Payer 835 List
Payer ID
Payer Name
AARP1
CX052
CX052
91136
80705
80705
87815
52133
43168
60054
95340
75261
60054
68246
91136
91136
91136
91136
91136
52133
47009
84103
80705
84105
84105
84105
CB923
81883
25133
39065
CX052
91136
36342
R7003
53589
CBAL1
47570
83470
47198
52133
84099
00700
84105
CBGA1
84105
CB621
84105
CBIA1
CBKS1
47171
84105
89070
23739
FX136
89070
CBMA1
AARP Dental Insurance Plan (Mechanicsburg, PA)
AD-Medicaid (Atlantic Dental, Inc)(Mequon, WI)
ADI -Medicaid (Atlantic Dental, Inc)(Coral Gables, FL
AGC- I.U.O.E Local 701 trust Funds
AH & L (Anthem Health & Life Ins of NJ)(Kennett, MO)
ALTA Health & Life Ins. Co. (Kennett, MO)
Accordia National (Charleston, WV)
Advantage Health Solutions (Salt Lake City, UT)
Advantica Administrative Svcs (St. Louis, MO)
Adventis Risk Management Inc
Adventist Health Claims (Roseville, CA)
Adventist Risk Management (Grapevine, TX) Old PO Box
Aetna
Aetna US Healthcare Encounters (PO Box 14530, Lexingt
Alaska Children's Services, Inc.
Alaska Hotel Restaurant and camp
Alaska Laborers Construction Industry Trust (Seattle, WA
Alaska Pipe Trades Local 375 (Seattle, WA)
Alaska United Food & Comm. Workers Health & Welfare
American Choice (Thiensville, WI)
Ameritas Life Insurance Corp. (Lincoln, NE)
Anthem (PO Box 1115, Minneapolis, MN)
Anthem Health & Life Insurance Co of New Jersey/AH&L
Anthem of CT (PO Box 547 North Haven, CT)
Anthem of CT (PO Box 9274, Oxnard, CA)
Anthem of TX (Po box 659444, texas)
Anthem of Virginia (Richmond, VA)
Arkansas Municipal Health Benefit (N Little Rock AR)
Associated Benefit Plan (London, KY)
Assurant Health (PO Box 2806, Clinton, IA)
Atlantic Dental Inc-Medicaid (Coral Gables, FL)
Automotive Machinists Local 289 Health & Welfare Trust
Benefit Systems & Services, Inc. (Westmont, IN)
Benefit, Inc. (Roseville, MN)
Blue Cross of AZ (Phoenix, AZ)
Blue Cross of Alabama (Birmingham, AL)
Blue Cross of Alaska & Washington (Anchorage, AK)
Blue Cross of Arkansas (PO Box 1206 Elk Grove Village, I
Blue Cross of CA (Oxnard, CA)
Blue Cross of CA (PO Box 272590 & 272540, Chico, CA)
Blue Cross of Colorado/Anthem - Colorado Springs, CO
Blue Cross of Connecticut (Blue Care Family Plan) (North
Blue Cross of Connecticut (PO Box 547 North Haven, CT)
Blue Cross of GA (Columbus, GA)
Blue Cross of IN (PO Box 188, Mpls., MN)
Blue Cross of Illinois (Oak Brooke Terrace, IL)
Blue Cross of Indiana Anthem (Louisville, KY)
Blue Cross of Iowa (FEP claims only) (Des Moines)
Blue Cross of Kansas (Topeka, KS)
Blue Cross of Kansas City (MO)
Blue Cross of Kentucky/Indiana/Ohio Anthem - Louisville,
Blue Cross of LA Advantage Plan (PO Box 69441)
Blue Cross of Louisiana (Baton Rouge, LA)
Blue Cross of MD (14111-14116, Lexington, KY)
Blue Cross of MN (Harrisburg, PA)
Blue Cross of Massachusettes (North Quincy, MA)
Payer 835 List
Payer ID
Payer Name
CBMI1
CBMS1
CBMT1
52133
55093
CBNY1
CBNE1
84101
22099
84100
CX004
00840
84105
CB850
54771
CB870
38520
CB900
CBUT1
CBUTF
84103
CB923
CB950
47570
93200
47198
CBID2
47009
CPPCA
84147
71063
37227
42141
CPPCA
FX136
91136
34097
61271
62308
75261
77828
62308
62308
52132
35182
35180
75136
35182
25133
25133
25133
25133
25133
25133
25133
06172
Blue Cross of Michigan (Detroit, MI)
Blue Cross of Mississippi (Jackson, MS)
Blue Cross of Montana (Helena, MT)
Blue Cross of NC (Mailed to Salt Lake City, UT)
Blue Cross of NY (Empire) Claims sent to MN
Blue Cross of NY - Empire
Blue Cross of Nebraska (Omaha, NE)
Blue Cross of Nevada - Colorado Springs, CO
Blue Cross of New Jersey (Horizon) (Newark, NJ)
Blue Cross of New Mexico Dental
Blue Cross of North Dakota (ND Dental Services) (Fargo,
Blue Cross of OK (PO Box 23100 Belleville, IL)
Blue Cross of Ohio Anthem (Louisville, KY)
Blue Cross of Oregon (Portland, OR)
Blue Cross of PA - Highmark
Blue Cross of Rhode Island (providence, RI)
Blue Cross of South Carolina (Columbia/Charleston SC)(P
Blue Cross of Texas (Dallas, TX)
Blue Cross of UT BCBS (PO Box 30270, Salt Lake City, U
Blue Cross of UT-FEP (PO Box 30272, Salt Lake City, UT)
Blue Cross of VA - Trigon (Colorado Springs, CO)
Blue Cross of VA / Anthem (Richmond, VA)
Blue Cross of WI (United)
Blue Cross of Washington & Alaska(Anchorage, AK)
Blue Cross of Washington (PO Box 30271 SLC UT)(PO Bo
Blue Cross/Trust Fund (San Antonio, TX)
Blue Shield of Idaho(PO Box 31603 Salt Lake City, UT)
Businessmen Assurance (NE)
CA Health Families (Sacramento, CA)
CHAMPVA - HAC - Denver, CO
CNA Health Partners of Arkansas
CNIC Healthcare Services (Englewood/Colorado Springs,
CTI Administrators (Des Moines, IA)
California State Gov. Programs
CareFirst (PO Box 14111 - 14116) (Lexington, KY))
Cement Masons & Plasters Health & Welfare Trust (Seatt
Central Reserve Life (Eagan, MN)
Christian Brothers Services (Colorado Springs, CO)
Cigna
Community Health Electronic Claims
Companion Life (PO Box 100102, Columbia, SC)
Connecticut General (Bloomfield, CT)
Continental Dental
(Plantation, FL)
Cooperative Benefit Administrators (CBA) (Lincoln, NE)
Core Source (Po Box 2920, Clinton IA)
CoreSource (NC, IN) (Charlotte, NC)
CoreSource of Little Rock (Little Rock, AR)
CoreSource of PA MD IL (Lancaster, PA)(Clinton, IA)
Coventry Health
Coventry Health & Life OK
Coventry Health (241508 Charlotte, NC)
Coventry Health (PO Box 241508 Charlotte, NC)
Coventry Health (PO Box 8403,8400,8402, London, KY)
Coventry Health (PO box 8403,8400,8402, London, KY)
Coventry Health Care of KS
Dart Management Corp. (Mason, MI)
Payer 835 List
Payer ID
Payer Name
07035
07035
CDIAM
66043
94276
94276
86027
CDAR1
77777
CDCA1
22189
51022
94276
94276
82029
05030
CDIN1
CDIA1
CDKS1
CDKY1
94276
02027
23166
CDMI0
CDMN1
94276
94276
CDNE1
94276
02027
22189
85022
11198
56101
CDND1
CDOH1
CDOK1
23166
660436769
CDTN1
94276
94276
02027
52147
91062
31096
39069
CPPCA
CX014
52133
52133
52133
64246
DNOA1
DSL01
CX004
DeCare (PO Box 1348, Mpls., MN) Northwest Employees
DeCare (Po Box 709, MPLS MN)
Delta Dental IA - Dental Wellness Plan (Johnston, IA)
Delta Dental Peurto Rico (San Juan, PR)
Delta Dental of Alabama ( Irving, TX)
Delta Dental of Alaska (Irving, TX)
Delta Dental of Arizona
Delta Dental of Arkansas
Delta Dental of California (PO Box 997330, Sacramento,
Delta Dental of California(Tricare) - PO Box 537007-537
Delta Dental of Connecticut (Parsipanny, NJ)
Delta Dental of Delaware (Mailed to Mechanicsburg, PA)
Delta Dental of Florida (Irving, TX)
Delta Dental of Georgia (Alpharetta, GA)
Delta Dental of Idaho (Boise, ID)
Delta Dental of Illinois (Lisle, IL)
Delta Dental of Indiana (Farmington Hills, MI)
Delta Dental of Iowa (Ankeny, IA)
Delta Dental of Kansas(Whichita, KS)
Delta Dental of Kentucky(Lousiville, KY)
Delta Dental of Louisiana(Irving, TX)
Delta Dental of Maine (Northeast)
Delta Dental of Maryland(Mechanicsburg, PA)
Delta Dental of Michigan(Farmington Hills, MI)
Delta Dental of Minnesota(Minneapolis, MN)
Delta Dental of Mississippi (Irving, TX)
Delta Dental of Montana (Sacramento, CA)
Delta Dental of Nebraska(Minneapolis, MN)
Delta Dental of Nevada (Irving TX)
Delta Dental of New Hampshire (Northeast)
Delta Dental of New Jersey (Parsipanny, NJ)
Delta Dental of New Mexico(Albuquerque, NM)
Delta Dental of New York (Mechanicsburg, PA)
Delta Dental of North Carolina(Farmington Hills, MI & Sa
Delta Dental of North Dakota(Bismark ND)
Delta Dental of Ohio(Farmington Hills,MI)
Delta Dental of Oklahoma(Oklahoma City, OK)
Delta Dental of Pennsylvania(Mechanicsburg, PA)
Delta Dental of Peurto Rico
Delta Dental of Tennesse (Nashville, TN)
Delta Dental of Texas(Irving TX)
Delta Dental of Utah (Irving TX)
Delta Dental of Vermont (Northeast)
Delta Dental of Washington DC (Mechanicsburg, PA)
Delta Dental of Washington-State
Delta Dental of West Virginia
Delta Dental of Wisconsin Stevens Point, WI)
Delta Dental-Health Families (Sacramento, CA)
DentaQuest (WI)
Dental Benefit Providers (CA) (San Fransico, CA)
Dental Benefit Providers (Thiensville, WI)
Dental Benefit Providers\United Health - Bethesda, MD,U
Dental Guard Preferred (Spokane, WA)
Dental Network of America (IL)
Dental Select (Draper, UT)
Dental Service Corp (Fargo, ND)
Payer 835 List
Payer ID
Payer Name
67814
94146
CX089
37272
CX014
CX014
CX014
CX014
CX014
CX014
CKKY3
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX014
CX079
62308
CX079
55093
47009
59297
91136
43168
93240
71412
91136
89070
72630
DenteMax (Wellesley Hills)
Denti-Cal (Medicaid of California) (Sacramento, CA)
Desert Mutual Benefit Admin (Salt Lake City, UT)
Direct Reimbursement Benefits (Newnan, GA)
Doral
Doral Dental of Arizona
Doral Dental of Arizona--CIGNA
Doral Dental of Connecticut
Doral Dental of Illinois
Doral Dental of Illinois
Doral Dental of Kentucky / Region 3 (Mequon , WI)
Doral Dental of Maryland Helix
Doral Dental of Maryland Physicians Care
Doral Dental of Maryland Priority partners
Doral Dental of Minnesota
Doral Dental of Minnesota Medicare
Doral Dental of Missouri St. Louis
Doral Dental of Missouri- Kansas City
Doral Dental of Nebraska
Doral Dental of New Jersey Amerigroup
Doral Dental of New Jersey HealthNet
Doral Dental of New Mexico
Doral Dental of New York
Doral Dental of New York Non global Budget
Doral Dental of Ohio
Doral Dental of Oklahoma Community Care
Doral Dental of Oklahoma Heartland
Doral Dental of Oklahoma Non Global Budget
Doral Dental of Oklahoma Unicare
Doral Dental of Oklahoma Unicare non global
Doral Dental of Pennsylvania- Keystone
Doral Dental of Pennysylvania Pittsburgh
Doral Dental of Pennysylvania- AmeriHealth
Doral Dental of Pennysylvania- Healthmate
Doral Dental of Pennysylvania-Philadelphia
Doral Dental of Tennessee Tenn Care
Doral Dental of Virginia (M)
Doral Dental of Virginia- Commercial
Doral Dental of Virginia- Premier
Doral Dental of Virginia- Sentara
Doral Dental of Virginia- Unicare
Doral Dental of Virginia-Commercial
Doral Dental of kansas
EMIA-Educators Mutual (Murray, UT)
EQUICOR
Educators Mutual Ins. Assoc. (Murray, UT)
Empire BCBS of NY (Minneapolis, MN)
Employee Benefits Services (Lincoln, NE)
Employers Mutual, Inc (Stuart and Jacksonville, FL)
Enstar Natural Gas (Detroit, MI)
Essex Dental Benefits (St Louis, MO)
Evergreen Health Co-Op (Clinton, IA)
ExclusiCare (Charlotte , NC)
FBX North Star Borough/ School District
Family Members Dental Plan (Harrisburg, PA)
First Ameritas Life Ins Corp of New York (Lincoln, NE)
Payer 835 List
Payer ID
Payer Name
64246
25133
25133
660537624
13317
39026
R7004
25133
DNOA1
39065
BOONG
67814
57254
44054
80314
67814
67814
67814
91136
GWD01
GWD01
44054
80705
72153
89070
64246
10004
22521
86066
62179
22521
46221
22100
CPPCA
CX010
CX009
22521
47009
76342
25133
25133
71063
71063
11271
89070
22099
22099
22099
91136
61101
64246
91136
CDOK1
CX070
660537624
61271
First CommonWealth(Spokane, WA & Chicago, IL)
First Health (Tucson, AZ - London, KY)
First Health - Tucson, AZ - London, KY, Coraoplis, PA)
First Medical (International)
First Reliance Standard (Lincoln, NE)
Fiserv (Wausau, WI & Pueblo, CO)
Flex Compensation (Mpls, MN)
Foreign Service Benefit Plan (London, KY)
Fort Dearborn Life Ins
Fortis Insurance Company - WI
Foundation Benefit Admin (FBA) (Austin, TX)
GEGLAC (Genworth Life & Health) GE Group
GEHA - All Plans except PO Box 4665 (Independence, M
GEHA Only (PO Box 4665, Independence, MO)
GIC-Idemnity Plan
Ge Group Life Assurance Co. Phoenix American Life (Gre
Genworth Dental (PO Box 40011, Lynchburg, VA)
Genworth Life & Health (GEGLAC)(GE Group LIfe)
Glassworkers Health & Welfare Fund (Seattle, WA)
Golden West Dental (21555 Oxnard S, Woodhills, CA)
Golden West Dental (PO Box 5347, Oxnard, CA)
Government Employees Hospital Assoc (GEHA) Only (PO
Great-West Life and Annuity Ins. Co. (Kennett, MO)
Group Benefit Administrators (Henderson, TN)
Group Health Coop. Ind. and Family (PO box 69443)
Guardian Life Insurance Company of America (Spokane,
HMSA Federal Program
Harrington Benefit Services (Oklahoma City, OK)
Hawaii-Mainland Admim (Tempe, AZ)
Health Choice (Medicaid) (Phoenix, Tempe, AZ)
Health Choice (Oklahoma City, OK)
Health Choice Insurance (Phoenix, AZ)
Health Choice Integrated Care (Flagstaff, AZ)
Health Families (Sacramento, CA)
Health Partners of Minnesota (Medicaid) (Minneapolis, M
Health Partners of Minnesota - Commercial (Minneapolis,
Health Plan SErvices of OK (Oklahoma City, OK
Health Plan Services (Lincoln, NE)
Health Plan of NV (Las Vegas, NV)
Health Right of CT (Medicaid Claims)
HealthRight of CT (Medicaid claims to First Health Strata
HealthSCOPE Benefits, Inc (Little Rock, AR)
HealthScope Benefits (Po Box 619055, Dallas, TX)
Healthplex, Inc. (Uniondale, NY)
Highmark/HHIC (PO Box 69433 Harrisbury, PA)
Horizon (Blue Cross of New Jersey) (Indianapolis, IN)
Horizon BCBS NJ ( Po box 1311, MPLS)
Horizon NJ Health (PO Box 299, Milwaukee, WI)
Hotel Employees & Restraunt Employess Health Trust(Se
Humana Medicare/Humana Gold
IBEW Welfare Trust Fund (Decatur, IL)
Idaho Pipe Trades
Indian Health Services (Oklahoma City, OK)
Indiana Childrens Special HealthCare (Indianapolis, IN)
International (First Medical)
J.F. Molloy and Associates, Inc.(Colorado Spring, CO)
Payer 835 List
Payer ID
Payer Name
41099
80314
05030
91136
52133
56205
94276
27401
41154
89070
R7005
91136
25133
64246
CX014
CX014
41154
LX049
74323
56205
CX026
CX026
CX014
CX014
CX014
CX014
CKAL1
CKAK1
CKAR1
94146
CKCT1
CKDE1
CKDC1
CKFL1
CKGA1
CX014
CKIL1
CKID1
CX014
CKIN1
CKIA1
CKKS1
CKKY1
CKKY3
CX014
CKME1
CX014
CKMI1
CKMN1
CKMS1
CKMO1
CX014
CX014
CX014
CX014
CX014
John Alden Life Ins. (501 W Michigan, Milwaukee, WI)
John Hanncock
Local 731 (Burr Ridge, IL)
Locals 302 and 612 of the I.U.O.E
M-Plan Dental (Salt Lake City, UT)
MBS (MedCost Benefit Services(MBS))Winston Salem, NC
MHHNP (Po Box 742567, Houston TX)
MI UFCW Union (Madison Heights, MI)
MMSI-Mayo Clinic Health Solutions (Rochester, MN)
MMSO (Military Medical Support) (Po Box 886999)
MN Power (Duluth, MN)
Machinists Health
Mail Handlers Benefit Plan (Jacksonville, FL)
Managed Dental Guard(Woodland Hills, CA)
Managed Health Services - WI State Employees
Mass Health (Doral Dental) Hingham, MA
Mayo Clinic Health Solutions-MMSI (Rocehster, MN)
McPrime West (1335 Industrial Blvd. Ste 150, Mpls, MN)
MedBen (Newark, OH)
MedCost Benefit Services (MBS)- Winston Salem, NC
Medica of MN - PO Box 1328, Mpls, MN
Medica of MN - PO Box 1519, Mpls, MN
Medicaid Pennysylvania Best Health Care Pittsburgh (Do
Medicaid Pennysylvania Gateway Health Plan (Doral Den
Medicaid Pennysylvania Health Partners Pittsburgh (Dor
Medicaid Pennysylvania Oaktree (Doral Dental of WI)
Medicaid of Alabama
Medicaid of Alaska
Medicaid of Arkansas
Medicaid of California (Denti-Cal)
Medicaid of Connecticut (New Britton, CT)
Medicaid of Delaware - New Castle, DE
Medicaid of Disctrict of Columbia (Washington, DC)
Medicaid of Florida
Medicaid of Georgia
Medicaid of Georgia Grady Healthcare Inc (Doral Dental
Medicaid of IL - Doral Dental of WI (Admin by Doral)
Medicaid of Idaho (Boise, ID)
Medicaid of Illinois (Doral Dental of WI)
Medicaid of Indiana (Boise, ID)
Medicaid of Iowa (Des Moines, IA)
Medicaid of Kansas (Mequon, WI)
Medicaid of Kentucky (Mequon , WI)
Medicaid of Kentucky Region #2 (Doral Dental Services)
Medicaid of Kentucky Region #3 (Doral Dental of WI)
Medicaid of Maine
Medicaid of Maryland-Dept of Health and Ment
Medicaid of Michigan
Medicaid of Minnesota
Medicaid of Mississippi
Medicaid of Missouri (Jefferson City, MO)
Medicaid of Missouri Blue Advantage (Doral Dental of WI
Medicaid of Missouri Community Care Plus- St Louis (Dor
Medicaid of Missouri Community Health PLan (Doral Den
Medicaid of Missouri First Guard Health Plan (Doral Dent
Medicaid of Missouri Health Net (Doral Dental of WI)
Payer 835 List
Payer ID
Payer Name
CX014
CX014
CKMT1
CKNE1
CKNV1
CKNH1
CKNJ1
CKNM1
CX014
CX014
CX014
CKNY1
CKNY2
CKNC1
CKOH1
CX014
CX014
CX014
CKOK1
CX014
CX014
CKOR1
CKPA1
CX014
CKRI1
CKSC1
CX014
CKTX1
CKUT1
CKVA1
CKVT1
CX014
CKWA1
CKWV1
CKWI1
CX014
CX014
CKWY1
CX014
74323
CB833
973
23160
86052
33628
65978
CDMI0
27401
89070
R7005
25133
52133
89070
CX087
71412
91136
Medicaid of Missouri Truman Care- Family Health Partner
Medicaid of Missouri health Care USA- St.Louis (Doral De
Medicaid of Montana
Medicaid of Nebraska (Lincoln, NE)
Medicaid of Nevada (San Antonio, TX)
Medicaid of New Hampshire
Medicaid of New Jersey (Trenton, NJ)
Medicaid of New Mexico
Medicaid of New Mexico Cimmaron Health Plan (Doral D
Medicaid of New Mexico Loveplace Community health pla
Medicaid of New Mexico Presbyterian Salud (Doral Denta
Medicaid of New York
Medicaid of New York (Dental Clinics Only)
Medicaid of North Carolina (Raleigh, NC)
Medicaid of Ohio (Administrated by Quadax) (Columbus,
Medicaid of Ohio Emerald HMO and Medicare INC. (Dora
Medicaid of Ohio Health Power HMO Cincinatti (Doral De
Medicaid of Ohio Personal Physicians Care Cleveland (Do
Medicaid of Oklahoma (Oklahoma City, OK)
Medicaid of Oklahoma Heartland Health PLan (Doral Den
Medicaid of Oklahoma Unicare Health PLan (Doral Dental
Medicaid of Oregon
Medicaid of Pennsylvania (Harrisburg, PA)
Medicaid of Pennysylvania (Doral Dental of WI)
Medicaid of Rhode Island
Medicaid of South Carolina
Medicaid of Tennessee (Doral Dental of WI)
Medicaid of Texas
Medicaid of Utah
Medicaid of VA - Richmond, VA
Medicaid of Vermont
Medicaid of Virginia HealthKeepers Plus (Doral Dental of
Medicaid of Washington
Medicaid of West Virginia (Charelston, WY)
Medicaid of Wisconsin (Madison. WI)
Medicaid of Wisconsin Humana/ TDC (Doral Dental of W
Medicaid of Wisconsin PrimeCare (Doral Dental of WI)
Medicaid of Wyoming (Cheyenne, WY)
Medicaid of ohio United Health Care Inc. Medicare COm
Medical Benefits Mutual - Newark, OH
Medical Mutual of Ohio (MMO)
Medicare Optimun / Triple S
Medico Insurance (IA, NE, MN)
Mercy Care Plan (Phoenix, AZ)
Mercy Maricopa Integrated Care (Phoenix, AZ)
Metlife (El Paso, TX)
Michigan Conference of Teamsters (Farmingotn Hills, MI)
Michigan UFCW (Madison Heights, MI)
Military Medical Support (MMSO) (Po Box 886999)
Minnesota Power (Duluth, MN)
Missouri Department of Transportation/MODot * St Louis
Morgan White (Salt Lake City, UT)
Mountain State BCBS (MSBCBS(PO Box 69434, Harrisbur
Mutual of Omaha (Sherwood, AR)
Mutual of Omaha/National Rural Letter Carrier (Charlotte
N.W. Int Assoc of machinists & Aerospace Eng Benefits
Payer 835 List
Payer ID
Payer Name
91136
91136
91136
23166
CKTX1
91136
91136
14142
23166
71412
43351
81264
47570
02027
LX062
91136
91136
22521
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
80705
91136
CX080
16111
93029
47009
52133
67814
67814
CX068
CX014
37224
41147
47570
LX049
CX014
61271
N.W. Iron Workers Health & Security Trust Fund (Seattle
N.W. Roofers & Employers Health & Security Trust Fund
N.W. Textile Processors (Seattle, WA)
NAS (Nat'l Auto Sprinklers (Landover, MD)
NHIC (Medicaid of TX)
NW Benefit ( Po Box 34176)
NW Plumbing and Pipfitting Industry
NY State Dept of Health (Albany, NY)
Nat'l Auto Sprinklers (NAS)(Landover, MD)
National Rural Letter Carrier (Charlotte, NC)
New England Dental Administrators - Concord, NH
Nippon Life Insurance Company of America
North Star Administrators
NorthEast Delta Dental
Northern MN Dental (Duluth, MN)
Northwest Iron Workers (PO box 34464) Seattle,WA
Nothwest I.A.M. Benefit Trust
OK State Employees & Educators (Oklahoma City, OK)
ONE Health Plan Inc of California
ONE Health Plan Inc of Colorado
ONE Health Plan Inc of Florida
ONE Health Plan Inc of Georgia
ONE Health Plan Inc of Idaho
ONE Health Plan Inc of Indiana
ONE Health Plan Inc of Iowa
ONE Health Plan Inc of Kentucky
ONE Health Plan Inc of Mississippi
ONE Health Plan Inc of New Jersey
ONE Health Plan Inc of New York
ONE Health Plan Inc of North Carolina
ONE Health Plan Inc of Oklahoma
ONE Health Plan Inc of Texas
ONE Health Plan Inc of The District of Columbia
ONE Health Plan Inc of Vermont
ONE Health Plan Inc of Virginia
ONE Health Plan Inc of Washington
ONE Health Plan Inc of Wisconsin
ONE Health Plan Inc. of Alaska
ONE Health Plan Inc. of Arizona
One Health Plan Inc of Wyoming
Operating Engineers Locals 302 & 612 Health & Security
PEHP (Public Employees Health Program)(Salt Lake City,
POMCO ( Syracuse, NY)
PacificSource Health Plans - Eugene, OR
Paul Revere / Provident
Peoples Benefit Life Ins. Co. (Salt Lake City, UT)
Phoenix American (Greenfield, MA)
Phoenix Home Life (Greenfield, MA)
Physicians Mutual (Lincoln, NE)
Physicians Plus Insurance Co., Wisconsin State Employee
Pittman & Associates (Memphis, TN)
Preferred (PO Box 59212) Mpls, MN
Premera Blue Cross (Seattle, WA)
Prime West (1335 Industrial Blvd., Ste 150, MPls, MN)
PrimeCare, Wisconsin State and Federal Employees and
Principal (Coloradp Springs, CO& DesMoines, IA)
Payer 835 List
Payer ID
Payer Name
38217
CX080
91136
93200
93200
80314
36088
RLHA1
73066
84102
25133
CX030
CX030
28530
93742
CX107
41143
76342
91136
84147
13411
93024
57254
64246
R7003
67814
47009
47009
67814
CX088
60054
41147
CDMI0
39065
CX112
CX112
65978
89070
CDCA1
84103
CB923
973
89070
62308
39026
39026
23281
80314
47009
52133
52133
89070
52133
71412
91136
89070
Priority Health (Grand Rapids, MI)
Public Employees Health Program (PEHP)(Salt Lake City,
Puget Sound Benefits Trust (Seattle, WA)
Regence Blue Shield (PO Box 30271 SLC UT)(PO Box 21
Regence Blue Shield WA- FEP(PO Box 30271 SLC, UT)(P
ReliaStar
Reliance Standard Life (Lincoln, NE)
Renaissance Life and Health (Indianpolis, IN)
Reserve National Insurance Company
Rocky Mountain Life Dental (Colorado Springs, CO)
Rural Carrier Benefit Plan (Charlotte, NC)
Safeguard (Po Box 981987, El Paso, TX)
Safeguard PPO -(PO box 30930 Laguna Hills & Aliso Viej
Secure Health Plan of GA (Macon, GA)
Securian Dental Plans (PO Box 9385, MPLS, MN) Delta of
Select Health (Salt Lake City, UT)
Sheffield, Olson & McQueen (2145 Ford Pkwy, St. Paul,
Sierra Health Services (Las Vegas, NV)
South Bay H.E.R.E. Funds
Spina Bifida - VA HAC
Standard Ins Co. of New York (PO Box 82520, Lincoln, N
Standard Insurance of Oregon (Lincoln, NE)
State of TX Dental Plan - All Plans except PO Box 4665 (
Strategic Ourtsourcing Inc. (SOI) (Charolotte, NC)
Sturm & Associates (Edina, MN)
Sun Life (Po Box 81633, Wellesley Hills)
Sun Life Canada
Sun Life Financial
Sun Life and Health (Formerly Genworth)
Surency Life and Health (Wichita, KS)
TRW
Teamsters (Po Box 7078) Duluth MN
Teamsters Welfare Fund (Farmington Hills, MI)
Time Insurance - WI
Total Dental Admin (Elk Grove, IL)
Total Dental Admin (PO Box 44035 Phoenix, AZ)
Travelers (El Paso, TX)
Tricare Dental Plan (UCCI) Harris burg, PA)
Tricare Retiree Dental-Delta Dental of CA - PO Box 5370
Trigon - Blue Cross and Blue Shield (Colorado Springs, C
Trigon Blue Cross of Virginia (Now Anthem BCBS of Virgi
Triple S / Medicare Optimun
UCCI (United Concordia)
UFT Welfare Fund
UMR-Wausau (Salt Lake City, UT)
UMR-Wausau (Wausau, WI & Pueblo, Co)
UPMC Health Plan (Pittsburg, PA)
Unicare
Unifi Companies (Lincoln, NE)
Unimerica Dental (Salt Lake City, UT)
Unique DentaCare (Salt Lake City, UT)
United Concordia (UCCI)
United Health Care - MD, UT (Salt Lake City, UT)
United of Omaha (Charlotte, NC)
University of Washington Students & Graduate Appts.(Se
Unum
Payer 835 List
Payer ID
Payer Name
12116
89070
91062
91136
39026
59332
75261
47198
87815
87815
37272
91136
93200
R7002
CX014
VA Fee Basis Programs (St Paul, MN)
Valley Baptist Health Plan (PO Box 69442)
Washington Dental Service (Seattle, WA)
Washington State Council of County & City Employees D
Wausau Insurance Companies, Wausau, WI
Web TPA, Inc. (Grand Prairie, TX)
WebTPA/Community Health Electronic Claims/CHEC (Gra
Wellpoint (CA) (Oxnard, CA)
Wells Fargo (Anchorage, AK)
Wells Fargo (Charleston, WV)
Wells Fargo TPA (JSL Administrators) (Newnan, GA)
West Coast Stationary Engineers health & Security Trust
Whatcom Medical Bureau (Bellingham, WA)
Wilson, McShane (Mpls, MN)
Xantus Health PLan- Tennessee