Payer ID Enroll Additional Info

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1 AARP AARP1 Detailed Benefits Advantica Benefits Detailed Benefits Aetna No Detailed Benefits AFLAC GA No Detailed Benefits AFLAC NY No Detailed Benefits Ameritas Life Insurance Corp No Yes/No Response Ameritas Life insurance Corp. of New York No Yes/No Response CareFirst, Inc. Maryland BCBS No CIGNA No Detailed Benefits Coventry Dental CX049 No Detailed Benefits DeCare Dental Health Insurance No Detailed Benefits Denex Dental CX049 No Detailed Benefits Dentist Direct UTUDD No Emblem Health (GHI - New York Group Health Inc.) No Everence No First Reliance Standard Life Ins. Co. (NY Business) No Yes/No Response GDS CX036 No Detailed Benefits Government Employees Health Association No Yes / No Response Government Employees Hospital Association (GEHA) No Yes / No Response Guardian Life Insurance Company of America No Detailed Benefits Health Choice Arizona No Detailed Benefits HealthPartners MN CX009 Yes Detailed Benefits. Only Subscriber Requests are Supported. Healthplex, Inc No Kaiser CX073 No Detailed Benefits Lincoln Financial Group CX061 No Detailed Benefits Managed Dental Guard GI813 Detailed Benefits MAPFRE PRFRE Yes MEDICA of Minnesota CX026 No Detailed Benefits Medical Card System (MCS) PRMCS Medical Mutual of Ohio No Detailed Benefits Page 1

2 Medical Mutual of Ohio CB833 No Detailed Benefits MetLife No Detailed Benefits MVP Health Care No Yes/No Response Nippon Life Insurance Company of America No Detailed Benefits OH Dental / UHC Dental Government Programs GP133 No Yes / No Response. f.k.a. Optum Specialty Svcs / Americhoice of NJ Pacificare Dental and Vision HMO CX060 No A United Healthcare Payer Pacificare Dental and Vision PPO CX053 No A United Healthcare Payer Principal Financial Group No Detailed Benefits Reliance Standard Life No Yes/No Response Securian No Detailed Benefits Sierra Health Services Yes Sierra health Services requires that providers register for the eligibility service prior to submitting requests. Provider can regtister for eligibility by contact Sierra Health provider services directlfy at: in Las Vegas or toll free at Eligibility requests submitted w2it6hout prior provider registraion will result in the error AAA*35 (Out of Network). Standard Ins. Co. (OR Business) No Yes/No Response Standard Insurance Company (NY) No Yes/No Response Triple-S Salud CBPR1 Yes Trustmark Insurance Company No Yes/No Response UMR - Cincinnati No Detailed Benefits UMR - Harrington No Detailed Benefits UMR - Harrington No Detailed Benefits UMR - Lexington No Detailed Benefits UMR - Onalaska No Detailed Benefits UMR - San Antonio No Detailed Benefits UMR - Wausau/UHIS No Detailed Benefits United Concordia - Dental Plus CX013 No Detailed Benefits United Concordia - Fee for Service CX007 No Detailed Benefits United HealthCare Insurance Company - Student Insurance No A United Healthcare Payer. Payer ID only valid if the P.O. Box on the Health ID Card matches one of the following P.O. Boxes: P.O. Box , , , , , , , , , or Dallas, Tax UnitedHealthcare Dental No Formerly OptumHealth Dental, Dental Benefit Providers/DBP and DBP of California Horizon Healthcare Dental Services No Detailed Benefits NorthStar Administrators No Detailed Benefits Premera Blue Cross No Detailed Benefits Blue Cross of Alaska and Washington No Detailed Benefits Page 2

3 Anthem Blue Cross No Detailed Benefits. Blue Cross of Massachusetts CBMA1 No Detailed Benefits Blue Cross Blue Shield of Kansas City MO Yes / No Response Empire Blue Cross Blue Shield CBNY1 No Detailed Benefits Pennsylvania Blue Shield CB865 No Detailed Benefits Pennsylvania Blue Shield Dental Plus CBPA2 No Detailed Benefits South Carolina BCBS No Detailed Benefits Blue Cross of Alaska and Washington No Detailed Benefits Delta Dental Insurance Co. (DDIC) - All Payers No Detailed Benefits DeltaCare USA Claims DDCA2 No Detailed Benefits DeltaCare USA Encounters DDCA3 Yes Detailed Benefits Northeast Delta Dental (ME, NH, VT) No Detailed Benefits Delta Dental of Arkansas CDAR1 No Detailed Benefits Delta Dental of Arizona No Detailed Benefits Delta Dental of California - CA00 Claims Office No Detailed Benefits Delta Dental of California/Tricare Retiree Dental CDCA1 No Detailed Benefits Delta Dental of Washington DC No Detailed Benefits Delta Dental of Delaware No Detailed Benefits Delta Dental of Florida (DDIC) DDFL1 No Detailed Benefits Delta Dental of Georgia (DDIC) DDGA1 No Detailed Benefits Delta Dental of Iowa CDIA1 No Detailed Benefits Delta Dental of Idaho No Detailed Benefits Delta Dental of Illinois Group Plans No Detailed Benefits Delta Dental of Indiana CDIN1 No Detailed Benefits Delta Dental of Kansas CDKS1 No Detailed Benefits Delta Dental of Kentucky CDKY1 No Detailed Benefits Delta Dental of Louisiana (DDIC) DDLA1 No Detailed Benefits Delta Dental Massachusetts No Detailed Benefits Delta Dental of Maryland and Pennsylvania No Detailed Benefits Delta Dental of Michigan CDMI0 No Detailed Benefits Delta Dental of Minnesota CDMN1 No Detailed Benefits Delta Dental of Missouri No Detailed Benefits Delta Dental of Mississippi (DDIC) DDMS1 No Detailed Benefits Delta Dental of Montana (DDIC) DDMT1 No Detailed Benefits Delta Dental of North Carolina No Detailed Benefits Delta Dental of Nebraska CDNE1 No Detailed Benefits Page 3

4 Delta Dental of New Jersey No Detailed Benefits Delta Dental of New Mexico No Detailed Benefits Delta Dental of Nevada (DDIC) DDNV1 No Detailed Benefits Delta Dental of New York No Detailed Benefits Delta Dental of Ohio CDOH1 No Detailed Benefits Delta Dental of Oklahoma CDOK1 No Detailed Benefits Delta Dental of Maryland and Pennsylvania No Detailed Benefits Delta Dental Puerto Rico No Detailed Benefits Altus No Detailed Benefits Delta Dental of Rhode Island No Detailed Benefits Delta Dental of South Carolina No Detailed Benefits Delta Dental of Tennessee CDTN1 No Detailed Benefits Delta Dental of Texas (DDIC) DDTX1 No Detailed Benefits Delta Dental of Utah (DDIC) DDUT1 No Detailed Benefits Delta Dental of Washington No Detailed Benefits. f.k.a. Washington Dental Service Delta Dental of Wisconsin No Detailed Benefits Delta Dental of West Virginia No Detailed Benefits DentaQuest - Government Plans CX014 No Detailed Benefits Medicaid of Alabama CKAL1 No Yes/No Response Medicaid of Arkansas CKAR1 No Yes/No Response Arizona Medicaid CKAZ1 No Yes/No Response Denti-Cal / Medicaid of California Yes Yes/No Response. Please call (916) for PIN. Medicaid of Colorado CKCO1 No Yes/No Response Medicaid of Connecticut CKCT1 No Yes/No Response District of Columbia Medicaid CKDC1 No Yes/No Response DentaQuest - Government Plans CX052 No Detailed Benefits Florida Medicaid CKFL1 Yes Yes/No Response Medicaid of Florida CKFL1 Yes Yes/No Response Medicaid of Georgia CKGA1 No Yes/No Response Delta Dental of Iowa Medicaid Program CDIAM No Detailed Benefits Medicaid of Iowa CKIA1 No Yes/No Response DentaQuest - Government Plans CKID1 No Detailed Befefits DentaQuest - Government Plans CKIL1 No Detailed Benefits Medicaid of Indiana CKIN1 No Yes/No Response Medicaid of Kansas CKKS1 No Yes/No Response DentaQuest - Government Plans CKKY3 No Detailed Benefits Page 4

5 Medicaid of Kentucky CKKY1 No Yes/No Response Massachusetts Health Program CKMA1 No Yes/No Response DentaQuest - Government Plans CKMD1 No Yes/No Response Medicaid of Maine CKME1 No Yes/No Response Medicaid of Michigan CKMI1 No Yes/No Response Medicaid of Minnesota CKMN1 No Yes/No Response Medicaid of Missouri CKMO1 No Yes/No Response Medicaid of Mississippi CKMS1 No Yes/No Response Medicaid of Montana CKMT1 No Yes/No Response Medicaid of North Carolina CKNC1 No Yes/No Response North Dakota Medicaid CKND1 No Yes/No Response Medicaid of New Hampshire CKNH1 No Yes/No Response Medicaid of New Jersey CKNJ1 No Yes/No Response New Mexico Medicaid CKNM1 No Yes/No Response Medicaid of Nevada CKNV1 No Yes/No Response Medicaid of New York CKNY1 No Yes/No Response Medicaid of New York (Dental Clinics Only) CKNY2 No Yes/No Response CareSource CKOH2 No Yes/No Response Medicaid of Ohio CKOH1 No Yes/No Response Medicaid of Oklahoma CKOK1 No Yes/No Response Medicaid of Oregon CKOR1 No Yes/No Response Medicaid of Pennsylvania CKPA1 No Yes/No Response Triple-S Medicaid Advantage PRADV Yes DentaQuest - Government Plans CKSC1 No Detailed Benefits South Dakota Medicaid CKSD1 No Yes/No Response DentaQuest - Government Plans No Detailed Benefits Tennessee Medicaid CKTN1 No Yes/No Response Medicaid of Texas CKTX1 No Yes/No Response DentaQuest - Government Plans CKVA1 No Detailed Benefits Medicaid of Vermont CKVT1 No Yes/No Response Medicaid of Washington CKWA1 No Yes/No Response Medicaid of Wisconsin CKWI1 No Yes/No Response Medicaid of West Virginia CKWV1 No Yes/No Response Page 5

6 Medicaid of Wyoming CKWY1 No Yes/No Response Page 6