Payer 835 List

Payer ID Payer Name

20413 3P Administrators (Onalaska, WI)

AARP1 AARP Dental Insurance Plan (Mechanicsburg, PA)

LX144 ABS - US Health (Oak Park, MI)

52133 ACEC Health Plans (SLC, UT)

61425 ACEC-Healthplan

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

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

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)

63240 ARM (Alternative Risk Management (Eagan, MN)

38265 ASR Corporation (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)

38265 Administration Systems Research Corp. (Grand Rapids,

22384 Administrative Concepts (Wayne, PA)

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

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

75137 Ameriben Solutions (Boise, ID)

52133 American Choice (Thiensville, WI)

GP133 Americhoice NJ(Thiensville, Milwaukee WI)

47009 Ameritas Life Insurance Corp. (Lincoln, NE)

84103 Anthem (PO Box 1115, Minneapolis, MN)

47198 Anthem CA (Po Box 1115, MPLS 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)

81883 Arkansas Municipal Health Benefit (N Little Rock AR)

25133 Associated Benefit Plan (London, KY)

74240 Assured Benefits Administrators (El Paso, TX)

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

Payer 835 List

Payer ID Payer Name

91136 Automotive Machinists Local 289 Health & Welfare Trust

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)

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

SX145 Banner Health Systems (Mesa, AZ)

LX154 Ben-e-lect (Visalia, CA)

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)

LX156 Benefit Coordinators Corporation (Pittsburgh, PA)

56139 Benefit Management (Matthews, NC)

43178 Benefit Management Inc of MO (Joplin, MO)

56139 Benefit Management Services, Inc (Charlotte, NC)

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

39081 Benefit Plan Administrators Co. Eau Claire, WI

R7003 Benefit, Inc. (Roseville, MN)

37248 Benesys, Inc (LaFayette, LA)

LX152 Benicomp, Inc. (Fort Wayne, IN)

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

83470 Blue Cross 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)

CBGA1 Blue Cross of GA (Columbus, GA)

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

CB621 Blue Cross of Illinois (Oak Brooke Terrace, IL)

84105 Blue Cross of Indiana Anthem (Louisville, KY)

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

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)

89070 Blue Cross of MN (Harrisburg, PA)

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)

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

CBNY1 Blue Cross of NY - Empire

CBNE1 Blue Cross of Nebraska (Omaha, NE)

84101 Blue Cross of Nevada - Colorado Springs, CO

Payer 835 List

Payer ID Payer Name

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

84100 Blue Cross of New Mexico Dental

CX004 Blue Cross of North Dakota (ND Dental Services) (Fargo,

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 South Carolina (Columbia/Charleston SC)(P

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)

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)

74237 Boon Chapman Benefit Administrators (Austin, TX)

20381 Boulder Admin Services (Boulder, MT)

51037 Brokerage Concepts (King of Prussia, PA)

47009 Businessmen Assurance (NE)

CPPCA CA Health Families (Sacramento, CA)

03036 CBA Blue (Comprehensive Benefits Admin (Burlington, V

88022 CDS Group Health (Sparks, NV)

84147 CHAMPVA - HAC - Denver, CO

CX075 CL Frates (Oklahoma City, OK)

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

68011 Capitol Administrators (Rancho Cordova, CA)

CAPHP Caprock Health Plans (Eagan, MN)

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

91136 Cement Masons & Plasters Health & Welfare Trust (Seatt

LX150 Central Dta Services Downtown (Pittsburgh, PA)

34097 Central Reserve Life (Eagan, MN)

34154 Chesterfield Resources (Akron, OH)

84147 Children of Women Vietnam Veterans

61271 Christian Brothers Services (Colorado Springs, CO)

62308 Cigna

CX071 Citizens Security Life Ins. (Louisville, KY)

14829 Co-Ordinated Benefit Plans (Eagan, MN)

LX166 Commercial Travelers (Utica, NY)

27905 Community Health Alliance (Knoxville, TN)

75261 Community Health Electronic Claims

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

03036 Comprehensive Benefits Admin - Burlington, VT

37307 Connecticut Carpenters Health Fund (Hamden, CT)

62308 Connecticut General (Bloomfield, CT)

LX146 Consolidated Health Plans (Springfiled, MA)

45321 Consumers Choice Health Plan (North Charleston, SC)

62308 Continental Dental (Plantation, FL)

Payer 835 List

Payer ID Payer Name

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

35182 Core Source (Po Box 2920, Clinton IA)

LX048 CoreSource (Mailed to IA)

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

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

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)

56116 Corporate Benefit Services(El Paso, TX)

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)

82056 Custom Design Benefits (3737 West Fork Road, Cincinna

LX082 Cypress (Appleton WI)

06172 Dart Management Corp. (Mason, MI)

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

07035 DeCare (Po Box 709, MPLS MN)

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)

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

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

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)

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)

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)

Payer 835 List

Payer ID Payer Name

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)

23166 Delta Dental of Pennsylvania(Mechanicsburg, PA)

660436769 Delta Dental of Peurto Rico

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)

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)

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

DDCA2 DeltaCare (Cerritos, CA)

CX014 DentaQuest

CX014 DentaQuest (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

64246 Dental Guard Preferred (Spokane, WA)

81264 Dental Health Alliance (Shawnee Mission, KS)

DNOA1 Dental Network of America (IL)

DSL01 Dental Select (Murray,Draper, UT)

DSL01 Dental Select (Richardson, TX)

DSL01 Dental Select (SLC, UT)

CX004 Dental Service Corp (Fargo, ND)

67814 DenteMax (Wellesley Hills)

43168 Dentemax (St. Louis, MO)

22384 DentexMax (Wayne, PA)

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

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

37272 Direct Reimbursement Benefits (Newnan, GA)

CX040 Diversified Admin Corp. - Marlborough, CT

25160 Diversified Group (Maryland) (Harrisburg, PA)

CX014 Doral Dental of Arizona

CX014 Doral Dental of Arizona--CIGNA

CX014 Doral Dental of Connecticut

CX014 Doral Dental of Illinois

CX014 Doral Dental of Illinois

CKKY3 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

Payer 835 List

Payer ID Payer Name

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

38241 EBC (Farmington Hills, MI)

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

CX079 EMIA-Educators Mutual (Murray, UT)

62308 EQUICOR

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

LX168 Electrical Welfare Trust (Lanham, MD)

A4681 Electrical Workers (Indianapolis, IN)

A4681 Electrical Workers (Indianpolis, IN)

55093 Empire BCBS of NY (Minneapolis, MN)

38241 Employee Benefit Consultants (Farmington Hills, MI)

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)

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

91136 Enstar Natural Gas (Detroit, MI)

CX046 Erin Group Administrators (Lancaster, PA)

43168 Essex Dental Benefits (St Louis, MO)

35605 Everence (Goshen, IN)

93240 Evergreen Health Co-Op (Clinton, IA)

71412 ExclusiCare (Charlotte , NC)

91136 FBX North Star Borough/ School District

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

95411 FL MCO PHC / PHP (La Verne, CA)

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

89070 Family Members Dental Plan (Harrisburg, PA)

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)

Payer 835 List

Payer ID Payer Name

660537624 First Medical (International)

13317 First Reliance Standard (Lincoln, NE)

39026 Fiserv (Wausau, WI & Pueblo, CO)

R7004 Flex Compensation (Mpls, MN)

25133 Foreign Service Benefit Plan (London, KY)

60054 Foreign Service Benefit(Washgington, WA)

DNOA1 Fort Dearborn Life Ins

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

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

45289 Fringe Benefits (Austin, TX)

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)

80314 GIC-Idemnity Plan

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

LX161 Gem Group (Pittsburgh, PA)

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

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

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)

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

64246 Guardian Life Insurance Company of America (Spokane,

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)

22521 Harrington Benefit Services (Oklahoma City, OK)

86066 Hawaii-Mainland Admim (Tempe, AZ)

25160 Health Aspex (Maryland)

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)

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)

Payer 835 List

Payer ID Payer Name

25133 Health Right of CT (Medicaid Claims)

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

41154 Health Traditions (MMSI)(Rochester, MN)

75234 HealthFirst TPA (Eagan, MN)

75234 HealthFirst TPA (Tyler, TX)

52133 HealthNet (SLC, UT)

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)

87815 HealthSmart (PO Box 91608, Lubbock, TX)

87815 HealthSmart Benefits(Charleston, WV)

11271 Healthplex, Inc. (Uniondale, NY)

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

CPPCA Healthy Families (Sacramento, CA)

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

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

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

LX145 IAA (Mt Laurel, NJ)

A4681 IBEW Local 481 (Carmel, IN)

64246 IBEW Welfare Trust Fund (Decatur, IL)

LX111 IMA (Bossier City LA)

91136 Idaho Pipe Trades

CDOK1 Indian Health Services (Oklahoma City, OK)

CX070 Indiana Childrens Special HealthCare (Indianapolis, IN)

13315 Insurance Design Administrators - Oakland, NJ

88006 Insurance Management Services, Elko, NV

74385 Insurance Systems Inc. (Monroe, LA)

51020 Integra Adminstrative Group - Seaford, DE

LX158 Interactive Medical Systems (Wake Forest, NC)

660537624 International (First Medical)

A4681 International Brotherhood of Electrical Workers (IBEW),

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

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

80314 John Hanncock

73100 Kempton Company - OK (Oklahoma City,OK)

73100 Kempton Group Administrators (Oklahoma City, OK)

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

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)

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)

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

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

R7005 MN Power (Duluth, MN)

LX159 MPE Employee Benefit Services (Jackson, MS)

91136 Machinists Health

Payer 835 List

Payer ID Payer Name

25133 Mail Handlers Benefit Plan (Jacksonville, FL)

25160 Manage Care of America (Pittsburgh, PA)

64246 Managed Dental Guard(Woodland Hills, CA)

CX014 Managed Health Services - WI State Employees

CX014 Mass Health (Doral Dental) Hingham, MA

LX157 Massachusetts Benefit Admin (Boston, MA)

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)

74323 MedBen (Newark, OH)

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

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

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)

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)

CKID1 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)

CKKY3 Medicaid of Kentucky Region #2 (Doral Dental Services)

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

CKME1 Medicaid of Maine

CX014 Medicaid of Maryland-Dept of Health and Ment

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

CKNJ1 Medicaid of New Jersey (Trenton, NJ)

Payer 835 List

Payer ID Payer Name

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

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

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

CKSC1 Medicaid of South Carolina

CX014 Medicaid of Tennessee (Doral Dental of WI)

CKTX1 Medicaid of Texas

CKUT1 Medicaid of Utah

CKVA1 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

74323 Medical Benefits Mutual - Newark, OH

CB833 Medical Mutual of Ohio (MMO)

973 Medicare Optimun / Triple S

23160 Medico Insurance (IA, NE, MN)

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

86052 Mercy Care Plan (Phoenix, AZ)

33628 Mercy Maricopa Integrated Care (Phoenix, AZ)

65978 Metlife (El Paso, TX)

CDMI0 Michigan Conference of Teamsters (Farmingotn Hills, MI)

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)

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

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)

Payer 835 List

Payer ID Payer Name

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

71412 Mutual of Omaha/National Rural Letter Carrier (Charlotte

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)

38225 NGS (St Claire Shores & Clinton Township, MI)

38225 NGS American (Lake Forest, IL)

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)

71412 National Rural Letter Carrier (Charlotte, NC)

MBAAZ Nationwide (El Paso, TX)

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)

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

91136 Nothwest I.A.M. Benefit Trust

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

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

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

80705 One Health Plan Inc of Wyoming

91136 Operating Engineers Locals 302 & 612 Health & Security

GP133 Optum Specialty Svcs (Thiensville, Milwaukee WI)

37287 PAI (Columbia, SC)

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

Payer 835 List

Payer ID Payer Name

16111 POMCO ( Syracuse, NY)

LX149 POMCO Group (Syracuse, NY)

93029 PacificSource Health Plans - Eugene, OR

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

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

47009 Paul Revere / Provident

LX148 Pekin Life Insurance (Pekin, IL)

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)

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

47570 Premera Blue Cross (Seattle, WA)

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)

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)

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

80314 ReliaStar

36088 Reliance Standard (PO Box 82510 Lincoln, NE)

RLHA1 Renaissance Life and Health (Indianpolis, IN)

LX094 Resource One Admin (Buckeystown MD)

84102 Rocky Mountain Life Dental (Colorado Springs, CO)

25133 Rural Carrier Benefit Plan (Charlotte, NC)

31441 S & S Health (Cincinnati, OH)

03699 SIEBA (Endicott, NY)

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

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

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)

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)

75280 Shasta Admin Services (Redmond, OR)

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

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

Payer 835 List

Payer ID Payer Name

76342 Sierra Health Services (Las Vegas, NV)

CX046 Significa Benefits Services

76578 Solstice Benefits

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

23266 South Central Preferred (Hingham, MA)

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

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

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

74227 Student Insurance (Lincoln, NE)

R7003 Sturm & Associates (Edina, MN)

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

67814 Sun Life (Po Box 81633, Wellesley Hills)

47009 Sun Life Canada

47009 Sun Life Financial

67814 Sun Life and Health (Formerly Genworth)

CX088 Surency Life and Health (Wichita, KS)

LX147 TLC Benefit Solutions (Valdosta, GA)

60054 TRW

88067 Tall Tree Administrators (Salt Lake City, UT)

LX102 Taylor Benefit Resource (Thomasville GA)

LX113 Teamster Local 463 (Pennsauken NJ)

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.

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)

37284 TransChoice Key Benefit Admin (Milwaukee, WI)

65978 Travelers (El Paso, TX)

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

91078 Trusteed Plan Service Corporation (Tacoma, WA)

61425 Trustmark Insurance - Lake Forest, IL

89070 UCCI (United Concordia)

62308 UFT Welfare Fund

GP133 UHC (United HealthCare)(Milwaukee, WI)

LX104 UMC Dental Reimbursement Plan (Lubbock TX)

33108 UMR - Cincinnati (Cincinatti, OH)

79480 UMR-Onalaska (Onalaska, WI)

39026 UMR-Wausau (Salt Lake City, UT)

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

23281 UPMC Health Plan (Pittsburg, PA)

93092 US Benefits, Inc. (Portland, OR)

41206 UltraBenefits, Inc (Westborough, MA)

80314 Unicare

47009 Unifi Companies (Lincoln, NE)

35198 Unified Group Services (Anderson, IN)

Payer 835 List

Payer ID Payer Name

52133 Unimerica Dental (Salt Lake City, UT)

52133 Unique DentaCare (Salt Lake City, UT)

25175 Unison - (Monroeville, PA)

89070 United Concordia (UCCI)

GP133 United Health Care (Milwaukee, WI)

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

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)

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

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

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)

CX014 Xantus Health PLan- Tennessee

LX143 Zelis Payments

R7001 Zenith Administrators (Mpls, MN)