Claims Payer List for UnitedHealthcare,

Affiliates and Strategic Alliances

Line of Business Medical Dental Smart
(LOB) Brand Name / Plan Name or Region Payer ID Payer ID COB Edits Comments
Commercial Arnett Health Plan 87726 Y Y former payer id 95440
Commercial Bind 25463 Y N
Commercial Harvard Pilgrim 04271 Y N
Commercial Harvard Pilgrim Passport Connect 87726 N N
Commercial Neighborhood Health Partnership (NHP) 87726 N Y
Commercial The Alliance 88461 Y N
Commercial UMR 39026 39026 Y N
Commercial UnitedHealthcare 87726 Y Y
Commercial UnitedHealthcare / All Savers Alternate Funding 81400 Y N
Commercial UnitedHealthcare / All Savers Insurance 81400 Y N
Commercial UnitedHealthcare / Definity Health Plan 87726 Y Y former payer id 64159
Commercial UnitedHealthcare / Empire Plan 87726 Y Y
* Commercial UnitedHealthcare / Oxford 06111 Y Y
UnitedHealthcare / UnitedHealthcare of the Mid-Atlantic, MD IPA, Optimum Choice and MAMSI Life
Commercial 87726 Y Y former payer id 52148
and Health (formerly MAMSI)
Commercial UnitedHealthcare / UnitedHealthcare Plan of the River Valley (formerly John Deere Healthcare) 87726 95378 Y Y former medical payer id 95378
Commercial UnitedHealthcare / UnitedHealthcare Shared Services - UHSS (formerly UHIS) 39026 39026 Y N
Commercial UnitedHealthcare / UnitedHealthcare StudentResources 74227 Y N
Commercial UnitedHealthcare / U.S. Networks and Administrative Services USN01 N N effective 3/1/2020
former payer id 95959, 95962, 95964,
Commercial UnitedHealthcare West / UnitedHealthcare of CA, OK, OR, TX, WA and PacifiCare of AZ, CO, NV 87726 Y Y
95999
Commercial UnitedHealthcare West / Encounters (formerly PacifiCare) 95958 Y N
Commercial UnitedHealthOne / Golden Rule 37602 Y N
Commercial UnitedHealthOne / UnitedHealthcare Life Insurance Company (formerly American Medical Security) 81400 CX001 Y N
Commercial UnitedHealthOne / UnitedHealthcare Life Insurance Company - Golden Rule 37602 Y N
UnitedHealthcare Dental (formerly OptumHealth Dental, Dental Benefit Providers/DBP and DBP of
Dental 52133 N N
California)

Medicaid, Dual SNP UnitedHealthcare Community Plan / AZ, Long Term Care, Children's Rehabilitative Services (CRS) 03432 Y N

UnitedHealthcare Community Plan / CA, DC, DE, FL, GA, HI, IA, KY, LA, MA, MD, MS, NC, NE, NM, former payer id 04567, 25175, 86002,
Medicaid, Dual SNP 87726 Y Y
NY, OH, OK, PA, RI, TX, VA, WA, WI (some are formerly AmeriChoice or Unison plans) 86003, 86048, 86049, 95378
Dual SNP UnitedHealthcare Community Plan / KS 87726 Y Y
Medicaid UnitedHealthcare Community Plan / KS - KanCare 96385 Y Y
Medicaid, Dual SNP,
UnitedHealthcare Community Plan / MI (formerly Great Lakes Health Plan) 95467 Y Y
MIChild
Medicaid, Dual SNP UnitedHealthcare Community Plan / MO 86050 Y Y
UnitedHealthcare Community Plan / NJ (formerly AmeriChoice NJ Medicaid, NJ Family Care, NJ
Medicaid, Dual SNP 86047 Y Y former payer id 86001
Personal Care Plus)
UnitedHealthcare Community Plan / TN (formerly AmeriChoice TN: TennCare, Secure Plus
Medicaid, Dual SNP 95378 Y Y
Complete)
Medicaid, Dual SNP UnitedHealthcare Community Plan / UnitedHealthcare Dual Complete (formerly Evercare) 87726 Y Y
Medicaid, Dual SNP UnitedHealthcare Community Plan / UnitedHealthcare Long Term Care (formerly Evercare) 87726 Y Y
Medicare, Retirement AARP Hospital Indemnity Plans insured by UnitedHealthcare Insurance Company 36273 N N
Medicare, Retirement AARP Medicare Supplement Plans insured by UnitedHealthcare Insurance Company 36273 Y N
Medicare, Retirement AARP MedicareComplete insured through UnitedHealthcare / WellMed WELM2 Y N

©2020 UnitedHealthcare Services, Inc. Page 1 of 3 05/22/2020

Claims Payer List for UnitedHealthcare,
Affiliates and Strategic Alliances
Line of Business Medical Dental Smart
(LOB) Brand Name / Plan Name or Region Payer ID Payer ID COB Edits Comments
AARP MedicareComplete insured through UnitedHealthcare (formerly AARP MedicareComplete from
Medicare, Retirement 87726 Y Y
SecureHorizons)
Medicare, Retirement AARP MedicareComplete insured through UnitedHealthcare / Oxford Medicare Network 87726 Y Y former payer id 06111
Medicare, Retirement AARP MedicareComplete insured through UnitedHealthcare / Oxford Mosaic Network 87726 Y Y former payer id 06111
Medicare, Retirement Medica HealthCare Plans / FL 78857 Y Y
Medicare, Retirement OptumCare / AZ, NV, UT (formerly Optum Medical Network & Lifeprint Network) LIFE1 N N
Medicare, Retirement OptumCare Network of Connecticut E3287 N N
Medicare, Retirement Preferred Care Partners / FL 65088 Y Y
Medicare, Retirement UnitedHealthcare Community Plan / UnitedHealthcare Dual Complete - Oxford Medicare Network 87726 Y Y
Medicare, Retirement UnitedHealthcare Medicare / Care Improvement Plus (CIP), XLHealth 87726 Y Y former payer id 77082
Medicare, Retirement UnitedHealthcare Medicare / UnitedHealthcare Chronic Complete (formerly Evercare) 87726 Y Y
Medicare, Retirement UnitedHealthcare Medicare / UnitedHealthcare Group Medicare Advantage 87726 Y Y
Medicare, Retirement UnitedHealthcare Medicare / UnitedHealthcare MedicareComplete (formerly SecureHorizons) 87726 Y Y
Medicare, Retirement UnitedHealthcare Medicare / UnitedHealthcare MedicareDirect (formerly SecureHorizons) 87726 Y Y
Medicare, Retirement UnitedHealthcare Medicare / UnitedHealthcare Nursing Home Plan (formerly Evercare) 87726 Y Y
Medicare, Retirement WellMed WELM2 Y N
Multiple Health Plan of Nevada 76342 Y N
Multiple Health Plan of Nevada - Encounters 76343 Y N
Multiple Medica 94265 Y N
Multiple Rocky Mountain Health Plans (RMHP) / CO - Professional claims SX141 Y N
Multiple Rocky Mountain Health Plans (RMHP) / CO - Institutional claims 84065 Y N
Multiple Sierra Health and Life 76342 Y N
Multiple Sierra Health and Life - Encounters 76343 Y N
OptumHealth Behavioral Solutions (formerly United Behavioral Health and PacifiCare Behavioral
Other 87726 Y N former payer id 33053
Health)
Other OptumHealth Behavioral Solutions of NM 87726 Y N
OptumHealth Complex Medical Conditions (CMC) (formerly OptumHealth Care Solutions and United
Other 41194 Y N former payer id 52190
Resource Networks)
Other OptumHealth Physical Health - includes Oxford 41161 Y N former payer id 41159, 41160

Applies only to 837P claims. Before

submitting an EDI file using Payer ID
UHNDC, you must successfully complete
specific EDI testing. Contact your
Other UnitedHealthcare / NDC Home Infusion Specialty Pharmacy Claims - NDC claims only UHNDC N N
clearinghouse to begin the testing
process. Refer to NDC Claim Submission
or call UnitedHealthcare EDI Support at
800-842-1109 for more information.

See delivery schedule for effective

dates of each region. Region 1: CT, DC,
DE, MA, MD, ME, NC, NH, NJ, PA, RI,
Other Veterans Affairs / Community Care Network (CCN) VACCN Y N VA, VT, WV Region 2: IA, IL, IN, KS,
KY, MI, MN, MO, ND, NE, OH, SD, WI
Region 3: AL, AR, FL, GA, LA, MS, OK,
PR, SC, TN, USVI

Vision March Vision 52461 N N

©2020 UnitedHealthcare Services, Inc. Page 2 of 3 05/22/2020

 Claims Payer List for UnitedHealthcare,
Affiliates and Strategic Alliances
Line of Business Medical Dental Smart
(LOB) Brand Name / Plan Name or Region Payer ID Payer ID COB Edits Comments
Vision UnitedHealthcare Vision 00773 N N

* change or addition to previously published list

Medical Payer ID applies to Professional (CMS-1500) and/or Institutional (UB-04) claims

COB = Coordination of Benefits; indicates secondary/COB claims accepted electronically
Smart Edits = Apply to electronic claims submissions; Not applicable to DSNP lines of business

©2020 UnitedHealthcare Services, Inc. Page 3 of 3 05/22/2020