| New Payor |
Payor I.D. |
Payor Name |
Additional Enrollment Required |
9/10/2007
|
TLU12
|
1199 National Benefit Fund
|
|
9/10/2007
|
20413
|
3P Admin
|
|
| 4/7/2004 |
CX044 |
A&I Benefits |
|
9/10/2007
|
AARP1
|
AARP Dental Insurance Plan
(Group # 1230 or 1231)
|
|
9/10/2007
|
PHP01
|
Abrazo Healthcare (Phoenix, AZ)
|
|
5/20/2005
|
AHP01
|
Abri Health Plan
|
|
9/10/2007
|
43178
|
Acceptius (Benefit Management
Inc of MO (BMI)
|
|
9/10/2007
|
AHS01
|
Access Administrators
|
Contact Payor to receive
provider I.D.
|
9/10/2007
|
TLU13
|
Accident Fund Insurance Company
of America
|
|
9/10/2007
|
64071
|
Acclaim
|
|
| 4/7/2004 |
87815 |
Accordia
National |
|
9/10/2007
|
61425
|
ACEC-Healthplan
|
|
9/10/2007
|
61473
|
ACS Benefit Solutions
|
|
|
72468 |
ACS Consulting Services, Inc. (PO Box 2000 Fort Valley, GA) |
|
|
38255 |
Activa Benefit Services, LLC (Grand Rapids, MI) |
|
9/10/2007
|
TLU14
|
ADENTA
|
|
9/10/2007
|
TLU87
|
Administration Services, Inc.
(ASI)
|
|
9/10/2007
|
TLU86
|
Administrative Concepts
|
|
| 6/30/2003 |
93524 |
Advantage Dental Plan, Inc. |
|
9/10/2007
|
52133
|
Advantage Health Solutions
|
|
9/10/2007
|
60054
|
Adventis Risk Management, Inc.
(NAD Retirees)
|
|
9/10/2007
|
95340
|
Adventist Health
|
|
| 9/10/2007 |
TLX35
|
AEI (Administrative Enterprises
Inc) (AZ)
|
|
| 9/10/2007 |
57604
|
Aetna Affordable Health Choices
(SM) - SRC
|
|
|
68246 |
Aetna Healthcare Encounters (DMO)
|
|
|
60054 |
Aetna Life & Casualty Co. |
|
| 9/10/2007 |
TLW02
|
Affordable Benefit
Administrators, Inc.
|
|
|
58066 |
AFLAC of Georgia (1932 Wynnton Road, Columbus, GA 3199907251) |
|
| 9/10/2007 |
91136
|
AGC-I.U.O.E Local 701 Trust Funds
|
|
|
80705 |
AH & L |
|
| 9/10/2007 |
TLW03
|
AHCP - American Healthcare
Partnership
|
|
| 9/10/2007 |
13545
|
AIG American General (US Life)
|
|
|
91136 |
Alaska Children's Services, Inc (Group #P68) |
|
2/7/2005
|
92600
|
Alaska Electric Health &
Welfare Fund
|
|
| 9/10/2007 |
91136
|
Alaska Hotel, Restaurant and Camp
|
|
|
91136 |
Alaska Laborers Construction Industry Trust (Group #F23) |
|
|
91136 |
Alaska Pipe Traders Local 375 (Group #F24) |
|
| 9/10/2007 |
91136
|
Alaska Plumbing and Pipefitting
Industry |
|
|
91136 |
Alaska United Food & Comm Workers Health & Welfare
Trust #F45 |
|
| 9/10/2007 |
TLU15
|
ALICARE
|
|
| 9/10/2007 |
TLU11
|
Allegiance Benefit Plan
Management
|
|
| 9/10/2007 |
ALMC1
|
Allen Lund Co
|
|
| inactive |
CX016 |
Allen Medical Claims Administrators |
|
| 4/7/2004 |
94177 |
Allied Administrators |
|
9/10/2007
|
TLX56 |
Allied Benefit Systems
|
|
|
69140 |
Allmerica Financial Services |
|
|
80705 |
ALTA Health & Life Insurance Company |
|
|
50503 |
Altus Dental (PO Box 1557, Providence, RI) |
|
9/10/2007
|
13343
|
Amalgamated Life - PA Alicare
|
|
| 11/13/2008 |
16120 |
America's TPA |
|
9/10/2007
|
75240
|
American Administrative Group,
Inc. (AAG)
|
|
| 11/13/2008 |
42112 |
American Administrators |
|
9/10/2007
|
TLU21
|
American Association of
Orthodontics (AAO-TPA)
|
|
9/10/2007
|
TLU24
|
American Benefit Plan
Administrators
|
|
|
E3750 |
American Bankers Life Assurance Co. |
|
6/25/2004
|
34187
|
American Benefits Management
(North Canton, Ohio)
|
|
9/10/2007
|
TLW04
|
American Community Mutual
Insurance Co
|
|
5/20/2005
|
ADP01
|
American Dental Payor of WI
|
|
| 9/10/2007 |
TAD01
|
American Dental
Professional Services
|
|
| 9/10/2007 |
TAD02
|
American Dental
Professional Services (Repriced Claims)
|
|
5/20/2005
|
AHG01
|
American Health Group
|
|
| 9/10/2007 |
TLU25
|
American Healthcare
|
|
9/10/2007
|
TLW75
|
American Heritage Life Insurance
Company
|
|
|
CX001 |
American Medical Security |
|
| 9/10/2007 |
74048
|
American National Insurance Co.
|
|
| 9/10/2007 |
TLU26
|
American Pioneer Life Insurance
|
|
|
44444 |
American Postal Workers Union Health Plan-APWU |
|
| 9/10/2007 |
TLX55
|
American Sentinel Insurance Inc
|
|
|
66667 |
Ameritas Bankers Assurance Co. |
|
|
66666 |
Ameritas Life Insurance Corp. |
|
9/10/2007
|
TLU23
|
Amierben Solutions (formerly IEC
Insurance)
|
|
| 9/10/2007 |
AML01
|
AMLICO - American Medical and
Life Insurance Company (Hicksville, NY)
|
|
|
38255 |
Amway Corporation |
|
| 9/10/2007 |
53085
|
Anchor Benefit Consulting, Inc.
|
|
| 9/10/2007 |
34192
|
Antares Management Solutions
|
|
|
H0098 |
Anthem - Blue Cross Blue Shield of Ohio (except FEP) |
|
|
80705 |
Anthem Health & Life Insurance Company of New Jersey |
|
|
16140 |
APA Partners of New York (for claims mailed to Latham, NY) |
|
| 9/10/2007 |
TLW68
|
APIPA (Arizona Physicians IPA) -
Claims ONLY
|
|
| 9/10/2007 |
TLX06
|
APIPA (Arizona Physicians IPA) -
Pre Determinations ONLY
|
|
| 9/10/2007 |
TLW65
|
Appalachian Benefit
Administrators
|
|
| 4/7/2004 |
75278 |
Arkansas Best Corporation - Choice Benefits |
|
| 9/10/2007 |
CX072
|
Ascent Benefits
|
|
| 9/10/2007 |
TLU87
|
ASEA / AFSCME Local 52
|
|
| 9/10/2007 |
TLU27
|
ASEA / AFSCME Local 52 Health
Benefit Trust
|
|
| 9/10/2007 |
TLU29
|
ASI
|
|
| 9/10/2007 |
TLU31
|
ASR
|
|
| 9/10/2007 |
TLU02
|
ASR Corporation
|
|
| 9/10/2007 |
TLU30
|
Associated Administrators
|
|
| 9/10/2007 |
TLU28
|
Associated Benefits
|
|
| 9/10/2007 |
70408
|
Assurant Employee Benefit -
Employee Claims
|
|
| 9/10/2007 |
TLW69
|
AssureCare, Inc. (IL)
|
|
| 9/10/2007 |
TLW70
|
AssureCare, Inc. (MI)
|
|
| 9/10/2007 |
TLW72
|
AssureCare, Inc. (MN)
|
|
| 9/10/2007 |
TLW71
|
AssureCare, Inc. (OH)
|
|
| 9/10/2007 |
95691
|
Athens Area Health Plan Select
|
|
| 9/10/2007 |
TLU32
|
Atlanta Plumbers & Steam
Fitters (Local 72)
|
|
2/7/2005
|
CX052
|
Atlantic Dental Inc
|
|
| 9/10/2007 |
TLU33
|
Atlas Administrators
|
|
| 9/10/2007 |
ATPA1
|
ATPA - Associated Third Party
Administrators
|
|
|
91136 |
Automotive Machinists Local 289 Health & Welfare Trust |
|
| 9/10/2007 |
86098
|
Avesis
|
|
9/10/2007
|
TLU34
|
Avesta Group Insurance
|
|
9/10/2007
|
TLU35
|
BAC
|
|
| 6/30/2003 |
74227 |
Bankers United Life |
|
6/25/2004
|
49153
|
BCI Administrators Inc
|
|
|
68241 |
Bell Atlantic |
|
|
23210 |
BeneCare Dental Plan (Chestnut St, Philadelphia, PA) |
|
| 9/10/2007 |
TLU36
|
Benefit Administration Services
|
|
| 9/10/2007 |
62121
|
Benefit Administrators, Inc.
(Erie, PA)
|
|
| 6/30/2003 |
25145 |
Benefit Coordinators Corporation |
|
| 9/10/2007 |
TLU37
|
Benefit Group (NE)
|
|
| 9/10/2007 |
20018
|
Benefit Management Group
|
|
| 9/10/2007 |
TLW73
|
Benefit Management, Inc.
|
|
| 9/10/2007 |
TLU45
|
Benefit Management Services (BMS)
|
|
| 9/10/2007 |
TLU05
|
Benefit Management Services --
FEP CLAIMS (LA)
|
|
| 9/10/2007 |
TLU04
|
Benefit Management Services (LA)
|
|
| 9/10/2007 |
TLU38
|
Benefit Management Services (NC)
|
|
| 4/7/2004 |
39081 |
Benefit Plan Administrators Inc |
|
|
74223 |
Benefit Planners of Texas (for claims mailed to Boerne, TX) |
|
| 9/10/2007 |
TLU03
|
Benefit Services, Inc.
|
|
| 9/10/2007 |
TLU39
|
Benefit Source (MI)
|
|
| 9/10/2007 |
TLU40
|
Benefit Systems (IN)
|
|
|
36342 |
Benefit Systems & Services, Inc. (BSSI) |
|
|
07000 |
Benefits Inc. (Construction Suppliers group only) |
|
5/20/2005
|
BMX01
|
Benemax
|
|
9/10/2007
|
87265
|
BeneSight
|
|
| 9/10/2007 |
37248
|
Benesys, Inc. (Lafayette, LA)
|
|
| 6/30/2003 |
95604 |
Best Life & Health Insurance Company (For claims mailed
to Irvine, CA) |
|
2/7/2005
|
32006
|
Better Health Plans of South
Carolina
|
|
| 9/10/2007 |
CX025
|
Big Lots Associate Benefit Plan
(OH)
|
|
9/10/2007
|
TLU42
|
Blue Bell Benefit Trust
|
|
| 11/13/2008 |
BBFL1 |
Blue Cross Blue Shield of Florida |
|
| 8/15/2003 |
H0143 |
Blue Cross Blue Shield of Georgia |
|
|
CBMI1 |
Blue Cross Blue Shield of Michigan |
|
|
22099 |
Blue Cross Blue Shield of New Jersey |
 |
| 9/10/2007 |
EXC02
|
Blue Cross Blue Shield of New
York (Central New York, Syracuse)
|
Call BCBS of NY for provider I.D. |
| 9/10/2007 |
CBNYR |
Blue Cross Blue Shield of New
York (Finger Lakes Region, Rochester, Utica/Watertown)
|
Call BCBS of NY for provider I.D.
|
|
H0098 |
Blue Cross Blue Shield of Ohio (Anthem) |
|
| 11/13/2008 |
BBOK1 |
Blue Cross Blue Shield of Oklahoma |
|
| 9/10/2007 |
39141
|
Blue Cross and Blue Shield
United of Wisconsin (ONLY - PO Box 10888, Geen Bay, WI 54307)
|
Call BCBS for provider I.D. |
|
CBAL1 |
Blue Cross of Alabama |
 |
|
47570 |
Blue Cross of Alaska |
|
|
CBAR1 |
Blue Cross of Arkansas |
Call UCCI @ 800-633-5430 for registration info. |
|
47198 |
Blue Cross of California (Wellpoint)
|
|
|
84099 |
Blue Cross of Colorado |
|
|
65358 |
Blue Cross of Connecticut (Anthem)
|
|
|
00700 |
Blue Cross of Connecticut Blue Care Family Plan |
|
|
53287 |
Blue Cross of Delaware |
|
|
CBID1 |
Blue Cross of Idaho |
 |
|
BS018 |
Blue Cross of Illinois |
 |
|
84105 |
Blue Cross of Indiana (Anthem)
|
|
|
CBIA1 |
Blue Cross of Iowa (FEP and Farm Bureau claims only) |
 |
|
CBIA2 |
Blue Cross of Iowa (First Administrators and Wellmark) |
 |
|
CBKS1 |
Blue Cross of Kansas |
 |
|
84105 |
Blue Cross of Kentucky - Anthem (PO Box 37180, Louisville, KY) |
|
|
23738 |
Blue Cross of Louisiana |
Call BC of Louisiana @ 225-297-2758 for Provider I.D. |
|
CBMA1 |
Blue Cross of Massachusetts |
 |
|
CBMA2 |
Blue Cross of Massachusetts PPO |
 |
6/25/2004
|
CBNE1
|
Blue Cross of Nebraska
|
|
|
84101 |
Blue Cross of Nevada |
|
| 2/7/2005 |
CBNM1 |
Blue Cross of New Mexico (For claims mailed to Belleville, IL) |
|
|
CX004 |
Blue Cross of North Dakota (North Dakota Dental Services) |
 |
|
66668 |
Blue Cross of Oregon |
 |
|
53473 |
Blue Cross of Rhode Island |
 |
|
CBTN1 |
Blue Cross of Tennessee |
 |
|
84980 |
Blue Cross of Texas |
 |
|
47570 |
Blue Cross of Washington (State) |
|
|
22226 |
Blue Cross of Wisconsin |
 |
|
BLUEP |
Blue Plus (Delta Dental of Minnesota Medical Assistance) |
|
|
CBID2 |
Blue Shield of Idaho |
 |
|
22223 |
Blue Shield of Pennsylvania |
Call UCCI @ 800-633-5430 for registration info. |
|
DPLUS |
Blue Shield of Pennsylvania Dental Plus |
Call UCCI @ 800-633-5430 for registration info. |
9/10/2007
|
TBT01
|
BlueCare Dental Traditional
|
|
|
36609 |
Boilermakers National Health & Welfare Fund of Kansas |
|
2/7/2005
|
74237
|
Boon-Chapman Benefit
Administrators
|
|
9/10/2007
|
14168
|
Boston Mutual Life Insurance -
Dental
|
|
| 9/10/2007 |
04210
|
Boston University Dental Health
Plan (Boston, MA)
|
|
|
CX028 |
Bridgeport LLC of Missouri (for claims mailed to St. Charles,
MO) |
|
|
CX032 |
Brokers National (other plans) |
|
|
CX031 |
Brokers National (plans Cavalier, Buccaneer, Brigadier,
Mansion) |
|
|
CX031 |
Brokers National (plans Homestead Homes, and Direct
Connection) |
|
|
61492 |
Businessmens Assurance |
|
9/10/2007
|
42150
|
Butler Benefits
|
|
| 9/10/2007 |
CX075
|
C. L. Frates
|
|
|
80659 |
Canada Life (for claims mailed to Atlanta, GA only) |
|
| 6/30/2003 |
37105 |
Cannon Cochran Management Services, Inc.(Danville, IL) |
|
| inactive |
68011 |
Capitol Administrators (For claims mailed to PO Box 2318,
Rancho Cordova, CA and PO Box 346, Alpharetta, GA) |
|
| 9/29/2003 |
CX037 |
Capital Dental (for claims mailed to PO Box 2727, Houston, TX) |
|
9/10/2007
|
TLU47
|
Caprock Health Plan
|
|
9/10/2007
|
TLU48
|
Carolina Summit
|
|
| 9/10/2007 |
TLW16
|
Carpenter's Health & Welfare
Fund (Philadelphia, PA)
|
|
| 9/10/2007 |
TLW06
|
Carpenters Health and Welfare
Trust Funds (St. Louis, MO)
|
|
| 9/10/2007 |
TLU49
|
Carpenters Health & Welfare
(Los Angeles, CA)
|
|
|
37060 |
Caterpillar Company |
|
9/10/2007
|
TLW14
|
CBCA - Comprehensive Benefits
& Claims Administrators
|
|
|
41124 |
CBSA Corporate Benefit Services of America |
|
9/10/2007
|
10050
|
CDH (Cigna Dental Care)
|
|
9/10/2007
|
TLW07
|
CDPHP - Capital District
Physicians’ Health Plan, Inc. (NY)
|
|
9/10/2007
|
88022
|
CDS Group Health
|
|
|
91136 |
Cement Masons & Plasterers Health & Welfare Trust |
|
9/10/2007
|
TLW85
|
Cement Masons Union - Local 502
|
|
9/10/2007
|
TLU50
|
Central Laborers Local 703
|
|
9/10/2007
|
TLU51
|
Central PA Teamsters Health
& Welfare Fund
|
|
9/10/2007
|
TLW76
|
Central Reserve Life Insurance
Company
|
|
| 11/13/2008 |
36215 |
Central States Health & Welfare Funds |
|
| 8/15/2003 |
84146 |
CHAMPVA - HAC (for claims mailed to PO Box 65024, Denver, CO) |
|
9/10/2007
|
TLX40
|
CHEC (subsidiary of Sprint)
|
|
9/10/2007
|
TLA11
|
Chesterfield Companies
|
|
9/10/2007
|
84147
|
Children of Women Vietnam
Veterans - VA HAC |
|
|
UCCI1 |
CHIPS, a childrens low cost Texas health plan administered by
UCCI |
Call UCCI @ 800-633-5430 for Provider I.D. |
|
68241 |
Choice Plus (TRW) |
|
|
61271 |
Christian Brothers Services |
|
|
62308 |
CIGNA (Connecticut General) |
|
9/10/2007
|
10050
|
CIGNA (DHMO) - Encounters Only
|
|
|
62310 |
CIGNA Flex Care (New Mexico only) |
|
9/10/2007
|
TLU52
|
Citizens Security Life Insurance
Co
|
|
| 9/10/2007 |
TLW99
|
City of Blair
|
|
| 9/10/2007 |
TLW43
|
City of Mesa
|
|
| 9/10/2007 |
CX054
|
Civil Service Employee
Association (CSEA)
|
|
| 9/10/2007 |
CMS01
|
Claim Management Services (WI)
|
|
| 9/10/2007 |
TLX41
|
Claredon Kids CHIP Program EPO
|
Contact Payor to receive
provider I.D.
|
| 9/10/2007 |
CCS01
|
Clayton County Self Funded
Dental Plan
|
|
|
71063 |
CNA Health Partners of Arkansas |
|
| 9/10/2007 |
37310
|
Coast Hotels and Casinos, Inc. /
DBA Coast Benefits
|
|
| 9/10/2007 |
TLU53
|
Combined Insurance Claims (FL)
|
|
| 9/10/2007 |
37237
|
CommonWealth Administrators
|
|
| 9/10/2007 |
61948
|
Community Choice Health Plan
Westchester
|
|
| 9/10/2007 |
PHP01
|
Community Connection (Phoenix,
AZ)
|
|
| 9/10/2007 |
TLX42
|
Community Health Choice
|
|
|
75261 |
Community Health Electronic Claims/CHEC/webTPA |
|
6/25/2004
|
34177
|
COMP - OHIO (Austintown, OH)
|
|
| 9/10/2007 |
77828
|
Companion Life
|
Contact Payor to receive
provider I.D. |
|
CX021 |
CompDent (for claims mailed to Chicago, IL) |
|
9/10/2007
|
34177
|
Compensation Programs of Ohio
|
|
|
03036 |
Comprehensive Benefits Administrator, Inc (PO Box 2365,
Burlington) |
|
|
07000 |
Comprehensive Care Systems |
|
| 9/10/2007 |
TLX25
|
Comton, Inc.
|
|
| 9/10/2007 |
TLX09
|
CONN EN Life Insurance Co
|
|
| 9/10/2007 |
37307
|
CONN EN Life Insurance Co
|
|
|
62308 |
Connecticut General (CIGNA) |
|
|
E3170 |
Consolidated Group Claims - Lincoln |
|
|
61305 |
Consolidated Group Dental |
|
5/20/2005
|
62308
|
Continental Dental
|
|
| |
52132 |
Cooperative Benefit Administrators |
|
| 9/10/2007 |
75136
|
CoreSource AR
|
|
| 9/10/2007 |
35180
|
CoreSource NC IN
|
|
| 9/10/2007 |
35183
|
CoreSource OH
|
|
9/29/2003
|
35182 |
CoreSource PA MD IL
|
|
|
41045 |
CoreStar |
|
| 6/30/2003 |
56117 |
Corporate Benefit Services (For claims mailed to Charlotte,
NC) |
|
|
41124 |
Corporate Benefit Services of America (CBSA) - Minneapolis, MN |
|
| 8/15/2003 |
58102 |
Covenant Administrators, Inc (for claims mailed to Atlanta,
GA) |
|
6/25/2004
|
25148
|
Coventry Health Care of Georgia
|
|
9/10/2007
|
37320
|
Creative Plan Administrators
|
|
| 9/10/2007 |
TLU54
|
Crescent Dental
|
|
| 9/10/2007 |
TLU56
|
CT Carpenters Health Fund
|
|
9/10/2007
|
TLU55
|
CT Pipe Trades Health Fund
(Local 77)
|
|
2/7/2005
|
39170
|
Custom Benefit Administrators
|
|
|
68241 |
CustomCare (Southwestern Bell-Exec) |
|
9/10/2007
|
DEW01
|
D. Edward Wright TPA
|
|
| 9/10/2007 |
TLX43
|
Dart Container Corporation
|
Contact Payor to receive
provider I.D.
|
| 9/10/2007 |
TLW96
|
DDS, Inc.
|
|
| 9/10/2007 |
07035 |
DeCare Dental Health Insurance |
|
| 6/30/2003 |
94276 |
Delta Dental Insurance Company (DDIC)
|
|
|
02027 |
Delta Dental Northeast |
|
| 6/30/2003 |
94276 |
Delta Dental of Alabama |
|
| 6/30/2003 |
94276 |
Delta Dental of Alaska |
|
|
86027 |
Delta Dental of Arizona |
|
|
22225 |
Delta Dental of Arkansas |
|
|
77777 |
Delta Dental of California |
|
|
CDCA1 |
Delta Dental of California, Tricare Retiree Dental Program |
|
|
84056 |
Delta Dental of Colorado |
|
5/20/2005
|
22189
|
Delta Dental of Connecticut
|
|
|
51022 |
Delta Dental of Delaware |
|
| 6/30/2003 |
94276 |
Delta Dental of Florida |
|
| 6/30/2003 |
94276 |
Delta Dental of Georgia |
|
| inactive |
99010 |
Delta Dental of Hawaii |
|
|
47791 |
Delta Dental of Idaho |
|
|
05030 |
Delta Dental of Illinois |
|
|
22220 |
Delta Dental of Indiana |
|
|
55786 |
Delta Dental of Iowa |
|
|
E3960 |
Delta Dental of Kansas |
|
|
54674 |
Delta Dental of Kentucky |
|
| 6/30/2003 |
94276 |
Delta Dental of Louisiana |
|
|
23166 |
Delta Dental of Maryland |
|
|
22222 |
Delta Dental of Massachusetts (also QIS and Select)
|
|
|
22228 |
Delta Dental of Michigan |
|
|
07000 |
Delta Dental of Minnesota |
|
| 6/30/2003 |
94276 |
Delta Dental of Mississippi |
|
|
43090 |
Delta Dental of Missouri |
|
| 6/30/2003 |
94276 |
Delta Dental of Montana |
|
|
07027 |
Delta Dental of Nebraska |
|
| 6/30/2003 |
94276 |
Delta Dental of Nevada |
|
|
66669 |
Delta Dental of New Jersey |
|
|
85022 |
Delta Dental of New Mexico |
|
|
11198 |
Delta Dental of New York |
|
|
56010 |
Delta Dental of North Carolina |
|
|
07029 |
Delta Dental of North Dakota |
|
|
22221 |
Delta Dental of Ohio |
|
|
22229 |
Delta Dental of Oklahoma |
|
|
CDOR1 |
Delta Dental of Oregon |
|
|
23166 |
Delta Dental of Pennsylvania |
|
|
22224 |
Delta Dental of Rhode Island |
|
|
43091 |
Delta Dental of South Carolina |
|
|
54097 |
Delta Dental of South Dakota |
|
|
CDTN1 |
Delta Dental of Tennessee |
|
| 6/30/2003 |
94276 |
Delta Dental of Texas |
|
| 6/30/2003 |
94276 |
Delta Dental of Utah |
|
|
54084 |
Delta Dental of Virginia |
|
|
52147 |
Delta Dental of Washington D.C. |
|
|
91062 |
Delta Dental of Washington (State) |
|
|
31096 |
Delta Dental of West Virginia |
|
|
39069 |
Delta Dental of Wisconsin |
|
|
07025 |
Delta Dental of Wyoming |
|
9/10/2007
|
94235
|
Delta Health Systems
|
|
|
07000 |
Delta USA (Minnesota employers only) |
|
9/23/2004
|
CX049
|
Denex/SG
|
|
5/20/2005
|
89070
|
DentaBenefits (Mutual of Omaha)
|
Contact UCCI @ 800-633-5430 to
obtain a provider I.D.
|
|
52133 |
Dental Benefit Providers (Bethesda, MD) |
|
| 6/30/2003 |
CX035 |
Dental Care Plus (for claims mailed to Cincinnati, OH) |
|
9/10/2007
|
TLU57
|
Dental CPM
|
|
| 5/20/2005 |
64246
|
Dental Guard Prefered
|
|
9/10/2007
|
DHA01
|
Dental Health Associates
|
|
| 6/30/2003 |
CX034 |
Dental Network (for claims mailed to Towson, MD) |
|
5/20/2005
|
DNOA1
|
Dental Network of America
|
|
9/10/2007
|
TLU18
|
Dental Select, Inc.
|
|
| 9/10/2007 |
TLX01
|
Dental-Comp, Inc. (WI)
|
|
| 9/10/2007 |
TLW24
|
Dental-Pay, Inc. / The Dental
Shop
|
|
| inactive |
CX017 |
DentalComp (for claims mailed to PO Box 10599, Harrisburg, PA) |
|
|
04356 |
DentaQuest |
|
| 9/10/2007 |
A1004
|
Detroit Laborers (Metropolitan)
|
|
| 9/10/2007 |
CX065
|
DH Evans
|
|
|
DHS01 |
DHS (Delta Dental of Minnesota Medical Assistance) |
|
| 9/10/2007 |
TLX38
|
Direct Reimbursement Plan
(Newman, GA)
|
|
| 9/10/2007 |
TLW78
|
District 1199 Health &
Welfare
|
|
| 9/10/2007 |
TLW34
|
District Council 57 Benefit Fund
|
|
| 9/10/2007 |
HSP01
|
District Counsel 37 Health &
Welfare Fund
|
|
| 4/7/2004 |
CX040 |
Diversified Administration Corporation |
|
9/10/2007
|
TLW78
|
Diversified Group Administrators
|
|
| 9/10/2007 |
DOM01
|
Dominion Dental USA (DHMO and
Commercial)
|
|
|
CX014 |
Doral Dental (all states - all varieties)
|
 |
9/10/2007
|
TLX44
|
DSCC (Div of Special Care
Children)
|
Contact Payor to receive
provider I.D.
|
| 9/10/2007 |
35186
|
Dunn & Associates (EHC
Central)
|
|
| 4/7/2004 |
34159 |
E-V Benefits Management Inc |
|
| inactive |
75232
|
E3 Health, Inc.
|
|
|
81039 |
EBMS Employee Benefit Management Services, Inc. |
|
| 4/7/2004 |
CX043 |
EBS Benefit Solutions |
|
9/10/2007
|
TLU58
|
ECIT Dental Plans
|
|
| 9/10/2007 |
TLU59
|
Educators Life Ins / Educators
Mutual
|
|
|
73288 |
EHI Employers Health of Wisconsin |
|
9/10/2007
|
52192 |
Elder Health
|
|
5/20/2005
|
EWF01
|
Electrical Workers Benefit Fund
(IBEW Local 481)
|
|
| 9/10/2007 |
TLW86
|
Elmco Insurance
|
|
|
73288 |
EMPHESYS Employers Health of Wisconsin |
|
|
55093 |
Empire Blue Cross Blue Shield of New York |
|
| 9/10/2007 |
CX012
|
Employee Benefit Administrators
(Pembroke, MA)
|
|
| 9/10/2007 |
TLW29
|
Employee Benefit Claims of
Wisconsin, Inc.
|
|
| 4/7/2004 |
38241 |
Employee Benefit Concepts |
|
9/23/2004
|
37257
|
Employee Benefit Consultants,
Inc. (EBC)
|
|
|
81039 |
Employee Benefit Management Services, Inc. (EBMS) |
|
|
CX025 |
Employee Benefit Mgmnt Corp (EBMC) (Dublin, OH) |
|
| 6/30/2003 |
03036 |
Employee Benefit Plan Administration, Inc |
|
| 9/10/2007 |
47009
|
Employee Benefit Services (NE)
|
|
| 9/10/2007 |
41198
|
Employee Benefit Services of
Louisiana, Inc (EBS)
|
|
| 9/10/2007 |
TLW79
|
Employee Benefits Corporation
|
|
|
CX022 |
Employee Group Services (PO, Box 75008, Cedar Rapids, IA) |
|
| 9/10/2007 |
CX031
|
Employee Plan Services, Inc.
(EPSI)
|
|
|
35112 |
Employee Plans, LLC (PO Box 2362, Fort Wayne, IN) |
|
|
54098 |
Employee Security, Inc. |
|
|
CX031 |
Employer Plan Services, Inc. |
|
9/10/2007
|
TLW30
|
Employers Dental Trust
|
|
| 9/10/2007 |
75232
|
Employers Direct Health
|
|
| 9/10/2007 |
75236
|
Employers Direct Health -
Employee Plan
|
|
|
73288 |
Employers Health of Wisconsin (EHIC) (EMPHESYS) |
|
| 9/10/2007 |
TLW32
|
Employers Life Insurance Corp
(SC)
|
|
2/7/2005
|
59297
|
Employers Mutual, Inc
|
|
9/10/2007
|
88726
|
Encompass
|
|
| 9/10/2007 |
TLW87
|
Engineers Joint Welfare Fund /
IUOE (NY)
|
|
| 6/30/2003 |
91136 |
Enstar Natural Gas |
|
9/10/2007
|
TLU60
|
Epoch Group LC (Overland Park)
|
|
| 9/10/2007 |
TLX13
|
Epoch Group LC (St. Louis)
|
|
|
62308 |
EQUICOR (Equitable HCA Corp) |
|
|
62308 |
Equitable (CIGNA) |
|
| 9/29/2003 |
73126 |
Equitable Plan Services ( for claims mailed to PO Box 720460,
Oklahoma City,, OK) |
|
6/25/2004
|
CX046
|
Erin Group Administrators
|
|
| 9/10/2007 |
74234
|
ERISA
|
Contact Payor to receive
provider I.D.
|
9/10/2007
|
34108
|
ES Beveridge and Associates
|
|
6/25/2004
|
43168
|
Essex Dental Benefits
|
|
9/10/2007
|
TLW77
|
Evans D H Associates Inc
|
|
| 9/10/2007 |
CBNYR
|
Excellus, Inc.
|
Contact Payor to receive
provider I.D.
|
| 9/10/2007 |
EXC03
|
Excellus, Inc - FEDERAL Claims
Only
|
|
|
71412 |
ExclusiCare |
|
9/10/2007
|
TLX14
|
Family Care Claims (TX)
|
|
| 9/10/2007 |
TLU61
|
Family Health Administrators
|
|
| 9/10/2007 |
TLU62
|
Fara Benefit Services
|
|
| 9/10/2007 |
91136
|
FBX North Star Borough / School
District
|
|
9/23/2004
|
71056
|
Fed Ex Freight East, Inc.
|
|
|
41041 |
Federated Mutual Insurance of Owatonna, MN |
|
9/10/2007
|
TLU69
|
Fidelio Insurance Co
|
|
| 9/10/2007 |
TLU67
|
First Administrators
|
|
|
69140 |
First Allmerica Financial Life Insurance Co. |
|
|
72630 |
First Ameritas Life Insurance Corporation of NY |
|
9/10/2007
|
TLX17
|
First Care/Southwest Life &
Health
|
|
| 9/10/2007 |
TLU68
|
First Choice Benefits
|
|
| 9/10/2007 |
TLU65
|
First Concord Group, Inc.
|
|
| 9/10/2007 |
TLU63
|
First Dental Health (FDH)
|
|
| 9/10/2007 |
70408
|
First Fortis Life Insurance
|
|
|
87043 |
First Health |
|
|
E3740 |
First Reliance Standard |
|
9/10/2007
|
TLU66
|
Fiserv Health
|
|
| 4/7/2004 |
11244 |
FitzHarris & Company Inc |
|
| 9/10/2007 |
TLX53
|
FL League of Cities
|
|
|
68241 |
FlexCare |
|
| 9/10/2007 |
TLU70
|
Flexible Benefit Fund
|
|
| 9/10/2007 |
TLW93
|
Florida Benefit Administrators
|
|
6/25/2004
|
48116
|
Florida Hospital Waterman
|
|
|
68241 |
Florida Power & Light |
|
6/25/2004
|
48117
|
FMH Benefit Services, Inc
|
|
9/10/2007
|
TLW97
|
Foreign Service Benefit Plan
|
|
| 9/10/2007 |
TLU19
|
Formula Dental
|
|
|
70408 |
Fortis Benefits Insurance Company |
|
|
39065 |
Fortis Insurance Company (Individual plans - formerly Time
Ins) |
|
9/10/2007
|
TLU72
|
Foundation Benefits
Administration
|
|
| 9/10/2007 |
TLU71
|
Fox Valley Welfare Fund
|
|
| 4/7/2004 |
CX041 |
Fraternal Order of Police |
|
9/10/2007
|
TLX20
|
G.W. Lisk Co
|
|
| 9/10/2007 |
37283
|
Gallagher Benefit Administrators
|
|
| 9/10/2007 |
TLU73
|
Gardner Denver
|
|
| 9/10/2007 |
GCU01
|
GCU Local 8-M & 96B Health
& Welfare Fund
|
|
| 9/10/2007 |
TLW17
|
GE Financial Assurance
|
|
| |
44054 |
GEHA (Government Employees Hospital Association) |
|
| 9/10/2007 |
TLX27
|
GEHA Connection Dental Plus (MO)
|
|
| 9/10/2007 |
75238
|
GEHA - G.E. Group Administrators
(TX)
|
Contact Payor to receive
provider I.D.
|
|
63665 |
General American Life |
|
|
67814 |
General Electric |
|
| 9/10/2007 |
67814
|
Genworth
|
|
| 9/10/2007 |
TLU74
|
Gettysburg Insurance Services
|
|
|
13551 |
GHI (Group Health Insurance of New York) |
|
| 6/30/2003 |
80314 |
GIC |
|
|
07205 |
Gilsbar, Inc. (Covington, LA and Jackson, MS) |
|
|
91136 |
Glassworkers Health & Welfare Fund |
|
9/10/2007
|
TLX45
|
Global Healthcare (c/o People
1st)
|
|
| 9/10/2007 |
TLW18
|
Golden Rule Insurance Company
|
Contact Payor to receive
provider I.D.
|
5/20/2005
|
GWD01
|
Golden West
|
|
9/10/2007
|
44054
|
Government Employees Hospital
Association (GEHA)
|
|
|
63665 |
Great-West Life & Annuity Ins Co. (formerly General
American Life) |
|
|
80705 |
Great-West Life Assurance Company |
|
|
36338 |
Group Administrators (in Schaumburg, Illinois) |
|
2/7/2005
|
72153
|
Group Benefit Administrators
|
|
| inactive |
CX011 |
Group Benefit Services (in East Lansing, Michigan) |
|
9/10/2007
|
CX036
|
Group Dental Service of
Maryland, Inc. / GDS-MD
|
|
| 9/29/2003 |
CX036 |
Group Dental Services (for claims mailed to PO Box 3827,
Houston, TX) |
|
|
13551 |
Group Health Insurance of New York (GHI) |
|
6/25/2004
|
38194
|
Group Health Managers
|
|
9/10/2007
|
37276
|
Group Insurance Service Center,
Inc
|
|
|
CX015 |
Group Link (in Indianapolis, Indiana) |
|
| 9/10/2007 |
TLU76
|
Group Resources, Inc. (TX)
|
|
| 9/10/2007 |
TLW81
|
Guarantee Trust Life Insurance Co
|
|
|
64246 |
Guardian Life Insurance Company |
|
|
95266 |
Harrington Benefit Services |
|
| 6/30/2003 |
59142 |
Harrington Benefit Services, Inc. (Oklahoma) |
|
| 9/10/2007 |
CX044
|
Harrison Electrical Trust Fund
|
|
| 9/10/2007 |
TLW11
|
Harvard Pilgrim Healthcare
|
|
| inactive |
99010 |
Hawaii Dental Services |
|
9/10/2007
|
TLU97
|
HCH Administration (NM)
|
|
| 9/10/2007 |
TLU98
|
HDM Benefit Solutions, Inc.
|
|
| 9/10/2007 |
TLW88
|
Health Alliance (IL)
|
|
| 9/10/2007 |
TLX24
|
Health Benefit Claims Dept
|
|
6/25/2004
|
22345
|
Health Choice Inc.
|
|
| 4/7/2004 |
82018 |
Health Claims Services |
|
| 9/10/2007 |
TLA18
|
Health Cost Solutions
|
|
| 9/29/2003 |
CX039 |
Health Economics Group, Inc. (for claims mailed to Rochester,
NY) |
|
| 9/10/2007 |
TLW61
|
Health First TPA
|
|
9/23/2004
|
30946
|
Health Future, LLC
|
|
|
84097 |
Health Management Systems (Managed Dental Care Network) |
|
9/10/2007
|
TLW20
|
Health Net (CA)
|
|
| 9/10/2007 |
20199
|
Health Network of America
|
|
|
HLTHC |
Health Partners (Commercial Plan) |
|
|
HLTHP |
Health Partners (Minnesota Medical Assistance) |
|
|
62157 |
Health Partners of Tennessee (PO Box 3490, Jacson, TN) |
|
9/10/2007
|
47009 |
Health Plan Services (HPS) |
|
|
59142 |
Health Plan Services of OK (Oklahoma City, OK) |
|
9/10/2007
|
CX055
|
Health Plans, Inc.
|
|
|
CX019 |
Health Resources Inc (314 SE Riverside Dr, Evansville, IN
47713) |
|
|
87043 |
Health Right Inc. of Connecticut |
|
|
41170 |
Health Risk Management |
|
9/10/2007
|
HTD99
|
Health Traditions - MMSI
|
|
| 9/10/2007 |
HMA01
|
Healthcare Management
Administrators, Inc.
|
Contact Payor to receive
provider I.D.
|
| 9/10/2007 |
TLW60
|
HealthComp
|
|
| 9/10/2007 |
52133
|
HealthNet of Oregon
|
|
|
11271 |
Healthplex, Inc. |
|
|
71063 |
HealthSCOPE Benefits, Inc. |
|
|
68195 |
Healthsource Provident Administrators, Inc. |
|
|
68195 |
Healthsource Provident Insurance |
|
|
69140 |
Healthy Choice |
|
|
69140 |
Healthy Choice Plus |
|
9/10/2007
|
HGL01
|
Heavy & General Laborers
|
|
| 9/10/2007 |
HMSA1
|
HMSA (Hawaii Medical Services) -
Commercial
|
|
| 9/10/2007 |
HMSA2
|
HMSA (Hawaii Medical Services) -
Federal
|
|
| 9/10/2007 |
88023
|
Hometown Health Plans Nevada
|
|
|
CX015 |
Hoosier Dental (in Indianapolis, Indiana) |
|
9/10/2007
|
22099
|
Horizon Healthcare of NY
|
 |
|
91136 |
Hotel Employees & Restaurant Employees Health Trust |
|
|
41170 |
HRM Claim Management |
|
|
73288 |
Humana Military Healthcare Svcs (PO Box 19081, Green Bay, WI) |
|
|
73288 |
Humana |
|
9/10/2007
|
TLW82
|
I.B.P.A.T. District
Council #11
|
|
| 9/10/2007 |
IAT01
|
IATSE - International
Association of Theatrical Stage Employees Atlanta Health & Welfare
Fund
|
|
| 9/10/2007 |
38234
|
IBA Self Funded Group
|
|
| 9/10/2007 |
A1117
|
IBEW Local 117
|
|
| 9/10/2007 |
TLW62
|
IBEW Local 1249
|
|
| 9/10/2007 |
TLW90
|
IBEW Local 176 (In-State
Only)
|
|
| 9/10/2007 |
TLW91
|
IBEW Local 176 (Out-of-State)
|
|
| 9/10/2007 |
A1317
|
IBEW Local 38
|
|
| 9/10/2007 |
A1461
|
IBEW Local 461
|
|
| 9/10/2007 |
A4681
|
IBEW Local 481
|
|
| 9/10/2007 |
64246
|
IBEW Welfare Trust Fund (IL)
|
|
|
41124 |
IBI |
|
9/10/2007
|
91136
|
Idaho Pipe Trades
|
|
9/23/2004
|
22175
|
IE Shaffer
|
|
| 9/29/2003 |
36600 |
Illinois Central Hospital Association (for claims mailed to
Tinley Park, IL) |
|
9/10/2007
|
TLW83
|
IMA Management, Inc. (LA)
|
|
| 9/10/2007 |
DELOK
|
Indian Health Services
|
|
| 9/10/2007 |
ICW01
|
Indiana Carpenters Welfare &
Pension Fund
|
|
| 9/10/2007 |
35107
|
Indiana Teamsters Health Benefit
Funds (formerly known as Local 135 Health Benefits Fund)
|
|
9/10/2007
|
52196
|
InforMed, LLC (Annapolis, MD)
|
|
|
13315 |
Insurance Design Administrators (Oakland, NJ) |
|
9/10/2007
|
TLW83
|
Insurance Management
Administrators Of Louisiana
|
|
| 6/30/2003 |
88006 |
Insurance Management Services (for claims mailed to Elko, NV) |
|
| 9/10/2007 |
TLW82
|
Insurance Programmers, Inc
|
|
9/10/2007
|
IAC01
|
Insurer's Administrative Corp
|
|
| 9/29/2003 |
51020 |
Integra Administrative Group (for claims mailed to Seaford,
DE) |
|
9/10/2007
|
TLW56
|
Interactive Medical Systems, Inc.
|
|
| 6/30/2003 |
36609 |
International Brotherhood of Boilermakers |
|
|
42234 |
Iowa Benefits, Inc. (IBI)
|
|
9/10/2007
|
TLX28
|
Iron Workers District (NY)
|
|
|
61271 |
J.F. Molloy and Associates, Inc. |
|
2/7/2005
|
34136
|
J.P. Farley Corporation
|
|
|
14168 |
Jardine Group Services |
|
9/10/2007
|
JPF01
|
Jefferson Pilot / Guarantee Life
Insurance Company (GLIC)
|
|
| 9/10/2007 |
JEN01
|
Jenkins & Associates (1299
Battlecreek Rd., Ste. 200 & PO Box 607, Jonesboro, GA 30237-0607)
|
|
| 9/10/2007 |
TLW64
|
JI Specialty Services Company
|
|
|
14168 |
JLT Services Corporation (Jardine Group Services) |
Contact Payor to receive provider I.D.
|
| 9/10/2007 |
41099
|
John Alden Life Insurance Co.
|
|
|
95378 |
John Deere |
 |
|
65099 |
John Hancock Health Security Plan |
|
|
65099 |
John Hancock Mutual Life Insurance Co. |
|
|
65099 |
John Hancock Preferred Health Plan |
|
|
57038 |
Kanawha Insurance Company (Lancaster & Greenville) |
|
9/10/2007
|
KBT01
|
Kansas Building Trades (4101
Southgate Dr., Topeka, KS 66609 & PO Box 5168, Topeka, KS 66605)
|
|
| 9/10/2007 |
TKC01
|
Kansas City Life Insurance
Company
|
|
| 9/10/2007 |
TLX46
|
Kelsey Seybold
|
Contact Payor to receive
provider I.D.
|
|
73100 |
Kempton Company |
|
9/10/2007
|
TLX29
|
Key Benefit Administrators, Inc.
|
|
9/10/2007
|
TPA01
|
Keylink Solutions
|
|
|
93200 |
King County Blue Shield |
|
|
93213 |
King County Blue Shield Clallam |
|
|
93220 |
King County Blue Shield Cowlitz |
|
|
93207 |
King County Blue Shield Grays Harbor |
|
|
93210 |
King County Blue Shield Lewis |
|
|
93219 |
King County Blue Shield Snohomish |
|
|
93211 |
King County Blue Shield Thurston |
|
|
93221 |
King County Blue Shield Walla Walla Valley |
|
|
93214 |
King County Blue Shield Yakima |
|
9/10/2007
|
LSH01
|
Laborers' Southeast Health &
Welfare Plan
|
|
| 9/10/2007 |
TLU99
|
Lawrence Paper Company
|
|
|
44066 |
Lewer Agency (Bartlesville, OK office only) |
|
|
78140 |
Life Insurance Company of Boston & New York |
|
|
65471 |
Life Insurance Company of Georgia |
|
9/23/2004
|
CX047
|
LifeRe
|
|
6/25/2004
|
91663
|
Lifewise/Washington Employers
Trust
|
|
|
73288 |
Lincoln National of Wisconsin (in Madison or Green Bay) |
|
9/10/2007
|
TLX21
|
Line Construction Benefit (Line
Co)
|
|
| 9/29/2003 |
35107 |
Local 135 Health Benefits (for claims mailed to Indianapolis,
IN) |
|
| 9/10/2007 |
PCM01
|
Local 148 Health & Welfare
Fund
|
|
| 9/10/2007 |
TLX08
|
Local 388 Dental Fund
|
|
5/20/2005
|
GCU01
|
Local 8-M & 96B Health &
Welfare Fund
|
|
| 9/10/2007 |
91136
|
Locals 302 And 612 of the
I.U O.E.
|
|
| 9/10/2007 |
LAF01
|
Los Angeles Firemen’s Relief
Association (LAFRA)
|
|
|
62310 |
Lovelace Health Plan |
|
|
62310 |
Lovelace Senior Options (LSO) |
|
|
62310 |
Lovelace Senior Plan (LSP) |
|
9/10/2007
|
52133
|
M-Plan Dental
|
|
|
10317 |
Machigonne Benefit Administrators (Bangor or Portland, ME) |
|
| 9/10/2007 |
91136
|
Machinists Health
|
|
| 9/10/2007 |
TLW30
|
MAG Employee Benefits
|
|
| 4/7/2004 |
CX042 |
Mahoney Benefit Administration, LLC |
|
|
62413 |
Mail Handlers Benefit Plan |
|
| 9/10/2007 |
TLX08
|
Maloney Associates
|
|
| 6/30/2003 |
CX033 |
MAMSI (For claims mailed to Frederick, MD) |
|
|
CX014 |
Managed Health Services - WI State Employees |
 |
|
98010 |
Manulife, W.J. Sutton Co. of Toronto, Ontario |
|
|
68241 |
Marriot |
|
| 11/13/2008 | CX023 | Marsh Advantage | |
9/10/2007
|
TLU77
|
Mashantucket Pequot
|
|
|
65935 |
Massachusetts Mutual |
|
|
56205 |
MBS (MedCost Benefit Services - PO Box 25987, Winston Salem,
NC) |
|
9/10/2007
|
TLW63
|
Med Cost, Inc.
|
|
|
74323 |
MedBen (Newark, OH) |
|
|
56205 |
Medcost of North Carolina (PO Box 25987, Winston Salem, NC) |
|
|
MEDIC |
Medica Commercial |
|
|
MEPUB |
Medica Public Programs (Medica MA, MEDICAID, HMO) |
|
|
CKAL1 |
Medicaid of Alabama |
 |
|
CKAL1 |
Medicaid of Alabama Change of Tax Identification Number Only |
 |
|
CKAK1 |
Medicaid of Alaska |
 |
9/10/2007
|
TLU09
|
Medicaid of Arizona
|
|
|
E0840 |
Medicaid of Arkansas |
|
|
94146 |
Medicaid of California (Denti-Cal) |
Call or email LTC |
|
CKCO1 |
Medicaid of Colorado |
 |
|
22235 |
Medicaid of Connecticut |
 |
|
CKDE1 |
Medicaid of Delaware |
|
9/10/2007
|
MDDC1
|
Medicaid of District of Columbia
(DC)
|
|
|
55555 |
Medicaid of Florida |
 |
|
E0920 |
Medicaid of Georgia |
 |
|
CX014 |
Medicaid of Georgia, Grady Healthcare, Inc. |
 |
|
E0900 |
Medicaid of Idaho |
 |
|
CKIL1 |
Medicaid of Illinois |
 |
|
E0730 |
Medicaid of Indiana |
 |
|
CKIA1 |
Medicaid of Iowa |
 |
|
CKKS1 |
Medicaid of Kansas |
 |
|
E0510 |
Medicaid of Kentucky |
 |
|
CKKY3 |
Medicaid of Kentucky Region #3 (Doral Dental Services) |
 |
9/10/2007
|
TLU10
|
Medicaid of Kentucky Region #5
(KY Health Select)
|
|
|
E3670 |
Medicaid of Louisiana (Adult 21 and older) |
 |
|
22000 |
Medicaid of Louisiana (EPSDT) |
 |
|
CKME1 |
Medicaid of Maine |
 |
|
CX014 |
Medicaid of Maryland, PhysiciansCare MCO |
 |
9/10/2007
|
MDMD1
|
Medicaid of Maryland (Dept of
Health & Mental Hygiene)
|
|
|
CKMA1 |
Medicaid of Massachusetts (diskette from Clearing House to
Payor) |
 |
|
MIMD1 |
Medicaid of Michigan |
Call or email LTC |
|
MNMA1 |
Medicaid of Minnesota (Minnesota Medical Assistance) |
 |
|
E3240 |
Medicaid of Mississippi |
Call or email LTC |
|
CX014 |
Medicaid of Missouri, Blue Advantage |
 |
|
CX014 |
Medicaid of Missouri, Community Care Plus-St. Louis |
 |
|
CX014 |
Medicaid of Missouri, Community Health Plans |
 |
|
CX014 |
Medicaid of Missouri, FirstGuard Health Plan |
 |
|
CX014 |
Medicaid of Missouri, HealthCare USA-St. Louis |
 |
|
CX014 |
Medicaid of Missouri, Healthnet |
 |
| 6/30/2003 |
CKMO1 |
Medicaid of Missouri (Medicaid claims administered by GTE
Data Services Inc.) |
 |
|
CX014 |
Medicaid of Missouri, TrumanCare-Family Health Partners |
 |
|
MTMDC |
Medicaid of Montana CHIPS |
 |
|
CKMT1 |
Medicaid of Montana (for claims mailed to PO Box 8000,
Helena, MT) |
 |
|
CX014 |
Medicaid of Nebraska, United HealthCare of the Midlands |
 |
| 9/23/2004 |
CKNV1 |
Medicaid of Nevada |
 |
|
E3360 |
Medicaid of New Hampshire |
 |
|
66665 |
Medicaid of New Jersey |
 |
|
CX014 |
Medicaid of New Mexico, Cimmaron Health Plan |
 |
|
CX014 |
Medicaid of New Mexico, Lovelace Community Health PLan |
 |
| 6/30/2003 |
CKNM1 |
Medicaid of New Mexico (Medicaid claims administered by
Consultec/ACS) |
 |
|
CX014 |
Medicaid of New Mexico, Presbyterian Salud |
 |
|
CKNY1 |
Medicaid of New York |
 |
|
CKNY2 |
Medicaid of New York (Clinics whose category of sevice is
0287) |
 |
|
22219 |
Medicaid of North Carolina |
Call or email LTC |
9/10/2007
|
CKND1
|
Medicaid of North Dakota
|
Call ND Medicaid to obtian a
provider I.D. |
|
E0340 |
Medicaid of Ohio |
Call Ohio Medicaid to obtian a provider I.D.
|
|
CKOH2 |
Medicaid of Ohio CareSource |
Call Caresource @ 937-224-8313 for Provider I.D. |
|
CX014 |
Medicaid of Ohio, Emarald HMO and Medicare, Inc. |
 |
|
CX014 |
Medicaid of Ohio, Health Power HMO, Cincinnati |
 |
|
CX014 |
Medicaid of Ohio, Personal Physicians Care, Cleveland |
 |
|
CX014 |
Medicaid of Ohio, United HealthCare, Inc. Medicare Complete |
 |
|
E0880 |
Medicaid of Oklahoma |
 |
|
CX014 |
Medicaid of Oklahoma, Community Care |
 |
|
CX014 |
Medicaid of Oklahoma, Heartland Health Plan |
 |
| 6/30/2003 |
CKOK1 |
Medicaid of Oklahoma (Medicaid claims administered by Unisys) |
 |
|
CX014 |
Medicaid of Oklahoma, Unicare Health Plan |
 |
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