Payer ID Payer Name Payer ID Payer Name

September

00243 MedStar Family Choice of MD MedStar Physician Partners Vestica Healthcare00315 Thomas H. Cooper00590 BCBS Florida Florida Blue HMO Health Options - Florida Blue01066 American Healthcare Alliance01508 Better Health03440 Phoenix Health Plan04218 Pan American Life Insurance Group05003 Medicaid New Mexico - Presbyterian Salud Presbyterian Salud (NM)05047 Neighborhood Health Plan of Rhode Island06102 Diversified Administration Corp Diversified Group Brokerage/Healthplan Services06541 County Care Health Plan06607 Cardinal Innovations Piedmont Behavioral Health07205 Gilsbar Inc. Healthplus of Louisiana10010 Careworks10525 Patient Advocates, LLC11334 New York Network Management12399 Physicians Health Plan of Northern Indiana13265 Metro Plus Health Plan13315 Insurance Design Administrators13334 Affinity Health Care13382 Orthonet-Uniformed Services Family Health13383 Orthonet- Aetna13407 Uniformed Services Family Health Plan16117 RMSCO Inc16644 Nova Healthcare Administrators20270 Health Payment Systems Inc20356 Health Exchange (Cerner Corp)20488 Better Health of Florida20553 Americas 1st Choice Health Plan of South Carolina22248 Amerihealth Mercy Health Plan CarePartners Passport22321 One Call Medical22326 Horizon Mercy Horizon NJ Health Mercy Health Plan of NJ (Horizon Mercy)22348 Maryland Physicians Care

22384 Administration Concepts Inc22521 EDS Healthchoice EGID - Employees Group Insurance Division HealthChoice of Oklahoma HP Administrative Services OK State Employees & Educators EDS OSEEGIB - Oklahoma State and Education Employees Group Ins Board22603 NJ Carpernters Health Fund23130 Fresenius Medical Care23284 Keystone Mercy23285 Select Health of South Carolina23287 Intergroup Services Corporation InterGroup Services PPO23342 QualCare, Inc. Advantra Advantra Freedom Altius Health Plan - Coventry Care Management Resources (CMR) Carelink Advantra Carelink Health Plan Carelink Medicaid Carenet Carpenters Hlth/Welf. Hazelwood,MO Claims Administration Corporation (CAC) Coventry Advantra (Texas, New Mexico, Arizona) Coventry Health and Life – Oklahoma Coventry Health and Life Insurance (Tennessee) Coventry Health Care - Nevada Coventry Health Care National Network Coventry Health Care of Kansas, Inc. -Wichita Coventry Healthcare25133 Coventry Healthcare of Delaware Coventry Healthcare of Florida (Aetna Medicaid) Coventry Healthcare of Georgia Coventry Healthcare of Illinois Coventry Healthcare of Indiana Coventry Healthcare of Iowa Coventry Healthcare of Kansas, Inc. - Kansas City Coventry Healthcare of Louisiana Coventry Healthcare of Missouri Coventry Healthcare of Nebraska Coventry Healthcare of the Carolinas Coventry Medicaid Nebraska Coventry Missouri

Coventry Nebraska Medicaid Diamond Plan Family Health Partners/MC + Missouri First Health (PayerID 25133) (Coventry) Foreign Service Benefit Plan Group Health Plan (GHP) Health America, Inc. Health Assurance Healthcare USA Kansas City Advantra (Coventry) Mailhandlers Benefit Plan25133 Mercy Managed Behavioral Health Montana Health Co-op Omnicare, A Coventry Health Plan ORNDA Health D296Corp (First Health)+D312 PersonalCare PHSIC Preferre Plus of Kansas Preferred Benefits Administrator Preferred Health Systems Insurance Company (PHSIC) Preferred Plus of Kansas Rural Carrier Benefit Plan (Coventry) Southern Health Services Inc. University of Missouri Vista Health Plan WELLPATH25169 Gateway Health Plan26054 ICare Health Options26492 Florida True Health27008 Health Systems International - ECOH27094 Simply Health Care Plan27357 AmeriHealth Caritas Louisiana Louisiana Care (LACare)28530 Secure Health Plans of Georgia, LLC31048 Western Southern Financial Group (Cincinnati, OH)31053 Individual Health Insurance Companies31053 State Farm Insurance Companies31059 State Farm Property & Casualty31127 Integra Group31172 Innovante Benefit Administrator31182 InnovAge Total Community Care31441 S & S Healthcare Strategies31625 ElderPlan, Inc.33036 Loma Linda Managed Care (33036) Loma Linda Univ. Healthcare - ManagedCare Claims33373 Molina Healthcare of CA Encounters33628 Mercy Maricopa Integrated Care34136 JP Farley Corporation34154 Chesterfield Technologies34159 E-V Benefits Management, Inc (Columbus, OH)

Loma Linda Univer. Med.Center Employee Health Plan37267 Loma Linda Univer. Med.Center Residents Health Plan Loma Linda University Student Health Plan37268 Prism Health Networks Prism Network, Inc.37275 Missoula County Medical Benefits Plan37279 Insurance Administrator of America, Inc. (IAA)37282 Select Benefit Administrators of America (WI) American Administrative37283 Gallagher Benefit Administrators, Inc/GBA HealthSmart Benefit Solutions (formerly American Administrative/Gallagher Benefit)37283 Poly America Medical & Dental Benefits Plan37284 TransChoice-Key Benefit Administrators TransChoice-Key Benefit Administrators KBA37287 Planned Administrators, Inc. (PAI)37290 Health Services for Children with Special Needs37301 Summit America Insurance Services, Inc.37314 North Broward Hospital District Anthem OMHS37331 Right Choice Benefit Administrators Self Insured Plans Inc37363 ComPsych37601 University of Illinois at Chicago Div of Specialized Care for Children38217 Priority Health HAP/AHL/Curanet (MI)38224 Health Alliance Plan of Michigan Medical Value Plan-MVP-OH McLaren38232 Meritain (Michigan address) Weyco, Inc. Bass Administrators, Inc. Benesys Inc.38238 Benesys-LHP Claims Unit LHP Claims Unit38259 Automated Benefit Services38265 Administration Systems Research Physicians Care38308 Christian Brothers Services38337 Upper Peninsula Health Plan (Medicaid)38353 MedDirect ASSURANT HEALTH39065 Fortis Insurance Company Time Insurance39081 Benefit Plan Administrators Co. (Eau Claire, WI) Custom Benefit Administrators39151 WEA Insurance Group39167 Group Health Coop. of S. Central Wisconsin Claims39168 Group Health Coop. of S. Central Wisconsin Encounters39182 Insurance TPA

56240 Detroit Medical Center56731 Healthcare Resources NW57080 ClaimsWare, Inc. dba ManageMed CWIBENEFITS, INC.57117 QVI Risk Solutions Inc57254 State of Texas Dental Plan (GEHA)58102 Covenant Administrators Inc Dental (Atlanta, GA)58213 Alignis58213 Healthways WholeHealth Networks58231 Core Administrative Services Core Management Resources Group58234 Alliant Health Plans of Georgia58730 Aetna ASA PPO/Assurant Health (Signature Admin)59140 Consolidated Group Health Plan Services Health Plan Services - Oklahoma HealthPlan Services (Tampa only) The Mutual Group59143 Harrington Health Non-EPO59266 Volusia Health Network59299 Employers Mutual, Inc. EMI-KP (Ambulance)59313 Evolutions Healthcare Systems (New Port Richey, FL)59324 Podiatry Network Florida59354 Wellcare Health Plans Encounters60061 Amerihealth Non-HMO New Jersey (Highmark)61102 Humana (Encounters only)61124 Bluegrass Family Health Signature Health Alliance61425 STARMARK Tooling and Manufacturing Assocation Trustmark Insurance62160 MedSolutions, Inc62180 Health Choice Generations62777 Trilogy Network63100 Behavioral Health Systems63103 American Behavioral63114 Viva Health Plan64157 Meritain Health (North American Health Plan.) North American Administrators, Inc.64158 Meritain Health / Agency Services64246 Dental Guard Preferred First Commonwealth HMO Dental Plan Guardian Life (The Guardian)64284 Independence Care Systems / FIDA-MMP65031 CarePlus Health Plans Physicians Healthcare Plans65054 Premier Eye Care65062 ATA Florida (American Therapy Association) Health Network One (HN1 Therapy Network)65101 AXA Assistance USA HAA Preferred Partners

Meritain (Cleveland address)34159 NABN (Cleveland, OH) North American Benefits Network34171 FrontPath Health Coalition34189 Ohio Health Choice, PPO Antares Management Solutions34192 Benefit Services Inc. Mutual Health Services34196 Apex Benefit Services35145 Highmark - Key Family35161 Indiana ProHealth Network35162 Managed Care Services, LLC QCA Health Plan35174 Qual Choice of Arkansas QualChoice Health Insurance35183 CoreSource OH35198 Unified Group Services United Group Services Encircle PPO Encore Health Network35206 Signature Care Health Network The Healthcare Group36215 Central States Health & Welfare Funds Teamcare36331 Professional Benefit Administrators, Inc.36334 MACNEAL HEALTH PROVIDERS - CHS36338 Group Administrators Ltd.36345 Physicians Care Network36373 Prairie States Enterprises, Inc.36396 Family Medical Network Resurrection Health Care Preferred (RHCP)37105 Hinsdale Physicians Healthcare Sage Technologies37116 St. Therese Physician Assoc.37121 Mashantucket Pequot Tribal Nation37217 Key Benefit Administrators37227 CNIC Health Solutions InterCare Health Plans37242 Aultra Administrative Group Professional Claims Management37256 Mutual Assurance37257 EMPLOYEE BENEFIT CON INC Loma Linda Default (37267) Loma Linda University Adventist Health Sciences Center Employee Health Plan Loma Linda Univer. Adventist Health Sciences Centers37267 Loma Linda Univer. Behavioral Medicine Center Employee Health Plan Loma Linda University Dept of Risk Management Loma Linda University Employee Health Plan Loma Linda Univer. Health Care Employee Health Plan

39182 International Funding Limited41041 Federated Mutual Health Insurance Company41206 Ultra Benefits American Administrators (West Des Moines)42137 Select Benefit Administrators (Des Moines, Iowa) TriStar (formerly Select Benefit Administrators)42138 Cook County Health Behavioral 42139 Cook County Health Medical 42140 Centurion42172 Puget Sound Health Partners Inc Soundpath Health43160 Corizon Inc Correctional Medical Services, Inc.43166 Mercy Health Plan Premier Benefits Inc. Premier Health Plans43178 Benefit Management Inc - Joplin Claims Joplin Claims44273 Health Plans, Inc.45281 Riverside Health Inc University of Maryland Health Partners (UMHP)45341 Maine Community Health Options45423 Advicare46050 Generations Globalhealth Generations Healthcare47027 Physicians Mutual Insurance Company47080 Midlands Choice, Inc.48026 Northshore Physician Associates48100 ProviDRs Care Network48117 CoreSource KC (FMH) FMH Benefit Services, Inc.50701 VGM Homelink52123 Johns Hopkins Healthcare USFHP52132 Cooperative Benefit Administrators (CBA) National Rural Electric Cooperative Assoc.52180 UMWA Health & Retirement Funds52189 Johns Hopkins Healthcare52629 UCare Minnesota53589 BCBS Arizona54154 Optima Health Plan Optima Insurance Company Sentara Family Care Sentara Health Management54763 AmeriHealth Administrators Independence Administrators56139 Benefit Management Services (NOT in LA) Integra BMS56144 Primary Physician Care Inc.56190 OptiCare Managed Vision (Prime Vision Health) Prime Vision Health56196 First Carolina Care

65391 CBHNP - HealthChoices66055 Netcare Life and Health Insurance (Hagatna, Guam)68039 Western Health Advantage68069 Louisiana Health Care Connections 72126 Peoples Health Network72467 ACS Benefit Services Inc.73100 Kempton Group73143 Com. Care Managed Health Care Plans of Oklahoma73145 Preferred Community Choice/PCCSelect/CompMed73159 CCN Managed Care Inc. (First Health Network) First Health Network (f.k.a. CCN, PPO OK, HCVM) PPO Oklahoma (now known as: First Health Network74095 USAA (United States Automobile Association)74323 Medical Benefits Mutual75190 NCAS - Fairfax, VA75191 NCAS-Charlotte75237 HealthSmart Accel75250 Provider Direct Network (HealthSmart Preferred Care)75278 Arkansas Best Corporation - Choice Benefits75281 New Era Life Insurance Company76066 Renaissance Physicians Organization77001 Amerihealth NorthEast77002 Amerihealth District of Columbia77076 Network Health Insurance - Medicare77153 Indiana Uni. Health Plan – Commercial/Marketplace Southeastern Indiana Health (SIHO)81264 Nippon Life Insurance Co.81883 Municipal Health Benefit Fund83028 CDO Technologies MBA Benefit Administrators84076 Sinclair Health Plan84109 Pinnacol Assurance84135 Denver Health Medical Plan84980 BCBS Texas/HMO Blue Shield (non-MediCaid)85578 Ingalls Provider Group87042 Union Pacific Railroad Employees Health System87071 Liberty Health Advantage87098 Avesis Third Party Administrator87815 Acordia HealthSmart Benefit Solutions (formerly Wells Fargo TPA/Acordia National) Shaw Industries Wells Fargo Third Party Administrators, Inc. (Accordia)87843 Consolidated Health Plans88019 Teachers Health Trust88022 CDS Group Health88023 Hometown Health Plan Nevada88027 Benefit Plan Admin - Northern Nevada Trust Fund Electrical Workers Health and Welfare Plan for Northern Nevada Northern Nevada Oper. Engineers Health and Welfare

88027 Northern Nevada Trust Fund88029 Saint Marys Health Plan St Marys Health Plan88030 Scott & White Health Care Plan88067 Tall Tree Administrators90001 Healthcare Plan PPO Healthlink PPO Nat.Capital Preferred Provider Organization (NCPPO)90560 Westlake Financial Group91078 Trusteed Plans Service Corporation91136 Alaska Carpenters Trust Group #F40 Alaska Childrens Services, Inc. Group #P68 Alaska Laborers Construction Ind. Trust Group #F23 Alaska Pipe Trades Local Group #F24 Alaska United Food & Commercial Workers Health & Welfare Trust Group #F45 Caremark WPAS, Group #P62 Cement Masons & Plasterers Health & Welfare Trust Group #F16 Enstar Natural Gas, Group #P61 Hotel Employees & Restaurant Employees Health Trust, Group #F19 N.W. Ironworkers Health & Sec. Trust Fund, Group #F15 N.W. Roofers & Employers Health & Security Trust Fund, Group #F26 N.W. Textile Processors Group #F14 Operating Engineers Locals 302 & 612 Health & Security Fund, Group #F12 Puget Sound Benefits Trust, Group #F25 Puget Sound Electrical Workers Trust, Group #3391171 Physicians of Southwest Washington91184 Sanford Health Plan93044 A & I Benefit Plan Administrators93092 US Benefits94123 Kaiser Permanente Health Plan of Hawaii94320 Kaiser California Select for Individuals Kaiser CSI Kaiser Self-Funded KPIC Self-Funded Claims Administrator94998 Firstcare (Medicaid)94999 Firstcare95044 AmeriHealth Delaware - POS Amerihealth HMO New Jersey and Delaware (Highmark) AmeriHealth New Jersey - POS AmeriHealth Pennsylvania - ERISA AmeriHealth Pennsylvania - HMO/POS95202 Summacare Health Plan (HMO)95348 Humana Ohio95377 Beech Street95397 Personal Insurance Administrators95426 Affordable Benefit Administrators

95444 Indiana University (IU) Health Plan – Medicare Advantage MPLAN, Inc./HealthCare Group, LLC95998 New Avenues98514 TRLHN AS99320 Benefit & Risk Management Services (BRMS) California Water Service (Cal Water)AHS01 Access AdministratorsAPG01 Affiliated Physicians GroupBTSS1 Brown & Toland Sutter SelectBV001 Block Vision - VIPA/Block Vision of TexasCB987 Dart Member CareCP001 InterCommunity Health CCO (IHN) Samaritan Advantage (SA01) Samaritan Choice (SCP) Samaritan Health Plans Samaritan Healthy Kids (KID)DOCSO Southwest Oregon IPA (DOCS) Western Oregon Advanced HealthEBSRM Lifetime Benefit SolutionsFS802 Bridgeview CompanyFS802 FirstSolutionsGEM01 Global Excel ManagementGHOKC Global HealthHESUN Healthsun Health PlanKLSY1 SelectCare of Texas (Kelsey-Seybold) TexanPlus of Texas (Kelsey-Seybold)LCM01 Little Company of MaryMAHP1 Medical Associates Health PlanMHHNP MEMORIAL HERMANN HLTH NETMRCHP CareSource Health Plan of OregonREHNA Rehn and AssociatesSHEBP Seton Employee PlanSX105 Deseret Mutual Benefit AdministratorsSX106 Public Employees Health Plan (PEHP)SX110 Educators Mutual of Utah (EMI Health)SX145 Banner Health AZ Banner Health Co, - ROCKY MOUNTAIN HMO GREELEY Banner Health Co. - ANTERO GREELEY Banner Health Co. - ANTERO HIGH PLAINS Banner Health Co. - ANTERO MOUNTAIN SHADOWS Banner Health Co. - CHOICE PLUS Banner Health Co. - HMO GREELEY Banner Health Co. - HMO HIGH PLAINS Banner Health Co. - HMO MOUNTAIN SHADOWS Banner Health Co. - PACIFICARE GREELEY Banner Health Co. - PACIFICARE HIGH PLAINS Banner Health Co. - PACIFICARE MOUNTAIN SHADOWS Banner Health Co. - ROCKY MNT HMO HIGH PLAINS Banner Health Co. - SECURE HORIZONS GREELEY Banner Health Co. - SECURE HORIZONS HIGH PLAINS Banner Health Co. - SECURE HORIZONS MNT SHADOWS

SX155 University of UtahSX172 MDwise Eskenazi Health - Healthy Indiana Plan (HCFA) MDwise Eskenazi Health - Hoosier Healthwise (HCFA)SX172 MDwise Excel Network - Healthy Indiana Plan (HCFA) MDwise Excel Network - Hoosier Healthwise (HCFA) MDwise Family Planning - Healthy Indiana Plan (HCFA) MDwise Family Planning - Hoosier Healthwise (HCFA) MDwise Franciscan - Healthy Indiana Plan (HCFA) MDwise Healthy Indiana Plan HIP (HCFA) MDwise Hoosier Care Connect (HCFA) MDwise Hoosier/Healthy Indiana (HCFA) MDwise IU Health - Healthy Indiana Plan (HCFA) MDwise IU Health - Hoosier Healthwise (HCFA) MDwise Marketplace (HCFA) MDwise Select Health Net. Healthy Indiana Plan (HCFA) MDwise St. Catherine - Healthy Indiana Plan (HCFA) MDwise St. Margaret - Healthy Indiana Plan (HCFA) MDwise St. Vincent - Healthy Indiana Plan (HCFA) MDwise Total Health - Healthy Indiana Plan (HCFA) MDwise Total Health - Hoosier Healthwise (HCFA)

Payer ID Payer Name Payer ID Payer Name

00243 MedStar Family Choice of MD MedStar Physician Partners Vestica Healthcare00315 Thomas H. Cooper00590 BCBS Florida Florida Blue HMO Health Options - Florida Blue01066 American Healthcare Alliance01508 Better Health03440 Phoenix Health Plan04218 Pan American Life Insurance Group05003 Medicaid New Mexico - Presbyterian Salud Presbyterian Salud (NM)05047 Neighborhood Health Plan of Rhode Island06102 Diversified Administration Corp Diversified Group Brokerage/Healthplan Services06541 County Care Health Plan06607 Cardinal Innovations Piedmont Behavioral Health07205 Gilsbar Inc. Healthplus of Louisiana10010 Careworks10525 Patient Advocates, LLC11334 New York Network Management12399 Physicians Health Plan of Northern Indiana13265 Metro Plus Health Plan13315 Insurance Design Administrators13334 Affinity Health Care13382 Orthonet-Uniformed Services Family Health13383 Orthonet- Aetna13407 Uniformed Services Family Health Plan16117 RMSCO Inc16644 Nova Healthcare Administrators20270 Health Payment Systems Inc20356 Health Exchange (Cerner Corp)20488 Better Health of Florida20553 Americas 1st Choice Health Plan of South Carolina22248 Amerihealth Mercy Health Plan CarePartners Passport22321 One Call Medical22326 Horizon Mercy Horizon NJ Health Mercy Health Plan of NJ (Horizon Mercy)22348 Maryland Physicians Care

22384 Administration Concepts Inc22521 EDS Healthchoice EGID - Employees Group Insurance Division HealthChoice of Oklahoma HP Administrative Services OK State Employees & Educators EDS OSEEGIB - Oklahoma State and Education Employees Group Ins Board22603 NJ Carpernters Health Fund23130 Fresenius Medical Care23284 Keystone Mercy23285 Select Health of South Carolina23287 Intergroup Services Corporation InterGroup Services PPO23342 QualCare, Inc. Advantra Advantra Freedom Altius Health Plan - Coventry Care Management Resources (CMR) Carelink Advantra Carelink Health Plan Carelink Medicaid Carenet Carpenters Hlth/Welf. Hazelwood,MO Claims Administration Corporation (CAC) Coventry Advantra (Texas, New Mexico, Arizona) Coventry Health and Life – Oklahoma Coventry Health and Life Insurance (Tennessee) Coventry Health Care - Nevada Coventry Health Care National Network Coventry Health Care of Kansas, Inc. -Wichita Coventry Healthcare25133 Coventry Healthcare of Delaware Coventry Healthcare of Florida (Aetna Medicaid) Coventry Healthcare of Georgia Coventry Healthcare of Illinois Coventry Healthcare of Indiana Coventry Healthcare of Iowa Coventry Healthcare of Kansas, Inc. - Kansas City Coventry Healthcare of Louisiana Coventry Healthcare of Missouri Coventry Healthcare of Nebraska Coventry Healthcare of the Carolinas Coventry Medicaid Nebraska Coventry Missouri

Coventry Nebraska Medicaid Diamond Plan Family Health Partners/MC + Missouri First Health (PayerID 25133) (Coventry) Foreign Service Benefit Plan Group Health Plan (GHP) Health America, Inc. Health Assurance Healthcare USA Kansas City Advantra (Coventry) Mailhandlers Benefit Plan25133 Mercy Managed Behavioral Health Montana Health Co-op Omnicare, A Coventry Health Plan ORNDA Health D296Corp (First Health)+D312 PersonalCare PHSIC Preferre Plus of Kansas Preferred Benefits Administrator Preferred Health Systems Insurance Company (PHSIC) Preferred Plus of Kansas Rural Carrier Benefit Plan (Coventry) Southern Health Services Inc. University of Missouri Vista Health Plan WELLPATH25169 Gateway Health Plan26054 ICare Health Options26492 Florida True Health27008 Health Systems International - ECOH27094 Simply Health Care Plan27357 AmeriHealth Caritas Louisiana Louisiana Care (LACare)28530 Secure Health Plans of Georgia, LLC31048 Western Southern Financial Group (Cincinnati, OH)31053 Individual Health Insurance Companies31053 State Farm Insurance Companies31059 State Farm Property & Casualty31127 Integra Group31172 Innovante Benefit Administrator31182 InnovAge Total Community Care31441 S & S Healthcare Strategies31625 ElderPlan, Inc.33036 Loma Linda Managed Care (33036) Loma Linda Univ. Healthcare - ManagedCare Claims33373 Molina Healthcare of CA Encounters33628 Mercy Maricopa Integrated Care34136 JP Farley Corporation34154 Chesterfield Technologies34159 E-V Benefits Management, Inc (Columbus, OH)

Loma Linda Univer. Med.Center Employee Health Plan37267 Loma Linda Univer. Med.Center Residents Health Plan Loma Linda University Student Health Plan37268 Prism Health Networks Prism Network, Inc.37275 Missoula County Medical Benefits Plan37279 Insurance Administrator of America, Inc. (IAA)37282 Select Benefit Administrators of America (WI) American Administrative37283 Gallagher Benefit Administrators, Inc/GBA HealthSmart Benefit Solutions (formerly American Administrative/Gallagher Benefit)37283 Poly America Medical & Dental Benefits Plan37284 TransChoice-Key Benefit Administrators TransChoice-Key Benefit Administrators KBA37287 Planned Administrators, Inc. (PAI)37290 Health Services for Children with Special Needs37301 Summit America Insurance Services, Inc.37314 North Broward Hospital District Anthem OMHS37331 Right Choice Benefit Administrators Self Insured Plans Inc37363 ComPsych37601 University of Illinois at Chicago Div of Specialized Care for Children38217 Priority Health HAP/AHL/Curanet (MI)38224 Health Alliance Plan of Michigan Medical Value Plan-MVP-OH McLaren38232 Meritain (Michigan address) Weyco, Inc. Bass Administrators, Inc. Benesys Inc.38238 Benesys-LHP Claims Unit LHP Claims Unit38259 Automated Benefit Services38265 Administration Systems Research Physicians Care38308 Christian Brothers Services38337 Upper Peninsula Health Plan (Medicaid)38353 MedDirect ASSURANT HEALTH39065 Fortis Insurance Company Time Insurance39081 Benefit Plan Administrators Co. (Eau Claire, WI) Custom Benefit Administrators39151 WEA Insurance Group39167 Group Health Coop. of S. Central Wisconsin Claims39168 Group Health Coop. of S. Central Wisconsin Encounters39182 Insurance TPA

56240 Detroit Medical Center56731 Healthcare Resources NW57080 ClaimsWare, Inc. dba ManageMed CWIBENEFITS, INC.57117 QVI Risk Solutions Inc57254 State of Texas Dental Plan (GEHA)58102 Covenant Administrators Inc Dental (Atlanta, GA)58213 Alignis58213 Healthways WholeHealth Networks58231 Core Administrative Services Core Management Resources Group58234 Alliant Health Plans of Georgia58730 Aetna ASA PPO/Assurant Health (Signature Admin)59140 Consolidated Group Health Plan Services Health Plan Services - Oklahoma HealthPlan Services (Tampa only) The Mutual Group59143 Harrington Health Non-EPO59266 Volusia Health Network59299 Employers Mutual, Inc. EMI-KP (Ambulance)59313 Evolutions Healthcare Systems (New Port Richey, FL)59324 Podiatry Network Florida59354 Wellcare Health Plans Encounters60061 Amerihealth Non-HMO New Jersey (Highmark)61102 Humana (Encounters only)61124 Bluegrass Family Health Signature Health Alliance61425 STARMARK Tooling and Manufacturing Assocation Trustmark Insurance62160 MedSolutions, Inc62180 Health Choice Generations62777 Trilogy Network63100 Behavioral Health Systems63103 American Behavioral63114 Viva Health Plan64157 Meritain Health (North American Health Plan.) North American Administrators, Inc.64158 Meritain Health / Agency Services64246 Dental Guard Preferred First Commonwealth HMO Dental Plan Guardian Life (The Guardian)64284 Independence Care Systems / FIDA-MMP65031 CarePlus Health Plans Physicians Healthcare Plans65054 Premier Eye Care65062 ATA Florida (American Therapy Association) Health Network One (HN1 Therapy Network)65101 AXA Assistance USA HAA Preferred Partners

Meritain (Cleveland address)34159 NABN (Cleveland, OH) North American Benefits Network34171 FrontPath Health Coalition34189 Ohio Health Choice, PPO Antares Management Solutions34192 Benefit Services Inc. Mutual Health Services34196 Apex Benefit Services35145 Highmark - Key Family35161 Indiana ProHealth Network35162 Managed Care Services, LLC QCA Health Plan35174 Qual Choice of Arkansas QualChoice Health Insurance35183 CoreSource OH35198 Unified Group Services United Group Services Encircle PPO Encore Health Network35206 Signature Care Health Network The Healthcare Group36215 Central States Health & Welfare Funds Teamcare36331 Professional Benefit Administrators, Inc.36334 MACNEAL HEALTH PROVIDERS - CHS36338 Group Administrators Ltd.36345 Physicians Care Network36373 Prairie States Enterprises, Inc.36396 Family Medical Network Resurrection Health Care Preferred (RHCP)37105 Hinsdale Physicians Healthcare Sage Technologies37116 St. Therese Physician Assoc.37121 Mashantucket Pequot Tribal Nation37217 Key Benefit Administrators37227 CNIC Health Solutions InterCare Health Plans37242 Aultra Administrative Group Professional Claims Management37256 Mutual Assurance37257 EMPLOYEE BENEFIT CON INC Loma Linda Default (37267) Loma Linda University Adventist Health Sciences Center Employee Health Plan Loma Linda Univer. Adventist Health Sciences Centers37267 Loma Linda Univer. Behavioral Medicine Center Employee Health Plan Loma Linda University Dept of Risk Management Loma Linda University Employee Health Plan Loma Linda Univer. Health Care Employee Health Plan

39182 International Funding Limited41041 Federated Mutual Health Insurance Company41206 Ultra Benefits American Administrators (West Des Moines)42137 Select Benefit Administrators (Des Moines, Iowa) TriStar (formerly Select Benefit Administrators)42138 Cook County Health Behavioral 42139 Cook County Health Medical 42140 Centurion42172 Puget Sound Health Partners Inc Soundpath Health43160 Corizon Inc Correctional Medical Services, Inc.43166 Mercy Health Plan Premier Benefits Inc. Premier Health Plans43178 Benefit Management Inc - Joplin Claims Joplin Claims44273 Health Plans, Inc.45281 Riverside Health Inc University of Maryland Health Partners (UMHP)45341 Maine Community Health Options45423 Advicare46050 Generations Globalhealth Generations Healthcare47027 Physicians Mutual Insurance Company47080 Midlands Choice, Inc.48026 Northshore Physician Associates48100 ProviDRs Care Network48117 CoreSource KC (FMH) FMH Benefit Services, Inc.50701 VGM Homelink52123 Johns Hopkins Healthcare USFHP52132 Cooperative Benefit Administrators (CBA) National Rural Electric Cooperative Assoc.52180 UMWA Health & Retirement Funds52189 Johns Hopkins Healthcare52629 UCare Minnesota53589 BCBS Arizona54154 Optima Health Plan Optima Insurance Company Sentara Family Care Sentara Health Management54763 AmeriHealth Administrators Independence Administrators56139 Benefit Management Services (NOT in LA) Integra BMS56144 Primary Physician Care Inc.56190 OptiCare Managed Vision (Prime Vision Health) Prime Vision Health56196 First Carolina Care

65391 CBHNP - HealthChoices66055 Netcare Life and Health Insurance (Hagatna, Guam)68039 Western Health Advantage68069 Louisiana Health Care Connections 72126 Peoples Health Network72467 ACS Benefit Services Inc.73100 Kempton Group73143 Com. Care Managed Health Care Plans of Oklahoma73145 Preferred Community Choice/PCCSelect/CompMed73159 CCN Managed Care Inc. (First Health Network) First Health Network (f.k.a. CCN, PPO OK, HCVM) PPO Oklahoma (now known as: First Health Network74095 USAA (United States Automobile Association)74323 Medical Benefits Mutual75190 NCAS - Fairfax, VA75191 NCAS-Charlotte75237 HealthSmart Accel75250 Provider Direct Network (HealthSmart Preferred Care)75278 Arkansas Best Corporation - Choice Benefits75281 New Era Life Insurance Company76066 Renaissance Physicians Organization77001 Amerihealth NorthEast77002 Amerihealth District of Columbia77076 Network Health Insurance - Medicare77153 Indiana Uni. Health Plan – Commercial/Marketplace Southeastern Indiana Health (SIHO)81264 Nippon Life Insurance Co.81883 Municipal Health Benefit Fund83028 CDO Technologies MBA Benefit Administrators84076 Sinclair Health Plan84109 Pinnacol Assurance84135 Denver Health Medical Plan84980 BCBS Texas/HMO Blue Shield (non-MediCaid)85578 Ingalls Provider Group87042 Union Pacific Railroad Employees Health System87071 Liberty Health Advantage87098 Avesis Third Party Administrator87815 Acordia HealthSmart Benefit Solutions (formerly Wells Fargo TPA/Acordia National) Shaw Industries Wells Fargo Third Party Administrators, Inc. (Accordia)87843 Consolidated Health Plans88019 Teachers Health Trust88022 CDS Group Health88023 Hometown Health Plan Nevada88027 Benefit Plan Admin - Northern Nevada Trust Fund Electrical Workers Health and Welfare Plan for Northern Nevada Northern Nevada Oper. Engineers Health and Welfare

88027 Northern Nevada Trust Fund88029 Saint Marys Health Plan St Marys Health Plan88030 Scott & White Health Care Plan88067 Tall Tree Administrators90001 Healthcare Plan PPO Healthlink PPO Nat.Capital Preferred Provider Organization (NCPPO)90560 Westlake Financial Group91078 Trusteed Plans Service Corporation91136 Alaska Carpenters Trust Group #F40 Alaska Childrens Services, Inc. Group #P68 Alaska Laborers Construction Ind. Trust Group #F23 Alaska Pipe Trades Local Group #F24 Alaska United Food & Commercial Workers Health & Welfare Trust Group #F45 Caremark WPAS, Group #P62 Cement Masons & Plasterers Health & Welfare Trust Group #F16 Enstar Natural Gas, Group #P61 Hotel Employees & Restaurant Employees Health Trust, Group #F19 N.W. Ironworkers Health & Sec. Trust Fund, Group #F15 N.W. Roofers & Employers Health & Security Trust Fund, Group #F26 N.W. Textile Processors Group #F14 Operating Engineers Locals 302 & 612 Health & Security Fund, Group #F12 Puget Sound Benefits Trust, Group #F25 Puget Sound Electrical Workers Trust, Group #3391171 Physicians of Southwest Washington91184 Sanford Health Plan93044 A & I Benefit Plan Administrators93092 US Benefits94123 Kaiser Permanente Health Plan of Hawaii94320 Kaiser California Select for Individuals Kaiser CSI Kaiser Self-Funded KPIC Self-Funded Claims Administrator94998 Firstcare (Medicaid)94999 Firstcare95044 AmeriHealth Delaware - POS Amerihealth HMO New Jersey and Delaware (Highmark) AmeriHealth New Jersey - POS AmeriHealth Pennsylvania - ERISA AmeriHealth Pennsylvania - HMO/POS95202 Summacare Health Plan (HMO)95348 Humana Ohio95377 Beech Street95397 Personal Insurance Administrators95426 Affordable Benefit Administrators

95444 Indiana University (IU) Health Plan – Medicare Advantage MPLAN, Inc./HealthCare Group, LLC95998 New Avenues98514 TRLHN AS99320 Benefit & Risk Management Services (BRMS) California Water Service (Cal Water)AHS01 Access AdministratorsAPG01 Affiliated Physicians GroupBTSS1 Brown & Toland Sutter SelectBV001 Block Vision - VIPA/Block Vision of TexasCB987 Dart Member CareCP001 InterCommunity Health CCO (IHN) Samaritan Advantage (SA01) Samaritan Choice (SCP) Samaritan Health Plans Samaritan Healthy Kids (KID)DOCSO Southwest Oregon IPA (DOCS) Western Oregon Advanced HealthEBSRM Lifetime Benefit SolutionsFS802 Bridgeview CompanyFS802 FirstSolutionsGEM01 Global Excel ManagementGHOKC Global HealthHESUN Healthsun Health PlanKLSY1 SelectCare of Texas (Kelsey-Seybold) TexanPlus of Texas (Kelsey-Seybold)LCM01 Little Company of MaryMAHP1 Medical Associates Health PlanMHHNP MEMORIAL HERMANN HLTH NETMRCHP CareSource Health Plan of OregonREHNA Rehn and AssociatesSHEBP Seton Employee PlanSX105 Deseret Mutual Benefit AdministratorsSX106 Public Employees Health Plan (PEHP)SX110 Educators Mutual of Utah (EMI Health)SX145 Banner Health AZ Banner Health Co, - ROCKY MOUNTAIN HMO GREELEY Banner Health Co. - ANTERO GREELEY Banner Health Co. - ANTERO HIGH PLAINS Banner Health Co. - ANTERO MOUNTAIN SHADOWS Banner Health Co. - CHOICE PLUS Banner Health Co. - HMO GREELEY Banner Health Co. - HMO HIGH PLAINS Banner Health Co. - HMO MOUNTAIN SHADOWS Banner Health Co. - PACIFICARE GREELEY Banner Health Co. - PACIFICARE HIGH PLAINS Banner Health Co. - PACIFICARE MOUNTAIN SHADOWS Banner Health Co. - ROCKY MNT HMO HIGH PLAINS Banner Health Co. - SECURE HORIZONS GREELEY Banner Health Co. - SECURE HORIZONS HIGH PLAINS Banner Health Co. - SECURE HORIZONS MNT SHADOWS

SX155 University of UtahSX172 MDwise Eskenazi Health - Healthy Indiana Plan (HCFA) MDwise Eskenazi Health - Hoosier Healthwise (HCFA)SX172 MDwise Excel Network - Healthy Indiana Plan (HCFA) MDwise Excel Network - Hoosier Healthwise (HCFA) MDwise Family Planning - Healthy Indiana Plan (HCFA) MDwise Family Planning - Hoosier Healthwise (HCFA) MDwise Franciscan - Healthy Indiana Plan (HCFA) MDwise Healthy Indiana Plan HIP (HCFA) MDwise Hoosier Care Connect (HCFA) MDwise Hoosier/Healthy Indiana (HCFA) MDwise IU Health - Healthy Indiana Plan (HCFA) MDwise IU Health - Hoosier Healthwise (HCFA) MDwise Marketplace (HCFA) MDwise Select Health Net. Healthy Indiana Plan (HCFA) MDwise St. Catherine - Healthy Indiana Plan (HCFA) MDwise St. Margaret - Healthy Indiana Plan (HCFA) MDwise St. Vincent - Healthy Indiana Plan (HCFA) MDwise Total Health - Healthy Indiana Plan (HCFA) MDwise Total Health - Hoosier Healthwise (HCFA)

Payer ID Payer Name Payer ID Payer Name

00243 MedStar Family Choice of MD MedStar Physician Partners Vestica Healthcare00315 Thomas H. Cooper00590 BCBS Florida Florida Blue HMO Health Options - Florida Blue01066 American Healthcare Alliance01508 Better Health03440 Phoenix Health Plan04218 Pan American Life Insurance Group05003 Medicaid New Mexico - Presbyterian Salud Presbyterian Salud (NM)05047 Neighborhood Health Plan of Rhode Island06102 Diversified Administration Corp Diversified Group Brokerage/Healthplan Services06541 County Care Health Plan06607 Cardinal Innovations Piedmont Behavioral Health07205 Gilsbar Inc. Healthplus of Louisiana10010 Careworks10525 Patient Advocates, LLC11334 New York Network Management12399 Physicians Health Plan of Northern Indiana13265 Metro Plus Health Plan13315 Insurance Design Administrators13334 Affinity Health Care13382 Orthonet-Uniformed Services Family Health13383 Orthonet- Aetna13407 Uniformed Services Family Health Plan16117 RMSCO Inc16644 Nova Healthcare Administrators20270 Health Payment Systems Inc20356 Health Exchange (Cerner Corp)20488 Better Health of Florida20553 Americas 1st Choice Health Plan of South Carolina22248 Amerihealth Mercy Health Plan CarePartners Passport22321 One Call Medical22326 Horizon Mercy Horizon NJ Health Mercy Health Plan of NJ (Horizon Mercy)22348 Maryland Physicians Care

22384 Administration Concepts Inc22521 EDS Healthchoice EGID - Employees Group Insurance Division HealthChoice of Oklahoma HP Administrative Services OK State Employees & Educators EDS OSEEGIB - Oklahoma State and Education Employees Group Ins Board22603 NJ Carpernters Health Fund23130 Fresenius Medical Care23284 Keystone Mercy23285 Select Health of South Carolina23287 Intergroup Services Corporation InterGroup Services PPO23342 QualCare, Inc. Advantra Advantra Freedom Altius Health Plan - Coventry Care Management Resources (CMR) Carelink Advantra Carelink Health Plan Carelink Medicaid Carenet Carpenters Hlth/Welf. Hazelwood,MO Claims Administration Corporation (CAC) Coventry Advantra (Texas, New Mexico, Arizona) Coventry Health and Life – Oklahoma Coventry Health and Life Insurance (Tennessee) Coventry Health Care - Nevada Coventry Health Care National Network Coventry Health Care of Kansas, Inc. -Wichita Coventry Healthcare25133 Coventry Healthcare of Delaware Coventry Healthcare of Florida (Aetna Medicaid) Coventry Healthcare of Georgia Coventry Healthcare of Illinois Coventry Healthcare of Indiana Coventry Healthcare of Iowa Coventry Healthcare of Kansas, Inc. - Kansas City Coventry Healthcare of Louisiana Coventry Healthcare of Missouri Coventry Healthcare of Nebraska Coventry Healthcare of the Carolinas Coventry Medicaid Nebraska Coventry Missouri

Coventry Nebraska Medicaid Diamond Plan Family Health Partners/MC + Missouri First Health (PayerID 25133) (Coventry) Foreign Service Benefit Plan Group Health Plan (GHP) Health America, Inc. Health Assurance Healthcare USA Kansas City Advantra (Coventry) Mailhandlers Benefit Plan25133 Mercy Managed Behavioral Health Montana Health Co-op Omnicare, A Coventry Health Plan ORNDA Health D296Corp (First Health)+D312 PersonalCare PHSIC Preferre Plus of Kansas Preferred Benefits Administrator Preferred Health Systems Insurance Company (PHSIC) Preferred Plus of Kansas Rural Carrier Benefit Plan (Coventry) Southern Health Services Inc. University of Missouri Vista Health Plan WELLPATH25169 Gateway Health Plan26054 ICare Health Options26492 Florida True Health27008 Health Systems International - ECOH27094 Simply Health Care Plan27357 AmeriHealth Caritas Louisiana Louisiana Care (LACare)28530 Secure Health Plans of Georgia, LLC31048 Western Southern Financial Group (Cincinnati, OH)31053 Individual Health Insurance Companies31053 State Farm Insurance Companies31059 State Farm Property & Casualty31127 Integra Group31172 Innovante Benefit Administrator31182 InnovAge Total Community Care31441 S & S Healthcare Strategies31625 ElderPlan, Inc.33036 Loma Linda Managed Care (33036) Loma Linda Univ. Healthcare - ManagedCare Claims33373 Molina Healthcare of CA Encounters33628 Mercy Maricopa Integrated Care34136 JP Farley Corporation34154 Chesterfield Technologies34159 E-V Benefits Management, Inc (Columbus, OH)

Loma Linda Univer. Med.Center Employee Health Plan37267 Loma Linda Univer. Med.Center Residents Health Plan Loma Linda University Student Health Plan37268 Prism Health Networks Prism Network, Inc.37275 Missoula County Medical Benefits Plan37279 Insurance Administrator of America, Inc. (IAA)37282 Select Benefit Administrators of America (WI) American Administrative37283 Gallagher Benefit Administrators, Inc/GBA HealthSmart Benefit Solutions (formerly American Administrative/Gallagher Benefit)37283 Poly America Medical & Dental Benefits Plan37284 TransChoice-Key Benefit Administrators TransChoice-Key Benefit Administrators KBA37287 Planned Administrators, Inc. (PAI)37290 Health Services for Children with Special Needs37301 Summit America Insurance Services, Inc.37314 North Broward Hospital District Anthem OMHS37331 Right Choice Benefit Administrators Self Insured Plans Inc37363 ComPsych37601 University of Illinois at Chicago Div of Specialized Care for Children38217 Priority Health HAP/AHL/Curanet (MI)38224 Health Alliance Plan of Michigan Medical Value Plan-MVP-OH McLaren38232 Meritain (Michigan address) Weyco, Inc. Bass Administrators, Inc. Benesys Inc.38238 Benesys-LHP Claims Unit LHP Claims Unit38259 Automated Benefit Services38265 Administration Systems Research Physicians Care38308 Christian Brothers Services38337 Upper Peninsula Health Plan (Medicaid)38353 MedDirect ASSURANT HEALTH39065 Fortis Insurance Company Time Insurance39081 Benefit Plan Administrators Co. (Eau Claire, WI) Custom Benefit Administrators39151 WEA Insurance Group39167 Group Health Coop. of S. Central Wisconsin Claims39168 Group Health Coop. of S. Central Wisconsin Encounters39182 Insurance TPA

56240 Detroit Medical Center56731 Healthcare Resources NW57080 ClaimsWare, Inc. dba ManageMed CWIBENEFITS, INC.57117 QVI Risk Solutions Inc57254 State of Texas Dental Plan (GEHA)58102 Covenant Administrators Inc Dental (Atlanta, GA)58213 Alignis58213 Healthways WholeHealth Networks58231 Core Administrative Services Core Management Resources Group58234 Alliant Health Plans of Georgia58730 Aetna ASA PPO/Assurant Health (Signature Admin)59140 Consolidated Group Health Plan Services Health Plan Services - Oklahoma HealthPlan Services (Tampa only) The Mutual Group59143 Harrington Health Non-EPO59266 Volusia Health Network59299 Employers Mutual, Inc. EMI-KP (Ambulance)59313 Evolutions Healthcare Systems (New Port Richey, FL)59324 Podiatry Network Florida59354 Wellcare Health Plans Encounters60061 Amerihealth Non-HMO New Jersey (Highmark)61102 Humana (Encounters only)61124 Bluegrass Family Health Signature Health Alliance61425 STARMARK Tooling and Manufacturing Assocation Trustmark Insurance62160 MedSolutions, Inc62180 Health Choice Generations62777 Trilogy Network63100 Behavioral Health Systems63103 American Behavioral63114 Viva Health Plan64157 Meritain Health (North American Health Plan.) North American Administrators, Inc.64158 Meritain Health / Agency Services64246 Dental Guard Preferred First Commonwealth HMO Dental Plan Guardian Life (The Guardian)64284 Independence Care Systems / FIDA-MMP65031 CarePlus Health Plans Physicians Healthcare Plans65054 Premier Eye Care65062 ATA Florida (American Therapy Association) Health Network One (HN1 Therapy Network)65101 AXA Assistance USA HAA Preferred Partners

Meritain (Cleveland address)34159 NABN (Cleveland, OH) North American Benefits Network34171 FrontPath Health Coalition34189 Ohio Health Choice, PPO Antares Management Solutions34192 Benefit Services Inc. Mutual Health Services34196 Apex Benefit Services35145 Highmark - Key Family35161 Indiana ProHealth Network35162 Managed Care Services, LLC QCA Health Plan35174 Qual Choice of Arkansas QualChoice Health Insurance35183 CoreSource OH35198 Unified Group Services United Group Services Encircle PPO Encore Health Network35206 Signature Care Health Network The Healthcare Group36215 Central States Health & Welfare Funds Teamcare36331 Professional Benefit Administrators, Inc.36334 MACNEAL HEALTH PROVIDERS - CHS36338 Group Administrators Ltd.36345 Physicians Care Network36373 Prairie States Enterprises, Inc.36396 Family Medical Network Resurrection Health Care Preferred (RHCP)37105 Hinsdale Physicians Healthcare Sage Technologies37116 St. Therese Physician Assoc.37121 Mashantucket Pequot Tribal Nation37217 Key Benefit Administrators37227 CNIC Health Solutions InterCare Health Plans37242 Aultra Administrative Group Professional Claims Management37256 Mutual Assurance37257 EMPLOYEE BENEFIT CON INC Loma Linda Default (37267) Loma Linda University Adventist Health Sciences Center Employee Health Plan Loma Linda Univer. Adventist Health Sciences Centers37267 Loma Linda Univer. Behavioral Medicine Center Employee Health Plan Loma Linda University Dept of Risk Management Loma Linda University Employee Health Plan Loma Linda Univer. Health Care Employee Health Plan

39182 International Funding Limited41041 Federated Mutual Health Insurance Company41206 Ultra Benefits American Administrators (West Des Moines)42137 Select Benefit Administrators (Des Moines, Iowa) TriStar (formerly Select Benefit Administrators)42138 Cook County Health Behavioral 42139 Cook County Health Medical 42140 Centurion42172 Puget Sound Health Partners Inc Soundpath Health43160 Corizon Inc Correctional Medical Services, Inc.43166 Mercy Health Plan Premier Benefits Inc. Premier Health Plans43178 Benefit Management Inc - Joplin Claims Joplin Claims44273 Health Plans, Inc.45281 Riverside Health Inc University of Maryland Health Partners (UMHP)45341 Maine Community Health Options45423 Advicare46050 Generations Globalhealth Generations Healthcare47027 Physicians Mutual Insurance Company47080 Midlands Choice, Inc.48026 Northshore Physician Associates48100 ProviDRs Care Network48117 CoreSource KC (FMH) FMH Benefit Services, Inc.50701 VGM Homelink52123 Johns Hopkins Healthcare USFHP52132 Cooperative Benefit Administrators (CBA) National Rural Electric Cooperative Assoc.52180 UMWA Health & Retirement Funds52189 Johns Hopkins Healthcare52629 UCare Minnesota53589 BCBS Arizona54154 Optima Health Plan Optima Insurance Company Sentara Family Care Sentara Health Management54763 AmeriHealth Administrators Independence Administrators56139 Benefit Management Services (NOT in LA) Integra BMS56144 Primary Physician Care Inc.56190 OptiCare Managed Vision (Prime Vision Health) Prime Vision Health56196 First Carolina Care

65391 CBHNP - HealthChoices66055 Netcare Life and Health Insurance (Hagatna, Guam)68039 Western Health Advantage68069 Louisiana Health Care Connections 72126 Peoples Health Network72467 ACS Benefit Services Inc.73100 Kempton Group73143 Com. Care Managed Health Care Plans of Oklahoma73145 Preferred Community Choice/PCCSelect/CompMed73159 CCN Managed Care Inc. (First Health Network) First Health Network (f.k.a. CCN, PPO OK, HCVM) PPO Oklahoma (now known as: First Health Network74095 USAA (United States Automobile Association)74323 Medical Benefits Mutual75190 NCAS - Fairfax, VA75191 NCAS-Charlotte75237 HealthSmart Accel75250 Provider Direct Network (HealthSmart Preferred Care)75278 Arkansas Best Corporation - Choice Benefits75281 New Era Life Insurance Company76066 Renaissance Physicians Organization77001 Amerihealth NorthEast77002 Amerihealth District of Columbia77076 Network Health Insurance - Medicare77153 Indiana Uni. Health Plan – Commercial/Marketplace Southeastern Indiana Health (SIHO)81264 Nippon Life Insurance Co.81883 Municipal Health Benefit Fund83028 CDO Technologies MBA Benefit Administrators84076 Sinclair Health Plan84109 Pinnacol Assurance84135 Denver Health Medical Plan84980 BCBS Texas/HMO Blue Shield (non-MediCaid)85578 Ingalls Provider Group87042 Union Pacific Railroad Employees Health System87071 Liberty Health Advantage87098 Avesis Third Party Administrator87815 Acordia HealthSmart Benefit Solutions (formerly Wells Fargo TPA/Acordia National) Shaw Industries Wells Fargo Third Party Administrators, Inc. (Accordia)87843 Consolidated Health Plans88019 Teachers Health Trust88022 CDS Group Health88023 Hometown Health Plan Nevada88027 Benefit Plan Admin - Northern Nevada Trust Fund Electrical Workers Health and Welfare Plan for Northern Nevada Northern Nevada Oper. Engineers Health and Welfare

88027 Northern Nevada Trust Fund88029 Saint Marys Health Plan St Marys Health Plan88030 Scott & White Health Care Plan88067 Tall Tree Administrators90001 Healthcare Plan PPO Healthlink PPO Nat.Capital Preferred Provider Organization (NCPPO)90560 Westlake Financial Group91078 Trusteed Plans Service Corporation91136 Alaska Carpenters Trust Group #F40 Alaska Childrens Services, Inc. Group #P68 Alaska Laborers Construction Ind. Trust Group #F23 Alaska Pipe Trades Local Group #F24 Alaska United Food & Commercial Workers Health & Welfare Trust Group #F45 Caremark WPAS, Group #P62 Cement Masons & Plasterers Health & Welfare Trust Group #F16 Enstar Natural Gas, Group #P61 Hotel Employees & Restaurant Employees Health Trust, Group #F19 N.W. Ironworkers Health & Sec. Trust Fund, Group #F15 N.W. Roofers & Employers Health & Security Trust Fund, Group #F26 N.W. Textile Processors Group #F14 Operating Engineers Locals 302 & 612 Health & Security Fund, Group #F12 Puget Sound Benefits Trust, Group #F25 Puget Sound Electrical Workers Trust, Group #3391171 Physicians of Southwest Washington91184 Sanford Health Plan93044 A & I Benefit Plan Administrators93092 US Benefits94123 Kaiser Permanente Health Plan of Hawaii94320 Kaiser California Select for Individuals Kaiser CSI Kaiser Self-Funded KPIC Self-Funded Claims Administrator94998 Firstcare (Medicaid)94999 Firstcare95044 AmeriHealth Delaware - POS Amerihealth HMO New Jersey and Delaware (Highmark) AmeriHealth New Jersey - POS AmeriHealth Pennsylvania - ERISA AmeriHealth Pennsylvania - HMO/POS95202 Summacare Health Plan (HMO)95348 Humana Ohio95377 Beech Street95397 Personal Insurance Administrators95426 Affordable Benefit Administrators

95444 Indiana University (IU) Health Plan – Medicare Advantage MPLAN, Inc./HealthCare Group, LLC95998 New Avenues98514 TRLHN AS99320 Benefit & Risk Management Services (BRMS) California Water Service (Cal Water)AHS01 Access AdministratorsAPG01 Affiliated Physicians GroupBTSS1 Brown & Toland Sutter SelectBV001 Block Vision - VIPA/Block Vision of TexasCB987 Dart Member CareCP001 InterCommunity Health CCO (IHN) Samaritan Advantage (SA01) Samaritan Choice (SCP) Samaritan Health Plans Samaritan Healthy Kids (KID)DOCSO Southwest Oregon IPA (DOCS) Western Oregon Advanced HealthEBSRM Lifetime Benefit SolutionsFS802 Bridgeview CompanyFS802 FirstSolutionsGEM01 Global Excel ManagementGHOKC Global HealthHESUN Healthsun Health PlanKLSY1 SelectCare of Texas (Kelsey-Seybold) TexanPlus of Texas (Kelsey-Seybold)LCM01 Little Company of MaryMAHP1 Medical Associates Health PlanMHHNP MEMORIAL HERMANN HLTH NETMRCHP CareSource Health Plan of OregonREHNA Rehn and AssociatesSHEBP Seton Employee PlanSX105 Deseret Mutual Benefit AdministratorsSX106 Public Employees Health Plan (PEHP)SX110 Educators Mutual of Utah (EMI Health)SX145 Banner Health AZ Banner Health Co, - ROCKY MOUNTAIN HMO GREELEY Banner Health Co. - ANTERO GREELEY Banner Health Co. - ANTERO HIGH PLAINS Banner Health Co. - ANTERO MOUNTAIN SHADOWS Banner Health Co. - CHOICE PLUS Banner Health Co. - HMO GREELEY Banner Health Co. - HMO HIGH PLAINS Banner Health Co. - HMO MOUNTAIN SHADOWS Banner Health Co. - PACIFICARE GREELEY Banner Health Co. - PACIFICARE HIGH PLAINS Banner Health Co. - PACIFICARE MOUNTAIN SHADOWS Banner Health Co. - ROCKY MNT HMO HIGH PLAINS Banner Health Co. - SECURE HORIZONS GREELEY Banner Health Co. - SECURE HORIZONS HIGH PLAINS Banner Health Co. - SECURE HORIZONS MNT SHADOWS

SX155 University of UtahSX172 MDwise Eskenazi Health - Healthy Indiana Plan (HCFA) MDwise Eskenazi Health - Hoosier Healthwise (HCFA)SX172 MDwise Excel Network - Healthy Indiana Plan (HCFA) MDwise Excel Network - Hoosier Healthwise (HCFA) MDwise Family Planning - Healthy Indiana Plan (HCFA) MDwise Family Planning - Hoosier Healthwise (HCFA) MDwise Franciscan - Healthy Indiana Plan (HCFA) MDwise Healthy Indiana Plan HIP (HCFA) MDwise Hoosier Care Connect (HCFA) MDwise Hoosier/Healthy Indiana (HCFA) MDwise IU Health - Healthy Indiana Plan (HCFA) MDwise IU Health - Hoosier Healthwise (HCFA) MDwise Marketplace (HCFA) MDwise Select Health Net. Healthy Indiana Plan (HCFA) MDwise St. Catherine - Healthy Indiana Plan (HCFA) MDwise St. Margaret - Healthy Indiana Plan (HCFA) MDwise St. Vincent - Healthy Indiana Plan (HCFA) MDwise Total Health - Healthy Indiana Plan (HCFA) MDwise Total Health - Hoosier Healthwise (HCFA)

Payer ID Payer Name Payer ID Payer Name

00243 MedStar Family Choice of MD MedStar Physician Partners Vestica Healthcare00315 Thomas H. Cooper00590 BCBS Florida Florida Blue HMO Health Options - Florida Blue01066 American Healthcare Alliance01508 Better Health03440 Phoenix Health Plan04218 Pan American Life Insurance Group05003 Medicaid New Mexico - Presbyterian Salud Presbyterian Salud (NM)05047 Neighborhood Health Plan of Rhode Island06102 Diversified Administration Corp Diversified Group Brokerage/Healthplan Services06541 County Care Health Plan06607 Cardinal Innovations Piedmont Behavioral Health07205 Gilsbar Inc. Healthplus of Louisiana10010 Careworks10525 Patient Advocates, LLC11334 New York Network Management12399 Physicians Health Plan of Northern Indiana13265 Metro Plus Health Plan13315 Insurance Design Administrators13334 Affinity Health Care13382 Orthonet-Uniformed Services Family Health13383 Orthonet- Aetna13407 Uniformed Services Family Health Plan16117 RMSCO Inc16644 Nova Healthcare Administrators20270 Health Payment Systems Inc20356 Health Exchange (Cerner Corp)20488 Better Health of Florida20553 Americas 1st Choice Health Plan of South Carolina22248 Amerihealth Mercy Health Plan CarePartners Passport22321 One Call Medical22326 Horizon Mercy Horizon NJ Health Mercy Health Plan of NJ (Horizon Mercy)22348 Maryland Physicians Care

22384 Administration Concepts Inc22521 EDS Healthchoice EGID - Employees Group Insurance Division HealthChoice of Oklahoma HP Administrative Services OK State Employees & Educators EDS OSEEGIB - Oklahoma State and Education Employees Group Ins Board22603 NJ Carpernters Health Fund23130 Fresenius Medical Care23284 Keystone Mercy23285 Select Health of South Carolina23287 Intergroup Services Corporation InterGroup Services PPO23342 QualCare, Inc. Advantra Advantra Freedom Altius Health Plan - Coventry Care Management Resources (CMR) Carelink Advantra Carelink Health Plan Carelink Medicaid Carenet Carpenters Hlth/Welf. Hazelwood,MO Claims Administration Corporation (CAC) Coventry Advantra (Texas, New Mexico, Arizona) Coventry Health and Life – Oklahoma Coventry Health and Life Insurance (Tennessee) Coventry Health Care - Nevada Coventry Health Care National Network Coventry Health Care of Kansas, Inc. -Wichita Coventry Healthcare25133 Coventry Healthcare of Delaware Coventry Healthcare of Florida (Aetna Medicaid) Coventry Healthcare of Georgia Coventry Healthcare of Illinois Coventry Healthcare of Indiana Coventry Healthcare of Iowa Coventry Healthcare of Kansas, Inc. - Kansas City Coventry Healthcare of Louisiana Coventry Healthcare of Missouri Coventry Healthcare of Nebraska Coventry Healthcare of the Carolinas Coventry Medicaid Nebraska Coventry Missouri

Coventry Nebraska Medicaid Diamond Plan Family Health Partners/MC + Missouri First Health (PayerID 25133) (Coventry) Foreign Service Benefit Plan Group Health Plan (GHP) Health America, Inc. Health Assurance Healthcare USA Kansas City Advantra (Coventry) Mailhandlers Benefit Plan25133 Mercy Managed Behavioral Health Montana Health Co-op Omnicare, A Coventry Health Plan ORNDA Health D296Corp (First Health)+D312 PersonalCare PHSIC Preferre Plus of Kansas Preferred Benefits Administrator Preferred Health Systems Insurance Company (PHSIC) Preferred Plus of Kansas Rural Carrier Benefit Plan (Coventry) Southern Health Services Inc. University of Missouri Vista Health Plan WELLPATH25169 Gateway Health Plan26054 ICare Health Options26492 Florida True Health27008 Health Systems International - ECOH27094 Simply Health Care Plan27357 AmeriHealth Caritas Louisiana Louisiana Care (LACare)28530 Secure Health Plans of Georgia, LLC31048 Western Southern Financial Group (Cincinnati, OH)31053 Individual Health Insurance Companies31053 State Farm Insurance Companies31059 State Farm Property & Casualty31127 Integra Group31172 Innovante Benefit Administrator31182 InnovAge Total Community Care31441 S & S Healthcare Strategies31625 ElderPlan, Inc.33036 Loma Linda Managed Care (33036) Loma Linda Univ. Healthcare - ManagedCare Claims33373 Molina Healthcare of CA Encounters33628 Mercy Maricopa Integrated Care34136 JP Farley Corporation34154 Chesterfield Technologies34159 E-V Benefits Management, Inc (Columbus, OH)

Loma Linda Univer. Med.Center Employee Health Plan37267 Loma Linda Univer. Med.Center Residents Health Plan Loma Linda University Student Health Plan37268 Prism Health Networks Prism Network, Inc.37275 Missoula County Medical Benefits Plan37279 Insurance Administrator of America, Inc. (IAA)37282 Select Benefit Administrators of America (WI) American Administrative37283 Gallagher Benefit Administrators, Inc/GBA HealthSmart Benefit Solutions (formerly American Administrative/Gallagher Benefit)37283 Poly America Medical & Dental Benefits Plan37284 TransChoice-Key Benefit Administrators TransChoice-Key Benefit Administrators KBA37287 Planned Administrators, Inc. (PAI)37290 Health Services for Children with Special Needs37301 Summit America Insurance Services, Inc.37314 North Broward Hospital District Anthem OMHS37331 Right Choice Benefit Administrators Self Insured Plans Inc37363 ComPsych37601 University of Illinois at Chicago Div of Specialized Care for Children38217 Priority Health HAP/AHL/Curanet (MI)38224 Health Alliance Plan of Michigan Medical Value Plan-MVP-OH McLaren38232 Meritain (Michigan address) Weyco, Inc. Bass Administrators, Inc. Benesys Inc.38238 Benesys-LHP Claims Unit LHP Claims Unit38259 Automated Benefit Services38265 Administration Systems Research Physicians Care38308 Christian Brothers Services38337 Upper Peninsula Health Plan (Medicaid)38353 MedDirect ASSURANT HEALTH39065 Fortis Insurance Company Time Insurance39081 Benefit Plan Administrators Co. (Eau Claire, WI) Custom Benefit Administrators39151 WEA Insurance Group39167 Group Health Coop. of S. Central Wisconsin Claims39168 Group Health Coop. of S. Central Wisconsin Encounters39182 Insurance TPA

56240 Detroit Medical Center56731 Healthcare Resources NW57080 ClaimsWare, Inc. dba ManageMed CWIBENEFITS, INC.57117 QVI Risk Solutions Inc57254 State of Texas Dental Plan (GEHA)58102 Covenant Administrators Inc Dental (Atlanta, GA)58213 Alignis58213 Healthways WholeHealth Networks58231 Core Administrative Services Core Management Resources Group58234 Alliant Health Plans of Georgia58730 Aetna ASA PPO/Assurant Health (Signature Admin)59140 Consolidated Group Health Plan Services Health Plan Services - Oklahoma HealthPlan Services (Tampa only) The Mutual Group59143 Harrington Health Non-EPO59266 Volusia Health Network59299 Employers Mutual, Inc. EMI-KP (Ambulance)59313 Evolutions Healthcare Systems (New Port Richey, FL)59324 Podiatry Network Florida59354 Wellcare Health Plans Encounters60061 Amerihealth Non-HMO New Jersey (Highmark)61102 Humana (Encounters only)61124 Bluegrass Family Health Signature Health Alliance61425 STARMARK Tooling and Manufacturing Assocation Trustmark Insurance62160 MedSolutions, Inc62180 Health Choice Generations62777 Trilogy Network63100 Behavioral Health Systems63103 American Behavioral63114 Viva Health Plan64157 Meritain Health (North American Health Plan.) North American Administrators, Inc.64158 Meritain Health / Agency Services64246 Dental Guard Preferred First Commonwealth HMO Dental Plan Guardian Life (The Guardian)64284 Independence Care Systems / FIDA-MMP65031 CarePlus Health Plans Physicians Healthcare Plans65054 Premier Eye Care65062 ATA Florida (American Therapy Association) Health Network One (HN1 Therapy Network)65101 AXA Assistance USA HAA Preferred Partners

Meritain (Cleveland address)34159 NABN (Cleveland, OH) North American Benefits Network34171 FrontPath Health Coalition34189 Ohio Health Choice, PPO Antares Management Solutions34192 Benefit Services Inc. Mutual Health Services34196 Apex Benefit Services35145 Highmark - Key Family35161 Indiana ProHealth Network35162 Managed Care Services, LLC QCA Health Plan35174 Qual Choice of Arkansas QualChoice Health Insurance35183 CoreSource OH35198 Unified Group Services United Group Services Encircle PPO Encore Health Network35206 Signature Care Health Network The Healthcare Group36215 Central States Health & Welfare Funds Teamcare36331 Professional Benefit Administrators, Inc.36334 MACNEAL HEALTH PROVIDERS - CHS36338 Group Administrators Ltd.36345 Physicians Care Network36373 Prairie States Enterprises, Inc.36396 Family Medical Network Resurrection Health Care Preferred (RHCP)37105 Hinsdale Physicians Healthcare Sage Technologies37116 St. Therese Physician Assoc.37121 Mashantucket Pequot Tribal Nation37217 Key Benefit Administrators37227 CNIC Health Solutions InterCare Health Plans37242 Aultra Administrative Group Professional Claims Management37256 Mutual Assurance37257 EMPLOYEE BENEFIT CON INC Loma Linda Default (37267) Loma Linda University Adventist Health Sciences Center Employee Health Plan Loma Linda Univer. Adventist Health Sciences Centers37267 Loma Linda Univer. Behavioral Medicine Center Employee Health Plan Loma Linda University Dept of Risk Management Loma Linda University Employee Health Plan Loma Linda Univer. Health Care Employee Health Plan

39182 International Funding Limited41041 Federated Mutual Health Insurance Company41206 Ultra Benefits American Administrators (West Des Moines)42137 Select Benefit Administrators (Des Moines, Iowa) TriStar (formerly Select Benefit Administrators)42138 Cook County Health Behavioral 42139 Cook County Health Medical 42140 Centurion42172 Puget Sound Health Partners Inc Soundpath Health43160 Corizon Inc Correctional Medical Services, Inc.43166 Mercy Health Plan Premier Benefits Inc. Premier Health Plans43178 Benefit Management Inc - Joplin Claims Joplin Claims44273 Health Plans, Inc.45281 Riverside Health Inc University of Maryland Health Partners (UMHP)45341 Maine Community Health Options45423 Advicare46050 Generations Globalhealth Generations Healthcare47027 Physicians Mutual Insurance Company47080 Midlands Choice, Inc.48026 Northshore Physician Associates48100 ProviDRs Care Network48117 CoreSource KC (FMH) FMH Benefit Services, Inc.50701 VGM Homelink52123 Johns Hopkins Healthcare USFHP52132 Cooperative Benefit Administrators (CBA) National Rural Electric Cooperative Assoc.52180 UMWA Health & Retirement Funds52189 Johns Hopkins Healthcare52629 UCare Minnesota53589 BCBS Arizona54154 Optima Health Plan Optima Insurance Company Sentara Family Care Sentara Health Management54763 AmeriHealth Administrators Independence Administrators56139 Benefit Management Services (NOT in LA) Integra BMS56144 Primary Physician Care Inc.56190 OptiCare Managed Vision (Prime Vision Health) Prime Vision Health56196 First Carolina Care

65391 CBHNP - HealthChoices66055 Netcare Life and Health Insurance (Hagatna, Guam)68039 Western Health Advantage68069 Louisiana Health Care Connections 72126 Peoples Health Network72467 ACS Benefit Services Inc.73100 Kempton Group73143 Com. Care Managed Health Care Plans of Oklahoma73145 Preferred Community Choice/PCCSelect/CompMed73159 CCN Managed Care Inc. (First Health Network) First Health Network (f.k.a. CCN, PPO OK, HCVM) PPO Oklahoma (now known as: First Health Network74095 USAA (United States Automobile Association)74323 Medical Benefits Mutual75190 NCAS - Fairfax, VA75191 NCAS-Charlotte75237 HealthSmart Accel75250 Provider Direct Network (HealthSmart Preferred Care)75278 Arkansas Best Corporation - Choice Benefits75281 New Era Life Insurance Company76066 Renaissance Physicians Organization77001 Amerihealth NorthEast77002 Amerihealth District of Columbia77076 Network Health Insurance - Medicare77153 Indiana Uni. Health Plan – Commercial/Marketplace Southeastern Indiana Health (SIHO)81264 Nippon Life Insurance Co.81883 Municipal Health Benefit Fund83028 CDO Technologies MBA Benefit Administrators84076 Sinclair Health Plan84109 Pinnacol Assurance84135 Denver Health Medical Plan84980 BCBS Texas/HMO Blue Shield (non-MediCaid)85578 Ingalls Provider Group87042 Union Pacific Railroad Employees Health System87071 Liberty Health Advantage87098 Avesis Third Party Administrator87815 Acordia HealthSmart Benefit Solutions (formerly Wells Fargo TPA/Acordia National) Shaw Industries Wells Fargo Third Party Administrators, Inc. (Accordia)87843 Consolidated Health Plans88019 Teachers Health Trust88022 CDS Group Health88023 Hometown Health Plan Nevada88027 Benefit Plan Admin - Northern Nevada Trust Fund Electrical Workers Health and Welfare Plan for Northern Nevada Northern Nevada Oper. Engineers Health and Welfare

88027 Northern Nevada Trust Fund88029 Saint Marys Health Plan St Marys Health Plan88030 Scott & White Health Care Plan88067 Tall Tree Administrators90001 Healthcare Plan PPO Healthlink PPO Nat.Capital Preferred Provider Organization (NCPPO)90560 Westlake Financial Group91078 Trusteed Plans Service Corporation91136 Alaska Carpenters Trust Group #F40 Alaska Childrens Services, Inc. Group #P68 Alaska Laborers Construction Ind. Trust Group #F23 Alaska Pipe Trades Local Group #F24 Alaska United Food & Commercial Workers Health & Welfare Trust Group #F45 Caremark WPAS, Group #P62 Cement Masons & Plasterers Health & Welfare Trust Group #F16 Enstar Natural Gas, Group #P61 Hotel Employees & Restaurant Employees Health Trust, Group #F19 N.W. Ironworkers Health & Sec. Trust Fund, Group #F15 N.W. Roofers & Employers Health & Security Trust Fund, Group #F26 N.W. Textile Processors Group #F14 Operating Engineers Locals 302 & 612 Health & Security Fund, Group #F12 Puget Sound Benefits Trust, Group #F25 Puget Sound Electrical Workers Trust, Group #3391171 Physicians of Southwest Washington91184 Sanford Health Plan93044 A & I Benefit Plan Administrators93092 US Benefits94123 Kaiser Permanente Health Plan of Hawaii94320 Kaiser California Select for Individuals Kaiser CSI Kaiser Self-Funded KPIC Self-Funded Claims Administrator94998 Firstcare (Medicaid)94999 Firstcare95044 AmeriHealth Delaware - POS Amerihealth HMO New Jersey and Delaware (Highmark) AmeriHealth New Jersey - POS AmeriHealth Pennsylvania - ERISA AmeriHealth Pennsylvania - HMO/POS95202 Summacare Health Plan (HMO)95348 Humana Ohio95377 Beech Street95397 Personal Insurance Administrators95426 Affordable Benefit Administrators

95444 Indiana University (IU) Health Plan – Medicare Advantage MPLAN, Inc./HealthCare Group, LLC95998 New Avenues98514 TRLHN AS99320 Benefit & Risk Management Services (BRMS) California Water Service (Cal Water)AHS01 Access AdministratorsAPG01 Affiliated Physicians GroupBTSS1 Brown & Toland Sutter SelectBV001 Block Vision - VIPA/Block Vision of TexasCB987 Dart Member CareCP001 InterCommunity Health CCO (IHN) Samaritan Advantage (SA01) Samaritan Choice (SCP) Samaritan Health Plans Samaritan Healthy Kids (KID)DOCSO Southwest Oregon IPA (DOCS) Western Oregon Advanced HealthEBSRM Lifetime Benefit SolutionsFS802 Bridgeview CompanyFS802 FirstSolutionsGEM01 Global Excel ManagementGHOKC Global HealthHESUN Healthsun Health PlanKLSY1 SelectCare of Texas (Kelsey-Seybold) TexanPlus of Texas (Kelsey-Seybold)LCM01 Little Company of MaryMAHP1 Medical Associates Health PlanMHHNP MEMORIAL HERMANN HLTH NETMRCHP CareSource Health Plan of OregonREHNA Rehn and AssociatesSHEBP Seton Employee PlanSX105 Deseret Mutual Benefit AdministratorsSX106 Public Employees Health Plan (PEHP)SX110 Educators Mutual of Utah (EMI Health)SX145 Banner Health AZ Banner Health Co, - ROCKY MOUNTAIN HMO GREELEY Banner Health Co. - ANTERO GREELEY Banner Health Co. - ANTERO HIGH PLAINS Banner Health Co. - ANTERO MOUNTAIN SHADOWS Banner Health Co. - CHOICE PLUS Banner Health Co. - HMO GREELEY Banner Health Co. - HMO HIGH PLAINS Banner Health Co. - HMO MOUNTAIN SHADOWS Banner Health Co. - PACIFICARE GREELEY Banner Health Co. - PACIFICARE HIGH PLAINS Banner Health Co. - PACIFICARE MOUNTAIN SHADOWS Banner Health Co. - ROCKY MNT HMO HIGH PLAINS Banner Health Co. - SECURE HORIZONS GREELEY Banner Health Co. - SECURE HORIZONS HIGH PLAINS Banner Health Co. - SECURE HORIZONS MNT SHADOWS

SX155 University of UtahSX172 MDwise Eskenazi Health - Healthy Indiana Plan (HCFA) MDwise Eskenazi Health - Hoosier Healthwise (HCFA)SX172 MDwise Excel Network - Healthy Indiana Plan (HCFA) MDwise Excel Network - Hoosier Healthwise (HCFA) MDwise Family Planning - Healthy Indiana Plan (HCFA) MDwise Family Planning - Hoosier Healthwise (HCFA) MDwise Franciscan - Healthy Indiana Plan (HCFA) MDwise Healthy Indiana Plan HIP (HCFA) MDwise Hoosier Care Connect (HCFA) MDwise Hoosier/Healthy Indiana (HCFA) MDwise IU Health - Healthy Indiana Plan (HCFA) MDwise IU Health - Hoosier Healthwise (HCFA) MDwise Marketplace (HCFA) MDwise Select Health Net. Healthy Indiana Plan (HCFA) MDwise St. Catherine - Healthy Indiana Plan (HCFA) MDwise St. Margaret - Healthy Indiana Plan (HCFA) MDwise St. Vincent - Healthy Indiana Plan (HCFA) MDwise Total Health - Healthy Indiana Plan (HCFA) MDwise Total Health - Hoosier Healthwise (HCFA)

Payer ID Payer Name

00243 MedStar Family Choice of MD MedStar Physician Partners Vestica Healthcare00315 Thomas H. Cooper00590 BCBS Florida Florida Blue HMO Health Options - Florida Blue01066 American Healthcare Alliance01508 Better Health03440 Phoenix Health Plan04218 Pan American Life Insurance Group05003 Medicaid New Mexico - Presbyterian Salud Presbyterian Salud (NM)05047 Neighborhood Health Plan of Rhode Island06102 Diversified Administration Corp Diversified Group Brokerage/Healthplan Services06541 County Care Health Plan06607 Cardinal Innovations Piedmont Behavioral Health07205 Gilsbar Inc. Healthplus of Louisiana10010 Careworks10525 Patient Advocates, LLC11334 New York Network Management12399 Physicians Health Plan of Northern Indiana13265 Metro Plus Health Plan13315 Insurance Design Administrators13334 Affinity Health Care13382 Orthonet-Uniformed Services Family Health13383 Orthonet- Aetna13407 Uniformed Services Family Health Plan16117 RMSCO Inc16644 Nova Healthcare Administrators20270 Health Payment Systems Inc20356 Health Exchange (Cerner Corp)20488 Better Health of Florida20553 Americas 1st Choice Health Plan of South Carolina22248 Amerihealth Mercy Health Plan CarePartners Passport22321 One Call Medical22326 Horizon Mercy Horizon NJ Health Mercy Health Plan of NJ (Horizon Mercy)22348 Maryland Physicians Care

22384 Administration Concepts Inc22521 EDS Healthchoice EGID - Employees Group Insurance Division HealthChoice of Oklahoma HP Administrative Services OK State Employees & Educators EDS OSEEGIB - Oklahoma State and Education Employees Group Ins Board22603 NJ Carpernters Health Fund23130 Fresenius Medical Care23284 Keystone Mercy23285 Select Health of South Carolina23287 Intergroup Services Corporation InterGroup Services PPO23342 QualCare, Inc. Advantra Advantra Freedom Altius Health Plan - Coventry Care Management Resources (CMR) Carelink Advantra Carelink Health Plan Carelink Medicaid Carenet Carpenters Hlth/Welf. Hazelwood,MO Claims Administration Corporation (CAC) Coventry Advantra (Texas, New Mexico, Arizona) Coventry Health and Life – Oklahoma Coventry Health and Life Insurance (Tennessee) Coventry Health Care - Nevada Coventry Health Care National Network Coventry Health Care of Kansas, Inc. -Wichita Coventry Healthcare25133 Coventry Healthcare of Delaware Coventry Healthcare of Florida (Aetna Medicaid) Coventry Healthcare of Georgia Coventry Healthcare of Illinois Coventry Healthcare of Indiana Coventry Healthcare of Iowa Coventry Healthcare of Kansas, Inc. - Kansas City Coventry Healthcare of Louisiana Coventry Healthcare of Missouri Coventry Healthcare of Nebraska Coventry Healthcare of the Carolinas Coventry Medicaid Nebraska Coventry Missouri

Coventry Nebraska Medicaid Diamond Plan Family Health Partners/MC + Missouri First Health (PayerID 25133) (Coventry) Foreign Service Benefit Plan Group Health Plan (GHP) Health America, Inc. Health Assurance Healthcare USA Kansas City Advantra (Coventry) Mailhandlers Benefit Plan25133 Mercy Managed Behavioral Health Montana Health Co-op Omnicare, A Coventry Health Plan ORNDA Health D296Corp (First Health)+D312 PersonalCare PHSIC Preferre Plus of Kansas Preferred Benefits Administrator Preferred Health Systems Insurance Company (PHSIC) Preferred Plus of Kansas Rural Carrier Benefit Plan (Coventry) Southern Health Services Inc. University of Missouri Vista Health Plan WELLPATH25169 Gateway Health Plan26054 ICare Health Options26492 Florida True Health27008 Health Systems International - ECOH27094 Simply Health Care Plan27357 AmeriHealth Caritas Louisiana Louisiana Care (LACare)28530 Secure Health Plans of Georgia, LLC31048 Western Southern Financial Group (Cincinnati, OH)31053 Individual Health Insurance Companies31053 State Farm Insurance Companies31059 State Farm Property & Casualty31127 Integra Group31172 Innovante Benefit Administrator31182 InnovAge Total Community Care31441 S & S Healthcare Strategies31625 ElderPlan, Inc.33036 Loma Linda Managed Care (33036) Loma Linda Univ. Healthcare - ManagedCare Claims33373 Molina Healthcare of CA Encounters33628 Mercy Maricopa Integrated Care34136 JP Farley Corporation34154 Chesterfield Technologies34159 E-V Benefits Management, Inc (Columbus, OH)

Loma Linda Univer. Med.Center Employee Health Plan37267 Loma Linda Univer. Med.Center Residents Health Plan Loma Linda University Student Health Plan37268 Prism Health Networks Prism Network, Inc.37275 Missoula County Medical Benefits Plan37279 Insurance Administrator of America, Inc. (IAA)37282 Select Benefit Administrators of America (WI) American Administrative37283 Gallagher Benefit Administrators, Inc/GBA HealthSmart Benefit Solutions (formerly American Administrative/Gallagher Benefit)37283 Poly America Medical & Dental Benefits Plan37284 TransChoice-Key Benefit Administrators TransChoice-Key Benefit Administrators KBA37287 Planned Administrators, Inc. (PAI)37290 Health Services for Children with Special Needs37301 Summit America Insurance Services, Inc.37314 North Broward Hospital District Anthem OMHS37331 Right Choice Benefit Administrators Self Insured Plans Inc37363 ComPsych37601 University of Illinois at Chicago Div of Specialized Care for Children38217 Priority Health HAP/AHL/Curanet (MI)38224 Health Alliance Plan of Michigan Medical Value Plan-MVP-OH McLaren38232 Meritain (Michigan address) Weyco, Inc. Bass Administrators, Inc. Benesys Inc.38238 Benesys-LHP Claims Unit LHP Claims Unit38259 Automated Benefit Services38265 Administration Systems Research Physicians Care38308 Christian Brothers Services38337 Upper Peninsula Health Plan (Medicaid)38353 MedDirect ASSURANT HEALTH39065 Fortis Insurance Company Time Insurance39081 Benefit Plan Administrators Co. (Eau Claire, WI) Custom Benefit Administrators39151 WEA Insurance Group39167 Group Health Coop. of S. Central Wisconsin Claims39168 Group Health Coop. of S. Central Wisconsin Encounters39182 Insurance TPA

56240 Detroit Medical Center56731 Healthcare Resources NW57080 ClaimsWare, Inc. dba ManageMed CWIBENEFITS, INC.57117 QVI Risk Solutions Inc57254 State of Texas Dental Plan (GEHA)58102 Covenant Administrators Inc Dental (Atlanta, GA)58213 Alignis58213 Healthways WholeHealth Networks58231 Core Administrative Services Core Management Resources Group58234 Alliant Health Plans of Georgia58730 Aetna ASA PPO/Assurant Health (Signature Admin)59140 Consolidated Group Health Plan Services Health Plan Services - Oklahoma HealthPlan Services (Tampa only) The Mutual Group59143 Harrington Health Non-EPO59266 Volusia Health Network59299 Employers Mutual, Inc. EMI-KP (Ambulance)59313 Evolutions Healthcare Systems (New Port Richey, FL)59324 Podiatry Network Florida59354 Wellcare Health Plans Encounters60061 Amerihealth Non-HMO New Jersey (Highmark)61102 Humana (Encounters only)61124 Bluegrass Family Health Signature Health Alliance61425 STARMARK Tooling and Manufacturing Assocation Trustmark Insurance62160 MedSolutions, Inc62180 Health Choice Generations62777 Trilogy Network63100 Behavioral Health Systems63103 American Behavioral63114 Viva Health Plan64157 Meritain Health (North American Health Plan.) North American Administrators, Inc.64158 Meritain Health / Agency Services64246 Dental Guard Preferred First Commonwealth HMO Dental Plan Guardian Life (The Guardian)64284 Independence Care Systems / FIDA-MMP65031 CarePlus Health Plans Physicians Healthcare Plans65054 Premier Eye Care65062 ATA Florida (American Therapy Association) Health Network One (HN1 Therapy Network)65101 AXA Assistance USA HAA Preferred Partners

Meritain (Cleveland address)34159 NABN (Cleveland, OH) North American Benefits Network34171 FrontPath Health Coalition34189 Ohio Health Choice, PPO Antares Management Solutions34192 Benefit Services Inc. Mutual Health Services34196 Apex Benefit Services35145 Highmark - Key Family35161 Indiana ProHealth Network35162 Managed Care Services, LLC QCA Health Plan35174 Qual Choice of Arkansas QualChoice Health Insurance35183 CoreSource OH35198 Unified Group Services United Group Services Encircle PPO Encore Health Network35206 Signature Care Health Network The Healthcare Group36215 Central States Health & Welfare Funds Teamcare36331 Professional Benefit Administrators, Inc.36334 MACNEAL HEALTH PROVIDERS - CHS36338 Group Administrators Ltd.36345 Physicians Care Network36373 Prairie States Enterprises, Inc.36396 Family Medical Network Resurrection Health Care Preferred (RHCP)37105 Hinsdale Physicians Healthcare Sage Technologies37116 St. Therese Physician Assoc.37121 Mashantucket Pequot Tribal Nation37217 Key Benefit Administrators37227 CNIC Health Solutions InterCare Health Plans37242 Aultra Administrative Group Professional Claims Management37256 Mutual Assurance37257 EMPLOYEE BENEFIT CON INC Loma Linda Default (37267) Loma Linda University Adventist Health Sciences Center Employee Health Plan Loma Linda Univer. Adventist Health Sciences Centers37267 Loma Linda Univer. Behavioral Medicine Center Employee Health Plan Loma Linda University Dept of Risk Management Loma Linda University Employee Health Plan Loma Linda Univer. Health Care Employee Health Plan

39182 International Funding Limited41041 Federated Mutual Health Insurance Company41206 Ultra Benefits American Administrators (West Des Moines)42137 Select Benefit Administrators (Des Moines, Iowa) TriStar (formerly Select Benefit Administrators)42138 Cook County Health Behavioral 42139 Cook County Health Medical 42140 Centurion42172 Puget Sound Health Partners Inc Soundpath Health43160 Corizon Inc Correctional Medical Services, Inc.43166 Mercy Health Plan Premier Benefits Inc. Premier Health Plans43178 Benefit Management Inc - Joplin Claims Joplin Claims44273 Health Plans, Inc.45281 Riverside Health Inc University of Maryland Health Partners (UMHP)45341 Maine Community Health Options45423 Advicare46050 Generations Globalhealth Generations Healthcare47027 Physicians Mutual Insurance Company47080 Midlands Choice, Inc.48026 Northshore Physician Associates48100 ProviDRs Care Network48117 CoreSource KC (FMH) FMH Benefit Services, Inc.50701 VGM Homelink52123 Johns Hopkins Healthcare USFHP52132 Cooperative Benefit Administrators (CBA) National Rural Electric Cooperative Assoc.52180 UMWA Health & Retirement Funds52189 Johns Hopkins Healthcare52629 UCare Minnesota53589 BCBS Arizona54154 Optima Health Plan Optima Insurance Company Sentara Family Care Sentara Health Management54763 AmeriHealth Administrators Independence Administrators56139 Benefit Management Services (NOT in LA) Integra BMS56144 Primary Physician Care Inc.56190 OptiCare Managed Vision (Prime Vision Health) Prime Vision Health56196 First Carolina Care

65391 CBHNP - HealthChoices66055 Netcare Life and Health Insurance (Hagatna, Guam)68039 Western Health Advantage68069 Louisiana Health Care Connections 72126 Peoples Health Network72467 ACS Benefit Services Inc.73100 Kempton Group73143 Com. Care Managed Health Care Plans of Oklahoma73145 Preferred Community Choice/PCCSelect/CompMed73159 CCN Managed Care Inc. (First Health Network) First Health Network (f.k.a. CCN, PPO OK, HCVM) PPO Oklahoma (now known as: First Health Network74095 USAA (United States Automobile Association)74323 Medical Benefits Mutual75190 NCAS - Fairfax, VA75191 NCAS-Charlotte75237 HealthSmart Accel75250 Provider Direct Network (HealthSmart Preferred Care)75278 Arkansas Best Corporation - Choice Benefits75281 New Era Life Insurance Company76066 Renaissance Physicians Organization77001 Amerihealth NorthEast77002 Amerihealth District of Columbia77076 Network Health Insurance - Medicare77153 Indiana Uni. Health Plan – Commercial/Marketplace Southeastern Indiana Health (SIHO)81264 Nippon Life Insurance Co.81883 Municipal Health Benefit Fund83028 CDO Technologies MBA Benefit Administrators84076 Sinclair Health Plan84109 Pinnacol Assurance84135 Denver Health Medical Plan84980 BCBS Texas/HMO Blue Shield (non-MediCaid)85578 Ingalls Provider Group87042 Union Pacific Railroad Employees Health System87071 Liberty Health Advantage87098 Avesis Third Party Administrator87815 Acordia HealthSmart Benefit Solutions (formerly Wells Fargo TPA/Acordia National) Shaw Industries Wells Fargo Third Party Administrators, Inc. (Accordia)87843 Consolidated Health Plans88019 Teachers Health Trust88022 CDS Group Health88023 Hometown Health Plan Nevada88027 Benefit Plan Admin - Northern Nevada Trust Fund Electrical Workers Health and Welfare Plan for Northern Nevada Northern Nevada Oper. Engineers Health and Welfare

88027 Northern Nevada Trust Fund88029 Saint Marys Health Plan St Marys Health Plan88030 Scott & White Health Care Plan88067 Tall Tree Administrators90001 Healthcare Plan PPO Healthlink PPO Nat.Capital Preferred Provider Organization (NCPPO)90560 Westlake Financial Group91078 Trusteed Plans Service Corporation91136 Alaska Carpenters Trust Group #F40 Alaska Childrens Services, Inc. Group #P68 Alaska Laborers Construction Ind. Trust Group #F23 Alaska Pipe Trades Local Group #F24 Alaska United Food & Commercial Workers Health & Welfare Trust Group #F45 Caremark WPAS, Group #P62 Cement Masons & Plasterers Health & Welfare Trust Group #F16 Enstar Natural Gas, Group #P61 Hotel Employees & Restaurant Employees Health Trust, Group #F19 N.W. Ironworkers Health & Sec. Trust Fund, Group #F15 N.W. Roofers & Employers Health & Security Trust Fund, Group #F26 N.W. Textile Processors Group #F14 Operating Engineers Locals 302 & 612 Health & Security Fund, Group #F12 Puget Sound Benefits Trust, Group #F25 Puget Sound Electrical Workers Trust, Group #3391171 Physicians of Southwest Washington91184 Sanford Health Plan93044 A & I Benefit Plan Administrators93092 US Benefits94123 Kaiser Permanente Health Plan of Hawaii94320 Kaiser California Select for Individuals Kaiser CSI Kaiser Self-Funded KPIC Self-Funded Claims Administrator94998 Firstcare (Medicaid)94999 Firstcare95044 AmeriHealth Delaware - POS Amerihealth HMO New Jersey and Delaware (Highmark) AmeriHealth New Jersey - POS AmeriHealth Pennsylvania - ERISA AmeriHealth Pennsylvania - HMO/POS95202 Summacare Health Plan (HMO)95348 Humana Ohio95377 Beech Street95397 Personal Insurance Administrators95426 Affordable Benefit Administrators

95444 Indiana University (IU) Health Plan – Medicare Advantage MPLAN, Inc./HealthCare Group, LLC95998 New Avenues98514 TRLHN AS99320 Benefit & Risk Management Services (BRMS) California Water Service (Cal Water)AHS01 Access AdministratorsAPG01 Affiliated Physicians GroupBTSS1 Brown & Toland Sutter SelectBV001 Block Vision - VIPA/Block Vision of TexasCB987 Dart Member CareCP001 InterCommunity Health CCO (IHN) Samaritan Advantage (SA01) Samaritan Choice (SCP) Samaritan Health Plans Samaritan Healthy Kids (KID)DOCSO Southwest Oregon IPA (DOCS) Western Oregon Advanced HealthEBSRM Lifetime Benefit SolutionsFS802 Bridgeview CompanyFS802 FirstSolutionsGEM01 Global Excel ManagementGHOKC Global HealthHESUN Healthsun Health PlanKLSY1 SelectCare of Texas (Kelsey-Seybold) TexanPlus of Texas (Kelsey-Seybold)LCM01 Little Company of MaryMAHP1 Medical Associates Health PlanMHHNP MEMORIAL HERMANN HLTH NETMRCHP CareSource Health Plan of OregonREHNA Rehn and AssociatesSHEBP Seton Employee PlanSX105 Deseret Mutual Benefit AdministratorsSX106 Public Employees Health Plan (PEHP)SX110 Educators Mutual of Utah (EMI Health)SX145 Banner Health AZ Banner Health Co, - ROCKY MOUNTAIN HMO GREELEY Banner Health Co. - ANTERO GREELEY Banner Health Co. - ANTERO HIGH PLAINS Banner Health Co. - ANTERO MOUNTAIN SHADOWS Banner Health Co. - CHOICE PLUS Banner Health Co. - HMO GREELEY Banner Health Co. - HMO HIGH PLAINS Banner Health Co. - HMO MOUNTAIN SHADOWS Banner Health Co. - PACIFICARE GREELEY Banner Health Co. - PACIFICARE HIGH PLAINS Banner Health Co. - PACIFICARE MOUNTAIN SHADOWS Banner Health Co. - ROCKY MNT HMO HIGH PLAINS Banner Health Co. - SECURE HORIZONS GREELEY Banner Health Co. - SECURE HORIZONS HIGH PLAINS Banner Health Co. - SECURE HORIZONS MNT SHADOWS

SX155 University of UtahSX172 MDwise Eskenazi Health - Healthy Indiana Plan (HCFA) MDwise Eskenazi Health - Hoosier Healthwise (HCFA)SX172 MDwise Excel Network - Healthy Indiana Plan (HCFA) MDwise Excel Network - Hoosier Healthwise (HCFA) MDwise Family Planning - Healthy Indiana Plan (HCFA) MDwise Family Planning - Hoosier Healthwise (HCFA) MDwise Franciscan - Healthy Indiana Plan (HCFA) MDwise Healthy Indiana Plan HIP (HCFA) MDwise Hoosier Care Connect (HCFA) MDwise Hoosier/Healthy Indiana (HCFA) MDwise IU Health - Healthy Indiana Plan (HCFA) MDwise IU Health - Hoosier Healthwise (HCFA) MDwise Marketplace (HCFA) MDwise Select Health Net. Healthy Indiana Plan (HCFA) MDwise St. Catherine - Healthy Indiana Plan (HCFA) MDwise St. Margaret - Healthy Indiana Plan (HCFA) MDwise St. Vincent - Healthy Indiana Plan (HCFA) MDwise Total Health - Healthy Indiana Plan (HCFA) MDwise Total Health - Hoosier Healthwise (HCFA)

Payer ID Payer Name Payer ID Payer Name

00243 MedStar Family Choice of MD MedStar Physician Partners Vestica Healthcare00315 Thomas H. Cooper00590 BCBS Florida Florida Blue HMO Health Options - Florida Blue01066 American Healthcare Alliance01508 Better Health03440 Phoenix Health Plan04218 Pan American Life Insurance Group05003 Medicaid New Mexico - Presbyterian Salud Presbyterian Salud (NM)05047 Neighborhood Health Plan of Rhode Island06102 Diversified Administration Corp Diversified Group Brokerage/Healthplan Services06541 County Care Health Plan06607 Cardinal Innovations Piedmont Behavioral Health07205 Gilsbar Inc. Healthplus of Louisiana10010 Careworks10525 Patient Advocates, LLC11334 New York Network Management12399 Physicians Health Plan of Northern Indiana13265 Metro Plus Health Plan13315 Insurance Design Administrators13334 Affinity Health Care13382 Orthonet-Uniformed Services Family Health13383 Orthonet- Aetna13407 Uniformed Services Family Health Plan16117 RMSCO Inc16644 Nova Healthcare Administrators20270 Health Payment Systems Inc20356 Health Exchange (Cerner Corp)20488 Better Health of Florida20553 Americas 1st Choice Health Plan of South Carolina22248 Amerihealth Mercy Health Plan CarePartners Passport22321 One Call Medical22326 Horizon Mercy Horizon NJ Health Mercy Health Plan of NJ (Horizon Mercy)22348 Maryland Physicians Care

22384 Administration Concepts Inc22521 EDS Healthchoice EGID - Employees Group Insurance Division HealthChoice of Oklahoma HP Administrative Services OK State Employees & Educators EDS OSEEGIB - Oklahoma State and Education Employees Group Ins Board22603 NJ Carpernters Health Fund23130 Fresenius Medical Care23284 Keystone Mercy23285 Select Health of South Carolina23287 Intergroup Services Corporation InterGroup Services PPO23342 QualCare, Inc. Advantra Advantra Freedom Altius Health Plan - Coventry Care Management Resources (CMR) Carelink Advantra Carelink Health Plan Carelink Medicaid Carenet Carpenters Hlth/Welf. Hazelwood,MO Claims Administration Corporation (CAC) Coventry Advantra (Texas, New Mexico, Arizona) Coventry Health and Life – Oklahoma Coventry Health and Life Insurance (Tennessee) Coventry Health Care - Nevada Coventry Health Care National Network Coventry Health Care of Kansas, Inc. -Wichita Coventry Healthcare25133 Coventry Healthcare of Delaware Coventry Healthcare of Florida (Aetna Medicaid) Coventry Healthcare of Georgia Coventry Healthcare of Illinois Coventry Healthcare of Indiana Coventry Healthcare of Iowa Coventry Healthcare of Kansas, Inc. - Kansas City Coventry Healthcare of Louisiana Coventry Healthcare of Missouri Coventry Healthcare of Nebraska Coventry Healthcare of the Carolinas Coventry Medicaid Nebraska Coventry Missouri

Coventry Nebraska Medicaid Diamond Plan Family Health Partners/MC + Missouri First Health (PayerID 25133) (Coventry) Foreign Service Benefit Plan Group Health Plan (GHP) Health America, Inc. Health Assurance Healthcare USA Kansas City Advantra (Coventry) Mailhandlers Benefit Plan25133 Mercy Managed Behavioral Health Montana Health Co-op Omnicare, A Coventry Health Plan ORNDA Health D296Corp (First Health)+D312 PersonalCare PHSIC Preferre Plus of Kansas Preferred Benefits Administrator Preferred Health Systems Insurance Company (PHSIC) Preferred Plus of Kansas Rural Carrier Benefit Plan (Coventry) Southern Health Services Inc. University of Missouri Vista Health Plan WELLPATH25169 Gateway Health Plan26054 ICare Health Options26492 Florida True Health27008 Health Systems International - ECOH27094 Simply Health Care Plan27357 AmeriHealth Caritas Louisiana Louisiana Care (LACare)28530 Secure Health Plans of Georgia, LLC31048 Western Southern Financial Group (Cincinnati, OH)31053 Individual Health Insurance Companies31053 State Farm Insurance Companies31059 State Farm Property & Casualty31127 Integra Group31172 Innovante Benefit Administrator31182 InnovAge Total Community Care31441 S & S Healthcare Strategies31625 ElderPlan, Inc.33036 Loma Linda Managed Care (33036) Loma Linda Univ. Healthcare - ManagedCare Claims33373 Molina Healthcare of CA Encounters33628 Mercy Maricopa Integrated Care34136 JP Farley Corporation34154 Chesterfield Technologies34159 E-V Benefits Management, Inc (Columbus, OH)

Loma Linda Univer. Med.Center Employee Health Plan37267 Loma Linda Univer. Med.Center Residents Health Plan Loma Linda University Student Health Plan37268 Prism Health Networks Prism Network, Inc.37275 Missoula County Medical Benefits Plan37279 Insurance Administrator of America, Inc. (IAA)37282 Select Benefit Administrators of America (WI) American Administrative37283 Gallagher Benefit Administrators, Inc/GBA HealthSmart Benefit Solutions (formerly American Administrative/Gallagher Benefit)37283 Poly America Medical & Dental Benefits Plan37284 TransChoice-Key Benefit Administrators TransChoice-Key Benefit Administrators KBA37287 Planned Administrators, Inc. (PAI)37290 Health Services for Children with Special Needs37301 Summit America Insurance Services, Inc.37314 North Broward Hospital District Anthem OMHS37331 Right Choice Benefit Administrators Self Insured Plans Inc37363 ComPsych37601 University of Illinois at Chicago Div of Specialized Care for Children38217 Priority Health HAP/AHL/Curanet (MI)38224 Health Alliance Plan of Michigan Medical Value Plan-MVP-OH McLaren38232 Meritain (Michigan address) Weyco, Inc. Bass Administrators, Inc. Benesys Inc.38238 Benesys-LHP Claims Unit LHP Claims Unit38259 Automated Benefit Services38265 Administration Systems Research Physicians Care38308 Christian Brothers Services38337 Upper Peninsula Health Plan (Medicaid)38353 MedDirect ASSURANT HEALTH39065 Fortis Insurance Company Time Insurance39081 Benefit Plan Administrators Co. (Eau Claire, WI) Custom Benefit Administrators39151 WEA Insurance Group39167 Group Health Coop. of S. Central Wisconsin Claims39168 Group Health Coop. of S. Central Wisconsin Encounters39182 Insurance TPA

56240 Detroit Medical Center56731 Healthcare Resources NW57080 ClaimsWare, Inc. dba ManageMed CWIBENEFITS, INC.57117 QVI Risk Solutions Inc57254 State of Texas Dental Plan (GEHA)58102 Covenant Administrators Inc Dental (Atlanta, GA)58213 Alignis58213 Healthways WholeHealth Networks58231 Core Administrative Services Core Management Resources Group58234 Alliant Health Plans of Georgia58730 Aetna ASA PPO/Assurant Health (Signature Admin)59140 Consolidated Group Health Plan Services Health Plan Services - Oklahoma HealthPlan Services (Tampa only) The Mutual Group59143 Harrington Health Non-EPO59266 Volusia Health Network59299 Employers Mutual, Inc. EMI-KP (Ambulance)59313 Evolutions Healthcare Systems (New Port Richey, FL)59324 Podiatry Network Florida59354 Wellcare Health Plans Encounters60061 Amerihealth Non-HMO New Jersey (Highmark)61102 Humana (Encounters only)61124 Bluegrass Family Health Signature Health Alliance61425 STARMARK Tooling and Manufacturing Assocation Trustmark Insurance62160 MedSolutions, Inc62180 Health Choice Generations62777 Trilogy Network63100 Behavioral Health Systems63103 American Behavioral63114 Viva Health Plan64157 Meritain Health (North American Health Plan.) North American Administrators, Inc.64158 Meritain Health / Agency Services64246 Dental Guard Preferred First Commonwealth HMO Dental Plan Guardian Life (The Guardian)64284 Independence Care Systems / FIDA-MMP65031 CarePlus Health Plans Physicians Healthcare Plans65054 Premier Eye Care65062 ATA Florida (American Therapy Association) Health Network One (HN1 Therapy Network)65101 AXA Assistance USA HAA Preferred Partners

Meritain (Cleveland address)34159 NABN (Cleveland, OH) North American Benefits Network34171 FrontPath Health Coalition34189 Ohio Health Choice, PPO Antares Management Solutions34192 Benefit Services Inc. Mutual Health Services34196 Apex Benefit Services35145 Highmark - Key Family35161 Indiana ProHealth Network35162 Managed Care Services, LLC QCA Health Plan35174 Qual Choice of Arkansas QualChoice Health Insurance35183 CoreSource OH35198 Unified Group Services United Group Services Encircle PPO Encore Health Network35206 Signature Care Health Network The Healthcare Group36215 Central States Health & Welfare Funds Teamcare36331 Professional Benefit Administrators, Inc.36334 MACNEAL HEALTH PROVIDERS - CHS36338 Group Administrators Ltd.36345 Physicians Care Network36373 Prairie States Enterprises, Inc.36396 Family Medical Network Resurrection Health Care Preferred (RHCP)37105 Hinsdale Physicians Healthcare Sage Technologies37116 St. Therese Physician Assoc.37121 Mashantucket Pequot Tribal Nation37217 Key Benefit Administrators37227 CNIC Health Solutions InterCare Health Plans37242 Aultra Administrative Group Professional Claims Management37256 Mutual Assurance37257 EMPLOYEE BENEFIT CON INC Loma Linda Default (37267) Loma Linda University Adventist Health Sciences Center Employee Health Plan Loma Linda Univer. Adventist Health Sciences Centers37267 Loma Linda Univer. Behavioral Medicine Center Employee Health Plan Loma Linda University Dept of Risk Management Loma Linda University Employee Health Plan Loma Linda Univer. Health Care Employee Health Plan

39182 International Funding Limited41041 Federated Mutual Health Insurance Company41206 Ultra Benefits American Administrators (West Des Moines)42137 Select Benefit Administrators (Des Moines, Iowa) TriStar (formerly Select Benefit Administrators)42138 Cook County Health Behavioral 42139 Cook County Health Medical 42140 Centurion42172 Puget Sound Health Partners Inc Soundpath Health43160 Corizon Inc Correctional Medical Services, Inc.43166 Mercy Health Plan Premier Benefits Inc. Premier Health Plans43178 Benefit Management Inc - Joplin Claims Joplin Claims44273 Health Plans, Inc.45281 Riverside Health Inc University of Maryland Health Partners (UMHP)45341 Maine Community Health Options45423 Advicare46050 Generations Globalhealth Generations Healthcare47027 Physicians Mutual Insurance Company47080 Midlands Choice, Inc.48026 Northshore Physician Associates48100 ProviDRs Care Network48117 CoreSource KC (FMH) FMH Benefit Services, Inc.50701 VGM Homelink52123 Johns Hopkins Healthcare USFHP52132 Cooperative Benefit Administrators (CBA) National Rural Electric Cooperative Assoc.52180 UMWA Health & Retirement Funds52189 Johns Hopkins Healthcare52629 UCare Minnesota53589 BCBS Arizona54154 Optima Health Plan Optima Insurance Company Sentara Family Care Sentara Health Management54763 AmeriHealth Administrators Independence Administrators56139 Benefit Management Services (NOT in LA) Integra BMS56144 Primary Physician Care Inc.56190 OptiCare Managed Vision (Prime Vision Health) Prime Vision Health56196 First Carolina Care

65391 CBHNP - HealthChoices66055 Netcare Life and Health Insurance (Hagatna, Guam)68039 Western Health Advantage68069 Louisiana Health Care Connections 72126 Peoples Health Network72467 ACS Benefit Services Inc.73100 Kempton Group73143 Com. Care Managed Health Care Plans of Oklahoma73145 Preferred Community Choice/PCCSelect/CompMed73159 CCN Managed Care Inc. (First Health Network) First Health Network (f.k.a. CCN, PPO OK, HCVM) PPO Oklahoma (now known as: First Health Network74095 USAA (United States Automobile Association)74323 Medical Benefits Mutual75190 NCAS - Fairfax, VA75191 NCAS-Charlotte75237 HealthSmart Accel75250 Provider Direct Network (HealthSmart Preferred Care)75278 Arkansas Best Corporation - Choice Benefits75281 New Era Life Insurance Company76066 Renaissance Physicians Organization77001 Amerihealth NorthEast77002 Amerihealth District of Columbia77076 Network Health Insurance - Medicare77153 Indiana Uni. Health Plan – Commercial/Marketplace Southeastern Indiana Health (SIHO)81264 Nippon Life Insurance Co.81883 Municipal Health Benefit Fund83028 CDO Technologies MBA Benefit Administrators84076 Sinclair Health Plan84109 Pinnacol Assurance84135 Denver Health Medical Plan84980 BCBS Texas/HMO Blue Shield (non-MediCaid)85578 Ingalls Provider Group87042 Union Pacific Railroad Employees Health System87071 Liberty Health Advantage87098 Avesis Third Party Administrator87815 Acordia HealthSmart Benefit Solutions (formerly Wells Fargo TPA/Acordia National) Shaw Industries Wells Fargo Third Party Administrators, Inc. (Accordia)87843 Consolidated Health Plans88019 Teachers Health Trust88022 CDS Group Health88023 Hometown Health Plan Nevada88027 Benefit Plan Admin - Northern Nevada Trust Fund Electrical Workers Health and Welfare Plan for Northern Nevada Northern Nevada Oper. Engineers Health and Welfare

88027 Northern Nevada Trust Fund88029 Saint Marys Health Plan St Marys Health Plan88030 Scott & White Health Care Plan88067 Tall Tree Administrators90001 Healthcare Plan PPO Healthlink PPO Nat.Capital Preferred Provider Organization (NCPPO)90560 Westlake Financial Group91078 Trusteed Plans Service Corporation91136 Alaska Carpenters Trust Group #F40 Alaska Childrens Services, Inc. Group #P68 Alaska Laborers Construction Ind. Trust Group #F23 Alaska Pipe Trades Local Group #F24 Alaska United Food & Commercial Workers Health & Welfare Trust Group #F45 Caremark WPAS, Group #P62 Cement Masons & Plasterers Health & Welfare Trust Group #F16 Enstar Natural Gas, Group #P61 Hotel Employees & Restaurant Employees Health Trust, Group #F19 N.W. Ironworkers Health & Sec. Trust Fund, Group #F15 N.W. Roofers & Employers Health & Security Trust Fund, Group #F26 N.W. Textile Processors Group #F14 Operating Engineers Locals 302 & 612 Health & Security Fund, Group #F12 Puget Sound Benefits Trust, Group #F25 Puget Sound Electrical Workers Trust, Group #3391171 Physicians of Southwest Washington91184 Sanford Health Plan93044 A & I Benefit Plan Administrators93092 US Benefits94123 Kaiser Permanente Health Plan of Hawaii94320 Kaiser California Select for Individuals Kaiser CSI Kaiser Self-Funded KPIC Self-Funded Claims Administrator94998 Firstcare (Medicaid)94999 Firstcare95044 AmeriHealth Delaware - POS Amerihealth HMO New Jersey and Delaware (Highmark) AmeriHealth New Jersey - POS AmeriHealth Pennsylvania - ERISA AmeriHealth Pennsylvania - HMO/POS95202 Summacare Health Plan (HMO)95348 Humana Ohio95377 Beech Street95397 Personal Insurance Administrators95426 Affordable Benefit Administrators

95444 Indiana University (IU) Health Plan – Medicare Advantage MPLAN, Inc./HealthCare Group, LLC95998 New Avenues98514 TRLHN AS99320 Benefit & Risk Management Services (BRMS) California Water Service (Cal Water)AHS01 Access AdministratorsAPG01 Affiliated Physicians GroupBTSS1 Brown & Toland Sutter SelectBV001 Block Vision - VIPA/Block Vision of TexasCB987 Dart Member CareCP001 InterCommunity Health CCO (IHN) Samaritan Advantage (SA01) Samaritan Choice (SCP) Samaritan Health Plans Samaritan Healthy Kids (KID)DOCSO Southwest Oregon IPA (DOCS) Western Oregon Advanced HealthEBSRM Lifetime Benefit SolutionsFS802 Bridgeview CompanyFS802 FirstSolutionsGEM01 Global Excel ManagementGHOKC Global HealthHESUN Healthsun Health PlanKLSY1 SelectCare of Texas (Kelsey-Seybold) TexanPlus of Texas (Kelsey-Seybold)LCM01 Little Company of MaryMAHP1 Medical Associates Health PlanMHHNP MEMORIAL HERMANN HLTH NETMRCHP CareSource Health Plan of OregonREHNA Rehn and AssociatesSHEBP Seton Employee PlanSX105 Deseret Mutual Benefit AdministratorsSX106 Public Employees Health Plan (PEHP)SX110 Educators Mutual of Utah (EMI Health)SX145 Banner Health AZ Banner Health Co, - ROCKY MOUNTAIN HMO GREELEY Banner Health Co. - ANTERO GREELEY Banner Health Co. - ANTERO HIGH PLAINS Banner Health Co. - ANTERO MOUNTAIN SHADOWS Banner Health Co. - CHOICE PLUS Banner Health Co. - HMO GREELEY Banner Health Co. - HMO HIGH PLAINS Banner Health Co. - HMO MOUNTAIN SHADOWS Banner Health Co. - PACIFICARE GREELEY Banner Health Co. - PACIFICARE HIGH PLAINS Banner Health Co. - PACIFICARE MOUNTAIN SHADOWS Banner Health Co. - ROCKY MNT HMO HIGH PLAINS Banner Health Co. - SECURE HORIZONS GREELEY Banner Health Co. - SECURE HORIZONS HIGH PLAINS Banner Health Co. - SECURE HORIZONS MNT SHADOWS

SX155 University of UtahSX172 MDwise Eskenazi Health - Healthy Indiana Plan (HCFA) MDwise Eskenazi Health - Hoosier Healthwise (HCFA)SX172 MDwise Excel Network - Healthy Indiana Plan (HCFA) MDwise Excel Network - Hoosier Healthwise (HCFA) MDwise Family Planning - Healthy Indiana Plan (HCFA) MDwise Family Planning - Hoosier Healthwise (HCFA) MDwise Franciscan - Healthy Indiana Plan (HCFA) MDwise Healthy Indiana Plan HIP (HCFA) MDwise Hoosier Care Connect (HCFA) MDwise Hoosier/Healthy Indiana (HCFA) MDwise IU Health - Healthy Indiana Plan (HCFA) MDwise IU Health - Hoosier Healthwise (HCFA) MDwise Marketplace (HCFA) MDwise Select Health Net. Healthy Indiana Plan (HCFA) MDwise St. Catherine - Healthy Indiana Plan (HCFA) MDwise St. Margaret - Healthy Indiana Plan (HCFA) MDwise St. Vincent - Healthy Indiana Plan (HCFA) MDwise Total Health - Healthy Indiana Plan (HCFA) MDwise Total Health - Hoosier Healthwise (HCFA)