| AARP |
AARP |
| AETNA |
AETNA |
| PENNS |
AETNA BETTER HEALTH |
| AFNTY |
AFFINITY HEALTH PLAN |
| 00091 |
AMERICHOICE NJ |
| AMGRP |
AMERIGROUP |
| 00039 |
ANTHEM BC CA |
| BCWIC |
ANTHEM BCBS |
| 00360 |
APWU HEALTH PLAN |
| SB510 |
BCBS ALABAMA |
| SB530 |
BCBS ARIZONA |
| SB550 |
BCBS COLORADO |
| BCCTC |
BCBS CONNECTICUT |
| 00267 |
BCBS FLORIDA |
| 00268 |
BCBS ILLINOIS |
| SB630 |
BCBS INDIANA |
| SB640 |
BCBS IOWA |
| SB660 |
BCBS KENTUCKY |
| 23738 |
BCBS LOUISIANA |
| SB680 |
BCBS MAINE |
| SB690 |
BCBS Maryland |
| 00139 |
BCBS MASSACHUSETTS |
| BCMID |
BCBS MICHIGAN |
| BCMOC |
BCBS MISSOURI |
| SB820 |
BCBS N DAKOTA |
| SB760 |
BCBS NEBRASKA |
| SB765 |
BCBS NEVADA |
| 00044 |
BCBS OF CNY |
| 00151 |
BCBS OF GEORGIA |
| BCNCC |
BCBS OF N CAROLINA |
| SB880 |
BCBS OF S CAROLINA |
| SB801 |
BCBS OF WESTERN NY |
| BCOHC |
BCBS OHIO |
| SB840 |
BCBS OK |
| SB870 |
BCBS RHODE ISLAND |
| SB889 |
BCBS S DAKOTA |
| BCCTC |
BCBS TENNESSEE |
| SB923 |
BCBS VIRGINIA |
| SB941 |
BCBS W VIRGINIA |
| BCWIC |
BCBS WISCONSIN |
| SB960 |
BCBS WYOMING |
| ELDER |
BRAVO HEALTH |
| BCMDC |
Carefirst |
| CIGNA |
CIGNA |
| 13285 |
CLOVER HEALTH-CARE POINT |
| CMTWA |
COMMUNITY HEALTH PLAN WA |
| CNTCR |
CONNECTICARE |
| 00510 |
COVENTRY HEALTH CARE |
| EMBLM |
EMBLEM HEALTH |
| 00044 |
EMPIRE NY |
| ECLLS |
EXCELLUS |
| 11315 |
FIDELIS CARE |
| 60550 |
GATEWAY HEALTH PLAN |
| 75273 |
GEISINGER HEALTH PLAN |
| EMBLM |
GHI |
| HPHC |
HARVARD PILGRIM |
| 00240 |
HEALTH FIRST |
| HNNC |
HEALTH NET OF CA |
| 00440 |
HIGHMARK PA |
| EMBLM |
HIP OF GREATER NY |
| 00087 |
HORIZON NJ |
| 00041 |
HUMANA |
| BCIBC |
INDEPENDENCE PA |
| 95308 |
INDEPENDENT HEALTH |
| 00282 |
KAISER PERMANENTE (NCA) |
| 00283 |
KAISER PERMANENTE (SCA) |
| KYMHP |
KEYSTONE HEALTH PLAN |
| 53275 |
Martin’s Point Health Care |
| MLNIL |
MOLINA HEALTHCARE OF IL |
| 00226 |
MOLINA HEALTHCARE OF MICH |
| 00445 |
MOLINA HEALTHCARE OF IL |
| 00432 |
MVP HEALTH PLAN OF NY |
| VNSNY |
NS CHOICE |
| 00016 |
OXFORD |
| 61129 |
PASSPORT HEALTH PLAN |
| 00430 |
STANDARD LIFE INS COMP |
| THRIV |
THRIVENT FINANCIAL |
| 00080 |
TRICARE / CHAMPUS |
| TREST |
TRICARE EAST |
| TDFIC |
TRICARE FOR LIFE |
| 57106 |
TRICARE NORTH/SOUTH |
| TRICE |
TRICARE WEST |
| TUFTS |
TUFTS HEALTH PLAN |
| UCARM |
UCARE OF MINNESOTA |
| 31107 |
UMR CINCINNATI |
| 62061 |
UMR KANSAS |
| 39026 |
UMR WAUSAU/UHIS |
| 00112 |
UNITED HEALTHCARE |
| 15003 |
UNIVERA COMMUNITY HEALTH |
| HC001 |
UNIVERA HEALTHCARE – CNY |
| UNINW |
UNIVERA TRADITIONALPPO |
| UPMC |
UPMC HEALTH PLAN |
| USFHP |
US FAMILY HEALTH PLAN |
| WCHP |
WELLCARE HEALTH PLANS |
| OOWPS |
WPS COMMERCIAL |
| SX022 |
WPS HEALTH INSURANCE |
| 00019 |
Cox Health Plan |
| 00050 |
BCBS Colorado - Anthem |
| 00130 |
Medpay |
| 00230 |
BCBS Mississippi |
| 00243 |
Helix Family Choice |
| 00243 |
Medstar Physician Partners |
| 00265 |
BCBS Nevada - Anthem |
| 00430 |
Premera |
| 00530 |
Missouri Care |
| 00540 |
SISCO |
| 00541 |
Healthy Blue - Missouri Care |
| 00544 |
Healthy Blue Nebraska |
| 00551 |
Healthy Blue Dual Advantage Louisiana |
| 00570 |
BCBS Delaware |
| 00580 |
BCBS Alabama |
| 00602 |
Healthy Blue North Carolina |
| 00610 |
BC Idaho |
| 00611 |
BS Idaho - Regence |
| 00630 |
BCBS Indiana - Anthem |
| 00660 |
BCBS Kentucky - Anthem |
| 00661 |
Healthy Blue Louisiana |
| 00680 |
BCBS Maine - Anthem |
| 00720 |
BS Minnesota |
| 00720 |
Commprehensive Care Services (BCBSMN) |
| 00790 |
BCBS New Mexico |
| 00800 |
BS Northeast New York |
| 00806 |
Blue Shield of Utica NY |
| 00820 |
BCBS North Dakota |
| 00822 |
Blue Shield of Alaska |
| 00870 |
BCBS Rhode Island |
| 00870 |
Blue Chip Rhode Island |
| 00910 |
BCBS Utah - Regence |
| 00922 |
BlueChoice South Carolina |
| 00923 |
BCBS Virginia |
| 00932 |
BS Washington - Regence |
| 00934 |
BC Washington State - Premera |
| 00960 |
BCBS Wyoming |
| 01260 |
Magellan Health |
| 01508 |
Better Health Florida |
| 03432 |
Arizona Physicians IPA |
| 03440 |
Phoenix Health Plan |
| 04218 |
Pan American Life Insurance |
| 04286 |
Health New England |
| 04293 |
Allways Health Plan |
| 04332 |
Network Health |
| 04332 |
Network Health Massachusetts |
| 05047 |
Neighborhood Health Plan of Rhode Island |
| 06541 |
CCHS |
| 06603 |
ASAGEHA |
| 07003 |
HealthPartners |
| 07205 |
360 Alliance PPO Gilsbar |
| 07205 |
Gilsbar Inc |
| 07503 |
University Family Care - Healthcare Group |
| 09824 |
Molina Healthcare of New Mexico Salud |
| 09830 |
University Family Care |
| 09908 |
University Family Care - Maricopa Health Plan |
| 10105 |
Inter Valley Health Plan |
| 10575 |
Select Health Utah |
| 10597 |
Healthe Exchange |
| 10629 |
Christus Health Medicare Advantage |
| 10850 |
Metropolitan Health Plan |
| 11067 |
Key Benefit Administrators (IN) |
| 11303 |
Magnacare |
| 11695 |
iCare Independent Care Health Plan |
| 12115 |
VA Fee Basis Programs |
| 12399 |
Physicians Health Plan of Northern Indiana |
| 12422 |
Medica IFB |
| 128CA |
Aetna Better Health CA |
| 128FL |
Aetna Better Health of Florida |
| 128KS |
Aetna Better Health Kansas |
| 128KY |
Aetna Better Health of Kentucky |
| 128LA |
Aetna Better Health of Louisiana |
| 128MD |
Aetna Better Health of Maryland |
| 128MI |
Aetna Better Health of Michigan |
| 128NV |
Aetna Better Health NV |
| 128VA |
Aetna Better Health of Virginia |
| 128WV |
Aetna Better Health of West Virginia |
| 13162 |
1199 SEIU Family of Funds |
| 13174 |
Montefiore Contract Management Organization |
| 13189 |
Meridian Health Plan |
| 13193 |
Loyal American |
| 13285 |
Clover (formerly Carepoint) |
| 13333 |
Affinity Health Plans - TMG Health |
| 13335 |
Hudson Health Plan |
| 13337 |
Boston Medical Center Healthnet |
| 13350 |
MODA Health - ODS Health Plan |
| 13402 |
Touchstone Health/Health Net Smart |
| 15460 |
PA Care Advantage Highmark Senior Health |
| 16146 |
Molina Healthcare of New York (Total Care NY) |
| 16644 |
Nova Healthcare Administrators, Inc |
| 16663 |
Banner Medicare Advantage Plus (PPO) |
| 16664 |
Banner Medicare Advantage Prime (HMO) |
| 20356 |
The Health Exchange - Cerner Corporation |
| 20377 |
Pacificsource Medicare |
| 20416 |
Pacificsource Community Solutions |
| 20554 |
Molina Healthcare of Texas |
| 21313 |
Kaiser Permanente Georgia |
| 22248 |
AmeriHealth Mercy Health Plan |
| 22254 |
Fallon Community Health |
| 22264 |
VYTRA Healthcare |
| 22326 |
Horizon New Jersey Health |
| 22348 |
Maryland Physicians Care |
| 22355 |
AmeriHealth VIP Care |
| 22771 |
Managed Health Networks - MHN |
| 23037 |
Amerihealth HMO |
| 23045 |
Capital Blue Cross Professional |
| 23160 |
Medico Insurance Company |
| 23223 |
The Loomis Company |
| 23249 |
Sentinel Management Services |
| 23250 |
Significa Benefit Services / Erin |
| 23253 |
Spectrum Administrators |
| 23284 |
Keystone First |
| 23285 |
Select Health of South Carolina |
| 23334 |
Affinity Essentials |
| 23342 |
Qualcare |
| 23626 |
Central Pennsylvania Teamsters Fund |
| 23856 |
Touchstone Health PSO |
| 24077 |
Santa Clara Family Health Plans |
| 24735 |
Pinnacle Claims Management |
| 25125 |
SL Carpenters Fund |
| 25127 |
Coventry Health Care Georgia |
| 25132 |
Coventry Health Care Iowa |
| 25135 |
Coventry Health Care Louisiana |
| 25136 |
Coventry Health Care Louisiana |
| 25150 |
OmniCare |
| 25160 |
DGA - Diversified Group Administrators |
| 25175 |
Americhoice Personal Care Plus PA - United Healcar |
| 25463 |
BIND - UHC Choice Multiplan |
| 26375 |
Amerigroup DC, GA, NM |
| 26378 |
Amerigroup |
| 27094 |
Simply HealthCare Plans |
| 27514 |
Amerigroup Georgia / Tennessee |
| 28804 |
Amerigroup |
| 28804 |
Amerigroup Illinois |
| 28805 |
Amerigroup / Americaid - Houston |
| 28807 |
Amerigroup - Maryland, Virginia and District of Co |
| 28809 |
Amerigroup Florida |
| 29076 |
Carolina Care Plan |
| 31048 |
Western Southern Financial Group |
| 31059 |
State Farm - Casualty and Property |
| 31114 |
Caresource |
| 31441 |
S and S Healthcare Strategies |
| 32002 |
BC Michigan Complete |
| 32004 |
Buckeye Community Health |
| 33001 |
Universal Care - California |
| 33033 |
FCE Benefit Administrators |
| 33628 |
Mercy Maricopa Integrated Care |
| 34097 |
Central Reserve Life |
| 34136 |
JP Farley Corporation |
| 34186 |
CSI Network Services |
| 34192 |
Antares Management Solutions |
| 34192 |
Mutual Health Services |
| 34196 |
Apex Benefit Services |
| 35092 |
Morris Associates aka HealthScope Benefits |
| 35161 |
Indiana ProHealth Network |
| 35174 |
QualChoice of Arkansas |
| 35180 |
CoreSource of North Carolina |
| 35182 |
CoreSource |
| 35183 |
CoreSource of Ohio |
| 35187 |
CoreSource |
| 35605 |
Everence |
| 36215 |
Central States Southeast and Southwest Areas Healt |
| 36215 |
Teamcare |
| 36331 |
Professional Benefit Administrators - Oak Brook, I |
| 36373 |
Prairie States Enterprises |
| 36405 |
Harmony Health Plan of Indiana |
| 36406 |
Harmony Health Plan of Illinois |
| 36878 |
Entrust |
| 37086 |
Pekin Insurance |
| 37217 |
Key Benefit Administrators |
| 37224 |
Pittman and Associates |
| 37287 |
Planned Administrators, Inc - PAI |
| 37290 |
Health Services for Children with Special Needs - |
| 37292 |
Machinist District 9 Welfare |
| 37301 |
Summit America Insurance Services |
| 37308 |
Allied Benefit Systems |
| 37316 |
Leon Medical Center Health Plan |
| 37330 |
Physicians Health Plan (PHP) Mid-Michigan |
| 37602 |
Golden Rule / All Savers Insurance |
| 37602 |
Rooney Life Ins |
| 38216 |
Health Plus of Michigan |
| 38259 |
Automated Benefit Services - ABS |
| 38308 |
Christian Brothers Services |
| 38309 |
Healthnet of AZ |
| 38333 |
Molina Healthcare of California |
| 38336 |
Molina Healthcare of Washington |
| 38338 |
McLaren Health Plan |
| 3833A |
McLaren Health Advantage |
| 39045 |
Security Health Plan |
| 39144 |
Network Health Plan of Wisconsin |
| 39151 |
WEA Insurance Group |
| 39156 |
Physicians Plus Insurance |
| 39185 |
Prevea Health Insurance Plan / Arise Health Plan |
| 39186 |
IN Managed Health Services |
| 39190 |
MedStar Family Choice |
| 39856 |
Angle Health |
| 41041 |
Federated Mutual Insurance |
| 41095 |
Wilson-McShane |
| 41124 |
IBI |
| 41147 |
Preferred One |
| 41154 |
Mayo Management Services |
| 41212 |
Freedom Health Plan |
| 42011 |
American Republic Insurance Company - ARIC |
| 42172 |
Riverlink / Soundpath Health |
| 43166 |
Premier Health Plan |
| 43174 |
Molina Healthcare of Washington - Encounters Only |
| 43197 |
Fresenius Health Partners |
| 43313 |
Harken Health |
| 43324 |
Beacon Health Strategies |
| 44054 |
Government Employees Hospital Association - GEHA |
| 45129 |
New Mexico Health Connections (Dates of Service pr |
| 451NM |
New Mexico Health Connections |
| 45289 |
Fringe Benefit Group |
| 45289 |
Lone Star TPA |
| 45332 |
Oregons Health CO-OP |
| 45341 |
Maine Community Health Options |
| 46045 |
Avera Health Plans |
| 46120 |
Crystal Run Health Plans |
| 46299 |
Molina Healthcare of South Carolina |
| 46430 |
Crystal Run Health Plans |
| 47027 |
Physicians Mutual Insurance Company |
| 47073 |
AmeriHealth Caritas Next Delaware |
| 47171 |
Blue Shield of Kansas City |
| 47181 |
Highmark BCBSD Health Options |
| 48117 |
FMH Benefit Services |
| 48143 |
Imagine360 |
| 48145 |
Community Health Choice |
| 50023 |
Aetna Better Health of Ohio |
| 51062 |
Molina Healthcare of Florida |
| 52103 |
National Telecommunications Cooperative Associatio |
| 52106 |
Christus Health Plan Texas HIX |
| 52123 |
Johns Hopkins - USFHP |
| 52132 |
Cooperative Benefits Administrators - CBA |
| 52132 |
National Rural Electric |
| 52180 |
UMWA Health and Retirement Funds |
| 52189 |
John Hopkins Healthcare - EHP/PP |
| 52312 |
Arbor Health |
| 52461 |
March Vision Care |
| 52629 |
Ucare of Minnesota – DOS before 2019 |
| 53011 |
National Association of Letter Carriers |
| 53120 |
BCBS Louisiana |
| 53589 |
BCBS Arizona |
| 53589 |
SW Service Administrators |
| 54154 |
Optima Insurance Company |
| 54154 |
Sentara Family Plan |
| 54154 |
Sentara Health Management |
| 54828 |
BCBS West Virginia - Highmark |
| 55204 |
HealthNow NY |
| 55764 |
HealthPartners of Minnesota |
| 55892 |
NextBlue |
| 56116 |
Corporate Benefits Service |
| 56139 |
Benefit Management Services |
| 56144 |
HealthGram |
| 56144 |
Primary PhysicianCare |
| 56152 |
PARTNERS National Health Plans of North Carolina |
| 56162 |
MedCost |
| 56196 |
First Carolina Care (Dates of Service prior to 1.1 |
| 56205 |
MedCost Benefit Services |
| 57115 |
Care 1st Health Plan of CA |
| 57116 |
Care 1st Health Plan of Arizona (DOS prior to 12/1 |
| 58102 |
Covenant Administrators |
| 58182 |
Naphcare |
| 58233 |
Evergreen Health Plan |
| 58234 |
Alliant Health Plans of Georgia |
| 58379 |
Qual Choice of Arkansas (formerly payer ID 35174) |
| 59140 |
American Benefits Plan Administrators - Las Vegas, |
| 59140 |
Consolidated Group |
| 59141 |
Administrative Services, Inc |
| 59144 |
Culinary Las Vegas - Unite HERE Health |
| 59204 |
Fringe Benefit Coordinators |
| 59222 |
Transamerica Life |
| 59274 |
AvMed |
| 59321 |
Florida Hospital Healthcare Systems |
| 59322 |
Florida Health Plan |
| 59354 |
Wellcare Health Plan |
| 59608 |
Healthease |
| 60061 |
AmeriHealth - New Jersey (Non-HMO Claims) |
| 60110 |
Preferred Health Systems |
| 60495 |
Community Health Plan |
| 61115 |
Humana Long Term Care |
| 61184 |
Tribute Health Plan |
| 61271 |
Principal Financial Group |
| 61325 |
Passport Health Plan |
| 61604 |
Prime West Health Plan |
| 62030 |
American General |
| 62073 |
Cariten Commercial |
| 62111 |
Health Cost Solutions |
| 62153 |
Windsor Medicare Extra |
| 62179 |
Health Choice of AZ |
| 62413 |
MailHandlers |
| 62553 |
Country Life |
| 63092 |
HealthSpring HMO/HealthSpring Medicare+Choice |
| 63114 |
Viva Health Plan |
| 64069 |
Fox-Everett |
| 64071 |
Acclaim |
| 64157 |
Meritain Health |
| 64158 |
Meritain Health / Agency Services |
| 64159 |
Definity Health |
| 64246 |
Guardian Life Insurance Company of America |
| 65088 |
Preferred Care Partners |
| 65465 |
MoreCare |
| 66006 |
Blue Cross Medicare Advantage |
| 66010 |
Care N Care |
| 66901 |
Banner-University Family Care - University of Ariz |
| 66917 |
Parkland Community Health Plan |
| 68011 |
Capitol Administrators |
| 68024 |
Aetna Better Health of Illinois Inc |
| 68035 |
Health Plan of San Joaquin |
| 68039 |
Western Health Advantage |
| 68048 |
Cenpatico Behavioral Health AZ |
| 68049 |
Peach State HP |
| 68055 |
Total Carolina Care |
| 68056 |
Centene Advantage |
| 68057 |
Sunshine Health Plan |
| 68060 |
Celticare |
| 68062 |
Magnolia |
| 68064 |
Healthy Texas |
| 68066 |
Illini Care Health. Invalid after 11.30.2020 |
| 68067 |
Kentucky Spirit Health |
| 68068 |
Integrated Mental Health Services |
| 68195 |
Healthpoint Corporation |
| 68195 |
Healthsource Provident |
| 71063 |
HealthSCOPE Benefits |
| 71064 |
HealthChoice |
| 71080 |
NovaSys Health Network |
| 71404 |
Continental General Insurance |
| 71412 |
Mutual of Omaha Insurance Company |
| 71890 |
Medica Health Plan Solutions |
| 72107 |
BCBS LA Blue Advantage |
| 72126 |
Peoples Health Network |
| 72128 |
Vantage Health Plan |
| 72467 |
ACS Benefit Services |
| 73066 |
Reserve National Insurance |
| 73067 |
Quicktrip Corporation |
| 73099 |
Standard Life and Accident |
| 73100 |
Kempton Group |
| 73143 |
Community Care Managed Health Care Plans of Oklaho |
| 73147 |
HealthCare Solutions Group |
| 73159 |
First Health Network |
| 74048 |
American National Insurance |
| 74095 |
USAA |
| 74205 |
Right Care from Scott and White |
| 74212 |
Employer Plan Services |
| 74227 |
MEGA Life and Health - Student Division |
| 74234 |
CompuSys Incorporated |
| 74238 |
Boon-Chapman Benefit Administrators |
| 74284 |
Driscoll Childrens Health Plan |
| 74289 |
Mental Health Network |
| 75068 |
Assurant Health Self Funded |
| 75136 |
Luminare Health Little Rock |
| 75137 |
Ameriben Solutions |
| 75261 |
webTPA - Community Health Electronic Claims/CHEC |
| 75281 |
New ERA Life |
| 75284 |
Consolidated Associates Railroad |
| 75544 |
Christie Student Health Plans |
| 76045 |
SelectCare of Texas -HPN - Heritage Physicians Net |
| 76048 |
Texas Children's Health Plan |
| 76342 |
Sierra Health and Life |
| 76498 |
Maryland Physicians Care (After DOS 12.31.2020) |
| 77001 |
AmeriHealth NorthEast |
| 77002 |
Amerihealth District of Columbia |
| 77003 |
Prestige Health Choice |
| 77013 |
Amerihealth Caritus VIP Michigan |
| 77022 |
Ultimate Health Plan |
| 77045 |
Arcadian Management Services |
| 77062 |
AmeriHealth Caritas VIP Care |
| 77075 |
Amerihealth Caritas Iowa |
| 77076 |
Network Health Insurance Corp - Medicare |
| 77082 |
Care Improvement Plus |
| 77153 |
Indiana University |
| 77153 |
Southeastern Indiana Health SIHO |
| 77160 |
Gold Coast |
| 77170 |
Common Ground Healthcare Cooperative |
| 77701 |
Vantage Health Plan |
| 77741 |
Keystone First PA Community Health Choices |
| 77780 |
BCBS Nebraska |
| 78375 |
Connecticare - Medicare |
| 78857 |
Medica Health Care Plan |
| 80095 |
Prominence Health Plan of Texas |
| 80141 |
Healthfirst NY |
| 80142 |
Health Partners PA |
| 80314 |
Unicare Life and Health |
| 80705 |
One Health Plan |
| 81039 |
EBMS - Employee Benefit Management Services |
| 81264 |
Nippon Life |
| 81400 |
All Savers Insurance (UnitedHealthOne) |
| 81671 |
Amerihealth Caritas NC |
| 81793 |
Molina Health Reforma |
| 81883 |
Municipal Health Benefits Fund |
| 83148 |
AmeriHealth Caritas Next North Carolina |
| 84129 |
Colorado Access |
| 84135 |
Denver Health Medical Plan |
| 84146 |
CHAMPVA-HAC |
| 84223 |
Keystone VIP Choice |
| 84980 |
BCBS Texas |
| 86052 |
Mercy Health Plan of AZ |
| 86220 |
Mass Advantage |
| 86304 |
Insurers Administrative |
| 87042 |
Union Pacific Railroad Employees Health Systems |
| 87406 |
AmeriHealth Caritas VIP Care - Delaware DSNP |
| 87716 |
Amerihealth Caritas Healthplan NH |
| 87815 |
Acordia National - Wells Fargo TPA |
| 87843 |
Consolidated Health Plans |
| 88022 |
CDS Group Health |
| 88023 |
Hometown Health Plan Nevada |
| 88030 |
Scott and White Health Care |
| 88050 |
National Health Benefits Corporation - NHBC02 |
| 88058 |
Med Pay |
| 88250 |
HealthTeam Advantage |
| 88600 |
MMM - Medicare y mucho mas |
| 88848 |
BCBS Iowa - Wellmark |
| 88848 |
BCBS South Dakota - Wellmark |
| 90551 |
US Family Health Plan |
| 90560 |
WestLake Financial Group |
| 90753 |
MedCost / Liberty Health Share |
| 91049 |
Lifewise Health Plan of Washington |
| 91051 |
Group Health Cooperative (WA) |
| 91121 |
Group Health Northwest |
| 91131 |
Sound Health |
| 91184 |
Sanford Health Plan |
| 91617 |
Kaiser Foundation Health Plan Colorado |
| 93029 |
PacificSource Health Plans |
| 93079 |
Kaiser Foundation Health Plan of the Northwest |
| 93082 |
Prominence Health Plan of Nevada |
| 93093 |
Lifewise |
| 93093 |
Lifewise Health Plan of Oregon |
| 93121 |
FamilyCare Coordinated Care Organization |
| 93221 |
Asuris NW Health |
| 93240 |
Evergreen Health Cooperative |
| 93688 |
AmeriHealth - DE (PPO) |
| 94135 |
Kaiser Foundation Health Plan of Northern CA Regio |
| 94265 |
Medica |
| 94999 |
FirstCare |
| 95112 |
Capital Health Plan |
| 95123 |
Neighborhood Health Partnership - NHP |
| 95202 |
SummaCare Health Plan |
| 95241 |
AGIA Inc |
| 95376 |
Community Health Group |
| 95378 |
AmeriChoice Tennesee |
| 95386 |
CenCal Health |
| 95397 |
PIA |
| 95397 |
Personal Insurance Administrators |
| 95444 |
Clarian Health Plans |
| 95655 |
Medigold |
| 95655 |
Mount Carmel |
| 95677 |
The Health Plan of West Virginia Inc |
| 95958 |
PacifiCare |
| 95999 |
PacifiCare PPO |
| 96240 |
Neighborhood Health Plan of RI - Integrity |
| 96385 |
United Healthcare Community Plan Kansas |
| 97300 |
Triple S |
| 99030 |
Aloha Care |
| A5236 |
Ochsner Health Plan |
| ABRI1 |
Abri Healthplan |
| ABRI1 |
Molina Healthcare Wisconsin |
| ALOHA |
AlohaCare |
| AMF11 |
American Family Insurance |
| ARCS1 |
CareSource Arkansas |
| ATRIO |
ATRIO Health Plans |
| AWNY6 |
Age Well NY |
| BANK1 |
BANKERS FIDELITY LIFE INSURANCE CO (ERA ONLY) |
| BC001 |
Directors Guild of America |
| BCSAL |
BCBS Alabama |
| BHOVO |
Carelon Behavioral Health |
| BOONG |
The Boon Group |
| BRGHT |
Bright HealthCare |
| BRIDG |
Bridgespan |
| BRT01 |
Bright Health Plan Medicare |
| BTSS1 |
Brown and Toland Sutter |
| C1SCA |
BS California Promise Health Plan |
| CALOP |
CalOptima Direct |
| CAPHP |
Caprock Health Plans |
| CARMO |
Caremore Value Plus |
| CB186 |
Bright Health Plan |
| CCHP1 |
Cook Children's Health Plan |
| CCStpa |
CCSTPA Comprehensive Care Services |
| CELTC |
Celtic Insurance |
| CHPWA |
Community Health Plan of WA |
| CIPA1 |
Central Senior Care |
| CLEAR |
Clear Health Alliance |
| CM001 |
Caremore |
| COACC |
Access Behavioral Care |
| COKSR |
Colorado Kaiser Permanente - Colorado plans only |
| COMMF |
Community First |
| CURTV |
Curative |
| DAK01 |
DakotaCare |
| DEAN1 |
Dean Health Plan (DOS prior to 1/1/24) |
| DRHCP |
Doctors HealthCare Plans |
| EBSRM |
Lifetime Benefits Solutions |
| EH001 |
Evry Health |
| EMBLM |
EMBLEM |
| FCC01 |
First Carolina Care |
| FCC01 |
FirstMedicare Direct |
| FOREN |
Tricare Overseas |
| GACS1 |
CareSource of Georgia |
| GHOKC |
Global Health |
| HCA77 |
Healthcomp |
| HCH01 |
Healthcare Highways |
| HIBCS |
BCBS Hawaii |
| HMA01 |
Healthcare Management Administrators - HMA service |
| HMAPD |
BlueCross Medicare Advantage |
| HPAMN |
Cooportunity Health |
| HPSM1 |
Health Plan of San Mateo |
| HT001 |
HealthSpring HMO |
| IDBLC |
BC Idaho |
| IEHP1 |
Inland Empire Health Plan |
| INCHN |
Intercommunity Health Net |
| INCS1 |
CareSource IN |
| J1908 |
Chesapeake Insurance |
| JAI01 |
JAI Medical Systems |
| KYCS1 |
CareSource KY |
| L0250 |
Preferred Medicare |
| L0260 |
Constellation Health |
| LACAR |
LA Care Health Plan |
| LIFE1 |
OptumCare (Optum Medical Network / Lifeprint) |
| MAHC1 |
Medical Associates Health Plan (Live360) |
| MAHP1 |
Medical Associates Health Plan |
| MC721 |
Blue Cross Community Centennial |
| MCA11 |
Memorial Clinical Associates |
| MCCVA |
Magellan Complete Care of VA |
| MCDIL |
Blue Cross Community Options |
| MCS01 |
GEMCare - Golden Empire Managed Care System |
| MCS04 |
Managed Care Systems |
| MEDM1 |
Medica Government Programs |
| MHPMI |
Meridian Health Plan Michigan Complete |
| MIBCN |
BCBS Michigan Blue Care HMO - BCN of Michigan |
| MIFEP |
Michigan FEP |
| MIMPB |
Michigan Medicare PlusBlue |
| MMLI3 |
Transamerica Premier Life Insurance - Monumental |
| MNAUL |
Aultcare |
| NG007 |
Kaiser Foundation Health Plan of Ohio |
| NG008 |
Kaiser Mid-Atlantic |
| NJBCS |
Blue Shield of New Jersey |
| NM505 |
Molina Healthcare of New Mexico |
| NWDC1 |
Northwest Diagnostic Clinic |
| OMN02 |
Omnicare IPA |
| OSCAR |
Oscar Health |
| PCCAZ |
Pacificare Arizona |
| PDSHM |
Plan de Salud Hospital Menonita |
| PEAK0 |
Peak Health |
| PHP00 |
Providence Preferred - PPO |
| PHP02 |
Partnership Health Plan |
| PRAHM |
Triple S - AHM |
| PRAUX |
Auxilio Salud Plus |
| PRBEL |
Plan de Salud Bella Vista |
| PRBIE |
Plan de Bienestar UTM-PRSSA |
| PREHP |
Presbyterian Health Plan |
| PREMD |
Preferred Medicare Choice (PMC) |
| PRFHC |
FHCHS of Puerto Rico |
| PRFMV |
First Medical Vital |
| PRMAP |
Mapfre Life Insurance |
| PRMCS |
Medical Card System - MCS |
| PRMEV |
Plan de Salud Hospital Menonita Vital |
| RGA01 |
Regence Group Administrators |
| RH011 |
Kaiser Permanente Hawaii |
| RLH01 |
Lifemap |
| RMHMO |
Rocky Mountain HMO |
| RMSCO |
RMSCO |
| RP061 |
Farm Bureau Health Plans MAPD |
| RRMCR |
Railroad Medicare |
| RX001 |
TransactRx Infusion and Specialty |
| SB570 |
BCBS Delaware |
| SB613 |
Community Health Plan of Washington |
| SB700 |
BCBS Massachusetts |
| SB731 |
MS BCBS State Employees |
| SB810 |
BCBS North Carolina |
| SC446 |
Employee Benefit Services DBA Key Benefit Administ |
| SCAN1 |
Scan CA |
| SFHP1 |
San Francisco Health Plan |
| SHMS1 |
Shared Health Mississippi |
| SHP01 |
Sharp Health Plan |
| SLIC1 |
Stonebridge Life - Valley Forge Pennsylvania |
| SMPLY |
Simply Healthcare Plans |
| STJOE |
Mission Hospital Affiliates |
| SX105 |
Deseret Mutual |
| SX106 |
PEHP - Utah Public Employee Health Plan |
| SX107 |
Intermountain Healthcare |
| SX109 |
Molina Healthcare Utah |
| SX110 |
EMI Health |
| SX113 |
Altius Health Plans |
| SX141 |
Rocky Mountain Health Plan Grand Junction |
| SX158 |
Paramount Health |
| SX169 |
Central California Alliance for Health |
| SX179 |
Asuris Northwest/MedAdvantage |
| TA720 |
Independence Administrators |
| TH095 |
American Family Insurance |
| THS01 |
Texas HealthSpring |
| TLINS |
Transamerica Life |
| TRP1E |
Transamerica Life |
| TRSEL |
Selman Tricare Supplement |
| TRULI |
Truli Health |
| TX1ST |
Texas First Health Plans |
| ULLIC |
Ullico - Valley Forge Pennsylvania |
| UNBCI |
Universal Benefits |
| UNITE |
UNITE HERE |
| UTAMS |
UNITED TEACHER ASSOCIATES |
| VCIPA |
Valley Care IPA |
| VFP11 |
Village Family Practice |
| VHA11 |
Valley Health Administrators |
| VHP01 |
Valley Health Plan |
| WLPNT |
Amerigroup - Wellpoint |
| BCCAC |
ANTHEM BC CA |
| SB520 |
BCBS ARKANSAS |
| SB580 |
BCBS DC / FED |
| 00151 |
BCBS GEORGIA |
| BCKSC |
BCBS KANSAS |
| 00751 |
BCBS MONTANA |
| BCNCC |
BCBS N CAROLINA |
| SB770 |
BCBS NEW HAMPSHIRE |
| SB840 |
BCBS OKLAHOMA |
| BCORC |
BCBS OREGON |
| BCSCC |
BCBS S CAROLINA |
| 00271 |
BCBS TEXAS |
| BCTXC |
BCBS TEXAS |
| SB915 |
BCBS VERMONT |
| SB801 |
BCBS WESTERN NY |
| SPBSC |
BS OF CALIFORNIA |
| BCMDC |
CAREFIRST MARYLAND |
| 71412 |
Mutual of Omaha |
| 00019 |
Cox Health Plan (Requires Provider ID in Box 33a. |
| 00403 |
Blue Choice Medicaid |
| 00562 |
BCBSMN BLUE PLUS MEDICAID |
| 00726 |
BCBSMN Blue Plus Medicaid |
| 02937 |
Anthem BCBS (Ohio Medicaid) |
| 03150 |
CareSource Ohio Medicaid |
| 04202 |
Buckeye Ohio Medicaid (Centene) |
| 07316 |
Molina Ohio Medicaid |
| 26337 |
Aetna Better Health Medicaid IL |
| 3833C |
McLaren Medicaid |
| 38692 |
Aetna TX Medicaid and CHIP |
| 61103 |
Humana - Healthy Horizons (Ohio Medicaid) |
| 66001 |
BCBS Texas Medicaid STAR CHIP |
| 77350 |
Providence Health Assurance Medicaid |
| 86916 |
Medicaid Texas Health Steps and CSHCN |
| 94998 |
FirstCare Star Medicaid |
| AKMCD |
Medicaid of Alaska |
| DEMCD |
Medicaid of Delaware |
| MICS1 |
HAP CareSource of Michigan Medicaid |
| NHMCD |
Medicaid of New Hampshire |
| UTMCD |
Medicaid of Utah |
| 00039 |
BCBS CA |
| 46320 |
AETNA Better Health NJ |
| 81040 |
Allegiance |
| 68069 |
Ambetter |
| 54763 |
Amerihealth Admin |
| 77799 |
Amerihealth Caritas DE |
| AMNPA |
Amerihealth Caritas PA |
| CDPHP |
Capital District PHP |
| 93975 |
Careoregon |
| 00324 |
Careplus Health Plan |
| 13360 |
Centerlight Healthcare |
| 42139 |
County Care |
| CTYCR |
Countycare |
| DEVOT |
Devoted Health |
| 31625 |
Elderplan |
| ESSNC |
Essence Healthcare |
| 77950 |
Health Alliance of IL |
| HAPMC |
Health Alliance of MI |
| 94267 |
Health Partners UPH |
| 51020 |
Integra Administrative |
| MHPIL |
Meridian Health Plan IL |
| 13265 |
Metro Plus Health Plan |
| 38217 |
Priority Health |
| PVDNC |
Providence for Oregon |
| 83035 |
Senior Whole Health |
| 31053 |
State Farm |
| 48055 |
Todays Option |
| SX006 |
Univera Community Health |
| 83248 |
Zing Health Choice |
| VNSNY |
VNS Choice |
| 54398 |
Allina Health (Aetna) |
| 44273 |
Health Plans Inc |
| 35245 |
WellSystems LLC |
| 74234 |
8th District Electrical |
| 36273 |
AARP Medicare Supplement/Fixed Indemity by UnitedHealthcare |
| 87726 |
AARP MedicareComplete |
| 36273 |
AARP UnitedHealthcare Insurance |
| 87815 |
Acordia National ‐ Wells Fargo TPA |
| 74234 |
Advanstaff |
| 23228 |
Aetna Better Health ‐ PA Medicaid |
| 60054 |
Aetna Health Plan ‐ PPO |
| 60054 |
Aetna Life and Casualty Company |
| 13333 |
Affinity Health Plans ‐ TMG Health |
| 80705 |
AH and L |
| 37602 |
All Savers Insurance |
| 81040 |
Allegiance Benefit Plan Management |
| 80705 |
ALTA Health and Life Insurance Company |
| 59140 |
American Benefits Plan Administrators ‐ Las Vegas, NV |
| 87726 |
American International Group |
| 81400 |
American Medical Security |
| 81400 |
American Medical Security (UnitedHealthOne) |
| 44444 |
American Postal Workers Union Health Plan ‐ APWU |
| 42011 |
American Republic Insurance Company ‐ ARIC |
| 87726 |
AmeriChoice ‐ CT, FL, MD, RI, TX, WI (UnitedHealthcare Community Plan) |
| 87726 |
AmeriChoice by UnitedHealthcare (NYU) (UnitedHealthcare Community Plan) |
| 87726 |
AmeriChoice MS ‐ CHIP and CAN (UnitedHealthcare Community Plan) |
| 86047 |
AmeriChoice NJ, Medicaid, NJ Family Care ‐ UnitedHealthcare Community Plan |
| 87726 |
AmeriChoice of Florida |
| 87726 |
AmeriChoice of Illinois |
| 87726 |
AmeriChoice of Maryland |
| 87726 |
AmeriChoice of Nebraska |
| 87726 |
AmeriChoice of Nebraska (UnitedHealthcare Community Plan) |
| 86047 |
AmeriChoice of NJ Medicaid and Family Care |
| 87726 |
AmeriChoice of Rhode Island |
| 25175 |
Americhoice Personal Care Plus PA ‐ United Healcare Community Plan |
| 95378 |
AmeriChoice Tennesee ‐ TennCare, Secure Plus Complete ‐ UnitedHealthcare
Community Plan |
| 28807 |
Amerigroup ‐ Maryland, Virginia and District of Columbia |
| 28806 |
Amerigroup ‐ New Jersey |
| WLPNT |
Amerigroup ‐ Wellpoint |
| 28805 |
Amerigroup / Americaid ‐ Houston |
| 27514 |
Amerigroup Georgia |
| 27514 |
Amerigroup Tennessee |
| 93688 |
AmeriHealth ‐ DE (PPO) |
| 60061 |
AmeriHealth ‐ New Jersey (Non‐HMO Claims) |
| 54763 |
AmeriHealth Administrators |
| 27357 |
Amerihealth Caritas |
| 35374 |
AmeriHealth Caritas Ohio Medicaid |
| 87406 |
AmeriHealth Caritas VIP Care ‐ Delaware DSNP |
| 77799 |
Amerihealth DE |
| 80705 |
Anthem Health and Life Insurance Company of New Jersey |
| 68069 |
Arizona Complete Health |
| 3432 |
Arizona Physicians IPA ‐ APIPA (UnitedHealthcare Arizona Physicians IPA) |
| 74234 |
Arizona Pipe Trades Health and Welfare Trust Fund Local Union Nos. 469 and 741 Metal
Trades Health Plan |
| 74234 |
Arizona Pipe Trades Health and Welfare Trust Fund Local Union Nos. 469 and 741 Pipe
Trades Health Plan |
| 68069 |
Ascension Complete |
| 38265 |
ASR Corporation |
| 38259 |
Automated Benefit Services ‐ ABS |
| 74227 |
Bankers United Life ‐ Student Division |
| 66901 |
Banner‐University Family Care ‐ University of Arizona Health Plans |
| 47198 |
BC California |
| 00934 |
BCBS PREMERA |
| 00520 |
BCBS Arkansas |
| 00050 |
BCBS Colorado ‐ Anthem |
| 00060 |
BCBS Connecticut ‐ Anthem |
| 00590 |
BCBS Florida |
| 00601 |
BCBS Georgia (State Health of GA) |
| 00601 |
BCBS Georgia State Health Benefit Plan |
| 00621 |
BCBS Illinois |
| 00630 |
BCBS Indiana ‐ Anthem |
| 88848 |
BCBS Iowa ‐ Wellmark |
| 00660 |
BCBS Kentucky ‐ Anthem |
| 00680 |
BCBS Maine ‐ Anthem |
| 00200 |
BCBS Massachusetts |
| 00710 |
BCBS Michigan |
| MIBCN |
BCBS Michigan Blue Care HMO ‐ BCN of Michigan |
| 00241 |
BCBS Missouri ‐ Anthem |
| BCSMT |
BCBS Montana |
| 00265 |
BCBS Nevada ‐ Anthem |
| 00770 |
BCBS New Hampshire ‐ Anthem |
| 00803 |
BCBS New York ‐ Anthem ‐ Empire |
| 00804 |
BCBS New York ‐ Blue Choice of Rochester NY |
| 00804 |
BCBS New York ‐ Blue Shield of Rochester NY ‐ Excellus |
| 00805 |
BCBS New York ‐ BS of Central NY HMO/PPO |
| 005536 |
BCBS North Carolina |
| 00834 |
BCBS Ohio ‐ Anthem |
| 00840 |
BCBS Oklahoma |
| 00851 |
BCBS Oregon ‐ Regence |
| 54771 |
BCBS Pennsylvania ‐ Highmark |
| SCBCS |
BCBS South Carolina |
| 88848 |
BCBS South Dakota ‐ Wellmark |
| 00601 |
BCBS State Merit GA |
| 00390 |
BCBS Tennessee |
| TXBLS |
BCBS Texas |
| 84980 |
BCBS Texas HCSC |
| 00910 |
BCBS Utah ‐ Regence |
| VTBLS |
BCBS Vermont |
| 00923 |
BCBS Virginia ‐ Blue Care PPO |
| 00923 |
BCBS Virginia ‐ Blue Shield of Virginia |
| 00923 |
BCBS Virginia ‐ COVA ‐ Commonwealth of VA |
| 00923 |
BCBS Virginia ‐ Healthkeeper HMO |
| 00923 |
BCBS Virginia ‐ Keycare PPO |
| 00923 |
BCBS Virginia ‐ Local Choice |
| 00923 |
BCBS Virginia ‐ Medicare Supplemental |
| 00923 |
BCBS Virginia ‐ Peninsula Healthcare |
| 00923 |
BCBS Virginia ‐ Priority Healthcare |
| 00923 |
BCBS Virginia ‐ VA State Employer Funds |
| 54828 |
BCBS West Virginia ‐ Highmark |
| 00801 |
BCBS Western New York |
| 00950 |
BCBS Wisconsin ‐ Anthem |
| 61425 |
Benefit Trust Life Insurance Company |
| 25463 |
BIND ‐ UHC Choice Multiplan |
| 47163 |
Blue Shield of Kansas |
| 74238 |
Boon‐Chapman Benefit Administrators |
| 84367 |
BRAVEN HEALTH |
| BTSS1 |
Brown and Toland SutterSelect |
| BS001 |
BS California |
| 00611 |
BS Idaho ‐ Regence |
| 00932 |
BS Washington ‐ Regence |
| 68069 |
Buckeye Community Health (Also 32004) |
| 68069 |
California Health and Wellness |
| 23045 |
Capital Advantage Insurance Company Professional |
| SX065 |
Capital District PHP |
| 68069 |
Care 1st Health Plan of Arizona |
| 57116 |
Care 1st Health Plan of Arizona (DOS prior to 12/1/22) |
| SB580 |
CareFirst BCBS ‐ DC, National Capital Area |
| CARMO |
Caremore IPA |
| 95092 |
CarePlus Health Plans |
| 68069 |
Carolina Crescent (Also 68055) |
| 41124 |
CBSA ‐ Corporation Benefit Services of America |
| 68068 |
Cenpatico ‐ Multiple States |
| 68068 |
Cenpatico Kansas |
| 68069 |
Centene Advantage Plans (Also 68056) |
| 36215 |
Central States Southeast and Southwest Areas Health and Welfare and Pensions Funds |
| 84146 |
CHAMPVA‐HAC |
| 62308 |
Cigna ‐ PPO |
| 62308 |
Cigna Health Plan ‐ HMO |
| 62308 |
Cigna Premier Plus |
| 74234 |
City of Austin |
| 77023 |
Clover formerly Carepoint Health Plan |
| COACC |
Colorado Access HMO |
| COKSR |
Colorado Kaiser Permanente ‐ Colorado plans only |
| 73143 |
Community Care Managed Health Care Plans of Oklahoma |
| 74234 |
CompuSys Incorporated Arizona |
| 74234 |
CompuSys Incorporated New Mexico |
| 74234 |
CompuSys Incorporated Utah |
| 74234 |
CompuSys/Erisa Group, Incorporated AZ |
| 74234 |
CompuSys/Erisa Group, Incorporated NM |
| 74234 |
CompuSys/Erisa Group, Incorporated TX |
| 80705 |
Confederation Admin Services |
| 80705 |
Confederation Life Insurance |
| 78375 |
Connecticare ‐ Medicare |
| 06105 |
Connecticare Inc |
| 52132 |
Cooperative Benefits Administrators ‐ CBA |
| 35182 |
CoreSource of Illinois |
| 35182 |
CoreSource of Iowa |
| 35182 |
CoreSource of Maryland |
| 35182 |
CoreSource of Pennsylvania |
| 00019 |
Cox Health Plan (Requires Provider ID in Box 33a. Contact Cox Health Plan for ID.) |
| 80705 |
Crown Life |
| 59140 |
Culinary Health and Welfare Fund ‐ Las Vegas, NV |
| 59144 |
Culinary Las Vegas ‐ Unite HERE Health |
| 87726 |
Definity Health Plan (UnitedHealthcare) |
| 87726 |
Definity Services |
| 25160 |
DGA ‐ Diversified Group Administrators |
| SX105 |
DMBA AKA Missionary Medical |
| 74284 |
Driscoll Childrens Health Plan ‐ CHIP |
| 81039 |
EBMS ‐ Employee Benefit Management Services |
| 52192 |
Elder Health Maryland HMO |
| 87726 |
Empire Plan (UnitedHealthcare) |
| SC446 |
Employee Benefit Services DBA Key Benefit Administrators |
| 62308 |
Equicor |
| 62308 |
Equicor ‐ PPO |
| 23250 |
Erin Group Administrators |
| 74234 |
Erisa Administrative Services |
| 74234 |
Erisa Administrative Services Incorporated |
| 57082 |
Essence Healthcare |
| 55413 |
EssentiaCare (2020 DOS) |
| 87726 |
Evercare Special Needs (Evercare by UnitedHealthcare) |
| 87726 |
Evercare Star Plus |
| 11315 |
Fidelis Care NY |
| 56196 |
First Carolina Care (Dates of Service prior to 1.1.2021) |
| 91131 |
First Choice Health Network |
| 80705 |
First Great‐West Life and Annuity |
| 87726 |
First Seniority Freedom |
| 41124 |
Fortis Self Funded Administrative Services |
| 64069 |
Fox‐Everett |
| 25169 |
Gateway Health Plan Medicaid PA |
| MCS01 |
GEMCare ‐ Golden Empire Managed Care System |
| 61271 |
Georgia Power Medical Benefits Plan |
| GHMCR |
GHI Medicare Part B of New York |
| 37602 |
Golden Rule Insurance |
| 44054 |
Government Employees Hospital Association ‐ GEHA |
| 80705 |
Great West ‐ SF |
| 80705 |
Great West ‐ WA |
| 80705 |
Great West Care |
| 80705 |
Great West Denver |
| 80705 |
Great West Life Assurance |
| 80705 |
Great West Life Assurance Company of America |
| 80705 |
Great‐West Bellevue |
| 13551 |
Group Health Incorporated ‐GHI ‐ New York |
| 61101 |
Group Health Insurance ‐ DE |
| 80705 |
GWL |
| 80705 |
GWL and A |
| 38224 |
HAP ‐ Health Alliance Plan of MI (DOS prior to 10/1/23) |
| 14163 |
Harmony‐Wellcare HMO, Inc |
| 4271 |
Harvard Pilgrim Health Care |
| 87726 |
Harvard Pilgrim Passport Connect |
| 77950 |
Health Alliance Medical Plans of Illinois |
| 95019 |
Health First Health Plans |
| 95567 |
Health Net ‐ California |
| 76342 |
Health Plan of Nevada |
| 59140 |
Health Plan Services, Tampa |
| 37290 |
Health Services for Children with Special Needs ‐ HSCSN |
| HMA01 |
Healthcare Management Administrators ‐ HMA serviceing Wester Region |
| 27514 |
Healthplus Amerigroup |
| 87815 |
HealthSmart Benefit Solutions ‐ Wells Fargo TPA |
| 68195 |
Healthsource Providen |
| 00541 |
Healthy Blue ‐ Missouri Care |
| 55247 |
HIP ‐ Health Insurance Plan of Greater NY |
| 68069 |
Home State Health Plan |
| 22099 |
Horizon BCBS New Jersey |
| 61103 |
Humana ‐ Healthy Horizons (Ohio Medicaid) |
| 74234 |
IBEW Local 640 and Arizona Chapter NECA Health and Welfare Trust |
| 74234 |
IBEW Western Utilities or Local 57 |
| 68069 |
Illinicare Group Health (Also 68066). Invalid after 11.30.2020 |
| 54704 |
Independent BLC of PA |
| INHEA |
Independent Health of New Jersey |
| 95444 |
Indiana University Health Plan |
| 51020 |
INTEGRA Administrative Group |
| 74234 |
Intermountain Ironworkers Trust Fund |
| 41124 |
Iowa Benefits, Inc |
| 80142 |
Jefferson Health Plans |
| 61271 |
JF Molloy |
| 52189 |
John Hopkins Healthcare ‐ EHP/PP |
| 52123 |
Johns Hopkins ‐ USFHP |
| 94135 |
Kaiser Foundation Health Plan of Northern CA Region |
| 94134 |
Kaiser Foundation Health Plan of Southern CA Region |
| NG008 |
Kaiser Mid‐Atlantic |
| KS003 |
Kaiser Permanente ‐ Northern California Only |
| 68069 |
Kentucky Spirit Health Plan (Also 68067) |
| 95056 |
Keystone Health Plan East (claims only) |
| 95056 |
Keystone Health Plan East (encounters only) |
| 27357 |
LA Care |
| EBSRM |
Lifetime Benefit Solutions |
| 68069 |
Louisiana Healthcare Connections |
| 60054 |
Magellan Behavioral Health |
| 68069 |
Magnolia Mississippi (Also 68062) |
| 87726 |
MAHP (MD IPA, Optumun Choice and MLH) UnitedHealthcare |
| 22771 |
Managed Health Networks ‐ MHN |
| 68069 |
Managed Health Services Indiana (Also 39186) |
| 68069 |
Managed Health Services of Wisconsin |
| 87726 |
MD‐Individual Practice Association, Inc. |
| ALMCD |
Medicaid of Alabama |
| AZMCD |
Medicaid of Arizona ‐ AHCCCS |
| ARMCD |
Medicaid of Arkansas |
| CAMCD |
Medicaid of California ‐ Medi‐Cal |
| COMCD |
Medicaid of Colorado |
| CTMCD |
Medicaid of Connecticut |
| FLMCD |
Medicaid of Florida |
| GAMCD |
Medicaid of Georgia |
| HIMCD |
Medicaid of Hawaii |
| IDMCD |
Medicaid of Idaho |
| ILMCD |
Medicaid of Illinois |
| INMCD |
Medicaid of Indiana |
| IAMCD |
Medicaid of Iowa |
| KSMCD |
Medicaid of Kansas |
| KYMCD |
Medicaid of Kentucky |
| LAMCD |
Medicaid of Louisiana ‐ Includes KidMed claims |
| MEMCD |
Medicaid of Maine |
| MDMCD |
Medicaid of Maryland |
| MAMCD |
Medicaid of Massachusetts |
| MIMCD |
Medicaid of Michigan |
| MNMCD |
Medicaid of Minnesota |
| MSMCD |
Medicaid of Mississippi |
| MOMCD |
Medicaid of Missouri |
| MTMCD |
Medicaid of Montana |
| NEMCD |
Medicaid of Nebraska |
| NVMCD |
Medicaid of Nevada |
| NJMCD |
Medicaid of New Jersey |
| NMMCD |
Medicaid of New Mexico |
| NYMCD |
Medicaid of New York |
| NCMCD |
Medicaid of North Carolina |
| NDMCD |
Medicaid of North Dakota |
| OHMCD |
Medicaid of Ohio |
| OKMCD |
Medicaid of Oklahoma |
| ORMCD |
Medicaid of Oregon |
| PAMCD |
Medicaid of Pennsylvania |
| RIMCD |
Medicaid of Rhode Island |
| SCMCD |
Medicaid of South Carolina |
| SDMCD |
Medicaid of South Dakota |
| TNMCD |
Medicaid of Tennessee (TennCare) |
| TXMCD |
Medicaid of Texas |
| VTMCD |
Medicaid of Vermont |
| VAMCD |
Medicaid of Virginia |
| DCMCD |
Medicaid of Washington DC |
| WAMCD |
Medicaid of Washington State |
| WVMCD |
Medicaid of West Virginia |
| WIMCD |
Medicaid of Wisconsin |
| WYMCD |
Medicaid of Wyoming |
| PRMCS |
Medical Card System ‐ MCS |
| 29076 |
Medical Mutual Ohio |
| 38224 |
Medical Value Plan ‐ Ohio MVP |
| ALMCR |
Medicare Part A/B of Alabama |
| AKMCR |
Medicare Part A/B of Alaska |
| AZMCR |
Medicare Part A/B of Arizona |
| ARMCR |
Medicare Part A/B of Arkansas |
| COMCR |
Medicare Part A/B of Colorado |
| CTMCR |
Medicare Part A/B of Connecticut |
| DEMCR |
Medicare Part A/B of Delaware |
| FLMCR |
Medicare Part A/B of Florida |
| GAMCR |
Medicare Part A/B of Georgia |
| HIMCR |
Medicare Part A/B of Hawaii |
| IDMCR |
Medicare Part A/B of Idaho |
| ILMCR |
Medicare Part A/B of Illinois |
| INMCR |
Medicare Part A/B of Indiana |
| IAMCR |
Medicare Part A/B of Iowa |
| KSMCR |
Medicare Part A/B of Kansas |
| KYMCR |
Medicare Part A/B of Kentucky |
| LAMCR |
Medicare Part A/B of Louisiana |
| MEMCR |
Medicare Part A/B of Maine |
| MDMCR |
Medicare Part A/B of Maryland |
| MAMCR |
Medicare Part A/B of Massachusetts |
| MIMCR |
Medicare Part A/B of Michigan |
| MNMCR |
Medicare Part A/B of Minnesota |
| MSMCR |
Medicare Part A/B of Mississippi |
| MOMCR |
Medicare Part A/B of Missouri |
| MTMCR |
Medicare Part A/B of Montana |
| NEMCR |
Medicare Part A/B of Nebraska |
| NVMCR |
Medicare Part A/B of Nevada |
| NHMCR |
Medicare Part A/B of New Hampshire |
| NMMCR |
Medicare Part A/B of New Mexico |
| ENMCR |
Medicare Part A/B of New York ‐ Empire ‐ Downstate |
| NYMCR |
Medicare Part A/B of New York ‐ Upstate |
| NJMCR |
Medicare Part A/B of NJ |
| NCMCR |
Medicare Part A/B of North Carolina |
| NDMCR |
Medicare Part A/B of North Dakota |
| CNMCR |
Medicare Part A/B of Northern California |
| OHMCR |
Medicare Part A/B of Ohio |
| OKMCR |
Medicare Part A/B of Oklahoma |
| ORMCR |
Medicare Part A/B of Oregon |
| PAMCR |
Medicare Part A/B of PA |
| RIMCR |
Medicare Part A/B of Rhode Island |
| SCMCR |
Medicare Part A/B of South Carolina |
| SDMCR |
Medicare Part A/B of South Dakota |
| CSMCR |
Medicare Part A/B of Southern California |
| TNMCR |
Medicare Part A/B of Tennessee |
| TXMCR |
Medicare Part A/B of Texas |
| UTMCR |
Medicare Part A/B of Utah |
| VTMCR |
Medicare Part A/B of Vermont |
| VAMCR |
Medicare Part A/B of Virginia |
| WAMCR |
Medicare Part A/B of Washington |
| DCMCR |
Medicare Part A/B of Washington DC |
| WVMCR |
Medicare Part A/B of West Virginia |
| WIMCR |
Medicare Part A/B of Wisconsin |
| WYMCR |
Medicare Part A/B of Wyoming |
| ASMCR |
Medicare Part B of American Samoa |
| QUMCR |
Medicare Part B of New York ‐ Queens |
| 74227 |
MEGA Life and Health ‐ Student Division |
| 86052 |
Mercy Health Plan ‐ AHCCCS |
| MHPIL |
Meridian Health Plan Illinois |
| 41124 |
Meritain Health Minneapolis |
| 74227 |
Mid‐West United Life ‐ Student Division |
| SX105 |
Missionary Medical |
| 88600 |
MMM ‐ Medicare y mucho mas |
| 13350 |
MODA Health ‐ ODS Health Plan |
| 20934 |
Molina Healthcare of Illinois |
| 38334 |
Molina Healthcare of Michigan |
| 43174 |
Molina Healthcare of Washington ‐ Encounters Only |
| 95444 |
MPLAN Healthcare Group |
| 71412 |
Mutually Preferred |
| 88050 |
National Health Benefits Corporation ‐ NHBC02 |
| 52103 |
National Telecommunications Cooperative Association ‐ NTCA |
| 95123 |
Neighborhood Health Partnership ‐ NHP |
| 96240 |
Neighborhood Health Plan of RI ‐ Integrity |
| 96240 |
Neighborhood Health RI Exchange, Unity, Integrity Plans |
| 77076 |
Network Health Insurance Corp ‐ Medicare |
| 68069 |
New Hampshire Healthy Family |
| 74234 |
New Mexico District Council of Carpenters |
| 45129 |
New Mexico Health Connections (Dates of Service prior to 1.1.2020) |
| 74234 |
New Mexico Painters and Allied Trades Local No 823 |
| 74234 |
New Mexico‐West Texas Multi‐Craft ‐ New Mexico Laborers |
| 64157 |
North American Administrators |
| 80705 |
One Health Plan Michigan |
| 80705 |
One Health Plan New York |
| 80705 |
One Health Plan of Alaska |
| 80705 |
One Health Plan of Arizona |
| 80705 |
One Health Plan of DC |
| 80705 |
One Health Plan of Florida |
| 80705 |
One Health Plan of Indiana |
| 80705 |
One Health Plan of Kansas and Missouri |
| 80705 |
One Health Plan of Maine |
| 80705 |
One Health Plan of Massachusetts |
| 80705 |
One Health Plan of Minnesota |
| 80705 |
One Health Plan of Nevada |
| 80705 |
One Health Plan of New Jersey |
| 80705 |
One Health Plan of North Carolina |
| 80705 |
One Health Plan of Ohio |
| 80705 |
One Health Plan of Pennsylvania |
| 80705 |
One Health Plan of South Carolina |
| 80705 |
One Health Plan of Tennessee |
| 80705 |
One Health Plan of Texas |
| 80705 |
One Health Plan of Virginia |
| 80705 |
One Health Plan of Washington |
| 80705 |
One Health Plan of Wisconsin |
| 80705 |
One Health Plan of Wyoming |
| 74234 |
Operating Engineers Local No 53 |
| 87726 |
Optimum Choice |
| 87726 |
OptumHealth Behavior Solutions |
| 87726 |
OptumHealth Behavioral Solutions of NM |
| 87726 |
OptumHealth New Mexico |
| 45332 |
Oregons Health CO‐OP |
| 61101 |
OSF Health Plans |
| 06111 |
Oxford ‐ UnitedHealthcare/Oxford |
| 06111 |
Oxford Health Plans |
| 81400 |
PacifiCare Individual Business Plan (UnitedHealthOne) |
| 95958 |
PacifiCare of CA Encounters |
| 95958 |
PacifiCare of OK Encounters |
| 95958 |
PacifiCare of OR Encounters |
| 95958 |
PacifiCare of TX Encounters |
| 95958 |
PacifiCare of WA Encounters |
| 68069 |
Peach State Health Plan ‐ Behavioral Health |
| 68069 |
Peach State Health Plan ‐ Medicaid |
| SX106 |
PEHP ‐ Utah Public Employee Health Plan |
| 54704 |
Personal Choice PPO of Pennsylvania |
| 38265 |
Physicians Care Network |
| 37330 |
Physicians Health Plan (PHP) Mid‐Michigan |
| PRBIE |
Plan de Bienestar UTM‐PRSSA |
| 37287 |
Planned Administrators, Inc ‐ PAI |
| 73159 |
PPO Oklahoma ‐ WinterBrook HealthCare Management |
| 60054 |
Primary Choice (Aetna HP‐NY/NJ) |
| 36331 |
Professional Benefit Administrators ‐ Oak Brook, IL |
| PHP01 |
Providence Choice Option |
| PHP01 |
Providence Good Health Plan |
| PHP00 |
Providence Preferred ‐ PPO |
| 68195 |
Provident Life and Accident Insurance Company |
| 68195 |
Provident Life and Accident Insurance Company of America |
| 68195 |
Provident Life and Casualty Insurance Company |
| 42172 |
Riverlink Health |
| 87726 |
SecureHorizons MedicareComplete |
| 87726 |
SecureHorizons MedicareDirect |
| 60054 |
Select Choice |
| 76045 |
SelectCare of Texas ‐HPN ‐ Heritage Physicians Network |
| 60054 |
Senior Choice (Aetna HP‐NY/NJ) |
| 95444 |
Senior Smart Choice |
| 76342 |
Sierra Health Services |
| 23250 |
Significa Benefit Services, Inc. |
| 68069 |
Silver Summit Health Plan |
| 42172 |
Soundpath Health |
| 61425 |
Starmark |
| 31059 |
State Farm ‐ Casualty and Property |
| SLIC1 |
Stonebridge Life ‐ Valley Forge Pennsylvania |
| 74227 |
Student Insurance |
| 74227 |
Student Insurance ‐ Boston Mutual Life Insurance Company |
| 74227 |
Student Insurance ‐ Life Insurance Company of Boston and New York |
| 74227 |
Student Insurance ‐ MEGA Life and Health Insurance Company |
| 74227 |
Student Insurance ‐ Mid‐West National Life Insurance Company of Tennessee |
| 74227 |
Student Insurance ‐ Reliance Insurance Company |
| 74227 |
Student Insurance ‐ Reliance National Insurance Company |
| 74227 |
Student Insurance Division |
| 74227 |
Student Resources International ‐ UnitedHealthcare |
| 68069 |
Sunflower State Healthcare Plan |
| 68069 |
Sunshine Health Plan (Also 68057) |
| 68069 |
Superior Health Plan (Also 39188) |
| 74234 |
Tech‐Steel |
| 87726 |
The Empire Plan |
| 20356 |
The Health Exchange ‐ Cerner Corporation |
| 63092 |
The Oath ‐ Health Partners of Alabama |
| 25175 |
Three Rivers Provider Network |
| 48055 |
Todays Option ‐ American Progressive and Pyramid Life ‐ APP |
| 61425 |
Tooling and Manufacturing |
| 68069 |
Total Carolina Care (Also 68055) |
| 87726 |
Touchpoint |
| MMLI3 |
Transamerica Premier Life Insurance ‐ Monumental |
| 74234 |
Transwestern General Agency |
| PRAHM |
Triple S ‐ AHM |
| 61425 |
Trustmark (Includes Starmark and TMA) |
| 04298 |
Tufts Associated Health |
| 87726 |
UBH Employer Division |
| 87726 |
UBH RIOS |
| 55413 |
UCare Individual and Family Plans |
| 55413 |
UCare Medicare (2020 DOS) |
| 55413 |
UCare Medicare with M Health Fairview and North Memorial Health (2020 DOS) |
| 55413 |
Ucare of Minnesota ‐ DOS after 1.1.2019 |
| BS001 |
UFCW Local 400‐5205 |
| 39026 |
UHIS‐UnitedHealthcare Integrated Services |
| ULLIC |
Ullico ‐ Valley Forge Pennsylvania |
| 25175 |
Unison DC, DE, NJ, OH, PA, SC, TN ‐UnitedHealthcare Community Plan |
| 25175 |
Unison Health Plan |
| 87726 |
United Behavioral Health |
| 31107 |
United Medical Resources |
| 71412 |
United of Omaha |
| 87726 |
UnitedHealthcare |
| 87726 |
UnitedHealthcare / MAMSI Life and Health ‐ MLH |
| 87726 |
UnitedHealthcare Group Medicare Advantage |
| 87726 |
UnitedHealthcare hawk‐I ‐ UnitedHealthcare Community Plan |
| 87726 |
UnitedHealthcare Plan of the River Valley ‐ UnitedHealthcare Community Plan |
| 87726 |
UnitedHealthcare River Valley |
| 87726 |
UnitedHealthcare West |
| 95958 |
UnitedHealthcare West Encounters |
| HC001 |
Univera Healthcare ‐ CNY |
| 33001 |
Universal Care ‐ California |
| 7503 |
University Family Care ‐ Healthcare Group |
| 9908 |
University Family Care ‐ Maricopa Health Plan |
| USFHP |
US Family Health Plan ‐ USFHP |
| 74234 |
Utah Carpenters |
| 74234 |
Utah Laborers |
| 74234 |
Utah Pipe Trades |
| 77073 |
VNS Choice Medicare |
| 39026 |
Wausau Insurance Companies |
| 75261 |
webTPA ‐ Community Health Electronic Claims/CHEC |
| 13337 |
Well Sense Health Plan |
| 24735 |
Western Grower's Assurance Trust |
| 24735 |
Western Grower's Insurance Company |
| 62061 |
Willis Administrative Services |
| 41095 |
Wilson‐McShane |
| 68069 |
YouthCare Health Choice |
| 83248 |
Zing Choice IL (HMO) |
| 20149 |
Molina Healthcare of Ohio |
| 14165 |
MVP Health Plan of NY |
| TDDIR |
Tricare for Life |
| 99726 |
Tricare West |
| 23281 |
UPMC Health Plan |
