Payer ID Payer Name Payer Status From Date To Date 00014 SELECT CARE A 01/01/2001 12/31/2999 00106 AMERICAL GENERAL A 01/01/2001 12/31/2999 00250 FIRST HEALTH A 01/01/2001 12/31/2999 00354 UNIVERSAL CARE A 01/01/2001 12/31/2999 00356 WESTERN HEALTH ADVANTAGE A 01/01/2001 12/31/2999 01041 HEALTHSOURCE MAINE A 01/01/2001 12/31/2999 01066 AMERICAN HEALTH ALLIANCE A 01/01/2001 12/31/2999 02038 HEALTHSOURCE NEW HAMPSHIRE A 01/01/2001 12/31/2999 02041 CENTRAL MASS HEALTH A 01/01/2001 12/31/2999 02631 GOLDEN RULE A 01/01/2001 12/31/2999 03036 COMPREHENSIVE BENEFITS ADMINISTRATORS A 01/01/2001 12/31/2999 04271 HARVARD PILGRIM INSURANCE A 01/01/2001 12/31/2999 04293 NEIGHBORHOOD HEALTH PLAN MASSACHUSETTS A 01/01/2001 12/31/2999 04294 GUARDIAN LIFE A 01/01/2001 12/31/2999 04332 NETWORK HEALTH PLANS A 01/01/2001 12/31/2999 04614 DELTA DENTAL MASSACHUSETTS A 01/01/2001 12/31/2999 06105 CONNECTTICARE A 01/01/2001 12/31/2999 06108 HEALTHNET NORTH EAST A 01/01/2001 12/31/2999 06111 OXFORD HEALTH PLANS A 01/01/2001 12/31/2999 06119 HEALTHSOURCE SOUTH CAROLINA A 01/01/2001 12/31/2999 06203 STANDARD LIFE A 01/01/2001 12/31/2999 10096 SELECTCARE TEXAS A 01/01/2001 12/31/2999 10160 ABRAZO ADVANTAGE PLAN A 01/01/2001 12/31/2999 10525 PATIENT ADVOCATES A 01/01/2001 12/31/2999 10642 CHEROKEE INSURANCE A 01/01/2001 12/31/2999 10850 METROPOLITAN HEALTH PLAN A 01/01/2001 12/31/2999 10952 STONEBRIDGE CASUALTY INSURANCE A 01/01/2001 12/31/2999 11072 HEALTH SERVICE REVIEW OF OHIO A 01/01/2001 12/31/2999 11082 SVS VISION CLAIMS A 01/01/2001 12/31/2999 11102 HEALTH ASSURANCE A 01/01/2001 12/31/2999 11113 GOLDEN DENTAL A 01/01/2001 12/31/2999 11116 WISCONSIN AUTO & TRUCK DEALERS A 01/01/2001 12/31/2999 11118 FEDERATED RURAL ELECTRIC INSURANCE A 01/01/2001 12/31/2999 11121 UNIFIED LIFE INSURANCE A 01/01/2001 12/31/2999 11122 AMERICAS HEALTH CHOICE A 01/01/2001 12/31/2999 11125 MVP HEALTH A 01/01/2001 12/31/2999 11157 MMM HEALTHCARE INC. A 01/01/2001 12/31/2999 11163 AVESIS A 01/01/2001 12/31/2999 11176 PREFERRED CARE PARTNERS A 01/01/2001 12/31/2999 11185 FOREMOST INSURANCE A 01/01/2001 12/31/2999 11204 HERITAGE VISION PLANS A 01/01/2001 12/31/2999 11222 MAGELLEN BEHAVIORAL HEALTH A 01/01/2001 12/31/2999 11271 HEALTHPLEX A 01/01/2001 12/31/2999 TPL and Medicare Payer IDs Revision Date: November 2021
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Payer ID Payer Name Payer Status From Date To Date
00014 SELECT CARE A 01/01/2001 12/31/2999
00106 AMERICAL GENERAL A 01/01/2001 12/31/2999
00250 FIRST HEALTH A 01/01/2001 12/31/2999
00354 UNIVERSAL CARE A 01/01/2001 12/31/2999
00356 WESTERN HEALTH ADVANTAGE A 01/01/2001 12/31/2999
01041 HEALTHSOURCE MAINE A 01/01/2001 12/31/2999
01066 AMERICAN HEALTH ALLIANCE A 01/01/2001 12/31/2999
02038 HEALTHSOURCE NEW HAMPSHIRE A 01/01/2001 12/31/2999
02041 CENTRAL MASS HEALTH A 01/01/2001 12/31/2999
02631 GOLDEN RULE A 01/01/2001 12/31/2999
03036 COMPREHENSIVE BENEFITS ADMINISTRATORS A 01/01/2001 12/31/2999
04271 HARVARD PILGRIM INSURANCE A 01/01/2001 12/31/2999
04293 NEIGHBORHOOD HEALTH PLAN MASSACHUSETTS A 01/01/2001 12/31/2999
04294 GUARDIAN LIFE A 01/01/2001 12/31/2999
04332 NETWORK HEALTH PLANS A 01/01/2001 12/31/2999
04614 DELTA DENTAL MASSACHUSETTS A 01/01/2001 12/31/2999
06105 CONNECTTICARE A 01/01/2001 12/31/2999
06108 HEALTHNET NORTH EAST A 01/01/2001 12/31/2999
06111 OXFORD HEALTH PLANS A 01/01/2001 12/31/2999
06119 HEALTHSOURCE SOUTH CAROLINA A 01/01/2001 12/31/2999
06203 STANDARD LIFE A 01/01/2001 12/31/2999
10096 SELECTCARE TEXAS A 01/01/2001 12/31/2999
10160 ABRAZO ADVANTAGE PLAN A 01/01/2001 12/31/2999
10525 PATIENT ADVOCATES A 01/01/2001 12/31/2999
10642 CHEROKEE INSURANCE A 01/01/2001 12/31/2999
10850 METROPOLITAN HEALTH PLAN A 01/01/2001 12/31/2999
10952 STONEBRIDGE CASUALTY INSURANCE A 01/01/2001 12/31/2999
11072 HEALTH SERVICE REVIEW OF OHIO A 01/01/2001 12/31/2999
11082 SVS VISION CLAIMS A 01/01/2001 12/31/2999
11102 HEALTH ASSURANCE A 01/01/2001 12/31/2999
11113 GOLDEN DENTAL A 01/01/2001 12/31/2999
11116 WISCONSIN AUTO & TRUCK DEALERS A 01/01/2001 12/31/2999
11118 FEDERATED RURAL ELECTRIC INSURANCE A 01/01/2001 12/31/2999
11121 UNIFIED LIFE INSURANCE A 01/01/2001 12/31/2999
11122 AMERICAS HEALTH CHOICE A 01/01/2001 12/31/2999
11125 MVP HEALTH A 01/01/2001 12/31/2999
11157 MMM HEALTHCARE INC. A 01/01/2001 12/31/2999
11163 AVESIS A 01/01/2001 12/31/2999
11176 PREFERRED CARE PARTNERS A 01/01/2001 12/31/2999
11185 FOREMOST INSURANCE A 01/01/2001 12/31/2999
11204 HERITAGE VISION PLANS A 01/01/2001 12/31/2999
11222 MAGELLEN BEHAVIORAL HEALTH A 01/01/2001 12/31/2999
11271 HEALTHPLEX A 01/01/2001 12/31/2999
TPL and Medicare Payer IDs
Revision Date: November 2021
Payer ID Payer Name Payer Status From Date To Date
11303 MAGNACARE A 01/01/2001 12/31/2999
11593 TEXAS HEALTHSPRING A 01/01/2001 12/31/2999
11691 COMMUNITYCARE RX / MEMBERHEALT A 01/01/2001 12/31/2999
11953 STERLING DENTAL SERVICES A 01/01/2001 12/31/2999
11991 NATIONAL CASUALTY COMPANY A 01/01/2001 12/31/2999
12321 AMERICAN CONTINENTAL INSURANCE A 01/01/2001 12/31/2999
12545 MARTIN'S POINT HEALTHCARE A 01/01/2001 12/31/2999
12816 PHP MID MICHIGAN A 01/01/2001 12/31/2999
12K03 COLORADO MEDICAID A 01/01/2001 12/31/2999
12M81 PARTNERSHIP HEALTH PLAN OF CALIFORNIA A 01/01/2001 12/31/2999
12T03 FIRSTCARE HEALTH PLANS A 01/01/2001 12/31/2999
12T05 SCOTT AND WHITE HEALTH PLAN A 01/01/2001 12/31/2999
12T06 VALLEY BAPTIST HEALTH A 01/01/2001 12/31/2999
12T30 COMMUNITY HEALTHPLAN WASHINGTON A 01/01/2001 12/31/2999
12T33 ACCESS ADMINISTRATORS A 01/01/2001 12/31/2999
12T48 US FAMILY HEALTH PLAN A 01/01/2001 12/31/2999
12T52 MASTERS,MATES & PILOTS HEALTH PLAN A 01/01/2001 12/31/2999
12T62 WESTLAKE FINANCIAL GROUP A 01/01/2001 12/31/2999
12T67 LIFE INVESTORS INSURANCE A 01/01/2001 12/31/2999
12X04 PREFERRED CARE NEW YORK A 01/01/2001 12/31/2999
12X29 WISCONSIN PHYSICIAN SERVICE A 01/01/2001 12/31/2999
12X40 BIEVIVIR INSURANCE A 01/01/2001 12/31/2999
12X51 COOPORTUNITY HEALTH A 01/01/2001 12/31/2999
12X56 VALUE OPTIONS MENTAL HEALTH A 01/01/2001 12/31/2999
13021 UNITED FIRE & CASUALTY COMPANY A 01/01/2001 12/31/2999
13122 THE PHYSICIANS ASSURANCE CORP. A 01/01/2001 12/31/2999
13162 1199 NATIONAL BENEFIT FUND A 01/01/2001 12/31/2999
13265 METROPLUS HEALTH PLAN A 01/01/2001 12/31/2999
13310 MERCER ADMINISTRATION A 01/01/2001 12/31/2999
13315 AIM ADMINISTRATORS LTD A 01/01/2001 12/31/2999
13335 HUDSON HEALTH PLAN A 01/01/2001 12/31/2999
13350 THE OREGON DENTAL SERVICE ODS COMPANIES A 01/01/2001 12/31/2999
13522 PERFECT HEALTH INSURANCE A 01/01/2001 12/31/2999
13550 AMALGAMATED LIFE INSURANCE COMPANY ALICARE A 01/01/2001 12/31/2999
13551 GROUP HEALTH INCORPORATED GHI A 01/01/2001 12/31/2999
13784 INSURANCE SYSTEMS INC. A 01/01/2001 12/31/2999
13788 ASSOCIATED ADMINISTRATORS INC A 01/01/2001 12/31/2999
14117 GRINNELL MUTUAL INSURANCE COMPANY A 01/01/2001 12/31/2999
14184 ACUITY MUTUAL INSURANCE A 01/01/2001 12/31/2999
14348 COVENTRY HEALTHCARE TEXAS A 01/01/2001 12/31/2999
15077 MAINE COMMUNITY HEALTH OPTIONS A 01/01/2001 12/31/2999
16111 POMCO A 01/01/2001 12/31/2999
16120 THE ARAZ GROUP A 01/01/2001 12/31/2999
TPL and Medicare Payer IDsRevision Date: November 2021
Payer ID Payer Name Payer Status From Date To Date
16644 NOVA HEALTHCARE ADMINISTRATORS A 01/01/2001 12/31/2999
17965 AMERICAN SENTINAL INSURANCE COMPANY A 01/01/2001 12/31/2999
19402 AIG - CHARTIS\SunAmerica A 01/01/2001 12/31/2999
20199 HEALTH NETWORK OF AMERICA A 01/01/2001 12/31/2999
20230 CENTRAL MUTUAL INSURANCE COMPANY A 01/01/2001 12/31/2999
20356 CERNER HEALTH PLANS A 01/01/2001 12/31/2999
20818 ESSENCE HEALTHCARE A 01/01/2001 12/31/2999
21313 KAISER GEORGIA A 01/01/2001 12/31/2999
22195 MAKSIN MANAGEMENT CORP A 01/01/2001 12/31/2999
22222222 MEDICAREELIGIBLE,NOT ENROLLED IN MEDICARE D A 01/01/2001 12/31/2999
22240 ST BARNABAS SYSTEM HEALTH PLAN A 01/01/2001 12/31/2999
22355 AMERIHEALTH VIP CARE A 01/01/2001 12/31/2999
22384 ADMINISTRATIVE CONCEPTS A 01/01/2001 12/31/2999
22771 MANAGED HEALTH NETWORK A 01/01/2001 12/31/2999
23139 TEACHERS MUTUAL PROTECTIVE INSURANCE A 01/01/2001 12/31/2999
23171 CHA HEALTH A 01/01/2001 12/31/2999
23218 HEALTH AMERICA A 01/01/2001 12/31/2999
23223 THE LOOMIS COMPANY A 01/01/2001 12/31/2999
23226 HEALTH GUARD LANCASTER A 01/01/2001 12/31/2999
23241 FIRST PRIORITY HEALTH A 01/01/2001 12/31/2999
23250 ERIN GROUP ADMINISTRATORS A 01/01/2001 12/31/2999
23252 AMERIHEALTH A 01/01/2001 12/31/2999
23281 UPMC A 01/01/2001 12/31/2999
23388 SHELTER LIFE INSURANCE A 01/01/2001 12/31/2999
24735 WESTERN GROWERS A 01/01/2001 12/31/2999
24740 SAFECO LIFE INSURANCE A 01/01/2001 12/31/2999
25126 HEALTH AMERICA A 01/01/2001 12/31/2999
25130 COVENTRY HEALTHCARE DELAWARE A 01/01/2001 12/31/2999
25132 COVENTRY HEALTHCARE IOWA A 01/01/2001 12/31/2999
25133 COVENTRY HEALTHCARE OKLAHOMA A 01/01/2001 12/31/2999
25135 COVENTRY HEALTHCARE LOUISIANA A 01/01/2001 12/31/2999
25139 CARELINK HEALTH PLANS A 01/01/2001 12/31/2999
25141 COVENTRY HEALTHCARE TENNESSEE A 01/01/2001 12/31/2999
25147 SOUTHCARE/HEALTHCARE PREFERRED A 01/01/2001 12/31/2999
25152 COVENTRY HEALTHCARE ARIZONA A 01/01/2001 12/31/2999
25175 THREE RIVERS BENEFIT CORP A 01/01/2001 12/31/2999
25976 UTICA MUTUAL INSURANCE COMPANY A 01/01/2001 12/31/2999
27008 ECOH CLAIMS A 01/01/2001 12/31/2999
27094 SIMPLY HEALTHCARE A 01/01/2001 12/31/2999
27514 AMERIGROUP-TENNCARE MEDICAID A 01/01/2001 12/31/2999
28530 SECURE HEALTH PLAN GEORGIA A 01/01/2001 12/31/2999
30497 CENTRAL RESERVE LIFE A 01/01/2001 12/31/2999
31053 STATE FARM A 01/01/2001 12/31/2999
TPL and Medicare Payer IDsRevision Date: November 2021
Payer ID Payer Name Payer Status From Date To Date
31096 DELTA DENTAL WEST VIRGINIA A 01/01/2001 12/31/2999
31118 HEALTHSCOPE BENEFITS A 01/01/2001 12/31/2999
31119 MEDICO INSURANCE COMPANY A 01/01/2001 12/31/2999
31121 GREATER CINCINNATI BRICKLAYERS WELFARE FUND A 01/01/2001 12/31/2999
31147 COMPMANAGEMENT HEALTH SYSTEM A 01/01/2001 12/31/2999
31441 S&S HEALTHCARE A 01/01/2001 12/31/2999
31478 PREFERRED HEALTH PROFESSIONALS A 01/01/2001 12/31/2999
31604 HEARTLAND NATIONAL PLAN A 01/01/2001 12/31/2999
31625 ELDERPLAN A 01/01/2001 12/31/2999
32748 BENEFIT ADMINISTRATION SERVICES A 01/01/2001 12/31/2999
32859 PENN AMERICAN GROUP A 01/01/2001 12/31/2999
33033 FCE BENEFIT ADMINISTRATORS, INC A 01/01/2001 12/31/2999
33053 PACIFICARE BEHAVIORAL HEALTH A 01/01/2001 12/31/2999
33104 HEALTHSPRING ALABAMA A 01/01/2001 12/31/2999
33162 BANKERS INSURANCE GROUP A 01/01/2001 12/31/2999
33333333 MEDICAREENROLLED IN PART A A 01/01/2001 12/31/2999
34080 MULTIPLAN WISCONSIN A 01/01/2001 12/31/2999
34131 SELF FUNDED PLANS INC. A 01/01/2001 12/31/2999
34136 JP FARLEY CORPORATION A 01/01/2001 12/31/2999
34145 KLAIS & COMPANY A 01/01/2001 12/31/2999
34158 HEALTH DESIGN PLUS A 01/01/2001 12/31/2999
34159 E V BENEFITS MANAGEMENT A 01/01/2001 12/31/2999
34167 EMERALD HEALTH A 01/01/2001 12/31/2999
34181 COMMERCE BENEFITS GROUP AGENCY, INC. A 01/01/2001 12/31/2999
34185 TRISURANT A 01/01/2001 12/31/2999
34196 APEX BENEFIT SERVICES A 01/01/2001 12/31/2999
35107 INDIANA TEAMSTERS A 01/01/2001 12/31/2999
35112 EMPLOYEE PLANS, LLC A 01/01/2001 12/31/2999
35122 STEWART C. MILLER COMPANY, INC A 01/01/2001 12/31/2999
35161 HEALTHMARK PROHEALTH A 01/01/2001 12/31/2999
35164 SAGAMORE HEALTH NETWORK A 01/01/2001 12/31/2999
35186 DUNN & ASSOCIATES TPA A 01/01/2001 12/31/2999
35198 UNIFIED GROUP SERVICES A 01/01/2001 12/31/2999
35204 INDIANA HEALTH NETWORKINDIANAPOLIS A 01/01/2001 12/31/2999
35206 ENCORE A 01/01/2001 12/31/2999
35209 ADVANTAGE HEALTH SOLUTIONS A 01/01/2001 12/31/2999
35212 NORTH TEXAS HEALTHCARE A 01/01/2001 12/31/2999
35245 CONTINENTAL BENEFITS A 01/01/2001 12/31/2999
35639 KAISER PERMANENTE A 01/01/2001 12/31/2999
36338 GROUP ADMINISTRATIVE SERVICES A 01/01/2001 12/31/2999
36342 BENEFIT SYSTEMS & SERVICES A 01/01/2001 12/31/2999
36373 PRAIRIE STATES ENTERPRISES A 01/01/2001 12/31/2999
36436 DESTINY HEALTH A 01/01/2001 12/31/2999
TPL and Medicare Payer IDsRevision Date: November 2021
Payer ID Payer Name Payer Status From Date To Date
36609 BOILERMAKERS NATIONAL HEALTH & WELFARE A 01/01/2001 12/31/2999
37111 HCH ADMINISTRATION A 01/01/2001 12/31/2999
37121 PEQUOT HEALTH CARE A 01/01/2001 12/31/2999
37135 CONSOCIATE GROUP A 01/01/2001 12/31/2999
37217 KEY BENEFIT ADMINISTRATORS A 01/01/2001 12/31/2999
37222 BENEFIT PLAN MANAGEMENT A 01/01/2001 12/31/2999
37224 PITTMAN AND ASSOCIATES A 01/01/2001 12/31/2999
37226 LONDON AGENCY A 01/01/2001 12/31/2999
37227 INTERCARE HEALTH PLAN A 01/01/2001 12/31/2999
37242 PROFESSIONAL CLAIMS MANAGEMENT A 01/01/2001 12/31/2999
37246 CORPORATE SYSTEMS ADMINISTRATORS A 01/01/2001 12/31/2999
37248 BENESYS A 01/01/2001 12/31/2999
37256 MUTUAL ASSURANCE ADMINISTRATORS A 01/01/2001 12/31/2999
37259 SAMBA HEALTH A 01/01/2001 12/31/2999
37272 JSL ADMINISTRATORS A 01/01/2001 12/31/2999
37279 INSURANCE ADMINISTRATORS OF AMERICA A 01/01/2001 12/31/2999
37280 AUTOMATED GROUP ADMINISTRATION INC A 01/01/2001 12/31/2999
37281 MID AMERICA ASSOCIATES INC A 01/01/2001 12/31/2999
37282 SELECT BENEFIT ADMINISTATORS A 01/01/2001 12/31/2999
37287 PLANNED ADMINISTRATORS A 01/01/2001 12/31/2999
37295 CONSUMER HEALTH SOLUTIONS A 01/01/2001 12/31/2999
37297 COMPBENEFITS OF ILLINOIS A 01/01/2001 12/31/2999
37300 FEDERATED HR SERVICE A 01/01/2001 12/31/2999
37304 MEDIVERSAL, INC. A 01/01/2001 12/31/2999
37318 SOUTHERN BENEFIT SERVICES LLC A 01/01/2001 12/31/2999
37322 AMERICAN WORKER HEALTH PLAN A 01/01/2001 12/31/2999
37330 PHP SOUTH MICHIGAN A 01/01/2001 12/31/2999
37958 ACCEPTANCE INSURANCE COMPANY A 01/01/2001 12/31/2999
38201 TOTAL HEALTH CARE INC A 01/01/2001 12/31/2999
38219 AMERAPLAN INC A 01/01/2001 12/31/2999
38225 NGS AMERICAN INC A 01/01/2001 12/31/2999
38232 WEYCO INC A 01/01/2001 12/31/2999
38238 EMPLOYEE BENEFIT PLAN A 01/01/2001 12/31/2999
38254 ACTIVA BENEFITS A 01/01/2001 12/31/2999
38265 ASR BENEFITS PHYSICIANS CARE A 01/01/2001 12/31/2999
38289 FARA BENEFITS A 01/01/2001 12/31/2999
38332 NEW WORLD CLAIMS SERVICES A 01/01/2001 12/31/2999
38335 COFINITY A 01/01/2001 12/31/2999
38336 MOLINA WASHINGTON APPLE A 01/01/2001 12/31/2999
38365 BRIDGE BENEFITS INC A 01/01/2001 12/31/2999
38830 LINCOLN NATIONAL A 01/01/2001 12/31/2999
39026 UMR FISERV HEALTH WAUSAU A 01/01/2001 12/31/2999
39033 SENTRY CLAIMS SERVICE A 01/01/2001 12/31/2999
TPL and Medicare Payer IDsRevision Date: November 2021
Payer ID Payer Name Payer Status From Date To Date
39065 ASSURANT GMS A 01/01/2001 12/31/2999
39081 BENEFIT PLAN ADMINISTRATION OF WISCONSIN A 01/01/2001 12/31/2999
39141 CLAIM MANAGEMENT SERVICES A 01/01/2001 12/31/2999
39170 CUSTOM BENEFIT ADMINISTRATOR A 01/01/2001 12/31/2999
3MBDT 3M BENEFITS DEPARTMENT A 01/01/2001 12/31/2999
3PADM 3PA ADMINISTRATORS A 01/01/2001 12/31/2999
40585 INDECS CORPORATION A 01/01/2001 12/31/2999
40800 AMERICAN STERLING INSURANCE A 01/01/2001 12/31/2999
41041 FEDERATED MUTUAL A 01/01/2001 12/31/2999
41099 ASSURANT GMS A 01/01/2001 12/31/2999
41101 MIDWEST DENTAL BENEFITS A 01/01/2001 12/31/2999
41124 CORPORATE BENEFIT SERVICES OF AMERICA A 01/01/2001 12/31/2999
41147 PREFERRED ONE A 01/01/2001 12/31/2999
41154 MMSI INC A 01/01/2001 12/31/2999
41161 AMERICAN CHIROPRACTIC NETWORK A 01/01/2001 12/31/2999
41173 OUTSOURCE ONE INC A 01/01/2001 12/31/2999
41194 OPTUMHEALTH BEHAVIORAL SOLUTIONS A 01/01/2001 12/31/2999
41555 MANATEE HEALTH PLAN A 01/01/2001 12/31/2999
41556 UNIVERSITY OF COLORADOHEALTH PLAN ADMIN/TPA A 01/01/2001 12/31/2999
41840 ALLMERICA FINANCIAL A 01/01/2001 12/31/2999
42150 BUTLER BENEFITS SERVICE A 01/01/2001 12/31/2999
42374 HOUSTON CASUALTY COMPANY A 01/01/2001 12/31/2999
42469 SOLVAY AMERICAN A 01/01/2001 12/31/2999
42978 AMERICAN SECURITY LIFE INSURANCE A 01/01/2001 12/31/2999
43166 PREMIER HEALTH PLAN A 01/01/2001 12/31/2999
43183 JW TERRILL A 01/01/2001 12/31/2999
43751 CIGNA A 01/01/2001 12/31/2999
44054 GOVERNMENT EMPLOYEE HEALTH ASSOCIATION GEHA A 01/01/2001 12/31/2999
44147 PREFERRED ONE A 01/01/2001 12/31/2999
44273 HEALTH PLANS INC A 01/01/2001 12/31/2999
44444 AMERICAN POSTAL WORKERS UNION APWU A 01/01/2001 12/31/2999
44444444 MEDICAREENROLLED IN PART B A 01/01/2001 12/31/2999
45150 MERITUS HEALTH PLAN A 01/01/2001 12/31/2999
45321 CONSUMERS CHOICE HEALTH PLAN A 01/01/2001 12/31/2999
45615 DELTA DENTAL OF KANSAS A 01/01/2001 12/31/2999
45935 UNICARE A 01/01/2001 12/31/2999
46045 AVERA HEALTH PLANS A 01/01/2001 12/31/2999
47009 AMERITAS LIFE INSURANCE A 01/01/2001 12/31/2999
47010 AMERITAS VISION A 01/01/1964 12/31/2999
47035 ESSEX DENTAL BENEFITS A 01/01/2001 12/31/2999
47036 VYTRA HEALTH SERVICES A 01/01/2001 12/31/2999
47054 DENTAL SERVICE CORPORATION OF ND A 01/01/2001 12/31/2999
47055 GROUP HEALTH COOPERATIVE A 01/01/2001 12/31/2999
TPL and Medicare Payer IDsRevision Date: November 2021
Payer ID Payer Name Payer Status From Date To Date
47058 EXPRESS SCRIPTS A 01/01/2001 12/31/2999
47076 REGIONAL CARE INC A 01/01/2001 12/31/2999
47079 DELTA DENTAL NEW HAMPSHIRE A 01/01/2001 12/31/2999
47081 MIDLANDS BENEFIT ADMIN HEALTH PARTNERS A 01/01/2001 12/31/2999
47083 GMS, INC A 01/01/2001 12/31/2999
47089 UNITED CONCORDIA DENTAL A 01/01/2001 12/31/2999
47091 DELTA DENTAL NEBRASKA A 01/01/2001 12/31/2999
47096 CASCADE EAST HEALTH A 01/01/2001 12/31/2999
47098 MODA HEALTH PLAN A 01/01/2001 12/31/2999
47155 DELTA DENTAL ARKANSAS A 01/01/2001 12/31/2999
47223 CITY OF SAN ANTONIO A 01/01/2001 12/31/2999
47287 DELTA DENTAL NEW MEXICO A 01/01/2001 12/31/2999
47317 VISION SERVICE PLAN A 01/01/2001 12/31/2999
47341 WASHINGTON DENTAL A 01/01/2001 12/31/2999
47589 DELTA DENTAL ILLINOIS A 01/01/2001 12/31/2999
47791 DELTA DENTAL IDAHO A 01/01/2001 12/31/2999
47953 UNIVERSITY HEALTH ALLIANCE A 01/01/2001 12/31/2999
48055 AMERICAN PROGRESSIVE A 01/01/2001 12/31/2999
48117 FMH BENEFIT SERVICES A 01/01/2001 12/31/2999
48143 GROUP & PENSION ADMINISTRATORS A 01/01/2001 12/31/2999
48160 DENTAL SOURCE A 01/01/2001 12/31/2999
48321 VISION SERVICE PLAN A 01/01/2001 12/31/2999
49153 BCI ADMINISTRATORS A 01/01/2001 12/31/2999
50408 ASSURANT HEALTH A 01/01/2001 12/31/2999
51020 INTEGRA ADMINISTRATIVE GROUP A 01/01/2001 12/31/2999
52005 VISION BENEFITS OF AMERICA A 01/01/2001 12/31/2999
52041 AMERICAN DENTAL A 01/01/2001 12/31/2999
52103 NATIONAL TELECOMMUNICATIONS ASSOCIATION A 01/01/2001 12/31/2999
52132 COOPERATIVE BENEFITS ADMIN A 01/01/2001 12/31/2999
52133 UNITED HEALTHCARE DENTAL A 01/01/2001 12/31/2999
52147 DELTA DENTAL DC A 01/01/2001 12/31/2999
52148 ALLIANCE PPO A 01/01/2001 12/31/2999
52149 ALLIANCE HEALTH PLAN A 01/01/2001 12/31/2999
52189 JOHNS HOPKINS HEALTHCARE A 01/01/2001 12/31/2999
52192 ELDER HEALTH TEXAS BRAVO HEALTH A 01/01/2001 12/31/2999
52196 INFORMED LLC A 01/01/2001 12/31/2999
52555 WILLIAMETTE DENTAL A 01/01/2001 12/31/2999
52559 MEDICAL ASSOCIATES HEALTH PLAN A 01/01/2001 12/31/2999
52629 U CARE MINNESOTA A 01/01/2001 12/31/2999
52634 DELTA DENTAL INDIANA A 01/01/2001 12/31/2999
53011 NATIONAL ASSOCIATION OF LETTER CARRIERS A 01/01/2001 12/31/2999
53012 MAIL HANDLERS BENEFIT PLAN A 01/01/2001 12/31/2999
53085 ANCHOR BENEFITS CONSULTING A 01/01/2001 12/31/2999
TPL and Medicare Payer IDsRevision Date: November 2021
Payer ID Payer Name Payer Status From Date To Date
53279 DELTA DENTAL VERMONT A 01/01/2001 12/31/2999
53872 KPS HEALTH PLANS A 01/01/2001 12/31/2999
53937 DELTA DENTAL PLAN OKLAHOMA A 01/01/2001 12/31/2999
54035 DELTA DENTAL MICHIGAN RENAISSANCE A 01/01/2001 12/31/2999
54046 DELTA DENTAL WISCONSIN A 01/01/2001 12/31/2999
54097 DELTA DENTAL SOUTH DAKOTA A 01/01/2001 12/31/2999
54154 SENTARA HEALTHCARE A 01/01/2001 12/31/2999
54195 LUMENOS INC A 01/01/2001 12/31/2999
54305 DELTA DENTAL MICHIGAN A 01/01/2001 12/31/2999
54402 DELTA DENTAL OHIO A 01/01/2001 12/31/2999
54526 DELTA DENTAL TENNESSEE A 01/01/2001 12/31/2999
54615 DELTA DENTAL KANSAS A 01/01/2001 12/31/2999
54658 DELTA DENTAL NORTH CAROLINA A 01/01/2001 12/31/2999
54674 DELTA DENTAL KENTUCKY A 01/01/2001 12/31/2999
54763 INTERCOUNTY HOSP PLAN A 01/01/2001 12/31/2999
54798 DELTA DENTAL PA A 01/01/2001 12/31/2999
55034 DELTA DENTAL MINNESOTA A 01/01/2001 12/31/2999
55085 DELTA DENTAL NEW JERSEY A 01/01/2001 12/31/2999
55263 DELTA DENTAL NEW YORK A 01/01/2001 12/31/2999
55301 DELTA DENTAL RHODE ISLAND A 01/01/2001 12/31/2999
55438 CBCA ADMINISTRATORS INC A 01/01/2001 12/31/2999
55555 CIGNA A 01/01/2001 12/31/2999
55555555 MEDICAREENROLLED IN MEDICARE ADVANTAGE PLAN A 01/01/2001 12/31/2999
55611 DELTA DENTAL VIRGINIA A 01/01/2001 12/31/2999
55697 DELTA DENTAL MISSOURI A 01/01/2001 12/31/2999
55786 DELTA DENTAL OF IA A 01/01/2001 12/31/2999
55816 TRIPLE S INC A 01/01/2001 12/31/2999
56014 THRIVENT FINANCIAL A 01/01/2001 12/31/2999
56116 CARE 1ST HEALTH PLAN ARIZONA A 01/01/2001 12/31/2999
56144 PRIMARY PHYSICIAN CARE INC A 01/01/2001 12/31/2999
56175 NATIONAL BENEFITS ADMINISTRATORS A 01/01/2001 12/31/2999
56196 FIRST CAROLINA CARE A 01/01/2001 12/31/2999
57029 HEWITT, COLEMAN, AND ASSOCIATES INC A 01/01/2001 12/31/2999
57080 MIDLANDS CHOICE A 01/01/2001 12/31/2999
57230 WOODMEN OF THE WORLD A 01/01/2001 12/31/2999
57487 CATHOLIC ORDER OF FORESTERS A 01/01/2001 12/31/2999
57991 MENNONITE MUTUAL AID A 01/01/2001 12/31/2999
58231 CORE ADMINISTRATIVE SERVICES A 01/01/2001 12/31/2999
58379 HEALTHCARE MGMT ADMI A 01/01/1964 12/31/2999
59069 UNITED BENEFITS/FBMC A 01/01/2001 12/31/2999
59141 ADMINISTRATIVE SERVICES INC A 01/01/2001 12/31/2999
59225 STAR HRG A 01/01/2001 12/31/2999
59230 HETITAGE CONSULTANTS, INC A 01/01/2001 12/31/2999
TPL and Medicare Payer IDsRevision Date: November 2021
Payer ID Payer Name Payer Status From Date To Date
59276 FIRST SERVICES ADMINISTRATORS A 01/01/2001 12/31/2999
59296 PROFESSIONAL BENEFIT ADMINISTRATORS A 01/01/2001 12/31/2999
59298 EMPLOYERS MUTUAL INC A 01/01/2001 12/31/2999
59313 EVOLUTIONS HEALTHCARE A 01/01/2001 12/31/2999
59347 HILLCREST BENEFITS ADMINISTRATORS A 01/01/2001 12/31/2999
59374 ADVANTICA INC A 01/01/2001 12/31/2999
60009 SOUTHERN NATIONAL A 01/01/2001 12/31/2999
60053 KAISER CALIFORNIA A 01/01/2001 12/31/2999
60054 AETNA A 01/01/2001 12/31/2999
60094 HEALTH INSURANCE PLAN NEW YORK A 01/01/2001 12/31/2999
60110 PREFERRED HEALTH KANSAS A 01/01/2001 12/31/2999
60186 ALLSTATE A 01/01/2001 12/31/2999
60216 AMALGAMATED LIFE INSURANCE COMPANY A 01/01/2001 12/31/2999
60237 PREMIER ACCESS A 01/01/2001 12/31/2999
60321 MAMSI LIFE A 01/01/2001 12/31/2999
60380 AFLAC A 01/01/2001 12/31/2999
60399 AMERICAN FAMILY MUTUAL A 01/01/2001 12/31/2999
60410 AMERICAN FIDELITY ASSURANCE A 01/01/2001 12/31/2999
60577 AMERICAN INCOME LIFE INSURANCE COMPANY A 01/01/2001 12/31/2999
60593 NATIONAL STATES INSURANCE A 01/01/2001 12/31/2999
60763 AMERICAN PIONEER A 01/01/2001 12/31/2999
60801 AMERICAN PUBLIC LIFE INSURANCE A 01/01/2001 12/31/2999
60895 AMERICAN UNDERWRITERS INSURANCE A 01/01/2001 12/31/2999
61101 HUMANA HEALTH CARE PLANS A 01/01/2001 12/31/2999
61124 BLUEGRASS FAMILY HEALTH A 01/01/2001 12/31/2999
61190 AUTO OWNERS INSURANCE COMPANY A 01/01/2001 12/31/2999
61239 BANKERS FIDELITY LIFE INSURANCE A 01/01/2001 12/31/2999
61271 PRINCIPAL MUTUAL A 01/01/2001 12/31/2999
61425 TRUSTMARK A 01/01/2001 12/31/2999
61476 BOSTON MUTUAL LIFE INSURANCE A 01/01/2001 12/31/2999
61581 CAPITOL LIFE INSURANCE COMPANY A 01/01/2001 12/31/2999
61665 PREFERRED BENEFITS ADMINISTRATORS A 01/01/2001 12/31/2999
61727 CENTRAL RESERVE LIFE A 01/01/2001 12/31/2999
61735 CENTRAL SECURITY LIFE A 01/01/2001 12/31/2999
61832 CHESAPEAKE LIFE INSURANCE A 01/01/2001 12/31/2999
61859 CHRISTIAN FIDELITY A 01/01/2001 12/31/2999
61883 CENTRAL UNITED LIFE A 01/01/2001 12/31/2999
61921 CITIZENS SECURITY LIFE A 01/01/2001 12/31/2999
62049 COLONIAL LIFE & ACCIDENT A 01/01/2001 12/31/2999
62061 UMR FISERV HEALTH KANSAS A 01/01/2001 12/31/2999
62111 HEALTH COST SOLUTIONS A 01/01/2001 12/31/2999
62149 COMMUNITY HEALTH NETWORK OF CT A 01/01/2001 12/31/2999
62183 UNISON HEALTH PLAN A 01/01/2001 12/31/2999
TPL and Medicare Payer IDsRevision Date: November 2021
Payer ID Payer Name Payer Status From Date To Date
62227 COMMONWEALTH LIFE A 01/01/2001 12/31/2999
62295 HEALTHMARKETS A 01/01/2001 12/31/2999
62302 CIGNA A 01/01/2001 12/31/2999
62308 CIGNA DENTAL A 01/01/2001 12/31/2999
62413 CONTINENTAL ASSURANCE COMPANY CNA A 01/01/2001 12/31/2999
62416 COMBINED INSURANCE A 01/01/2001 12/31/2999
62537 COTTON STATES INSURANCE A 01/01/2001 12/31/2999
62553 COUNTRY FINANCIAL A 01/01/2001 12/31/2999
62804 EDUCATOR MUTUAL A 01/01/2001 12/31/2999
62928 EMC NATIONAL LIFE CO A 01/01/2001 12/31/2999
62952 EQUITABLE LIFE & CASUALTY A 01/01/2001 12/31/2999
63079 MID ATLANTIC HEALTH A 01/01/2001 12/31/2999
63092 HEALTHSPRING INC A 01/01/2001 12/31/2999
63114 VIVA HEALTHCARE A 01/01/2001 12/31/2999
63126 FARM FAMILY INSURANCE A 01/01/2001 12/31/2999
63282 PENN TREATY LIFE INSURANCE A 01/01/2001 12/31/2999
63479 UNITED TEACHERS ASSOCIATES A 01/01/2001 12/31/2999
63665 GENERAL AMERICAN A 01/01/2001 12/31/2999
64017 JEFFERSON NATIONAL LIFE INSURANCE A 01/01/2001 12/31/2999
64069 FOX EVERETT A 01/01/2001 12/31/2999
64071 ACCLAIM A 01/01/2001 12/31/2999
64130 AEGON USA A 01/01/2001 12/31/2999
64159 DEFINITY HEALTH PLANS A 01/01/2001 12/31/2999
64211 GUARANTEE TRUST LIFE A 01/01/2001 12/31/2999
64238 GUARANTY INCOME LIFE A 01/01/2001 12/31/2999
64246 GUARDIAN A 01/01/2001 12/31/2999
64335 HARTFORD INSURANCE GROUP A 01/01/2001 12/31/2999
64440 HOME LIFE INSURANCE A 01/01/2001 12/31/2999
64580 ILLINOIS MUTUAL A 01/01/2001 12/31/2999
64696 FIRST CONTINENTAL LIFE & ACCIDENT A 01/01/2001 12/31/2999
65021 STONEBRIDGE LIFE INSURANCE COMPANY A 01/01/2001 12/31/2999
65074 OLYMPUS MANAGED CARE A 01/01/2001 12/31/2999
65093 NATIONAL STATES INSURANCE A 01/01/2001 12/31/2999
65110 KANAWA INSURANCE A 01/01/2001 12/31/2999
65129 KANSAS CITY LIFE A 01/01/2001 12/31/2999
65269 UNITED BENEFIT LIFE INSURANCE A 01/01/2001 12/31/2999
65395 MASS MUTUAL A 01/01/2001 12/31/2999
65412 LIFE INSURANCE COMPANY OF ALABAMA A 01/01/2001 12/31/2999
65471 LIFE INSURANCE COMPANY OF GEORGIA A 01/01/2001 12/31/2999
65722 LOYAL AMERICAN LIFE INSURANCE A 01/01/2001 12/31/2999
65781 MADISON NATIONAL LIFE A 01/01/2001 12/31/2999
65935 UNICARE A 01/01/2001 12/31/2999
65978 UNITED HEALTHCARE A 01/01/2001 12/31/2999
TPL and Medicare Payer IDsRevision Date: November 2021
Payer ID Payer Name Payer Status From Date To Date
65987 AETNA US HEALTHCARE A 01/01/2001 12/31/2999
66443 WASHINGTON NATIONAL A 01/01/2001 12/31/2999
66605 PEOPLES BENEFIT LIFE INSURANCE A 01/01/2001 12/31/2999
66666 CIGNA A 01/01/2001 12/31/2999
66666666 MEDICAREENROLLED IN MEDICARE PART D A 01/01/2001 12/31/2999
66893 NEW ENGLAND LIFE A 01/01/2001 12/31/2999
66914 NEW YORK LIFE A 01/01/2001 12/31/2999
66915 NEW YORK LIFE A 01/01/2001 12/31/2999
67121 TRANSAMERICA OCCIDENTAL LIFE A 01/01/2001 12/31/2999
67199 OLD AMERICAN INSURANCE COMPANY A 01/01/2001 12/31/2999
67202 LOUISIANA HEALTH COOPERATIVE A 01/01/2001 12/31/2999
67466 PACIFIC LIFE A 01/01/2001 12/31/2999
67477 MEDCO HEALTH A 01/01/2001 12/31/2999
67539 PAN AMERICAN LIFE A 01/01/2001 12/31/2999
67636 SIGNIFICA A 01/01/2001 12/31/2999
67660 PENNSYLVANIA LIFE INSURANCE A 01/01/2001 12/31/2999
67695 FEDERAL HOME LIFE A 01/01/2001 12/31/2999
67784 PHILADELPHIA AMERICA A 01/01/2001 12/31/2999
67814 PHOENIX MUTUAL A 01/01/2001 12/31/2999
67815 GENWORTH FINANCIAL A 01/01/2001 12/31/2999
67865 JEFFERSON PILOT A 01/01/2001 12/31/2999
67903 PROVIDENT AMERICAN LIFE & HEALTH A 01/01/2001 12/31/2999
68011 CAPITOL ADMINISTRATION A 01/01/2001 12/31/2999
68035 HEALTH PLAN OF SAN JOAQUIN A 01/01/2001 12/31/2999
68050 CONTINENTAL LIFE INSURANCE A 01/01/2001 12/31/2999
68069 ARKANSAS HEALTH & WELLNESS (AMBETTER) A 01/01/2001 12/31/2999
68225 PROVIDENT MUTUAL LIFE A 01/01/2001 12/31/2999
68241 AETNA STRATEGIC RESOURCE A 01/01/2001 12/31/2999
68357 RELIABLE LIFE INSURANCE COMPANY A 01/01/2001 12/31/2999
68381 RELIANCE STANDARD A 01/01/2001 12/31/2999
68420 WESTERN MUTUAL A 01/01/2001 12/31/2999
68462 RESERVE NATIONAL A 01/01/2001 12/31/2999
68500 CONTINENTAL LIFE INSURANCE A 01/01/2001 12/31/2999
68721 SECURITY LIFE INSURANCE COMPANY A 01/01/2001 12/31/2999
68772 SECURITY LIFE INSURANCE A 01/01/2001 12/31/2999
68845 SHENANDOAH LIFE INSURANCE A 01/01/2001 12/31/2999
69140 STATE MUTUAL A 01/01/2001 12/31/2999
69477 ASSURANT HEALTH A 01/01/2001 12/31/2999
69493 TOWER LIFE INSURANCE A 01/01/2001 12/31/2999
69531 TRANSPORT LIFE A 01/01/2001 12/31/2999
69701 UNION BANKERS A 01/01/2001 12/31/2999
69779 UNION NATIONAL LIFE A 01/01/2001 12/31/2999
69930 UNITED INSURANCE COMPANY OF AMERICA A 01/01/2001 12/31/2999
TPL and Medicare Payer IDsRevision Date: November 2021
Payer ID Payer Name Payer Status From Date To Date
69965 CHUBB LIFE AMERICA A 01/01/2001 12/31/2999
70106 US LIFE A 01/01/2001 12/31/2999
70122 UNIVERSAL FIDELITY LIFE A 01/01/2001 12/31/2999
70408 ASSURANT EMPLOYEE BENEFITS DENTAL CLAIMS A 01/01/2001 12/31/2999
70483 WESTERN & SOUTHERN A 01/01/2001 12/31/2999
70580 HUMANA DENTAL PLANS A 01/01/2001 12/31/2999
70629 WORLD INSURANCE COMPANY A 01/01/2001 12/31/2999
70939 GERBER LIFE INSURANCE A 01/01/2001 12/31/2999
71063 HEALTHSCOPE BENEFITS A 01/01/2001 12/31/2999
71072 MARQUETTE NATIONAL LIFE A 01/01/2001 12/31/2999
71080 NOVAYS HEALTH A 01/01/2001 12/31/2999
71404 CONTINENTAL GENERAL INSURANCE A 01/01/2001 12/31/2999
71412 MUTUAL OF OMAHA A 01/01/2001 12/31/2999
71420 SIERRA NEVADA A 01/01/2001 12/31/2999
71471 ABILITY INSURANCE A 01/01/2001 12/31/2999
71595 LEWER LIFE INSURANCE A 01/01/2001 12/31/2999
71870 FIDELITY SECURITY LIFE INSURANCE COMPANY A 01/01/2001 12/31/2999
72087 OFFICE OF GROUP BENEFITS A 01/01/2001 12/31/2999
72099 AMERICAN LIFE CARE A 01/01/2001 12/31/2999
72467 ACS BENEFIT SERVICES A 01/01/2001 12/31/2999
73071 OSMA HEALTH A 01/01/2001 12/31/2999
73100 KEMPTON GROUP ADMIN A 01/01/2001 12/31/2999
73147 HEALTH CARE SOLUTIONS A 01/01/2001 12/31/2999
73159 CCN MANAGED CARE A 01/01/2001 12/31/2999
74065 LEGACY HEALTH PLANS A 01/01/2001 12/31/2999
74095 USAA INSURANCE A 01/01/2001 12/31/2999
74101 FIRST UNITED AMERICAN A 01/01/2001 12/31/2999
74214 TEXAS MUNICIPAL LEAGUE TML A 01/01/2001 12/31/2999
74217 MEDICAL SAVINGS INSURANCE COMPANY A 01/01/2001 12/31/2999
74223 BENEFIT PLANNERS A 01/01/2001 12/31/2999
74227 BANKERS LIFE & CASUALTY A 01/01/2001 12/31/2999
74238 BOON CHAPMAN ADMINISTRATORS A 01/01/2001 12/31/2999
74240 ASSURED BENEFITS ADMINISTRATORS A 01/01/2001 12/31/2999
74323 MEDICAL BENEFITS MUTUAL A 01/01/2001 12/31/2999
75130 UMC HEALTH PLAN A 01/01/2001 12/31/2999
75185 ICON BENEFIT ADMIN A 01/01/2001 12/31/2999
75196 HARRINGTON HEALTH A 01/01/2001 12/31/2999
75234 HEALTHFIRST TPA A 01/01/2001 12/31/2999
75236 EMPLOYERS DIRECT HEALTH A 01/01/2001 12/31/2999
75238 GFRE GROUP ADMINISTRATORS A 01/01/2001 12/31/2999
75240 AMERICAN ADMIN GROUP A 01/01/2001 12/31/2999
75250 HEALTHSMART BENEFIT SOLUTIONS A 01/01/2001 12/31/2999
75261 WEB TPA A 01/01/2001 12/31/2999
TPL and Medicare Payer IDsRevision Date: November 2021
Payer ID Payer Name Payer Status From Date To Date
75275 NATIONAL HEALTH INSURANCE COMPANY A 01/01/2001 12/31/2999
75280 SHASTA ADMINISTRATORS A 01/01/2001 12/31/2999
75281 NEW ERA LIFE A 01/01/2001 12/31/2999
75284 CONSOLIDATED ASSOCIATION OF RAILROADS A 01/01/2001 12/31/2999
75914 AMERICAN CHAMBERS LIFE INSURANCE A 01/01/2001 12/31/2999
76031 FLORIDA COMBINED LIFE A 01/01/2001 12/31/2999
76112 OXFORD LIFE INSURANCE A 01/01/2001 12/31/2999
76342 SIERRA HEALTH & LIFE A 01/01/2001 12/31/2999
77082 CARE IMPROVEMENT PLUS A 01/01/2001 12/31/2999
77180 HEALTHYCT A 01/01/2001 12/31/2999
77399 STERLING LIFE INSURANCE A 01/01/2001 12/31/2999
77701 CARILION HEALTH PLAN A 01/01/2001 12/31/2999
77705 HIGHMARK BCBS A 01/01/2001 12/31/2999
77777 DELTA DENTAL CALIFORNIA A 01/01/2001 12/31/2999
77828 COMPANION LIFE A 01/01/2001 12/31/2999
77894 KENTUCKY HEALTH COOPERATIVE A 01/01/2001 12/31/2999
78068 P5 HEALTH SERVICES A 01/01/2001 12/31/2999
79065 SUN LIFE ASSURANCE COMPANY A 01/01/2001 12/31/2999
80141 HEALTHFIRST NEW YORK A 01/01/2001 12/31/2999
80578 PHYSICIANS MUTUAL A 01/01/2001 12/31/2999
80667 CONFEDERATION LIFE A 01/01/2001 12/31/2999
80705 GREAT WEST A 01/01/2001 12/31/2999
81027 VETERANS LIFE INSURANCE A 01/01/2001 12/31/2999
81040 ALLIEGENCE BENEFIT PLAN A 01/01/2001 12/31/2999
81060 CANADA LIFE A 01/01/2001 12/31/2999
81108 UNITED SECURITY LIFE A 01/01/2001 12/31/2999
81264 NIPPON LIFE INSURANCE A 01/01/2001 12/31/2999
81396 DELTA DENTAL DELAWARE A 01/01/2001 12/31/2999
81400 UNITED HEALTHCARE ALL SAVERS A 01/01/2001 12/31/2999
81418 AMERICAN MEDICAL & LIFE INSURANCE A 01/01/2001 12/31/2999
81426 COMMERCIAL TRAVELERS MUTUAL INSURANCE A 01/01/2001 12/31/2999
81434 SHELTERPOINT A 01/01/2001 12/31/2999
81973 COVENTRY HEALTHCARE NORTH CAROLINA A 01/01/2001 12/31/2999
83028 MBA UTAH A 01/01/2001 12/31/2999
84068 FRINGE BENEFIT GROUP A 01/01/2001 12/31/2999
84076 SINCLAIR HEALTH PLAN A 01/01/2001 12/31/2999
84095 MOUNTAIN STATES ADMINISTRATION A 01/01/2001 12/31/2999
84096 SLOANS LAKE PREFERRED HEALTH A 01/01/2001 12/31/2999
84103 TRIGON DENTAL A 01/01/2001 12/31/2999
84132 UNITED MEDICAL ALLIANCE A 01/01/2001 12/31/2999
84506 FHP LIFE A 01/01/2001 12/31/2999
84549 SYMPHONIX HEALTH INSURANCE A 01/01/2001 12/31/2999
84930 LIFEWISE PLAN OF OREGON A 01/01/2001 12/31/2999
TPL and Medicare Payer IDsRevision Date: November 2021
Payer ID Payer Name Payer Status From Date To Date
85256 WABASH MEMORIAL HOSPITAL ASSOCIATION A 01/01/2001 12/31/2999
85729 HEALTHCOMP INC A 01/01/2001 12/31/2999
86040 MOUNTAIN STATES ADMIN A 01/01/2001 12/31/2999
86062 ARIZONA FOUNDATION FOR MEDICAL CARE A 01/01/2001 12/31/2999
86066 HAWAII MAINLAND ADMINISTRATORS A 01/01/2001 12/31/2999
86071 SUMMERLIN LIFE & HEALTH INSURANCE CO A 01/01/2001 12/31/2999
86231 TRANSAMERICA LIFE INSURANCE A 01/01/2001 12/31/2999
86304 INSURERS ADMIN. CORPORATION A 01/01/2001 12/31/2999
86753 BENEFIT ADMIN SYSTEM A 01/01/2001 12/31/2999
87043 ALTA HEALTH STRATEGIES A 01/01/2001 12/31/2999
87265 FISERV HEALTH A 01/01/2001 12/31/2999
87718 CONCERT HEALTH PLAN A 01/01/2001 12/31/2999
87726 UNITED HEALTHCARE A 01/01/2001 12/31/2999
87815 HEALTH SMART WEST VIRGINIA A 01/01/2001 12/31/2999
88022 CDS GROUP HEALTH A 01/01/2001 12/31/2999
88027 NORTHERN NEVADA LABORERS A 01/01/2001 12/31/2999
88029 SAINT MARYS HEALTHPLANS A 01/01/2001 12/31/2999
88052 BENEFIT PLAN ADMINISTRATORS A 01/01/2001 12/31/2999
88067 TALL TREE ADMINISTRATORS A 01/01/2001 12/31/2999
88072 HARTFORD LIFE/ACCIDENT A 01/01/2001 12/31/2999
88536 PROTECTIVE LIFE INSURANCE A 01/01/2001 12/31/2999
88888 UNITED HEALTHCARE A 01/01/2001 12/31/2999
89184 STERLING INVESTORS LIFE A 01/01/2001 12/31/2999
90010 COMMUNITY HEALTH PLAN MISSOURI A 01/01/2001 12/31/2999
90611 ALLIANZ LIFE A 01/01/2001 12/31/2999
91068 NORTHWEST ADMINISTRATORS A 01/01/2001 12/31/2999
91121 GROUP HEALTH OPTIONS INC A 01/01/2001 12/31/2999