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					      Ingenix Eligibility Payer List
      ANSI HIPAA 270/271
      (As of 03/11/2011)



                                                           Payer ID
                           Payer Name                        2100A        State                            Additional Information                                  Type
                                                            NM109
Payers highlighted are new or have been altered in the last 90 days. Please verify that your system is setup correctly for this payer


AARP-UnitedHealthcare Ins Co                                     36273           ALL       Loop 2100B should contain Tax Identification Number and/or NPI.          T
                                                                                           Loop 2100B Provider ID should contain Aetna PIN, Aetna PVN,
                                                                                           Organization Number Tax ID, or NPI. AETNA Requires NPI
                                                                                           Registration. http://www.aetna.com/healthcare-professionals/policies-
Aetna Health Plans (AHP)                                         60054           ALL       guidelines/national_provider_identifier.html                             T
                                                                                           Loop 2100B Provider ID should contain Aetna PIN, Aetna PVN,
                                                                                           Organization Number, Tax ID, or NPI. AETNA requires NPI
                                                                                           registration. See following link: http://www.aetna.com/healthcare-
Aetna Health Plans PPO                                           60054           ALL       professionals/policies-guidelines/national_provider_identifier.html      T
                                                                                           Loop 2100B Provider ID should contain Aetna PIN, Aetna PVN,
                                                                                           Organization Number, Tax ID, or NPI. AETNA requires NPI
                                                                                           registration. See following link: http://www.aetna.com/healthcare-
AHP of New Jersey, Parsippany                                    60054           ALL       professionals/policies-guidelines/national_provider_identifier.html      T
                                                                                           Loop 2100B Provider ID should contain Aetna PIN, Aetna PVN,
                                                                                           Organization Number, Tax ID, or NPI. AETNA requires NPI
                                                                                           registration. See following link: http://www.aetna.com/healthcare-
AHP of New Jersey, Purchase, NY                                  60054           ALL       professionals/policies-guidelines/national_provider_identifier.html      T


Alabama Blue Cross (Institutional)                               ALBLC           AL        Loop 2100B must contain NPI.                                             NC


Alabama Blue Shield (Professional)                               ALBLS           AL        Loop 2100B must contain NPI.                                             NC


Alabama Medicaid                                                 ALMCD           AL        Loop 2100B must contain NPI.                                             NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Alabama Medicare                                                 CMSEL           AL        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                           NC
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Alaska Medicare                                                  CMSEL           AK        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                           NC

                                                                                           Loop 2100B must contain Service Provider Number assigned by the
Altius Health Plans                                              00364           ALL       payer and/or NPI.                                                        G


American Medical Security (AMS)                                  81400           ALL       Loop 2100B must be Medicare Provider number and/or NPI.                  T


American Republic Insurance Company (ARIC)                       41099           ALL       Loop 2100B should contain Tax ID and/or NPI.                             G
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
American Samoa Medicare                                          CMSEL           AS        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                           NC


AmeriChoice of New Jersey                                        86047           NJ        Loop 2100B should contain Tax ID, SSN, and/or NPI                        G


AmeriGroup                                                       28806           ALL       Loop 2100B should only contain a Federal Tax ID Number.                  G


Arizona Blue Cross Blue Shield                                   AZBLS           AZ        Loop 2100B must contain NPI.                                             NC


Arizona Medicaid (AHCCCS)                                       AZMCD            AZ        Loop 2100B must contain NPI.                                             NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Arizona Medicare                                                 CMSEL           AZ        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                           NC


Arkansas Medicaid                                               ARMCD            AR        Loop 2100B must contain NPI.                                             NC
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Arkansas Medicare                                                CMSEL           AK        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                           NC


Assurant-Time Insurance Company                                  AHTIN           ALL       Loop 2100B should contain Tax ID and/or NPI.                             G


Assurant-Union Security Insurance Company                        AHUSY           ALL       Loop 2100B should contain Tax ID and/or NPI.                             G


California Anthem Blue Cross (WellPoint Health Network)          00540           CA        Loop 2100B should contain Tax Identification Number and/or NPI.          NC

                                                                                           Loop 2100B must be Service Provider number, Personal ID number
California Medicaid (Medi-Cal)                                  CAMCD            CA        (PIN), and/or NPI.                                                       NP



      -----------
      NP or NC: Non Participating Payers. Ingenix charges a per transaction fee for non-par payers
      For up-to-date payer information, please access the payer list from the Ingenix website at: http://www.enshealth.com
        Ingenix Eligibility Payer List
        ANSI HIPAA 270/271
        (As of 03/11/2011)



                                                                 Payer ID
                           Payer Name                             2100A          State                              Additional Information                        Type
                                                                  NM109
                                                                                             Enrollment required. Form and instructions at
                                                                                             http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
California Medicare                                                CMSEL           CA        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                        NC

                                                                                             Loop 2100B: If NPI is submitted in NM109, send a REF02 = Federal
Cariten Healthcare                                                 62073           TN        Tax ID                                                                G


CHAMPVA                                                            84146           ALL       Loop 2100B should contain Tax ID and/or NPI.                          G


CIGNA                                                              62308           ALL       Loop 2100B should contain Tax Identification Number and/or NPI.       C

Colorado Anthem Blue Cross Blue Shield (WellPoint Health
Network)                                                           COBLS           CO        Loop 2100B should contain Tax Identification Number and/or NPI.       NC


Colorado Medicaid                                                 COMCD            CO        Loop 2100B must contain NPI.                                          NP
                                                                                             Enrollment required. Form and instructions at
                                                                                             http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Colorado Medicare                                                  CMSEL           CO        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                        NC


ConnectiCare                                                       06105           ALL       Loop 2100B should contain Tax Identification Number and/or NPI.       G

Connecticut Anthem Blue Cross Blue Shield (WellPoint Health
Network)                                                           CTBLS           CT        Loop 2100B should contain Tax Identification Number and/or NPI.       NC


Connecticut General Life                                           06105           ALL       Loop 2100B should contain Tax Identification Number and/or NPI.       G


Connecticut Medicaid                                               CTMCD           CT        Loop 2100B must contain NPI.                                          NP
                                                                                             Enrollment required. Form and instructions at
                                                                                             http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Connecticut Medicare                                               CMSEL           CT        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                        NC


CoreSource (AZ & MN)                                               00234         AZ,MN       Loop 2100B should contain Tax Identification Number and/or NPI.       G


CoreSource (MD, PA, & IL)                                          CRSC1        MD,PA,IL     Loop 2100B should contain Tax Identification Number and/or NPI.       G


CoreSource (NC & IN)                                               CRSC2         NC,IN       Loop 2100B should contain Tax Identification Number and/or NPI.       G

                                                                                             Loop 2100B must contain Service Provider Number assigned by the
Coventry Carelink Medicaid                                         00182           WV        payer and/or NPI.                                                     G

                                                                                             Loop 2100B must contain Service Provider Number assigned by the
Coventry Health American/Health Assurance of Pennsylvania          00148         PA,OH       payer and/or NPI.                                                     G

                                                                                             Loop 2100B must contain Service Provider Number assigned by the
Coventry Health Care USA                                           00186           MO        payer and/or NPI.                                                     G

                                                                                             Loop 2100B must contain Service Provider Number assigned by the
Coventry Health Carelink                                           00160           WV        payer and/or NPI.                                                     G

                                                                                             Loop 2100B must contain Service Provider Number assigned by the
Coventry Health CareNet                                            00190           VA        payer and/or NPI.                                                     G

                                                                                             Loop 2100B must contain Service Provider Number assigned by the
Coventry Health Group Health Plan                                  00184         IL,MO       payer and/or NPI.                                                     G

                                                                                             Loop 2100B must contain Service Provider Number assigned by the
Coventry Health of Carolinas/WellPoint                             25129         NC,SC       payer and/or NPI.                                                     G

                                                                                             Loop 2100B must contain Service Provider Number assigned by the
Coventry Health of Delaware                                        25130           DE        payer and/or NPI.                                                     G

                                                                                             Loop 2100B must contain Service Provider Number assigned by the
Coventry Health of Georgia                                         25127           GA        payer and/or NPI.                                                     G

                                                                                             Loop 2100B must contain Service Provider Number assigned by the
Coventry Health of Iowa                                            25132           IA        payer and/or NPI.                                                     G

                                                                                             Loop 2100B must contain Service Provider Number assigned by the
Coventry Health Care of Illinois/ Personal Care                    00179           IL        payer and/or NPI.                                                     G

                                                                                             Loop 2100B must contain Service Provider Number assigned by the
Coventry Health of Kansas (Kansas City)                            25133         KS,MO       payer and/or NPI.                                                     G


        -----------
        NP or NC: Non Participating Payers. Ingenix charges a per transaction fee for non-par payers
        For up-to-date payer information, please access the payer list from the Ingenix website at: http://www.enshealth.com
       Ingenix Eligibility Payer List
       ANSI HIPAA 270/271
       (As of 03/11/2011)



                                                                Payer ID
                           Payer Name                            2100A          State                              Additional Information                          Type
                                                                 NM109

                                                                                            Loop 2100B must contain Service Provider Number assigned by the
Coventry Health of Kansas (Wichita)                               25134         KS,MO       payer and/or NPI.                                                       G

                                                                                            Loop 2100B must contain Service Provider Number assigned by the
Coventry Health of Louisiana                                      25135           LA        payer and/or NPI.                                                       G

                                                                                            Loop 2100B must contain Service Provider Number assigned by the
Coventry Health of Nebraska                                       25136          IA,NE      payer and/or NPI.                                                       G

                                                                                            Loop 2100B must contain Service Provider Number assigned by the
Coventry Health Southern Health Services                          25128           VA        payer and/or NPI.                                                       G


Definity Health                                                   87726           ALL       Loop 2100B should contain Service Provider ID and/or NPI.               T
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Delaware Medicare                                                 CMSEL           DE        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC
                                                                                            Loop 2100B must contain the Rendering Provider TIN and NPI.
                                                                                            Rendering Provider NPI must already be enrolled for Claim
Deseret Mutual (DMBA)                                            DMBAU            UT        Submissions before they can send RTT to Deseret Mutual (DMBA).          NC


Diamond Plan (Maryland Medicaid)                                  00177           MD        Loop 2100B should contain Tax Identification Number and/or NPI.         G
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
District of Columbia Medicare                                     CMSEL           DC        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Federated States of Micronesia Medicare                           CMSEL           FM        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC


Fidelis (CenterCare)                                              FIDEL           ALL       Loop 2100B should contain Provider Number or NPI.                       NP


First Ameritas of NY                                              00426           ALL       Loop 2100B should contain Tax ID and/or NPI.                            G

                                                                                            Loop 2100B should contain Tax ID, SSN, Service Provider ID, and/or
First Health                                                      87043           ALL       NPI.                                                                    G

                                                                                            Loop 2100B should contain Tax ID, SSN, Service Provider ID, and/or
First Health (Mail Handlers)                                      00251           ALL       NPI.                                                                    G


Florida Blue Cross Blue Shield                                    FLBLS           FL        Loop 2100B should contain BCBSFL Facility or Provider ID and/or NPI.    NC


Florida Medicaid                                                  FLMCD           FL        Enrollment required. Call Hope Richardson at (719)277-7545 ext. 1309    NP
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Florida Medicare                                                  CMSEL           FL        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC

Georgia Anthem Blue Cross Blue Shield (WellPoint Health
Network)                                                          GABLS           GA        Loop 2100B should contain Tax Identification Number and/or NPI.         NC


Georgia Medicaid                                                 GAMCD            GA        Loop 2100B must contain NPI.                                            NP
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Georgia Medicare                                                  CMSEL           GA        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC


Government Employees Hospital Association (GEHA)                  44054           ALL       Loop 2100B should contain either the Tax ID or NPI.                     P


Great West                                                        80705           ALL       Loop 2100B should contain Tax ID and/or NPI.                            C
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Guam Medicare                                                     CMSEL           GU        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Hawaii Medicare                                                   CMSEL           HI        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC


Health Net of Arizona                                             00213           AZ        Loop 2100B should contain Tax ID and/or NPI.                            G


Health Net of California                                          95567           CA        Loop 2100B should contain Tax ID and/or NPI.                            G


Health Net of the Northeast                                       00213      CT,NJ,NY,PA    Loop 2100B should contain Tax ID and/or NPI                             G


       -----------
       NP or NC: Non Participating Payers. Ingenix charges a per transaction fee for non-par payers
       For up-to-date payer information, please access the payer list from the Ingenix website at: http://www.enshealth.com
       Ingenix Eligibility Payer List
       ANSI HIPAA 270/271
       (As of 03/11/2011)



                                                                Payer ID
                          Payer Name                             2100A          State                              Additional Information                         Type
                                                                 NM109


HealthFirst of New York                                           HF1NY           NY        Loop 2100B should contain Legacy ID and/or NPI.                        G


HealthPartners                                                    HPART           PA        Loop 2100B should contain NPI.                                         G

                                                                                            2100B must contain NPI. Enrollment required. Form and instructions
HealthPartners of Minnesota                                       94267           MN        at http://www.enshealth.com/enspublic/Download/EMCagreement.asp.       NP


Humana                                                            00041           ALL       Loop 2100B should contain Tax ID and/or NPI.                           G


Idaho Medicaid                                                    IDMCD           ID        Loop 2100B should contain Payer Assigned Provider ID Number or NPI.    NP
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Idaho Medicare                                                    CMSEL           ID        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC

                                                                                            Loop 2100B should contain Service Provider Number assigned by the
Illinois Blue Cross Blue Shield                                   ILBLS           IL        payer and/or NPI.                                                      NP

                                                                                            Loop 2100B should contain Service Provider Number assigned by the
Illinois Medicaid                                                 ILMCD           IL        payer and/or NPI.                                                      NP
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Illinois Medicare                                                 CMSEL           IL        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC

Indiana Anthem Blue Cross Blue Shield (WellPoint Health
Network)                                                          INBLS           IN        Loop 2100B should contain Tax Identification Number and/or NPI.        NC

                                                                                            Loop 2100B should contain Service Provider Number assigned by the
Indiana Medicaid                                                  INMCD           IN        payer and/or NPI.                                                      NP
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Indiana Medicare                                                  CMSEL           IN        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Iowa Medicare                                                     CMSEL           IA        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC


John Alden Life Insurance Company                                 41099           ALL       Loop 2100B should contain Tax ID and/or NPI.                           G


Kaiser Foundation Health Plan of Ohio                             00280           ALL       Loop 2100B should contain Tax ID and/or NPI.                           G


Kansas Medicaid                                                  KSMCD            KS        Loop 2100B must contain an NPI.                                       NC
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Kansas Medicare                                                   CMSEL           KS        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC

Kentucky Anthem Blue Cross Blue Shield (WellPoint Health
Network)                                                          KYBLS           KY        Loop 2100B should contain Tax Identification Number and/or NPI.        NC
                                                                                            Loop 2100B should contain Payer Assigned Prov ID Number or NPI.
                                                                                            Provider must be an active KYMCD Provider, prior to sending RT 270
Kentucky Medicaid                                                KYMCD            KY        Requests. Call KY Prov Enrollment at 877-838-5085.                    NC
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Kentucky Medicare                                                 CMSEL           KY        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC

                                                                                            Loop 2100B should contain NPI and Facility ID / Federal Tax ID
Keystone Mercy                                                    KEYST           PA        (2100B/REF02 for REF01=1J).                                            NP

                                                                                            Loop 2100B should contain Service Provider Number assigned by the
Louisiana Blue Cross Blue Shield                                  LABLS           LA        payer and/or NPI.                                                      NP

                                                                                            Loop 2100B should contain Service Provider Number assigned by the
Louisiana Medicaid                                               LAMCD            LA        payer and/or NPI.                                                      NP
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Louisiana Medicare                                                CMSEL           LA        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC

                                                                                            Loop 2100B must be should contain Service Provider Number and/or
MAHP/MAMSI                                                        52148           ALL       NPI.                                                                   T

Maine Anthem Blue Cross Blue Shield (WellPoint Health
Network)                                                          MEBLS           ME        Loop 2100B should contain Tax Identification Number and/or NPI.        NC


Maine Medicaid                                                   MEMCD            ME        Loop 2100B must contain Payer Assigned Provider Number ID.             NP


       -----------
       NP or NC: Non Participating Payers. Ingenix charges a per transaction fee for non-par payers
       For up-to-date payer information, please access the payer list from the Ingenix website at: http://www.enshealth.com
      Ingenix Eligibility Payer List
      ANSI HIPAA 270/271
      (As of 03/11/2011)



                                                               Payer ID
                         Payer Name                             2100A          State                              Additional Information                         Type
                                                                NM109
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Maine Medicare                                                   CMSEL           ME        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Marshall Islands Medicare                                        CMSEL           MH        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC


Maryland Medicaid                                               MDMCD            MD        Loop 2100B must contain Payer Assigned Provider ID or NPI.             NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Maryland Medicare                                                CMSEL           MD        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC

                                                                                           Loop 2100B should contain either the 6-character Provider ID or 10-
Massachusetts Blue Cross Blue Shield                             00139           MA        character Facility ID, and/or NPI.                                     G

                                                                                           Loop 2100B must be a Provider Medicaid ID, User Identification
Massachusetts Medicaid                                          MAMCD            MA        number, UPIN, and/or NPI.                                              NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Massachusetts Medicare                                           CMSEL           MA        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC


Medica Health Plans                                              94265           ALL       Loop 2100B should contain Service Provider ID and/or NPI.              T


Medical Mutual of Ohio                                           29076           OH        Loop 2100B should contain Service Provider number and/or NPI.          G


Mega Life (Transamerica Life)                                    TLINS           ALL       Loop 2100B should contain Tax ID and/or NPI.                           G


Mega Life and Health Insurance                                   59221           ALL       Loop 2100B should contain Tax ID and/or NPI.                           G

                                                                                           Loop 2100B must contain NPI. This NPI must be enrolled with MI
Michigan Medicaid                                               MIMCD            MI        BCBS for Claims prior to sending RT Eligibility Requests.              NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Michigan Medicare                                                CMSEL           MI        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Minnesota Medicare                                               CMSEL           MN        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC


Mississippi Blue Cross Blue Shield                               MSBLS           MS        Loop 2100B must contain NPI.                                           NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Mississippi Medicare                                             CMSEL           MS        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC

Missouri Anthem Blue Cross Blue Shield (WellPoint Health
Network)                                                        MOBLS            MO        Loop 2100B should contain Tax Identification Number and/or NPI.        NC


Missouri Medicaid                                               MOMCD            MO        Loop 2100B should contain Service Provider number and/or NPI.          NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Missouri Medicare                                                CMSEL           MO        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Montana Medicare                                                 CMSEL           MT        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC


Mutual of Omaha                                                  71412           ALL       Loop 2100B should contain Tax ID and/or NPI.                           T


National Association of Letter Carriers (NALC)                   53011           ALL       Loop 2100B should contain Tax ID and/or NPI.                           G
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Nebraska Medicare                                                CMSEL           NE        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC

Nevada Anthem Blue Cross Blue Shield (WellPoint Health
Network)                                                         NVBLS           NV        Loop 2100B should contain Tax Identification Number and/or NPI.        NC


Nevada Medicaid                                                 NVMCD            NV        Loop 2100B should contain NPI.                                         NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Nevada Medicare                                                  CMSEL           NV        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC

New Hampshire Anthem Blue Cross Blue Shield (WellPoint
Health Network)                                                  NHBLS           NH        Loop 2100B should contain Tax Identification Number and/or NPI.        NC


      -----------
      NP or NC: Non Participating Payers. Ingenix charges a per transaction fee for non-par payers
      For up-to-date payer information, please access the payer list from the Ingenix website at: http://www.enshealth.com
      Ingenix Eligibility Payer List
      ANSI HIPAA 270/271
      (As of 03/11/2011)



                                                                Payer ID
                          Payer Name                             2100A         State                              Additional Information                          Type
                                                                 NM109
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
New Hampshire Medicare                                           CMSEL           NH        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC


New Jersey Blue Cross Blue Shield (Horizon)                      22099           NJ        Loop 2100B should contain Tax ID and/or NPI.                            G


New Jersey Medicaid                                              NJMCD           NJ        Loop 2100B should contain Service Provider number and/or NPI.           NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
New Jersey Medicare                                              CMSEL           NJ        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC


New Mexico Medicaid                                              NMMCD           NM        Loop 2100B must contain an NPI.                                         NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
New Mexico Medicare                                              CMSEL           NM        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC


New York Blue Cross Blue Shield (Empire Health Choice)           NYBLS           NY        Loop 2100B should contain Service Provider Number and/or NPI.           NP


New York Medicaid                                                NYMCD           NY                                                                                NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
New York Medicare                                                CMSEL           NY        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC


Nippon Life (Principal Financial Group)                          81264           ALL       Loop 2100B should contain Tax ID and/or NPI.                            G


North Carolina Medicaid                                          NCMCD           NC        Loop 2100B should contain Service Provider number and/or NPI.           NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
North Carolina Medicare                                          CMSEL           NC        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
North Dakota Medicare                                            CMSEL           ND        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Northern Mariana Islands Northern Mariana Medicare               CMSEL           MP        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC


Ohio Anthem Blue Cross Blue Shield (WellPoint Health Network)    OHBLS           OH        Loop 2100B should contain Tax Identification Number and/or NPI.         NC

                                                                                           Loop 2100B must contain the Provider's Legacy Provider ID in the
Ohio Medicaid                                                    OHMCD           OH        NM109. OH Medicaid does not accept the Provider's NPI at this time.     NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Ohio Medicare                                                    CMSEL           OH        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC


Ohio Valley HMO, Cincinnati (Aetna)                              60054           ALL       Loop 2100B should contain Tax ID and/or NPI.                            P


Oklahoma Medicaid                                                MC030           OK        Enrollment required. Call Hope Richardson at (719)277-7545 ext. 1309    NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Oklahoma Medicare                                                CMSEL           OK        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Oregon Medicare                                                  CMSEL           OR        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                          NC


Oxford Health Plans                                              06111           ALL       Loop 2100B should contain Oxford Provider ID and/or NPI.                T


PacifiCare of Arizona (HMO)                                      95964           AZ        Loop 2100B should contain Tax ID and/or NPI.                            T


PacifiCare of California (HMO)                                   PHSCA           CA        Loop 2100B should contain Tax ID and/or NPI.                            T


PacifiCare of California (HMO)                                   95959           CA        Loop 2100B should contain Tax ID and/or NPI.                            T


PacifiCare of Colorado (HMO)                                     95962           CO        Loop 2100B should contain Tax ID and/or NPI.                            T


PacifiCare of Colorado (HMO)                                     COPHS           CO        Loop 2100B should contain Tax ID and/or NPI.                            T


      -----------
      NP or NC: Non Participating Payers. Ingenix charges a per transaction fee for non-par payers
      For up-to-date payer information, please access the payer list from the Ingenix website at: http://www.enshealth.com
       Ingenix Eligibility Payer List
       ANSI HIPAA 270/271
       (As of 03/11/2011)



                                                                Payer ID
                          Payer Name                             2100A          State                              Additional Information                              Type
                                                                 NM109


PacifiCare of Nevada (HMO)                                        95970           NV        Loop 2100B should contain Tax ID and/or NPI.                                T


PacifiCare of Oklahoma (HMO)                                      PHSOK           OK        Loop 2100B should contain Tax ID and/or NPI.                                T


PacifiCare of Oregon (HMO)                                        PHSOR           OR        Loop 2100B should contain Tax ID and/or NPI.                                T


PacifiCare of Texas (HMO)                                         PHSTX           TX        Loop 2100B should contain Tax ID and/or NPI.                                T


PacifiCare of Washington (HMO)                                   PHSWA            WA        Loop 2100B should contain Tax ID and/or NPI.                                T


PacifiCare PPO (All States)                                       95999           ALL       Loop 2100B should contain Tax ID and/or NPI.                                T
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Palau Medicare                                                    CMSEL           PW        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                              NC


PEHP Utah                                                         PEHPU           UT        Loop 2100B must contain the Rendering Provider NPI.                         NC
                                                                                            Loop 2100B must contain the Group NPI and be enrolled at Highmark
                                                                                            for claims prior to sending a 270 Request. If Group NPI is not enrolled,
Pennsylvania Blue Cross Blue Shield (Highmark)                    PABLS           PA        please refer to the ICS website for a copy of the enrollment form and       T

                                                                                            Loop 2100B should contain Service Provider number (13 digit PA
Pennsylvania Medicaid                                            PAMCD            PA        Provider Medicaid ID)                                                       NP
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Pennsylvania Medicare                                             CMSEL           PA        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                              NC

                                                                                            Loop 2100B Provider ID should contain Aetna PIN, Aetna PVN,
PHP of Georgia, Atlanta, Aetna                                    60054           ALL       Organization Number, Tax ID, and/or NPI.                                    T

                                                                                            Loop 2100B Provider ID should contain Aetna PIN, Aetna PVN,
PHP of North Ohio, Cleveland, Aetna                               60054           ALL       Organization Number, Tax ID, and/or NPI.                                    T

                                                                                            Loop 2100B Provider ID should contain Aetna PIN, Aetna PVN,
Primary Choice (Aetna Health Plan of NY/NJ)                       60054           ALL       Organization Number, Tax ID, and/or NPI.                                    T


Principal Financial Group (Principal Life)                        61271           ALL       Loop 2100B must be Medicare Provider number and/or NPI.                     G
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Puerto Rico Medicare                                              CMSEL           PR        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                              NC


QualChoice                                                        35174           ALL       Loop 2100B must contain Tax Identification Number or NPI.                   G
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Railroad Medicare                                                 CMSEL           ALL       ityEnrollmentForm.pdf. Loop 2100B must be NPI.                              NC
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Rhode Island Medicare                                             CMSEL           RI        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                              NC

                                                                                            Loop 2100B Provider ID should contain Aetna PIN, Aetna PVN,
Select Choice (Aetna Health Plan of NY/NJ)                        60054           ALL       Organization Number, Tax ID, and/or NPI.                                    P


SelectHealth                                                      SELHT           UT        Loop 2100B must contain the Rendering Provider NPI.                        NC

                                                                                            Loop 2100B Provider ID should contain Aetna PIN, Aetna PVN,
Senior Choice (Aetna Health Plan of NY/NJ)                        60054           ALL       Organization Number, Tax ID, and/or NPI.                                    P
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
South Carolina Medicare                                           CMSEL           SC        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                              NC
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
South Dakota Medicare                                             CMSEL           SD        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                              NC

                                                                                            Loop 2100B Provider ID should contain Aetna PIN, Aetna PVN,
Southwest Health Plan (Aetna HMO)                                 60054           ALL       Organization Number, Tax ID, and/or NPI.                                    P


Tennessee Medicaid (TennCare)                                    TNMCD            TN        Loop 2100B must contain Tax Identification Number.                          NP
                                                                                            Enrollment required. Form and instructions at
                                                                                            http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Tennessee Medicare                                                CMSEL           TN        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                              NC


       -----------
       NP or NC: Non Participating Payers. Ingenix charges a per transaction fee for non-par payers
       For up-to-date payer information, please access the payer list from the Ingenix website at: http://www.enshealth.com
      Ingenix Eligibility Payer List
      ANSI HIPAA 270/271
      (As of 03/11/2011)



                                                               Payer ID
                           Payer Name                           2100A          State                              Additional Information                         Type
                                                                NM109


Texas Blue Cross Blue Shield                                     TXBLS           TX        Loop 2100B should contain either the Provider ID or NPI.               NP


Texas Medicaid                                                  TXMCD            TX        Loop 2100B must contain NPI.                                           NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Texas Medicare                                                   CMSEL           TX        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC

                                                                                           Loop 2100B should contain Service Provider number, Tax ID, Provider
Three Rivers Health Plan                                         00199           TN        Plan Network number, Provider Plan Facility Network ID, and/or NPI.    G

                                                                                           Loop 2100B should contain Service Provider number, Tax ID, Provider
Three Rivers Health Plan / Unison MedPLUS (Medicaid)             00198      OH,PA,TN,SC    Plan Network number, Provider Plan Facility Network ID, and/or NPI.    G


TRICARE (Champus)                                                00080           ALL       Loop 2100B should contain Service Provider Number and/or NPI.          NP


Trustmark                                                        TRUST           ALL       Loop 2100B should contain Tax Identification Number and/or NPI.        G


Tufts Health Plan                                                04298           ALL       Loop 2100B should contain Tax Identification Number and/or NPI.        G
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
U.S. Minor Outlying Islands Medicare                             CMSEL           UM        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC

                                                                                           Loop 2100B must contain either the Tax Identification Number,
UMR Wausau                                                       39026           ALL       Provider Identification Number or NPI.                                 G


UniCare (WellPoint Health Network)                                UNI            ALL       Loop 2100B should contain Tax Identification Number and/or NPI.        NC


UnitedHealthcare                                                 87726           ALL       Loop 2100B should contain Service Provider ID and/or NPI.              T


UnitedHealthcare                                                  UHC            ALL       Loop 2100B should contain Service Provider ID and/or NPI.              T
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Utah Medicare                                                    CMSEL           UT        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Vermont Medicare                                                 CMSEL           VT        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Virgin Islands of the U.S Medicare                               CMSEL           VI        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC

Virginia Anthem Blue Cross Blue Shield (WellPoint Health
Network)                                                         VABLS           VA        Loop 2100B should contain Tax Identification Number and/or NPI.        NC


Virginia Medicaid                                               VAMCD            VA        Loop 2100B should contain Service Provider number and/or NPI.          NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Virginia Medicare                                                CMSEL           VA        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Washington Medicare                                              CMSEL           WA        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC
                                                                                           Contact Rick Hammes, rhammes@weatrust.com, prior to submission
                                                                                           for Payer ID and approval.
WEA Trust                                                         CALL           WI        Loop 2100B must contain Service Provider NPI.                          NC


West Virginia Medicaid                                          WVMCD            WV        Loop 2100B must contain an NPI.                                        NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
West Virginia Medicare                                           CMSEL           WV        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC

Wisconsin Anthem Blue Cross Blue Shield (WellPoint Health
Network)                                                         WIBLS           WI        Loop 2100B should contain Tax Identification Number and/or NPI.        NC


Wisconsin Medicaid                                              WIMCD            WI        Loop 2100B should contain Service Provider number and/or NPI.          NP
                                                                                           Enrollment required. Form and instructions at
                                                                                           http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Wisconsin Medicare                                               CMSEL           WI        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                         NC


Wyoming Medicaid                                                WYMCD            WY        Loop 2100B should contain Medicaid Provider Number and/or NPI.         NP


      -----------
      NP or NC: Non Participating Payers. Ingenix charges a per transaction fee for non-par payers
      For up-to-date payer information, please access the payer list from the Ingenix website at: http://www.enshealth.com
     Ingenix Eligibility Payer List
     ANSI HIPAA 270/271
     (As of 03/11/2011)



                                                              Payer ID
                       Payer Name                              2100A          State                              Additional Information                        Type
                                                               NM109
                                                                                          Enrollment required. Form and instructions at
                                                                                          http://www.enshealth.com/enspublic/Download/Enrollment/CMSEligibil
Wyoming Medicare                                                CMSEL           WY        ityEnrollmentForm.pdf. Loop 2100B must be NPI.                        NC




     -----------
     NP or NC: Non Participating Payers. Ingenix charges a per transaction fee for non-par payers
     For up-to-date payer information, please access the payer list from the Ingenix website at: http://www.enshealth.com
Payers highlighted are new or have been
altered in the last 90 days. Please verify

				
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