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HealthSmart Information Systems EDI Clearinghouse Payor List
PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE TRANSACTION TYPE 13162 1199 Local Benefit Fund PAR Professional Institutional Dental 20413 3P Administrators PAR PLUS Professional Institutional Dental 93044 A & I Benefit Plan Administrators NONPAR Professional Institutional Dental 48185 ABC Health Plan of New York NONPAR Professional Institutional AHS01 ACCESS ADMINISTRATORS PAR PLUS Professional Institutional 76049 Access Plus (UTMB) PAR Professional Institutional 64071 Acclaim NONPAR Professional Institutional BS049 Accordia - Anthem BS of Indiana NONPAR Professional Institutional 87815 Accordia National PAR Professional Institutional 87066 ACMG PAR PLUS Professional Institutional 72467 ACS Benefit Services, Inc. PAR Professional Institutional Dental 38254 Activa Benefit Services, LLC PAR PLUS Professional Institutional 22384 Administrative Concepts, Inc. NONPAR Professional Institutional Dental SB740 Administrative Service of Kansas NONPAR Professional Institutional Dental 37278 AdminOne PAR Professional Institutional 61123 Advantage Care NONPAR Professional 35209 Advantage Health Solutions PAR Professional Institutional 25152 Advantra Freedom NONPAR Professional Institutional 25126 Advantra/Hlth America IncHealth PAR Professional Institutional 13376 Advica/NE Georgia Hlth SystemInc PAR Professional Institutional 36320 Advocate Health Centers PAR PLUS Professional Institutional 65093 Advocate Health Partners (PHO's) PAR PLUS Professional Institutional 60054 AETNA PAR Professional Institutional 57604 Aetna Affordable Health Choices PAR Professional Institutional Dental 23222 Aetna HMO NONPAR Professional Institutional 38692 Aetna TX Medicaid & CHIP PAR Professional Institutional Dental 34444 AFLCIO Food/Bev Dlr's Trst Fund NONPAR Professional 13346 AFTRA Health Fund PAR Professional Institutional 64158 Agency Services NONPAR Institutional 95241 AGIA, Inc. NONPAR Professional 06311 Alabama Medical Surgical Associates NONPAR Professional 91136 Alaska Children's Services, Inc. PAR Professional Institutional 92600 Alaska Electrical Health & Welfare PAR Professional Institutional Dental AKCRA Alaska Medicare A / Noridian Direct Government Institutional 37117 Alexian Brothers NONPAR Institutional 39160 All Saints Covenant PAR Institutional 96218 Alliance Health Network NONPAR Institutional 23251 Alliance Health Plan - Pennsylvania NONPAR Professional Institutional 58234 Alliant Health Plans of Georgia NONPAR Professional Institutional 94177 Allied Administrators (SanFrancCA) PAR Professional Institutional 37308 Allied Benefit Systems PAR Professional Institutional ALLSTATE Allstate Insurance Company PAR Professional Institutional 37231 Alternative Technology Resource PAR PLUS Professional Institutional 25149 ALTIUS NONPAR Professional Institutional TH071 AMA Insurance Agency NONPAR Professional Institutional Dental 13550 Amalgamated Life Ins, (Care) PAR Professional Institutional December 9, 2010 Page | 1 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE 76061 AMCARE (LA, OK, TX) NONPAR TRANSACTION TYPE Institutional 75137 AmeriBen Solutions, Inc. PAR Professional Institutional 26375 Americaid Dallas/Ft. Worth PAR Professional Institutional 26374 Americaid Houston PAR Professional Institutional 75240 American Administrative Group PAR PLUS Professional Institutional Dental 34187 American Benefit Management (North) PAR Professional Institutional AMC11 American Capitol Insurance PAR Professional Institutional 41160 American Chiropract Ntwrk IPA N Y NONPAR Professional Institutional Dental 41161 American Chiroprctc Ntwrk (CAN) PAR Professional 37128 American Commercial Barge Lines NONPAR Professional Institutional 60305 American Community Mutual Insurance NONPAR Professional Institutional IP080 American Family Health Providers PAR PLUS Professional AMF11 American Family Insurance Company PAR PLUS Professional Institutional 62030 American General NONPAR Institutional AHG99 American Health Group NONPAR Professional Institutional 01066 American Healthcare Alliance PPO Professional Institutional 36369 American Imaging Management, Inc. NONPAR Professional Institutional 81949 American Insurance Company Of Texas NONPAR Professional 13311 American International Group, Inc. PAR Professional Institutional 72099 American LIFECARE PAR Professional Institutional 81400 American Medical Security PAR PLUS Professional AMNT4 American National - Midlands Choice PAR PLUS Professional Institutional 44444 American Postal Workers Union PAR Professional Institutional 42011 American Republic Insurance Co. PAR Professional Institutional 97055 American Services NONPAR Institutional NMAAC1 America's Choice Health Plans PAR Professional Institutional 100767 America's Choice/EBA PAR Professional Institutional 86002 AmeriChoice New York Prsnl Care + PAR Professional Institutional 86001 AmeriChoice Nw Jrsy Prsnl Care + Indirect Government Professional Institutional 86048 AmeriChoice of New York, Inc. Indirect Government Professional Institutional 86049 AmeriChoice of Pennsylvania, Inc. Indirect Government Professional Institutional 86003 AmeriChoice PA, Personal Care + PAR Professional Institutional 28804 Amerigroup Dallas/Ft. Worth PAR PLUS Professional Institutional 28809 Amerigroup Florida PAR PLUS Professional Institutional 28805 Amerigroup Houston PAR PLUS Professional Institutional 28808 Amerigroup Illinois PAR PLUS Professional Institutional 28807 Amerigroup Maryland PAR PLUS Professional 28806 Amerigroup New Jersey PAR PLUS Professional 23252 AmeriHealth Administrators Direct Government Professional 23037 AmeriHealth HMO NJ and DE Direct Government Professional 22248 AmeriHealth Mercy Health Plan PAR Professional Institutional AHPDE AmeriHealth PPO DE Direct Government Professional AHPNJ AmeriHealth PPO NJ Direct Government Professional 53085 Anchor Benefit Consulting, Inc. PAR PLUS Professional Institutional Dental 16140 APA Parners, Inc. NONPAR Professional Institutional 54160 APS Healthcare NONPAR Professional Institutional December 9, 2010 Page | 2 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE 16120 ARAZ PAR TRANSACTION TYPE Professional Institutional 77045 Arcadian Management Services, Inc. PAR Professional Institutional AZBLS Arizona BCBS Indirect Government Professional Institutional AZCRA Arizona Medicare A / Noridian Direct Government Institutional AZCRE Arizona Medicare B / Noridian Direct Government Professional ARBLU Arkansas BCBS Direct Government Professional Institutional 75278 Arkansas Best Corporation PAR Professional Institutional AMC01 Arkansas Managed Care Organization PAR Professional Institutional MC029 Arkansas Medicaid Indirect Government Professional ARCRE Arkansas Medicare B (Pinnacle) Direct Government Professional 95440 Arnett Health Plans PAR Professional Institutional Dental IP002 Arrowhead Phys Allnce Labs Only NONPAR Professional 56192 Ascendia HealthCare MGMTHOS NONPAR Institutional IP008 Assoc Hispanic Phys Labs Only NONPAR Professional 36326 Associates for Health Care, Inc. PAR Professional Institutional 37313 Assurance Health Self Funded PAR Professional Institutional Dental ABA001 Assured Benefits Administrators PAR PLUS Professional Institutional 93221 Asuris NW Health PAR Professional Institutional 95691 Athens Area Health Plan Select NONPAR Professional Institutional 22304 Atlanticare Adminstrators, Inc. PAR Professional Institutional 13853 Atlantis Health Plan NONPAR Professional ATLAD Atlas Adminstrators PAR Professional Institutional CMSEB Austin Reg Clinic Empl Bnft Pln NONPAR Professional Institutional ABS11 Automated Benefit Services PAR PLUS Professional Institutional 37280 Automated Group Administration, Inc PAR PLUS Professional Institutional 46045 Avera Health Plans NONPAR Professional Institutional 59274 AvMed, Inc. PAR PLUS Professional AZLUT AZ Lutheran PHO/Banner Hlth Sys PAR Professional 37248 Bass Administrators, Inc. PAR Professional Institutional 95377 Beech Street Corporation PAR Professional Institutional 68241 Bell Atlantic NONPAR Institutional 33192 Benecorp National Corporation PAR Professional Institutional Dental 37125 BeneFirst NONPAR Professional Institutional 36149 Benefit Administrative Systems PAR Professional Institutional Dental 51037 Brokerage Concepts, Inc. PAR PLUS Professional Institutional 25145 Benefit Coordinators Corporation PAR Professional Institutional BMATP BENEFIT MANAGEMENT ADMIN (BMA) PAR PLUS Professional Institutional 00999 Benefit Management Services, Inc. NONPAR Professional Dental 37212 Benefit Management Systems, Inc. PAR PLUS Professional Institutional 37286 Benefit Plan Administrators ND PAR Professional Institutional 37118 Benefit Plan Administrators Roanoke PAR Professional Institutional 37222 Benefit Plan Management, Inc. PAR Professional Institutional 34178 Benefit Services, Inc. NONPAR Professional Institutional BSEMP Benefit Source Employees PAR PLUS Professional Institutional 38257 Benefit Source, Inc. PAR PLUS Professional Institutional 36342 Benefit Systems & Services, Inc. PAR Professional Institutional December 9, 2010 Page | 3 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE 42148 Benefits, INC. PAR PLUS TRANSACTION TYPE Professional Institutional 87265 Benesight PAR Professional Institutional 95604 Best Life & Hlth Ins Comp. PAR Professional Institutional 62183 Better Health Plans, Inc. PAR Professional Institutional BVTX1 Block Vision of TX PAR Professional Institutional ECIBB BLUE BELL BENEFITS TRUST PAR PLUS Professional Institutional 37244 Blue Bonnett Administrators NONPAR Institutional 12b15 Blue Cross of MO/Wellpoint NONPAR Professional Institutional Dental HM007 Blue Shield HMO - HMO Indirect Government Professional BS030 Blue Shield of Iowa Indirect Government Professional Institutional BS056 Blue Shield of South Dakota Indirect Government Professional Institutional BS175 BlueChip-Rhode Island NONPAR Professional Institutional 61124 Bluegrass Family Services PAR Professional Institutional 13337 BMC Health Plan PAR PLUS Professional Institutional 74238 Boon-Chapman Benefit Administrators PAR PLUS Professional Institutional 38324 Botsford Health Plan NONPAR Professional Institutional 37285 Bridgestone Claims Services PAR Professional Institutional Dental 94316 Brown & Toland Medical Group PAR Professional Institutional 32004 Buckeye Community Health NONPAR Institutional 50240 Buenaventura Medical Group, Inc. NONPAR Professional 42150 Butler Benefit Service, Inc. PAR PLUS Professional Institutional Dental 23708 C&O Employees Hospital Association NONPAR Professional CLFR2 C.L. Frates and Co. PAR PLUS Professional Institutional CNMCR CA Medicare North NONPAR Professional Institutional 59129 CAC Ramsey PAR Institutional HM006 California BC (California Care HMO) PAR PLUS Professional CABS1 California BS Direct Government Professional IP059 California Cre Humboldt Del Norte PAR PLUS Professional CACR3 California Medicare B-Southern Indirect Government Professional IP020 California Prim Cre Med Grp Labs NONPAR Professional 37105 Cannon Cochran Mngmnt Srvcs, Inc. NONPAR Professional Institutional 38245 Cape Health Plan NONPAR Professional Institutional SX065 Capital District Physicians Health NONPAR Professional Institutional Dental 68011 Capitol Administrators PAR Professional Institutional HM037 Care Choices HMO PAR PLUS Professional 77082 Care Improvement Plus NONPAR Professional 00344 Care Management Resources NONPAR Professional 43172 Care Partners NONPAR Professional Institutional 14179 CareCore Nat LLC (Aetna Rad Clms) NONPAR Professional 14180 CareCore Nat LLC Oxford Rad Clms NONPAR Professional SB690 CareFirst BCBS - Maryland Region Indirect Government Professional Institutional SB580 CareFirst BCBS DC,Nat Capital Area Indirect Government Professional Institutional 25139 Carelink Health Plan NONPAR Professional Institutional 31114 CareSource PAR Professional Institutional 62073 Cariten Healthcare PAR Professional Institutional 62072 Cariten Senior Health NONPAR Professional Institutional December 9, 2010 Page | 4 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE 37245 Carolina Benefit Admin, Inc. NONPAR TRANSACTION TYPE Professional Institutional 57105 Carolina Care Plan PAR Professional Institutional 56195 Carolina Summit Healthcare, Inc. NONPAR Professional Institutional 25125 Carptener Hlth&Wlfr Fund,StLuis PAR Professional Institutional CAS01 Cascade East Health Plan PAR PLUS Professional 55438 CBCA Administrators PAR Professional Institutional 41124 CBSA PAR Professional Institutional 33005 CCN Managed Care, Inc. PAR Professional Institutional 95166 CedarsSinai Med Ntwrk Services PAR PLUS Professional CELTC Celtic Individual Health PAR PLUS Professional Institutional 37250 Cemara Administrators, Inc. NONPAR Professional Institutional 31118 Central Benefits Life PAR Professional Institutional IP037 Central Coast IPA (Labs Only) NONPAR Professional IP010 Central PA, Physicians Labs Only NONPAR Professional 34097 Central Reserve Life PAR Professional Institutional 37214 Central State Jnt Brd Hlth&Wlfr PAR Professional Institutional 20356 Cerner Health PAR Professional Institutional 23171 CHA - Commonwealth Health Alliance PAR Professional Institutional CHTRN Champus/Tricare North PAR PLUS Professional CHTRS Champus/TriCare South - Palmetto PAR PLUS Professional 59223 Chesapeake Life Insurance Company NONPAR Professional Institutional EPOTX CHIP - Clarendon Kids PAR Professional SHPCH CHIP - Seton Health Plan PAR PLUS Professional DCHCH CHIP,Driscoll Children's Hlth Pln PAR Professional UHSCH Choice One UTMB Chip Mediview PAR PLUS Professional Institutional CHCNT ChoiceNet TPA PAR PLUS Professional 62308 CIGNA PAR Professional Institutional 76051 CIGNA Aria PAR Institutional SX071 CIGNA Behavioral Health PAR Professional Institutional 86033 CIGNA HealthCare for Seniors NONPAR Institutional CIG002 CIGNA-2 PAR Professional Institutional CIMSA Cimmaron Salud! Indirect Government Professional 39141 Claim Management Services PAR Professional Institutional 57080 ClaimsWare, Inc. DBA ManageMed NONPAR Professional 34172 Cleveland Health Network NONPAR Institutional CNICHS CNIC Health Solutions PAR Professional Institutional COBA1 COBA Medicare Direct Government Professional Institutional COACC Colorado Access HMO PAR Professional Institutional COBLU Colorado BS Indirect Government Professional COKSR Colorado Kaiser Permanente PAR PLUS Professional MC004 Colorado Medicaid NONPAR Professional COCRE Colorado Medicare B / Noridian Direct Government Professional 25351 Columbia Cornell Care NONPAR Professional Institutional 91162 Columbia United Providers NONPAR Professional 12014 Columbia/Medi Care PAR Institutional 73143 Comm Care Managed Hlth Cre Pln,OK PAR Professional Institutional December 9, 2010 Page | 5 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE 62149 Comm Hlth Ntwrk of Connecticut NONPAR TRANSACTION TYPE Professional 90010 Comm Hlth Plan - St. Joseph, MO PAR Professional Institutional 95155 Comm Hlth Pln of the Rockies PAR Professional 32481 Comm PremierPls Neighbrhood HthPro NONPAR Professional Institutional 34181 Commerce Benefits Group PAR Professional Institutional 37237 CommonWealth Administrative Group PAR Professional Institutional CATPA CommonWealth Administrators PAR PLUS Professional 25179 Community Care Behavioral Hlth Org PAR Professional Institutional 23282 Community Care BHO NONPAR Professional Institutional Dental 71079 Community Care Plus PAR PLUS Professional Institutional COMMF Community First PAR PLUS Professional 35193 Community Health Alliance/CareVu PAR PLUS Professional Institutional 48145 Community Health Choice PAR PLUS Professional 23742 Community Health Plan of ALBAN COMMUNITY HEALTH PLAN OF WASHINGTON Community Medical Group PAR Institutional PAR Professional Institutional PAR PLUS Professional Institutional 13374 Community Premier Plus NONPAR Institutional 34177 Comp - Ohio (Austintown,OH) NONPAR Institutional BS060 Companion Healthcare NONPAR Professional Institutional CmpCre CompCare PAR Professional 93101 Complementary HealthCare Plans PAR PLUS Professional 59314 Comprehensive Behavioral Care NONPAR Professional Institutional Dental 03036 Comprehensive Bnfts Admin, Inc. PAR Professional Institutional CMPUU Compusys of Utah PAR Professional 06105 ConnectiCare, Inc. PAR PLUS Professional Institutional 63208 Connecticut PRI NONPAR Professional Institutional CMV001 Conservent Benefit Plan Admin PAR PLUS Professional Institutional 37135 Consociate Group NONPAR Professional Institutional 75284 Consolidated Associated Railroad NONPAR Professional Institutional 04274 Consolidated Group / HPS PAR PLUS Professional CHPWA CMGWV CNTNM Consultec - New Mexico Indirect Government Professional 37295 Consumer Health Solutions NONPAR Professional Institutional 71404 Continental General Ins. NONPAR Professional Institutional CCHP1 Cook Childrens Health Plan PAR PLUS Professional Institutional CCHP9 Cook Childrens Star Health Plan PAR PLUS Professional Institutional 58231 Core Mngmnt Resources Grp, Inc NONPAR Professional 75136 Coresource Little Rock PAR Professional Institutional 41045 CoreSource of AZ, MN PAR Professional Institutional 35182 CoreSource of Illinois (ECAMS) PAR Professional Institutional 35180 CoreSource of North Carolina PAR Professional Institutional 35183 Coresource OH PAR Professional Institutional 35202 Cornerstone Benefits Administrators PAR PLUS Professional Institutional 56116 Corporate Benefits Service, Inc. PAR Professional 37246 Corporate Systems Administration PAR Professional Institutional 43160 Correctional Medical Services PAR PLUS Professional 62553 Country Life Insurance Company NONPAR Professional Institutional December 9, 2010 Page | 6 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE TRANSACTION TYPE 58102 Covenant Administrators, Inc. PAR Professional Institutional 25127 Coventry Health Care of Georgia PAR Professional Institutional 25132 Coventry Health Care of Iowa, Inc. PAR Professional Institutional 25131 Coventry Healthcare of Indiana NONPAR Professional Institutional 25130 Coventry Hlth Care,Delaware,Inc NONPAR Professional Institutional 25129 Coventry Hlth Cre, Carolinas,Inc. NONPAR Professional Institutional 25133 Coventry Hlth Cre, Kansas, Inc. PAR Professional Institutional 25135 Coventry Hlth Cre, Louisiana, Inc. PAR Professional Institutional 25136 Coventry Hlth Cre, Nebraska, Inc. PAR Professional Institutional 00019 Cox Health Plan PAR Professional Institutional 64068 Creative Medical Systems NONPAR Professional Institutional CYPRS01 Cypress Benefits PAR PLUS Professional Institutional DAK01 Dakota Care PAR PLUS Professional Institutional DARTC DART PAR PLUS Professional Institutional WIHMO Dean Health Plan NONPAR Professional Institutional 64159 DEFINITY HEALTH PAR Professional Institutional DEBLU Delaware BS Indirect Government Professional 63081 Delaware Health Plan Consortium NONPAR Professional Institutional DECAD Delaware Medicaid-DelawareCare CHC Indirect Government Professional Institutional DECRE Delaware Medicare B (TrailBlazer) Direct Government Professional HM023 Delta Hlth Sys Gallo Union Encount NONPAR Professional HM021 Delta Hlth Sys Memorial Encounters NONPAR Professional HM022 Delta Hlth SysGallo (Encounters) NONPAR Professional 84135 Denver Health Medical Plan NONPAR Institutional DNS22 Derm Ntwrk Solutions, LLC BCBS PAR PLUS Professional DNS77 Derm Ntwrk Solutions, LLC Humana PAR PLUS Professional 36436 Destiny Health NONPAR Professional Institutional 23706 Directors Guild of America Producer PAR Professional Institutional 06102 Diversified Administration PAR Professional Institutional 25160 Diversified Group Administrators PAR Professional Institutional MR030 DMERC Region A Indirect Government Professional Institutional DMRCC DMERC Region C Direct Government Professional DMRCD DMERC Region D PAR PLUS Professional DNLY1 Donley & Company, Inc. PAR PLUS Professional Institutional 75232 E3 Health PAR PLUS Professional 81039 EBMS Employee Benefit Mgmt Svcs NONPAR Professional Institutional SX182 EBMS Professional NONPAR Professional 98006 EHS Grp Hlth Plan Milwaukee, WI NONPAR Professional Institutional EPF03 EL Paso First - CHIP NONPAR Professional EPF08 El Paso First Group Health NONPAR Professional Institutional 52192 Elder Health Maryland HMO Inc. NONPAR Professional Institutional 31625 ElderPlan PAR Professional Institutional 75260 Electronic Transmission Corp NONPAR Professional Institutional 34555 Emerald HMO Hospital PAR Institutional 73288 Emphesys PAR Professional Institutional 38241 Employee Benefit Concepts, Inc. NONPAR Professional Institutional December 9, 2010 Page | 7 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE TRANSACTION TYPE CX025 Employee Benefit Management Corp PAR Professional Institutional EBS11 Employee Benefit Services PAR PLUS Professional Institutional Dental 95288 Employee Benefits Admin & Mgmt PAR PLUS Professional Institutional 37216 Employee Bnft Srvcs, Charlotte, NC NONPAR Professional 35112 Employee Plans, LLC PAR Professional Institutional 54098 Employee Security, Inc. NONPAR Professional Institutional 75233 Employer Health Direct PAR Professional 74212 Employer Plan Services, Inc. PAR PLUS Professional Institutional EMPHE Employers Health Insurance PAR Professional 37249 Employers Life Insurance Corp. NONPAR Professional 59298 Employers Mutual, Inc. (FL) NONPAR Professional Institutional MIDSC Emplyers Coalition on Hlth (ECOH) PAR PLUS Professional Institutional 37110 Encompass PAR Professional 36364 ENH Medical Group IPA NONPAR Professional Institutional 73126 Equitable Plan Services PAR Professional Institutional 23250 Erin Group Administrators PAR Professional Institutional 74234 ERISA Administrative Services NONPAR Professional Institutional 58233 Evergreen Health Plan PAR Professional Institutional 37300 FACS Group NONPAR Institutional 22254 Fallon Community Health PAR Professional Institutional 31472 Family Health Partners of KS NONPAR Professional Institutional Dental 96865 Family Health Plan PAR PLUS Professional 39518 Family Health Systems NONPAR Institutional 43173 Family Hlth Partners MC+Missouri NONPAR Professional Institutional IP017 Family/Seniors Medical Grp, Inc. PAR PLUS Professional 37289 FARA NONPAR Institutional 33033 FCE Benefit Administrators PAR Professional Institutional Dental 41041 Federated Mutual Insurance PAR Professional Institutional 11315 Fidelis Care NY PAR Professional FAMR1 First Administrators PAR PLUS Professional 56196 First Carolina Care NONPAR Professional Institutional FCADM First Choice Administrators PAR PLUS Professional Institutional FCMW1 First Choice of the MidWest PPO Professional Institutional 87043 First Health PAR Professional 23241 First Priority PAR Professional Institutional 63080 First State Health Plan NONPAR Professional 94999 Firstcare PAR PLUS Professional Institutional 90060 FirstGuard Health Plan PAR Professional Institutional 62061 Fiserv (Willis Admin Services Corp) PAR Professional Institutional FLHLT FL Health Options NONPAR Professional FLENC FL Health Options Encounters NONPAR Professional 59276 Florida 1st PAR Professional Institutional FLBLU Florida BCBS Indirect Government Professional Institutional FL001 Florida Healthcare Administrators PAR PLUS Professional Institutional 59321 Florida Hospital Hlthcre Srvcs NONPAR Professional 48116 Florida Hospital Waterman NONPAR Professional December 9, 2010 Page | 8 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE MC010 Florida Medicaid Indirect Government TRANSACTION TYPE Professional Institutional FLCRE Florida Medicare Indirect Government Professional 48117 FMH Benefit Services, Inc. PAR Professional Institutional BOONG Foundation Benefits Administrator PAR Professional Institutional Dental FH001 Foundation Health PAR PLUS Professional FH002 Foundation Health - HMO PAR PLUS Professional FHFLC Foundation Health of Florida Claims PAR Professional FHFLE Foundation Hlth, Florida Encounters Indirect Government Professional 64067 Fox-Everett Ingalls Ship Building NONPAR Professional 64069 Fox-Everett, Inc PAR Professional 62324 Freedom Life Insurance Co NONPAR Professional 59204 Fringe Benefit Coordinators, Inc. PAR PLUS Professional Institutional 75238 G.E. Group Administrators PAR Professional Institutional 67815 G.E. Group Life Assurance Company PAR Professional 37283 Gallagher Benefit Administrators PAR PLUS Professional Institutional Dental 25169 Gateway Health Plan PAR Professional Institutional 60550 Gateway Health Plan - Medicare Assu PAR Professional Institutional Dental 06143 GE Group Administrators PAR Professional 75273 Geisinger Health Plan PAR Professional Institutional 63665 Gencare Health (St. Louis) PAR Professional Institutional IP062 General Hosp Humboldt Del Norte PAR PLUS Professional IP087 Genesis Healthcare (EMG) PAR PLUS Professional GACAD Georgia Medicaid - ACS Direct Government Professional GACRE Georgia Medicare B Direct Government Professional 13551 GHI - New York (Group Health Inc) PAR Professional Institutional 25531 GHI HMO PAR Professional Institutional 25141 GHP (Group Health Plan) PAR Professional 39018 GIC Indemnity Plan NONPAR Professional 07205 Gilsbar, Inc. PAR Professional Institutional 37602 Golden Rule PAR PLUS Professional Institutional GTPA1 Golden Triangle Physicians Alliance PAR PLUS Professional IP086 Good Samaritan Med Prac AsscGSMPA PAR PLUS Professional 44054 Government Employees Hosp AssocGEHA PAR Professional Institutional 37234 Grant Phys Practice Assoc NONPAR Professional Institutional 95467 Great Lakes Health Plan NONPAR Professional Institutional 80705 Great West PAR PLUS Professional Institutional 95379 GreatWest Hlthcre One Hlth PlnCA, PAR PLUS Professional 95569 GreatWest Hlthcre One HlthPln GA PAR PLUS 78521 GreenTree Administrators PAR PLUS Professional Institutional 36338 Group Administrators, Ltd. PAR Professional Institutional 48143 Group and Pension Administrators PAR Professional Institutional 38223 Group Benefit Services, Inc. NONPAR Professional Institutional GE001 Group Health NONPAR Professional 39167 Group Health Coop - Madison, WI NONPAR Professional Institutional 91121 Group Health Cooperative - East PAR Professional Institutional 37276 Group Insurance Service Center, Inc PAR Professional Institutional December 9, 2010 Page | 9 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE TRANSACTION TYPE 47083 Group Management Services PAR PLUS Professional Institutional GUCRE Guam Medicare B / Noridian Direct Government Professional 64246 Guardian Life Ins Co of America PAR Professional Institutional 39180 Gundersen Lutheran Health Plan Inc NONPAR Professional Institutional 37114 H.E.R.E.I.U. Welfare Pension Funds NONPAR Professional Institutional 36406 HARMONY HEALTH PLAN OF ILLINOIS NONPAR Institutional 36405 Harmony Health Plan of Indiana PAR Professional Institutional 95266 Harrington Benefit Services PAR Professional Institutional 75196 Harrington Benefit Srvcs (Centra) PAR Professional Institutional 59142 Harrington Benefit Srvcs (Oklahoma) PAR Professional 75201 HARRIS METHODIST HEALTH PLAN NONPAR Institutional 04271 Harvard Pilgrim Health Care NONPAR Professional Institutional 48330 Hawaii Management Alliance PAR Professional Institutional HICRE Hawaii Medicare B / Noridian Direct Government Professional 37111 HCH Administration (Illinois) NONPAR Professional Institutional 37329 HCHA Albq - Self Funded PAR Professional 82018 HCS HEALTH CLAIMS SERVICE (BOISE ID NONPAR Institutional HDMCO HDM Benefit Solutions NONPAR Professional Institutional 34185 Health Administration Service, Inc PAR Professional Institutional 23172 Health Alliance Exclusive & Plus NONPAR Professional 77950 Health Alliance Medical Plans Inc PAR Professional Institutional 56142 Health Care Savings PAR Professional Institutional 37263 Health Connecticut NONPAR Professional HCSOL Health Cost Solutions PAR PLUS Professional Institutional 34158 Health Designs Plus (Hudson, OH) PAR Professional Institutional 95019 Health First Health Plan NONPAR Professional 38309 Health Net - Arizona PAR Professional Institutional 95567 Health Net - California and Oregon PAR Professional Institutional HM001 Health Net (Encounters Only) PAR PLUS Professional 06108 Health Net of the Northeast, Inc PAR Professional Institutional SX185 Health Net Pearl PAR Professional Dental 95570 Health Net,CA Professions Encounte PAR Professional 20199 Health Network America PAR Professional Institutional Dental 04286 Health New England NONPAR Professional Institutional 62157 Health Partners - Jackson, TN PAR Professional Institutional HPPA2 Health Partners, PA PAR Professional Institutional 20270 Health Payment Systems, Inc. PPO Professional Institutional 68035 Health Plan of San Joaquin PAR Professional Institutional Dental HPSM1 Health Plan of San Mateo NONPAR Professional Institutional 59256 Health Plan S/E (Tallahassee, FL) PAR Professional 44273 Health Plans Inc NONPAR Professional 95435 Health Pledge HMO/HealthPledge Plus NONPAR Professional HT001 Health Spring PAR PLUS Professional 34167 Health Srv Pref. (HSP) Emerald Hlth PAR Professional Institutional 34654 Health/WelfareFund/Plmbrs/Ppeftrslc NONPAR Professional 73147 HealthCare Solutions Group PAR PLUS Professional Institutional December 9, 2010 Page | 10 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE 25143 Healthcare USA PAR TRANSACTION TYPE Professional Institutional 62179 Healthchoice of Arizona NONPAR Professional 62168 HealthChoice of Memphis NONPAR Professional HCOMP HealthComp, Inc. PAR PLUS Professional Institutional 59608 Healthease NONPAR Professional Institutional HCPHM HealthFirst (HMO) Indirect Government Professional 75234 Healthfirst Tyler, TX PAR Professional Institutional 80141 Healthfirst, Inc. (NY) PAR Professional Institutional 23226 HealthGuard of Lancaster NONPAR Professional Institutional 59087 HealthHelp Network, Inc. (HHNI) NONPAR Professional Institutional 90001 Healthlink - National Capital PPO PPO Professional Institutional 96475 Healthlink HMO PAR Professional Institutional 94267 Healthpartners PAR PLUS Professional 31106 HealthPower HMO PAR Professional 71063 HealthSCOPE Bnft Pln, PCP Only PAR Professional Institutional HSPC1 HealthSmart Preferred Care PPO Professional Institutional 68195 Healthsource Provident (Cigna) PAR PLUS Professional Institutional 25193 HealthSpring HMO PAR Professional Institutional Dental RENGQ Healthspring Renaissance IPA PAR Professional 36332 HealthStar, Inc PAR Professional Institutional HLTHQ Healthy Equations NONPAR Professional 91051 Healthy Options (DSHS) PAR PLUS Professional 59230 Heritage Consultants PAR Professional Institutional 11328 Heritage New York Medical Group PAR Professional Institutional 36335 HFN, Inc. PPO Professional Institutional HERZ0 High Desert Medical Group NONPAR Professional HIL01 Hill Physicians Medical Group PAR Professional Institutional 59347 Hillcrest Benefit Administrators PAR PLUS Professional Institutional 37115 Hinsdale Physicians Health NONPAR Professional Institutional 55247 HIPHealth Ins Pln of Greater Nw Yrk PAR Professional 34193 HlthCre Pyr's Coalition Toledo, OH PAR Professional HMA01 HMA - Health Management Admin NONPAR Professional Institutional 86066 HMA Inc NONPAR Professional HM033 HMO Blue - MediCaid NONPAR Professional 34150 Home Town Health Network PAR PLUS Professional Institutional 88023 Hometown Health Plan Nevada PAR Professional Institutional Dental HMLIC Horace Mann Life Insurance Company PAR PLUS Professional Institutional 22326 Horizon Mercy NONPAR Professional Institutional HPN11 HPN PAR PLUS Professional 41170 HRM Claim Management/HRM PAR Professional 55905 HSI Health Plans, Inc NONPAR Professional 13335 Hudson Health Plan NONPAR Professional Institutional Dental 61102 Humana (Encounters) PAR Professional Institutional 95348 Humana Health Plan of Ohio PAR Professional Institutional 61101 Humana Inc PAR Professional Institutional 37260 Hunt Insurance Group NONPAR Professional Institutional December 9, 2010 Page | 11 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE 38234 IBA Self Funded Group NONPAR TRANSACTION TYPE Professional Institutional 37296 ICM PAR Professional Institutional Dental 75185 ICON Benefit Administrators PAR PLUS Professional Institutional Dental IDCRA Idaho Medicare A / Noridian Direct Government Institutional IDCAD Idaho Medicaid Indirect Government Professional IDCRE Idaho Medicare Indirect Government Professional 39017 IE Shaffer NONPAR Professional 39015 IL Central Hospital NONPAR Professional ILBLU Illinois BCBS Indirect Government Professional 86069 Illinois Health Solutions NONPAR Professional 41600 I'Mcare NONPAR Professional Institutional IP089 Imperial Valley Med Group (IMPV) PAR PLUS Professional 86070 IMX EZ NONPAR Professional 40585 Indecs PAR Professional Institutional SX073 Independent Health NONPAR Professional Institutional INBLU Indiana BCBS - Anthem Direct Government Professional Institutional 35204 Indiana Health Network NONPAR Professional Institutional MR041 Indiana Medicare NONPAR Professional Institutional 35161 Indiana ProHealth Network NONPAR Professional Institutional 52196 Informed, LLC PAR Professional Institutional 93112 Inpronet, Portland, OR NONPAR Professional VAICE INS Health Services NONPAR Professional Institutional IAC01 Insur. Admin. Corp. of AZ (IAC) PAR PLUS Professional Institutional 37279 Insurance Admin of AmericaIncIAA PAR Professional Institutional 63082 Insurance Clms Srvcs,Inc.Birmingha NONPAR Professional 13315 Insurance Design Administrators PAR Professional Institutional 88006 Insurance Management Services PAR Professional Institutional IMSMS Insurance Management Services of TX PAR Professional Institutional ISL11 Insurance Services of Lubbock PAR PLUS Professional Institutional 31127 Integra Group PAR Professional Institutional 31129 Integra Group-CHA NONPAR Professional Institutional Dental INET1 Integranet PAR PLUS Professional Institutional 37124 Integrated Benefit Services, IL NONPAR Professional Institutional 94770 Integrity Administrators PAR Professional 37227 InterCare Health Plans, Inc. PAR Professional Institutional 60280 Interface EAP PAR PLUS Professional Institutional 23287 Intergroup Service Corporation PAR Professional Institutional IMGIN International Medical Group NONPAR Professional IHGCVC Interplan Health Group CVC PPO Professional Institutional 37241 Intrntnal Union Oper EngineersLcl4 PAR Professional 36609 Intrntnl Brtherhood Boilermakers PAR Professional Institutional 37269 Intrntnl Union Oper Engineers Lcl15 PAR Professional Institutional IACAD Iowa Medicaid / Noridian Direct Government Professional IACRE Iowa Medicare B / Noridian Direct Government Professional Dental JFM11 JF Molloy PAR Professional JISSP JI Specialty Services, Inc. PAR PLUS Professional December 9, 2010 Page | 12 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE TRANSACTION TYPE 41099 John Alden Life Insurance Company PAR PLUS Professional Institutional 95378 John Deere Health Care PAR Professional Institutional 68036 John Muir Health Network PAR Professional Institutional 37215 John P Pearl and Associates NONPAR Professional Institutional 43178 Joplin Claims PAR Professional Institutional 34136 JP Farley Corporation PAR Professional Institutional 37272 JSL Administrators PAR Professional Institutional 52095 Kaiser Fndation Hlth Plan MidAtl St PAR Professional Institutional 21313 Kaiser Foundation Health Plan of GA PAR Professional Institutional 94134 Kaiser Foundation Hlth Pln S/CAReg PAR Professional Institutional HM044 Kaiser Permanente (CO Encntrs) PAR Professional 94135 Kaiser Permanente (N CA) PAR Professional Institutional KS001 Kaiser Permanente (S CA) PAR Professional Institutional HM036 Kaiser Permanente Encnter Data PAR Professional 93079 Kaiser Permanente Northwest PAR Professional Institutional Dental 57038 Kanawha HealthCare Solutions, Inc PAR Professional Institutional KSBLU Kansas BCBS Indirect Government Professional Institutional 25144 Kansas City Advantra NONPAR Professional Institutional BS024 Kansas City Blue Shield Indirect Government Professional Institutional 44030 Kansas City Life Insurance Co PAR Professional Institutional KSCAD Kansas Medicaid Indirect Government Professional Institutional KAP01 Kapiolani Health Commercial PAR Professional KELSE Kelse PAR PLUS Professional 73100 Kempton Company NONPAR Professional Institutional Dental KTBCBS Kentucky BCBS - Anthem Direct Government Professional Institutional 63077 Kentucky Health Select NONPAR Professional Institutional KYCAD Kentucky Medicaid Indirect Government Professional Institutional KYCRE Kentucky Medicare Indirect Government Professional 37217 Key Benefit Administrators PAR Professional Institutional Dental IP082 Key Medical Group NONPAR Professional 23284 Keystone Mercy Health Plan Indirect Government Professional Institutional KPS01 Kitsap Physicians Services PAR Professional 34145 Klais & Company PAR PLUS Professional Institutional IP021 Korean American Medical Grp (Labs) NONPAR Professional HM039 LA Care (Encounter Data Only) PAR PLUS Professional 37116 Lake County/St. Therese Phys Assoc NONPAR Professional Institutional 95415 Lakeside Health Services Indirect Government Professional Institutional 95416 Lakeside IPA PAR PLUS Professional Professional LNDMK Landmark Healthcare PAR PLUS 35107 Lcl135 HlthBnftsFnd Indianapolis,IN NONPAR Professional Institutional 75279 Leggett and Platt PAR Professional Institutional 37281 Liberty Union Life Assurance Co NONPAR Professional 93093 LifeWise Healthplan of Oregon NONPAR Professional 75283 Linn County PAR Professional 37226 London Health Administrators PAR Professional 23223 Loomis PAR Professional Institutional December 9, 2010 Page | 13 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE LACAD Louisiana Medicaid Indirect Government TRANSACTION TYPE Professional Institutional LSHP1 Lovelace Sandia Health Plans NONPAR Professional IP060 Mad River Comm Humboldt Del Norte PAR PLUS Professional 01260 Magellan Health Services PAR Professional Institutional AXN01 Magellan Spc Hlth Cigna NY gnrlsur NONPAR Professional 11303 MagnaCare PAR Professional Institutional 34103 MahoningTrumbullCntyBldgTradeFund NONPAR Professional Institutional 35162 Managed Care Services NONPAR Professional Institutional 22771 Managed Health Networks NONPAR Professional Institutional 39187 Managed Health Services Wisconsin NONPAR Professional Institutional 41159 Managed Physical Network PAR Professional Institutional 93900 Managed Physical Network - MPN PAR PLUS Professional 41555 Manatee Srvce Cntr Bradenton, FL NONPAR Professional Institutional 75258 MAPCO, Inc NONPAR Professional Institutional IP097 Marin IPA PAR PLUS Professional MDCAD Maryland Medicaid Indirect Government Professional MDCRE Maryland Medicare B (TrailBlazer) Direct Government Professional 37121 Mashantucket Pequot Tribal Nation NONPAR Professional Institutional 22195 Maskin Management Corporation PAR Professional MABLU Massachusetts Blue Shield Indirect Government Professional Institutional MMPHB Master, Mates & Pilot Plan PAR PLUS Professional Institutional 41154 Mayo Management Services, Inc PAR Professional Institutional 56205 MBS (MedCost Benefit Services) PAR Professional Institutional MM001 M-Care PAR PLUS Professional 59331 McCreary Corporation NONPAR Professional Institutional 52148 MD Individual Practice Assoc Inc. PAR Professional Institutional 11338 MDNY Healthcare NONPAR Professional Institutional 58202 MedAdmin Sltions/AdvncdDataSltions NONPAR Professional Institutional 74323 MedBen (Newark, OH) NONPAR Professional Institutional 59231 MedCom PAR PLUS Professional Institutional 56162 MedCost, Inc. PAR Professional Institutional 94265 Medica PAR Professional Institutional MC019 Medicaid of Mississippi NONPAR Professional Institutional MC059 Medicaid of New Hampshire NONPAR Professional Institutional 37298 Medical Benefit Admin of Maryland PAR Professional Institutional 68041 Medical Benefit Administration PAR PLUS Professional Institutional 04258 Medical Claims Service, Inc. PAR Professional Institutional 52181 Medical Development International PAR Professional Institutional 58203 Medical Resource Network (MRN) PAR Professional Institutional 38224 Medical Value Plan Ohio (MVP) PAR PLUS Professional MC051 Medi-Cal-California NONPAR Professional Institutional MR060 Medicare Of Kansas NONPAR Professional Institutional MR050 Medicare of Mississippi NONPAR Professional Institutional MR051 Medicare Of New Hampshire NONPAR Professional Institutional 58228 Medicare Smart PAR Professional 95436 Medicare-Extra Indirect Government Professional December 9, 2010 Page | 14 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE TRANSACTION TYPE 62160 MedSolutions Inc NONPAR Professional Institutional 82160 Medspan, Inc NONPAR Professional 00243 Medstar Physician Partners PAR PLUS Professional 59221 MEGA Life & Health Ins Co PAR Professional Institutional 74227 Mega Life and Health Student Ins PAR Professional Institutional TH112 Memorial Clinical Associates NONPAR Professional Institutional 36193 Memphis Managed Care PAR Professional Institutional M3433 Mercy Care of Arizona PAR Professional Institutional 86052 Mercy Care Plan PAR Professional Institutional Dental 43166 Mercy Health Plans PAR Professional Institutional 85035 Mesa Mental Health NONPAR Professional Institutional 23550 Methodist First Choice NONPAR Professional Institutional MWP01 Metrowest Hlth Pln-Preferred Cre NONPAR Professional Institutional MIBLU Michigan BCBS Indirect Government Professional Institutional MICAD Michigan Medicaid Indirect Government Professional Institutional MICRE Michigan Medicare Indirect Government Professional 43132 Mid America Health NONPAR Professional Institutional 63079 Mid-Atlantic Health System NONPAR Professional Institutional 52149 MidAtlantic Psych Srvcs,Inc(MAPSI) PAR Professional Institutional IP004 Midcoast Care Marian IPA (Labs) NONPAR Professional MGT01 Midland Management Company of IL PAR PLUS Professional Institutional 47081 Midlands Benefits Administrators NONPAR Professional Institutional 47080 Midlands Choice, Inc. PAR Professional 31140 Mid-Valley CareNet, Inc. NONPAR Professional Institutional MWGB01 Midwest Group Benefits PAR PLUS Professional Institutional 59224 MidWest National Lfe Ins Co.TN PAR Professional Institutional MPMG1 Mills Peninsula Medical Group PAR PLUS Professional 1513I Minnesota Blue Cross Indirect Government Institutional MNBLU Minnesota Blue Shield Indirect Government Professional MNCAD Minnesota Medicaid Indirect Government Professional Institutional MNCRE Minnesota Medicare Indirect Government Professional Institutional MNCRA Minnesota Medicare A / Noridian Direct Government Institutional IP014 MissionValleyIPA Med Grp/LompocLab NONPAR Professional 37233 Mississippi Pblc Entty EmpBnft Trst NONPAR Professional Institutional 37275 Missoula Cnty Med Benefits Plan NONPAR Professional Institutional BS062 Missouri Blue Choice NONPAR Professional Institutional BS025 Missouri Blue Shield - Anthem Direct Government Professional Institutional 43179 Missouri Care MC PAR Professional Institutional Dental MOCAD Missouri Medicaid Indirect Government Professional Institutional MR044 Missouri Medicare (Midwestern) Indirect Government Professional Institutional MOCRE Missouri Medicare (Pinnacle) Indirect Government Professional KCMCR Missouri Medicare B (KC) Indirect Government Professional Institutional 62178 MMS, LLC NONPAR Professional Institutional 38333 Molina Healthcare of California PAR Professional Institutional Dental 20554 Molina Healthcare of Texas PAR Professional Institutional 38336 Molina Healthcare of Washington PAR Professional Institutional December 9, 2010 Page | 15 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE TRANSACTION TYPE 20149 Molina of Ohio PAR Professional Institutional Dental IP095 Monarch Healthcare IPA PAR PLUS Professional MTCRA Montana Medicare A / Noridian Direct Government Institutional MTCRE Montana Medicare B / Noridian Direct Government Professional 13174 Montefiore Contract Management Org NONPAR Professional Institutional IP083 Mosiac IPA Medical Group NONPAR Professional MPI01 Motion Picture Health Plan PAR Professional Institutional 36111 Motorola PAR Professional Institutional MTNST Mountain States Admin PAR PLUS Professional 86040 Mountain States Admin (Tucson AZ) PAR Professional Institutional 100064 MPE Employee Benefits PAR Professional Institutional Dental 95444 MPLAN, Inc./HealthCare Group, LLC NONPAR Professional Institutional 95655 MT. Carmel Health Plan NONPAR Professional Institutional 37256 Mutual Assurance Administrators PAR Professional Institutional 14165 MVP Health Plan of NY PAR Professional Institutional 56176 National Benefit Admin - N Carolina PAR Professional Institutional 56175 National Benefit Admin-New Jersey NONPAR Professional Institutional 37126 National Claim Administration, Inc. NONPAR Professional Institutional 90956 National Financial Insurance Co. NONPAR Professional 98205 National Foundation Life Ins Co NONPAR Professional 52132 National Rrl Elctrc Coop (NRECA) PAR Professional Institutional NTA11 National Teachers Association PAR PLUS Professional Institutional NTCA1 National Telephone Cooperative NONPAR Professional Institutional 37120 National Travelers Life Co PAR Professional Institutional 31417 Nationwide Health Plans PAR Professional Institutional 53011 Natl Assn Letter Carriers (NALC/Aff PAR Professional Institutional 75191 NCAS Charlotte PAR Professional Institutional 75190 NCAS Fairfax, VA PAR Professional Institutional BS058 Nebraska Blue Shield Indirect Government Professional Institutional NECAD Nebraska Medicaid Indirect Government Professional Institutional 96107 NeighborHood Hlth Part FL PAR Professional Institutional 04293 Neighborhood Hlth Pln Boston, MA PAR PLUS Professional Institutional 11325 Neighborhood HlthPrv & SuffolHlthPl NONPAR Professional Institutional 66055 Netcare Life and Health Insurance PAR Professional Institutional 39144 Network Health Plan of Wisconsin NONPAR Professional BS019 Nevada BCBS NONPAR Professional Institutional MC008 Nevada Medicaid Indirect Government Professional Institutional NVCRE Nevada Medicare B / Noridian Direct Government Professional 86067 NevedaCare Kids NONPAR Professional 75281 New Era Life PAR Professional NHBLU New Hampshire BS Indirect Government Professional Institutional NJCD1 New Jersey Medicaid Indirect Government Professional Institutional NJCR2 New Jersey Medicare (Empire) NONPAR Professional Institutional NJCRE New Jersey Medicare (HGSA) Direct Government Professional NMBLU New Mexico BCBS Indirect Government Professional NMCRE New Mexico Medicare (Pinnacle) Direct Government Professional December 9, 2010 Page | 16 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE 84141 New West Health Plan NONPAR TRANSACTION TYPE Professional Institutional BS087 New York Blue Shield Western Indirect Government Professional BS061 New York BS-Rochester Indirect Government Professional Institutional BS033 New York Empire BS Indirect Government Professional NYMCD New York Medicaid Indirect Government Professional NYCRE New York Medicare (Empire) Indirect Government Professional NYCR2 New York Medicare (GHI) Indirect Government Professional Institutional MR059 New York Medicare-Upstate/Albany Indirect Government Professional Institutional 11334 New York Network Management NONPAR Professional 48186 NewYork Presbyterian Comm Hlth Pln NONPAR Professional Institutional 38225 NGS American PAR Professional Institutional 81264 Nippon Lfe Ins Co of America PAR Professional Institutional LS328 NM Medicaid Lovelace Sandia/Salud NONPAR Professional Institutional 64157 North American Administrators, Inc. PAR Professional Institutional 34159 North American Benefits Ntwrk NABN PAR Professional Institutional 36398 North American Med Mngmnt IL NONPAR Professional NCBLU North Carolina BS Indirect Government Professional Institutional NCCAD North Carolina Medicaid Indirect Government Professional Institutional NCCRE North Carolina Medicare Indirect Government Professional Institutional NDBLU North Dakota BCBS / Noridian Direct Government Professional Institutional NDCAD North Dakota Medicaid / Noridian Direct Government Professional NDCRA North Dakota Medicare A / Noridian Direct Government Institutional NDCRE North Dakota Medicare B / Noridian Direct Government Professional PH018 North West Life PAR PLUS Professional 88027 Northern Nevada Trust Fund PAR Professional Institutional 36346 Northwest Suburban IPA (Illinois) NONPAR Professional Institutional 16644 Nova Healthcare Admin,Inc(GI, NY) PAR Professional Institutional 71080 NovaSys Health Network PAR Professional Institutional 94321 NWP Children's First Healthcare Net PAR PLUS Professional Institutional PARHC NWP Paramount Health Care NONPAR Professional Institutional 95358 Oaktree Health Plan NONPAR Professional IP016 Oakview Med Grp,Inc Labs IPA NONPAR Professional OCH01 OCHSNER Health Plans NONPAR Professional 13350 ODS Health Plan NONPAR Professional Institutional 72087 Office of Group Benefits PAR Professional Institutional OHBS1 Ohio BS - Anthem Direct Government Professional Institutional 34189 Ohio Health Choice, PPO PAR Professional Institutional OHCAD Ohio Medicaid Indirect Government Professional Institutional OHCRE Ohio Medicare B Indirect Government Professional OKBLU Oklahoma BCBS Indirect Government Professional Institutional OKCAD Oklahoma Medicaid Indirect Government Professional Institutional OKCRE Oklahoma Medicare (Pinnacle) Direct Government Professional IP061 Omni HealthCare Humboldt Del Norte PAR PLUS Professional 25150 Omnicare Coventry PAR Professional Institutional 38252 Omnicare Health Plan of Michigan NONPAR Professional Institutional IP088 Omnicare Medical Group (Omni) PAR PLUS Professional December 9, 2010 Page | 17 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE 95412 One Health Plan of Colorado, Inc PAR PLUS TRANSACTION TYPE Professional 95388 One Health Plan of Illinois, Inc PAR PLUS Professional Institutional 911336 Operating Engineers Locals 302 & 61 PAR Professional Institutional Dental 06163 OptiCare Eye Health NONPAR Professional 56190 OptiCare Eye Health Network PAR Professional 54154 Optima Health Insurance Co. NONPAR Professional Institutional 52152 Optimum Choice Carolinas (OCCI) PAR PLUS Professional ORCRA Oregon Medicare A / Noridian Direct Government Institutional ORCRE Oregon Medicare B / Noridian Direct Government Professional 13381 Orthonet Corporation NONPAR Professional 13382 Orthonet-Uniformed Services Family PAR Professional ORT33 Orthopedix Network INC Humana PAR PLUS Professional ORT88 Orthopedix Ntwrk of S Florida,LLC PAR PLUS HM032 Oxford PAR 06111 Oxford Health Plans PAR Professional Institutional 87068 P5 Health Plan Solutions of Utah PAR Professional Institutional Dental 95964 Pacific Care Arizona PAR Professional Institutional HM012 PacifiCare PAR Professional Professional COFHP Pacificare - Colorado PAR PLUS Professional 95959 Pacificare - Secure Horizon CA PAR PLUS Professional Institutional 33053 PacifiCare Behavioral Health Inc PAR Professional 95958 PacifiCare of CA (Encounters) PAR PLUS Professional Institutional 95969 PacifiCare of Texas (Encounters) PAR Professional Institutional 77042 PacifiCare Oregon/Meridian HlthCreM PAR PLUS Professional Institutional 95999 Pacificare PPO PAR PLUS Professional 93029 PacificSource Health Plans PAR Professional Institutional PAPER Paper Vendor PAR Professional Institutional 66917 Parkland Community Health Plan PAR Professional Institutional SX154 Passport Advantage NONPAR Professional Institutional 61129 Passport Health Plan PAR Professional Institutional 68050 PeachState Health Plan (Behavioral) NONPAR Professional Institutional 68049 PeachState Health Plan (Surgical) PAR Professional Institutional PABL1 Pennsylvania BC (Capital) Indirect Government Professional PABL3 Pennsylvania BC (Independence) Direct Government Professional PABL4 Pennsylvania BC (Keystone - East) Direct Government Professional PABL2 Pennsylvania BC (Keystone) Indirect Government Professional PABL5 Pennsylvania BS (Highmark) Direct Government Professional PACAD Pennsylvania Medicaid Direct Government Professional PACRE Pennsylvania Medicare (HGSA) Direct Government Professional 34173 Personal Physician Care NONPAR Professional 67814 Phoenix American Life (PAL) PAR Professional Institutional 62155 PHP Tenncare NONPAR Professional Institutional 37330 Phyicians Health Plan (PHP) NONPAR Professional Institutional Dental IP094 Physician Associates of GSGV PAR PLUS Professional 58204 Physician Associates of Lousianna NONPAR Professional Institutional 57098 Physicians Care Network (PCN) NONPAR Professional Institutional December 9, 2010 Page | 18 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE 36345 Physicians Care Network (Rockford) NONPAR TRANSACTION TYPE Professional Institutional 65018 Physicians Corp America Florida pln NONPAR Professional 37136 Physicians Health Assoc of IL NONPAR Professional Institutional PHCS1 Physicians Health Choice - Claims PAR PLUS Professional Institutional 65031 Physicians Healthcare Plans, Inc PAR Professional Institutional PMGSJ Physicians Medical Grp San Jose PAR PLUS Professional 47027 Physicians Mutual Insurance Company PAR Professional Institutional 39156 Physicians Plus Ins Corp NONPAR Professional Institutional 77008 Physicians Services, Inc NONPAR Professional CCIA1 Pinnacle (CCIA) PAR PLUS Professional 24735 Pinnacle Claims Management, Inc PAR Professional Institutional 73074 Pipeline Indstry Bnft Fnd Tulsa,OK PAR Professional Institutional 37224 Pittman & Associates PAR Professional Institutional 37287 Planned Administrators, Inc (PAI) PAR Professional Institutional 72054 Plumbers & Steamfitters Local #106 PAR Professional Institutional 67466 PM Group PAR Professional Institutional POD11 Podiatry Network Solutions PAR PLUS Professional POD12 Podiatry Ntwrk Solutions FloridaLLC PAR PLUS Professional 32680 Poly America Medical Benefits Plan PAR Professional 16111 POMCO PAR Professional Institutional 73159 PPO OK,WinterBrook HlthCre Mngmnt PAR Professional Institutional 38335 PPOM (Southfield MI) PAR Professional Institutional 72148 PPOPlus, LLC PAR PLUS Professional Institutional 04334 Practicare Inc NONPAR Professional Institutional Dental EPF10 Preferred Administrators NONPAR Professional Institutional 53476 Preferred Benefit Administrators PAR PLUS Professional Institutional 35173 Preferred Health Network (PHN) NONPAR Professional Institutional 60110 Preferred Health Systems Ins Co PAR Professional Institutional 61106 Preferred HealthPlan(Louisville,KY) NONPAR Professional Institutional 39021 Preferred Network Access Inc PAR Professional 41147 Preferred One (MN) PAR Professional Institutional 73145 PreferredCommChce/PCCSelect/CompMed PAR Professional Institutional 00360 Premier Benefits Inc NONPAR Professional 90440 Premier Health Systems NONPAR Professional Institutional Dental PREHP Presbyterian Health Plan (Comm) PAR Professional PRESA Presbyterian Salud! NONPAR Professional 39185 Prevea Health Insurance Plan NONPAR Professional Institutional IP096 PrimaHealth IPA PAR PLUS Professional 56144 Primary PhysicianCare, Inc PAR Professional Institutional UH015 Prime Care Health Plan PAR PLUS Professional 63088 Prime Health of Alabama NONPAR Professional Institutional 33029 PrimeCare NONPAR Professional IP079 PrimeCare Medical Network PAR PLUS Professional 04320 PrimeSource Health Network PAR Professional Institutional 61271 Principal Life Insurance PAR Professional Institutional 38217 Priority Health PAR Professional Institutional December 9, 2010 Page | 19 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE TRANSACTION TYPE 37315 Prism - Univera PAR Professional Institutional Dental 37268 Prism Health Networks PAR Professional Institutional 31132 Pro Health Comp Care NONPAR Professional PEBSI Producers Exchange Benefit Services PAR PLUS Professional Institutional 59296 Professional Benefit Adm, FL PAR PLUS Professional Institutional 36331 Professional Benefit Adm, IL PAR Professional Institutional 41163 Professional Claim Administrators NONPAR Professional Institutional 37242 Professional Claims Management NONPAR Professional Institutional PHP01 Providence Choice Option PAR PLUS Professional 51032 Provider Networks of America PAR Professional Institutional 09822 PSN-Florida Medicaid PAR Professional Institutional Dental 48055 Pyramid Life Insurance PAR Professional Institutional Dental 39197 Quad Med NONPAR Professional Institutional 35174 Qual Choice of Arkansas PAR Professional Institutional 35172 Qual Choice of North Carolina PAR Professional 23342 QualCare, Inc PAR Professional Institutional 37129 Quincy Health Care Management NONPAR Professional Institutional RRCRE Railroad Medicare (TrailBlazer) Direct Government Professional REH55 Rehab Network, LLC Humana PAR PLUS Professional RPN01 Rehab Provider Network Indirect Government Professional 37277 Resurrection HlthCre Hlth Preferred PAR Professional Institutional RICRE Rhode Island Medicare (Pinnacle) Direct Government Professional 16117 RMSCO Inc. NONPAR Professional Institutional Dental RMHMO Rocky Mountain HMO PAR PLUS Professional Institutional 36389 Rush Prudential Health Plans (HMO) NONPAR Professional Institutional 31441 S & S Healthcare Strategies PAR Professional Institutional 35164 Sagamore Health Network PAR Professional Institutional 37259 SAMBA PAR Professional Institutional Dental 90328 Sandia Health Plans (Commericial) NONPAR Professional Institutional 37288 Santa Barbara Cottage Hospital NONPAR Professional Institutional IP027 Santa Marta Med Grp (Labs) NONPAR Professional 99999 SC Champus Indirect Government Professional 88030 Scott & White PAR PLUS Professional IC102 SD Medicaid - Institutional Indirect Government Institutional TH611 SE Texas Gov Employees Benefit Pool NONPAR Professional Dental 13310 Seabury & Smith PAR Professional Institutional 28530 Secure Health Plans of Georgia, LLC PAR Professional Institutional 42142 SecureCare of Iowa NONPAR Professional Institutional 39045 Security Health Plan PAR Professional Institutional 64088 Select Administrative Services NONPAR Professional Institutional 37282 Select Benefit AdministratorAmerica PAR Professional Institutional 42137 Select Benefit Administrators PAR Professional Institutional 23285 Select Health of South Carolina NONPAR Professional Institutional 00014 Selectcare PAR Professional Institutional 59111 Self Insured Benefit Administrators PAR Professional Institutional 36404 Self Insured Plans PAR Professional Institutional December 9, 2010 Page | 20 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE 34131 Self-Funded Plans NONPAR TRANSACTION TYPE Professional Institutional 83035 Senior Whole Health NONPAR Professional Institutional Dental 23249 Sentinel Management Services NONPAR Professional Institutional SHEBP Seton Employee Plan PAR PLUS Professional Institutional 12T55 Seton Health Plan NONPAR Professional Institutional SHMAP Seton Health Plan - City Map PAR PLUS Professional Institutional 75280 Shasta Administrative Services PAR Professional Institutional TH115 Sheet Metal Workers - Local 91 NONPAR Professional Institutional Dental HM024 Shield 65+ PAR PLUS Professional SIERR2 SIERRA HEALTH SERVICES (ENCOUN) PAR Professional 76342 SIERRA HEALTH SERVICES (ONLY) PAR Professional Institutional 62159 Signature Health Alliance PAR Professional Institutional 20310 Skylands Benefit Consultants, LLC PAR Professional Institutional 84096 Sloans Lake Managed Care PAR Professional Institutional 02057 Smith Administrators PAR PLUS Professional Institutional AMS01 Sooner Health Network PAR PLUS Professional Institutional 91131 Sound Health First Choice Hlth Ntwk PAR Professional Institutional 25147 South Care/Health Care Preferred PAR Professional Institutional Dental SCBLU South Carolina BS Indirect Government Professional Institutional SCCAD South Carolina Medicaid Indirect Government Professional Institutional MR028 South Carolina Medicare Indirect Government Professional Institutional MC102 South Dakota Medicaid Indirect Government Professional SDCRA South Dakota Medicare A / Noridian Direct Government Institutional SDCRE South Dakota Medicare B / Noridian Direct Government Professional 25128 Southern Health Services, Inc PAR Professional Institutional SPA98 Southwest Physicians Associates NONPAR Professional 37266 Southwest Service Life PAR Professional Institutional 52190 Special Risk International NONPAR Professional Institutional 23253 Spectrum Administrators PAR Professional Institutional Dental 84146 Spina Bifida / ChampVA PAR Professional SPOHN Spohn Network PAR PLUS Professional 95286 SSM Exclusive Choice NONPAR Professional Institutional 22240 St. Barnabas System Health Plan PAR Professional Institutional 37264 St. John's Claims Administration PAR Professional Institutional 88029 St. Mary's Health NONPAR Professional Institutional Dental 59225 Star HRG PAR Professional Institutional Dental 31053 State Farm Grp Med & Ind Hlth Ins PAR Professional Institutional Dental SWELL Staywell PAR Professional 14163 Staywell Health Plan PAR Professional Institutional 91151 Sterling Option 1 PAR PLUS Professional Institutional 58128 Stowe Associates NONPAR Professional 95202 SummaCare Health Plans PAR Professional Institutional 37301 Summit America Insurance Services NONPAR Professional Institutional Dental 23218 Superior Benefits PAR Professional Institutional SHP11 Superior Health Plan PAR PLUS Professional HM056 Sutter Connect - ABMG Enc PAR PLUS Professional December 9, 2010 Page | 21 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE TRANSACTION TYPE IP084 Sutter Connect ABMG Clm PAR PLUS Professional IP092 Sutter Connect Clm (SIP,SMG,SWMG) PAR PLUS Professional HM059 Sutter Connect Enc (SIP,SMG,SWMG) PAR PLUS Professional IP099 Sutter Connect Reg Med Grp Clm PAR PLUS Professional HM062 Sutter Connect Solano Reg Med Grp E PAR PLUS Professional IP091 Sutter Connect Sutter Gould Med Clm PAR Professional Institutional HM058 Sutter Connect Sutter Gould Med Enc PAR PLUS Professional HM057 Sutter Connect SutterMedGrpRedlands PAR PLUS Professional IP090 SutterConnectSutterMed Grp Redlands PAR PLUS Professional 88067 Tall Tree Administrators NONPAR Professional Institutional Dental 37228 Tarrant Health Services PAR Professional Institutional 88019 Teachers Health Trust PAR Professional Institutional 36215 Teamcare PAR Professional 36612 Teamsters Local Union 301 NONPAR Professional Institutional 72126 TENET NONPAR Professional Institutional MC092 TennCare NONPAR Professional Institutional TNBLU Tennessee BCBS Indirect Government Professional 37293 Tennessee Benefit Administrators NONPAR Professional Institutional TNCRE Tennessee Medicare (Cigna) Indirect Government Professional TXBLU Texas BCBS Direct Government Professional Institutional 76048 Texas Childrens Health Plan PAR PLUS Professional TXCSM Texas Children's Star Medicaid PAR PLUS Professional TX1ST Texas First PAR Professional Institutional TXCAD Texas Medicaid (TMHP) Direct Government Professional Institutional TXCRA Texas Medicare A (TrailBlazer) Direct Government Institutional TXCRE Texas Medicare B (TrailBlazer) Direct Government Professional EPF02 Texas Premier Plan (Medicaid ) NONPAR Professional Institutional TH055 Texas True Choice NONPAR Professional Institutional CRI01 The Chester Companies PAR PLUS Professional Institutional 28777 The EPOCH Group PAR Professional Institutional 35206 The Healthcare Group NONPAR Professional Institutional 58200 The Integrity Benefit Network NONPAR Professional Institutional 59140 The Mutual Group PAR Professional Institutional 70491 The Mutual Group/Life Insurance Grp NONPAR Professional Institutional 66893 The New England PAR Professional Institutional 72112 The Oath for Louisiana NONPAR Professional Institutional 63092 The OATH Health Partners of AL NONPAR Professional 13142 The Union Labor Life Insurance Co PAR Professional Institutional 16131 Third Party Claims Management PAR Professional 25175 Three Rivers Health Plan PAR Professional Institutional 39065 Time Insurance Company PAR PLUS Professional Institutional 74214 TML Intergovernmental Emp Bnft Pool PAR Professional Institutional 92620 Tongass Timber Trust PAR PLUS Professional Institutional 61425 Tooling & Manufacturing Assoc PAR Professional Institutional 31182 Total Community Care PAR Professional Institutional Dental 69493 Tower Life Insurance Co PAR Professional December 9, 2010 Page | 22 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE TRANSACTION TYPE 37230 TR Paul, Inc. NONPAR Professional Institutional Dental 59222 TransAmerica Life Insurance Company NONPAR Professional Institutional 37284 TransChoice-KBA PAR Professional Institutional 62777 Trilogy Health PAR Professional Institutional TH083 True Choice USA NONPAR Professional 91078 Trustee Plan Corp NONPAR Professional Institutional 04298 Tufts Health Plan PAR PLUS Professional 74249 TX Assoc of School Boards PAR Professional 75206 TXEN AltPros NONPAR Professional UBHRI UBH United Behavioral Hlth Emp Div PAR PLUS Professional 19991 Ucare of Minnesota PAR Professional Institutional UFC97 UFCW Local 400-5205 PAR PLUS Professional Institutional 22329 UHP of New Jersey Centene NONPAR Institutional 75245 UICI Administrators State of Nevada PAR Professional 52180 UMWA Health & Retirement Funds PAR PLUS Professional Institutional 80314 UNICARE PAR Professional Institutional 47195 UNICARE OF TEXAS PAR Professional 65099 UNICARE Special Accounts PAR Professional 62170 Unified Health Services NONPAR Professional Institutional 75243 Uniform Med Pln/HarringtonBnftSrv PAR PLUS Professional 87042 Union Pacific Railroad Employees PAR Professional Institutional 70408 Union Security Insurance Company PAR PLUS Professional Institutional UABT1 United Agriculture Benefit Trust NONPAR Professional Institutional Dental 16412 United Behavioral Health PAR PLUS Professional Institutional 59069 United Benefits PAR Professional Institutional UFCW1 United Food and Commercial Workers PAR PLUS Professional Institutional 57011 United Government Services, LLC NONPAR Professional Institutional Dental 87726 United HealthCare PAR PLUS Professional Institutional 31107 United Medical Resources PAR Professional Institutional 71412 United of Omaha PAR PLUS Professional PRGON United Physc of N Colorado PFC-IPA PAR PLUS Professional 41194 United Resource Network PAR Professional Institutional HC001 Univera Healthcare Plans, Inc NONPAR Professional 33001 Universal Care California PAR Professional Institutional UNIV1 Universal Health Care NONPAR Professional Institutional 38298 Universal Standard Healthcare, Inc. NONPAR Professional 59000 University Health Plan of N. J. NONPAR Professional Institutional 11149 UMC HPO PAR PLUS Professional Institutional 23281 UPMC Health Plan (Commercial) PAR Professional Institutional 38337 Upper Peninsula Health Plan NONPAR Professional Institutional 93092 US Benefits PAR PLUS Professional Institutional 74095 USAA (United States Automobile Asc) PAR Professional Institutional 13407 USFHP-St. Vincent Catholic Med Ctr NONPAR Professional Institutional 23217 USI Administrators NONPAR Professional Institutional UTCAD Utah Medicaid Indirect Government Professional Institutional UTCRA Utah Medicare A / Noridian Direct Government Institutional December 9, 2010 Page | 23 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE UTCRE Utah Medicare B / Noridian Direct Government TRANSACTION TYPE Professional 12115 VA Fee Basis Programs PAR Professional VBHP1 Valley Baptist Health Plan PAR Professional IP044 Valley of the Moon PAR PLUS Professional 77004 Valley Physician's IPA NONPAR Professional 72128 Vantage Health Plan, Inc. NONPAR Professional Institutional 75256 Verity National Group (GASA) PAR PLUS Professional Institutional BS065 Vermont Blue Shield NONPAR Professional Institutional VTCAD Vermont Medicaid Indirect Government Professional Institutional 23173 VHP Community Care NONPAR Professional Institutional 86079 Vista Del Sol Health Care NONPAR Professional 55248 Vista Health Plan PAR Professional Institutional VN126 VIVRA NONPAR Professional 22264 Vytra Healthcare PAR Professional Institutional 62111 W.C. Beeler & Company PAR Professional Institutional 75257 Wal-Mart PAR Professional Institutional WABLU Washington BC (Premera) Direct Government Professional LABOR Washington Labor and Industries PAR Professional Institutional Dental WACAD Washington Medicaid (Premera) Direct Government Professional WACRA Washington Medicare A / Noridian Direct Government Institutional WACRE Washington Medicare B / Noridian Direct Government Professional DCCRE WashingtonDC Medicare (TrailBlazer) Direct Government Professional 73155 Waterstone Benefit Administrators PAR Professional Institutional Dental 58082 Watkins Associated Industries, Inc. PAR Professional Institutional 39026 Wausau Benefits, Inc. PAR Professional Institutional 39151 WEA Insurance Group NONPAR Professional Institutional 75261 WebTPA PAR PLUS Professional Institutional 77072 WellCare PAR Professional 14164 Wellcare of CT and NY NONPAR Professional Institutional WELM2 WellMed PAR PLUS Professional Institutional WELMD WellMed (Encounters) PAR PLUS Professional BS055 West Virginia Blue Shield NONPAR Professional MC048 West Virginia Medicaid NONPAR Professional MR056 West Virginia Medicare NONPAR Professional IP026 Western Arizona Regional Physicians NONPAR Professional 37247 Western Mutual Insurance/WMI-TPA PAR Professional Institutional 31048 Western Southern Benefit PAR Professional Institutional IP023 Westgrove Medical Group (Labs Only) NONPAR Professional 38232 Weyco, Inc. PAR Professional Institutional 93050 William C. Earhart Co., Inc. NONPAR Professional Institutional Dental 62153 Windsor Medicare Extra NONPAR Professional Institutional BS053 Wisconsin Blue Shield Indirect Government Professional Institutional WICAD Wisconsin Medicaid Indirect Government Professional MR053 Wisconsin Medicare Indirect Government Professional Institutional 75276 World Insurance Company PAR Professional Institutional WPS01 WPS Commercial NONPAR Professional Institutional December 9, 2010 Page | 24 PAYOR LIST HealthSmart Information Systems PAYOR ID PAYOR NAME PAYOR TYPE TRANSACTION TYPE 23710 Writer's Guild - Industry Hlth Plan PAR Professional Institutional WYBLU Wyoming BCBS / Noridian Direct Government Professional Institutional WYCRA Wyoming Medicare A / Noridian Direct Government Institutional WYCRE Wyoming Medicare B / Noridian Direct Government Professional 06121 Yale New Haven Health - MSO, Inc NONPAR Professional Institutional 95376 Yale Preferred Hlth/Hlth Chce of CT NONPAR Professional Institutional December 9, 2010 Page | 25
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