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Updated	Par/ Non-Par/ Trans	Payer ID	Payer Type	ST	Payer Name	Line of Business	EDI Version	NPI Level	Enrollment Authorization	Payer Response Level	Payer Testing Required	Accept COB	Agreement	Notes
U: 03/10/2013	Non-Par	MR094	Government		Medicare - Missouri - Eastern	Remittance	4010A1 and 5010A1	All_Use	Enrollment
U: 12/31/2012	Non-Par	MC042	Government	WY	Medicaid - Wyoming	Remittance	4010A1	All_Use	Enrollment
U: 02/12/2013	Non-Par	MC048	Government	WV	Medicaid - West Virginia	Remittance	5010A1	All_Use	Enrollment
U: 03/15/2013	Non-Par	MR056	Government	WV	Medicare - West Virginia	Remittance	4010A1	All_Use	Enrollment
U: 12/21/2012	Non-Par	BS055	Government	WV	Blue Shield - West Virginia	Remittance	4010A1	All_Use	Enrollment
U: 03/10/2013	Non-Par	MR023	Government	IL	Medicare - Illinois	Remittance	4010A1 and 5010A1	All_Use	Enrollment
U: 03/10/2013	Non-Par	MR053	Government	WI	Medicare - Wisconsin	Remittance	4010A1 and 5010A1	All_Use	Enrollment
U: 03/10/2013	Non-Par	MR019	Government	MN	Medicare - Minnesota	Remittance	4010A1 and 5010A1	All_Use	Enrollment
U: 03/10/2013	Non-Par	MR017	Government	MI	Medicare - Michigan	Remittance	4010A1 and 5010A1	All_Use	Enrollment
U: 03/10/2013	Non-Par	MR044	Government	MO	Medicare - Missouri	Remittance	4010A1 and 5010A1	All_Use	Enrollment
U: 03/10/2013	Non-Par	MR092	Government	NE	Medicare - Nebraska	Remittance	4010A1 and 5010A1	All_Use	Enrollment
U:03/10/2013	Non-Par	MR036	Government	IA	Medicare - Iowa	Remittance	4010A1 and 5010A1	All_Use	Enrollment
U: 03/10/2013	Non-Par	MR060	Government	KS	Medicare - Kansas	Remittance	4010A1 and 5010A1	All_Use	Enrollment
U: 10/09/2012	Non-Par	WPS01	Commercial		WPS Commercial Insurance	Remittance	5010A1	All_Use	Enrollment
U: 04/19/2013	Non-Par	TDDIR	Government		Tricare for Life	Remittance	4010A1	All_Use	Enrollment
	Non-Par	MC049	Government	WI	Medicaid - Wisconsin	Remittance	4010A1	All_Use	Enrollment
11/11/2011	Non-Par	BS053	Government	WI	Blue Shield - Wisconsin (Anthem)	Remittance	4010A1	All_Use	Enrollment
06/19/2012	Non-Par	39113	Commercial	WI	Dean Health Plan	Remittance	5010A1	All_Use	Enrollment	No Response From Payer
U:07/24/2012	Non-Par	39045	Commercial	WI	Security Health Plan	Remittance	4010A1	All_Use	Enrollment					Please go to SHP Website to download form: http://www.securityhealth.org/providers/?page=edi Fax Completed Form to: 715-221-9699
U:08/17/12	Non-Par	WC001	Commercial		Labor and Industry	Remittance	5010A1	All_Use	Enrollment

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