Electronic Attachment Payer List (January 2009) NEA Payer ...

1 Electronic Attachment Payer List (January 2009) Payer NameNEA Payer IDPayer NameNEA Payer IDAdministrative Services Only, Inc089002 Blue Cross of Kentucky026020 AETNA037001 Blue Cross of Nevada026017 Aetna DMO037018 Blue Cross of Ohio026019 AETNA Life and Casualty037004 Blue Cross of WA and AK016002 AETNA Select037003 Blue Cross of WV022010 American dental Plan of GA, Shield of California005004 American dental Plan of NC, dental Services032001 American dental Plan, National Life Assurance Company038002 American dental Prov. of AR, 's Assurance001007 American Prepaid dental Plan of OH, Inc017027 Caterpillar Company005005 American Prepaid Professional Svcs., Inc017028 CBS Health Benefits088001 Americhoice005006 CDH (Cigna dental Health)002017 Ameritas001001 Choice Care008015 Anthem BCBS Colorado026030 Choice Plus037008 Anthem BCBS Connecticut026031 Christian Brothers Employee Benefit Serv088002 Anthem BCBS Indiana026032 Christian Brothers Employee Benefit Trst088000 Anthem BCBS Kentucky026033 CIGNA (All of Cigna)002009 Anthem BCBS Maine026026 Cigna Health Plan - HMO002011 Anthem BCBS Missouri026027 CompBenefits Corporation017001 Anthem BCBS Nevada026035 CompBenefits dental and Vision Company017015 Anthem BCBS New Hampshire026025 CompBenefits Direct, BCBS Ohio026036 CompBenefits of AL, BCBS Virginia026028 CompBenefits of GA, BCBS Wisconsin026029 CompDent017002 Anthem Blue Cross- (CA only)

2 026024 CompDent of AL, Benefits Company086002 CompDent of GA, , of IL, Preferred Networks, Employee Benefits009007 Concordia Plus022007 Assurant Health009005 Concordia Preferred022008 Assurant, General002010 BCBS of Alabama076001 Continental Dental002015 BCBS of Connecticut026023 CustomCare (Southwestern Bell - Exec)037009 BCBS of Georgia026006 Delta dental CA - Tricare Retirees039003 BCBS of Georgia - Federal026015 Delta dental CA (Commercial)019001 BCBS of Illinois034003 Delta dental CA federal (TRDP)039001 BCBS of Massachusetts051001 Delta dental Plan of Alaska030003 BCBS of Michigan042001 Delta dental Plan of Arizona086001 BCBS of New Mexico034001 Delta dental Plan of Arkansas018001 BCBS of North Carolina - dental Blue078001 Delta dental Plan of Colorado020001 BCBS of North Carolina - dental Blue Select078002 Delta dental Plan of Idaho036001 BCBS of Oklahoma034006 Delta dental Plan of Illinois087001 BCBS of Tennessee091001 Delta dental Plan of Indiana028003 BCBS of Texas034004 Delta dental Plan of Iowa080001 BCBS of Wisconsin026022 Delta dental Plan of Kansas081001 Bell Atlantic037007 Delta dental Plan of Kentucky004001 Benefits Management Associates077002 Delta dental Plan of Massachusetts024001 Blue Cross (CA)

3 Life and Health026005 Delta dental Plan of Michigan028001 Blue Cross of California - Wellpoint026011 Delta dental Plan of Missouri027001 Blue Cross of California- Anthem026010 Delta dental Plan of Missouri in SC027002 Blue Cross of Colorado026016 Delta dental Plan of New Jersey and CT021001 Blue Cross of Indiana026018 Delta dental Plan of New Mexico025001 For an updated Payer list, please visit our website at 1 Electronic Attachment Payer List (January 2009) Payer NameNEA Payer IDPayer NameNEA Payer IDDelta dental Plan of North Carolina055001 Government Employees Hospital dental Plan of Ohio028002 Group dental Service083001 Delta dental Plan of Oklahoma029001 Group Health Incorporated (GHI)045001 Delta dental Plan of Oregon030004 Guardian007001 Delta dental Plan of South Carolina027003 Harrington Benefit Services010001 Delta dental Plan of South Dakota033001 HCS, dental Plan of Tennessee003001 Health Care Systems, dental Plan of Virginia014001 Health Plan Services010002 Delta dental Plan of Washington048002 Health Services Group030007 Delta dental Plan of Wisconsin082001 Healthplex085001 Denex Dental038003 Healthsource Provident002014 dental Benefit Providers005001 HealthStream Services, Care Plus Management Health Smile022006 dental Guard Preferred Network007002 Highmark Blue Cross022004 dental Health Management, Choice Care008016 dental Network of America (DNOA)

4 034002 Humana Dental008001 dental Select061001 Humana Gold Choice008014 DentaQuest060001 Humana Military Healthcare008011 Dentical044001 Idaho Smiles006096 DentiCare, Penney037005 DentLease, Alden009006 Diamond dental of Arkansas, Hancock026008 Diversified Administrators017018 Kaiser Permanente dental Choice083003 Doral dental USA006001 Lincoln National008010 Eastern Life and Health047002 Managed dental Care (CA) - Guardian007004 Educators Mutual Life047001 Managed DentalGuard FL, NJ, NY, TX007005 Emphesys008002 Managed Health Services006092 Employee Benefit Managment Corp049001 Marriott037012 Employee Benefit Services001014 MassHealth dental Medicaid006091 Employer Plan Services, AZ - ALTCS059002 Employers Health Insurance008003 Medicaid AZ - Maricopa Health006040 Employers Health Insurance of Wisconsin008012 Medicaid CA - BC Life006066 Equicor002012 Medicaid CA - CMSP006041 Equitable Life002013 Medicaid CT - Health Net006042 ExclusiveCare013002 Medicaid DC - Amerigroup006043 First Ameritas Life Ins.

5 FL - Amerigroup006097 First Commonwealth Dental007003 Medicaid GA - Amerigroup006038 First Fortis Benefits009001 Medicaid GA - Avesis Third Party Reliance Standard001005 Medicaid GA - GA Medicaid (ACS)057001 Fiserv Health- Harrington010006 Medicaid GA - Wellcare006039 FlexCare037010 Medicaid IL006003 Florida Power & Lights037011 Medicaid IL - Amerigroup IL006044 Fort Dearborn Life034007 Medicaid IL - Medical Assistance Program006045 Fortis Benefits009002 Medicaid KS006047 Fortis Insurance009010 Medicaid KS - Kansas Medical Assistance006046 Fortis Self Funded Adm. Services009009 Medicaid KY - FFS-KY006048GE Group Life Assurance054001 Medicaid KY - Passport Health Plan006004 geha connection dental Federal056005 Medicaid KY (Region 3)006093 geha connection dental Plus056003 Medicaid MD - Amerigroup006049 geha Employee Benefit Plan056004 Medicaid MD - Coventry Diamond Plan006050 Genworth Group dental Benefits054002 Medicaid MD - Helix006051 GIC026014 Medicaid MD - MD Physician Care - MCO006005 For an updated Payer list, please visit our website at 2 Electronic Attachment Payer List (January 2009)

6 Payer NameNEA Payer IDPayer NameNEA Payer IDMedicaid MD - Priority Partners006053 ODS Community Health030006 Medicaid MN - UCare of MN006054 ODS Health Plan030002 Medicaid MO - BCBS Kansas City006055 OHS of Georgia, MO - FirstGuard Health006009 Oral Health Services (OHS)017003 Medicaid MO - HealthCareUSA006058 Oral Health Services of Alabama, MO - Missouri, HealthNet006090 Oregon dental Service - ODS030001 Medicaid NJ - Amerigroup006060 Oxford Health Plans005007 Medicaid NJ - Health Net006061 Pacific Source031001 Medicaid NJ - University Health Plan006062 Pacific Union005008 Medicaid NM - Amerigroup006098 Paul Revere / Provident001008 Medicaid NM - Loveless Community Health006026 Pennsylvania Blue Shield022003 Medicaid NM - Molina HealthCare of NM006037 Pennsylvania Blue Shield dental Plus022015 Medicaid NM - Presbyterian Salud006025 Phoenix American054004 Medicaid NY - CenterCare006067 Phoenix Home Life054003 Medicaid NY - Empire BCBS006068 Physicians Mutual001011 Medicaid NY - Fidelis Health006069 PMI dental Health Plan -DeltaCare Claims053001 Medicaid NY - GHI006070 Preferred dental Organization (PDO)

7 037013 Medicaid NY - Healthfirst006071 Premera Blue Cross (WA/AK)016001 Medicaid NY - Managed Health Access Insurance Company050001 Medicaid NY - Metro Plus006072 Premier dental Group084001 Medicaid NY - Presbyterian Community006073 Primary Delivery Systems008007 Medicaid NY - Suffolk County006052 Prime Care Wisconsin006095 Medicaid OH - Amerigroup006075 Principal Financial Group040004 Medicaid OH - Buckeye Health006076 Principal Life Insurance040001 Medicaid OH - Molina OH006079 Protective Life009004 Medicaid OH - QualChoice006077 Prudential037002 Medicaid OH - Unison006078 Quality Plan Administrators, Inc093001 Medicaid OK - Heartland Health006018 Randmark008004 Medicaid OK - Unicare Health Plan006019RE Harrington Benefit Services010004 Medicaid PA - Amerihealth Mercy006082 Reliance Standard001003 Medicaid PA - Health Partners Philadelph006056 ReliaStar026004 Medicaid PA - ION006057 SelectCare (Coca Cola)

8 037014 Medicaid PA - Keystone Mercy006085 Self Insured dental Services089004 Medicaid PA - Three Rivers Health Plans041002 Serentas dental Solutions004002 Medicaid PA - UPMC Health Plan - Dental006059 SIDS089003 Medicaid PA - UPMC Health Plan Pittsburg006063 Southwest Benefit Administrators086003 Medicaid SD033002 Southwestern Bell037015 Medicaid TN - Doral Health Plan006099 Standard Insurance001004 Medicaid TN - TennCare006027 Standard Insurance Company of New York001012 Medicaid VA006094 State of Texas dental Plan ( geha )056002 Medicaid VA - Doral Health Plan006100 Sun Life Financial Employee Benefits Group054005 Medicaid VA - Smiles for Children006088 Sun Life of Canada001006 Medicaid WI - Doral Health Plan006064 Superior dental Care015001 Medicaid WI - UHC of WI006065 Texas dental Plan017013 MetLife012001 The dental Companies (TDC, Inc.)

9 008005 Motorola008017 The dental Concern (TDC, Ltd.)008006 Mountain States (BC of WV)022012 The ODS Companies030005 Mutual of Omaha013001 Three Rivers Health Plans041001 Mutually Preferred013004 Time Insurance009003 National dental Plans, Benefits, INC077001 National Rual Letter Carriers Assoc001015 Transamerica Life (NM)090001 Nippon Life Insurance of America040005 Travelers012002 For an updated Payer list, please visit our website at 3 Electronic Attachment Payer List (January 2009) Payer NameNEA Payer IDPayer NameNEA Payer IDTricare Active Reservists (UCCI)022009 Unison Health Plan041003 Tricare dental (UCCI)022001 Unistar026007 Tricare Family Member dental Plan - TFMDP022013 United Concordia022002 Tricare Retiree dental Program039002 United HealthCare005002 Trustmark ACEC001009 United Of Omaha013003 Trustmark NY ACEC001010 United Parcel Service037006 TRW037017 Varian Health Care Plan037016 TSRDP dental Claim008013 Vencor/Kindred Healthcare008008 UFT Welfare Fund002016 Vistica Administrators006035 Unicare Health Insurance Company of the026003 Washington dental Service048001 Unicare Life and Health026002 WASHINGTON DEPARTMENT SOC.

10 HEALTH 068001 UNICARE of Texas - HMO026013 WellPoint dental Services026012 Unicare Special Accounts026009 WellPoint Health Networks026001 UniLife Insurance Company017021 Woodward Health Care Services013006 Union Security Insurance Company009011 Xantus Health Plan006034 For an updated Payer list, please visit our website at 4