|
|
|||||
| ID | Payer Name | Enrollment | |||
| AARP1 | AARP Dental Insurance Plan | No | |||
| 60054 | Aetna | No | |||
| 94177 | Allied Administrators (CA) | No | |||
| 50503 | Altus Dental | No | |||
| STR01 | Always Care Benefits | No | |||
| 34187 | American Benefits Management (North Canton, OH) | No | |||
| 52133 | Americhoice NJ | No | |||
| 47009 | Ameritas Life Insurance Corp. | No | |||
| 47198 | Anthem Blue Cross (California) | No | |||
| 84099 | Anthem Blue Cross Blue Shield of Colorado | No | |||
| 65358 | Anthem Blue Cross Blue Shield of Connecticut | No | |||
| CBGA1 | Anthem Blue Cross Blue Shield of Georgia | No | |||
| 84105 | Anthem Blue Cross Blue Shield of Indiana | No | |||
| 84105 | Anthem Blue Cross Blue Shield of Kentucky | No | |||
| BME01 | Anthem Blue Cross Blue Shield of Maine | No | |||
| 84105 | Anthem Blue Cross Blue Shield of Missouri (excluding Kansas City) | No | |||
| BNH01 | Anthem Blue Cross Blue Shield of New Hampshire | No | |||
| 84105 | Anthem Blue Cross Blue Shield of Ohio | No | |||
| CB923 | Anthem Blue Cross Blue Shield of Virginia | No | |||
| BWI01 | Anthem Blue Cross Blue Shield of Wisconsin (Green Bay, WI claim address only) | No | |||
| 84103 | Anthem Blue Cross Blue Shield Virginia (Trigon) - Colorado Claim Office | No | |||
| 65358 | Anthem Blue Cross of Connecticut | No | |||
| 70408 | Assurant | No | |||
| 93221 | Asuris - Washington | No | |||
| ADN01 | Atlantic Dental (ADI) | No | |||
| A2051 | BAC Local 15 Welfare Fund (Kansas) | No | |||
| 60054 | Bell Atlantic | No | |||
| 25145 | Benefit Coordinators Corporation (Pittsburgh) | No | |||
| 39081 | Benefit Plan Administrators Co. | No | |||
| BMX01 | Benemax | No | |||
| 37248 | Benesys, Inc. (Louisiana) | No | |||
| BNMK1 | BenMark (Mississippi) | No | |||
| 84101 | Blue Cross and Blue Shield Nevada Dental | No | |||
| CB621 | Blue Cross and Blue Shield of Illinois | No | |||
| 23739 | Blue Cross and Blue Shield of Louisiana | Yes | |||
| CBMA1 | Blue Cross and Blue Shield of Massachusetts | Yes | |||
| BCBSM | Blue Cross and Blue Shield of Michigan | No | |||
| 84100 | Blue Cross and Blue Shield of New Mexico (BCBS of New Mexico) | No | |||
| CB900 | Blue Cross and Blue Shield of Texas | No | |||
| 00700 | Blue Cross Connecticut Blue Care Plan | No | |||
| CB865 | Blue Cross of Pennsylvania | Yes | |||
| 54771 | Blue Shield of Pennsylvania | Yes | |||
| CB865 | Blue Shield of Pennsylvania / United Concordia | Yes | |||
| CBPA2 | Blue Shield of Pennsylvania Dental Plus (UCCI must be submit with CB865) | Yes | |||
| BOLL1 | Bollinger (Group number is required) | No | |||
| 47009 | Businessmen's Assurance (NE) | No | |||
| CLF01 | C.L. Frates & Company | No | |||
| 37105 | Cannon Cochran Management Services, Inc. (CCMSI) | No | |||
| A2005 | Cement Masons & Plasteres Local 518 (Kansas) | No | |||
| 60054 | Choice Plus (TRW) | No | |||
| 62308 | CIGNA | No | |||
| CSL01 | Citizens Security Life | No | |||
| CX071 | Citizens Security Life | No | |||
| CMS01 | Claim Management Services (WI) | No | |||
| CX021 | CompBenefits/CompDent | No | |||
| 34177 | Compensation Programs of Ohio, Inc. | No | |||
| 03036 | Comprehensive Benefits Administrator (VT) | No | |||
| 62308 | Connecticut General | No | |||
| 61305 | Consolidated Group Dental | No | |||
| 58102 | Covenant Administrators, Inc. | No | |||
| 39170 | Custom Benefit Administrators (WI) | No | |||
| 60054 | CustomCare | No | |||
| DEW01 | D. Edward Wright TPA | No | |||
| DELTU | DDP-USA | No | |||
| 94276 | Delta Dental Insurance Company (DDIC) | No | |||
| 94276 | Delta Dental of Alabama | No | |||
| 94276 | Delta Dental of Alaska | No | |||
| 86027 | Delta Dental of Arizona | No | |||
| DELAR | Delta Dental of Arkansas (DDP-AR) | No | |||
| 77777 | Delta Dental of California | No | |||
| CDCA1 | Delta Dental of California/Tricare Retiree Dental | No | |||
| DELTC | Delta Dental of Colorado | No | |||
| 22189 | Delta Dental of Connecticut | No | |||
| 51022 | Delta Dental of Delaware | No | |||
| 94276 | Delta Dental of Florida | No | |||
| 94276 | Delta Dental of Georgia | No | |||
| 82029 | Delta Dental of Idaho | No | |||
| 47598 | Delta Dental of Illinois | No | |||
| DELTI | Delta Dental of Indiana | No | |||
| CDIA1 | Delta Dental of Iowa | No | |||
| CDKY1 | Delta Dental of Kentucky | No | |||
| 94276 | Delta Dental of Louisiana | No | |||
| 23166 | Delta Dental of Maryland | No | |||
| 04614 | Delta Dental of Massachusetts | No | |||
| DELTA | Delta Dental of Michigan | No | |||
| DDPFS | Delta Dental of Michigan (Federal) | No | |||
| 94276 | Delta Dental of Mississippi | No | |||
| 43090 | Delta Dental of Missouri | No | |||
| 94276 | Delta Dental of Montana | No | |||
| 94276 | Delta Dental of Nevada | No | |||
| 22189 | Delta Dental of New Jersey | No | |||
| DELTM | Delta Dental of New Mexico | No | |||
| 11198 | Delta Dental of New York | No | |||
| 02027 | Delta Dental of Northeast (ME, NH, VT) | No | |||
| DELTO | Delta Dental of Ohio | No | |||
| DELOK | Delta Dental of Oklahoma (DDP-OK) | No | |||
| 23166 | Delta Dental of Pennsylvania | No | |||
| 05029 | Delta Dental of Rhode Island | No | |||
| 54097 | Delta Dental of South Dakota | No | |||
| DELTN | Delta Dental of Tennessee (DDP-TN) | No | |||
| 94276 | Delta Dental of Texas | No | |||
| 94276 | Delta Dental of Utah | No | |||
| 54084 | Delta Dental of Virginia | No | |||
| 91062 | Delta Dental of Washington State | No | |||
| 52147 | Delta Dental of Washington, D.C. | No | |||
| 31096 | Delta Dental of West Virginia | No | |||
| 39069 | Delta Dental of Wisconsin | No | |||
| 04356 | Denta Quest | No | |||
| 04356 | Denta Quest of Mid Atlantic | No | |||
| 89070 | DentaBenefits | Yes | |||
| 52133 | Dental Benefit Providers | No | |||
| CX056 | Dental Benefit Providers | No | |||
| CX057 | Dental Benefit Providers | No | |||
| DCP01 | Dental Care Plus | No | |||
| DNOA1 | Dental Network of America | No | |||
| DSL01 | Dental Select | No | |||
| 11271 | Detectives Endowment Association (New York) | No | |||
| A1004 | Detroit Laborers (Metropolitan) | No | |||
| 25172 | DH Evans | No | |||
| HSP01 | District Council 37 Health & Welfare Fund | No | |||
| 25160 | Diversified Group (Maryland) | No | |||
| DOM01 | Dominion Dental (DHMO only) | No | |||
| CX014 | Doral Dental USA | No | |||
| 73288 | EHI | No | |||
| 73288 | EMPHESYS | No | |||
| 55093 | Empire Dental | No | |||
| 38241 | Employee Benefit Concepts, Inc. | No | |||
| 37257 | Employee Benefit Consultants | No | |||
| CX025 | Employee Benefit Management Corp (EBMC) | No | |||
| 73288 | Employees Health of Wisconsin (EHIC) | No | |||
| 59297 | Employers Mutual | No | |||
| 62308 | EQUICOR | No | |||
| 73126 | Equitable Plan Services | No | |||
| CX046 | Erin Group | No | |||
| 72630 | First Ameritas Life Insurance Corporation of New York (Formerly Ameritas Bankers Assurance Co.) | No | |||
| 70408 | First Fortis Life Insurance | No | |||
| 13317 | First Reliance Standard (NY Business) | No | |||
| 11244 | Fitzharris & Company | No | |||
| 60054 | FlexCare | No | |||
| 60054 | Florida Power & Light | No | |||
| LX050 | Formula Card | No | |||
| 70408 | Fortis Benefit Insurance | No | |||
| 63665 | General American | No | |||
| 13551 | GHI | No | |||
| GWD01 | Golden West Dental | No | |||
| 44054 | Government Employees Hospital Association (GEHA) | No | |||
| 80705 | Great West | No | |||
| 10006 | Group Health Cooperative of South Central Wisconsin | No | |||
| CX015 | GroupLink - Indiana | No | |||
| 64246 | Guardian Life Insurance Company of America | No | |||
| HDMCO | HDM Benefit Solutions | No | |||
| 25160 | Health Aspex (Maryland) | No | |||
| 82018 | Health Claim Service | No | |||
| DX029 | Health Comp | No | |||
| CX009 | Health Partners (MN) | No | |||
| CX019 | Health Resources | No | |||
| 86066 | Healthcare Management Administrators, Inc | No | |||
| 11271 | HealthPlex | No | |||
| HGL01 | Heavy & General Laborers | No | |||
| 54771 | HighMark Dental | Yes | |||
| CX015 | Hoosier Dental (Indianapolis, IN) | No | |||
| CX015 | Hoosier Dental Benefit Trust | No | |||
| 22099 | Horizon | Yes | |||
| 73288 | Humana | No | |||
| 22175 | I.E. Shaffer | No | |||
| A1117 | IBEW Local 117 | No | |||
| A1317 | IBEW Local 38 | No | |||
| A1461 | IBEW Local 461 | No | |||
| A1464 | IBEW Local 464 | No | |||
| A4681 | IBEW Local 481 | No | |||
| ICW01 | Indiana Carpenters | No | |||
| 52196 | InforMed, LLC (MD) | No | |||
| 88006 | Insurance Management Services | No | |||
| 51020 | INTEGRA Administrative Group, Inc. | No | |||
| 61271 | J.F. Molloy & Associates | No | |||
| JPF01 | Jefferson Pilot/Guarantee Life Insurance | No | |||
| JISSP | JI Companies | No | |||
| 41099 | John Alden Life Insurance | No | |||
| 34136 | JP Farley Corporation | No | |||
| A2032 | Kansas City Laborers Welfare Fund | No | |||
| 73288 | Lincoln National (WI - in Madison or Green Bay) | No | |||
| NYT01 | Local 1149 Baldwinsville, NY | No | |||
| NYT01 | Local 118 Rochester, NY | No | |||
| NYT01 | Local 182 Utica, NY | No | |||
| NYT01 | Local 264 Cheektowaga, NY | No | |||
| NYT01 | Local 294 Albany, NY | No | |||
| NYT01 | Local 317 Syracuse, NY | No | |||
| NYT01 | Local 375 Buffalo, NY | No | |||
| NYT01 | Local 449 Buffalo, NY | No | |||
| NYT01 | Local 529 Elmira, NY | No | |||
| NYT01 | Local 669 Albany, NY | No | |||
| NYT01 | Local 687 Potsdam, NY | No | |||
| NYT01 | Local 693 Binghamton, NY | No | |||
| NYT01 | Local 791 Rochester, NY | No | |||
| 23223 | Loomis | No | |||
| 65030 | Managed Care of North America (MCNA) | No | |||
| CX014 | Managed Health Services - WI State Employees | No | |||
| 65030 | MCNA (Managed Care of North America) | No | |||
| CKAL1 | Medicaid - Alabama | Yes | |||
| CX014 | Medicaid - Arizona - Maricopa Health Systems Health Plans | No | |||
| 94146 | Medicaid - California - DentiCal | Yes | |||
| CKCO1 | Medicaid - Colorado | Yes | |||
| CKCT1 | Medicaid - Connecticut | Yes | |||
| CX014 | Medicaid - Connecticut - HealthNet | No | |||
| CX014 | Medicaid - District of Columbia - Amerigroup | No | |||
| CX014 | Medicaid - Georgia - Amerigroup | No | |||
| CX014 | Medicaid - Georgia - Wellcare | No | |||
| CX014 | Medicaid - Idaho - BCI of Idaho | No | |||
| CKID1 | Medicaid - Idaho (Disabled adults only) | Yes | |||
| CX014 | Medicaid - Illinois - Amerigroup | No | |||
| CX014 | Medicaid - Illinois Medical Assistance Program | No | |||
| CKIN1 | Medicaid - Indiana | Yes | |||
| CKIA1 | Medicaid - Iowa | Yes | |||
| CX014 | Medicaid - Kansas Medical Assistance Program | No | |||
| CKKY1 | Medicaid - Kentucky | Yes | |||
| CKMD1 | Medicaid - Maryland | Yes | |||
| CX014 | Medicaid - Maryland - Amerigroup | No | |||
| CX014 | Medicaid - Maryland - Coventry Diamond Plan | No | |||
| CX014 | Medicaid - Maryland - HELIX | No | |||
| CX014 | Medicaid - Maryland - PhysicianCare of MCO | No | |||
| CX014 | Medicaid - Maryland - Priority Partners | No | |||
| CKMA1 | Medicaid - Massachusetts - MassHealth | Yes | |||
| CKMI1 | Medicaid - Michigan | Yes | |||
| CKMN1 | Medicaid - Minnesota | Yes | |||
| CX014 | Medicaid - Minnesota - UCare | No | |||
| CKMS1 | Medicaid - Mississippi | Yes | |||
| CKMO1 | Medicaid - Missouri | Yes | |||
| CX014 | Medicaid - Missouri - Blue Cross Blue Shield of Kansas City | No | |||
| CX014 | Medicaid - Missouri - FirstGuard Health Plan | No | |||
| CX014 | Medicaid - Missouri - HealtCare USA - St. Louis | No | |||
| CKNJ1 | Medicaid - New Jersey | Yes | |||
| CX014 | Medicaid - New Jersey - Amerigroup | No | |||
| CX014 | Medicaid - New Jersey - HealthNet | No | |||
| CX014 | Medicaid - New Jersey - University Health Plan | No | |||
| CKNM1 | Medicaid - New Mexico | Yes | |||
| CX014 | Medicaid - New Mexico - Lovelace Community Health Plan | No | |||
| CX014 | Medicaid - New Mexico - Molina Healthcare (Formerly Cimarron) | No | |||
| CX014 | Medicaid - New Mexico - Prebyterian Salud | No | |||
| CX014 | Medicaid - New York - CenterCare | No | |||
| CX014 | Medicaid - New York - Empire Blue Cross Blue Shield | No | |||
| CX014 | Medicaid - New York - Fidelis Care | No | |||
| CX014 | Medicaid - New York - GHI | No | |||
| CX014 | Medicaid - New York - Healthfirst | No | |||
| CX014 | Medicaid - New York - Managed Health Inc (MHI) | No | |||
| CX014 | Medicaid - New York - Metro Plus | No | |||
| CX014 | Medicaid - New York - New York Presbyterian Community Health Plan | No | |||
| CX014 | Medicaid - New York - Suffolk County | No | |||
| CKNY1 | Medicaid - New York | Yes | |||
| CKND1 | Medicaid - North Dakota | Yes | |||
| CKOH1 | Medicaid - Ohio | Yes | |||
| CX014 | Medicaid - Ohio - Amerigroup | No | |||
| CX014 | Medicaid - Ohio - Anthem Blue Cross Blue Shield Partnership Plan (Formerly QualChoice) | No | |||
| CX014 | Medicaid - Ohio - Buckeye Health Plan | No | |||
| CX014 | Medicaid - Ohio - Molina | No | |||
| CX014 | Medicaid - Ohio - Unison Health Plan (Formerly Better Heatlh Plan) | No | |||
| CKOK1 | Medicaid - Oklahoma | Yes | |||
| CKPA1 | Medicaid - Pennsylvania | Yes | |||
| CX014 | Medicaid - Pennsylvania - Amerihealth Mercy Health Plan | No | |||
| CX014 | Medicaid - Pennsylvania - Health Partners, Philadelphia | No | |||
| CX014 | Medicaid - Pennsylvania - Ion Health, Inc | No | |||
| CX014 | Medicaid - Pennsylvania - Keystone Mercy Health Plan | No | |||
| CX014 | Medicaid - Pennsylvania - UPMC Health Plan - Dental | No | |||
| CX014 | Medicaid - Pennsylvania - UPMC Health Plan, Pittsburgh | No | |||
| CKRI1 | Medicaid - Rhode Island | Yes | |||
| CKSC1 | Medicaid - South Carolina | Yes | |||
| CX014 | Medicaid - Tennessee - TennCare | No | |||
| CKTX1 | Medicaid - Texas | Yes | |||
| CKVT1 | Medicaid - Vermont | Yes | |||
| CX014 | Medicaid - Virginia - Virginia Smiles for Children | No | |||
| CKWA1 | Medicaid - Washington State | Yes | |||
| CKWI1 | Medicaid - Wisconsin | Yes | |||
| CX014 | Medicaid - Wisconsin - United Health Care | No | |||
| CX014 | Medicare - New Mexico - Molina Healthcare of New Mexico | No | |||
| MNM01 | Mennonite Mutal Aid | No | |||
| 65978 | MetLife/ Metropolitan Life Insurance Company (Formally Travelers) | No | |||
| A1004 | Metropolitan Detroit Laborers | No | |||
| A1432 | Michigan Laborers | No | |||
| 38238 | Michigan Regional Council of Carpenters (Troy, MI) | No | |||
| A1404 | Michigan State Painters | No | |||
| 52148 | Mid - Atlantic Medical Services, Inc. (MAMSI) (MAHP) | No | |||
| CX033 | Mid - Atlantic Medical Services, Inc. (MAMSI) (PO Box 940 Frederick MD 21788) | No | |||
| MAMS1 | Mid - Atlantic Medical Services, Inc. (MAMSI) (PO Box 940 Frederick MD 21788) | No | |||
| 79480 | Midwest Security | No | |||
| A1402 | Millwrights Local 1102 Health & Welfare Fund | No | |||
| CB833 | MMO (Medical Mutual of Ohio) | Yes | |||
| 89070 | Mutual of Omaha | Yes | |||
| 65085 | NAA (TN) | No | |||
| 95123 | Neighborhood Health | No | |||
| 43351 | New England Dental Administrators | No | |||
| NYT01 | New York State Teamsters Union | No | |||
| 16644 | Nova Healthcare Administrators | No | |||
| OAC01 | Ohio AFSCME Care Plan | No | |||
| CLF01 | OSMA Health (Formerly PLICO – Oklahoma) | No | |||
| CX053 | PacificCare | No | |||
| CX060 | PacificCare | No | |||
| 93029 | PacificSource Health Plans | No | |||
| 47009 | Paul Revere/Provident | No | |||
| 60054 | PDO | No | |||
| PIP02 | Pipefitters 597 (45 N. Ogden Ave. Chicago IL 60607) | No | |||
| 60054 | Preferred Dental Organization | No | |||
| 41147 | Preferred One | No | |||
| CX029 | Premier Dental (MN) | No | |||
| 61271 | Principal Financial Group | No | |||
| 61271 | Principal Mutual Life Insurance Co. | No | |||
| 36331 | Professional Benefit Administrators, Inc. (IL) | No | |||
| 70408 | Protective Life Insurance Co. (Birmingham AL) | No | |||
| 60054 | Prudential | No | |||
| 60054 | Prudential Dental Organization | No | |||
| 60054 | Prudential for Health | No | |||
| 60054 | Prudential HealthCare & Life Ins. Co of America | No | |||
| 60054 | Prudential HealthCare Health Maintenance Organization | No | |||
| 60054 | Prudential HealthCare HMO for Small Business | No | |||
| 60054 | Prudential HealthCare of America | No | |||
| 60054 | Prudential HealthCare POS for Small Business | No | |||
| 60054 | Prudential HealthCare PPO for Small Business | No | |||
| 39197 | QuadMed (West Allis, WI) | No | |||
| 00611 | Regence Idaho | No | |||
| 00851 | Regence Oregon | Yes | |||
| 00932 | Regence Washington | No | |||
| 36088 | Reliance Standard Life | No | |||
| RLHA1 | Renaissance Life and Health | No | |||
| RR001 | Royale Resources | No | |||
| CX030 | SafeGuard Dental | No | |||
| SCD01 | Secure Care Dental | No | |||
| 64088 | Select Administrative Services (SAS) (Gulfport, MS) | No | |||
| 60054 | SelectCare (Coca Cola) | No | |||
| 59111 | Self Insured Benefit Administrators (FL) | No | |||
| 34131 | Self-Funded Plans, Inc. (Ohio) | No | |||
| 38610 | Set Inc. | No | |||
| SMW01 | Sheet Metal Workers Local 91 | No | |||
| SLI01 | Shenandoah Life Insurance Company | No | |||
| CX076 | SIDS (New York) | No | |||
| 76342 | Sierra Health | No | |||
| CX030 | Smile Makers | No | |||
| 23266 | South Central Preferred | No | |||
| SPD01 | Southwest Preferred Dental Organization | No | |||
| 60054 | Southwestern Bell | No | |||
| 60054 | Southwestern Bell Exec. - Custom Care | No | |||
| 60054 | Southwestern Bell Exec. - Southwestern Bell | No | |||
| 93024 | Standard Insurance | No | |||
| STR01 | Starmount Life Insurance Company | No | |||
| 31121 | Stoner & Associates | No | |||
| 47009 | Sun Life of Canada | No | |||
| 31117 | Superior Dental Care | No | |||
| DELTA | Teamsters Welfare Fund - Detroit | No | |||
| 73288 | The Dental Companies | No | |||
| 73288 | The Dental Concern | No | |||
| TDN01 | The Dental Network (7400 York Road, Suite 200, Towson, MD 21204) | No | |||
| JPF01 | Lincoln Financial Group/Jefferson Pilot Financial | No | |||
| TIC01 | TIC International, Inc. | No | |||
| CMS01 | Total Claims Solution | No | |||
| CX025 | TPAC | No | |||
| 65978 | Travelers (now MetLife) | No | |||
| 73288 | Tricare Active Reservists Only | No | |||
| 91078 | Trusteed Plans Service Corporation | No | |||
| 61425 | Trustmark Insurance Company | No | |||
| 73288 | TSRDP Dental Claims | No | |||
| A5205 | UFCW Local 400-5205 | No | |||
| 80314 | Unicare Dental | No | |||
| 13142 | Union Labor Life Insurance Company | No | |||
| CB865 | United Concordia | Yes | |||
| CBPA2 | United Concordia | Yes | |||
| 89070 | United Concordia (DentaBenefits/Mutual of Omaha PO Box 69416) | Yes | |||
| CX002 | United Concordia (TRICARE FMDP) (UCCI Federal Claims must be submitted using CB865) | Yes | |||
| CX013 | United Concordia Dental Plus (UCCI Federal Claims must be submitted using CB865) | Yes | |||
| CX007 | United Concordia-Fee for Service | Yes | |||
| 70408 | United Dental - Texas | No | |||
| UFC01 | United Food & Commercial Workers Union of Central Ohio (UFCW of Central Ohio) | No | |||
| UFC02 | United Food & Commercial Workers Union of Cleveland (UFCW of Cleveland) | No | |||
| 52133 | United Health Care | No | |||
| 33108 | United Medical Resources (UMR) | No | |||
| 95378 | Unitedhealthcare River Valley | No | |||
| 74227 | Unitedhealthcare Student Resources | No | |||
| VHP01 | Valley Health Plan (WI) | No | |||
| 60054 | Varian Health Care Plan | No | |||
| 91062 | Washington Dental Service | No | |||
| 73155 | Waterstone Benefit Administrators | No | |||
| 39026 | Wausau Benefits Inc. (Wausau, WI) | No | |||
| 39151 | WEA Insurance | No | |||
| 47198 | Wellpoint Dental | No | |||
| 98010 | William J Sutton & Co. Ltd | No | |||
|
|
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