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 |
60550 |
Gateway 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 |