Payer 835 List

Payer ID Payer Name

59069 21st Century Health (MedsavUSA)(NJ)

74237 32 Dental (PO Box 9150, Austin, TX)

20413 3P Administrators (Onalaska, WI)

37283 AAG-American Administrative Group (Lubbock, TX)

AARP1 AARP Dental Insurance Plan (Mechanicsburg, PA)

52133 ACEC Health Plans (SLC, UT)

61425 ACEC-Healthplan

72468 ACS Benefit Services (Salem Winston, NC)

72468 ACS Consulting, Salem Winston, NC

CX052 AD-Medicaid (Atlantic Dental, Inc)(Mequon, WI)

CX052 ADI -Medicaid (Atlantic Dental, Inc)(Coral Gables, FL

37280 AGA (Automated Group Admin (Fort Wayne, IN)

91136 AGC- I.U.O.E Local 701 trust Funds

80705 AH & L (Anthem Health & Life Ins of NJ)(Kennett, MO)

80705 ALTA Health & Life Ins. Co. (Kennett, MO)

44444 APWU (American Postal Workers (Silver Springs, MD)

63240 ARM (Alternative Risk Management (Eagan, MN)

38265 ASR Corporation (Grand Rapids, MI)

38265 ASR Health Benefits (Grand Rapids, MI)

ASRM1 ASRM (Moorestown, NJ)

75261 AXA (Web-TPA) Grapevine, TX

43178 Acceptius (Benefit Management Inc of MO, Joplin, MO)

64071 Acclaim (Tupelo, MS)

87815 Accordia National (Charleston, WV)

38255 Activa Benefit Services, LLC - Grand Rapids, MI

38265 Administration Systems Research Corp. (Grand Rapids,

22384 Administrative Concepts (Wayne, PA)

93524 Advantage Dental Plan - Roseburg, OR

52133 Advantage Health Solutions (Salt Lake City, UT)

83077 Advantek Benefit Admin (Fresno, CA)

43168 Advantica Administrative Svcs (St. Louis, MO)

60054 Adventis Risk Management Inc

95340 Adventist Health Claims (Roseville, CA)

75261 Adventist Risk Management (Grapevine, TX) Old PO Box

60054 Aetna

57604 Aetna (SRC)(Blue Bell, PA & Columbia, SC)

57604 Aetna Affordable Health Choices (SRC)(Columbia, SC)

128WV Aetna Better Health of WV (Phoenix, AZ)

18014 Aetna Medicare

68246 Aetna US Healthcare Encounters (PO Box 14530, Lexingt

95426 Affordable Benefits Admin (Burbank, CA)

91136 Alaska Children's Services, Inc.

91136 Alaska Hotel Restaurant and camp

91136 Alaska Laborers Construction Industry Trust (Seattle, WA

91136 Alaska Pipe Trades Local 375 (Seattle, WA)

91136 Alaska United Food & Comm. Workers Health & Welfare

13343 AliCare (Amalgamated Life (New York, NY)

CXALC AllCare CCO Dental (Salem, OR)

81040 Allegiance Benefit Plan (Missoula, MT)

51037 Allied Administrators (Eagan, MN)

37308 Allied Benefit Systems (Chicago, IL)

22155 Allied National (Eagan, MN)

63240 Alternative Risk Management (ARM) Eagan, MN)

13343 Amalgamated Life - PA Alicare (New York, NY) (King of P

38219 Ameraplan (Troy, MI)

86048 AmeriChoice - New York Medicaid (Salt Lake City, UT)

Payer 835 List

Payer ID Payer Name

86002 AmeriChoice - New York Medicare (Salt Lake City, UT)

86047 AmeriChoice of NJ Medicaid (salt Lake City, UT)

75137 Ameriben Solutions (Boise, ID)

37283 American Admin Group (PO Box 93670, Lubbock, TX)

52133 American Choice (Thiensville, WI)

CX001 American Medical Security (Green Bay, WI)

44444 American Postal Workers Union Health Plan (Silver Sprin

LX185 American Progressive (Pensacola, FL)

20029 Americas Choice (Houston, TX)

GP133 Americhoice NJ(Thiensville, Milwaukee WI)

SCNAC Amerihealth Caritas PA (PO Box 7118 London, KY)

47009 Ameritas Life Insurance Corp. (Lincoln, NE)

38255 Amway Corporation (East Ada, MI)

34192 Antares Management Solutions (Westlake, OH)

84103 Anthem (PO Box 1115, Minneapolis, MN)

80705 Anthem Health & Life Insurance Co of New Jersey/AH&L

84105 Anthem of CT (PO Box 547 North Haven, CT)

84105 Anthem of CT (PO Box 9274, Oxnard, CA)

84105 Anthem of TX (Po box 659444, texas)

CB923 Anthem of Virginia (Richmond, VA)

34196 Apex Benefits (Akron, OH)

ARGUS Argus (Tampa, FL & Eagan, MN)

75278 Arkansas Best Corp-Choice Benefits-Fort Smith, AR

81883 Arkansas Municipal Health Benefit (N Little Rock AR)

25133 Associated Benefit Plan (London, KY)

39065 Assurant Health (PO Box 2806, Clinton, IA)

74240 Assured Benefits Administrators (El Paso, TX)

93221 Asuris Northwest Health(PO Box 30271 SLC, UT)

CX052 Atlantic Dental Inc-Medicaid (Coral Gables, FL)

LX081 Aultra ( Canton, OH)

38259 Automated Benefit Services (Oak Park, MI)

37280 Automated Group Admin (Fort Wayne, IN)

91136 Automotive Machinists Local 289 Health & Welfare Trust

CX022 Auxiant (Cedar Rapids, IA)

86098 Avesis (PO Box 7777 Phoenix, AZ)

36149 BAS (Benefit Admin Systems (Farmington Hill, MI)

36149 BAS (Benefit Admin Systems (Homeward, IL)

36149 BAS (Benefit Admin Systems (Milwaukee, WI)

36149 BAS (Benefit Admin Systems)(St. Louis, MO)

77078 BAnner - Medisun (Mesa, AZ)

36342 BSSI (Benefit System & Services (Westmont, IN)

74227 Bankers United Life/Student Insurance (Lincoln, NE)

SX145 Banner Health Systems (Mesa, AZ)

LX154 Ben-e-lect (Visalia, CA)

23210 BeneCare Dental Plan - Philadelphia, PA

LX165 Benefit & Risk Mgmt Services - BRMS (Folsom, CA)

36149 Benefit Admin Systems (BAS) (PO Box 2920 Milwaukee,

36149 Benefit Admin Systems (BAS)(Farmington Hill, MNI)

36149 Benefit Admin Systems (BAS)(St. Louis, MO)

36149 Benefit Admin Systems(BAS) (Homewood, IL)

41205 Benefit Administration Services (Eagan, MN)

25145 Benefit Coordinators Corporation (Pittsburgh, PA)

43178 Benefit Management Inc of MO (Joplin, MO)

37212 Benefit Management Systems (Madison, MS)

48611 Benefit Management, Inc. (Great Bend, KS)

39081 Benefit Plan Administrators Co. Eau Claire, WI

Payer 835 List

Payer ID Payer Name

36342 Benefit Systems & Services, Inc. (Westmont, IN)

R7003 Benefit, Inc. (Roseville, MN)

58102 BenefitStream (Po Box 1990, Jasper GA)

CB833 Benefits Services

37248 Benesys, Inc (LaFayette, LA)

LX152 Benicomp, Inc. (Fort Wayne, IN)

83470 Blue Advantage (BCBS of AR)(Harrisburg, PA)

00700 Blue Care Family Plan Blue Cross of CT (North Haven, CT

BBMDQ Blue Care Network (BCBSM MA/BNCA - Medicare Advant

83470 Blue Cross of AR (Harrisburg, PA)

53589 Blue Cross of AZ (Phoenix, AZ)

CBAL1 Blue Cross of Alabama (Birmingham, AL)

47570 Blue Cross of Alaska & Washington (Anchorage, AK)

83470 Blue Cross of Arkansas (PO Box 1206 Elk Grove Village, I

47198 Blue Cross of CA (Oxnard, CA)

52133 Blue Cross of CA (PO Box 272590 & 272540, Chico, CA)

84099 Blue Cross of Colorado/Anthem - Colorado Springs, CO

00700 Blue Cross of Connecticut (Blue Care Family Plan) (North

84105 Blue Cross of Connecticut (PO Box 547 North Haven, CT)

89070 Blue Cross of DE - UCCI

53287 Blue Cross of Delaware (Wilmington, DE)

FX046 Blue Cross of FL (Jacksonville, FL)

76031 Blue Cross of Florida (Florida Combined Life)(PO Box 100

CBGA1 Blue Cross of GA (Columbus, GA)

84105 Blue Cross of IN (PO Box 188, Mpls., MN)

CBID1 Blue Cross of Idaho (PO Box 7408, Boise, ID)

CB621 Blue Cross of Illinois (Belleville, IL)

84105 Blue Cross of Indiana Anthem (Louisville, KY)

CBIA1 Blue Cross of Iowa (FEP claims only) (Des Moines)

CBIA2 Blue Cross of Iowa (Po Box 935 Des Moines, IA)

CBKS1 Blue Cross of Kansas (Topeka, KS)

47171 Blue Cross of Kansas City (MO)

84105 Blue Cross of Kentucky/Indiana/Ohio Anthem - Louisville,

89070 Blue Cross of LA Advantage Plan (PO Box 69441)

23739 Blue Cross of Louisiana (Baton Rouge, LA)

FX136 Blue Cross of MD (14111-14116, Lexington, KY)

BBMDQ Blue Cross of MI - Medicare Advantage(Milwaukee, WI)

89070 Blue Cross of MN (Harrisburg, PA)

BCAFD Blue Cross of MN (PO Box 75, Minneapolis, MN)

89070 Blue Cross of MN - UCCI

BME01 Blue Cross of Maine

CBMA1 Blue Cross of Massachusettes (North Quincy, MA)

CBMI1 Blue Cross of Michigan (Detroit, MI)

CBMS1 Blue Cross of Mississippi (Jackson, MS)

CBMT1 Blue Cross of Montana (Helena, MT)

52133 Blue Cross of NC (Mailed to Salt Lake City, UT)

89070 Blue Cross of ND

00800 Blue Cross of NE Nork York (Buffalo, NY)

55093 Blue Cross of NY (Empire) Claims sent to MN

55204 Blue Cross of NY(Western)(PO Box 80, Buffalo, NY)

CBNE1 Blue Cross of Nebraska (Omaha, NE)

84101 Blue Cross of Nevada - Colorado Springs, CO

BNH01 Blue Cross of New Hampshire

22099 Blue Cross of New Jersey (Horizon) (Newark, NJ)

84100 Blue Cross of New Mexico Dental

CBNYR Blue Cross of New York - Par (PO Box 22999, Rochester,

Payer 835 List

Payer ID Payer Name

00840 Blue Cross of OK (PO Box 23100 Belleville, IL)

84105 Blue Cross of Ohio Anthem (Louisville, KY)

CB850 Blue Cross of Oregon (Portland, OR & SLC, UT)

54771 Blue Cross of PA - Highmark

CB870 Blue Cross of Rhode Island (providence, RI)

38520 Blue Cross of SC (Columbia/Charleston SC)(PO Box 1003

CBTN1 Blue Cross of Tennessee (Chattanooga, TN)

CB900 Blue Cross of Texas (Dallas, TX)

CBUT1 Blue Cross of UT BCBS (PO Box 30270, Salt Lake City, U

CBUTF Blue Cross of UT-FEP (PO Box 30272, Salt Lake City, UT)

84103 Blue Cross of VA - Trigon (Colorado Springs, CO)

CB923 Blue Cross of VA / Anthem (Richmond, VA)

84097 Blue Cross of WA and AK (MCDN-Manage Dental Care)(P

CB950 Blue Cross of WI (United)

47570 Blue Cross of Washington & Alaska(Anchorage, AK)

93200 Blue Cross of Washington (PO Box 30271 SLC UT)(PO Bo

47198 Blue Cross/Trust Fund (San Antonio, TX)

52133 Blue Shield of CA (SLC, UT)

CBID2 Blue Shield of Idaho(PO Box 31603 Salt Lake City, UT)

89070 Blue Shield of Northestern New York (UCCI)

36609 Boilermakers Natl Health & Welfare Fund/International B

74237 Boon Chapman Benefit Administrators (Austin, TX)

20381 Boulder Admin Services (Boulder, MT)

BRIDG Bridgespan (Lewiston, ID)

51037 Brokerage Concepts (King of Prussia, PA)

CX032 Brokers National (Houston TX)

59069 Brown & Brown United Benefits Fringe (PO Box 2480, Da

11198 Buffalo Teachers Federation

47009 Businessmen Assurance (NE)

42150 Butler Benefits (Davenport, IA, Eagan, MN)

CPPCA CA Health Families (Sacramento, CA)

CAS89 CAS Benefits Plans (PO Box 3070, Bellingham, WA)

03036 CBA Blue (Comprehensive Benefits Admin (Burlington, V

55438 CBCA Administrators (TX,NY,KY,GA,MN)

41124 CBSA (Mpls, MN)

88022 CDS Group Health (Sparks, NV)

84147 CHAMPVA - HAC - Denver, CO

10000 CIGNA (DHMO) (PO Box 188046, Chattanooga, TN)

CX075 CL Frates (Oklahoma City, OK)

DESAZ CMDP (Comprehensive Medical and Dental (Phoenix, AZ)

71063 CNA Health Partners of Arkansas

37227 CNIC Healthcare Services (Englewood/Colorado Springs,

42141 CTI Administrators (Des Moines, IA)

LX167 CWI Benefits (Greenville, SC)

CPPCA California State Gov. Programs

CX061 Canada Life Assurance Company(Atlanta, GA)

71057 Cannon Cochran Mgmt Services, Inc. (Metairie, LA)

68011 Capitol Administrators (Rancho Cordova, CA)

CAPHP Caprock Health Plans (Eagan, MN)

FX136 CareFirst (PO Box 14111 - 14116) (Lexington, KY))

INCS1 CareSource of IN (JustME)(Dayton, OH)

GACS1 Caresource GA (Dayton, OH)

KYCS1 Caresource KY (Dayton, OH)

CKOH2 Caresource- Dayton OH

CB833 Carolina Care Plan

37060 Caterpillar Inc.

Payer 835 List

Payer ID Payer Name

91136 Cement Masons & Plasters Health & Welfare Trust (Seatt

46278 Centene

LX150 Central Data Services Downtown (Pittsburgh, PA)

34097 Central Reserve Life (Eagan, MN)

34154 Chesterfield Resources (Akron, OH)

84147 Children of Women Vietnam Veterans

EM205 Childrens Medical Services (CMS) Po Box 917833 El Paso

61271 Christian Brothers Services (Colorado Springs, CO)

62308 Cigna

10050 Cigna DHMO

LX208 Cigna International (PO Box 15050, Wilminton, DE)

CX071 Citizens Security Life Ins. (Louisville, KY)

38219 ClaimChoice Administrators (Troy, MI)

14829 Co-Ordinated Benefit Plans (Eagan, MN)

CAS89 Coastal Admin Serv (CAS) (PO Box 3070, Bellingham, W

77052 Coastal Admin Services (Salinas, CA)

34181 Commerce Benefits Group (Elyria, OH)

LX166 Commercial Travelers (Utica, NY)

27905 Community Health Alliance (Knoxville, TN)

75261 Community Health Electronic Claims

CX021 CompBenefits - (Chicago, IL & Roswell, GA)

48005 Companion Life

77828 Companion Life (PO Box 100102, Columbia, SC)

CX021 Compdent - (Chicago, IL & Roswell, GA)

03036 Comprehensive Benefits Admin - Burlington, VT

DESAZ Comprehensive Medical and Dental Program (CMDP)(Pho

37307 Connecticut Carpenters Health Fund (Hamden, CT)

62308 Connecticut General (Bloomfield, CT)

37135 Consociate (Decatur, IL)

LX146 Consolidated Health Plans (Springfiled, MA)

LX186 Constitution Life (Pensacola, FL)

45321 Consumers Choice Health Plan (North Charleston, SC)

CB833 Consumers Life

62308 Continental Dental (Plantation, FL)

52132 Cooperative Benefit Administrators (CBA) (Lincoln, NE)

35182 Core Source (Po Box 2920, Clinton IA)

35180 CoreSource (NC, IN) (Charlotte, NC)

35183 CoreSource (Po Box 279, SHeldon IA)

48117 CoreSource KC(FMH Benefit)(Overland Park, KS)

35183 CoreSource OH - mailed to OH

75136 CoreSource of Little Rock (Little Rock, AR)

35182 CoreSource of PA MD IL (Lancaster, PA)(Clinton, IA)

56116 Corporate Benefit Services (Charlotte, NC)

56116 Corporate Benefit Services (Eagan, MN)

41124 Corporate Benefit Services - Meritan Health (Mpls, MN)

56116 Corporate Benefit Services(El Paso, TX)

58102 Covenant Admin, Inc - (PO Box 105738 Atlanta, GA)

CX049 Coventry (Po Box 7402, London KY)

25133 Coventry Health

25133 Coventry Health & Life OK

25133 Coventry Health (241508 Charlotte, NC)

25133 Coventry Health (PO Box 241508 Charlotte, NC)

25133 Coventry Health (PO Box 8403,8400,8402, London, KY)

25133 Coventry Health (PO box 8403,8400,8402, London, KY)

25133 Coventry Health Care of KS

37320 Creative Plan Administrators (Hartford, CT)

Payer 835 List

Payer ID Payer Name

CX074 Crescent Dental (Amherst, NY & Richardson, TX)

39170 Custom Benefit Adminstrators(Lacrosse, WI)

82056 Custom Design Benefits (3737 West Fork Road, Cincinna

TLZ04 Cypress Ancillary Benefits (Appleton WI, Milwaukee, WI,

LX082 Cypress Ancillary Benefits (Appleton WI, Milwaukee, WI,

89070 DE (Deleware) Adult Medicaid

06172 Dart Management Corp. (Mason, MI)

07035 DeCare (PO Box 1348, Mpls., MN) Northwest Employees

07035 DeCare (Po Box 709, MPLS MN)

39113 Dean Health Plan (Madison, WI)

CDIAM Delta Dental IA - Dental Wellness Plan (Johnston, IA)

CDIAM Delta Dental IA - Government Programs (Johnston, IA)

66043 Delta Dental Peurto Rico (San Juan, PR)

DDCA2 Delta Dental USA (Cerritos, CA)

94276 Delta Dental of Alabama ( Irving, TX)

94276 Delta Dental of Alaska (Irving, TX)

86027 Delta Dental of Arizona

CDAR1 Delta Dental of Arkansas

DDCA2 Delta Dental of CA (Cerritos, CA)

DDCA3 Delta Dental of CA (Encounter, CAP)(Cerritos, CA)

CDCAP Delta Dental of CA (PMI) (12898 Towne Center Drive, Ce

77777 Delta Dental of California (PO Box 997330, Sacramento,

CDCA1 Delta Dental of California(Tricare) - PO Box 537007-537

84056 Delta Dental of Colorado (Denver, Co)

22189 Delta Dental of Connecticut (Parsipanny, NJ)

51022 Delta Dental of Delaware (Mailed to Mechanicsburg, PA)

94276 Delta Dental of Florida (Irving, TX)

94276 Delta Dental of Georgia (Alpharetta, GA)

10002 Delta Dental of HI (Honolulu, HI)

82029 Delta Dental of Idaho (Boise, ID)

05030 Delta Dental of Illinois (Lisle, IL)

CDIN1 Delta Dental of Indiana (Farmington Hills, MI)

CDIA1 Delta Dental of Iowa (Ankeny, IA)

CDKS1 Delta Dental of Kansas(Whichita, KS)

CDKY1 Delta Dental of Kentucky(Lousiville, KY)

94276 Delta Dental of Louisiana(Irving, TX)

02027 Delta Dental of Maine (Northeast)

23166 Delta Dental of Maryland(Mechanicsburg, PA)

04614 Delta Dental of Massachusetts (Boston, MA, Milwaukee,

CDMI0 Delta Dental of Michigan(Farmington Hills, MI)

CDMN1 Delta Dental of Minnesota(Minneapolis, MN)

94276 Delta Dental of Mississippi (Irving, TX)

43090 Delta Dental of Missouri

94276 Delta Dental of Montana (Sacramento, CA)

CDNE1 Delta Dental of Nebraska(Minneapolis, MN)

94276 Delta Dental of Nevada (Irving TX)

02027 Delta Dental of New Hampshire (Northeast)

22189 Delta Dental of New Jersey (Parsipanny, NJ)

85022 Delta Dental of New Mexico(Albuquerque, NM)

11198 Delta Dental of New York (Mechanicsburg, PA)

56101 Delta Dental of North Carolina(Farmington Hills, MI & Sa

CDND1 Delta Dental of North Dakota(Bismark ND)

CDOH1 Delta Dental of Ohio(Farmington Hills,MI)

CDOK1 Delta Dental of Oklahoma(Oklahoma City, OK)

CDOR1 Delta Dental of Oregon (Oregon Dental Service)(Portland

23166 Delta Dental of Pennsylvania(Mechanicsburg, PA)

Payer 835 List

Payer ID Payer Name

660436769 Delta Dental of Puerto Rico

05029 Delta Dental of Rhode Island (Providence, RI)

43091 Delta Dental of South Carolina(Columbia SC)

CDTN1 Delta Dental of Tennesse (Nashville, TN)

94276 Delta Dental of Texas(Irving TX)

94276 Delta Dental of Utah (Irving TX)

02027 Delta Dental of Vermont (Northeast)

54084 Delta Dental of Virginia

CDVA1 Delta Dental of Virginia (Roanoak, VA)

52147 Delta Dental of Washington DC (Mechanicsburg, PA)

91062 Delta Dental of Washington-State

31096 Delta Dental of West Virginia

39069 Delta Dental of Wisconsin Stevens Point, WI)

CPPCA Delta Dental-Healthy Families (Sacramento, CA)

94235 Delta Health Systems (Stockton, CA)

CDNE1 Delta NE (Po Box 9120, Farmington Hills)

WIMAN Delta of MI (PO Box 30416, Lansing, MI)

CDMN1 Delta of MN ( Po Box 9120, Farmington Hills, MI)

DDCA2 DeltaCare (Cerritos, CA)

CDCAP DeltaCare USA - Encounters Only (12898 Town Center, C

CX036 Denex (Houston, TX & Rockville, MD)

CX049 Denex/SG (PO Box 2767, Houston, TX)

CX014 DentaQuest

CX014 DentaQuest (WI)

EMBDQ DentaQuest-Emblem(Emblem Health)(Milwaukee, WI)

52133 Dental Benefit Providers (CA) (San Fransico, CA)

GP133 Dental Benefit Providers (PO Box 427 Thiensville, Milwau

52133 Dental Benefit Providers (Thiensville, WI)

52133 Dental Benefit Providers\United Health - Bethesda, MD,U

58102 Dental Decisions (2600 McCormick) Clearwater, FL)

64246 Dental Guard Preferred (El Paso, TX, Spokane, WA)

46278 Dental Health & Wellness (St. Louis, MO & Milwaukee, W

46278 Dental Health & Wellness (Tampa, FL)

81264 Dental Health Alliance (Shawnee Mission, KS)

CX094 Dental Health Services of America (Long Beach, CA)

DNOA1 Dental Network of America (IL)

DSL01 Dental Select (Murray,Draper, UT)

DSL01 Dental Select (Richardson, TX)

DSL01 Dental Select (SLC, UT)

89070 Dental Service Corp (Fargo, ND)

67814 DenteMax (Wellesley Hills)

88888 Dentegra (Alpharetta, GA)

43168 Dentemax (St. Louis, MO)

22384 DentexMax (Wayne, PA)

94146 Denti-Cal (Medicaid of California) (Sacramento, CA)

DESAZ Department of Economic Security (Phoenix, AZ)

CX089 Desert Mutual Benefit Admin (Salt Lake City, UT)

58102 Direct Assignment Benefits (PO Box 9077 Clearwater, FL

37272 Direct Reimbursement Benefits (Newnan, GA)

HSP01 District Council 37 Health & Welfare Fund

CX040 Diversified Admin Corp. - Marlborough, CT

DOM01 Dominion Dental (115 S Union Ste 300, Alexandria, VA

DOM01 Dominion Dental (Elk Grove Village, IL)

DOM01 Dominion Dental (PO Box 1920, Boie, MD)

25145 Dominion Dental Benefit Coordinators Corp. - Pittsburgh,

CX014 Doral Dental of Arizona

Payer 835 List

Payer ID Payer Name

CX014 Doral Dental of Arizona--CIGNA

CX014 Doral Dental of Connecticut

CX014 Doral Dental of Illinois

CX014 Doral Dental of Kentucky/ Region 3 (Mequon, WI)

CX014 Doral Dental of Maryland Helix

CX014 Doral Dental of Maryland Physicians Care

CX014 Doral Dental of Maryland Priority partners

CX014 Doral Dental of Minnesota

CX014 Doral Dental of Minnesota Medicare

CX014 Doral Dental of Missouri St. Louis

CX014 Doral Dental of Missouri- Kansas City

CX014 Doral Dental of Nebraska

CX014 Doral Dental of New Jersey Amerigroup

CX014 Doral Dental of New Jersey HealthNet

CX014 Doral Dental of New Mexico

CX014 Doral Dental of New York

CX014 Doral Dental of New York Non global Budget

CX014 Doral Dental of Ohio

CX014 Doral Dental of Oklahoma Community Care

CX014 Doral Dental of Oklahoma Heartland

CX014 Doral Dental of Oklahoma Non Global Budget

CX014 Doral Dental of Oklahoma Unicare

CX014 Doral Dental of Oklahoma Unicare non global

CX014 Doral Dental of Pennsylvania- Keystone

CX014 Doral Dental of Pennysylvania Pittsburgh

CX014 Doral Dental of Pennysylvania- AmeriHealth

CX014 Doral Dental of Pennysylvania- Healthmate

CX014 Doral Dental of Pennysylvania-Philadelphia

CX014 Doral Dental of Tennessee Tenn Care

CX014 Doral Dental of Virginia (M)

CX014 Doral Dental of Virginia- Commercial

CX014 Doral Dental of Virginia- Premier

CX014 Doral Dental of Virginia- Sentara

CX014 Doral Dental of Virginia- Unicare

CX014 Doral Dental of Virginia-Commercial

CX014 Doral Dental of kansas

35186 Dunn and Associates Benefits Administrators, Inc

LX112 EBA M Corp (Westlake Village CA)

81039 EBMS (Emp Benefit Mngmt Serv, Inc.) Billings, MT & Salt

EBSRM EBS-RMSCO (NY)

73288 EHI Employers Health of Wisconsin (Lexington, KY)

CX079 EMIA-Educators Mutual (Murray, UT)

73288 EMPHESYS Employers Health of Wisconsin

62308 EQUICOR

34108 ES Beveridge & Associates (Mansfield, OH)

CX079 Educators Mutual Ins. Assoc. (Murray, UT)

13551 Emblem Health (Group Health)(New York, NY)

EMBDQ Emblem Health Medicaid-DentaQuest(Milwaukee, WI)

55093 Empire BCBS of NY (Minneapolis, MN)

37257 Employee Benefit Consultants(Albuquerque, NM)

37257 Employee Benefit Consultants(Appleton, WI)

37257 Employee Benefit Consultants(Broadview Hts, OH)

37257 Employee Benefit Consultants(Findlay, OH)

37257 Employee Benefit Consultants(Louisville, KY)

37257 Employee Benefit Consultants(Milwaukee, WI)

Payer 835 List

Payer ID Payer Name

81039 Employee Benefit Mngmt Serv (EBMS)(Billings, MT)

03036 Employee Benefit Plan Admin (Burlington, VT)

03036 Employee Benefit Plan Administration, Inc (PO Box 2000,

47009 Employee Benefits Services (Lincoln, NE)

CX022 Employee Group Services (EGS) PO Box 75008 Cedar Ra

35112 Employee Plans, LLC - PO Box 2362, Fort Wayne, IN

73288 Employers Health of Wisconsin (EHIC) (EMPHESYS) (Lexi

59297 Employers Mutual, Inc (Stuart and Jacksonville, FL)

91136 Enstar Natural Gas (Detroit, MI)

46278 Envolve (Dental Health & Wellness)

73126 Equitable Plan Services, PO Box 720460, Oklahoma City,

43168 Essex Dental Benefits (St Louis, MO)

35605 Everence (Goshen, IN)

93240 Evergreen Health Co-Op (Clinton, IA)

CBNYR Excellus (PO Box 22999, Rochester, NY)

71412 ExclusiCare (Charlotte , NC)

91136 FBX North Star Borough/ School District

33033 FCE Benefit Administrators (Eagan, MN & San Antonio, T

48117 FMH Benefit Services, Inc. of KS (Overland Park, KS)

89070 Family Members Dental Plan (Harrisburg, PA)

71056 FedEx Freight East, Inc (Harrison, AR)

72630 First Ameritas Life Ins Corp of New York (Lincoln, NE)

LX162 First Benefit Admin (Largo, FL)

64246 First CommonWealth(Spokane, WA & Chicago, IL)

25133 First Health (Tucson, AZ - London, KY)

25133 First Health - Tucson, AZ - London, KY, Coraoplis, PA)

660537624 First Medical (International)

13317 First Reliance Standard (Lincoln, NE)

39026 Fiserv (Wausau, WI & Pueblo, CO)

95266 Fiserv - Harrington Benefit (Columbus, OH)

R7004 Flex Compensation (Mpls, MN)

76031 Florida Combined Life(Blue Cross of FL)(PO Box 100135,

25133 Foreign Service Benefit Plan (London, KY)

60054 Foreign Service Benefit(Washgington, WA)

DNOA1 Fort Dearborn Life Ins

39065 Fortis Insurance Company - WI

BOONG Foundation Benefit Admin (FBA) (Austin, TX)

64069 Fox Everett, Inc (Ridgeland & Jackson, MS)

59069 Fringe Benefit Management (Fl)

45289 Fringe Benefits (Austin, TX)

59204 Fringe Benefits Coorinators of FL (Daytona Beach, Ormo

80241 GBS (Eagan, MN)

67814 GEGLAC (Genworth Life & Health) GE Group

57254 GEHA - All Plans except PO Box 4665 (Independence, M

44054 GEHA Only (PO Box 4665, Independence, MO)

LX071 GEM Group (Claymont, DE)

13551 GHI - New York (Group Health, Inc)(New York, NY)

80314 GIC-Idemnity Plan

LX187 GMS (Omaha, NE)

48143 GPA (Group Pension Admin)(Richardson, TX)

37283 Gallagher Benefit Administrators (Lisle, IL)

67814 Ge Group Life Assurance Co. Phoenix American Life (Gre

86098 Geisinger Health Plan

LX161 Gem Group (Pittsburgh, PA)

67814 Genworth Dental (PO Box 40011, Lynchburg, VA)

67814 Genworth Life & Health (GEGLAC)(GE Group LIfe)

Payer 835 List

Payer ID Payer Name

07205 Gilsbar, Inc - Covington, LA & Jackson, MS (Covington, L

91136 Glassworkers Health & Welfare Fund (Seattle, WA)

52133 Golden Rule (SLC, UT)

GWD01 Golden West Dental (21555 Oxnard S, Woodhills, CA)

GWD01 Golden West Dental (PO Box 5347, Oxnard, CA)

57254 Government Employees Health Assoc. (GEHA)(All Plans e

44054 Government Employees Hospital Assoc (GEHA) Only (PO

80705 Great-West Life and Annuity Ins. Co. (Kennett, MO)

72153 Group Benefit Administrators (Henderson, TN)

LX151 Group Benefit Administrators (SLC, UT)

80241 Group Benefit Services (Eagan, MN)

CB951 Group Benefit Services (Luterville, MD & East Lansing, M

CX036 Group Dental Services(Houston, TX & Rockville, MD)

89070 Group Health Coop. Ind. and Family (PO box 69443)

13551 Group Health Insurance (New York, NY)

48143 Group Pension Admin (GPA)(Richardson, TX)

48143 Group and Pension Admin (GPA)(Richardson, TX)

CX061 Guarantee Life Insurance

64246 Guardian Life Insurance Company of America (Spokane,

GGE01 Gulf Guaranty (Jackson MS)

48330 HMAA (Hawaii)

10004 HMSA Federal Program

10001 HMSA-Hawaii Medical Services Assoc (Honolulu, HI)

51037 HNAS (Eagan, MN)

37224 HSBS (Health Smart Benefit Solutions (Memphis, TN)

37256 HSBS Oklahoma City (Oklahoma City, OK)

LX188 HSR (Franklin, OH)

95266 Harrington Benefit Services (Columbus, OH)

22521 Harrington Benefit Services (Oklahoma City, OK)

10002 Hawaii Dental Service Assoc (Honululu(, HI)

86066 Hawaii-Mainland Admim (Tempe, AZ)

71056 Health Benefit Claims Dept (Harrison, AR)

LX105 Health Care Solutions Group (Muskogee OK)

62179 Health Choice (Medicaid) (Phoenix, Tempe, AZ)

22521 Health Choice (Oklahoma City, OK)

46221 Health Choice Insurance (Phoenix, AZ)

22100 Health Choice Integrated Care (Flagstaff, AZ)

62111 Health Cost Solutions (Hendersonville, TX 37077)

16112 Health Economics (Rochester, NY)

75234 Health First TPA (Eagan, MN & Tyler, TX)

CX083 Health Net (Liberty Dental) (Santa Ana, CA & Tamp, FL)

51037 Health Now (Eagan, MN)

CX010 Health Partners of Minnesota (Medicaid) (Minneapolis, M

CX009 Health Partners of Minnesota - Commercial (Minneapolis,

22521 Health Plan SErvices of OK (Oklahoma City, OK

47009 Health Plan Services (Lincoln, NE)

76342 Health Plan of NV (Las Vegas, NV)

CX055 Health Plans, Inc (Westborough, MA)

25133 Health Right of CT (Medicaid Claims)

37283 Health Smart ( Po Box 93670, Lubbock TX)

37283 Health Smart Benefit (PO Box 167768, Irving TX)

37224 Health Smart Benefit Solutions (HSBS)(Memphis, TN)

41154 Health Traditions (MMSI)(Rochester, MN)

71064 HealthChoice (Lubbock, TX)

85729 HealthComp TPA (PO Box 45018, Fresno, CA)

75234 HealthFirst TPA (Eagan, MN)

Payer 835 List

Payer ID Payer Name

75234 HealthFirst TPA (Tyler, TX)

52133 HealthNet (SLC, UT)

HND2 HealthNet - Gov't Program

55204 HealthNow Commercial

55204 HealthNow NY (PO Box 80, Buffalo, NY)

25133 HealthRight of CT (Medicaid claims to First Health Strata

71063 HealthSCOPE Benefits, Inc (Little Rock, AR)

71063 HealthScope Benefits (Po Box 619055, Dallas, TX)

37256 HealthSmart (Oklahoma City, OK)

87815 HealthSmart (PO Box 91608, Lubbock, TX)

87815 HealthSmart Benefits(Charleston, WV)

31172 HealthTrans (Innovative Benefit Admin)(Greenwood Villa

HMA01 Healthcare Management Administrators, Inc (Bellevue,

56144 Healthgram Inc. (Primary Physician)(Charlotte, NC)

11271 Healthplex, Inc. (Uniondale, NY)

68195 Healthsource/Provident Insurance Co.(Chattanooga, TN)

CPPCA Healthy Families (Sacramento, CA)

95378 Heritage National Healthplan/John Deere Health Care

89070 Highmark West Virginia - UCCI

89070 Highmark/HHIC (PO Box 69433 Harrisbury, PA)

88023 Hometown Health (Reno, NV)

22099 Horizon (Blue Cross of New Jersey) (Indianapolis, IN)

22099 Horizon BCBS NJ ( Po box 1311, MPLS)

22099 Horizon NJ Health (PO Box 299, Milwaukee, WI)

91136 Hotel Employees & Restraunt Employess Health Trust(Se

61101 Humana Medicare/Humana Gold

73288 Humana/Employers Health of WI (Lexington, KY)

22175 I.E. Shaffer (West Trenton, NJ)

LX145 IAA (Mt Laurel, NJ)

A1317 IBEW Local 38(Carmel, IN)

64246 IBEW Welfare Trust Fund (Decatur, IL)

41124 IBI ( Minneapolis, MN)

LX111 IMA (Bossier City LA)

660537624 IMCC

91136 Idaho Pipe Trades

CDOK1 Indian Health Services (Oklahoma City, OK)

CX070 Indiana Childrens Special HealthCare (Indianapolis, IN)

31172 Innovative Benefit Admin (HealthTrans)(Greenwood Villa

37279 Insurance Admin of America (Mount Laurel, NJ)

13315 Insurance Design Administrators - Oakland, NJ

15688 Insurance Management Services (Elko, NV)

LX104 Insurance Services of Lubbock (Lubbock, TX)

74385 Insurance Systems Inc. (Monroe, LA)

51020 Integra Adminstrative Group - Seaford, DE

87765 Interactive Medical Systems (PO Box 21145, Eagan, MN)

LX158 Interactive Medical Systems (Wake Forest, NC)

660537624 International (First Medical)

36609 International Brotherhood of Boilermakers (Kansas City,

A1317 International Brotherhood of Electrical Workers (IBEW) L

15688 Interplan Health Group (Elko, NV)

41124 Iowa Benefits, Inc( Minneapolis, MN)

61271 J.F. Molloy and Associates, Inc.(Colorado Spring, CO)

79480 JMS-MSA (Po Box 679, Farmington MI)

CX061 Jefferson Pilot (Omaha, NE)

41099 John Alden Life Ins. (501 W Michigan, Milwaukee, WI)

95378 John Deere Health Care/Heritage National Healthpla(Moli

Payer 835 List

Payer ID Payer Name

80314 John Hanncock

J1410 Jopari Careworks (Columbus, OH)

CX073 Kaiser Permanente (PO Box 4360, Rockville, MD)

73100 Kempton Company - OK (Oklahoma City,OK)

73100 Kempton Group Administrators (Oklahoma City, OK)

37217 Key Benefit Admin (Milwaukee, WI)

37323 Key Solution (Fort Mill, SC)

KEY01 Keystone Mercy Health Plan (Milwaukee, WI)

52193 LBA HealthPlans, Inc (Timonium, MD)(El Paso, TX)

CX083 Liberty Dental Plan (Santa Ana, CA & Tampa, FL)

CX047 LifeRe (San Antonio, TX)

EBSRM LifeTime Benefits (EBS-RMSCO)(NY)

35182 LifeWell (Coresource)(Clinton, IA)

93093 Lifewise Health Plan or Oregon (Bend, OR)

CX061 Lincoln National (Omaho, NE & Orlando, FL)

73288 Lincoln National of Wisconsin (Madison or Green Bay)

LCB01 Line Construction Benefit (Lombard, IL)

05030 Local 731 (Burr Ridge, IL)

91136 Locals 302 and 612 of the I.U.O.E

CB752 Lockard & Williams (Pascaqoula, MS)

45289 LoneStar (Eagan, MN)

45289 LoneStar TPA via ECOM (Tyler, TX)

23223 Loomis Company (Wyomissing, PA)

52133 M-Plan Dental (Salt Lake City, UT)

MBAAZ MBA (El Paso, TX)

56205 MBS (MedCost Benefit Services(MBS))Winston Salem, NC

94276 MHHNP (Po Box 742567, Houston TX)

27401 MI UFCW Union (Madison Heights, MI)

35605 MMA (Mennonite Mutual Associaton) (Goshen, IN)

41154 MMSI-Mayo Clinic Health Solutions (Rochester, MN)

89070 MMSO (Military Medical Support) (Po Box 886999)

R7005 MN Power (Duluth, MN)

37233 MPEEBT / MPE Services, Inc (Jackson, MS)

91136 Machinists Health

25133 Mail Handlers Benefit Plan (Jacksonville, FL)

64246 Managed Dental Guard(Woodland Hills, CA)

CX014 Managed Health Services - WI State Employees

PRFRE MapFre

60230 Masonry Welfare (Portland, OR)

CX014 Mass Health (Doral Dental) Hingham, MA

LX157 Massachusetts Benefit Admin (Boston, MA)

37217 Maverist (Milwaukee, WI)

41154 Mayo Clinic Health Solutions-MMSI (Rocehster, MN)

37287 McCrew Care (Columbia, SC)

LX164 McLaren Health Plan (Flint, MI)

LX049 McPrime West (1335 Industrial Blvd. Ste 150, Mpls, MN)

EM843 Med3000 CMS Title 19

EM205 Med3000 CMS Title 21

74323 MedBen (Newark, OH)

56205 MedCost Benefit Services (MBS)- Winston Salem, NC

56205 Medcost of North Carolina

CX026 Medica of MN - PO Box 1328, Mpls, MN

CX026 Medica of MN - PO Box 1519, Mpls, MN

CX014 Medicaid Pennysylvania Best Health Care Pittsburgh (Do

CX014 Medicaid Pennysylvania Gateway Health Plan (Doral Den

CX014 Medicaid Pennysylvania Health Partners Pittsburgh (Dor

Payer 835 List

Payer ID Payer Name

CX014 Medicaid Pennysylvania Oaktree (Doral Dental of WI)

CKAL1 Medicaid of Alabama

CKAK1 Medicaid of Alaska

CKAR1 Medicaid of Arkansas

94146 Medicaid of California (Denti-Cal)

CKCO1 Medicaid of Colorado

CKCT1 Medicaid of Connecticut (New Britton, CT)

89070 Medicaid of DE - Adult

CKDE1 Medicaid of Delaware - New Castle, DE

CKDC1 Medicaid of Disctrict of Columbia (Washington, DC)

CKFL1 Medicaid of Florida

CKGA1 Medicaid of Georgia

CX014 Medicaid of Georgia Grady Healthcare Inc (Doral Dental

CKIL1 Medicaid of IL - Doral Dental of WI (Admin by Doral)

CX014 Medicaid of Idaho (Boise, ID)

CX014 Medicaid of Illinois (Doral Dental of WI)

CKIN1 Medicaid of Indiana (Boise, ID)

CKIA1 Medicaid of Iowa (Des Moines, IA)

CKKS1 Medicaid of Kansas (Mequon, WI)

CKKY1 Medicaid of Kentucky (Mequon , WI)

CX014 Medicaid of Kentucky Region # 2 (Doral Dental Services)

CX014 Medicaid of Kentucky Region #3 (Doral Dental of WI)

CKLA1 Medicaid of Louisiana (EPSDT) (Baton Rouge, LA)

CKME1 Medicaid of Maine

CX014 Medicaid of Maryland-Dept of Health and Ment

CKMA1 Medicaid of Massachusetts

CKMI1 Medicaid of Michigan

CKMN1 Medicaid of Minnesota

CKMS1 Medicaid of Mississippi

CKMO1 Medicaid of Missouri (Jefferson City, MO)

CX014 Medicaid of Missouri Blue Advantage (Doral Dental of WI

CX014 Medicaid of Missouri Community Care Plus- St Louis (Dor

CX014 Medicaid of Missouri Community Health PLan (Doral Den

CX014 Medicaid of Missouri First Guard Health Plan (Doral Dent

CX014 Medicaid of Missouri Health Net (Doral Dental of WI)

CX014 Medicaid of Missouri Truman Care- Family Health Partner

CX014 Medicaid of Missouri health Care USA- St.Louis (Doral De

CKMT1 Medicaid of Montana

CKNE1 Medicaid of Nebraska (Lincoln, NE)

CKNV1 Medicaid of Nevada (San Antonio, TX)

CKNH1 Medicaid of New Hampshire

86047 Medicaid of New Jersey (Admin by Americhoice)(Salt Lak

CKNJ1 Medicaid of New Jersey (Trenton, NJ)

CKNM1 Medicaid of New Mexico

CX014 Medicaid of New Mexico Cimmaron Health Plan (Doral D

CX014 Medicaid of New Mexico Loveplace Community health pla

CX014 Medicaid of New Mexico Presbyterian Salud (Doral Denta

CKNY1 Medicaid of New York

86048 Medicaid of New York (Administrated by AmeriChoice)

CKNY2 Medicaid of New York (Dental Clinics Only)

CKNC1 Medicaid of North Carolina (Raleigh, NC)

CKOH1 Medicaid of Ohio (Administrated by Quadax) (Columbus,

CX014 Medicaid of Ohio Emerald HMO and Medicare INC. (Dora

CX014 Medicaid of Ohio Health Power HMO Cincinatti (Doral De

CX014 Medicaid of Ohio Personal Physicians Care Cleveland (Do

CKOH2 Medicaid of Ohio: Caresource (Dayton, OH)

Payer 835 List

Payer ID Payer Name

CKOK1 Medicaid of Oklahoma (Oklahoma City, OK)

CX014 Medicaid of Oklahoma Heartland Health PLan (Doral Den

CX014 Medicaid of Oklahoma Unicare Health PLan (Doral Dental

CKOR1 Medicaid of Oregon

CKPA1 Medicaid of Pennsylvania (Harrisburg, PA)

CX014 Medicaid of Pennysylvania (Doral Dental of WI)

CKRI1 Medicaid of Rhode Island

CX014 Medicaid of South Carolina

CX014 Medicaid of Tennessee (Doral Dental of WI)

CKTX1 Medicaid of Texas

CKUT1 Medicaid of Utah

CX014 Medicaid of VA- Richmond VA

CKVT1 Medicaid of Vermont

CX014 Medicaid of Virginia HealthKeepers Plus (Doral Dental of

CKWA1 Medicaid of Washington

CKWV1 Medicaid of West Virginia (Charelston, WY)

CKWI1 Medicaid of Wisconsin (Madison. WI)

CX014 Medicaid of Wisconsin Humana/ TDC (Doral Dental of W

CX014 Medicaid of Wisconsin PrimeCare (Doral Dental of WI)

CKWY1 Medicaid of Wyoming (Cheyenne, WY)

CX014 Medicaid of ohio United Health Care Inc. Medicare COm

MAHC1 Medical Associate Health Plan (Dubuque, IA)

74323 Medical Benefits Mutual - Newark, OH

29076 Medical Mutual of Ohio

CB833 Medical Mutual of Ohio (MMO)

973 Medicare Optimun / Triple S

23160 Medico Insurance (IA, NE, MN)

59069 MedsavUSA (Fringe Benefit)(FL)

35605 Mennonite Mutual Association (MMA) (Goshen, IN)

MBAAZ Merchants Benefit (MultiFlex Dental)(Scottsdale, AZ)

86052 Mercy Care Plan (Phoenix, AZ)

33628 Mercy Maricopa Integrated Care (Phoenix, AZ)

CX074 Meritain Health (Amherst, NY & Richardson, TX)

41124 Meritain Health (Formerly CBSA) (Minneapolis, MN)

65978 Metlife (El Paso, TX)

CDMI0 Michigan Conference of Teamsters (Farmingotn Hills, MI)

A1432 Michigan Laborers (Carmel, IN)

27401 Michigan UFCW (Madison Heights, MI)

37281 Mid America Associates, Inc (Madison Heights, MI)

22823 Mid America Benefits (Po Box 685, Arnold MD)

74227 Mid-West National Life Ins. Co. of TN-Student Ins

61146 Midwest Group Benefits, Inc. (Decorah, IA)

05030 Midwest Operating Engineers (MOE) Welfare Fund Local

79480 Midwest Security of WI (Onalaska, WI)

89070 Military Medical Support (MMSO) (Po Box 886999)

R7005 Minnesota Power (Duluth, MN)

64088 Mississippi Select Healthcare (Gulfport, MS)

25133 Missouri Department of Transportation/MODot * St Louis

SKYGN Molina Health Care (Milwaukee, WI)

CX083 Molina HealthCare(Liberty Dental) (Santa Ana, CA & Tam

86098 Molina Medicare

52133 Morgan White (Salt Lake City, UT)

89070 Mountain State BCBS (MSBCBS(PO Box 69434, Harrisbur

MBAAZ MultiFlex Dental (Merchants Benefit)(Scottsdale, AZ)

81883 Municpal Health

37256 Mutual Assurance Admin (Oklahoma City, OK & Addison,

Payer 835 List

Payer ID Payer Name

LX190 Mutual Health Services (Cleveland, OH)

CX087 Mutual of Omaha (Sherwood, AR & Indianapolis, IN)

71412 Mutual of Omaha/National Rural Letter Carrier (Charlotte

34192 Mututal Health Services (Antares Mgmt)(Westlake, OH)

91136 N.W. Int Assoc of machinists & Aerospace Eng Benefits

91136 N.W. Iron Workers Health & Security Trust Fund (Seattle

91136 N.W. Roofers & Employers Health & Security Trust Fund

91136 N.W. Textile Processors (Seattle, WA)

65085 NAA (TN) North America Administrators, LP - Nashville,

23166 NAS (Nat'l Auto Sprinklers (Landover, MD)

CKTX1 NHIC (Medicaid of TX)

91136 NW Benefit ( Po Box 34176)

91136 NW Plumbing and Pipfitting Industry

14142 NY State Dept of Health (Albany, NY)

23166 Nat'l Auto Sprinklers (NAS)(Landover, MD)

LX172 Natinoal Assoc. of Letter Carriers(NALC)(Ashbury, VA)

CX045 National Elevator Industry Benefit Plan (NEIB) (Newtown

CX057 National Pacific of TX (TX)

71412 National Rural Letter Carrier (Charlotte, NC)

MBAAZ Nationwide (El Paso, TX)

19191 Native Care Health, LLC (Quapaw, OK)

43351 New England Dental Administrators - Concord, NH

81264 Nippon Life Insurance Company of America

65085 North America Administrators, LP - Nashville, TN

CKNC1 North Carolina Health Choice (Raleigh, NC)

47570 North Star Administrators

02027 NorthEast Delta Dental (ME, NH, VT)

LX062 Northern MN Dental (Duluth, MN)

93525 Northwest Dental Services - Roseburg, OR

91136 Northwest Iron Workers (PO box 34464) Seattle,WA

91136 Nothwest I.A.M. Benefit Trust

16644 Nova Health Administrators, Inc. (Grand Island, NY)

CDOR1 ODS Healthplans (Oregon Dental Services/Delta Dental o

22521 OK State Employees & Educators (Oklahoma City, OK)

CX075 OK State Medical Assoc. (OSMA)(Oklahoma City, OK

80705 ONE Health Plan Inc of California

80705 ONE Health Plan Inc of Colorado

80705 ONE Health Plan Inc of Florida

80705 ONE Health Plan Inc of Georgia

80705 ONE Health Plan Inc of Idaho

80705 ONE Health Plan Inc of Indiana

80705 ONE Health Plan Inc of Iowa

80705 ONE Health Plan Inc of Kentucky

80705 ONE Health Plan Inc of Mississippi

80705 ONE Health Plan Inc of New Jersey

80705 ONE Health Plan Inc of New York

80705 ONE Health Plan Inc of North Carolina

80705 ONE Health Plan Inc of Oklahoma

80705 ONE Health Plan Inc of Texas

80705 ONE Health Plan Inc of The District of Columbia

80705 ONE Health Plan Inc of Vermont

80705 ONE Health Plan Inc of Virginia

80705 ONE Health Plan Inc of Washington

80705 ONE Health Plan Inc of Wisconsin

80705 ONE Health Plan Inc. of Alaska

80705 ONE Health Plan Inc. of Arizona

Payer 835 List

Payer ID Payer Name

CX075 OSMA (OK State Medical Assoc)(Oklahoma City, OK)

LX191 One Call Care (Tampa, FL)

80705 One Health Plan Inc of Wyoming

91136 Operating Engineers Locals 302 & 612 Health & Security

GP133 Optum Specialty Svcs (Thiensville, Milwaukee WI)

CDOR1 Oregon Dental Services & ODS Healthplans (Portland, O

37287 PAI (Columbia, SC)

CX080 PEHP (Public Employees Health Program)(Salt Lake City,

CDCAP PMI (Delta Dental of CA) (12898 Towne Center Drive Ce

16111 POMCO ( Syracuse, NY)

UPMCD PUMC Medicaid (Milwaukee, WI)

CX056 Pacific Union Dental Benefits (LasVegas, NV)

93031 PacificSource Admin (Portland, OR)

93029 PacificSource Health Plans - Eugene, OR

CX060 Pacificare Dental and Vision (HMO Claims Only) (PO Box

CX053 Pacificare Dental and vision (PDVA) (Santa Ana, CA)

74237 Paid Dental (PO Box 9150, Austin, TX)

04218 Pan American Life Ins. (El Paso, TX)

06126 Paper Claims

58174 Paragon Benefits, Inc. (Columbus, GA)

58174 Paragon Benefits, Inc. (Po Box 981600, El Paso TX)

10525 Patients Advocates, LLC (Portland & Gray, ME)

32069 Patriot Mutual Dental Programs(PO Box 192, MPLS, MN)

47009 Paul Revere / Provident

LX148 Pekin Life Insurance (PO Box 1587, Pekin, IL)

LX148 Pekini Life (PO Box 21424, Eagan, MN)

52133 Peoples Benefit Life Ins. Co. (Salt Lake City, UT)

37121 Pequot Plus Health (PO Box 3559 Manshantucket, CT)

LX163 Personal Insurance Administrators (Agoura Hills, CA)

67814 Phoenix American (Greenfield, MA)

67814 Phoenix Home Life (Greenfield, MA)

38265 Physicians Care (Grand Rapids, MI)

12399 Physicians Health Plan of Northern IN(Fort Wayne, IN)

CX068 Physicians Mutual (Lincoln, NE)

47009 Physicians Mutual (Lincoln, NE)

CX014 Physicians Plus Insurance Co., Wisconsin State Employee

37224 Pittman & Associates (Memphis, TN)

37287 Planned Administrators, Inc.

36373 Prairie States Enterprises, Inc ( Sheboygan, WI)

41147 Preferred (PO Box 59212) Mpls, MN

16112 Preferred Care (Rochester, NY & Middleton, CT)

CB404 Preferred Health Plan of the Carolinas (Charlotte, NC)

47570 Premera Blue Cross (Seattle, WA)

56144 Primary Physician Care, Inc. (Charlotte, NC)

LX049 Prime West (1335 Industrial Blvd., Ste 150, MPls, MN)

CX014 PrimeCare, Wisconsin State and Federal Employees and

61271 Principal (Coloradp Springs, CO& DesMoines, IA)

38217 Priority Health (Grand Rapids, MI)

36331 Professional Benefit Administrators, Inc. (Oak Brook, IL)

88029 Prominence Health Plan (Reno & Henderson, NV)

DOM01 Providence (Po Box 1126)

PAS01 Providence Admin Services (Eagan, MN)

68195 Provident\Healthsource (Memphis TN)

60054 Prudential

CX080 Public Employees Health Program (PEHP)(Salt Lake City,

91136 Puget Sound Benefits Trust (Seattle, WA)

Payer 835 List

Payer ID Payer Name

95266 R.E. Harrington Inc (Colombus, OH)

HMA01 RGA (Bellevue, IL)

93200 Regence (FEP Po Box 857, ID)

93200 Regence Blue Shield (PO Box 30271 SLC UT)(PO Box 21

93200 Regence Blue Shield WA- FEP(PO Box 30271 SLC, UT)(P

47076 Regional Care Inc. (Scottsbluff, NE)

80314 ReliaStar

ASRM1 Reliance Standard (ARMS) (Moorestown, NJ)

36088 Reliance Standard (PO Box 82510 Lincoln, NE)

RLHA1 Renaissance Life and Health (Indianpolis, IN)

73066 Reserve National Insurance Company (Oklahoma City, O

84102 Rocky Mountain Life Dental (Colorado Springs, CO)

25133 Rural Carrier Benefit Plan (Charlotte, NC)

31441 S & S Health (Cincinnati, OH)

SCION SCION Dental (Milwaukee, WI)

SCION SCION Dental (Thiensville, WI)

SCION SCION Dental Kansas (Milwaukee, WI)

03699 SIEBA (Endicott, NY)

LX206 Safeguard (DHMO) PO Box 981987, El Paso, TX)

CX030 Safeguard (Po Box 981987, El Paso, TX)

CX030 Safeguard PPO -(PO box 30930 Laguna Hills & Aliso Viej

91184 Sanford Health Plan (Sioux Falls, SD)

28530 Secure Health Plan of GA (Macon, GA)

93742 Securian Dental Plans (PO Box 9385, MPLS, MN) Delta of

35202 Security Adminstrative Services (Marshfield, WI)

CX092 Security Life Insurance (Schenectady, NY)

64088 Select Administrative Services (Gulfport, MS)

CX107 Select Health (Salt Lake City, UT)

36404 Self Insured Plans LLC (Naples, FL)

CX020 Self Insured Services Company (SISCO) - Dubuque, IA

LX155 Seminole Tribe of FL (Fort Lauderdale, FL)

36426 Sendero Health Plans (Austin, TX)

75280 Shasta Admin Services (Redmond, OR)

LX024 Sheet Metal Workers (PO Box 1449, Goodlettsville TN)

SMW01 Sheet Metal Workers Local 91 (West Burlington, IA)

41143 Sheffield, Olson & McQueen (2145 Ford Pkwy, St. Paul,

76342 Sierra Health Services (Las Vegas, NV)

58102 Simple (1745 N Brown Rd, Lawrencevill GA)

SKYGN Skygen USA (Milwaukee, WI)

91136 South Bay H.E.R.E. Funds

37318 Southern Benefits Services (Lafayette, LA)

77153 Southern Indiana Health (Columbus, IN)

84147 Spina Bifida - VA HAC

13411 Standard Ins Co. of New York (PO Box 82520, Lincoln, N

93024 Standard Insurance of Oregon (PO Box 82622 Lincoln, N

62154 Standard Security (Parkridge, IL)

57254 State of TX Dental Plan - All Plans except PO Box 4665 (

62179 Steward Health Choice Claims (Medicaid)(Phoenix, Temp

64246 Strategic Ourtsourcing Inc. (SOI) (Charolotte, NC)

74227 Student Insurance (Lincoln, NE)

R7003 Sturm & Associates (Edina, MN)

95202 SummaCare (Akron, OH)

86083 Summit Admin Services, Inc. (Scottsdale, AZ)

67814 Sun Life (Po Box 81633, Wellesley Hills)

47009 Sun Life Canada

47009 Sun Life Financial

Payer 835 List

Payer ID Payer Name

67814 Sun Life and Health (Formerly Genworth)

CX088 Surency Life and Health (Wichita, KS)

73288 TDC (PO Box 1100 Employers Blvd, Green Bay, WI)

79480 TML (Austin, TX)

60054 TRW

73288 TSRDP Dental Claims (PO Box 1100 Employers Blvd, Gre

88067 Tall Tree Administrators (Salt Lake City, UT)

LX102 Taylor Benefit Resource (Thomasville GA)

41147 Teamsters (Po Box 7078) Duluth MN

CDMI0 Teamsters Welfare Fund (Farmington Hills, MI)

TXABA Texas Ag Benefit Admin (PO Box 211575, Eagan, MN)

79480 Texas Municipal League (TML) Austin, TX

74227 The Chesapeake Life Insurance Co.-Student Ins.

73288 The Dental Companies (PO Box 1100 Employers Blvd, Gr

73288 The Dental Concern (PO Box 1100 Employers Blvd, Gree

TDN01 The Dental Network (7400 York Raod, Suite 200, Towso

LX110 The Dental Shop (Amherst NY)

23223 The Loomis Company (Wyomissing, PA)

74227 The MEGA Life & Health Ins. Co.-Student Ins.

25175 Three Rivers Health Plan - (Monroeville, PA)

CX112 Total Dental Admin (Elk Grove, IL)

CX112 Total Dental Admin (PO Box 44035 Phoenix, AZ)

LX153 Total Plan Services, Inc. (Addison, TX)

69493 Tower Life Insurance (San Antonio, TX)

37284 TransChoice Key Benefit Admin (Milwaukee, WI)

65978 Travelers (El Paso, TX)

73288 Tricare Active Reservists (PO Box 1100 Employers Blvd,

89070 Tricare Dental Plan (UCCI) Harris burg, PA)

CDCA1 Tricare Retiree Dental-Delta Dental of CA - PO Box 5370

84103 Trigon - Blue Cross and Blue Shield (Colorado Springs, C

CB923 Trigon Blue Cross of Virginia (Now Anthem BCBS of Virgi

973 Triple S / Medicare Optimun

61425 Trustmark Insurance - Lake Forest, IL

89070 UCCI (United Concordia)

UFC01 UFCW of Central Ohio

62308 UFT Welfare Fund

GP133 UHC (United HealthCare)(Milwaukee, WI)

87726 UHC/Medica Po Box 30990 SLC UT

LX104 UMC Dental Reimbursement Plan (Lubbock TX)

33108 UMR - Cincinnati (Cincinatti, OH)

95266 UMR-Harrington Benefits (PO Box 30530,33,34,40, Salt L

79480 UMR-Onalaska (Onalaska, WI)

39026 UMR-Wausau (Salt Lake City, UT)

39026 UMR-Wausau (Wausau, WI & Pueblo, Co)

52180 UMWA Health & Retirement (Lubbock, TX)

UPMCD UPMC Community HealthChoice (CHC) (Milwaukee, WI)

23281 UPMC Dental Advantage

UPMCD UPMC Health Plan (CHIP) (Milwaukee, WI)

23281 UPMC Health Plan (Pittsburg, PA)

93092 US Benefits, Inc. (Portland, OR)

LX193 USAA (San Antonio, TX)

41206 UltraBenefits, Inc (Westborough, MA)

80314 Unicare

47009 Unifi Companies (Lincoln, NE)

35198 Unified Group Services (Anderson, IN)

52133 Unimerica Dental (Salt Lake City, UT)

Payer 835 List

Payer ID Payer Name

52133 Unique DentaCare (Salt Lake City, UT)

25175 Unison - (Monroeville, PA)

59069 United Benefits (Ormond Beach, FL)

89070 United Concordia (UCCI)

UFC01 United Food & Commerical Workers Union of Central Ohi

UGP19 United Group Program

GP133 United Health Care (Milwaukee, WI)

52133 United Health Care - MD, UT (Salt Lake City, UT)

95378 United Health Care of River Valley (Moline, IL)

87726 United Health Care, GA, PA

33108 United Medical Resources (Cincinatti, OH)

71412 United of Omaha (Charlotte, NC)

91136 University of Washington Students & Graduate Appts.(Se

89070 Unum

LX151 Utah Idaho Teamsters (SLC, UT)

12116 VA Fee Basis Programs (St Paul, MN)

89070 Valley Baptist Health Plan (PO Box 69442)

59266 Volusia Health Network (Daytona Beach, FL)

84105 WI Electrical Employees ( PO Box 659444, San Antonio,

LX160 WMI Mutual Insurance Company (Brownville, NY)

LX150 WPEE Insurance Trust Fund (Pittsburgh, PA)

91062 Washington Dental Service (Seattle, WA)

91136 Washington State Council of County & City Employees D

39026 Wausau Insurance Companies, Wausau, WI

59332 Web TPA, Inc. (Grand Prairie, TX)

75261 WebTPA/Community Health Electronic Claims/CHEC (Gra

10050 Webster Dental

CX083 WellCare(Liberty Dental)(Santa Ana, CA & Tampa, FL)

47198 Wellpoint (CA) (Oxnard, CA)

87815 Wells Fargo (Anchorage, AK)

87815 Wells Fargo (Charleston, WV)

37272 Wells Fargo TPA (JSL Administrators) (Newnan, GA)

91136 West Coast Stationary Engineers health & Security Trust

TLW33 Western PA Teamsters Fund (50 Penn, Pittsburgh, PA)

LX150 Western Pennsylvania Electric (Pittsburgh, PA)

93200 Whatcom Medical Bureau (Bellingham, WA)

93050 William C Earhart (Portland, OR)

R7002 Wilson, McShane (Mpls, MN)

R7006 Wisconsin Auto & Truck (WATDA) (Madison, WI)

84105 Wisconsin Electrical Employees (PO Box 659444, San Ant

20333 Worksite Benefit Services (PO Box 707 Tifton, GA)

CX014 Xantus Health PLan- Tennessee

62154 Xantus Health Plan (TN) (Lincoln, NE)

LX143 Zelis Payments

R7001 Zenith Administrators (Mpls, MN)