Professional (Medical) Payer List Payer Name Order Administrative Services of Kansas Updated October 2015 Administrative Services of Kansas (ASK) is Blue Cross and Blue Shield of Kansas DBA ASK. ASK 1
ASK accepts claims for the payers listed on this page at no charge to the trading partner. Participation in the EDI Midwest Commercial Clearinghouse is not required for any transactions submitted for these payers. Additional Payers Available (Free) Payer ID 47163 47171 00301 00801 00800 31478 31478 31478 55204 31478 31478 31478 PAYER NAME Blue Cross and Blue Shield of Kansas Blue Cross and Blue Shield of Kansas City BlueCross and BlueShield of Western New York BlueCross and BlueShield of Western New York BlueShield of Northeastern New York Freedom Network Freedom Network Select Health Partners of Kansas (HPK) HealthNow New York, Inc Mo-Kan Sheet Metal Workers Welfare Fund PHP (Preferred Health Professionals) Preferred Health Professionals PPO (PHP PPO) ASK 2
Professional (Medical) Payer List EDI Midwest 13162 1199 National Benefit Fund 20413 3P ADMIN 93044 A & I Benefit Plan Administrators 75240 AAG Benefit Plan Administrators Inc. 75185 AAG-American Administravie Group ( Formerly Icon Benefit Admin) 36273 AARP Hospital Indemnity Plans insured by UnitedHealthcare Insurance Co 36273 AARP Medicare Supplement Plans insured by UnitedHealthcare Insurance Co AARP MedicareComplete through UHC / Oxford Medicare Network AARP MedicareComplete through UHC / Oxford Mosaic Network - AARP MedicareCo 06111 AARP MedicareComplete through UnitedHealthcare / Oxford Medicare Network 06111 AARP MedicareComplete through UnitedHealthcare / Oxford Mosaic Network AARP MedicareComplete through UnitedHealthcare/AARP MedicareComplete E3510 ABMA (Alta Bates Medical Assocs) Medical Corp (Hnet Sr. and Secure Horizon) 68069 Absolute Total Care 95424 Access Medical Group 64071 Acclaim 38254 Activa Benefit Services LLC 38265 Administration Systems Research Corporation 58202 ADVANCED DATA SOLUTIONS 68069 Advantage by Bridgeway Health Solutions 68069 Advantage by Buckeye Community Health Plan 68069 Advantage by Managed Health Services 68069 Advantage by Peach State 68069 Advantage by Sunshine State 68069 Advantage by Superior HealthPlan 83077 Advantek Benefit Administrators 59374 Advantica Benefits 25133 Advantra Savings 59314 Advanzeon Solutions 36320 Advocate Medical Group - AMG (Legacy AHC) CB637 Aegis Administrative Services 60054 Aetna 60054 Aetna Encounters 57604 Aetna Affordable Health Choices (SM) - SRC 128MI Aetna Better Health of Michigan ASK 3
128MO Aetna Better Health of Missouri 34734 Aetna Better Health of NY 60055 Aetna Encounters Encounters 46594 AFFINITY MEDICAL GROUP 13346 AFTRA Health Fund 20048 Agate Resources Inc. (LIPA) 64158 Agency Services Inc 31138 AHPO (Cleveland OH) 22195 AIG Educational Markets 91136 Alaska Carpenters Trust 91136 Alaska Children's Services Inc. 91136 Alaska Laborers Construction Industry Trust 91136 Alaska Pipe Trades Local 375 91136 Alaska United Food & Commercial Workers Health & Welfare Trust 13550 ALICARE 26158 AllCare PEBB 55649 Allegian Choice 81040 Allegiance Benefit Plan Management Inc. 59335 Alpha Health Plan Inc. A0701 Alta Bates Medical Group E3510 Alta Senior Care (Hnet Sr and Secure Horizons only) 88035 Alternative Risk Management Inc. 25133 Altius (Utah) 13550 Amalgamated Life 13343 Amalgamated Life - PA / Alicare 68069 Ambetter from Buckeye Community Health Plan 68069 Ambetter from CeltiCare Health Plan 68069 Ambetter from Magnolia Health 68069 Ambetter from Managed Health Services 68069 Ambetter from Peach State Health Plan 68069 Ambetter from Sunshine Health 68069 Ambetter from Superior Health 68069 Ambetter of Arkansas 75137 AmeriBen Solutions Inc. 27517 Americaid Community Care (Maryland) 27516 Americaid Community Care (New Jersey) 75240 American Administrative Group 95170 American Benefit Plan Administrators 56071 American Family Medicare Supplement and PPO Policies Administered by Am Rep 62030 American General 01066 American Healthcare Alliance 36369 American Imaging Management Inc. 74048 American National Ins. Co. (ANICO) 44444 American Postal Workers Union Health Plan ASK 4
42011 American Republic Insurance 43146 American Specialty Health 56195 American Trust Administrators Inc. 16120 America's PPO 27514 Amerigroup Community Care 27514 AMERIGROUP Community Care of New Mexico 27514 Amerigroup Corporation (Ft Worth) 27515 Amerigroup Corporation (Houston) 27519 Amerigroup Florida 27514 AMERIGROUP Georgia 27518 Amerigroup Illinois 27518 Amerigroup Ohio 77002 Amerihealth Caritas District of Columbia 27357 AmeriHealth Caritas Louisiana 77001 AmeriHealth Caritas NorthEast 22248 AmeriHealth Caritas Pennsylvania 77013 AmeriHealth Caritas VIP Care Plus (Michigan) 77051 AmeriHealth Connect (AMERIHEALTH CARITAS) 77007 Amerihealth VIP Care- DC 77006 Amerihealth VIP Care- LA 22355 AmeriHealth VIP Care PA 64090 AmFirst Insurance Company 79966 Amida Care Medicare 53085 Anchor Benefit Consulting Inc. 86062 Ancillary Benefit Services (ABS) 75299 Angeles IPA (SynerMed) 34196 Apex Benefit Services 54160 APS Healthcare Inc. 16120 ARAZ Group 52312 Arbor Health Plan 77045 Arcadian Management Services Inc 39185 ARISE 86062 Arizona Foundation for Medical Care (AFMC) 27154 Arizona Priority Care Plus 36335 Arkansas Managed Care Organization Inc. (AMCO) 88035 ARM Grp Arnett Health Plan 06603 ASAGEHA 16180 Aspen 46156 Aspire Health Plan 38265 ASR 38265 ASR Corporation 38265 ASR Health Benefits 36326 Associates for Health Care Inc. (AHC) 25133 Association Benefit Plan 39065 Assurant Health (IM & GROUP FULLY-INSURED) ASK 5
58730 Assurant Health/ASA (Assurant Health members with ASA PPO Network) 74240 Assured Benefits Administrators 93221 Asuris Northwest 95691 Athens Area Health Plan Select 38259 Automated Benefit Services 46045 Avera Health Plans 59275 AVMED INC Encounters 59274 AvMed Inc. 77005 Bakersfield Family Medical Group 95377 Beech Street 75299 Bellflower Hospital (Synermed) 99320 Benefit & Risk Management Services 36149 Benefit Administrative Systems 25145 Benefit Coordinators Corporation (Pittsburgh PA) 56139 BENEFIT MANAGEMENT SERVICES 88052 Benefit Plan Administrators 39081 Benefit Plan Administrators Co. (Eau Claire WI) 62183 Better Health Plans Inc. 32006 Better Health Plans of South Carolina 32002 Blue Cross Complete of Michigan 61124 Bluegrass Family Health 13337 BMC HealthNet Plan 36609 Boilermakers National Health & Welfare Fund 13337 Boston Medical Center Health Plan Inc. 13337 Boston Medical Center Health Plan Inc. Encounters 52192 Bravo Health 52192 Bravo Health Star Plus 68069 Bridgeway Arizona 51037 Brokerage Concepts 94316 Brown & Toland Medical Group BTSS1 Brown & Toland Sutter Select 68069 Buckeye Community Health 42150 Butler Benefit 23708 C&O Employees Hospital Association 73071 C. L. Frates & Co - OSMA Health 68047 California Health & Wellness CAIPA California IPA 94056 California Pacific Medical Center 95399 CAP Management Systems 95112 Capital Health Plan 57116 Care 1st Health Plan of Arizona 57115 CARE 1ST HEALTH PLAN OF CA 77082 Care Improvement Plus (CIP) 11345 CareCentrix 14182 CareCore National ASK 6
14179 CareCore National LLC (Aetna Radiology ) 14180 CareCore National LLC (Oxford Radiology ) 14188 CareCore/WCNY RAD 65088 CareFlorida 25133 Carelink Medicaid 25133 Carenet 93975 CareOregon Inc. 65031 CarePlus Health Plans Inc. 77023 Carepoint Health Plans INCS1 Caresource Indiana Inc KYCS1 CareSource KY 31114 CareSource OH 95166 Cedars-Sinai Medical Network Services 95167 Cedars-Sinai Medical Network Services Encounters 68069 CeltiCare 91136 Cement Masons & Plasterers Health & Welfare Trust 68068 Cenpatico - Arizona 68068 Cenpatico - FL 68068 Cenpatico - Georgia 68068 Cenpatico - Indiana 68068 Cenpatico - OHIO 68068 Cenpatico - WI 68068 Cenpatico Behavioral Health 68068 Cenpatico Behavioral Health Texas 68068 Cenpatico Massachuetts 68068 Cenpatico New Hampshire 68068 Cenpatico South Carolina 42138 Cenpatico TPA 36474 Centegra Health System 68068 Centene Advantage Plans 42139 Centene TPA 94312 Center for Elders Independence 13360 CenterLight Healthcare 66698 CentraCare 26041 Central California Women's Health 36314 Central DuPage Physician Group 34097 Central Reserve Life 13193 Central Reserve Life Ins Co-Medicare Supplement 36215 Central States Health & Welfare Funds 77035 Central Valley Medical Group E3510 Central Valley Medical Group 42140 Centurion 36393 Century PHO INC 20356 Cerner HealthPlan Services 84146 CHAMPVA - HAC 16600 Chautauqua County Healthcare Plan (Mayville NY) ASK 7
94321 Children First Medical Group 84146 Children of Women Vietnam Veterans-VA HAC 94302 Chinese Community Health Plan 90441 CHP DIRECT SUPERMED 59355 Christian Care Ministry 75544 Christie Student Health Plans 10629 Christus Health Medicare Advantage 21062 Christus Health New Mexico HIX 62308 CIGNA 62308 CIGNA - PPA 62308 CIGNA - PPO SX071 CIGNA Behavioral Health 62308 CIGNA Health Plan - HMO 86033 CIGNA Medicare Advantage 52192 Cigna-Healthspring 46871 Cincinnati Financial Corporation 43056 Development Corporation 57080 Ware Inc. dba ManageMed 77201 Clearchoice Health Plan / COIHS EM843 CMS MMA SPECIALTY PLAN 37227 CNIC Health Solutions Inc. 47394 Coastal Care Services Inc 51579 Coastal Communities Physician Network 38335 Cofinity 91162 Columbia United Providers 88091 Commercial Travelers/PHX 23282 Community Care BHO 60995 Community Care Inc. - Family Care (Wisconsin) 39126 Community Care Inc. (Wisconsin) CCI01 Community Care IPA 73143 Community Care Managed Health Care Plans of Oklahoma 48145 Community Health Choice 60495 Community Health Choice-Health Insurance Marketplace 66170 Community Health Group 66121 Community Medical Group of the West Valley Inc. 95192 CommunityConnect HealthPlan 34177 Comp - Ohio (Austintown OH) 95192 Compcare (Wisconsin BadgerCare only) 37363 Compsych 19028 Concentrix Insurance Solutions 52196 Conifer (formerly InforMed) 55649 Conifer Value-Based Care 78375 Connecticare - Medicare 06105 ConnectiCare Inc 62308 Connecticut General (CIGNA) L0260 Constellation Health ASK 8
29076 Consumers Life Insurance Company 13193 Continental General Ins Co-Medicare Supplement 71404 Continental General Insurance Company 46478 Continuum Health Solutions LLC 55544 Conversion Plan-APWU THCP9 Cook Children Star Plan 35199 COOPERATIVE MANAGED CARE SERVICES SX009 CoOportunity Health 58204 Coordinated Medical Specialists CORIZ Corizon Health Inc. 35202 Cornerstone Benefit Adminstrators CMSP1 County Services Medical Program 25133 Coventry Advantra Texas 25133 Coventry Health & Life (Oklahoma) 25133 Coventry Health and Life Insurance Company administered by PersonalCare 25133 Coventry Health and Life Insureance (Tennessee) 25133 Coventry Health Care 25133 Coventry Health Care Encounters 25133 Coventry Health Care Carelink - West Virginia only 25133 Coventry Health Care Carelink Medicaid - West Virginia only 25133 Coventry Health Care National Network 25133 Coventry Health Care of Florida 25133 Coventry Health Care of Florida Inc. 25133 Coventry Health Care of Georgia Inc. 25133 Coventry Health Care of Illinois 25133 Coventry Health Care of Iowa Inc. 25133 Coventry Health Care of Kansas Inc. 25133 Coventry Health Care of Louisiana Inc. 25133 Coventry Health Care of Missouri 25133 Coventry Health Care of Nebraska Inc. 25133 Coventry Health Care of Nevada 25133 Coventry Health Care of the Carolinas 25133 Coventry Health Care of Virginia 128FL Coventry Healthcare of Florida 25133 Coventry Missouri 25133 Coventry of Health Care Delaware Inc. 25133 Coventry Summitt Health Plan Inc. 25133 CoventryCares of Kentucky 25133 CoventryCares of Michigan 25133 CoventryCares of Nebraska 25133 CoventryCares of Pennsylvania 46120 Crystal Run Health Plans 57080 CWIBENEFITS INC. 39113 Dean Health Plan 77124 DELANO IPA ASK 9
27009 Delaware Physicians Care Inc. 94235 Delta Health Systems 63740 DentaQuest Vision 84133 Denver Health and Hospital Authority 84134 Denver Health and Hospital Authority - Indigent Care 84135 Denver Health Medical Plan 84131 Denver Health Medical Plan Inc. - Medicare Choice 56240 Detroit Medical Center 25133 Diamond Plan (Maryland Medicaid) 06102 Diversified Administration Corporation - CT DREYR Dreyer Health 35186 Dunn and Associates Benefits Administrators Inc. 75299 East LA - APMG 66122 Eastland Medical Group 31074 EBMC 22521 EGID (Employees Group Insurance Division) 04326 ELDER SERVICE PLAN OF THE NORTH SHORE 03964 Elderwood Health 13551 Emblem Health (GHI - New York Group Health Inc.) 34167 Emerald Health Network Inc. (All PPO Business) 95600 Emergency Medical Services Fund - Orange County CA 38241 Employee Benefit Concepts (Farmington Hills MI) 31074 Employee Benefit Management Corp (EBMC) 75299 Employee Health System Medical Group 35112 Employee Plans LLC 75232 Employers Direct Health 75236 Employer's Direct Health - Employee Plan 75235 Employer's Direct Health - FI 75233 Employer's Direct Health - SF 35206 Encircle PPO 35206 Encore Health Network 91136 Enstar Natural Gas 36878 Entrust 62308 EQUICOR 62308 EQUICOR - PPO 73126 Equitable Plan Services (Oklahoma City OK) 20818 ESSENCE HEALTHCARE 34159 E-V Benefits Management Inc (Columbus OH) 71412 ExclusiCare 63740 EyeQuest 95432 Facey Medical Foundation 22254 Fallon Community Health Plan 45559 Fallon Total Care 14140 Farm Family Life 41041 Federated Mutual Insurance 11315 Fidelis Care New York ASK 10
77054 Fidelis Seniorcare 88055 First Agency 56196 First Carolina Care 91131 First Choice Health Administrators 91131 First Choice Health Network 75138 First Choice of Midwest (PPO) 37510 First Choice VIP Care 77009 First Choice VIP Care Plus - SC 73159 First Health Network (f.k.a. CCN Managed Care Inc. & PPO Oklahoma) 23241 First Priority 59276 First Service Administrator's Inc Lakeland Florida 11244 Fitzharris & Company Inc. 95411 FL MCO PHC/PHP 59321 Florida Hospital Healthcare Systems 26492 Florida True Health 25133 Foreign Service Benefit Plan 75299 Fresno - ENH Medical Group 99660 Fresno PACE 59204 Fringe Benefits Coordinators 34171 FrontPath Health Coalition 30005 Galveston County Indigent Health Care 75299 Gardena Memorial Medical Center 60550 Gateway Health Plan - Medicare Assured 25169 Gateway Health Plan Medicaid PA 91741 Gateway Health Plan OH- Medicare Assured 05506 Gateway Healthy PA 75273 Geisinger Health Plan 20376 Gemcare Health Plan 27133 Gemcare IPA 80314 GIC Indemnity Plan 07689 Global Care Inc. GEM01 Global Excel Management GHOKC Global Health 47083 GMS Inc. IP086 Good Samaritan Medical Practice Association 76923 Good Sheperd Hospice Inc 45235 Government Employees Health Association (GEHA PHCS) 44054 Government Employees Health Association (GEHA) 45275 Government Employees Health Association (GEHA-PHCS- 45275) 68069 Granite State Health Plan 13193 Great American Life Ins. Co-Medicare Supplement 39640 Great Lakes PACE 80705 Great-West Healthcare 63665 Great-West Healthcare (formerly American General) ASK 11
48143 Group and Pension Administrators 91051 Group Health Cooperative - WA State 95192 Group Health Cooperative of Eau Claire 91051 Group Health Options - WA State 38224 HAP/AHL/Curanet 58305 Harbor Advantage (Abrazo Health Care) 55649 Harbor Choice 70259 Harbor Health Plan 75126 Harpeth IPA - Amerivantage 99208 Hawaii Medical Assurance Association (HMAA/HWMG) 82018 HCS - Health Service (Boise ID) 25133 Health America Inc./Health Assurance/Advantra 42102 Health Care Network of Wisconsin (HCN) 34158 Health Design Plus (Hudson OH) 95570 Health Net - California (Professional Encounters ONLY) Encounters 68021 Health Net - VA Patient Centered Community Care Program 38309 Health Net of Arizona 95567 Health Net of California and Oregon - 62157 Health Partners - Jackson TN 83253 Health Plan of Michigan 76342 Health Plan of Nevada 76343 Health Plan of Nevada (Encounters) Encounters 68035 Health Plan of San Joaquin SX174 Health Plan of San Mateo 44273 Health Plans Inc. 41150 Health Services Management 34167 Health Services Preferred (HSP) by Emerald Health 73147 Healthcare Solutions Group 25133 Healthcare USA 85729 Healthcomp Inc. 95213 HealthEdge Administrators (Bakersfield CA) 80141 Healthfirst Health Plan of New Jersey 80141 Healthfirst Inc. (New York) 56144 Healthgram Inc 96475 Healthlink HMO 90001 Healthlink PPO SX009 HealthPartners MN 27514 HealthPlus Amerigroup 52429 Healthscope Benefits - EHC Repricing 75237 Healthsmart Accel 37272 HealthSmart Benefit Solutions 37283 HealthSmart Benefit Solutions 87815 HealthSmart Benefit Solutions fka Wells Fargo TPA.Inc. 75250 HealthSmart Preferred Care Inc. 71075 Healthsource AR (Med) (CIGNA) 02041 Healthsource CMHC ASK 12
58210 Healthsource GA (CIGNA) 61127 Healthsource KY 02041 Healthsource Massachusetts Inc. 01041 Healthsource ME 75255 Healthsource N. TX (CIGNA) 56147 Healthsource NC (CIGNA) 02038 Healthsource NH 31141 Healthsource OH 68195 Healthsource Provident 06119 Healthsource SC 62129 Healthsource TN (CIGNA) 34092 Healthspan 31434 HealthSpan Inc HSPAN HealthSpan Network Repricing 63092 HealthSpring HMO/HealthSpring Medicare+Choice HESUN Healthsun Health Plans 58213 Healthways WholeHealth Networks 45336 HealthyCT Inc 59230 Heritage Consultants 30862 Heritage Victor Valley Medical Group 36335 HFN Inc. 95393 High Desert Medical Group 47181 Highmark BCBSD Health Options Inc. 00046 Hill Physicians Medical Group 86066 HMA Hawaii 75299 Hollywood Presbyterian (Synermed) 88023 Hometown Health Plan Nevada 22326 Horizon NJ Health 91136 Hotel Employees & Restaurant Employees Health Trust 22521 HP Administrative Services LLC 37137 HSHS Medical Group IPA 13335 Hudson Health Plan 61101 Humana Emphesys 61101 Humana Employers Health Insurance 61101 Humana Inc. 61102 Humana Inc. Encounters Encounters 61101 Humana Insurance Company Choice Care Network 61125 Humana Military - Tricare South 61120 Humana Veterans Healthcare Services 94154 Humboldt-Del Norte Foundation for Medical Care 37279 IAA 97661 IEC Group - AmeriBen 75274 IHG Direct 68068 ILCBH 68069 IlliniCare 41600 IMCare ASK 13
40585 INDECS Corporation 45048 INDEPENDENT LIVING SYSTEMS 35161 Indiana ProHealth Network 35107 Indiana Teamsters Health Benefits Fund (Indianapolis IN) 95444 Indiana University Health Plan 31053 Individual Health Insurance Companies 96490 InforMed LLC 50946 Informed UHC 36348 Ingalls Provider Group 85578 Ingalls Provider Group 75299 Inland Valleys IPA 31182 Innovage 40025 Innovation Health 80087 Innovative Physician Associates LLC 37279 Insurance Administrators of America Inc. 13315 Insurance Design Administrators 86304 Insurers Administrative Corp. 31127 Integra Group 31129 Integra Group-CHA 34167 Integrated Care Network (ICN) by Emerald Health 60280 Interface EAP (IEAP) 23287 Intergroup Services Corporation 36609 International Brotherhood of Boilermakers 84137 InterWest Health (Acceptius Gateway payer) 10262 InTotal Health 61271 J. F. Molloy and Associates Inc. 41099 John Alden Life Insurance Co. 38310 JOHN MORRELL COMPANY CO. - AHPBA 68036 John Muir Mt. Diablo Health System 68036 John Muir Physician Network 52189 Johns Hopkins Healthcare (EHP/PP) 52123 Johns Hopkins Healthcare (USFHP) 43178 Joplin / Benefit Management Inc 34136 JP Farley Corporation 91617 Kaiser Foundation Health Plan of Colorado 94135 Kaiser Foundation Health Plan of Northern CA Region 94134 Kaiser Foundation Health Plan of Southern CA Region 52095 Kaiser Foundation Health Plan of the Mid-Atlantic States Inc. 93079 Kaiser Foundation of the Northwest 94123 Kaiser Permanente Health Plan of Hawaii 21313 Kaiser Permanente of Georgia 94320 Kaiser Self Funded 57038 Kanawha HealthCare Solutions Inc. 57038 Kanawha Insurance Co. KCIPA Kane County BCBS 95279 Keenan Associates (CA) ASK 14
KELSE Kelseycare 77894 Kentucky Health Cooperative 68069 Kentucky Spirit Health Plan 28021 Kern County CDCR 77039 Kern Health Systems 95460 Key Health Medical Solutions Inc 77050 Keystone Connect (Amerihealth) 23284 Keystone First 84223 Keystone VIP Choice 34145 Klais & Company 3414A Klais & Company (Repricing for HealthSpan Network Only) 68068 KS - Cenpatico Kansas 68069 KS - Sunflower State Health 68068 KY - Cenpatico Kentucky 37116 Lake County Physicians Association 66127 Lakeside Comprehensive Healthcare 66125 LakeSide Medical Group LNDMK Landmark Healthcare Inc NMM02 LaSalle Medical Group 33LGC Life Gift Cards 41136 Life Trac 71498 LifeCircles PACE 76870 LifePath Hospice Inc 27005 Lifestyle Health Plans EBSRM Lifetime Benefit Solutions 93093 LifeWise Healthplan of Oregon 35107 Local 135 Health Benefits Fund (Indianapolis IN) 33036 Loma Linda University Health Care Managed Care Dept 88075 Louisiana Health Cooperative 68069 Louisiana Healthcare Connections 13193 Loyal American Life Ins Co-Medicare Supplement 01260 Magellan Health Services 68069 Magnolia 25133 Mail Handlers Benefit Plan 35162 Managed Care Services LLC 36312 MANAGED HEALTH CARE ASSOCIATES 22771 Managed Health Network 68069 Managed Health Services Indiana (Medicaid HMO) 68069 Managed Health Services Wisconsin 98010 Manulife W. J. Sutton Company 52461 March Vision Care Inc. 53275 Martin's Point Health Care 25133 Maryland Medicaid 22348 Maryland Physicians Care 95019 Matrix - Health First Health Plan 88090 Mayo Clinic FL/GA ASK 15
41154 Mayo Clinic Health Solutions 83028 MBA Benefit Administrators Inc (Salt Lake UT) 25160 MCA Administrators Inc. 80026 MDI Holdings (Formerly Medical Partners of America) 20475 MDwise Excel Network SX172 MDwise Inc. MDXHI MDX Hawaii 88058 MED PAY EM216 MED3000 EM350 MED3000 CMS EARLY STEPS EM284 MED3000 CMS SAFETY NET EM205 MED3000 CMS TITLE 21 EM521 MED3000 COVENTRY HEALTHY KIDS EM039 MED3000 PEDICARE TITLE 19 EM522 MED3000 PEDICARE TITLE 21 58202 MedAdmin Solutions 58204 MedAdmin Solutions 74323 MedBen (Newark OH) 59231 MedCom 56162 MedCost Inc. 95321 Medfocus 94265 Medica (UHC) 12422 Medica2 MAHC1 MEDICAL ASSOCIATES HEALTH PLAN 74323 Medical Benefits Administrators Inc. (Newark OH) 74323 Medical Benefits Companies (Newark OH) 74323 Medical Benefits Mutual (Newark OH) 74323 Medical Benefits Mutual Life Insrance Co. 52181 MEDICAL DEVELOPMENT INTERNATIONAL 29076 Medical Mutual of Ohio 12057 Medical Services Initiative 38224 Medical Value Plan - Ohio (MVP) 23160 Medico Life and Health Insurance Company 95655 MediGold 33LGC Mediphe STAR1 Mediview Inc. 21547 MedSettlements LLC 251MS Medstar Select/Medstar Medicare Choice 59065 Memorial Integrated Healthcare/South Florida Community Care Network 86052 Mercy Care Plan (AHCCCS) 43166 Mercy Health Plans 33628 Mercy Maricopa Integrated Care 43185 Mercy Provider Network 39114 MercyCare 13189 Meridian Health Plan ASK 16
64157 Meritain Health 64158 Meritain Health / Agency Services 41124 Meritain Health Minneapolis 45150 Meritus Health Partners 13265 MetroPlus Health Plan 10850 Metropolitan Health Plan 23550 MFC & HealthPlus Peoria 74289 MHNET 68069 Michigan Fidelis Secure Care 77012 MidCoast IPA 47080 Midlands Choice Inc. 76079 Midwest Health Partners 94115 Mills Peninsula Medical Group(SPS) 64084 Mississippi Physicians Care Network 64088 Mississippi Select Health Care 68068 MO - Cenpatico Missouri 68069 MO - Missouri Home State Health Care 33373 Molina Healthcare of California - Encounters Only Encounters 38333 Molina Healthcare of California ( only) 38334 Molina Healthcare of MICHIGAN 81794 Molina Healthcare of Puerto Rico SX109 Molina Healthcare Utah (aka American Family Care) 20934 Molina Illinois 16098 Monitor Life Insurance Company 13174 Montefiore Contract Management Organization 46161 Montefiore HMO TLINS Monumental Life Insurance Company TRCLF Monumental Life Insurance Company TRLTC Monumental Life Insurance Company TRP1E Monumental Life Insurance Company TRP1P Monumental Life Insurance Company 35092 MORRIS ASSOCIATES 99282 Motion Pictures Industry 86040 Mountain States Administrative Services (Tucson AZ) 68068 MS - Cenpatico Mississippi 80019 MSC (Medical Service Company) Group Inc 95655 Mt. Carmel Health 75299 Multicultural Primary Care Medical Group (San Diego) (Synermed) 34080 Multiplan Wisconsin Preferred Provider Network 34192 Mutual Health Services 71412 Mutual of Omaha Insurance Company 71412 Mutually Preferred 14165 MVP Health Plan of NY 33020 My Family Medical Group 91136 N.W. Ironworkers Health & Security Trust Fund ASK 17
91136 N.W. Roofers & Employers Health & Security Trust Fund 91136 N.W. Textile Processors 65085 NAA (North America Administrators L.P.) (Nashville TN) 34159 NABN (Cleveland OH) 53011 NALC/Affordable L0110 NAMCI/Global Care CB148 National Allied Workers Union Local 831 53011 National Association of Letter Carriers 53011 National Association of Letter Carriers/NALC 90001 National Capital Preferred Provider Organization (NCPPO) SX190 National Imaging Associates 52120 National Telecommunications Cooperative Association 31417 Nationwide Health Plans 96107 Neighborhood Health Partnership (NHP) 04293 Neighborhood Health Plan (Boston MA) 05047 Neighborhood Health Plan of Rhode Island (NHPRI) 96240 Neighborhood Health Plan RI - Exchange Unity Integrity 58204 Network TPA LLC 90091 Nevada Health Coop 11334 New York Network Management 88050 NHBCAUX 22603 NJ Carpenters Health Fund 34159 North American Benefits Network (Cleveland OH) E3510 North American Medical Management (NAMM) - Northern California E3510 North American Medical Management (NAMM) - Southern California 17516 North Shore - LIJ (Healthfirst) 46227 North Shore - LIJ CareConnect Insurance Company Inc. 35212 North Texas Healthcare Network 38238 Northern California Sheet Metal Workers Health Care Plan 36347 Northern Illinois Health Plan 88027 Northern Nevada Trust Fund 36364 NorthShore University Health System Medical Group 60058 Northstar Advantage NPN11 Northwest Physicians Network 36346 Northwest Suburban IPA (Illinois) 36402 OAK WEST PRIMARY PHYSICIAN ASSOCIATION L0140 Ocular Benefits 13350 ODS Health Plan 34189 Ohio Health Choice PPO 68037 OMNI/Medicore HP 57116 OneCare 52149 OneNet PPO (formerly Alliance PPO / MAPSI) 91136 Operating Engineers Locals 302 & 612 Health & Security Fund ASK 18
56190 OptiCare Managed Vision 52152 Optimum Choice of the Carolinas Inc. (OCCI) 41194 Optum? Complex Medical Conditions (CMC) (formerly OptumHealth Care Solutio LIFE1 Optum Medical Network / AZ UT (formerly Lifeprint Network) OptumHealth OptumHealth / OptumHealth Behavioral Solutions of NM 33053 OptumHealth Behavioral Solutions (formerly Pacificare Behavioral Health) OptumHealth Behavioral Solutions (formerly United Behavioral Health) 41194 OptumHealth Care Solutions (formerly United Resource Networks) 41194 OptumHealth Care Solutions (formerly United Resource Networks) Encounters 52190 OptumHealth Care Solutions (formerly United Resources Networks 41160 OptumHealth Physical Health - includes Oxford (formerly ACN & ACNIPA) 41161 OptumHealth Physical Health - includes Oxford (formerly ACN & ACNIPA) 65021 Orange County Health Care Agency 45332 Oregon's Health CO-OP 13382 Orthonet - Uniformed Services Family Health Plan 13383 Orthonet- Aetna 13381 Orthonet Corporation - CIGNA 25681 Orthonet-HealthNet 22521 OSEEGIB (Oklahoma State and Education Employees Group Ins. Board) 73071 OSMA Health - C. L. Frates 70454 PACE CNY 86711 PACE Southeast Michigan 75299 Pacific Alliance Medical Center 75299 Pacific Alliance Medical Group and Hospital (Synermed) 93029 PacificSource Health Plans 37287 PAI 04218 Pan American Life Insurance Group 66917 Parkland Community Health Plan 27048 Payer Fusion 68069 Peach State Health Plan 72126 Peoples Health Network 72099 PHCS (formerly American LIFECARE) 13306 PHCS Savility Payers 55649 Phoenix Choice 03440 Phoenix Health Plan (Medicaid) 03443 Phoenix Health Plans (Medicare - Abrazo) ASK 19
58204 Physician Associates of Louisiana 58204 Physician Care Network LLC 57549 Physician Health Cooperative/SRRIPA PHPMD Physician Health Partners 28943 PHYSICIAN'S ACCOUNTABLE CARE ORG 38265 Physicians Care (ASR Corporation) 38265 Physicians Care Health Plans (ASR Corporation) 38265 Physicians Care Network (ASR Corporation) 36345 Physicians Care Network (Rockford IL only) PCN12 PHYSICIANS CARE NETWORK LLC/Polyclinic Seattle 37136 Physicians Health Association of Illinois 20398 Physicians Health Collaborative 09173 Physicians Health Plan (PHP) - SC PMGSC Physicians Medical Group of Santa Cruz County 39156 Physicians Plus Insurance Corporation 251PD Piedmont WellStar Health Plan 24735 Pinnacle Management Inc. 84109 Pinnacol Assurance 23283 Pittsburgh Care Partnership Inc. 37287 Planned Administrators Inc. 58204 Podi Care Managed Care 59324 PODIATRY NETWORK FL 38335 PPOM LLC UHNDC PPONE 72148 PPOPlus LLC 65088 Preferred Care Partners Encounters 65088 Preferred Care Partners Florida 73145 Preferred Community Choice/PCCSelect/CompMed 61106 Preferred Health Plan (Louisville KY) 61665 Preferred Health Systems A Coventry Health Care Plan 60110 Preferred Health Systems Insurance Company 36401 Preferred Network Access Inc. 60110 Preferred Plus of Kansas 41147 PreferredOne (MN) 43166 Premier Benefits Inc. PCI01 Premier Care IPA 251PR Premier Health Plan 43166 Premier Health Plans 29076 Premier Health Systems Inc. 88056 Premier HealthCare Exchange 88051 Premier Healthcare Exchange Inc. (PHX) 05003 Presbyterian (NM) 77003 Prestige Health Choice 82048 Primary Health Network 61604 PrimeWest Health 61271 Principal Financial Group ASK 20
38217 Priority Health 38329 Pro Care Health Plan Inc. (Detroit MI) SX133 Providence of Oregon Health Plan SX187 Providence PPO 13193 Provident American Life & Health Ins Co-Medicare Supplement 48100 ProviDRs Care Network PSKW0 PSKW 91136 Puget Sound Benefits Trust 91136 Puget Sound Electrical Workers Trust 39197 Quad Med LLC (Pewaukee WI) 35174 Qual Choice of Arkansas 73067 QuikTrip 57117 QVI Risk Solutions Inc. 33065 Rady Children's Hospital 91176 RBMS LLC 75299 Redlands IPA (Synermed) 95449 Regal Medical Group 76066 Renaissance Physicians Organization RPPG1 Resurrection Physician Provider Group 26316 Retiree Health Trust 37331 RightChoice Benefit Administrators 88035 Risk Administration Management Inc. RCMG1 RIVER CITY MEDICAL GROUP 16117 RMSCO INC. SX141 Rocky Mountain Health Plan - Grand Junction 25133 Rural Carrier Benefit Plan 36389 Rush Prudential Health Plans (HMO Only) 31441 S & S Healthcare Strategies 75299 Sacramento - Primary Care Practices of Sacramento - EHS 35164 Sagamore Health Network 37105 Sage Technologies CP001 Samaritan Employer Group Plans CP001 Samaritan Health Plans MSO77 San Diego County Coverage Initiative (CI) MSO11 San Diego County Medical Services (CMS) MSO33 San Diego County Ryan White Care Act 96400 San Diego PACE 68035 San Joaquin Health Administrators 33072 San Louis Obispo Select 91184 Sanford Health Plan 24077 SANTA CLARA FAMILY HEALTH PLAN 77038 Sante Health System and Affiliates 72261 SCAN Health Plan 73172 Scan Health Plan Arizona 16146 SCHC Total Care - Net ASK 21
SDCOM Scion Dental Commercial E4618 Seaside Health Plan Encounters 28530 Secure Health Plans of Georgia LLC 39045 Security Health Plan 64088 Select Administrative Services (SAS) 93031 Select Benefit Administrators Inc. 37282 Select Benefit Administrators of America 23285 Select Health of South Carolina 76045 SelectCare of Texas (HPN) Heritage Physicians Network 34131 Self-Funded Plans Inc. 36390 Senior Care Partners 80141 Senior Health Partners (SHP) 83035 SENIOR WHOLE HEALTH 23249 Sentinel Management Services 39033 Sentry Insurance a Mutual Company 39033 Sentry Life Insurance Company 39033 Sentry Life of New York SMG01 Seoul Medical Group 76056 Seton CHIP 62308 Seton Employee Plan 25404 Seven Corners 38238 Sheet Metal Workers Local 104 Health Care Plan (San Ramon CA) 76342 Sierra Health and Life 76343 Sierra Health and Life (Encounters) Encounters 30891 Sierra Medical Group 23250 Significa Benefits Services Inc. 65093 Silver Cross Health Connection 84096 Sloans Lake Preferred Health Networks 02057 Smith Administrators 91131 Sound Health (now known as First Choice Health Network) 25147 SouthCare/Healthcare Preferred 77153 Southeastern Indiana Health (SIHO) 75299 Southern CA Children's Network (SynerMed) SIPA1 Southland BCBS 84146 Spina Bifida - VA HAC 35199 St. Anthony Memorial Healthcare Centers - MDWISE 22240 St. Barnabas System Health Plan 35199 St. Catherine Hospital PHO - MDWISE 35199 St. Francis Health Network 35199 St. Margaret Mercy Healthcare Centers - MDWISE 73099 Standard Life and Accident Insurance Company 46450 State Auto Insurance Companies 31053 State Farm Insurance Companies 57254 State of Texas Dental Plan 67829 Sterling Medicare Advantage ASK 22
91151 Sterling Option 1 TRLTC Stonebridge Life Insurance Company TRP1E Stonebridge Life Insurance Company TRP1P Stonebridge Life Insurance Company 31121 Stoner and Associates (Cincinnati OH) 57492 Stones River IPA - Amerivantage 15750 Stones River Regional IPA/BCBST 15754 Stones River Regional IPA/BHFG 15752 Stones River Regional IPA/Windsor 95202 SummaCare Health Plan 68069 Sunshine State Health Plan 23218 Superior Administrators Inc (Santa Ana CA) 68069 Superior Health Plan Texas 77318 Sutter Delta Medical Group 94269 Sutter East Bay Medical Foundation 96176 Sutter East Bay Regional Hospital 94119 Sutter East Bay Regional Hospital- Non Sutter Group 77302 Sutter Gould Medical Foundation 77304 Sutter Medical Group of the Redwoods 36411 Swedish Covenant Hospital 88067 Tall Tree Administrators 88019 Teachers Health Trust 36215 Teamcare 88054 TEAMSTERS (UT/ ID / MT) - Group Benefit Admin 75299 Temple Community Hospital 33104 Texas HealthSpring 88461 The Alliance 75600 The City of Odessa 20356 The Health Exchange (Cerner Corporation) 34150 The Health Plan (Massillon Ohio and St. Clairsville Ohio only) 35206 The Healthcare Group 59087 The National Radiology Network 31074 The Physicians Assurance Corp (TPAC) /Employee Benefit Management Corp (EBM 92620 Tongass Timber Trust 31182 Total Community Care 38201 Total Healthcare Inc. 31182 Total Long Term Care 31074 TPAC/Employee Benefit Management Corp 37230 TR Paul Inc. PARTD Transact RX RX001 TransactRX Infusion and Specialty TLINS Transamerica Financial Life Insurance Company TRLTC Transamerica Financial Life Insurance Company TRP1E Transamerica Financial Life Insurance Company TRP1P Transamerica Financial Life Insurance Company ASK 23
TLINS Transamerica Life Insurance Company TRLTC Transamerica Life Insurance Company TRP1E Transamerica Life Insurance Company TRP1P Transamerica Life Insurance Company TLINS Transamerica Premier Life Insurance Company TRCLF Transamerica Premier Life Insurance Company TRLTC Transamerica Premier Life Insurance Company TRP1E Transamerica Premier Life Insurance Company TRP1P Transamerica Premier Life Insurance Company 20807 Transchoice or TransSmile - First Service Administrator's Inc 36397 Trellis Health Partners 31118 Tribute Health Plan 57106 Tricare North Region SX163 Tricare Overseas SCWI0 Tricare West 62777 TRILOGY NETWORK 98514 TRLHN/AS 91078 Trusteed Plans Service Corporation 04332 Tufts Health Plan 94603 UC-Davis Health 77022 Ultimate Health Plan 41206 Ultra Benefits Inc. 79480 UMR (formerly UMR Onalaska) 52180 UMWA Health & Retirement Funds 80314 UNICARE 62170 Unified Health Services 34638 Unified Physicians Network TRP1E Union Labor Life Insurance Company - Admin By UBC 87042 UNION PACIFIC RAILROAD EMPLOYES Health Systems 70408 Union Security Insurance Company 62183 Unison Health Plan/Better Health Plans 36659 United Food & Comm. Workers Midwest Unions 84132 United Medical Alliance 71412 United of Omaha 13193 United Teacher Assoc Ins Co-Medicare Supplement UnitedHealthcare 81400 UnitedHealthCare / All Savers Alternate Funding UnitedHealthcare / Definity Health Plan UnitedHealthcare / Empire Plan UnitedHealthcare / MAHP - MD IPA Optimum Choice MLH (formerly MAMSI) 06111 UnitedHealthcare / Oxford 00773 UnitedHealthcare / Spectera Eyecare Networks UnitedHealthcare / UnitedHealthcare Plan of River Valley 95378 UnitedHealthcare / UnitedHealthcare Plan of River Valley ASK 24
UnitedHealthcare / UnitedHealthcare West (UnitedHealthcare of CA OK OR 95958 UnitedHealthcare / UnitedHealthcare West Encounters (formerly Encounters PacifiCare) 03432 UnitedHealthcare Community Plan / AZ (formerly AZ Physicians IPA APIPA) UnitedHealthcare Community Plan / IA hawk-i (formerly AmeriChoice of Iowa) 95378 UnitedHealthcare Community Plan / IA hawk-i (formerly AmeriChoice of Iowa) 96385 UnitedHealthcare Community Plan / KS (KanCare) 95467 UnitedHealthcare Community Plan / MI (formerly Great Lakes Health Plan) UnitedHealthcare Community Plan / MS CHIP (formerly AmeriChoice MS - CHIP) 95378 UnitedHealthcare Community Plan / MS CHIP (formerly AmeriChoice MS - CHIP) UnitedHealthcare Community Plan / NE 86001 UnitedHealthcare Community Plan / NJ 86047 UnitedHealthcare Community Plan / NJ 86048 UnitedHealthcare Community Plan / NY (formerly AmeriChoice NY Medicaid) 86002 UnitedHealthcare Community Plan / NY (formerly AmeriChoice Personal Care) 86049 UnitedHealthcare Community Plan / PA (formerly AmeriChoice PA Medicaid&CHIP 86003 UnitedHealthcare Community Plan / PA (formerly AmeriChoice Personal Care ) 25175 UnitedHealthcare Community Plan / SC (formerly Unison) UnitedHealthcare Community Plan / UnitedHealthcare Dual Complete UnitedHealthcare Community Plan / UnitedHealthcare Long UnitedHealthcare Community Plan of Louisiana 25175 UnitedHealthcare Community Plan/DEFLHILAMDMS CANNMOHPARI TX WA UnitedHealthcare Community Plan/DEFLHILAMDMS CANNMOHPARITXWAWI UnitedHealthcare Community Plan/FLHILAMDMS CANNMOHRITXWI 86001 UnitedHealthcare Community Plan/NJ (formerly AmeriChoice Personal Care Pl UnitedHealthcare Medicare Solutions / UnitedHealthcare Chronic Complete UnitedHealthcare Medicare Solutions / UnitedHealthcare Group Medicare Advan ASK 25
UnitedHealthcare Medicare Solutions / UnitedHealthcare MedicareComplete UnitedHealthcare Medicare Solutions / UnitedHealthcare MedicareDirect UnitedHealthcare Medicare Solutions / UnitedHealthcare 74227 UnitedHealthcare StudentResources 95964 UnitedHealthcare West (formerly PacifiCare of Arizona) 95962 UnitedHealthcare West (formerly PacifiCare of Colorado) 95999 UnitedHealthcare West (formerly PacifiCare PPO - All States) 95959 UnitedHealthcare West / UnitedHealthcare of CA OK OR TX WA 37602 UnitedHealthOne / Golden Rule 81400 UnitedHealthOne / PacifiCare Life and Health Insurance Company 66705 Unity Health Insurance 95380 Universal American Financial Services TRP1E Universal Benefits - Admin For Chubb Life Insurance Company Of America TRP1E Universal Benefits - Admin For City Of Bridgeport CT TRP1E Universal Benefits - Admin For Hartford Life And Accident Insurance Co TRP1E Universal Benefits - Admin For Hartford Life Insurance Company 33001 Universal Care - California 09830 University Family Care 09908 University Family Care - Maricopa Health Plan 99026 University Health Alliance 46407 University Health Care Advantage 45437 University Healthcare Marketplace 25133 University of Missouri 23281 UPMC Health Plan 25184 UPMC Vision Advantage 93092 US Benefits 90551 US Family Health Plan 74095 USAA (United Services Automobile Association) 13407 USFHP - St. Vincent Catholic Medical Centers of New York 25133 UT- Altius (UHIN) 91136 UW Graduate Appointee Plan 12115 VA Fee Basis Programs 64009 Valir Pace 55912 VA-Patient-Centered Community Care Program (VAPCCC) 55915 VA-Patient-Centered Community Care Program (VAPCCC) Region 5A 55916 VA-Patient-Centered Community Care Program (VAPCCC) Region 5B ASK 26
55917 VA-Patient-Centered Community Care Program (VAPCCC) Region 6 86062 VentureNet Healthcare 66126 Verdugo Hills Medical Group 75256 Verity National Group 50701 VGM Homelink 48123 Via Christi HOPE 84806 Virginia Coordinated Care-VCC 54176 Virginia Premier Health Plan 31626 VNA Homecare Options 77073 VNS CHOICE Medicare 68069 WA - Washington Coordinated Care 85256 Wabash Memorial Hospital Association 73155 Waterstone Benefit Administrators (Oklahoma Providers) 23051 Waterstone Benefit Administrators (Outside Oklahoma) 13337 Well Sense Health Plan WELM2 WellMed 35245 WellSystems LLC 91064 Wenatchee Valley Medical Center 66124 West Covina Medical Group 45276 West Virginia Family Health Plan 24735 Western Grower's Assurance Trust 24735 Western Grower's Insurance Company 37247 Western Mutual Insurance TRLTC Western Reserve Life Insurance Company 38232 Weyco Inc. 93050 William C. Earhart 41095 Wilson-McShane 62153 Windsor Medicare Extra 74101 Wisconsin Department of Corrections 77080 WPP-ElderCare Wisconsin SX022 WPS Health Insurance ASK 27