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Select Payer 64556: 90 Degrees Benefits PO BOX 211348 Eagan Mn 55121 22384: Admin Concepts 22384: ADMINISTRATIVE CONCEPTS 60054: AETNA GRV01: AETNA GRAVIE 61425: AETNA Trustmark 11370: AG Admin 64884: AITHER HEALTH 81040: ALLEGIANCE BENEFIT PLAN MANAGEMENT INC 99588: Allegiance Health Management 37308: Allied Benefit - Aetna Signature Admin 75068: Allied Benefits 68069: AMBETTER 10596: AMERICAN NATIONAL LIFE INSURANCE COMPANY OF TEXAS 44444: AMERICAN POSTAL WORKERS UNION 88050: Auxiant 62777: Auxiant - Aetna Signature Admin 76079: Auxiant Emoden 88050: AUXIANT NATIONAL HEALTH BENEFIT CORPORATION 66006: BC TEXAS MEDICARE ADVANTAGE 03036: BCBS EBA Blue Benefit 66006: BCBS Medicare Advantage 84980: BCBS TEXAS 20044: Berkshire Hathaway Homestate Companies 74238: Boon Chapman 74238: Boon Chapman BRGHT: BRIGHT HEALTHCARE TP021: Broadspire J1445: Brotherhood Mutual 6400 Brotherhood Way Fort Wayne IN 46825 J1010: CCMSI PO BOX 7457 Metairie LA 70010 WR322: CCMSI PO BOX 35350 Las Vegas NV 35350 84146: ChampVA PO BOX 30750 Tampa Flo 33630-3750 TAYLR: Charles Taylor TPA PO BOX 436499 Louisville KY 40253 62308: CIGNA 76066: Cigna Renaissance Physicians 20443: CNA INSURANCE : Coeur Plan Services 38335: Cofinity - Aetna Signature Administrators 60495: Community Health MP PO BOX 301424 Houston Tx 77230 J4110: CorVel PO Box 6966 Portland OR 97228 95019: COVENTRY FIRST HEALTH 25133: COVENTRY HEALTHCARE NATIONAL NETWORK CURTV: Curative PO BOX 1786 Austin TX 78767 DEVOT: Devoted Health Plan SX182: EBMS SX110: EDUCATORS MUTUAL (EMIA) 76079: Emdeon/Auxiant SX110: EMI - Aetna Signature Administrators 81039: EMPLOYEE BENEFIT MANAGEMENT SYSTEM (EBMS) 75261: Employers Health Network P.O. Box 99906 Grapevine Tx 76099 IHS07: Employers Health Network 36878: Entrust TP043: ESIS 73159: First Health Network TP057: Gallagher Bass 37602: GOLDEN RULE 39026: GOVERNMENT EMPLOYEES HEALTH ASSOCIATION (GEHA) GRV01: Gravie - Aetna Signature Administrators 48143: GROUP AND PENSION ADMINISTRATORS 80705: GWH CIGNA (GREAT WEST HEALTHCARE) 60495: Harris Health PO BOX 301424 Houston Tx 77230 85729: Health Comp 07205: Health Comp Aetna 94267: Health Partners CAPHP: Health Smart/ Caprock PO BOX 21548 Eagan MN 55121 40026: HealthSCOPE Benefits HSM01: Healthsmart PPO PO BOX 53070 Lubbock Tx 79453-3070 61101: HUMANA 48143: Imagine 360 PO BOX Dallas Tx 75374 IHHMG: Imperial Health IICTX: Imperial Insurance Company Texas KELSE: Kelsey Seybold 73100: Kempton Group 33600: Liberty Mutual 45289: LONE STAR TPA 04412: Medicare MHHNP: MEMORIAL HERMANN HEALTH INSURANCE COMPANY MHHNP: Memorial Hermann Health Network 64157: MERITAIN HEALTH 41124: Meritain/Change Healthcare 20554: MOLINA HEALTHCARE TEXAS 14165: MVP Health Care 53011: NALC Cigna NONBILL: NONBILL:Medicare/Medicaid OSCAR: Oscar PO BOX 52146 Phoenix AZ 85072-2146 20510: Ovation Health 22001 Northpark Drive Kingwood TX 77339 93029: PACIFIC SOURCE 93029: PacifiSource - Aetna 20510: Patient-Physician Cooperatives 22001 Northpark Drive Kingwood Tx 77339 07205: Personify Health PO BOX 660091 Dallas Tex 75266 PHCS1: PHCS 59355: PHCS Christian Care Ministries 13306: Private Health Care System 50114: SANA SANA1: Sana Benefits 50114: Sana Benefits TP097: Sedgwick PO BOX 14450 Lexington Ken 40512 : Self Pay SELFPAY: SELFPAY 39033: Sentry PO BOX 8032 Steven Point WI 54481 77721: Solidarity Healthshare 31059: STATE FARM CASUALTY AND PROPERTY INSURANCE 31053: STATE FARM INSURANCE COMPANIES : Student Assurance Services PO BOX 196 Stillwater MN 55082 25463: Surest Health Plan PO BOX 211758 Eagan MN 55121 A0234: TASB 22945: Texas Mutual 88461: THE ALLIANCE J1422: The Hartford PO BOX 14187 Lexington KY 40512 95677: The Health Plan 1110 Main Street Wheeling WV 26330 : The Reny Company 1820 Preston BLVD Plano Tex 75093 A0245: TML 19046: TRAVELERS INSURANCE 74227: UHC STUDENT RESOURCES 39026: UMR (UMR WAUSAU) 87726: United Healthcare USN01: United Healthcare Options - USNAS 81400: UNITEDHEALTHCARE - ALL SAVERS INSURANCE 06111: UNITEDHEALTHCARE - OXFORD 93220: Universal Fidelity PO Box 304 Duncan OK 73534 90551: US FAMILY HEALTH PLAN USFHP: US FAMILY HEALTH PLAN (USFHP) TEXAS AND LOUISIANA 37105: Village MD Po BOX 981750 El Paso TEX 79998-1750 75261: WebTPA Aetna Signature PO BOX 99906 Grapevine TX 76099 14163: WELLCARE HMO WELM2: WELLMED (CLAIMS) A0245: WORKERS COMP 89677: ZENITH AMERICAN SOLUTIONS INC 16535: ZURICH INSURANCE N A

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