV Yes Yes

WIMCD Medicaid of Wisconsin WI Yes Yes

WYMCD Medicaid of Wyoming WY Yes Yes

86916 MEDICAID TEXAS HEALTH STEPS & CSHCN All Yes No

SKTX1 MEDICAID TEXAS LTC All Yes No

SKVI0 MEDICAID UNITED STATES VIRGIN ISLANDS All Yes No

MAHP1 Medical Associates Health Plan All Yes Yes

MAHC1 Medical Associates Health Plan All Yes No

68041 Medical Benefit Administration, Inc. All Yes No

74323 Medical Benefits Mutual All Yes Yes

MPM18 Medi-Cal by MedPoint All Yes No

PRMCS Medical Card System (MCS) PR Yes Yes

9043P MEDICAL CONTROL All Yes No

52181 Medical Development International All Yes Yes

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) OH Yes Yes

CSMED Medical Network of Colorado Springs CO Yes No

CAMCD MediCal of California CA Yes Yes

MHIPA Medical Orange Coast Memorial IPA CA Yes No

62177 Medical Reimbursements of America All Yes No

58203 Medical Resource Network (MRN, INC) All Yes Yes

13375 Medical Select Management All Yes No

80019

MEDICAL SERVICE COMPANY GROUP

INCORPORATED (MSC) All Yes No

12057 Medical Services Initiative All Yes No

38224 Medical Value Plan - Ohio (MVP) All Yes Yes

SCC63 Medicare Blue Advantage of South Carolina SC Yes Yes

KMMCR

Medicare of Missouri (Includes both Eastern and

Western Missouri.) KS,MS Yes Yes

VIMCR Medicare of the Virgin Islands VI Yes No

WPMCR Medicare Part A of Illinois WPS IL No Yes

ALMCR Medicare Part A/B of Alabama AL Yes Yes

AKMCR Medicare Part A/B of Alaska AK Yes Yes

AZMCR Medicare Part A/B of Arizona AZ Yes Yes

ARMCR Medicare Part A/B of Arkansas AR Yes Yes

COMCR Medicare Part A/B of Colorado CO Yes Yes

CTMCR Medicare Part A/B of Connecticut CT Yes Yes

DCMCR Medicare Part A/B of DC DC Yes Yes

DEMCR Medicare Part A/B of Delaware DE Yes Yes

FLMCR Medicare Part A/B of Florida FL Yes Yes

GAMCR Medicare Part A/B of Georgia GA Yes Yes

HIMCR Medicare Part A/B of Hawaii HI Yes Yes

IDMCR Medicare Part A/B of Idaho ID Yes Yes

ILMCR Medicare Part A/B of Illinois IL Yes Yes

INMCR Medicare Part A/B of Indiana IN Yes Yes

IAMCR Medicare Part A/B of Iowa IA Yes Yes

KSMCR Medicare Part A/B of Kansas KS Yes Yes

KYMCR Medicare Part A/B of Kentucky KY Yes Yes

LAMCR Medicare Part A/B of Louisiana LA Yes Yes

MEMCR Medicare Part A/B of Maine ME Yes Yes

MDMCR Medicare Part A/B of Maryland MD Yes Yes

MAMCR Medicare Part A/B of Massachusetts MA Yes Yes

MIMCR Medicare Part A/B of Michigan MI Yes Yes

MNMCR Medicare Part A/B of Minnesota MN Yes Yes

MSMCR Medicare Part A/B of Mississippi MS Yes Yes

MOMCR

Medicare Part A/B of Missouri (Eastern) (Specialty

testing required) MO Yes Yes

MTMCR Medicare Part A/B of Montana MT Yes Yes

NEMCR Medicare Part A/B of Nebraska NE Yes Yes

NVMCR Medicare Part A/B of Nevada NV Yes Yes

NHMCR Medicare Part A/B of New Hampshire NH Yes Yes

NMMCR Medicare Part A/B of New Mexico NM Yes Yes

ENMCR Medicare Part A/B of New York (Empire) NY Yes Yes

NYMCR Medicare Part A/B of New York (Upstate) NY Yes Yes

NJMCR Medicare Part A/B of NJ (Specialty testing required) NJ Yes Yes

NCMCR Medicare Part A/B of North Carolina NC Yes Yes

NDMCR Medicare Part A/B of North Dakota ND Yes Yes

CNMCR Medicare Part A/B of Northern California CA Yes Yes

VNMCR

Medicare Part A/B of Northern Virginia (inc. Prince

George, Montgomery, Fairfax and Arlington

Counties and City of Alexandria) VA Yes Yes

OHMCR Medicare Part A/B of Ohio OH Yes Yes

OKMCR Medicare Part A/B of Oklahoma OK Yes Yes

ORMCR Medicare Part A/B of Oregon OR Yes Yes

PAMCR Medicare Part A/B of PA (Specialty testing required) PA Yes Yes

RIMCR Medicare Part A/B of Rhode Island RI Yes Yes

SCMCR Medicare Part A/B of South Carolina SC Yes Yes

SDMCR Medicare Part A/B of South Dakota SD Yes Yes

CSMCR Medicare Part A/B of Southern California CA Yes Yes

TNMCR Medicare Part A/B of Tennessee TN Yes Yes

TXMCR Medicare Part A/B of Texas TX Yes Yes

UTMCR Medicare Part A/B of Utah UT Yes Yes

VTMCR Medicare Part A/B of Vermont VT Yes Yes

VAMCR Medicare Part A/B of Virginia VA Yes Yes

WAMCR Medicare Part A/B of Washington WA Yes Yes

WVMCR Medicare Part A/B of West Virginia WV Yes Yes

MWMCR Medicare Part A/B of Western Missouri MO Yes Yes

WIMCR Medicare Part A/B of Wisconsin WI Yes Yes

WYMCR Medicare Part A/B of Wyoming WY Yes Yes

ASMCR Medicare Part B of American Samoa AM Samoa Yes No

GUMCR Medicare Part B of Guam Guam Yes No

QUMCR Medicare Part B of New York GHI NY Yes Yes

ISMCR Medicare Part B of Northern Mariana Islands CNMI Yes No

PRMCR Medicare Part B of Puerto Rico (In Test) PR Yes No

00923 Medicare Supplemental VA Yes Yes

AMM11 MEDICHOICE IPA All Yes No

23160 Medico Insurance Company All Yes Yes

95655 MEDIGOLD All Yes No

94254 MediPrime All Yes No

20039 Mediture All Yes Yes

V360H MEDIVIEW VISTA 360 HEALTH All Yes No

441MP Medpartners All Yes Yes

35205 MEDPARTNERS ADMIN All Yes No

412MP MedPartners Admin Services All Yes No

00130 MedPay MO,IL Yes No

MPM20 MEDPOINT All Yes No

62160 MedSolutions, Inc. All Yes Yes

39190 MedStar Family Choice All Yes No

00243 Medstar Physician Partners MD Yes No

251MS Medstar Select All Yes Yes

MX001 MEDXOOM All Yes No

97055 Mega Life & Health (United Insurance Division) All No Yes

74227 MEGA Life & Health Ins. Co. (Student Division) All Yes Yes

59221

Mega Life & Health Insurance Company (SSN is not a

valid Insured ID. Must be similar to 01234567899 or

AA1234567) All Yes No

01047 MEMIC All Yes No

MMFMC Memorial Care Medical Foundation All Yes No

MCA11 Memorial Clinical Associates All Yes No

62181

MEMORIAL CLINICAL ASSOCIATES SELECTCARE

TEXAS All Yes No

MHIPA Memorial Healthcare IPA CA Yes No

MHHNP Memorial Hermann Health Network All Yes No

59065 Memorial Integrated HC All Yes Yes

59064 Memorial Integrated Healthcare All Yes No

CALL

Memorial Integrated Healthcare (Please email Tracy

Harswick at [email protected] for payer ID

information.) All Yes No

IP080 Mendicina Familiar Medical Group CA Yes No

MNM99 Mennonite Mutual All Yes Yes

74289

Mental Health Network (Only claims for PO Box

209010 Austin TX 78720) All Yes Yes

37050 Mental Heath Consultants Inc All Yes Yes

CALL Mercy Care (Please call 608-758-7739 for payerID.) All Yes No

86052 Mercy Health Plan (AHCCCS) AZ Yes Yes

86052 Mercy Health Plan of AZ AZ Yes Yes

22326

Mercy Health Plan of New Jersey (Provider ID

Required in Box33a - Contact (800) 682-9091 to

obtain ID) All Yes Yes

MER11 Mercy Health Plans NULL Yes No

63002 MERCY LIFE ALABAMA All Yes No

33628 Mercy Maricopa Integrated Care All Yes No

43185 MERCY PROVIDER NETWORK All Yes No

39114 MERCYCARE All Yes No

13189 Meridian Health Plan All Yes Yes

65157 Meritain - Luminx All No Yes

64157 Meritain Health (North American Health Plan.) All Yes Yes

64158 Meritain Health / Agency Services All Yes No

41124 Meritain Health Minneapolis All Yes Yes

45150 Meritus Health All Yes No

16928 Metal Culverts All Yes Yes

65113 METCARE HEALTH PLANS All Yes No

95420 MethodistCare, Inc. All Yes No

13265 Metro Plus Health Plan All Yes Yes

10850 Metropolitan Health Plan All Yes Yes

38325 MI COMMUNITY CHOI All Yes No

82832 Miami Children's Health Plan All Yes Yes

MIBCN Michigan Blue Care HMO (BCN of Michigan) MI Yes No

MIFEP Michigan FEP MI Yes No

MIMPB Michigan Medicare PlusBlue MI Yes No

96598 Micron Tech All Yes No

52149 Mid Atlantic Psychiatric Services, Inc. (MAPSI) All Yes Yes

MVBCN MID VALLEY BEHAVIORAL HEALTH NETWORK All Yes No

37281 Mid-America Associates All Yes No

22823 Mid-American Benefits All Yes No

77012 MIDCOAST IPA All Yes No

23550 Midland Management/MFC All Yes No

90956 Midland National Life Ins Co (NFIC Plan only) All Yes No

47080 Midlands Choice NE,IA Yes Yes

47078 MIDLANDS CHOICE All Yes No

47080 Midlands Health Partners All Yes Yes

C1051 MIDWEST FAMILY MUTUAL INSURANCE COMPANY All Yes No

61146 Midwest Group Benefits All Yes No

76079 Midwest Health Partners All Yes No

MHP77 Midwest Health Plans, INC. All Yes No

59224

Mid-West National Life Insurance Co. of Tennessee

(ID valid only for following: PO Box 982017, North

Richland Hills, TX 76182) TN Yes Yes

TH088 MIDWEST PHYSICIAN ADMINISTRATIVE SERVICES All Yes No

66727 MIDWEST PHYSICIAN ADMINISTRATIVE SERVICES All Yes No

74227 Mid-West United Life (Student Division) All Yes Yes

MPMG1 Mills Penisula Medical Group CA Yes No

68241 Minneapolis Prudential Business MN Yes No

01776 MINUTEMAN All Yes No

PHM10 MISSION COMMUNITY IPA & PACIFIC HEALTH MSO All Yes No

MPM07 Mission Community IPA Med Grp CA Yes No

STJOE Mission Hospital Affiliates CA Yes Yes

SX105 Missionary Medical UT Yes Yes

64084 Mississippi Physicians Care Network All Yes Yes

64088

Mississippi Select Healthcare (Mississippi Select

Health Care) All Yes Yes

37275 Missoula County Medical Benefits MT No No

00530 MISSOURI CARE All Yes No

MMS01 MISSOURI MEDICARE SELECT All Yes No

26097 ML HEALTHCARE All Yes No

35316 MMA All Yes No

88600 MMM (Medicare y mucho mas) PR Yes No

PRMMM MMM Multihealth Government Health PR Yes Yes

13350 MODA Health - Formerly ODS Health Plan All Yes Yes

71079 MOLINA HC MISSOUR All Yes No

04423 Molina Healcare of New Mexico - SCI All Yes No

81793 Molina Health Reforma PR Yes No

77010 Molina Healthcare Mississippi MS Yes Yes

33373 MOLINA HEALTHCARE OF CA - ENCOUNTERS ONLY. CA Yes No

38333

Molina Healthcare of California (Rendering provider

must use Medi-Cal ID number or State License

Number. Billing provider should use Federal TaxID

only.) CA Yes No

51062 Molina Healthcare of Florida All Yes No

20934 Molina Healthcare of Illinois All Yes Yes

38334 Molina Healthcare of Michigan MI Yes No

20676 MOLINA HEALTHCARE OF NEVADA All Yes No

NM505 Molina Healthcare of New Mexico NM Yes No

09824 Molina Healthcare of New Mexico Salud NM Yes No

20149 Molina Healthcare of Ohio OH Yes Yes

46299 Molina Healthcare of South Carolina All Yes Yes

20554 Molina Healthcare of Texas TX Yes No

38336

Molina Healthcare of Washington (Rendering

providers use DSHS Medicaid ID or State Licence

Number.) WA Yes Yes

43174

MOLINA HEALTHCARE OF WASHINGTON

ENCOUNTERS ONLY All Yes No

SX109 Molina Healthcare Utah UT No No

12X09 MOLINA MEDICAID - MNS All No Yes

72135 Momentum Health Services All Yes No

IP095

Monarch Healthcare IPA (Rendering provider ID#

required on all claims.) All Yes Yes

50749 MONDIAL ASSISTANCE All Yes No

01759

Monitor Life (Payer accepts secondary claims only

and Medicare cannot be primary payer.) All Yes No

13174

Montefiore Contract Management Organization

(Provider ID required, call 914-377-4400 for ID prior

to first claims submissions.) All Yes No

MBIPA MONTEREY BAY IPA All Yes No

J1890

MONTGOMERY COUNTRY GOVERNMENT SELF INS

PROGRAM (MCSIP) All Yes No

46161 Montifore HMO All Yes Yes

MMLIC

Monumental Life Ins Co. (Specialized claims only.

Call 501-277-1284 for information.) All Yes Yes

MMLI6

MONUMENTAL LIFE INSURANCE COMPANY

BALTIMORE All Yes No

MMLI7



MMLI9 MONUMENTAL LIFE INSURANCE COMPANY PLANO All Yes No

MMLI5


SCRANTON All Yes No

MMLI4

MONUMENTAL LIFE INSURANCE COMPANY VALLEY

FORGE All Yes No

35092 Morris Associates aka HealthScope Benefits All Yes Yes

IP083

Mosaic IPA Medical Group (Providers please contact

Brandi Guinn @ 559-735-3892 x233 for

authorization.) CA Yes No

99282 MOTION PICTURE INDUSTRY All Yes No

MPI01 Motion Picture Industry Health Plan CA Yes No

COMMA Mountain Medical - MMA All Yes No

MTNST Mountain States Administrators (COLORADO ONLY) CO Yes No

80900 MPA - CUSTOM PROVIDER NETWORK All Yes No

37233 MPE Employee Benefit Services All Yes Yes

95444 MPLAN Inc. Healthcare Group All Yes Yes

MPM16 MPM Prospect All Yes No

26161 MRIPA Allcare CCO All Yes Yes

SB731 MS BCBS State Employees MS Yes No

20572 MSA CARE GUARD All Yes No

95655 Mt. Carmel All Yes No

86040 MTN STATES ADMINI All Yes No

45235 MultiPlan GEHA All Yes Yes

9048P MULTIPLAN INCORPORATED All Yes No

34080 Multiplan Wisconsin Preferred Provider Network All Yes Yes

MLTOT MULTNOMAH COUNTY All Yes No

81883 Municipal Health Benefits Fund All Yes No

A1681 Muskegon Care MI Yes No

37256 Mutual Assurance Administrators All Yes Yes

39065 Mutual Benefit All Yes Yes

39065 Mutual Benefit Life All Yes Yes

34192 Mutual Health Services All Yes Yes

71412 Mutual of Omaha Insurance Company All Yes No

71412 Mutually Preferred All Yes No

14165 MVP Health Plan of NY NY Yes No

MIDSC MWEST SECURITIES All Yes No

33020 MY FAMILY MEDICAL GROUP All Yes No

32043 MYNEXUS INCORPORATED All Yes No

91136

N.W. Ironworkers Health & Security Trust Fund -

Grp#F15 All Yes Yes

91136

N.W. Roofers & Employers Health & Security Trust

Fund - Grp#F14 All Yes Yes

91136 N.W. Textile Processors - Grp#F14 All Yes Yes

65085 NAA (North America Administrators) All Yes Yes

L0110 NAMCI Global Care All Yes No

NANPR NAMM Partners All Yes No

NHCA1 Naperville Health Care Associates All No No

58182 Naphcare Inc All Yes Yes

p0001 Nascentia Health NY Yes Yes

67788

NATIONAL ACCIDENT AND HEALTH GENERAL

AGENCY INCORPORATED All Yes No

CB148 National Allied WU Local 831 All Yes No

53011 National Association of Letter Carriers All Yes Yes

56175 National Benefit Administrators - New Jersey NJ Yes Yes

56176 National Benefits Administrators - North Carolina NC Yes Yes

NCABS National Capital Area DC,VA,MD Yes No

90001

National Capital Preferred Provider Organization

(NCPPO) (To obtain your provider ID number, please

call the NCPPO Customer Service Department at

(800) 272-5911 All Yes Yes

90956 National Financial Insurance Company All Yes No

98205 National Foundation Life Insurance Company All Yes No

ASHC1 NATIONAL GENERAL ACCIDENT HEALTH All Yes Yes

NHC01

NATIONAL HEALTCHARE CORPORATION

ADVANTAGE All Yes No

NHAIN National Health Administrators Inc. All Yes No

88057 National Health Benefit All Yes Yes

88050 National Health Benefits Corporation - NHBC02 All Yes Yes

NIA11 National Imaging Associates All No Yes

52132 National Rural Electric All Yes Yes

NTA11 National Teachers Association (NTA) All Yes No

52103

National Telecommunications Cooperative

Association (NTCA) All Yes Yes

52104

National Tellecommunications Cooperative

Association (NTCS Staff) All Yes Yes

NVADM NATIONAL VISION All Yes No

31417 Nationwide Group All Yes No

31112 Nationwide Health Plans - HMO, PPO, POS All Yes No

31417 Nationwide Insurance All Yes No

31417 Nationwide Life and Health All Yes No

31417 Nationwide Mutual Insurance All Yes No

31417

Nationwide Specialty Health (Formerly Nationwide

Health Plans All Yes No

19191 NATIVE CARE HEALTH All Yes Yes

75191 NCAS - Charlotte, VA VA Yes Yes

75190 NCAS - Fairfax, VA VA Yes Yes

19988 NEA GROUP INSURAN All Yes No

51909 Neighborhood Doctors Organization All Yes No

95123 Neighborhood Health Partnership (NHP) All Yes Yes

96107 Neighborhood Health Partnership (NHP) All Yes No

05047

Neighborhood Health Plan of Rhode Island (Contact

NHPRI 401-459-6030 to verify provider and vendor

number.) RI Yes Yes

96240 Neighborhood Health Plan of RI - Integrity RI Yes Yes

11325 Neighborhood Health Providers ALL but FL Yes Yes

96240

Neighborhood Health RI Exchange, Unity, Integrity

Plans RI Yes Yes

37255 Nesika Health Group All Yes No

66055 Netcare Life and Health Insurance All Yes Yes

04332

Network Health (Before initiating submissions,

please call Provider Relations at (617)806-8104 or

www.network-health.org for an EDI startup plan.) All Yes Yes

77076 Network Health Insurance Corp - Medicare All Yes No

04332 Network Health Massachusetts All Yes Yes

39144

Network Health Plan of Wisconsin, Inc.(Prior to

initial claims submission, please contact Network

Health Plan EDI specialist at 920-720-1506.) All Yes Yes

AMS01 Network Health PPO All Yes No

NSIPA NETWORK SOLUTIONS IPA All Yes No

90091 Nevada Health Coop All Yes Yes

86067 Nevada Health Solutions (Provider ID Required) NV Yes No

86067 NevadaCare (Provider ID Required) NV Yes No

86067 NevadaCare Kids (Provider ID Required) NV Yes No

95998 New Avenues Inc. All Yes No

NCH09 New Century Health - Vista Cardiology All Yes No

NCHOR New Century Health Arizona Integrated Physicians All Yes No

NCHCA NEW CENTURY HEALTH CENTERS All Yes No

NCH03 NEW CENTURY HEALTH UROLOGY All Yes No

66893 New England, The All Yes No

66893 New England, The All Yes No

75281 New ERA Life All Yes Yes

76031 NEW ERA WELFARE BENEFIT PLAN TRUST All Yes No

68069 New Hampshire Healthy Family NH Yes Yes

65056 New Market Dimensions All Yes No

74234 New Mexico District Council of Carpenters NM Yes No

45129 New Mexico Health Connections All Yes Yes

74234 New Mexico Painters and Allied Trades Local No 823 UT Yes No

85036

NEW MEXICO PUBLIC SCHOOLS INSURANCE

AUTHORITY All Yes No

74234

New Mexico-West Texas Multi-Craft (lso known as

New Mexico Laborers) UT Yes No

84141 New West Health Plan MT Yes No

NYL11 New York Life - Long Term Care All Yes Yes

14179 New York Medical Imaging-MVP NY Yes Yes

11334 New York Network Management All Yes No

ADSL1 Nexcaliber All Yes No

69821 Next Level Health All Yes Yes

38225 NGS American, Inc. All Yes No

81264 Nippon Life Insurance Company All Yes No

22603 NJ Carpenters Health Fund NJ Yes Yes

NMPPO NM BLUE MCARE PPO All Yes No

IP080 Noble Community CA Yes No

64157 North American Administrators, Inc. All Yes Yes

34159 North American Benefits Network (NABN) All Yes Yes

76112 NORTH AMERICAN INSURANCE COMPANY All Yes No

IP079

North American Medical Management (Provider

number must be in box 33a) All Yes No

37314 North Broward Hospital District FL Yes No

78353 NORTH IOWA COMMUNITY HEALTHCARE (NICH) All Yes No

46227 North Shore - LIJ CareConnect Insurance Company All Yes Yes

17516 North Shore - LU MLTCP All Yes Yes

36392 North Suburban Associated Physicians All Yes No

35212 North Texas Healthcare Network All Yes No

PH018 North West Life All Yes No

58169 NORTHEAST GEORGIA HEALTH SERVICES All Yes No

72690 NORTHEAST IOWA AREA AGENCY All Yes No

SISCO Northeast Iowa Community Health Plan All Yes Yes

NCA01

NORTHERN CALIFORNIA ADVANTAGE MEDICAL

GROUP All Yes No

J1923 NORTHERN CLAIMS MANAGEMENT All Yes No

36347 Northern Illinois Health Plan IL Yes Yes

88027

Northern Nevada Trust Funds (Call 775-826-7200

prior to submitting claims.) NV Yes Yes

NMG01 Northridge Medical Group All Yes No

48026 NorthShore Physicians Associates All Yes No

60058 NORTHSTAR ADVANTAGE All Yes No

52627 Northstar Advantage (MHP) NULL Yes No

NANWC Northwest Community Health Partners IL No Yes

NWDC1 Northwest Diagnostic Clinic NULL Yes No

NPN11 Northwest Physicians Network NULL Yes Yes

36346 Northwest Suburban IPA (IL) IL Yes No

PH018 Northwestern National Life All Yes No

16114 Nova Casualty Company All Yes Yes

16644

Nova Healthcare Administrators, Inc. (Grand Island,

NY) All Yes No

71080 NOVASYS Health Network All Yes Yes

37120 NTL IA Yes No

62119 NW Diagnostic Clinic SelectCare of TX (NWDC) All Yes No

N2FEP

NY Central FEP (Federal Employee Program) Blue

Shield NY Yes No

24819 NY PRESBYTERIAN S All Yes No

37299 Nyhart All Yes Yes

14142 NYS DOH UCP NY Yes No

OAKST OAK STREET HEALTH All Yes No

36400 Oak West Physician Association All Yes Yes

36402

Oak West Primary Physician Association (Claims

after 6.01.2015) All Yes Yes

NAOAK

Oak West Primary Physician Association (Claims

prior to 6.01.2015) IL Yes Yes

OCFMC OC FOUNDATION MED All Yes No

L0140 Occular Benefits All Yes No

50653

OCCUPATIONAL EYEWEAR NETWORK

INCORPORATED All Yes No

72127 Ochsner Health Plan All Yes No

OBA18 OGDEN BENEFITS ADMINISTRATION All Yes No

31147 OH WORKERS COMP All Yes No

34189 Ohio Health Choice PPO OH Yes No

74431 Ohio PPO Connect All Yes Yes

OKSSI OK CAID SSI GROUP OK Yes No

OLRMC OLOLRMC Uninsured Patient Services Program LA Yes No

91150 Olympic Health Management Systems, Inc. All Yes No

65074 Olympus Management Healthcare All Yes No

25150

OmniCare (For claims with Dates of Service after

10/01/04) All Yes No

OMN02 Omnicare IPA All Yes No

IP088 OMNICARE MEDICAL GROUP All Yes No

99485 ON LOK SENIOR HEALTH SERVICES INCORPORATED All Yes No

ONOCI Oncology Network of Orange County All Yes No

22321 One Call Medical All Yes No

80705 One Health Plan Inc. All Yes Yes

80705 One Health Plan Michigan, Inc. MI Yes Yes

80705 One Health Plan New York, Inc. NY Yes Yes

80705 One Health Plan of Alaska AK Yes Yes

80705 One Health Plan of Arizona, Inc. AZ Yes Yes

95379 One Health Plan of California CA Yes No

95412 One Health Plan of Colorado CO Yes No

80705 One Health Plan of DC Inc, DC Yes Yes

80705 One Health Plan of Florida FL Yes Yes

95569 One Health Plan of Georgia GA Yes No

95388 One Health Plan of Illinois IL Yes No

80705 One Health Plan of Indiana, Inc. IN Yes Yes

80705 One Health Plan of Kansas and Missouri KS,MS Yes Yes

80705 One Health Plan of Maine, Inc. ME Yes Yes

80705 One Health Plan of Massachusetts, Inc. MA Yes Yes

80705 One Health Plan of Minnesota, Inc. MN Yes Yes

80705 One Health Plan of Nevada, Inc. NV Yes Yes

80705 One Health Plan of New Jersey NJ Yes Yes

80705 One Health Plan of North Carolina NC Yes Yes

80705 One Health Plan of Ohio OH Yes Yes

80705 One Health Plan of Pennsylvania PA Yes Yes

80705 One Health Plan of South Carolina SC Yes Yes

80705 One Health Plan of Tennessee TN Yes Yes

80705 One Health Plan of Texas TX Yes Yes

80705 One Health Plan of Virginia, Inc. VA Yes Yes

80705 One Health Plan of Washington WA Yes Yes

80705 One Health Plan of Wisconsin, Inc. WI Yes Yes

80705 One Health Plan of Wyoming WY Yes Yes

ONEHC ONE HOMECARE SOLUTIONS All Yes No

52149

OneNet PPO, LLC. (Formerly known as Alliance PPO,

Inc.) MD Yes Yes

BPA01 OPEIU Locals 30 & 537 All Yes No

66771

OPERATING ENGINEERS LOCAL 139 HEALTH BENEFIT

FUND All Yes Yes

74234 Operating Engineers Local No 53 UT Yes No

91136

Operating Engineers Locals 302 & 612 Health &

Security Fund - Grp#F12 All Yes Yes

56190 Opticare Eye Health Network All Yes No

OPCAU Opticare of Utah All Yes No

54154 Optima Insurance Company All Yes Yes

52152 Optimum Choice of the Carolina's (MAMSI) NC,SC Yes No

87726

Optimum Choice, Inc. (OCI) (Previously Payer ID

52148) All Yes Yes

20133 Optimum Healthcare, Inc. All Yes No

U6885 OPTUM BEHAVIORAL HEALTH SLCO All Yes No

41161

Optum Health - Physical Health (Includes Oxford)

(OptumHealth) All Yes Yes

87726 OptumHealth Behavior Solutions All Yes Yes

87726

OptumHealth Behavioral Solutions of NM

(OptumHealth) NM Yes Yes

41194 OptumHealth Care Solutions (Formerly U.R.N.) All Yes Yes

41194

OptumHealth Care Solutions (Formerly United

Resources Networks)(OptumHealth) All Yes Yes

87726 OptumHealth New Mexico NM Yes Yes

00773 OptumHealth Vision All Yes No

MHIPA Orange Coast Memorial IPA CA Yes No

65021 ORANGE COUNTY HEALTHCARE AGENCY All Yes No

OHMS OREGON HEALTH MANAGEMENT SERVICES (OHMS) All Yes No

OHMSP

Oregon Health Mgmt OHMS aka Primary Health of

Josephine All Yes No

45332 Oregons Health CO-OP OR Yes Yes

21455

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

PAYERID 45332) All Yes No

13383 Orthonet - AETNA All Yes No

13381 Orthonet Corporation All Yes No

25681 Orthonet-HealthNet All No No

OSCAR Oscar Health All Yes No

OSFMC OSF CARE ADVANTAGE All Yes No

62171 OSF HEALTH PLAN All Yes No

61101 OSF Health Plans IL Yes No

OSFE9 OSF HEALTHCARE EAST All Yes No

37127 OSG-Michael Reese IL Yes Yes

J1904 OSI GROUP LLC All Yes No

73071 OSMA HEALTH CL FRATES All Yes No

EPF06 Outsourcing Program NULL Yes No

06111 Oxford (UnitedHealthcare/Oxford) All Yes Yes

06111 Oxford Health Plans All Yes Yes

58375 P3 Health Partners- Arizona All Yes Yes

59379 P3 Health Partners- Nevada All Yes Yes

87068 P5 Health Plan Solutions of Utah All Yes Yes

15460 PA Care Advantage Highmark Senior Health PA Yes Yes

CALL

PA Preferred Health (Call PPHN Claims Operations at

410-349-3222) All Yes No

72436 PACE CENTRAL IOWA All Yes No

70454 PACE CNY All Yes No

35416 PACE NEBRASKA All Yes No

45114 PACE OF SOUTHWEST MICHIGAN INCORPORATED All Yes No

86711 PACE SOUTHEAST MICHIGAN All Yes No

53534 PACE SOUTHWEST IOWA All Yes No

99486 PACEPARTNER SOLUTIONS All Yes No

J1913 PACIFIC COMPENSATION INSURANCE COMPANY All Yes No

J1916 PACIFIC GAS AND ELECTRIC 115 All Yes No

75309 PACIFIC SOUTHWEST ADMININSTRATORS (PSWA) All Yes No

33053 PACIFICARE BEHAV All Yes No

81400

PacifiCare Individual Business Plan

(UnitedHealthOne) All Yes Yes

95958 PacifiCare of CA Encounters CA Yes Yes

95958 PacifiCare of OK Encounters OK Yes Yes

95958 PacifiCare of OR Encounters OR Yes Yes

95958 PacifiCare of TX Encounters TX Yes Yes

95958 PacifiCare of WA Encounters WA Yes Yes

95999 PacifiCare PPO All Yes Yes

20416 PACIFICSOURCE COMMUNITY SOLUTIONS All Yes No

93029 PacificSource Health Plans All Yes Yes

20377 Pacificsource Medicare All Yes No

COIHS Pacificsource OHP All Yes No

81240 Palic / Pan-American Health PR Yes No

37268

Palladian Muscular Skeletal Health (Formerly Prism

Health Networks) All Yes No

38520

Palmetto Tricare (Regions 1-6) Northern and

Southern Region Various Yes No

IP132 PALO ALTO MEDICAL FOUNDATION All Yes No

94115 PALO ALTO MEDICAL FOUNDATION All Yes No

04218 Pan American Life Insurance All Yes Yes

PAPER PAPER CLAIMS All Yes Yes

PRINT Paper Claims All Yes Yes

58174 PARAGON BENEFITS All Yes No

SX158 Paramount Health All Yes Yes

58204 Parity Healthcare, Inc. All Yes Yes

66917 Parkland Community Health Plan All Yes Yes

14966 Partners Health Plan All Yes Yes

PARTH PARTNERS IN HEALTH All Yes No

56152 PARTNERS NAT HPNC All Yes No

PHP02

PARTNERSHIP HEALTH PLAN (OPTUMINSIGHT FOR

ENROLL FORMS) CA Yes No

IP080 Pasadena Primary Care Physicians CA Yes No

97652 Passport Advantage All Yes Yes

66008 Passport Advantage (After 7/1/18) ALL Yes No

61129 Passport Health Plan All Yes No

61325 Passport Health Plan ALL Yes Yes

76569 PASSPORTADVANTAGE All Yes No

PAN01 PATIENT ACCESS All Yes No

55489 Patient Advocates LLC All Yes Yes

10525 Patient Advocates, LLC - Dental All Yes No

CB733 Patient Services Inc. All Yes No

26335 PATIENTPAY All Yes No

20907 PAUL MUELLER All Yes No

26048 PAYER FUSION All Yes No

27048 Payer Fusion All Yes Yes

25449 PBS OREGON ALASKA INDUSTRIAL HARDWARE All Yes No

27267 PBS OREGON ALASKA RUBBER AND SUPPLY All Yes No

27277 PBS OREGON CASCADE RUBBER PRODUCTS All Yes No

26224

PBS OREGON CONSTRUCTION MACHINERY

INDUSTRIAL All Yes No

73624 PBS OREGON PENINSULA AIRWAYS All Yes No

83926 PBS OREGON TDX CORPORATION All Yes No

95885 PCA HEALTHPLANS TEXAS All Yes No

68050 Peach State Health Plan (Behavioral Health) GA No Yes

68069 Peach State Health Plan (Behavioral Health) GA Yes Yes

68069

Peach State Health Plan (Medicaid) (Call 800-225-

2573 ext 25525 prior to submitting claims.) (Also

39187) GA Yes Yes

68049 Peach State HP All Yes No

27034 PEAK PACE SOLUTIONS All Yes No

20472 Pediatric Associates of Broward All Yes No

M3FL8 Pedicare Title 19 NULL Yes Yes

M3FL6 Pedicare Title 21 NULL Yes No

PEF01 PEF CLINIC All Yes No

J1924 PEGASUS RISK MANAGEMENT CALIFORNIA All Yes No

CALL PEHP - Utah Public Employee Health Plan UT Yes No

SX106

PEHP - Utah Public Employee Health Plan

(Enrollment required, please contact Provider

Relations 800-765-7347) UT Yes Yes

UH136 PEHP CHIROHLTHPLA All Yes No

37086 PEKIN INSURANCE All Yes No

00923 Peninsula Healthcare VA Yes Yes

53226 PENN BEHAVIORAL HEALTH All Yes Yes

95056

Pennsylvania Keystone Health Plan East (claims

only) PA Yes Yes

PCBLS

PENNSYLVANIA KEYSTONE HEALTH PLAN EAST

(CLAIMS ONLY) PA Yes No

95056

Pennsylvania Keystone Health Plan East (encounters

only) PA Yes Yes

PEBLS

PENNSYLVANIA KEYSTONE HEALTH PLAN EAST

(ENCOUNTERS ONLY) PA Yes No

23130 Pennsylvania Life Insurance PA Yes Yes

20172 Pennsylvania Pace All Yes No

06161

PENNSYLVANIA PREFERRED HEALTH NETWORK

(PPHN) All Yes No

72126

Peoples Health Network (Tenet) (Network ID must

be on claim. Contact

[email protected]) LA Yes Yes

54704

Personal Choice PPO of Pennsylvania (Also know as

Independent BLC) PA Yes Yes

95397 Personal Insurance Administrators All Yes Yes

25146 PERSONALCARE All Yes No

45275 PHCS GEHA All Yes Yes

13306 PHCS Savility (ONLY for Savility card members.) All Yes Yes

PHIF4 PHIFER WIRE INS All Yes No

67814 Phoenix American Life All Yes No

75238 PHOENIX GROUP SER All Yes No

03440 Phoenix Health Plan AZ Yes Yes

22729 PHOENIX HEALTH PLAN (MEDICARE) All Yes No

67814 Phoenix Home Life All Yes No

67814 Phoenix Home Life Mutual Ins. Co. All Yes No

67814 Phoenix Mutual All Yes No

PHYCR Phycor (Ft Collins office only) CO Yes No

EXC01 PHYS MED GROUP OF SAN JOSE All Yes No

PA513 Physician Associates of Greater San Gabriel Valley CA Yes No

58204 Physician Associates of Lousiana (PAL) LA Yes Yes

57549 PHYSICIAN HEALTH COOPERATIVE/SRRIPA All Yes No

PHPMC Physician Health Partners CO Yes Yes

PHPMD Physician Health Partners Medicare All Yes Yes

PPRT1 Physician Partners IPA All Yes No

28943 PHYSICIANS ACCOUNTABLE CARE ORGANIZATION All Yes No

38265 Physicians Care Network All Yes Yes

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. IL Yes Yes

PCN12 Physicians Care Network/The Polyclinic All Yes No

MCI01 Physicians Choice Medical Santa Maria All Yes No

SLOS1 Physicians Choice Medical SLO All Yes No

65018

Physicians Corporation of America (Florida Plan

Only) FL Yes No

37136 Physicians Health Association of Illinois IL Yes No

PHCS1

Physicians Health Choice - Claims (Administered by

Wellmed) All Yes Yes

PHCEN

Physicians Health Choice - Encounters (Administered

by Wellmed) All Yes No

20398 Physicians Health Collaborative All Yes No

MHCM2 Physicians Health Network All Yes No

37330 Physicians Health Plan (PHP) Mid-Michigan All Yes Yes

09173 Physicians Health Plan (PHP-SC) All Yes No

12399 Physicians Health Plan of Northern Indiana IN Yes Yes

06108

Physicians Health Services (now Health Net of NE)

(Health Net six digit ID REQUIRED in B0X33a; call

866-334-4638) All Yes Yes

PHIPA Physicians Healthways IPA CA Yes No

PMGSC Physicians Medical of Santa Cruz CA Yes No

47027 Physicians Mutual Insurance Company All Yes Yes

91171 Physicians of Southwest Washington All Yes No

39156 Physicians Plus Insurance Corp. All Yes Yes

TH131 PHYSICIANS UNITED PLAN All Yes No

95397 PIA All Yes Yes

87056 PIASC All Yes No

251PD Piedmond WellStar Health Plan All Yes No

56151 Piedmont Administrators All Yes Yes

06607 Piedmont Behavioral Health All Yes No

PMA86 PIMA HEALTH SYSTE All Yes No

24735 Pinnacle Claims Management All Yes Yes

45985

PINNACLE PHYSICIAN MANAGEMENT

ORGANIZATION All Yes No

CCIA1 Pinnacol Assurance CO Yes Yes

PPNZZ Pioneer Provider Network CA Yes No

COMPU Pipe Industry Health & Welfare Fund of Colorado CO Yes No

59700 PIPEFITTERS L 597 All Yes No

37224 Pittman and Associates All Yes Yes

23283 Pittsburgh Care Partnership All Yes No

37287 Planned Administrators, Inc. (PAI) All Yes Yes

CLFRS PLICO All Yes No

PMGSJ PMG of San Jose CA Yes No

POD1S Podiatry First NULL Yes No

PDFST Podiatry First All Yes No

POD1ST Podiatry First Inc NULL Yes No

59324 Podiatry Network FL FL Yes Yes

PCU01 POINT COMFORT UNDERWRITERS All Yes No

PCU02 POINT COMFORT UNDERWRITERS All Yes No

32680 Poly America Medical & Dental Benefit Plan All Yes No

16111 POMCO All Yes Yes

IP057 Pomona Valley Medical Group (PVMG) ProMed CA Yes No

73159

PPO Oklahoma (WinterBrook HealthCare

Management) OK Yes Yes

UHNDC PPO ONE All Yes No

59333 PPO Plus NULL Yes No

72148 PPO Plus, LLC All Yes Yes

A0009 PPOM LLC All Yes No

PPOM1 PPOM LLC All Yes No

36332 PPONEXT All Yes No

04334 PRACTICARE All Yes No

36373 Prairie States Enterprises, Inc. All Yes No

TCC13 PRE MED DEFENDER All Yes No

EPF10

Preferred Administrator (Contact Provider Relations

@ (915)532-2778, x1068) TX Yes Yes

EPF11 PREFERRED ADMINISTRATORS CHILDRENS HOSPITAL All Yes No

53476 Preferred Benefit Administrators All Yes No

SC481 Preferred Blue SC SC Yes Yes

SX089 Preferred Care NY NY Yes Yes

CALL

Preferred Care Partners (Encounters from delegated

entities only. To get payerID, call Jeff Nehms at 305-

670-8440.) FL Yes No

65088 Preferred Care Partners (Miami,Florida) FL Yes Yes

73145 Preferred Community Choice All Yes Yes

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. PA Yes No

33898 PREFERRED HEALTH CARE (PHC) All Yes No

PMP01 Preferred Health Plan All No Yes

61106 Preferred Health Plan (Louisville, KY) KY Yes Yes

CB404 PREFERRED HEALTH PLAN OF CAROLINAS (PHPC) All Yes No

31478 Preferred Health Professionals All Yes Yes

00036 Preferred Health Professionals Kansas City KS,MO Yes No

61665 Preferred Health Systems Insurance Co (PPO) All Yes Yes

60110 Preferred Health Systems, Inc. All Yes Yes

PFIPA Preferred IPA All Yes No

L0250 Preferred Medicare All Yes No

36401 Preferred Network Access All Yes Yes

41147 Preferred One All Yes Yes

00430 Premera WA Yes Yes

PCI01 Premier Care IPA All Yes No

PCL01 PREMIER CARE IPA All Yes No

65054 Premier Eye Care All Yes No

43166 PREMIER HEALTH PL All Yes No

251PR PREMIER HEALTH PLAN All Yes Yes

90440 Premier Health Systems, Inc. All Yes No

88051 Premier Healthcare Exchange All Yes Yes

88056 Premier HealthCare Exchange (Cypress) All Yes Yes

CAPMN Premier Physicians Network All No No

MPM22 PREMIER PHYSICIANS NETWORK All Yes No

PREHP

Presbyterian Health Plan (Commercial) (Provider ID

is required. Contact (888) 923-5757, #6 then #2 to

obtain ID. New Mexico Providers only.) NM Yes Yes

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.) NM Yes Yes

05003 Presbyterian(NM) NM Yes Yes

46311 Presence ERC All Yes Yes

77003 PRESTIGE HEALTH CHOICE All Yes Yes

45056 Prestige Health Choice All Yes No

39185 Prevea Health Insurance Plan / Arise Health Plan All Yes Yes

PCACZ

Primary Care Assoc of California (Customer Service

Phone Number 877-602-1563) CA Yes No

PCJOL PRIMARY CARE OF JOLIET All Yes No

PCSNCHD PRIMARY CARE SERVICES NCHD All Yes No

60054 Primary Choice (Aetna HP-NY/NJ) NY,NJ Yes Yes

73288 Primary Delivery Systems All Yes No

82048 Primary Health Network All Yes Yes

PRIME Primary Health Plan All Yes Yes

56144 Primary PhysicianCare, Inc. All Yes Yes

E3510 Prime Care All Yes No

MVCV1 PRIME COMMUNITY CARE CENTRAL VALLEY All Yes No

61604 Prime West Health Plan MN Yes Yes

IP079 PrimeCare Health Plan CA Yes No

04320 PrimeSource Health Network All Yes Yes

J1891

PRINCE GEORGES COUNTY GOVERNMENT

MARYLAND All Yes No

PRI01 Princeton Premier IPA NULL Yes No

61271 Principal Financial Group All Yes No

61271 Principal Mutual Life Insurance Company All Yes No

38217

Priority Health (Please contact Priority Health EDI

Dept at 616-464-8686 or email EDISETUP@Priority-

Health.com) All Yes Yes

00923 Priority Healthcare VA Yes Yes

37268

Prism Health Networks (Now known as Palladian

Muscular Skeletal Health ) All Yes No

37315 Prism Univera All Yes No

PRNLK PRNLINK MLK All Yes No

38329

Pro Care Health Plan, Inc. (Valid for PO Box 3160

and 3590, Detroit MI only.) MI No Yes

70259 ProCare Health Plan Medicaid All Yes Yes

PEBSI Producer's Exchange All Yes No

13396 Productive Processing All Yes No

36331

Professional Benefit Administrators, Inc. (Oak Brook,

IL) IL Yes Yes

59296

Professional Benefits Administrators (Winter Park,

FL) FL Yes Yes

37242 Professional Claims Management All Yes Yes

56001 Professional Claims Management All Yes No

J1821 PROFESSIONAL CLAIMS MANAGEMENT All Yes No

34134 Professional Risk Management, Inc. All No Yes

WK476 PROGRESSIVE INSURANCE All Yes No

pROGY PROGYNY All Yes Yes

58226 Promina All Yes No

93082 Prominence Health Plan of Nevada All Yes Yes

80095 Prominence Health Plan of Texas All Yes Yes

88082

PROMINENCE-ST. MARY'S HEALTH PLAN

ENCOUNTERS All Yes No

PROSP Prospect Medical Group CA Yes No

37309 Protective Life Insurance Company All Yes No

SX187 PROVIDENCE All Yes No

PHP01 Providence Choice Option All No No

PHP01 Providence Good Health Plan All No No

PAS01

PROVIDENCE INSURANCE AND ADMINISTRATIVE

SERVICES All Yes No

SX133 PROVIDENCE OF OREGON HEALTH PLAN All Yes No

PHP00

Providence Preferred (PPO) (ProviderID and

Enrollment required.) All Yes No

68195 Provident Life & Accident Insurance Company All Yes Yes

68195

Provident Life & Accident Insurance Company of

America All Yes Yes

68195 Provident Life & Casualty Insurance Company All Yes Yes

48100 ProviDRs Care Network All Yes Yes

68241 PruCare All Yes No

HM015 PruCare HMO (Encounters Only) All Yes No

68241 Prucare Plus All Yes No

MPM25 PRUDENT MEDICAL GROUP All Yes No

68241 Prudential All Yes No

HM015 Prudential Encounters All Yes No

68241 Prudential Health Care Systems All Yes No

PH001 PRUITT HEALTH PREMIER All Yes No

68241 PruNetwork All Yes No

PSKW0 PSKW All Yes No

09822 PSN FL Medicaid JMH All Yes Yes

51052 Psychcare, LLC All Yes Yes

J1897 PUBLIX SUPER MARKETS INCORPORATED All Yes No

CALL Puerto Rico Triple S (BCBS) PR Yes No

91136 Puget Sound Benefits Trust - Grp#F25 WA Yes Yes

91136 Puget Sound Electrical Workers Trust - Grp#33 WA Yes Yes

44827 QUAD CITIES COMMUNITY HEALTH PLAN All Yes No

40437 QUAD CITY COMMUNITY HEALTHCARE (QCCH) All Yes No

39197 QuadMed (West Allis, WI) All No Yes

35172 QUAL CHOICE NC All Yes No

35174 Qual Choice of Arkansas AR Yes Yes

01250 Qual Choice of Ohio OH Yes No

QMDCE QUAL MEDICAL COLORADO All Yes No

QUANM QUAL MEDICAL NEW MEXICO All Yes No

QMDPO QUAL MEDICAL PORTLAND All Yes No

23342 Qualcare All Yes No

22312 QUALCARE ALLIANCE NETWORKS INC. (QANI) All Yes No

89461 Quality Care Partners All Yes Yes

88622 QUALITY HEALTH PLANS OF NEW YORK ALL Yes Yes

QHPNY Quality Health Plans of NY NY Yes No

QCTPA QuantumCare (We Care Health Plan) All Yes No

QUARTZASO

QUARTZ ADMINISTRATIVE SERVICES ORGANIZATION

(ASO) All Yes No

84562 Questcare Medical All Yes No

73067 Quicktrip Corporation All Yes Yes

57117 QVI Risk Solutions, Inc. All Yes No

CALL

Radcon, Inc. (Please contact Kathy King @ 856-608-

1350 for Payer ID information.) All Yes No

RCHN1 RADY CHILDRENS HEALTH NETWORK All Yes No

RRMCR Railroad Medicare All Yes No

J1894 RAM MUTUAL INSURANCE COMPANY All Yes No

RPAWC RAVENSWOOD PHYSICIAN ASSOCIATES All Yes No

91176 RBMS, LLC All Yes Yes

SYMED Redlands IPA (Synermed) All Yes No

REGAL Regal Medical Group All Yes No

00932 Regence Blue Shield of Washington WA Yes Yes

RGA01 REGENCE GROUP ADMINISTRATORS All Yes Yes

38221 REGENCY EMPLOYEE BENEFITS All Yes No

47076 Regional Care, Inc. All Yes Yes

REHNA Rehn and Associates All Yes No

PH018 RELIASTAR (Formerly NWNL) All Yes No

76066 Renaissance Physicians Organization All Yes Yes

RENRO Renaissance Riveroaks NULL Yes No

RENRB Renaissance Riveroaks Blue NULL Yes No

73066

Reserve National Insurance (For Claims rejections,

please contact Reserve national Customer Service at

(405)848-7931.) All Yes No

20481

Resolve Health Plan Administrators (Authorization

number required: begins with the number 5 and is

13 characters in length.) All Yes Yes

RHA01 RESOLVE HEALTH PLAN ADMINISTRATORS LLC All Yes No

58200 ResourrceOne Administrators All Yes Yes

RPPG1 Resurrection Physician Provider Group All Yes Yes

26316 RETIREE HEALTH TRUST All Yes No

A0010 REVCLAIMS LLC All Yes No

74205 Right Care from Scott & White All Yes Yes

37331 RightChoice Benefits Administrators All Yes Yes

RCMG1 RIVER CITY MEDICAL GROUP CA Yes No

42172 Riverlink Health All Yes Yes

MPM08 Riverside Family Health Med Grp IPA CA Yes No

45281 Riverside Health Inc All Yes No

RMC01 RIVERSIDE MEDICAL CLINIC All Yes No

RMSCO RMSCO NY Yes No

SX141 Rocky Mountain Health Plan Grand Junction CO Yes No

RMHMO Rocky Mountain HMO CO Yes No

37602 Rooney Life Ins. All Yes Yes

46166

Royal Health on Behalf of Extended Care MLTC (For

claims with service dates/statement dates after

12/1/2013.) All Yes Yes

36389 Rush Prudential Health Plans (HMO Only) All Yes No

68241 Rush Prudential Insurance Co. (PPO & POS Only) All Yes No

31441 S & S Healthcare Strategies All Yes Yes

SFG99 SafeGuard All Yes No

35164 Sagamore Health Network, Inc. All Yes Yes

MNDH1 Sage All Yes No

MNDH1 Sage Plus All Yes No

37137 Sage Technologies - PBS All Yes No

37105

Sage Technologies (Formerly CCMSI) (Claims for

payer address of Rockford, IL ONLY.) All Yes Yes

STA01 Saint Anthony PHO All Yes No

88029 Saint Marys Health Plan All Yes No

SAMAD Samaritan Advantage All No No

SAMCP Samaritan Choice Plan All No No

SAM00 SAMARITAN COMMERCIAL PLAN All Yes No

SAMHK Samaritan Health Kids Connect All No No

CP001 SAMARITAN HEALTH PLANS All Yes No

SAMSE Samaritan Select All No No

MSO77

San Diego County Low Income Health

Program/Coverage Initiative CA Yes No

MSO11 San Diego County Medical Services (CMS) CA Yes No

MSO22 San Diego County Physician Emergency Services CA No No

MSO44 San Diego County Primary Care Services CA Yes Yes

MSO33 San Diego County Ryan White Primary Care Program CA Yes Yes

MSO55 SAN DIEGO COUNTY SHERIFFS DEPARTMENT CA Yes No

96400 San Diego PACE All Yes No

SFHP1 San Francisco Health Plan All Yes Yes

J1886

SAN FRANCISCO MUNICIPAL TRANSPORTATION

AGENCY All Yes No

33072 San Luis Obispo Select IPA All Yes No

SHC30 Sandhills Center All Yes No

SHC303 SANDHILLS CENTER All Yes No

68241 Sandia Triple Option Plan (Sandia TOP) All Yes No

91184 Sanford Health Plan All No No

MNSHP Sanford Health Plan All Yes Yes

SCACO Santa Clara County IPA All Yes No

24077 Santa Clara Family Health Plans CA Yes Yes

SNTMC

SANTE COMMUNITY PHYSICIANS MEDICAL GROUP

CORP All Yes No

77038 Sante Health Systems All Yes No

63665 Sanus HMO-St. Louis (General America) All Yes No

63665 Sanus PPO (General America) All Yes No

45552 Satellite Health Plan MA Yes Yes

SC922 SC BCBS Companion Health SC Yes Yes

SC886 SC BCBS Planned Administrators SC Yes Yes

SC400 SC BCBS State Employee Health Plan SC Yes Yes

SC402 SC FEP Blue Cross SC Yes Yes

SCAN1 Scan CA CA Yes No

99157 SCAN Encounters (Diversified Data Design (DDD)) All Yes Yes

72261 SCAN Health Plan All Yes No

73172 Scan Health Plan Arizona AZ Yes Yes

20460 SCAN Long Term Care All Yes Yes

SCH01 Schaller Anderson CHOC Health Alliance All Yes No

16146 SCHC Total Care NY Yes Yes

88030 Scott & White Health Care TX Yes Yes

99289 Screen Actors Guild All Yes No

SHPM1

SCRIPPS HEALTH PLAN MANAGEMENT SERVICES

ORGANIZATION All Yes No

SHPS1 Scripps Health Plan Services All Yes No

46187 Seaside Health Plan (Starting with DOS 9/1/2013) CA Yes No

SVIPA Seaview IPA All Yes No

28530 Secure Health of Georgia GA Yes Yes

42142 SecureCare of Iowa IA Yes No

87726

SecureHorizons MedicareComplete (SecureHorizons

by UnitedHealthcare) All Yes Yes

87726

SecureHorizons MedicareDirect (SecureHorixons by

UnitedHealthcare) All Yes Yes

39045 Security Health Plan All Yes Yes

TP097 SEDGWICK All Yes No

77024 SEECHANGE All Yes No

35098 SEECHANGE HEALTH INSURANCE All Yes No

SCHP1 SeeChange HealthPlan All Yes No

20618 SEIU LOCAL 1 CLEVELAND WELFARE FUND All Yes No

42137

Select Benefit Administrators (PayerID valid for

claims submission address of PO Box 8339, Des

Moines, IA 50301) IA Yes No

37282 Select Benefit Administrators of America All Yes Yes

93031 Select Benefit Administrators, Inc. All Yes No

60054 Select Choice All Yes Yes

23285

Select Health of South Carolina (Provider ID required

in Box33a.) SC Yes No

SSC11 SELECT SENIOR CLINIC All Yes No

00014 SelectCare MO,IL Yes Yes

68241 SelectCare (Coca Cola) All Yes No

76045

SelectCare of Texas (HPN) Heritage Physicians

Network TX Yes Yes

GTPA1

SelectCare of TX (Beaumont) (Provider ID Required -

Contact (713) 843-6780 to obtain ID.) TX Yes Yes

HPN11

SelectCare of TX (Houston) (Provider ID Required -

Contact (713) 843-6780 to obtain ID.) TX Yes Yes

KLSY1

SelectCare of TX (Kelsey-Seybold) (Provider ID

Required - Contact (713) 843-6780 to obtain ID.) TX Yes Yes

61225 SELECTCARE TEXAS (KELSEY SEYBOLD) All Yes No

72189

SELECTCARE TEXAS BEAUMONT & GOLDEN

TRIANGLE All Yes No

UH107 SelectHealth (Formerly IHC) UT Yes No

59111

Self Insured Benefit Administrators (Clearwater, FL)

(Payer ID valid for claim submission address of

18167 US 19 N #300, Clearwater FL 33764) FL Yes No

36404 Self Insured Plans, LLC All Yes No

34131 Self-Funded Plans (IL, PA, OH) IL,PA,OH Yes Yes

TRSEL SELMAN TRICARE SUPP All Yes No

J1915 SEMPRA ENERGY EMPLOYEE CARE SERVICES All Yes No

36426 Sendero Health All Yes Yes

MV440 Sendero IdealCare All Yes Yes

68241 Senior Care All Yes No

NANPR Senior Care Partners All Yes No

60054 Senior Choice (Aetna HP-NY/NJ) All Yes Yes

15682 SENIOR NETWORK HEALTH ALL Yes No

95444 Senior Smart Choice All Yes Yes

83035 Senior Whole Health All Yes No

54154 Sentara Family Plan All Yes Yes

54154 Sentara Health Management All Yes Yes

5415M Sentara Mental Health Professional All Yes No

23249 Sentinel Management Services All Yes No

39033

Sentry Insurance Co. (Sentry LIfe Insurance Co.

Group and Substriber numbers 800-426-7234) All No Yes

AMM07 SEOUL MEDICAL GROUP All Yes No

IP080 Seoul Medical Group CA Yes No

SHPCH Seton CHIP (Provider ID required.) All Yes No

SHEBP Seton Employee Plan All Yes No

SHMAP

Seton Map Program - Mediview (Provider ID

required) All Yes No

STAR1 Seton Star All Yes No

25404 Seven Corners All Yes Yes

11789 SGIC All Yes Yes

SCMG1 Sharp Community Medical Group CA Yes No

SHP01 SHARP HEALTH PLAN All Yes No

SRS83 SHARP REES STEALY MEDICAL GROUP All Yes No

SRS76 Sharp Rees-Stealy Med Group All Yes No

75280

Shasta Administrative Services, (Jeld-Wen Claims

only) All Yes Yes

10002 Sheakley UniComp (OH BWC) OH Yes No

38238

Sheet Metal Workers Local 104 (PayerID valid for

submission add of PO Box 1138, San Ramon, CA

94583.) CA Yes Yes

41143 SHEFFIELD OLSON AND MCQUEEN INCORPORATED All Yes No

SC359 SHERMAN CHOICE All Yes No

03699 Sieba LTD All Yes Yes

76343

Sierra Health and Life (Encounter claims)

(SecureHorizons by UnitedHealthcare) All Yes Yes

76342

Sierra Health and Life (FFS Claims) (SecureHorizons

by UnitedHealthcare) CA,NV Yes Yes

76342 Sierra Health Services CA,NV Yes Yes

76343 Sierra Health Services Encounters CA,NV Yes Yes

SMG01 Sierra Medical Group CA Yes No

SA001 Signature Advantage All Yes Yes

62159 Signature Health NULL Yes No

23250 Significa Benefit Services, Inc. All Yes Yes

NTWKS SIHO All Yes Yes

77871 SIHRTE All Yes No

36387 Silver Care Managed Care Organization IL Yes No

NASCR Silver Cross Managed Care Organization IL Yes Yes

97691 SILVER STAR PACE All Yes No

37228 Silverback TPA All Yes Yes

27094 Simply HealthCare Plans All Yes No

84076 Sinclair Health Plan All Yes Yes

00540 SISCO All Yes No

25125 SL CARPENTERS FUN All Yes No

84096 SLOANS LAKE MANAGED CARE All Yes No

72112 SMA All Yes No

72112 SMA 65 All Yes No

72112 SMA Health Plan All Yes No

72112 SMA HMO All Yes No

J1824 SMART AND FINAL All Yes No

72112 SmartPlan All Yes No

72112 SmartPlan 65 All Yes No

SMITH Smith Administrators All Yes Yes

02057 SMITH ADMINISTRATORS All Yes No

13010 Smokey Mountain Center All Yes Yes

CB695 SOLARTE HEALTH INCORPORATED All Yes No

77721 Solidarity Healthshare ALL Yes Yes

73581 Solis Health Plan All Yes Yes

91131 Sound Health All Yes Yes

42172

Soundpath Health (Formerly known as Puget Sound

Health Partners, Inc.) All Yes Yes

SAMG1 South Atlantic Medical Group CA Yes No

42406 SOUTH CAROLINA SOLUTIONS SC Yes No

23266

South Central Preferred - PPO York, PA (IHS

Gateway Payer) ( Contact Jane Grove for South

Central Preferred (717) 851-6715.) All Yes No

CASD2 South Dakota Chiropractic (Sanford Health Plan) SC Yes No

59065 South Florida Common Services FL Yes Yes

06294 SOUTH FLORIDA MUSCULOSKELETAL CARE All Yes No

SX142 South Indiana Health Options - HMO IN Yes No

35227 SOUTH POINT HOTEL AND CASINO All Yes No

28580 SOUTH TAHOE REFUSE All Yes No

25147 Southcare / Healthcare Preferred All Yes Yes

86068 Southeast Iowa Health Plan (Provider ID Required) IA Yes No

72112 Southeast Medical Alliance All Yes No

90448

SOUTHEASTERN INDIANA HEALTH ORGANIZATION

SIHO All Yes No

77153 Southeastern Indiana Health SIHO All Yes Yes

37318 Southern Benefit Services All Yes No

SCP01 Southern Cal Physicians Managed Care Services CA No No

NWADM Southern California Bakery Drivers Security Fund CA Yes No

25128 SOUTHERN HEALTH SERVICES INCORPORATED All Yes No

SIHCA SOUTHERN ILLINOIS HEALTHCARE ASSOCIATION All Yes No

SIPA1 Southland IPA NULL Yes No

PHM11 SOUTHLAND SAN GABRIEL VALLEY All Yes No

M3IL2 Southwest BCBS of FL FL Yes No

A3268 Southwest Michigan Behavioral health All Yes Yes

SWPG1 SOUTHWEST PHYSICIANS GROUP All Yes No

CX100 SOUTHWEST SERVICE ADMINISTRATORS All Yes No

37266 Southwest Service Life All Yes Yes

68241 Southwestern Bell All Yes No

68241 Southwestern Bell Executive - Custom Care All Yes No

68241 Southwestern Bell Executive - Southwestern Bell All Yes No

00773 Spectera All Yes No

23253 Spectrum Administrators All Yes No

38416 SPENCER STUART (ARM LTD) All Yes No

J1922 SPRINGFIELD INSURANCE COMPANY All Yes No

52190 SRI URN MGD TRANS All Yes No

11158 St James PHO All No Yes

IP062 St Joseph Health CA Yes No

SLCH1 ST LAWRENCE COUNTY HEALTHCARE PLAN All Yes No

SMIPA ST MARY'S IPA CA Yes No

J1926 ST PAUL INSURANCE All Yes No

STM01 St Thomas Medical Network NULL Yes No

22240 St. Barnabas System Health Plan All Yes Yes

JOEHD St. Joe High Desert CA Yes No

37264 St. John's Claims Administration All Yes No

IP106 St. Joseph Heritage Healthcare CA Yes No

IP059 St. Joseph HUMBOLT County CA Yes No

37116 St. Therese Physician Association All Yes Yes

01758 Standard Life & Accident All Yes Yes

73099 Standard Life & Accident Insur Co All Yes Yes

59225 STAR HRG (Now part of CT General Life Insurance.) All Yes Yes

61425 Starmark All Yes No

06057 STARMARK 4MOST All Yes No

46450 STATE AUTO INSURANCE COMPANIES All Yes No

72087 State Employees Group Benefits LA Yes No

LABLS STATE EMPLOYEES GROUP BENEFITS LA Yes No

31059 State Farm (Casualty and Property) All Yes Yes

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.) All Yes Yes

00601 State Merit GA GA Yes Yes

GABLS STATE MERIT GA GA Yes No

75087 States General Life Insurance All No No

67829 Sterling Medicare Advantage All Yes Yes

91151 Sterling Option 1 All No Yes

06089 STIRLING AND STIR All Yes No

STL01 STIRLING MULTIPLAN NULL Yes No

SLIC2

STONEBRIDGE LIFE INS COMPANY (CEDAR RAPIDS

IOWA) All Yes No

SLIC1

STONEBRIDGE LIFE INS COMPANY (VALLEY FORGE

PENNSYLVANIA) All Yes No

31121 Stoner & Associates All Yes No

57492 Stones River IPA Amerivantage All Yes No

15752 Stones River Regional IPA - Windsor All Yes No

74227 Student Insurance All Yes Yes

74227

Student Insurance - Boston Mutual Life Insurance

Company NY Yes Yes

74227

Student Insurance - Life Insurance Company of

Boston and New York NY Yes Yes

74227

Student Insurance - MEGA Life & Health Insurance

Company TN Yes Yes

74227

Student Insurance - Mid-West National Life

Insurance Company of Tennessee TN Yes Yes

74227 Student Insurance - Reliance Insurance Company TN Yes Yes

74227

Student Insurance - Reliance National Insurance

Company TN Yes Yes

74227 Student Insurance Division TN Yes Yes

74227 Student Resources International (UnitedHealthcare) All Yes Yes

95202 SummaCare Health Plan All Yes Yes

86071 SUMMERLIN LIFE AND HEALTH All Yes No

86083 Summit Administration Services, Inc. All Yes No

37301

Summit America Insurance Services, Inc. (Student

Accident and Sickness, College Sports and NASCC

claims only.) All No No

SX186 SUN HEALTH CORPOR All Yes No

68241 Sun Trust Bank, Inc. All Yes No

90956 SunAmerica Life Ins Co (NFIC Plan only) All Yes No

68069 Sunflower State Healthcare Plan IA Yes Yes

SPA01 Sunrise Advantage Plan Pennsylvania All Yes Yes

68057 Sunshine Health Plan All No No

68057 Sunshine Health Plan All Yes No

68069 Sunshine Health Plan (Also 68057) All Yes Yes

23218 Superior Administrators, Inc. All Yes No

39188 Superior Health All Yes No

68069 Superior Health Plan (Also 39188) TX Yes Yes

SHP11 Superior Health/Centene Corp All Yes Yes

97802 SUPERIOR INSURANCE SERVICES All Yes No

77035 Sutter Connect - Central Valley Med Group (Claims) CA Yes No

IP100 Sutter Connect - Delta - Claims CA No No

HM059 Sutter Connect - SIP, SMG, SWMG - Encounters only CA No No

IP099

Sutter Connect - Solano Regional Medical Group -

Claims CA No No

IP091

Sutter Connect - Sutter Gould Medical Foundation -

Claims CA No No

IP130 Sutter Connect East Bay Med Foundation CA No No

HM065 Sutter Connect East Bay Medical CA Yes No

HM069

Sutter Connect East Bay Regional Affinity

Encounters CA Yes No

HM068

Sutter Connect East Bay Regional Brown & Toland

Encounters. CA Yes No

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 CA No No

SC050 Sutter Connect-Palo Alto Medical Foundation CA Yes No

77318 SUTTER DELTA MEDICAL GROUP All Yes No

94269 SUTTER EAST BAY MEDICAL FOUNDATION All Yes No

SC052 Sutter East Bay Regional Hosp-Affinity Claims CA Yes No

HM057

Sutter Medical Group of the Redwoods (SMGR)

(Please contact Sutter to get setup to send

Encounters, 800-611-5191) CA No No

SC028 SUTTER SENIOR CARE All Yes No

53589 SW Service Administrators AZ Yes Yes

NASWD Swedish Covenant Hospital IL Yes No

36411 Swedish Covenant Hospital All Yes No

07040 SWIFT GLASS CORPORATION All Yes No

98022 TakeCare Insurance Company All Yes No

TALMG Talbert Medical Group All Yes No

88067 Tall Trees Administrators All Yes Yes

COMPU Tattered Cover, Inc. CO Yes No

TAYLR Tayler Benefits All Yes No

39157 TBG ADM SERVICES All Yes No

88019 Teachers Health Trust All Yes No

75133 TEAM CHOICE PNS All Yes No

75134 Team Choice UMC All No Yes

75139 Team Health Gold All Yes No

36215 Teamcare All Yes No

88054 Teamsters (UT/ID/MT) UT ID MT Yes No

94304 Teamsters Benefit Trust All Yes No

NWADM

Teamsters Local 631 Security Fund for Southern

Nevada CA Yes No

NWADM Teamsters Miscellaneous Security Trust Fund CA Yes No

74234 Tech-Steel, Inc. All Yes No

22483 TELAMON All Yes No

20212 Tethys Health Ventures All Yes No

TXABA Texas Agricultural Cooperative Trust All Yes No

TXCSN Texas Children Plan for Texas Medicaid All Yes No

76048 Texas Children's Health Plan TX Yes Yes

75228 Texas Children's Health Plan (Medicaid) TX Yes Yes

TXCSM

Texas Childrens Star Medicaid (Enrollment

verification calls should be directed to 800-990-

TCHP (8247)) TX No No

TOPA1 Texas First Health (TIOPA) TX Yes No

76046 TEXAS FIRST HEALTH PLAN (TOPA) All Yes No

TX1ST Texas First Health Plans TX Yes No

THS01 Texas HealthSpring TX Yes Yes

74214 Texas Municipal League Group Benefits Risk Pool TX Yes Yes

J1921 TEXAS POLITICAL SUBDIVISIONS JSIF All Yes No

TTCEC Texas True Choice TX Yes No

13185 TexasFirst Health Plan All Yes No

TBGNE THE BENEFIT GROUP INCORPORATED All Yes No

BOONG The Boon Group All Yes Yes

68423 The Care Network All Yes Yes

34154 The Chesterfield Companies All Yes Yes

COA01 The City of Amarillo TX Yes No

75600 The City of Odessa All Yes Yes

87726 The Empire Plan All Yes Yes

37305 The Ford Meter Box Company, INC All Yes Yes

20356 The Health Exchange (Cerner Corporation) All Yes Yes

30757

The Health Plan (Formerly known as Hometown

Health Plan of Ohio.) OH Yes No

34150 The Health Plan (Upper Ohio Valley) All Yes Yes

29018 THE HEALTH PLAN OF WESTERN ILLINOIS (HOWI) All Yes No

35206 The Healthcare Group (THCG) All Yes Yes

23223

The Loomis Company (Call Provider Relations at 610-

374-4040 ext. 2438 for procedures prior to

submitting electronically.) All Yes Yes

59227

The MEGA Life and Health Insurance Company-OKC

(Valid if PO BOX 548801 Oklahoma City OK 73154.) All Yes Yes

70491 THE MUTUAL GROUP All Yes No

63092

The Oath - Health Partners of Alabama (Now known

as HealthSpring HMO/HealthSpring

Medicare+Choice) All Yes Yes

THERA THERAPHYSICS All Yes No

COTHE THERAPHYSICS COLORADO ONLY All Yes No

J1831 THERAPY DIRECT NETWORK All Yes No

75305 THERAPY REVIEW SY All Yes No

SC315

Thomas Cooper (Provider must be enrolled with SC

Blue Shield.) SC Yes Yes

MP340 THREE RIVERS PREFERRED All Yes No

25175

Three Rivers Provider Network (Now known as

Unison Health Plan.) All Yes Yes

THRIV THRIVENT FINANCIAL All Yes No

58600 TIFT REGIONAL All Yes No

39065 Time Insurance (A Fortis Company) All Yes Yes

TLC01 TLC Advantage in Sioux Falls SD Yes Yes

TLC79 TLC Benefit Solutions All Yes No

WITH1 TODAYS HEALTH All Yes No

20081 Todays Health Wisconsin All Yes No

48055

Todays Option (American Progressive and Pyramid

Life) All Yes No

92620 Tongass Timber Trust AK Yes No

61425 Tooling & Manufacturing Assoc. All Yes Yes

THIPA TORRANCE HOSPITAL IPA All Yes No

TMMC1 TORRANCE MEMORIAL All Yes No

TCARE Total Care of NY NY Yes No

68055 Total Carolina Care All Yes No

68069 Total Carolina Care (Also 68055) All Yes Yes

31182 Total Community Care All Yes Yes

38201 Total Healthcare, Inc. MI Yes Yes

41202 TOTAL PLAN SERVICES All Yes No

87726 Touchpoint All Yes Yes

TPS01 TOUCHPOINT SOLUTIONS TOUCHPOINT CRM All Yes No

23856 Touchstone Health PSO All Yes Yes

13402 Touchstone Health/Health Net Smart All Yes Yes

69493 TOWER LIFE INSURA All Yes No

44448 TPA Systems All Yes No

37230 TR Paul Inc. All Yes Yes

RX001 TRANSACTRX INFUSION AND SPECIALTY ALL Yes No

TFLI4

TRANSAMERICA FINANCIAL LIFE INSURANCE


TFLI6

TRANSAMERICA FINANCIAL LIFE INSURANCE CEDAR

RAPIDS All Yes No

TFLI2


COMPANY All Yes No

TFLI3


COMPANY All Yes No

TFLI5


COMPANY All Yes No

TRCLF


COMPANY All Yes No

TRLTC


COMPANY All Yes No

TRP1P


COMPANY All Yes No

TFLIC


COMPANY HURST TEXAS All Yes No

TLIN7 TRANSAMERICA FINANCIAL LIFE INSURANCE PLANO All Yes No

TLINS

Transamerica Life Ins. Co.(Specialized claims only.

Call 501-277-1284 for information.) All Yes No

TRP1E TRANSAMERICA LIFE INSURANCE COMPANY All Yes No

59222

TransAmerica Life Insurance Company (Valid for PO

Box 982009, North Richland Hills, TX 76182) All Yes No

MMLI3

TRANSAMERICA PREMIER LIFE INSURANCE

COMPANY (MONUMENTAL) All Yes No

20807 Transchoice - First Administrator's All Yes Yes

37284 Transchoice - Key Benefit Admin All Yes Yes

20807

Transchoice or TransSmile First Service

Administrators All Yes Yes

74234 Transwestern General Agency All Yes No

TRAN1 Transwestern Insurance Administrators, Inc. All Yes No

TCHD1 Travis County Hospital District NULL Yes Yes

TCMAP TRAVIS COUNTY MAP MEDIVIEW All Yes No

36397 TRELLIS HEALTH PARTNERS All Yes No

J1905 TRI CITY HEALTHCARE DISTRICT All Yes No

39181 Triad Healthcare Inc All Yes No

TREST TRICARE EAST All Yes Yes

TDDIR Tricare for Life (All Regions 1-12) All Yes Yes

57106 Tricare North NULL Yes Yes

FOREN TRICARE OVERSEAS All Yes No

38520

TriCare Palmetto (Regions 1-6) Northern and

Southern Region Various Yes No

57106 Tricare South NULL Yes Yes

99726 Tricare West All Yes Yes

WESTR TRICARE WEST All Yes No

31144 TriHealth Physician Solutions All Yes Yes

31143 TRIHEALTH PHYSICIAN SOLUTIONS CONCERN All Yes No

A0011 TRILLIUM HEALTHCARE RESOURCES All Yes No

98514 Trilogy Health All Yes Yes

TPACE TRINITY HEALTH PACE ALL No Yes

97300 Triple S PR Yes No

PRAHM Triple S (AHM) PR Yes Yes

64300 Triplefin LLC All Yes Yes

62777 TRLHN/EB All Yes Yes

TCUSA TRUE CHOICE USA All Yes No

TCUCH True Choice USA - Christus Healthplan NULL Yes Yes

L0230 Trusted Health Plan All Yes Yes

91078 Trusteed Plans Service Corporation All Yes Yes

61425 Trustmark (Includes Starmark & TMA) All Yes No

THA01 TUALITY HEALTH All Yes No

THASC TUALITY HEALTH SELECT All Yes No

04298 Tufts Associated Health All Yes No

TULCR TulareCare CA Yes No

TH055 TX TRUE CHOICE All Yes No

87726 UBH Employer Division All Yes Yes

87726 UBH RIOS All Yes Yes

68241 UC Care (University of CA) CA Yes No

UCDMG UC Davis Health Systems All Yes Yes

19991 Ucare of Minnesota MN No No

55413 Ucare of Minnesota - DOS after 1.1.2019 MN Yes Yes

52629 Ucare of Minnesota - DOS prior 1.1.2019 MN Yes Yes

94603 UC-DAVIS HEALTH CA Yes No

USMBP UCLA Medical Group All Yes No

93235 UCS All Yes Yes

36582 UCS BASI: Carey Johnson Oil ALL Yes Yes

36493 UCS BASI: Consolidated Turbine ALL Yes Yes

76251 UCS Benveo- FirstHealth All Yes Yes

76253 UCS Benveo- MultiPlan All Yes Yes

76255 UCS Benveo- No Network All Yes Yes

97041 UCS HEWITT COLEMAN All Yes No

59573 UCS HOCKENBERGOS EQUIPMENT All Yes No

60230 UCS Masonry Industry Trust All Yes No

52323 UCS NEBRASKA PLASTICS GROUP All Yes No

08354 UCS NX HEALTH NETWORK All Yes No

97736 UCS RTG MEDICAL GROUP All Yes No

20452 UCS WINSTON HOSPITALITY All Yes No

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.) CA Yes Yes

95375 UHC COMMUNITY IA All Yes No

86001 UHC COMMUNITY NJ2 All Yes No

86002 UHC COMMUNITY NY2 All Yes No

39026

UHIS-UnitedHealthcare Integrated Services

(UnitedHealthcare) All Yes Yes

UHP01 UHP Management All Yes Yes

75245 UICI Administrators - State of Nevada NV Yes No

ULLIC

ULLICO INCORPORATED (VALLEY FORGE

PENNSYLVANIA) All Yes No

77022 ULTIMATE HEALTH PLAN All Yes Yes

41206 Ultra Benefits Inc All Yes Yes

UMHCJ

UMASS MEDICAL SCHOOL HEALTH AND CRIMINAL

JUSTICE PROGRAM All Yes No

75130 UMC Health Plan All Yes No

31107 UMR Cincinnati All Yes Yes

UMRC1 UMR CINCINNATI HS All Yes No

62061 UMR Kansas (Formerly Fiserv Health - Kansas) All Yes Yes

79480 UMR Onalaska (formerly Midwest Security) All Yes Yes

74223 UMR SAN ANTONIO All Yes No

39026 UMR Wausau/UHIS All Yes Yes

75243 UMR Westerville (Harrington Health) All No Yes

79480 UMR-Midwest Securities All Yes Yes

95266 UMRWESTERVILLE 95 All Yes No

52180 UMWA Health & Retirement Funds All Yes Yes

80314 Unicare Life & Health All Yes Yes

35198 Unified Group Services OH Yes Yes

62170 Unified Health Services All Yes No

51368 UNIFIED IPA All Yes No

34638

Unified Physicians Network (For Claims rejections,

please contact Unified Physicians claim department

at 847-763-1700) All Yes Yes

01691 UNIFIED PHYSICIANS NETWORK (UPN) All Yes No

75243 Uniform Medical Plan All Yes No

13407 Uniformed Service Family Health Plan All Yes Yes

87042 Union Pacific Railroad Employees Health Systems All Yes No

25175

Unison DC, DE, NJ, OH, PA, SC, TN (UnitedHealthcare

Community Plan) DC,DE,NJ,OH,PA,SC,TNYes Yes

25175

Unison Health Plan (Formerly Three Rivers Provider

Network.) All Yes Yes

UABT1 United Agriculture Benefit Trust All Yes No

92916 United American Insurance Company All Yes Yes

87726 United Behavioral Health All Yes Yes

59069 United Benefits, Inc (a Brown & Brown Company) All Yes Yes

ADCUC United Care Medical Group All Yes No

20090 UNITED CLAIM SOLUTIONS All Yes No

A0047 UNITED CLAIM SOLUTIONS All Yes No

36659

UNITED FOOD AND COMMERCIAL WORKERS

MIDWEST UNIONS All Yes No

21850

UNITED FOOD AND COMMERCIAL WORKERS UFCW

LOCAL 1529 All Yes No

UFWIF United Furniture Workers NULL Yes No

UGP19 United Group Programs All Yes Yes

96385 United Healthcare Community Plan Kansas All Yes Yes

84132 United Medical Alliance (UMA) CO Yes Yes

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.) All Yes Yes

71412 United of Omaha All Yes No

ECMSO UNITED PHYSICIANS INTERNATIONAL (UPI) All Yes No

MPM15 United Physicians International IPA CA No No

84132 United Physicians of Northern Colorado CO Yes Yes

87726 UnitedHealthcare All Yes Yes

87726

UnitedHealthcare / MAMSI Life and Health

Insurance Co. (MLH) (Previously Payer ID 52148) All Yes Yes

04567 Unitedhealthcare Comm Plan PA ALL Yes No

86050 UnitedHealthcare Community Plan Missouri All Yes Yes

87726 UnitedHealthcare Group Medicare Advantage All Yes Yes

87726

UnitedHealthcare hawk-I (UnitedHealthcare

Community Plan) All Yes Yes

52148

UNITEDHEALTHCARE MAHP MARYLAND IPA

OPTIMUM CHOICE MAMSI All Yes No

87726

UnitedHealthcare Plan of the River Valley

(UnitedHealthcare Communit Plan) All Yes Yes

87726

UnitedHealthcare River Valley (formerly known as

John Deere Healthcare All Yes Yes

00773 UnitedHealthcare Vision All Yes No

87726

UnitedHealthcare West (formerly know as

PacifiCare) (UnitedHealthcare) All Yes Yes

95958

UnitedHealthcare West Encounters(Formerly know

as PacifiCare) (UnitedHealthcare) WA Yes Yes

66705

Unity Health Insurance (Before submitting claims,

please call Joe Boerboom at 608-643-1531 for EDI

Signup.) All Yes Yes

A0012 UNITY HEALTH PLAN All Yes No

81108 UNITY SECURITY LIFE AND HEALTH All Yes No

15003 UNIVERA COMMUNITY HEALTH All Yes No

SX087

UNIVERA HEALTH CARE PLAN/CHOICECARE

BUFFALO All Yes No

HC001 Univera Healthcare - CNY NY Yes No

SX091 Univera Healthcare (SSA) All Yes No

UNINW Univera Traditional PPO All Yes No

12X19 Univera Traditional PPO All No Yes

12X18 Univera WNY All No Yes

UNBCI UNIVERSAL BENEFITS CORPORATION All Yes No

UNBC2 UNIVERSAL BENEFITS CORPORATION CEDAR RAPIDS All Yes No

33001 Universal Care - California (ProviderID required.) CA Yes Yes

93220 UNIVERSAL FIDELITY ADMINISTRATORS COMPANY All Yes No

95380 UNIVERSAL FINANCIAL SERVICES All Yes No

50528 UNIVERSAL HEALTH All Yes No

38298 UNIVERSALSTANDARD All Yes No

09830 University Family Care AZ Yes No

07503 University Family Care - Healthcare Group All Yes Yes

09908 University Family Care - Maricopa Health Plan All Yes Yes

09908 University Family Care - Maricopa Health Plan AZ Yes Yes

99026 University Health Alliance All Yes Yes

46407 University Health Care Advantage All Yes Yes

45437 UNIVERSITY HEALTHCARE MARKETPLACE All Yes Yes

UIC67 UNIVERSITY OF ILLINOIS All Yes No

37601

UNIVERSITY OF ILLINOIS AT CHICAGO DIV OF

SPECIALIZED CARE All Yes No

45282 UNIVERSITY OF MARYLAND HEALTH ADVANTAGE All Yes Yes

92579 University of Miami Behavioral Health All No No

SX155 University of Utah Health Plans UT Yes Yes

91136

University of Washington Students & Graduate

Appts. - Grp#P67 WA Yes Yes

A0013 UNIVERSITY PHYSICIANS HEALTHCARE All Yes No

IP056

Upland Medical Group (Customer Service Phone

number (909) 291-4400) CA Yes No

23281 UPMC Health Plan All Yes No

25184 UPMC VISION ADVANTAGE All Yes No

37324 UPPER PENINSULA HEALTH GROUP (TPA) All Yes No

38337 Upper Peninsula Health Plan All Yes Yes

93092 US Benefits All Yes Yes

90551 US FAMILY HEALTH PLAN All Yes No

USFHP US Family Health Plan (USFHP) All Yes No

50383 US IMAGING NETWORK (NEW YORK) All Yes No

74095 USAA All Yes Yes

J1822 USAA All Yes No

9047P USC HEALTH SERVICES All Yes No

74234 Utah Carpenters UT Yes No

74234 Utah Laborers UT Yes No

74234 Utah Pipe Trades UT Yes No

N4FEP Utica NY FEP Blue Shield NY Yes No

36369 UtiliMED, Inc. All Yes No

UT3F UTMB 3 SHARE PROGRAM All Yes No

UHSCH

UTMB Healthcare Systems (PayerID only valid for

Dates of service prior to 2-01-2012. For later claims

submit claims to 87726.) All Yes No

12115 VA Fee Basis Programs All Yes Yes

55912

VA PATIENT CENTERED COMMNITY CARE PROGRAM

(VAPCCC REGION 3) All Yes No

55915


(VAPCCC REGION 5A) All Yes No

55917


(VAPCCC REGION 6) All Yes No

VAP33 VA Patient Centered Region 3 All Yes No

VAPC3 VA Patient Centered Region 5A All Yes No

VAP5A VA Patient Centered Region 5A All Yes No

VAP5B VA Patient Centered Region 5B ALL Yes No

VAPC6 VA Patient Centered Region 6 All Yes No

VABLS VA PLANS VA Yes No

00923 VA State Employer Funds VA Yes Yes

64009 Valir PACE All Yes No

82420 Valley Baptist Health All Yes Yes

VBHP1

Valley Baptist Health Plan (This payer is only

accepting claims with Dates of Service prior to 2-29-

2004. For later claims send to First Care. PayerID of

94999) All Yes No

VCIPA Valley Care IPA All Yes No

VHA11 Valley Health Administrators All Yes No

94293 VALLEY MENTAL HEALTH All Yes No

12X56 Value Options All No Yes

00814 VALUE OPTIONS AZ MEDICAID All Yes No

00815 Value Options Colorado Medicaid CO Yes No

00813 Value Options Commercial Claims All Yes Yes

00823 Value Options Maryland All Yes No

00816

Value Options Massachusetts Behavioral Health

Partnership MA Yes No

00817 Value Options Pennsylvania Medicaid PA Yes No

00818 Value Options Texas Northstar TX Yes No

43307

ValueOptions/MBHP (For claim rejections please

contact [email protected] or

888-247-9311) MA Yes Yes

72128 Vantage Health Plan, Inc. All Yes Yes

PPM01 Vantage Medical Group All Yes No

55916 VAPCCC REGION 5B All Yes No

VPA18 VARIABLE PROTECTION ADMINISTRATORS (VPA) All Yes No

68241 Varian Health Care Plan All Yes No

73288 VENCOR All Yes No

VCHCP Ventura County Healthcare Plan CA Yes Yes

66126 VERDUGO HILLS MEDICAL GROUP All Yes No

VMMH1 VERITY All Yes No

75256 Verity National Group All Yes Yes

VMMH2 VERITY PLUS All Yes No

42558 VHS- Cedar Valley Community Healthcare (CVHC) All Yes Yes

52511 VHS- Lakes Area Community Healthcare (LACH) ALL Yes Yes

48123 Via Christi Hope All Yes No

54182 VICARE ADMIN SVCS All Yes No

24818 Vida Care (Now known as Amida Care.) All Yes Yes

25924

VIECARE LIFE BEAVER AND LIFE LAWRENCE

COUNTIES All Yes No

73743 VILLAGE FAMILY PHYSICIAN All Yes No

VFP11 VILLAGE FAMILY PRACTICE All Yes No

VLGMD VILLAGE MD All Yes No

26545 VillageCareMAX All Yes Yes

84806 VIRGINIA COORDINATED CARE VCC All Yes No

CALL

Virginia Health Network,Inc (To get the payerID, call

payer at (804)320-3837) All Yes No

VPCCP Virginia Premier Complete Care All Yes No

VPELT Virginia Premier Elite All Yes No

54176 Virginia Premier Health Plan VA Yes No

VAPRM Virginia Premier Health Plans VA Yes Yes

M3FL2 Vista - Tallahassee NULL Yes No

55248 VISTA HEALTH PLAN & FOUNDATION HEALTH PLAN All Yes No

NCH08 Vista Oncology New Century Infusion Solutions All Yes No

VESTA VistaCare/RH Admin All Yes No

67524 Vital Protection All Yes No

63114 Viva Health Plan All Yes Yes

31626 VNA Homecare Options All Yes Yes

77073

VNS Choice Medicare (Formerly Visiting Nurse

Service) All Yes Yes

59266 Volusia Health Network All Yes Yes

23173 VPH COMMUNITY CAR All Yes No

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.) All Yes Yes

91062 WA DENTAL SERVICE All Yes No

85256 Wabash Memorial Hospital Association All No No

31650 WAGNER MEINERT All Yes No

WCHHS

WASHINGTON COUNTY HEALTH AND HUMAN

SERVICES All Yes No

WALAI Washington State Dept of Labor & Industries WA Yes No

00934 Washington State Premera Blue Cross WA Yes No

WABLC WASHINGTON STATE PREMERA BLUE CROSS WA Yes No

73155 Waterstone Benefit Administrators OK Yes No

23051

WATERSTONE BENEFIT ADMINISTRATORS (OUTSIDE

OKLAHOMA) All Yes No

MPM09 Watts Healthcare Corp IPA CA No No

39026

Wausau Insurance Companies (Now known as UMR

Wausau/UHIS.) All Yes Yes

77072 WCARE PRI FEE SER All Yes No

39151 WEA Insurance Group All Yes Yes

36337 Weiss Health Providers All Yes No

A0014 WELL SENSE HEALTH PLAN All Yes No

59354 Wellcare Health Plan, Inc. (Encounters only) All Yes Yes

14164 Wellcare of CT CT Yes Yes

14164 Wellcare of NY NY Yes Yes

WELM2 WellMed All Yes No

WELMD Wellmed Medical Management ENC NULL Yes Yes

25711 WELLNET HEALTH PLANS All Yes No

87815 Wells Fargo TPA All Yes No

CB457 WELLSPAN EMPLOYEE ASSISTANCE PROGRAM All Yes No

35245 WellSystems LLC All Yes Yes

91064 Wenatchee Valley Medical Center All Yes Yes

91136

West Coast Stationary Engineers Health & Security

Trust Fund - Grp#F13 All Yes Yes

66124 WEST COVINA MEDICAL GROUP All Yes No

80942 West Suburban Health Providers All Yes Yes

45276 West Virginia Family Health Plan WV Yes Yes

WVS01 WEST VIRGINIA SENIOR CHOICE All Yes No

75196 WEST VIRGINIA STA All Yes No

77025 WEST VIRGINIA WORKERS COMP All Yes No

39065 Western All Yes Yes

93128 Western Benefits (Western Grocers) All Yes No

39065 Western Care All Yes Yes

24735 Western Grower's Assurance Trust All Yes Yes

24735 Western Grower's Insurance Company All Yes Yes

68039 WESTERN HEALTH ADVANTAGE All Yes No

39065 Western Life Ins. Benefit Plan (FORTIS) All Yes Yes

37247 Western Mutual Insurance All Yes Yes

DOCSO WESTERN OREGON ADVANCED HEALTH (CCO) All Yes No

WOAHM WESTERN OREGON ADVANCED HEALTH (CCO) All Yes No

31048 Western Southern Financial Group All Yes Yes

90560 WestLake Financial Group, Inc. All Yes No

38232 Weyco Inc. All Yes Yes

33711 WILLAMETTE VALLEY COMMUNITY All Yes No

WVCH5 WILLAMETTE VALLEY COMMUNITY HEALTH All Yes No

93050 William C. Earhart Co, Inc. GA Yes Yes

98010 William J Sutton & Co. Ltd. All Yes Yes

62061

Willis Administrative Services Corporation (Now

UMR Kansas) All Yes Yes

WHLTH WILLOW HEALTH All Yes No

J1893 WILSON MUTUAL INSURANCE All Yes No

41095 Wilson-McShane All Yes Yes

13413 WIN Healthcare (Woman's Integrated Network, Inc.) All Yes No

62153 Windsor Medicare Extra All Yes No

RMWIN

WINHealth Partners Medicare Plan administered by

Rocky Mountain HMO WY Yes No

27327 WinHealth Partners/Wyoming Health Solutions All Yes Yes

39200

Wisconsin Auto & Truck Dealers Insurance

Corporation WI No Yes

WPS01 WISCONSIN COMMERCIAL All Yes No

74101 WISCONSIN DEPARTMENT OF CORRECTIONS All Yes No

VEST1 Wisconsin Dept of Corrections WI Yes No

81949 Woodman Accident and Life Co (AICT Plans only) All Yes No

20333 Worksite Benefit Services All Yes Yes

75276 World Insurance Company All Yes No

77080 WPP Eldercare Wisconsin All Yes Yes

WP481 WPPA-ProviDRs Care Network All Yes No

OOWPS WPS Commercial WI Yes Yes

SX022 WPS HEALTH INSURANCE All Yes No

23710 Writers' Guild - Industry Health Plan All Yes No

15459 WV Care Advantage Highmark Senior Health WV Yes No

WYSCH Wyoming School Boards Association Insurance Trust WY Yes No

60646 Yale University Health Plan All Yes No

YAMHL YAMHILL COMMUNITY CARE ORGANIZATION (CCO) All Yes No

09829 YAVAPAI COUNTY All Yes No

51350 YERINGTON PAIUTE TRIBE All Yes No

88858 Zebrahealth NULL Yes No

ZNTHW ZENITH ADMINISTRATORS All Yes No

ZOOM1 ZOOMCARE All Yes No

PHICURE - CONFIDENTIAL - November 01, 2019 837 …PHICURE - CONFIDENTIAL - November 01, 2019 Payer ID Payer Name State Prof Claim Inst Claim 13162 1199 SEIU National Benefit Fund All

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