Electronic Attachment Dental Payer List NEA Payer …

1 Electronic Attachment Dental Payer ListMarch 2010 Payer NameNEA Payer IDPayer NameNEA Payer IDAdministrative Services Only, Inc089002 BCBS of Texas034004 AETNA037001 BCBS of Wisconsin026022 Aetna DMO037018 Bell Atlantic037007 AETNA Life and Casualty037004 Benefits Inc. (Alan Sturm)100013 AETNA Select037003 Blue Cross (CA) Life and Health026005 Alan Sturm & Associates100001 Blue Cross of California - Wellpoint026011 American Dental Plan of GA, Cross of California- Anthem026010 American Dental Plan of NC, Cross of Colorado026016 American Dental Plan, Cross of Idaho092001 American Dental Prov. of AR, Cross of Indiana026018 American Prepaid Dental Plan of OH, Inc017027 Blue Cross of Kentucky026020 American Prepaid Professional Svcs.

2 , Inc017028 Blue Cross of Nevada026017 America's TPA150000 Blue Cross of Ohio026019 Americhoice005006 Blue Cross of WA and AK016002 Ameritas001001 Blue Cross of WV022010 Anthem BCBS Colorado026030 Blue Shield of California005004 Anthem BCBS Connecticut026031 Bridgeport Dental Services032001 Anthem BCBS Indiana026032 Brokers National Life Assurance Company038002 Anthem BCBS Kentucky026033 Businessmen's Assurance001007 Anthem BCBS Maine026026 CareFirst Blue Cross/Blue Sheild - MD095001 Anthem BCBS Missouri026027 CareFirst BlueChoice - DC095002 Anthem BCBS Nevada026035 Caterpillar Company005005 Anthem BCBS New Hampshire026025 CBS Health Benefits088001 Anthem BCBS Ohio026036 CDH (Cigna Dental Health)002017 Anthem BCBS Virginia026028 Chartered medicaid - EPSDT (Under 21)093002 Anthem BCBS Wisconsin026029 Choice Care008015 Anthem Blue Cross- (CA only)026024 Choice Plus037008 Anthem Health & Life Insurance Company026037 Christian Brothers Employee Benefit Serv088002 Ascent Benefits Company086002 Christian Brothers Employee Benefit Trst088000 ASO, (All of Cigna)002009 ASO/SIDS089000 Cigna Health Plan - HMO002011 Assurant Employee Benefits009007 Claim Management Services - Wisconsin026040 Assurant Health009005 Commercial FL ADI - Choice PPO006136 Assurant, FL ADI - Select006133 Atlantic Dental Inc.

3 (ADI) Medicaid006101 Commercial FL ADI - Series006131 Atlantic Dental Inc. (ADI) Medicaid006102 Commercial FL ADI - UltraCare006134 BCBS of Alabama076001 Commercial FL ADI JMH Select Discount006137 BCBS of Connecticut026023 Commercial FL ADI Signature006130 BCBS of Georgia026006 Commercial FL ADI-Total Health Choice006135 BCBS of Georgia - Federal026015 CompBenefits Corporation017001 BCBS of Illinois034003 CompBenefits Dental and Vision Company017015 BCBS of Massachusetts051001 CompBenefits Direct, of Michigan042001 CompBenefits of AL, of New Mexico034001 CompBenefits of GA, of North Carolina - Dental Blue078001 CompDent017002 BCBS of North Carolina - Dental Blue Select078002 CompDent of AL, of Oklahoma034006 CompDent of GA, of Tennessee091001 CompDent of IL.

4 An updated Payer list, please visit our website 1 Electronic Attachment Dental Payer ListMarch 2010 Payer NameNEA Payer IDPayer NameNEA Payer IDCompDent Preferred Networks, Network of America (DNOA)034002 Concordia Plus022007 Dental Select - Utah061001 Concordia Preferred022008 DentaPremier - Ohio140002 Connecticut General002010 DentaQuest Commercial060001 Continental Dental002015 DentaQuest Government (formarly Doral)006218 CSEA Employee Benefit Plan099001 DentaSelect - Ohio140001 CustomCare (Southwestern Bell - Exec)037009 Dentical044001DC Healthcare Alliance - Chartered093003 DentiCare, Healthcare Alliance - HeathRight093004 DentLease, Healthy Smiles093007 Diamond Dental of Arkansas, Dental130000 Diversified Administrators017018 Delta Dental CA - Tricare Retirees039003 Doral Dental USA006001 Delta Dental CA (Commercial)019001 Eastern Life and Health047002 Delta Dental CA Federal (TRDP)

5 039001 Educators Mutual Life047001 Delta Dental of Arizona086001 Emphesys008002 Delta Dental of Colorado020001 Employee Benefit Managment Corp049001 Delta Dental of Idaho036001 Employee Benefit Services001014 Delta Dental of Illinois087001 Employer Plan Services, Dental of Iowa080001 Employers Health Insurance008003 Delta Dental of Kentucky004001 Employers Health Insurance of Wisconsin008012 Delta Dental of Massachusetts024001 Equicor002012 Delta Dental of Michigan028001 Equitable Life002013 Delta Dental of Minnesota100000 First Ameritas Life Ins. Dental of Missouri027001 First Commonwealth Dental007003 Delta Dental of New Jersey and CT021001 First Dental Health098001 Delta Dental of New Mexico025001 First Fortis Benefits009001 Delta Dental of North Carolina055001 First Reliance Standard001005 Delta Dental of Oklahoma029001 Fiserv Health- Harrington010006 Delta Dental of Virginia014001 FlexCare037010 Delta Dental of Wisconsin082001 Florida Power & Lights037011 Delta Dental of Wyoming033003 Fort Dearborn Life034007 Delta Dental Plan of Alaska030003 Fortis Benefits009002 Delta Dental Plan of Arkansas018001 Fortis Insurance009010 Delta Dental Plan of Indiana028003 Fortis Self Funded Adm.

6 Services009009 Delta Dental Plan of Kansas081001GE Group Life Assurance054001 Delta Dental Plan of Missouri in SC027002 GEHA Connection Dental Choice056006 Delta Dental Plan of Ohio028002 GEHA Connection Dental Federal056005 Delta Dental Plan of Oregon030004 GEHA Connection Dental Plus056003 Delta Dental Plan of South Carolina027003 GEHA Employee Benefit Plan056004 Delta Dental Plan of South Dakota033001 Genworth Group Dental Benefits054002 Delta Dental Plan of Tennessee003001 GIC026014 Delta Dental Plan of Washington048002 Golden West Dental & Vison Plan026038 Denex Dental038003 Government Employees Hospital Benefit Providers005001 Group Dental Service083001 Dental Care Plus Group - Ohio140000 Group Health Incorporated (GHI)045001 Dental Care Plus Management Guard Preferred Network007002 Harrington Benefit Services010001 Dental Health Management, , an updated Payer list, please visit our website 2 Electronic Attachment Dental Payer ListMarch 2010 Payer NameNEA Payer IDPayer NameNEA Payer IDHealth Care Systems, FL - Amerigroup006097 Health Resources FL Better Health - Adults006139 Health Services for Children with Special needs093006 medicaid FL Better Health-Children006138 Health Services Group030007 medicaid FL Childrens - Charlee006111 Healthplex085001 medicaid FL Childrens - Miami-Dade 0-5006110 HealthRight medicaid - EPSDT (Under 21)

7 093005 medicaid FL Childrens - Miami-Dade 6-20006112 Healthsource Provident002014 medicaid FL Healthy Kids006113 HealthStream Services, FL Humana - Children 0-5006114 Hershey Health Smile022006 medicaid FL Humana - Children 6-20006115 Highmark Blue Cross022004 medicaid FL Humana - Non-Reform - Adult006117 Humana Choice Care008016 medicaid FL Humana - PW/H/A006116 Humana Dental008001 medicaid FL Humana - SSI - Adult006118 Humana Gold Choice008014 medicaid FL Humana - TANF - Adult006119 Humana Military Healthcare008011 medicaid FL Independent Living - Adult006120 Idaho Smiles006096 medicaid FL JMH - Health & Wellness006129JC Penney037005 medicaid FL Prestige Health Choice Adult006121 John Alden009006 medicaid FL SFCCN-PSN Adult006132 John Hancock026008 medicaid FL THC - Children006122 Kaiser Permanente Dental Choice083003 medicaid FL THC.

8 Non-Reform - Adult006123 Liberty Dental Plan110000 medicaid FL THC - Reform - Adult006124 LifeWise Health Plan of Oregon016003 medicaid FL THCA lternateIDProdt-no bnfit006125 Managed Dental Care (CA) - Guardian007004 medicaid FL WC HealthEaseNon-Reform-Adlt006126 Managed DentalGuard FL, NJ, NY, TX007005 medicaid FL WCHealthEase Non-Reform-Adlt006128 Managed Health Services006092 medicaid FL WC-Staywell Non-Reform-Adult006127 Marriott037012 medicaid GA - Amerigroup006038 MassHealth Dental Medicaid006091 medicaid GA - GA medicaid (ACS)057001 MCNA Dental Plans097001 medicaid GA - Peachstate Health Plan006104 Medica Commercial Program100012 medicaid GA - Wellcare006039 Medica MN Public Program100003 medicaid IL006003 Medicad NVAmerigroupCommunityCareChek-up006178 medicaid IL - Amerigroup IL006044 medicaid - MN Blue Plus100004 medicaid IL - Medical Assistance Program006045 medicaid - MN CivicSmiles100008 medicaid KS006047 medicaid - MN First Plan Blue100007 medicaid KS - Kansas Medical Assistance006046 medicaid - MN MHP (Metropolitan Health)100005 medicaid KY - FFS-KY006048 medicaid AZ - ALTCS059002 medicaid KY - Passport Health Plan006004 medicaid AZ - Maricopa Health006040 medicaid KY (Region 3)

9 006093 medicaid CA - BC Life006066 medicaid MA - CeltiCare006151 medicaid CA - CMSP006041 medicaid MA - Network Health Forward006150 medicaid CT - Health Net006042 medicaid MA - NHP Commonwealth Care006148 medicaid DC - Amerigroup006043 medicaid MD - Amerigroup006049 medicaid DC Healthy Smiles Adult(21&up)006108 medicaid MD - Coventry Diamond Plan006050 medicaid DC Healthy Smiles Child(upto21)006109 medicaid MD - Helix006051 medicaid DC Mid - Atlantic Access/EPPO006159 medicaid MD - History Load006143 medicaid DC Mid - Atlantic Choice006153 medicaid MD - MD Physician Care - MCO006005 medicaid DC Mid - Atlantic DHMO006157 medicaid MD - Priority Partners006053 medicaid DC Unison-Capitol Area Child006105 medicaid MD Healthy Smiles REM 21andOver006142 medicaid DC-Unison CapitalAlliance Adult006106 medicaid MD Healthy Smiles Under 21006140 medicaid DC-Unison CapitalAlliance Child006107 medicaid MD Mid - Atlantic Access/EPPO006160 For an updated Payer list.

10 Please visit our website 3 Electronic Attachment Dental Payer ListMarch 2010 Payer NameNEA Payer IDPayer NameNEA Payer IDMedicaid MD Mid - Atlantic Choice006154 medicaid NY - CenterCare006067 medicaid MD Mid - Atlantic DHMO006156 medicaid NY - Empire BCBS006068 medicaid MD UnitedHealthcare PAC006146 medicaid NY - Fidelis Health006069 medicaid MD UnitedHealthcareHealthChoice006145 medicaid NY - GHI006070 medicaid MDHealthySmilesConfirmPregnancy006144 medicaid NY - Healthfirst006071 medicaid MN - UCare of MN006054 medicaid NY - Managed Health MN SCHA - Ability Care006171 medicaid NY - Metro Plus006072 medicaid MN SCHA - MSHO006164 medicaid NY - NHP CHP (no co-pay)006197 medicaid MN SCHA (GA) - over 21006163 medicaid NY - NHP FHP (co-pay)006195 medicaid MN SCHA (MA) - over 21006162 medicaid NY - NHP FHP (no co-pay)006196 medicaid MN SCHA MA - under 21006161 medicaid NY - NHP medicaid Adult006193 medicaid MN Senior Care Plus - SCHA006165 medicaid NY - NHP medicaid Child006194 medicaid MNCare SCHA Basic Plus One(M3)006168 medicaid NY - Presbyterian Community006073 medicaid MNCare SCHA Basic Plus Two(M4)006169 medicaid NY - Suffolk County006052 medicaid MNCare SCHA Care Basic (M2)006166 medicaid NY Fidelis 1199 - Adult006204 medicaid MNCare SCHA Care Basic Plus(M5)006167 medicaid NY Fidelis 1199 - Child006205 medicaid MNCare SCHA Expanded (M1)