12.2015

Payer ID Payer Name Enrollment Required10001 AARP10906 Absolute Total Care13187 Access Medicare10916 ACS Benefit Services, Inc.10923 Administrative Services, Inc.10927 Advantage by Bridgeway Health Solutions10928 Advantage by Buckeye Community Health Plan10929 Advantage by Managed Health Services10930 Advantage by Superior HealthPlan10011 Aetna13185 Aetna Administrator Medicare Supplement13186 Aetna Better Health (IL)13188 Aetna Better Health (LA)13189 Aetna Better Health (MI)13190 Aetna Better Health (MO)13191 Aetna Better Health (NJ)13192 Aetna Better Health (PA)13193 Aetna Better Health (TX)13222 Aetna Better Health (TX) CHIP13221 Aetna Better Health of (NE)13213 Aetna Health and Life Insurance Company13212 Aetna Life Insurance Company13093 Aetna Long Term Care13194 Aetna Senior Supplemental13195 Aetna Signature Administrators10944 Affinity Health Plan13196 Affinity Health Plan - Medicare13201 AFLAC10014 AFLAC - Dental13199 Aflac-Medicare Supplemental10015 Aftra Health Fund10018 Alabama Medicaid13197 Alan Sturm and Associates - Dental13094 Alaska Medicaid13198 All Savers Life Insurance10965 Allegiance Benefit Plan Management Inc.13211 Allianz Life Insurance Company of New York10973 Allied Benefit Systems, Inc.13180 AlohaCare

12.2015

13220 Alternative Insurance Resources, Inc13219 Altus Dental13095 AMC - Alaska Electrical Health & Welfare Fund13096 AMC - American General Life & Accident13097 AMC - Health Future13098 AMC - Poly America13099 AMC - Touchstone13100 AMC - Touchstone PSO10982 Ameriben Solutions, Inc.10030 American Community Mutual13210 American Continental Insurance Company12961 American Family Insurance Group-Medicare Sup and PPO13209 American General Life Insurance Company13218 American Health Medicare (Inmediata Health)13217 American Income Life Insurance Company13101 American Medical Security (AMS)11008 American National Insurance13102 American National Life Insurance Co. of Texas13216 American Network Ins. Medicare Supplement10043 American Postal Workers Union (APWU)10045 American Republic Insurance Company (ARIC)12962 American Retirement Life Ins Co - Medicare Supplement10048 Americhoice Of New Jersey10049 Amerigroup13214 Amerihealth (DE, NJ, PA)11039 AmeriHealth Administrators11939 AmeriHealth Caritas Louisiana (formerly LaCare)13215 AmeriHealth Caritas Pennsylvania10051 Amerihealth Mercy Health Plan13103 Ameritas Group - Ameritas Life Insurance Co.13104 Ameritas Group - First Ameritas of New York13105 Ameritas Group - First Reliance Standard Life13106 Ameritas Group - Reliance Standard Life13107 Ameritas Group - Standard Insurance13108 Ameritas Group - Standard Insurance of New York11048 Antares13109 Arbor Health Plan10057 Arizona Medicaid (AHCCCS)11064 Arizona Physicians IPA (APIPA)10059 Arkansas Medicaid

12.2015

10062 Assurant Health - John Alden Insurance Company (JALIC)13110 Assurant Health - Time Insurance Company (FIC)11075 Assurant Health - Union Security Insurance Company (FBIC)10064 Asuris Northwest Health10065 AULTCARE10067 AvMed Health Plans11097 Banner Health Plans10077 BCBS of Alabama Yes13170 BCBS of Alabama (Institutional) Yes10079 BCBS of Arizona10080 BCBS of Arkansas Yes10082 BCBS of Colorado (Anthem)10083 BCBS of Connecticut (Anthem)10084 BCBS of Delaware10086 BCBS of Florida10087 BCBS of Georgia (Anthem)11141 BCBS of Hawaii10088 BCBS of Illinois10089 BCBS of Indiana (Anthem)10090 BCBS of Iowa10091 BCBS of Kansas Yes13111 BCBS of Kansas City10092 BCBS of Kentucky (Anthem)10093 BCBS of Louisiana10094 BCBS of Maine (Anthem)10096 BCBS of Massachusetts12964 BCBS of Michigan (Institutional) Yes12965 BCBS of Michigan (Professional) Yes10098 BCBS of Minnesota10099 BCBS of Mississippi10100 BCBS of Missouri (Anthem)10101 BCBS of Nebraska10102 BCBS of Nevada (Anthem)10103 BCBS of New Hampshire (Anthem)10104 BCBS of New Jersey10105 BCBS of New Mexico12963 BCBS of New York (Central)10223 BCBS of New York (Empire)10106 BCBS of New York (Excellus)12967 BCBS of New York (Rochester Area)

12.2015

12968 BCBS of New York (Utica-Watertown)10107 BCBS of North Carolina10108 BCBS of North Dakota Yes10109 BCBS of Ohio (Anthem)11150 BCBS of Oklahoma11151 BCBS of Oregon (Regence)11152 BCBS of Pennsylvania (Highmark) - Institutional Yes10110 BCBS of Pennsylvania (Highmark) - Professional Yes10111 BCBS of Rhode Island10112 BCBS of South Carolina11153 BCBS of South Dakota10113 BCBS of Tennessee10114 BCBS of Texas11154 BCBS of Utah (Regence)11155 BCBS of Vermont10115 BCBS of Virginia (Anthem)11101 BCBS of West Virginia Yes10117 BCBS of Wisconsin (Anthem)10118 BCBS of Wyoming Yes13113 Best Choice Health Plan11127 Best Life and Health11128 Better Health Plans (Unison Health Plan)11144 Blue Cross Blue Shield of Montana11156 Blue Cross Blue Shield of Virginia (Anthem)10366 Blue Cross Independence (Pennsylvania) Yes12996 Blue Cross Northeastern Pennsylvania10081 Blue Cross of California (Anthem)10119 Blue Cross Of Idaho12970 Blue Cross of Washington and Alaska (Premera)10128 Blue Cross Pennsylvania (Capital) Yes11173 Blue Shield of California12577 Blue Shield of Idaho (Regence)12578 Blue Shield of Washington (Regence)10121 BlueChoice HealthPlan South Carolina Medicaid11177 Bluegrass Family Health11179 BMC HealthNet Plan11188 Bravo Health11191 Bridgeway Arizona11196 Buckeye Community Health13179 California Health & Wellness

12.2015

10127 California Medicaid (Medi-Cal)11213 Capital District Physicians Health Plan (CDPHP)11221 Care Improvement Plus10095 CareFirst BCBS (MD, DC, N.Virginia)10132 Careplus Health Plan10134 Caresource Health10135 Cariten Healthcare11270 Celticare13117 Cenpatico - Arizona13118 Cenpatico - Florida13119 Cenpatico - Illinois13120 Cenpatico - Indiana13121 Cenpatico - Kansas13122 Cenpatico - Kentucky11277 Cenpatico - Massachusetts11278 Cenpatico - Ohio13123 Cenpatico - South Carolina13124 Cenpatico - Texas13125 Cenpatico - Wisconsin13181 Central CA Alliance for Health12971 Central Reserve Insurance Company12972 Central Reserve Life Ins Co. - Medicare Supplement10140 Central States Fund11301 CHAMPVA/Spina Bifida/Children of Women Vietnam Vets10158 CIGNA-GreatWest11350 Colorado Access10161 Colorado Medicaid13208 Combined Insurance Company of America10163 Community Care Of Oklahoma11373 Community Health Plan of Washington (CHPW)12973 Community Healthfirst Medicare Advantage10164 CONNECTICARE10165 Connecticut Medicaid11390 Consolidated Associates Railroad13183 Constellation Health12974 Continental General Ins Co - Medicare Supplement10168 Continental General Insurance Company13207 Continental Life Insurance Company

of Brentwood, Tennessee11395 Cook Childrens Health Plan

12.2015

10170 Cooperative Benefit Administrators (CBA)10003 Coordinated Care10171 Coresource (Fmh)10172 Coresource (Little Rock)10174 CoreSource (MD,PA,IL,NC,IN,AZ,MN)10175 CoreSource (Ohio)10181 Coventry Healthcare - Advantra (TX, NM, AZ Only)10009 Coventry Healthcare - Advantra Freedom13126 Coventry Healthcare - Advantra Savings13127 Coventry Healthcare - Altius Health Plans10145 Coventry Healthcare - Carelink (Advantra)13128 Coventry Healthcare - Carelink Medicaid10182 Coventry Healthcare - CareNet10184 Coventry Healthcare - Coventry Health and Life (Nevada)10185 Coventry Healthcare - Coventry Health and Life (Oklahoma)10186 Coventry Healthcare - Coventry Health and Life (Tennessee)10206 Coventry Healthcare - CoventryCares13171 Coventry Healthcare - CoventryCares of Kentucky10207 Coventry Healthcare - CoventryOne10200 Coventry Healthcare - Delaware10183 Coventry Healthcare - Diamond Plan (Maryland Medicaid)10187 Coventry Healthcare - Federal10144 Coventry Healthcare - Florida/Vista/Summit10190 Coventry Healthcare - Georgia10146 Coventry Healthcare - Group Health Plan (GHP)10195 Coventry Healthcare - HealthAmerica and HealthAssurance10188 Coventry Healthcare - HealthCare Inc. (Promina)10197 Coventry Healthcare - Healthcare USA(HCUSA)10148 Coventry Healthcare - Iowa10192 Coventry Healthcare - Kansas10150 Coventry Healthcare - Louisiana10198 Coventry Healthcare - Mail Handlers Benefit Plan10205 Coventry Healthcare - Missouri10196 Coventry Healthcare - National Network10194 Coventry Healthcare - Nebraska10199 Coventry Healthcare - Nebraska Medicaid10201 Coventry Healthcare - OmniCare (Michigan)10202 Coventry Healthcare - PersonalCare/Coventry

Health of Illinois10203 Coventry Healthcare - Southern Health Services (SHS)

12.2015

13129 Coventry Healthcare - University of Missouri13130 Coventry Healthcare - Vista (MCD, FHK, LTC)10153 Coventry Healthcare - WellPath Select (Carolinas)12975 CSA Fraternal Live - Medicare Supplement10208 DAKOTACARE10212 Delaware Medicaid Yes11452 Denver Health Medical Plan13131 Deseret Mutual (DMBA)10209 District of Columbia Medicaid10854 Emblem Health11534 Essence Healthcare10230 Fallon Community Health Plan11546 FamilyCare10251 Federated Insurance10253 Fidelis Care New York13132 Florida Health Care Plans13133 Florida Hospital Healthcare System10263 Florida Medicaid10265 Freedom Blue Yes13134 Fresenius Medical Care11611 Gateway Health Plan10275 GEHA - Government Employees Hospital Association10282 Geisinger Health Plan11618 Geisinger Health Plan Gold11623 Generations Healthcare13206 Genworth Life and Annuity Insurance13203 Genworth Life Insurance Company10281 Georgia Medicaid10285 Gilsbar12994 Great American Insurance Company - Medicare Supplement12976 Great American Life Assurance Company -

Medicare Supplement11662 Group Health Cooperative11677 Group Practice Affiliates11685 Harmony Health Plan10318 Hawaii Medicaid11697 Health Alliance Medical Plan10319 Health Alliance Medical Plans (HAP)11705 Health Choice Arizona11767 Health Net National

12.2015

13135 Health New England11724 Health Partners of MN10330 Health Partners Of Philadelphia11730 Health Plan of San Mateo11750 HealthCare Solutions Group13136 HEALTHe Exchange11757 HealthEase13137 HealthEase Kids10338 Healthfirst New York10337 Healthfirst Of New Jersey13138 HealthMarkets (Chesapeake National Life)10460 HealthMarkets (Mega Life and Health Insurance)13139 HealthMarkets (Mid-West National Life)13140 HealthMarkets (TransAmerica Life)10339 Healthplus Of Michigan11773 HealthScope (Morris Assoc, Central Benefits,

Employers Health, Plan Handlers)11783 HealthSpring10345 HIP Healthplan of NY11811 Hometown Health10351 Horizon New Jersey Health10353 HUMANA10363 Idaho Medicaid11845 IlliniCare Health Plan10365 Illinois Medicaid11849 Independence Administrators10368 Independent Health10371 Indiana Medicaid11861 Inland Empire Health13144 Integrated Mental Health Services13145 Inter Valley Health Plan10381 Iowa Medicaid11890 Jackson Memorial Hospital Health Plan10393 John Hopkins Health Plan10395 Kaiser Foundation Health Plan Of Colorado Yes10397 Kaiser Foundation Health Plan Of Hawaii Yes10401 Kaiser Foundation Health Plan Of Ohio Yes10403 Kaiser Foundation Health Plan Of The Mid-Atlantic Yes10404 Kaiser Foundation Health Plan Of The Northwest Yes10396 Kaiser Permanente of Georgia Yes

12.2015

10399 Kaiser Permanente of Northern CA Yes10402 Kaiser Permanente of Southern CA Yes10413 Kansas Medicaid10416 Kentucky Medicaid11928 Key Benefit Administrators10417 Keystone Mercy Health Plan13146 Kitsap Physician Services10002 Louisiana Healthcare connections10434 Louisiana Medicaid10435 Lovelace Health Plan12977 Loyal American Life Insurance Company -

Medicare Supplement11991 Magellan Behavioral Health Services10439 Magnolia Health Plan10441 Maine Medicaid10442 MAMSI Health Plan12002 Managed Health Services Indiana12003 Managed Health Services Wisconsin10445 Maricopa Care Advantage (Arizona)10444 Maricopa Health Plan (Arizona)10448 Maryland Medicaid Yes10450 Massachusetts Medicaid12032 Mdwise Hoosier Alliance10454 MedCost Benefit Services10455 Medica10456 Medical Mutual Of Ohio10000 Medicare (HETS)13015 Medicare (HETS) - DSH Only13177 Medicare y Mucho Mas (INMEDIATA HEALTH GROUP)10459 Mega Life (Oklahoma City)10462 Mercy Care Plan (Arizona)10463 Meritain Health12983 Metlife Dental Family10465 Metropolitan Health Plan (MHP)13200 MHNET Behavioral Health12980 Michigan Medicaid - Pending Eligibility Yes10466 Michigan Medicaid Yes12981 Michigan MIChild Yes10474 Minnesota Medicaid10477 Mississippi Medicaid

12.2015

12985 Mississippi State Employees and Teachers Health Plan10479 Missouri Medicaid10480 MMSI (Mayo Health)10482 Molina Healthcare Of California10483 Molina Healthcare Of Florida13178 Molina Healthcare of Illinois10484 Molina Healthcare Of Michigan10485 Molina Healthcare Of Missouri10486 Molina Healthcare Of New Mexico10487 Molina Healthcare Of Ohio10488 Molina Healthcare Of Texas10489 Molina Healthcare Of Utah10490 Molina Healthcare Of Washington13147 Molina Healthcare of Wisconsin13184 Molina of Puerto Rico10491 Montana Medicaid13182 Montefiore CMO10498 Mutual Of Omaha10500 MVP Health Care (New York)10503 National Association Of Letter Carriers (NALC)10521 Nationwide Specialty Health10004 Nebraska Medicaid10316 NEHEN - Harvard Pilgrim Health Care12281 NEHEN - Neighborhood Health Plans10752 NEHEN - Tufts Associated Health Plan13148 Neighborhood Health Plan (RI)12285 Network Health12286 Network Health Insurance Corporation - Medicare10526 Nevada Medicaid13175 New Hampshire Healthy Families10529 New Hampshire Medicaid10530 New Jersey Medicaid10531 New Mexico Medicaid10533 New York Medicaid10539 North Carolina Medicaid10541 North Dakota Medicaid12340 Nova Healthcare Administrators12986 Novasys Health12350 ‘Ohana Health Plan10554 Ohio Medicaid

12.2015

10557 Oklahoma Medicaid10569 Optima/Sentara10573 Oregon Medicaid10574 Oxford Health Plans12395 Pacific Source Health Plan12402 Partners National Health Plans of NC10586 Partnership Health Plan of California10589 Passport Health Plan12410 Peach State Health Plan10594 Pennsylvania Medicaid10599 Phoenix Health Plan10604 Physicians Mutual Insurance Company12462 Pittman and Associates12482 Preferred Care Partners (Miami , FL)10616 PreferredOne12501 Presbyterian Health Plan12504 Prestige Health Choice10622 Principal Financial Group (Nippon Life)10625 Priority Health12551 Providence Health Plan12987 Provident American Life and Health Ins Co -

Medicare Supplement13150 Public Employees Health Program10639 Puerto Rico Medicaid12565 QualCare10643 QualChoice12569 QuikTrip Corporation13151 Recall Systems - Boon-Chapman Benefit Admin13152 Recall Systems - Corporate Benefit Service13153 Recall Systems - Group and Pension Administrators12989 Recall Systems - Mississippi Admin Services13155 Recall Systems - Professional Benefits Administrators13157 Recall Systems - Underwriters Safety and Claims12598 Rocky Mountain Health Plan Yes10331 San Joaquin Health Plan10664 Sanford Health Plan12618 Santa Clara Family Health Plan12619 Santa Clara Valley Health and Hospital System10666 SCAN - Senior Care Action Network (HMO)12624 Schaller Anderson Parkland Community Health Plan

12.2015

13159 Scott & White Health Plan10682 Select Health Of South Carolina13161 Select Health Utah13162 Significa Benefit Services12668 Simply Health Care Plan10693 South Carolina Medicaid10695 South Dakota Medicaid13163 Special Agents Mutual Benefit Association12990 SPJST - Medicare Supplement10702 Standard Life and Accident Insurance10708 StayWell13164 StayWell Kids12720 Student Insurance10716 SummaCare12725 Sunshine State Health Plan12728 Superior HealthPlan Texas10725 Tennessee Medicaid13165 TexanPlus North Texas Area13166 TexanPlus Southeast Texas Area10730 Texas Medicaid12758 Texas Medicaid & Healthcare Partnership (TMHP)12778 Three Rivers Health Plans (Unison Health Plan)12783 Todays Health10737 Todays Option12791 Total Health Care Yes13167 Tribute/Select Care of Oklahoma10747 Tricare12807 TriCare for Life13176 Triple-S Salud (BCBS Puerto Rico)10750 Trustmark Insurance10756 UCare of Minnesota12991 UMR (Wausau)10763 Unicare (Wellpoint)13202 Union Fidelity Life Insurance Company10774 Union Pacific Railroad Employees Health Systems10784 United Healthcare12992 United Healthcare Plan of River Valley10795 United Teacher Assoc Insurance Co. - Medicare Supplement10821 Unity Health Plans12853 Univera Healthcare

12.2015

12860 University Family Care12864 University Physicians Care Advantage (Arizona)13168 University Physicians Healthcare Group (Arizona)12870 UPMC Health Plan (Tristate)10839 USAA Life13169 Utah Medicaid Yes10841 VA Fee Basis12890 Vantage Health Plan, Inc.10846 Vermont Medicaid10851 Virginia Medicaid13204 Virginia Surety Company, Inc10853 VIVA Health12910 VNS Choice10857 Washington Medicaid13205 Washington National Insurance Company10863 WEA Trust10864 WebTPA10868 WellCare Health Plans10870 Wells Fargo Third Party Administrators, Inc. (CHIP and PEIA)13174 Wellsense10871 West Virginia Medicaid12936 Western Health Advantage10882 Windsor Medicare Extra10885 Wisconsin Medicaid10894 Wisconsin Medicaid Chronic Disease Program10895 Wisconsin Medicaid Well Woman Program10889 World Insurance (ARIC)12955 Writers Guild10892 Wyoming Medicaid