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Column1 Column2 Column3 Column4 Payer Code Payer Name 10319 Subscriber Dependent *****Blue Exchange 1 (Pass-Through)(Wellpoint)(ONLY USED IF NO STATE BLUE PLAN PAYER ID LISTED!!)***** Y Y 10431 AARP (A United HealthCare Insurance Company) Y N 10560 Absolute Total Care Y N 10619 Administrative Services, Inc. Y N 10561 Advantage by Bridgeway Health Solutions Y N 10562 Advantage by Buckeye Community Health Plan Y N 10563 Advantage by Managed Health Services Y N 10564 Advantage by Superior HealthPlan Y N 10004 Aetna Y Y 10816 Aetna Better Health New York Y N 10397 Aetna Long Term Care Y N 10594 Affinity Health Plan Y N 10661 Affinity Health Plan Medicare Y N 10398 AFLAC - Dental Y Y 10663 AFLAC - Medicare Supplemental Y Y 10006 Aftra Health Fund Y Y 10007 Alabama Medicaid Y N 10639 Alameda Alliance Health Plan Y N 10798 Alan Sturm and Associates - Dental Y N 10654 Allegiance Benefit Plan Management Y N 10786 Altus Dental Y N American Family Insurance Group - Medicare Supplement and PPO 10487 Policies Y Y 10664 American Health Medicare Y N 10829 American Medical Security Y Y 10595 American National Insurance Company Y Y

10596 American National Life Insurance Company of Texas Y Y 10016 American Postal Workers Union (APWU) Y Y 10017 American Republic Insurance Company (ARIC) Y Y 10538 American Retirement Life Ins Co Medicare Supplement Y N 10018 AmeriChoice of New Jersey (Commercial) Y N 10019 AMERIGROUP Y N 10416 AmeriHealth Administrators Y Y 10820 Amerihealth Caritas Pennsylvania Y N 10340 AmeriHealth Mercy Health Plan Y N 10020 Ameritas Group - Ameritas Life Insurance Co. Y Y 10232 Ameritas Group - First Ameritas of New York Y Y 10233 Ameritas Group - First Reliance Standard Life Y Y 10234 Ameritas Group - Reliance Standard Life Y Y 10236 Ameritas Group - Standard Insurance Y Y 10237 Ameritas Group - Standard Insurance of New York Y Y 10559 Antares Y Y 10708 Apex Benefits Services Y Y 10641 Arbor Health Plan Y N 10021 Arizona Medicaid (AHCCCS) Y N 10022 Arizona Physicians IPA (APIPA) Y N 10023 Arkansas Medicaid Y N 10230 Assurant Health - John Alden Insurance Company (JALIC) Y Y 10087 Assurant Health - Time Insurance Company (FIC) Y Y 10227 Assurant Health - Union Security Insurance Company (FBIC) Y Y 10529 Asuris Northwest Health Y Y 10472 AultCare Y Y 10024 AvMed Health Plans Y N

10707 Banner Health Plans Y Y 10831 BCBS Delaware Y Y 10025 BCBS of Alabama Y Y 10609 BCBS of Alabama (Institutional) Y Y 10027 BCBS of Arizona Y Y 10028 BCBS of Arkansas Y Y 10029 BCBS of Colorado (Wellpoint) Y Y 10030 BCBS of Connecticut (Wellpoint) Y Y 10031 BCBS of Florida Y Y 10032 BCBS of Georgia (Wellpoint) Y Y 10530 BCBS of Hawaii Y Y 10033 BCBS of Illinois Y Y 10258 BCBS of Indiana (Wellpoint) Y Y 10396 BCBS of Iowa Y Y 10034 BCBS of Kansas Y Y 10473 BCBS of Kansas City Y Y 10259 BCBS of Kentucky (Wellpoint) Y Y 10035 BCBS of Louisiana Y Y 10036 BCBS of Maine (Wellpoint) Y Y 10037 BCBS of Massachusetts Y Y 10519 BCBS of Michigan (Institutional) Y Y 10038 BCBS of Michigan (Professional) Y Y 10039 BCBS of Minnesota Y Y 10040 BCBS of Mississippi Y N 10322 BCBS of Missouri (Wellpoint) Y Y 10516 BCBS of Montana Y Y 10384 BCBS of Nebraska Y Y

10260 BCBS of Nevada (Wellpoint) Y Y 10261 BCBS of New Hampshire (Wellpoint) Y Y 10041 BCBS of New Jersey (Horizon) Y Y 10042 BCBS of New Mexico Y Y 10043 BCBS of New York (Empire) Y Y 10323 BCBS of New York (Excellus) Y Y 10461 BCBS of New york(central) Y Y 10469 BCBS of New york(rochester Area) Y Y 10470 BCBS of New york(utica-watertown) Y Y 10383 BCBS of North Carolina Y Y 10302 BCBS of North Carolina (Blue Exchange Only) Y Y 10478 BCBS of North Dakota Y Y 10044 BCBS of Ohio (Wellpoint) Y Y 10582 BCBS of Oklahoma Y Y 10045 BCBS of Oregon (Regence) Y Y 10046 BCBS of Pennsylvania (Highmark) Y Y 10524 BCBS of Pennsylvania (Highmark) Institutional Y Y 10304 BCBS of Rhode Island Y Y 10047 BCBS of South Carolina Y Y 10395 BCBS of South Dakota (Wellmark) Y Y 10430 BCBS of Tennessee Y Y 10048 BCBS of Texas Y Y 10618 BCBS of Utah Y Y 10049 BCBS of Virginia (Wellpoint) Y Y 10462 BCBS of West Virginia Y Y 10498 BCBS of Western NY Y Y 10299 BCBS of Wisconsin (Wellpoint) Y Y

10480 BCBS of Wyoming Y Y 10665 Benefit Management Inc Y Y 10256 Best Choice Health Plan Y N 10050 Best Life and Health Y Y 10187 Better Health Plans (Unison Health Plans) Y N 10803 Blue Benefit Administrators of Mass Y Y 10262 Blue Cross Independence (Pennsylvania) Y Y 10264 Blue Cross Northeastern Pennsylvania Y Y 10051 Blue Cross of California (Wellpoint) Y Y 10638 Blue Cross of Idaho Y Y 10326 Blue Cross of Washington and Alaska (Premera) Y Y 10325 Blue Cross Pennsylvania (Capital) Y Y 10053 Blue Shield of California Y N 10052 Blue Shield of Idaho (Regence) Y Y 10499 Blue Shield of NorthEastern NY Y N 10054 Blue Shield of Washington (Regence) Y Y 10504 BlueChoice HealthPlan South Carolina Medicaid Y N 10429 Bluegrass Family Health Y Y 10556 BMC HealthNet Plan (Boston Medical) Y N 10821 Boon Group Y Y 10399 Bravo Health Y N 10827 Bridgespan Y N 10565 Bridgeway Arizona Y N 10783 Brokers National - Dental Y N 10566 Buckeye Community Health Y N 10759 California Health & Wellness Y N 10055 California Medicaid (Medi-Cal) Y N

10458 Capital District Physicians Health Plan (CDPHP) Y N 10660 Caprock Y N 10806 Care Improvement Plus Y Y 10270 Carefirst DC - Federal Employee Program Y Y 10270 Carefirst MD Blue Cross Blue Shield Y Y 10056 CarePlus Health Plan Y N 10822 Carepoint Medicare Advantage Y N 10057 CareSource Health Y N 10058 Cariten Healthcare Y Y 10059 Cariten Senior Health Y N 10762 Carolina Care Plan Y Y 10667 CDS Group Health Y Y 10668 Celtic Insurance Y Y 10859 Celticare Y Y 10567 Cenpatico - Arizona Y N 10568 Cenpatico - Florida Y N 10569 Cenpatico - Georgia Y N 10631 Cenpatico - Illinois Y N 10570 Cenpatico - Indiana Y N 10571 Cenpatico - Kansas Y N 10632 Cenpatico - Kentucky Y N 10588 Cenpatico Massachusetts Y N 10769 Cenpatico - Mississippi Y N 10768 Cenpatico - Missouri Y N 10770 Cenpatico - New Hampshire Y N 10572 Cenpatico - Ohio Y N 10573 Cenpatico - South Carolina Y N

10633 Cenpatico - Texas Y N 10766 Cenpatico Behavioral Health Y N 10767 Cenpatico Behavioral Health Texas Y N 10634 Cenptatico - Wisconsin Y N 10765 Centene - Granite State Health Plan Y N 10763 Centene - Advantage by Peach State Y N 10764 Centene - Advantage by Sunshine State Y N 10566 Centene - Buckeye Community Health Y N 10759 Centene - California Health & Wellness Y N 10761 Centene - Coordinated Care Y N 10760 Centene - Home state Health Plan Y N 10757 Centene - Illinicare Health Plan Y N 10620 Centene - Kentucky Spirit Health Plan Y N 10756 Centene - Louisiana Healthcare Connections Y N 10590 Centene - Peach State Health Plan Y N 10758 Centene - Sunflower State Health Plan Y N 10592 Centene - Superior HealthPlan Texas Y N 10771 Centene Advantage Plans Y N 10666 CenterLight Healthcare Y N 10450 Central Reserve Insurance Company Y Y 10539 Central Reserve Life Ins Co Medicare Supplement Y N 10486 Central States Fund Y Y 10744 Central States Indemnity Y N 10061 CHAMPVA/Spina Bifida/Children of Women Vietnam Vets Y N 10447 CHC Advantra (TX, NM, AZ Only) Y Y 10419 CHC - Advantra Savings Y Y 10216 CHC - Altius Health Plans Y Y

10307 CHC - Avantra Freedom Y Y 10448 CHC Coventry Health and Life Nevada Y Y 10212 CHC - Coventry Health and Life (Oklahoma) Y Y 10405 CHC - Coventry Health and Life (Tenn) Y Y 10214 CHC - Coventry Health Care Carelink (Advantra) Y Y 10215 CHC - Coventry Health Care Carelink Medicaid Y Y 10217 CHC - Coventry Health Care Carenet Y Y 10481 CHC - Coventry Healthcare Federal Y Y 10449 CHC Coventry Missouri Y Y 10614 CHC CoventryCares Y Y 10440 CHC CoventryOne Y Y 10076 CHC - Delaware Y Y 10218 CHC - Diamond Plan (Maryland Medicaid) Y Y 10551 CHC - Florida/Vista/Summit Y Y 10206 CHC - Georgia Y Y 10219 CHC - Group Health Plan (GHP) Y Y 10220 CHC - HealthAmerica & HealthAssurance Y Y 10221 CHC - HealthCare Inc. (Promina) Y Y 10222 CHC - HealthCare USA (HCUSA) Y Y 10207 CHC - Iowa Y Y 10208 CHC - Kansas Y Y 10210 CHC - Louisiana Y Y 10085 CHC - Mail Handlers Benefit Plan Y Y 10211 CHC - Nebraska Y Y 10223 CHC - OmniCare (Michigan) Y Y 10224 CHC - PersonalCare Y Y 10225 CHC - Southern Health Services (SHS) Y Y

10428 CHC - University of Missouri Y Y 10483 CHC - Vista (MCD, FHK, LTC) Y Y 10226 CHC - WellPath Select (Carolinas) Y Y 10642 CHC- CoventryCares Kentucky Y Y 10062 CIGNA Y Y 10064 Colorado Access Y N 10065 Colorado Medicaid Y N 10066 Community Care of Oklahoma Y Y 10329 Community Health Plan of Washington (CHPW) Y N 10421 Community HealthFirst Medicare Advantage Y N 10303 ConnectiCare Y Y 10067 Connecticut Medicaid Y N 10669 Consolidated Associates Railroad Y Y 10540 Continental General Ins Co Medicare Supplement Y N 10454 Continental General Insurance Company Y Y 10610 Cook Children s Health Plan Y N 10068 Cooperative Benefit Administrators (CBA) Y Y 10701 CoOportunity Health/Healthpartners MN Y Y 10761 Coordinated Care Y N 10311 CoreSouce (FMH) Y Y 10071 CoreSource (Little Rock) Y Y 10072 CoreSource (MD,PA,IL,NC,IN,AZ,MN) Y Y 10074 CoreSource (OH) Y Y 10670 Country Life Insurance Company Y Y 10084 Coventry Healthcare National Network Y Y 10428 Coventry Healthcare University of Missouri Y Y 10548 Coventry Nebraska Medicaid Y Y

10838 Cox Health Plan Y N 10541 CSA Fraternal Live Medicare Supplement Y N 10671 CTI Administrators Y Y 10775 Culinary Health Fund Y Y 10577 DakotaCare Y Y 10653 Dean Health Plan Y N 10780 DeCare Dental Health Insurance Y N 10828 Definity Health Y Y 10293 Delaware Medicaid Y N 10817 Delaware Physicians Y N 10709 Delta Dental Ins. Co. - Alabama Y N 10710 Delta Dental Ins. Co. - Florida Y N 10711 Delta Dental Ins. Co. - Georgia Y N 10712 Delta Dental Ins. Co. - Louisiana Y N 10713 Delta Dental Ins. Co. - Mississippi Y N 10714 Delta Dental Ins. Co. - Montana Y N 10715 Delta Dental Ins. Co. - Nevada Y N 10716 Delta Dental Ins. Co. - Texas Y N 10717 Delta Dental Ins. Co. - Utah Y N 10705 Delta Dental of California Y N 10718 Delta Dental of Colorado Y N 10719 Delta Dental of Connecticut Y N 10720 Delta Dental of Delaware Y N 10721 Delta Dental of Hawaii Y N 10722 Delta Dental of Indiana Y N 10723 Delta Dental of Maryland Y N 10724 Delta Dental of Michigan Y N

10725 Delta Dental of Minesota Y N 10726 Delta Dental of Nebraska Y N 10727 Delta Dental of New Jersey Y N 10728 Delta Dental of New Mexico Y N 10729 Delta Dental of New York Y N 10730 Delta Dental of North Carolina Y N 10731 Delta Dental of North Dakota Y N 10732 Delta Dental of Ohio Y N 10733 Delta Dental of Pennsylvania Y N 10734 Delta Dental of Rhode Island Y N 10735 Delta Dental of Tennessee Y N 10736 Delta Dental of Virginia Y N 10737 Delta Dental of Washington DC Y N 10738 Delta Dental of Washington State Y N 10739 Delta Dental of West Virginia Y N 10740 DeltaCare USA - Claims Y N 10741 DeltaCare USA - Encounters Y N 10787 Dental Benefit Providers Y N 10331 Denver Health Medical Plan Y N 10578 Deseret Mutual (DMBA) Y Y 10077 Director's Guild Y Y 10078 District of Columbia Medicaid Y N 10616 Emblem Health (GHI NY & HIP of Greater NY) Y N 10784 Employee Benefit Services - Dental Y N 10601 Essence Healthcare Y N 10807 Evercare Y Y 10772 Everence Financial Y Y

10082 Fallon Community Health Plan Y N 10427 FamilyCare Y Y 10672 FCE Benefit Administrators Y Y 10083 Federated Insurance Company Y Y 10459 Fidelis Care New York Y N 10859 Fidelis SecureCare of Michigan Y N 10799 Flex Compensation - Dental Y N 10811 Florida Combined Life - Dental Y N 10615 Florida Health Care Plans Y Y 10333 Florida Hospital Healthcare System Y N 10086 Florida Medicaid Y N 10839 Florida True Health Y N 10776 Food Employers & Bakery Workers Benefit Y Y 10502 Freedom Blue Y N 10602 Fresenius Medical Care Y N 10629 Gateway Health Plan Y N 10611 Geisinger Health Plan Y N 10612 Geisinger Health Plan-Gold Y N 10603 Generations Healthcare Y N 10088 Georgia Medicaid Y N 10745 Gerber Life Insurance Y N 10808 GHI - Group Health Incorporated Y N 10509 Gilsbar Y Y 10652 Golden Rule Y Y 10394 Government Employees Hospital Association (GEHA) Y Y 10765 Granite State Health Plan Y N 10542 Great American Life Assurance Co Medicare Supplement Y N

10543 Great American Life Insurance Co Medicare Supplement Y N 10062 Great-West Healthcare now Cigna Y N 10608 Group Health Cooperative Y Y 10781 Group Health Cooperative of South Central Wisconsin - Dental Y N 10583 Group Practice Affiliates Y N 10788 Guardian Life Insurance Co. of America Dental Y N 10514 Harmony Health Plan Y N 10376 Harvard Pilgrim Health Care Y N 10091 Hawaii Medicaid Y N 10785 Hawaii Medical Assurance Association - Dental Y N 10308 Health Alliance Medical Plans (HAP) Y N 10092 Health Choice Arizona Y N 10673 Health First Health Plan Y Y 10674 Health First Insurance Y Y 10385 Health Net National Y N 10276 Health Net of Arizona Y N 10627 Health New England Y N 10484 Health Partners Minnesota Y Y 10098 Health Partners of Philadelphia Y N 10362 Health Plan of San Mateo Y N 10657 Health Plan of Upper Ohio Valley Y N 10584 Health Services Children Special Needs Y N 10823 Health Share of Oregon Y N 10463 Healthcare Solutions Group Y N 10597 HEALTHe Exchange Y N 10510 HealthEase Y N 10511 HealthEase Kids Y N

10656 HealthEZ (America's TPA) Y Y 10438 Healthfirst New Jersey Y N 10099 Healthfirst New York Y N HealthMarkets Y Y 10500 Healthnow Y N 10804 HealthPlan of Nevada Y Y 10856 HealthPlan Services - Celtic Insurance Company Y N 10802 HealthPlans Inc Y N 10309 HealthPlus of Michigan Y N 10621 Healthscope Y N 10789 Healthsource Provident - Dental Y N 10552 Healthspring Y N 10824 Healthy Texas Y Y 10746 Heartland National Life Y N 10795 Hershey Healthsmile - Dental Y N 10406 HIPNY Y N 10760 Home State Health Plan Y N 10335 Hometown Health Y N 10337 Horizon NJ Health Y N 10100 Humana Y N 10338 Humana of Florida Y N 10855 IBEW Local 508 Health Plan Y N 10101 Idaho Medicaid Y N 10747 Ideal Life Insurance Y N 10757 IlliniCare Health Plan Y N 10102 Illinois Medicaid Y N 10417 Independence Administrators Y Y

10536 Independent Health Y N 10103 Indiana Medicaid Y N 10104 Inland Empire Health Y N 10842 Integral Quality Care Florida Y N 10585 Integrated Mental Health Services Y N 10105 Inter Valley Health Plan Y N 10581 Intracorp Y N 10107 Iowa Medicaid Y N 10675 Island Home Insurance Y N 10108 Jackson Memorial Hospital Health Plan Y N 10267 John Hopkins Health Plan Y N 10110 Kaiser Foundation Health Plan of Colorado Y N 10111 Kaiser Foundation Health Plan of Hawaii Y N 10676 Kaiser Foundation Health Plan of Hawaii (DHMO Choice) Y Y 10112 Kaiser Foundation Health Plan of Ohio Y N 10113 Kaiser Foundation Health Plan of the Mid-Atlantic Y N 10114 Kaiser Foundation Health Plan of the Northwest Y N 10238 Kaiser Permanente of Georgia Y N 10115 Kaiser Permanente of Northern CA Y N 10239 Kaiser Permanente of Southern CA Y N 10116 Kansas Medicaid Y N 10117 Kentucky Medicaid Y N 10857 Kentucky Health Exchange Y Y 10620 Kentucky Spirit Health Plan Y N 10754 Key Benefits Administrators (IN) Y N 10300 Keystone Mercy Health Y N 10341 Kitsap Physician Services Y N

10748 KSKJ Life Y N 10640 LACare - AmeriHealth Caritas Louisiana Y N 10677 Leon Medical Centers Health Plan Y N 10843 Lifewise Arizona Y N 10651 Lifewise Health Plan Of Oregon Y Y 10650 Lifewise Health Plan of Washington y Y 10678 Lincoln Financial Y Y 10749 Lincoln Heritage Y N 10755 Loomis Company y Y 10830 Louisiana Health Exchange Y Y 10756 Louisiana Healthcare Connections Y N 10118 Louisiana Medicaid Y N 10119 Lovelace Health Plan Y N 10544 Loyal American Life Insurance Co Medicare Supplement Y N 10649 Magellan Behavioral Health Y Y 10704 Magnolia Health Plan Y N 10121 Maine Medicaid Y N 10818 Majestacare VA Y N 10122 MAMSI Health Plan Y N 10586 Managed Health Services Indiana Y N 10587 Managed Health Services Wisconsin Y N 10679 MAPFRE Life Puerto Rico Y N 10680 MAPFRE Medicare Excel Y N 10435 Maricopa Care Advantage(Arizona) Y N 10434 Maricopa Health Plan (Arizona) Y N 10289 Maryland Medicaid Y N 10124 Massachusetts Medicaid Y N

10598 MDWise Hoosier Alliance Y N 10681 MedBen - Newark Ohio Y Y 10272 MedCost Benefits Services Y N 10125 Medica Y Y 10683 Medical Associates Health Plan/Health Choices Y Y 10126 Medical Mutual of Ohio Y Y 10001 Medicare (Part A & B) Y N 10800 Medigold Health Plans Y N 10682 Med-Pay Inc Y N 10844 Medstar Family Choice Y N 10845 Medstar Health Plan Y N 10248 Mega Life (Chesapeake National Life) Y Y 10129 Mega Life (Mid-West National Life) Y Y 10130 Mega Life (Oklahoma City) Y Y 10131 Mega Life (TransAmerica Life) Y Y 10127 Mega Life and Health Insurance Y Y 10133 Mercy Care Plan (Arizona) Y N 10644 Meridian Health Plan of Illinois Y N 10635 Meritain Health Y N 10134 MetLife Dental Family Y Y 10135 Metropolitan Health Plan (MHP) Y N 10659 MHNet Behavioral Health Y Y 10136 Michigan Medicaid Y N 10392 Michigan Medicaid Pending Eligibility Y N 10138 Michigan MIChild Y N 10139 Minnesota Medicaid Y N 10140 Mississippi Children's Health Insurance Program Y Y

10141 Mississippi Medicaid Y N 10142 Mississippi State Employees and Teachers Y N 10702 Missouri Care Y N 10143 Missouri Medicaid Y Y 10144 MMSI (Mayo Health) Y Y 10145 Molina Healthcare of California Y N 10445 Molina Healthcare of Florida Y N 10685 Molina Healthcare of Illinois Y N 10250 Molina Healthcare of Michigan Y N 10523 Molina Healthcare of Missouri Y N 10146 Molina Healthcare of New Mexico Y N 10251 Molina Healthcare of Ohio Y N 10815 Molina Healthcare of South Carolina Y N 10391 Molina Healthcare of Texas Y N 10252 Molina Healthcare of Utah Y N 10253 Molina Healthcare of Washington Y N 10147 Montana Medicaid Y N 10687 Municipal Health Benefit Fund Y Y 10686 Mutual Health Services Y Y 10686 Mutual Health Services Y N 10382 Mutual of Omaha Y Y 10148 MVP Health Care (New York) Y N 10149 National Association of Letter Carriers (NALC) Y Y 10812 National Telecommunications Cooperative Association (NTCA) Y Y 10150 Nationwide Specialty Health Y N 10151 Neighborhood Health Partnership Y N 10377 Neighborhood Health Plans Massachusetts Y N

10630 Neighborhood Health Plans Rhode Island Y N 10688 Network Health Insurance Corp Y N 10626 Network Health Plan of MA Y N 10706 Network Health Plan of WI Y N 10152 Nevada Medicaid Y N 10153 New Hampshire Medicaid Y N 10154 New Jersey Medicaid Y N 10247 New Mexico Medicaid Y N 10155 New York Medicaid Y N 10156 North Carolina Medicaid Y N 10298 North Carolina Medicaid (Batch) Y N 10157 North Dakota Medicaid Y N 10537 Nova Healthcare Administrators Y Y 10466 NovaSys Health Y N 10515 Ohana Health Plan Y N 10158 Ohio Medicaid Y N 10159 Oklahoma Medicaid Y N 10777 Operating Engineers Local No. 428 Y N 10477 Optima/Sentara Y N 10160 Oregon Medicaid Y N 10161 Oxford Health Plans Y N 10375 Pacific Source Health Plan Y N 10002 PacifiCare (PPO) Y N 10002 PacifiCare of Arizona (HMO) Y N 10002 PacifiCare of California (HMO) Y Y 10002 PacifiCare of Colorado (HMO) Y N 10002 PacifiCare of Nevada (HMO) Y N

10002 PacifiCare of Oklahoma (HMO) Y Y 10002 PacifiCare of Oregon (HMO) Y Y 10002 PacifiCare of Texas (HMO) Y Y 10002 PacifiCare of Washington (HMO) Y Y 10689 Panamerican Life Puerto Rico Y N 10369 Partners National Health Plans of NC Y N 10164 Partnership Health Plan of California Y N 10368 Passport Health Plan Y N 10782 Patriot Dental Y N 10590 Peach State Health Plan Y N 10165 Pennsylvania Medicaid Y N 10471 PHCS Savility Payers Y Y 10166 Phoenix Health Plan Y N 10658 Physicians Health Plan Northern Indiana Y N 10167 Physicians Mutual Insurance Company Y Y 10825 Piedmont Wellstar Health Plans Y N 10408 Pittman and Associates Y Y 10778 Plumbers and Pipefitters Local Union 525 Y Y 10691 Preferred Care Partners Y N 10847 Preferred Health System of Kansas Y N 10169 PreferredOne Y N 10848 Premier Health Y N 10646 Presbyterian Health Plan Y N 10692 Primary PhysicianCare Inc Y Y 10170 Principal Financial Group (Nippon Life) Y Y 10490 Priority Health Y N 10172 Providence Health Plan Y N

10545 Provident American Life & Health Ins Co Medicare Supplement Y N 10790 Provident Preferred Network - Dental Y N 10574 Public Employees Health Plan (PEHP) Y Y 10173 Puerto Rico Medicaid Y N 10743 Puritan Life Insurance Y N 10637 Qualcare Y N 10553 Qualchoice Y Y 10508 QuikTrip Corporation Y Y 10414 Recall Systems - Boon-Chapman Benefit Admin Y Y 10411 Recall Systems - Corporate Benefit Service Y Y 10174 Recall Systems - Group & Pension Administrators Y Y 10241 Recall Systems - Mississippi Admin Services Y Y 10242 Recall Systems - Professional Benefits Administrators Y Y 10246 Recall Systems - Underwriters Safety & Claims Y Y 10175 Rocky Mountain Health Plan Y N 10751 Royal Neighbors of America Y N 10849 San Francisco Health Plan Y N 10177 San Joaquin Health Plan Y N 10533 Sanford Health Plan Y Y 10693 Schaller Anderson Maryland Physicians Care Y N 10694 Schaller Anderson Mercy Care of Arizona Y N 10695 Schaller Anderson Missouri Care Y N 10643 Schaller Anderson Parkland Community Health Plan Y N 10696 Schaller Anderson Texas Christus Y N 10360 Scott & White Health Plan Y N 10655 Secure Horizons UHC Y Y 10792 Securian Dental Y N

10793 Securian/Patriot Dental Y N 10520 Select Health SC Y N 10575 Select Health Utah Y Y 10178 Senior Care Action Network (SCAN) HMO Y N 10697 Senior Health Services Ctr- Univ American Family Co Y Y 10752 Shenandoah Life Insurance Y N 10282 Sierra Health Services Y Y 10081 Significa Benefit Services Y Y 10826 Simply Healthcare Plans Y N 10179 South Carolina Medicaid Y N 10180 South Dakota Medicaid Y N 10591 Special Agents Mutual Benefit Association Y Y 10546 SPJST Medicare Supplement Y N 10593 Standard Life and Accident Insurance Company Y N 10833 Star HRG Y Y 10645 State Farm Y N 10750 State Mutual Med Supplement Y N 10512 StayWell Y N 10513 StayWell Kids Y N 10753 Sterling Investors Life Insurance Y N 10183 Student Insurance Y Y 10294 SummaCare Health Plan Y N 10758 Sunflower State Health Plan Y N 10451 Sunshine State Health Plan Y N 10592 Superior HealthPlan Texas Y N 10184 Tennessee Medicaid Y N 10794 TennDent - Dental Y N

10604 TexanPlus North Texas Area Y N 10605 TexanPlus Southeast Texas Area Y N 10186 Texas Medicaid Y N 10698 The Kempton Company Y Y 10318 Three Rivers Health Plans (Unison Health Plan) Y N 10688 TMG Health Network Y N 10606 Today s Health Y N 10505 Today s Option Y N 10805 Total Healthcare Y N 10607 Tribute/SelectCare of Oklahoma Y N 10189 TRICARE Y Y 10190 Trustmark Insurance Y Y 10379 Tufts Associated Health Plan Y N 10352 UCare of Minnesota Y N 10501 UMR (WAUSAU) Y Y 10791 Unicare - Dental Y N 10285 Unicare (Wellpoint) Y Y 10599 Union Pacific Railroad Employees Health Systems Y N 10810 United Concordia Companies, Inc - Dental Y N 10809 United Concordia Federal Employees Program - Dental Y N 10002 United Healthcare Y Y 10192 United Healthcare Plan of River Valley Y Y 10547 United Teacher Assoc Insurance Co Medicare Supplement Y N 10835 UnitedHealthcare Community Plan - Kansas Y N 10836 UnitedHealthcare Facets Detroit Community & State Y Y 10834 UnitedHealthcare Facets Pittsburgh Community & State Y Y 10837 UnitedHealthcare Nevada Market Y N

10349 Unity Health Plans Y N 10535 Univera Y N 10193 Universal Care of California Y N 10699 University Care Advantage Arizona Y Y 10194 University Family Care Y N 10433 University Physicians Care Advantage (Arizona) Y N 10439 University Physicians Healthcare Group (Arizona) Y N 10288 UPMC Health Plan (Tristate) Y N 10195 USAA Life Insurance Company Y N 10648 Utah Medicaid Y N 10196 VA Fee Basis Program Y N 10850 VA Healthcare Y N 10858 Vantage Health Plan Inc Y Y 10197 Vermont Medicaid Y N 10198 Virginia Medicaid Y N 10468 VIVA Health Y N 10600 VNS CHOICE Y N 10407 VYTRA Y N 10424 Washington Medicaid (ProviderOne) Y N 10501 Wausau Y Y 10554 WEA Trust Y Y 10532 WEB-TPA, Inc. Y Y 10814 Well Sense Y N 10488 WellCare Health Plans Y N 10003 Wells Fargo Third Party Administrators (Healthsmart Benefit Solutions) Y N 10200 West Virginia Medicaid Y N 10201 Western Health Advantage Y N

10797 Wilson McShane - Dental Y N 10774 Windsor Health Plan Y N 10576 Windsor Medicare Extra Y N 10202 Wisconsin Medicaid Y N 10452 Wisconsin Medicaid Chronic Disease Program Y N 10453 Wisconsin Medicaid Well Woman Program Y N 10700 World Corp Y Y 10386 World Insurance (ARIC) Y Y 10203 Writer's Guild Y Y 10204 Wyoming Medicaid Y N 10796 Zenith Administrators (MN)- Dental Y N