STATE & FEDERAL & BCBS PLAN we Process as of 03/18/2009
P/P ST PAYOR INTERMEDIARY AG TEST EMC PAPER SURCHG  
CPID CPID
HEALTHSPRING INC. Y N 2795 1350 N/A
  AK ALASKA MEDICAID FIRST HEALTH SERVICES Y N 4489 4302 N/A
AK ALASKA MEDICARE NORIDIAN ADMIN. SERVICES Y N 1455 4301 N/A
  AK BLUE CROSS WA/AK PREMERA BLUE CROSS PREMERA BLUE CROSS Y N 7445 4303 N/A
AL ALABAMA BLUE SHIELD ALABAMA BCBS Y N 2423 4303 N/A
  AL ALABAMA MEDICAID N N 4479 4302 N/A
AL ALABAMA MEDICARE CAHABA GBA Y N 2468 4301 N/A
  AL HEALTHSPRING OF ALABAMA Y N 2795 1350 N/A
AR ARKANSAS BLUE SHIELD ARKANSAS BC BS Y N 2416 4303 N/A
  AR ARKANSAS MEDICAID Y N 1489 4302 N/A
AR ARKANSAS MEDICARE ARKANSAS BC BS Y N 2455 4301 N/A
  AZ ARIZONA BLUE SHIELD ALL PAYOR NETWORK (APN) N N 4426 4303 N/A
AZ ARIZONA MEDICAID AHCCCS N N 4405 4302 N/A
  AZ ARIZONA MEDICARE NORIDIAN ADMIN. SERVICES Y N 1456 4301 N/A
CA ANTHEM BLUE CROSS N N 4417 4303 N/A
  CA CALIFORNIA BLUE CROSS - FEP only N N 1409 4303 N/A
CA CALIFORNIA BLUE SHIELD N N 1409 4303 N/A
  CA CALIFORNIA BLUE SHIELD - HMO N N 4463 4303 N/A
CA CALIFORNIA MEDI-CAL EDS - ELECTRONIC DATA SYS Y N 1473 4302 N/A
  CA NORTHERN CALIFORNIA MEDICARE PALMETTO GBA Y N 1436 4301 N/A
CA SANTA BARBARA REGIONAL HEALTH AUTHORITY Y N 3447 4302 N/A
  CA SOUTHERN CALIFORNIA MEDICARE PALMETTO GBA Y N 1444 4301 N/A
CO COLORADO BLUE SHIELD ROCKY MTN HEALTH CARE Y N 1415 4303 N/A
  CO COLORADO MEDICAID ACS Y N 1496 1391CO N/A
CO COLORADO MEDICARE TRAILBLAZER HLTHENT-GPNET Y N 1449 4301 N/A
  CT CONNECTICUT BLUE SHIELD ANTHEM EAST N N 1420 4303 N/A
CT CONNECTICUT BLUECARE FAM PLAN (MEDICAID) ANTHEM EAST N N 2427 4302 N/A
  CT CONNECTICUT FEDERAL EMP HLTH BENEFITS   N N 3419 4303 N/A  
CT CONNECTICUT MEDICAID EDS - ELECTRONIC DATA SYS Y N 4476 4302 N/A
  CT CONNECTICUT MEDICARE NATIONAL GOVERNMENT SERV. Y N 1452 4301 N/A
CT CONNECTICUT MEDICARE BLUE(MEDICARE RISK) N N 3420 4303 N/A
  DC BLUE SHIELD OF NATIONAL CAPITOL AREA - CAREFIRST N N 2425 2304DC N/A  
DC DISTRICT OF COLUMBIA MEDICAID Y N 4425 4302 N/A
  DC WASHINGTON DC MEDICARE HIGHMARK MEDICARE SERVICE Y N 2459 4301 N/A
DE DELAWARE BLUE SHIELD (CAREFIRST) Y N 7456 4303 N/A
  DE DELAWARE MEDICAID EDS - ELECTRONIC DATA SYS Y N 2726 4302 N/A
DE DELAWARE MEDICARE HIGHMARK MEDICARE SERVICE Y N 2456 4301 N/A
  FL FLORIDA BLUE SHIELD N N 1414 4303 N/A
FL FLORIDA MEDICAID EDS - ELECTRONIC DATA SYS Y N 1478 4302 N/A
  FL FLORIDA MEDICARE FIRST COAST SERV OPTIONS Y N 1448 4301 N/A
FL FLORIDA WORKERS' COMPENSATION N N 2316 2316FL N/A
  FL JACKSON MEMORIAL HEALTH PLAN - MEDICAID   N N 2784 1387 N/A  
GA GEORGIA BANKERS ANTHEM MIDWEST N N 1407 4303 N/A
  GA GEORGIA BLUE CHOICE ANTHEM MIDWEST N N 1407 4303 N/A
GA GEORGIA BLUE SHIELD ANTHEM MIDWEST N N 1407 4303 N/A
  GA GEORGIA MEDICAID ACS Y N 1494 4302 N/A
GA GEORGIA MEDICAID ANESTHESIA ACS Y N 1499 4302 N/A
  GA GEORGIA MEDICARE CAHABA GBA Y N 1466 4301 N/A
GA PEACH STATE HEALTH PLAN CENTENE CORPORATION Y N 2417 4302 N/A
  GA STATE MERIT ANTHEM MIDWEST N N 1407 4303 N/A
HI HAWAII HMSA HMSA Y N 2714 4303 N/A
  HI HAWAII MEDICAID ACS Y N 2715 4302 N/A
HI HAWAII MEDICARE PALMETTO GBA Y N 2467 4301 N/A
  IA IOWA BLUE SHIELD WELLMARK EDS/EC SOL Y N 1404 4303 N/A
IA IOWA MEDICAID NORIDIAN ADMIN. SERVICES Y N 1469 4302 N/A
  IA IOWA MEDICARE WPS Y N 1438 4301 N/A
ID IDAHO BLUE CROSS BOISE Y N 7430 4303 N/A
  ID IDAHO BLUE SHIELD REGENCE N N 7426 4303 N/A
ID IDAHO MEDICAID EDS - ELECTRONIC DATA SYS Y N 7427 4302 N/A
  ID IDAHO MEDICARE CIGNA GOVERNMENT SERVICES Y N 2465 4301 N/A
IL HEALTHSPRING ILLINOIS Y N 2795 1350 N/A
  IL ILLINOIS BLUE SHIELD N N 1405 4303 N/A
IL ILLINOIS MEDICAID N N 2488 1369IL N/A
  IL ILLINOIS MEDICARE WPS Y N 1437 4301 N/A
IN INDIANA BLUE SHIELD ANTHEM MIDWEST N N 1412 4303 N/A
  IN INDIANA MEDICAID EDS - ELECTRONIC DATA SYS N N 1474 4302IN N/A
IN INDIANA MEDICARE ADMINASTAR FEDERAL, INC. Y N 1445 4301 N/A
Y IN MANAGED HEALTH SERVICES - INDIANA CENTENE CORPORATION Y N 2703 4302 N/A
KS KANSAS BLUE SHIELD - TOPEKA BC BS OF KANSAS Y N 2422 4303 N/A
  KS KANSAS MEDICAID EDS - ELECTRONIC DATA SYS N N 1485 4302 N/A
KS KANSAS MEDICARE WPS Y N 2463 4301 N/A
  KY ANTHEM BLUE ACCESS PRODUCTS ANTHEM MIDWEST N N 2421 4303 N/A
KY ANTHEM BLUE PREFERRED ANTHEM MIDWEST N N 2421 4303 N/A
  KY ANTHEM BLUE PREFERRED PLUS ANTHEM MIDWEST N N 2421 4303 N/A
KY FEP ANTHEM MIDWEST N N 2421 4303 N/A
  KY KENTUCKY BLUE SHIELD ANTHEM MIDWEST N N 2421 4303 N/A
KY KENTUCKY MEDICAID EDS - ELECTRONIC DATA SYS Y N 1493 4302KY N/A
  KY KENTUCKY MEDICARE ADMINASTAR FEDERAL, INC. Y N 2462 4301 N/A
LA BENEFIT MANAGEMENT SERVICES of LOUISIANA LOUISIANA BCBS N N 2265 4300 N/A
  LA LOUISIANA BLUE SHIELD Y N 2758 4303 N/A
LA LOUISIANA MEDICAID UNISYS Y N 1475 4302 N/A
  LA LOUISIANA MEDICAID - AMBULANCE UNISYS Y N 2236 4302 N/A
LA LOUISIANA MEDICAID KIDMED UNISYS Y N 4249 4302 N/A
  LA LOUISIANA MEDICARE ARKANSAS BC BS Y N 1460 4301 N/A
MA MASSACHUSETTS BLUE SHIELD Y N 2424 1301MA N/A
  MA MASSACHUSETTS MEDICAID (FORMAT 5) EDS - ELECTRONIC DATA SYS Y N 4492 4302 N/A
MA MASSACHUSETTS MEDICAID (FORMAT 9) EDS - ELECTRONIC DATA SYS Y N 4491 4302 N/A
  MA MASSACHUSETTS MEDICARE NATIONAL HERITAGE INS CO Y N 2469 4301 N/A
MD MARYLAND BLUE SHIELD - CAREFIRST N N 2419 1301MD N/A
  MD MARYLAND MEDICAID Y N 1488 4302 N/A
MD MARYLAND MEDICARE HIGHMARK MEDICARE SERVICE Y N 7402 4301 N/A
  MD MARYLAND MEDICARE (MONTG, PRINCE GEORGE) HIGHMARK MEDICARE SERVICE Y N 2464 4301 N/A  
ME MAINE BLUE SHIELD ANTHEM EAST N N 7446 4303 N/A
  ME MAINE MEDICAID MAINE DEPT OF HUMAN SERV. Y N 7414 4302 N/A
ME MAINE MEDICARE NATIONAL HERITAGE INS CO Y N 2472 4301 N/A
  MI BLUE CARE NETWORK HMO BC BS OF MICHIGAN Y N 2426 4303 N/A
MI MEDICARE PLUS BLUE - MEDICARE ADVANTAGE PLAN BC BS OF MICHIGAN Y N 2287 4301 N/A
  MI MICHIGAN BLUE SHIELD BC BS OF MICHIGAN Y N 1421 4303 N/A
MI MICHIGAN HLTH BENEFITS CLAIM REVIEW FORM N N 1306 1306MI N/A
  MI MICHIGAN MEDICAID Y N 2480 4302MI N/A
MI MICHIGAN MEDICARE WPS Y N 1461 4301 N/A
  MI MICHIGAN WORKERS' COMPENSATION N N 2319 2319MI N/A
MN BEHAVIORAL HEALTH SERV. INC. (BHSI) Y N 1402 4303 N/A
  MN MINNESOTA BLUE CROSS AND BLUE SHIELD Y N 1402 4303 N/A
MN MINNESOTA BLUE CROSS/BLUE SHIELD HMO Y N 1429 4303 N/A
  MN MINNESOTA BLUE PLUS Y N 1429 4303 N/A
MN MINNESOTA CC SYSTEMS Y N 1410 4303 N/A
  MN MINNESOTA MEDICAID Y N 1468 4302 N/A
MN MINNESOTA MEDICARE WPS Y N 1435 4301 N/A
  MN UCARE OF MINNESOTA N N 4496 4302 N/A
MO EASTERN MISSOURI MEDICARE WPS Y N 1441 4301 N/A
  MO KANSAS CITY BLUE SHIELD - KANSAS CITY, MO BC BS OF KANSAS Y N 4419 4303 N/A  
MO MISSOURI BLUE SHIELD - ST LOUIS MO ANTHEM MIDWEST N N 1408 4303 N/A
  MO MISSOURI MEDICAID INFOCROSSING HLTHCRE SERV Y N 1471 4302 N/A
MO WESTERN MISSOURI MEDICARE WPS Y N 4451 4301 N/A
  MS MISSISSIPPI BLUE SHIELD TRISPAN Y N 2415 4303 N/A
MS MISSISSIPPI MEDICAID ACS Y N 1490 4302 N/A
  MS MISSISSIPPI MEDICARE CAHABA GBA Y N 2451 4301 N/A
MT MONTANA BLUE SHIELD Y N 7450 4303 N/A
  MT MONTANA MEDICAID ACS Y N 4427 4302MT N/A
MT MONTANA MEDICARE NORIDIAN ADMIN. SERVICES Y N 7400 4301 N/A
  NC NORTH CAROLINA BLUE SHIELD NORTH CAROLINA BC BS Y N 1411 4303 N/A
NC NORTH CAROLINA MEDICAID EDS - ELECTRONIC DATA SYS Y N 1480 4302 N/A
  NC NORTH CAROLINA MEDICARE  CIGNA GOVERNMENT SERVICES Y N 1464 4301 N/A
ND NORTH DAKOTA BLUE SHIELD NORIDIAN ADMIN. SERVICES Y N 2411 4303 N/A
  ND NORTH DAKOTA MEDICAID N N 1487 4302 N/A
ND NORTH DAKOTA MEDICARE NORIDIAN ADMIN. SERVICES Y N 2453 4301 N/A
  NE NEBRASKA BLUE SHIELD Y N 1417 4303 N/A
NE NEBRASKA MEDICAID Y N 1476 4302 N/A
  NE NEBRASKA MEDICARE WPS Y N 1451 4301 N/A
NH NEW HAMPSHIRE BLUE SHIELD ANTHEM EAST N N 7422 4303 N/A
  NH NEW HAMPSHIRE MEDICAID EDS - ELECTRONIC DATA SYS Y N 7423 4302 N/A
NH NEW HAMPSHIRE MEDICARE NATIONAL HERITAGE INS CO Y N 2470 4301 N/A
  NJ HORIZON BLUE SHIELD OF NEW JERSEY Y N 2414 4303 N/A
NJ HORIZON BLUE SHIELD OF NJ FEP Y N 2414 4303 N/A
  NJ HORIZON BLUE SHIELD OF NJ OUT OF AREA Y N 2414 4303 N/A
NJ NEW JERSEY BLUE CHOICE Y N 2414 4303 N/A
  NJ NEW JERSEY BLUE SELECT Y N 2414 4303 N/A
NJ NEW JERSEY MEDICAID UNISYS Y N 1483 4302 N/A
  NJ NEW JERSEY MEDICARE HIGHMARK MEDICARE SERVICE Y N 1465 4301 N/A
NJ UNIVERSITY HEALTH PLAN (UHP) of NEW JERSEY CENTENE CORPORATION Y N 1425 4302 N/A
  NM NEW MEXICO BLUE SHIELD N N 7403 4303 N/A
NM NEW MEXICO MEDICAID ACS N N 1492 4302 N/A
  NM NEW MEXICO MEDICARE TRAILBLAZER HLTHENT-GPNET Y N 1457 4301 N/A
NV NEVADA BLUE SHIELD ANTHEM WEST Y N 7496 4303 N/A
  NV NEVADA MEDICAID FIRST HEALTH SERVICES Y N 7495 4302 N/A
NV NEVADA MEDICARE PALMETTO GBA Y N 1446 4301 N/A
  NY BLUE SHIELD OF WESTERN NEW YORK Y N 4409 4303 N/A
NY HEALTHNOW NEW YORK BLUE SHIELD Y N 7485 4303 N/A
  NY HMO BLUE EXCELLUS Y N 7432 4303 N/A
NY NEW YORK BLUE SHIELD CENTRAL REGION EXCELLUS Y N 3449 4303 N/A
  NY NEW YORK BLUE SHIELD OF ROCHESTER EXCELLUS Y N 4408 4303 N/A
NY NEW YORK BLUE SHIELD UTICA REGION EXCELLUS Y N 7432 4303 N/A
  NY NEW YORK BLUE SHIELD of NORTHEASTERN NEW YORK Y N 7433 4303 N/A  
NY NEW YORK COMMUNITY BLUE HMO Y N 4409 4303 N/A
  NY NEW YORK EMPIRE BLUE SHIELD NEW YORK EMPIRE BC BS N N 4437 4303 N/A
NY NEW YORK EMPIRE BLUE SHIELD - HEALTHNET NEW YORK EMPIRE BC BS N N 4459 4303 N/A
  NY NEW YORK EMPIRE MEDICARE NATIONAL GOVERNMENT SERV. Y N 4442 4301 N/A
NY NEW YORK MEDICAID - PHASE II COMPUTER SCIENCES CORP Y N 1422 1387 N/A
  NY NEW YORK MEDICARE (UPSTATE) HEALTHNOW UPSTATE MEDICAR Y N 1463 4301 N/A
NY NEW YORK MEDICARE GHI NATIONAL GOVERNMENT SERV. Y N 7401 4301 N/A
  NY UNIVERA UNINW EXCELLUS Y N 2773 4303 N/A
NY UNIVERA WNY EXCELLUS Y N 2779 4303 N/A
Y OH BUCKEYE COMMUNITY HEALTH - OHIO CENTENE CORPORATION Y N 4717 4302 N/A
OH OHIO BLUE SHIELD ANTHEM MIDWEST N N 2418 4303 N/A
  OH OHIO MEDICAID N N 2481 4302 N/A
OH OHIO MEDICARE PALMETTO GBA Y N 1447 4301 N/A
  OH OHIO WORKERS' COMP MCO'S N N 2704 1360 N/A
OK OKLAHOMA BLUE SHIELD N N 1403 4303 N/A
  OK OKLAHOMA MEDICAID EDS - ELECTRONIC DATA SYS N N 2753 4302 N/A
OK OKLAHOMA MEDICARE TRAILBLAZER HLTHENT-GPNET Y N 1458 4301 N/A
  OR OREGON BLUE SHIELD N N 2404 4303 N/A
OR OREGON MEDICAID Y N 1481 4302 N/A
  OR OREGON MEDICARE NORIDIAN ADMIN. SERVICES Y N 1459 4301 N/A
PA CLARITY VISION HIGHMARK, INC. Y N 2718 4303 N/A
  PA HEALTH KEEPERS, INC. HIGHMARK, INC. Y N 2413 4303 N/A
PA INDEPENDENCE BLUE CROSS PERSONAL CHOICE INDEPENDENCE BLUE CROSS N N 2781 4303 N/A
  PA PENINSULA HEALTH CARE HIGHMARK, INC. Y N 2413 4303 N/A
PA PENNSYLVANIA BLUE CHOICE HIGHMARK, INC. Y N 2413 4303 N/A
  PA PENNSYLVANIA BLUE SHIELD HIGHMARK, INC. Y N 2413 4303 N/A
PA PENNSYLVANIA MEDICAID EDS - ELECTRONIC DATA SYS N N 1491 4302 N/A
  PA PENNSYLVANIA MEDICARE HIGHMARK MEDICARE SERVICE Y N 2457 4301 N/A
PA PENNSYLVANIA PERSONAL CHOICE HIGHMARK, INC. Y N 2413 4303 N/A
  PA PRIORITY HEALTH CARE HIGHMARK, INC. Y N 2413 4303 N/A
PA SENIOR BLUE OF PENNSYLVANIA CAPITAL BLUE CROSS Y Y/15 2713 4303 N/A
  PR PUERTO RICO MEDICARE FIRST COAST SERV OPTIONS Y N 2785 4301 N/A
RI BLUE CHIP Y N 7420 4303 N/A
  RI RHODE ISLAND BLUE SHIELD Y N 7420 4303 N/A
RI RHODE ISLAND MEDICAID Y N 7421 4302 N/A
  RI RHODE ISLAND MEDICARE ARKANSAS BC BS Y N 7419 4301 N/A
RI RHODE ISLAND WORKERS COMPENSATION Y N 7420 4303 N/A
  SC CAROLINA BENEFIT ADMINISTRATORS N N 2410 4303 N/A
SC CONSOLIDATED BENEFITS INC. N N 2410 4303 N/A
  SC EMPLOYEE BENEFIT SERVICES N N 2410 4303 N/A
SC EMPLOYERS LIFE INSURANCE N N 2410 4303 N/A
  SC MEDICAL CLAIMS MANAGEMENT CORPORATION N N 2410 4303 N/A  
SC PLANNED ADMINISTRATORS, INC. N N 2410 4303 N/A
  SC PREFERRED BLUE N N 2410 4303 N/A
SC SOUTH CAROLINA BCBS PREFERRED HLTH SYS - HMO BLUE N N 2410 4303 N/A
  SC SOUTH CAROLINA BCBS STATE EMPLOYEES   N N 2410 4303 N/A  
SC SOUTH CAROLINA BLUE SHIELD N N 2410 4303 N/A
  SC SOUTH CAROLINA MEDICAID Y N 1484 4302 N/A
SC SOUTH CAROLINA MEDICARE PALMETTO GBA Y N 2452 4301 N/A
  SC THOMAS COOPER AGENCY N N 2410 4303 N/A
SD SOUTH DAKOTA BLUE SHIELD WELLMARK EDS/EC SOL Y N 2490 4302 N/A
  SD SOUTH DAKOTA MEDICAID Y N 4478 4302 N/A
SD SOUTH DAKOTA MEDICARE NORIDIAN ADMIN. SERVICES Y N 2454 4301 N/A
  TN HEALTHSPRING TENNESSEE Y N 2795 1350 N/A
TN STONES RIVER IPA forTN BLUE CROSS BLUE SHIELD only N N 2273 4300 N/A
  TN TENNESSEE BLUE SHIELD Y N 2401 4303 N/A
TN TENNESSEE BLUECARE TENNESSEE BC BS Y N 2495 4302 N/A
  TN TENNESSEE MEDICARE CIGNA GOVERNMENT SERVICES Y N 1453 4301 N/A
TX HEALTHSPRING TEXAS Y N 2795 1350 N/A
Y TX SUPERIOR HEALTH PLAN - TEXAS CENTENE CORPORATION Y N 2701 4300 N/A *
TX TEXAS BLUE SHIELD N N 1406 4303 N/A
  TX TEXAS MEDICAID ACS Y N 1470 4302 N/A
TX TEXAS MEDICARE TRAILBLAZER HLTHENT-GPNET Y N 1440 4301 N/A
  TX TEXAS WORKERS' COMPENSATION N N 1360 1360TX N/A
UT UTAH BLUE SHIELD UHIN Y N 2412 4303 C.168
  UT UTAH BLUE SHIELD - FEP UHIN Y N 2788 4303 C.168
UT UTAH MEDICAID UHIN Y N 1486 4302 C.168
  UT UTAH MEDICARE NORIDIAN ADMIN. SERVICES Y N 2458 4301 N/A
VA VIRGINIA BLUE SHIELD ANTHEM EAST N N 1413 4303 N/A
  VA VIRGINIA MEDICAID FIRST HEALTH SERVICES N N 1472 4302 N/A
VA VIRGINIA MEDICAID LAB FIRST HEALTH SERVICES N N 7447 4302 N/A
  VA VIRGINIA MEDICARE TRAILBLAZER HLTHENT-GPNET Y N 1442 4301 N/A
VA VIRGINIA MEDICARE (ALEX, ARLGTN, FAIRFAX HIGHMARK MEDICARE SERVICE Y N 2461 4301 N/A
  VI VIRGIN ISLANDS MEDICARE FIRST COAST SERV OPTIONS Y N 4487 4301 N/A
VT VERMONT BLUE SHIELD Y N 7493 4303 N/A
  VT VERMONT MEDICAID EDS - ELECTRONIC DATA SYS Y N 7492 4302 N/A
VT VERMONT MEDICARE NATIONAL HERITAGE INS CO Y N 2471 4301 N/A
  WA BLUE CROSS WA/AK PREMERA BLUE CROSS PREMERA BLUE CROSS Y N 7445 4303 N/A
WA REGENCE BLUE SHIELD N N 7451 4303 N/A
  WA WASHINGTON MEDICAID ACS Y N 1482 4302 N/A
WA WASHINGTON MEDICARE NORIDIAN ADMIN. SERVICES Y N 1462 4301 N/A
  WA WASHINGTON WORKERS COMPENSATION Y N 4404 4300 N/A
WI ATRIUM HEALTH PLAN INC - MEDICAID HMO N N 7453 4302 N/A
  WI GROUP HEALTH COOPERATIVE - MEDICAID HMO N N 7453 4302 N/A  
WI GROUP HEALTH COOPERATIVE OF EAU CLAIRE N N 7453 4302 N/A
Y WI MANAGED HEALTH SERVICES - WISCONSIN CENTENE CORPORATION Y N 2702 4302 N/A
WI WISCONSIN BLUE SHIELD ANTHEM MIDWEST N N 1401 4303 N/A
  WI WISCONSIN MEDICAID EDS - ELECTRONIC DATA SYS N N 1467 4302 N/A
WI WISCONSIN MEDICARE WPS Y N 1434 4301 N/A
  WV BRICKSTREET MUTUAL INSURANCE ACS Y N 4428 4300 N/A
WV MOUNTAIN STATE BLUE SHIELD (WEST VIRGINIA) Y N 7474 4303 N/A
  WV WEST VIRGINIA MEDICAID UNISYS N N 2477 4302 N/A
WV WEST VIRGINIA MEDICARE PALMETTO GBA Y N 1450 4301 N/A
  WY WYOMING BLUE SHIELD NORIDIAN ADMIN. SERVICES Y N 7489 4303 N/A
WY WYOMING MEDICAID ACS Y N 7458 4302 N/A
  WY WYOMING MEDICARE NORIDIAN ADMIN. SERVICES Y N 2466 4301 N/A
MEDICARE DME MAC JURISDICTION A NATIONAL GOVERNMENT SERV. Y N 7475 4301 N/A
  MEDICARE DME MAC JURISDICTION B NATIONAL GOVERNMENT SERV. Y N 7476 4301 N/A
MEDICARE DME MAC JURISDICTION C NATIONAL GOVERNMENT SERV. Y N 7477 4301 N/A
  MEDICARE DME MAC JURISDICTION D NATIONAL GOVERNMENT SERV. Y N 7478 4301 N/A
RETIRED RAILROAD MEDICARE PALMETTO GBA Y N 1443 4301 N/A
Y TRICARE - NORTH AND SOUTH REGION PALMETTO GBA Y N 4456 4300 N/A
TRICARE - WEST REGION WPS Y N 7452 4300 N/A
     
     
     
 
   
   
EMC CPID The RelayHealth-assigned payor identification number used to process electronic claims. Clicking on this link will open the Payor Guide containing payor-specific information for processing electronic and paper claims through RelayHealth.
PAPER CPID The RelayHealth-assigned payor identification number used to process paper claims.
SURCHG A per transaction fee charged to McKesson. This will be passed onto the customer. C.12 indicates a $0.12 per transaction surcharge for Claims and R.05 indicates a $0.05 per transaction surcharge for Remittance. C.12/R.05 indicates a surcharge for both Claims and Remittance.
The last column indicates updates to the payor connections lists.
* Indicates updates to the payor connection reports within the last 30 days
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