Blue Cross and Blue Shield of Arizona (00030, FI)
| State(s) Covered: AL, AZ, CA, CO, TX | Blue Cross and Blue Shield of Georgia (00101, FI)
PO Box 9048
Columbus, GA 31908-9048
| James Cope, M.D., Medical Director
State(s) Covered: AZ, CA, CT, DC, FL, GA, IL, IA, KS, KY, LA, MD, MA, MI, MS, MO, NE, NV, NH, NJ, NY, NC, OH, OK, OR, PA, SC, TN, TX, VA, WV, WI | Blue Cross and Blue Shield of Montana (00250, FI)
| State(s) Covered: MT | Blue Cross and Blue Shield of Nebraska (00260, FI)
| State(s) Covered: NE | Blue Cross and Blue Shield of Rhode Island (00370, FI)
| State(s) Covered: RI | Blue Cross and Blue Shield of Wyoming (00460, FI)
| State(s) Covered: WY | BlueCross BlueShield of Tennessee (Riverbend Government Benefits Administrator) (00390, FI)
730 Chestnut Street
Chattanooga, TN 37402-1790
| Edward Humpert, MD, MS
State(s) Covered: AL, AK, AZ, AR, CA, CO, CT, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, NE, NV, NJ, NM, NY, NC, ND, OH, OK, OR, PA, RI, SC, TN, TX, UT, VT, VA, WA, WV, WI, WY | Cahaba GBA, LLC - Alabama (00010, FI)
P. O. Box 13384
Birmingham, AL 3520-2
| Greg McKinney, MD, MBA, Contractor Medical Director
State(s) Covered: AL | Cahaba Government Benefit Administrators®, LLC - Midwest (00011, FI)
| State(s) Covered: IA | CareFirst Blue Cross and Blue Shield of Maryland (00190, FI)
| State(s) Covered: AL, AR, CA, CO, CT, DE, DC, FL, GA, IL, IA, KS, KY, LA, ME, MD, MA, MI, MO, NE, NV, NJ, NM, NY, NC, ND, OH, OK, PA, SC, SD, TN, TX, UT, VA, WA, WI, WY | Chisholm Administrative Services (00340, FI)
| State(s) Covered: OK | Cooperativa de Seguros de Vida de Puerto Rico (57400, FI)
| State(s) Covered: PR, VI | First Coast Service Options, Inc. (00090, FI)
532 Riverside Ave.
Jacksonville, FL 32202
| James Corcoran, MD, Chief Contractor Medical Director
State(s) Covered: FL | Highmark Medicare Services MD/Washington, DC Fiscal Intermediary (00366, FI)
| State(s) Covered: AL, AR, CA, CO, CT, DE, DC, FL, GA, IL, IA, KS, KY, LA, ME, MD, MA, MI, MO, NE, NV, NJ, NM, NY, NC, ND, OH, OK, PA, SC, SD, TN, TX, UT, VA, WA, WI, WY | Highmark Medicare Services Pennsylvania Fiscal Intermediary (00363, FI)
| State(s) Covered: CA, CT, DE, FL, GA, IL, MD, MA, NH, NJ, NY, NC, OH, PA, RI, SC, TX, VT, VA, WV | Medicare Northwest (Regence of Blue Cross and Blue Shield of Oregon) (00350, FI)
| State(s) Covered: ID, OR, UT, WA | Mutual of Omaha Insurance Company (52280, FI)
| State(s) Covered: AL, AK, AZ, CA, CO, CT, DE, FL, GA, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WA, WV, WI, WY | National Government Services, Inc. (00308, FI)
| State(s) Covered: CT, DE, NY | National Government Services, Inc. (00450, FI)
P.O. Box 7149
Indianapolis, IN 46207-7149
| Dr. James Cope, Medical Director
State(s) Covered: WI | National Government Services, Inc. (00452, FI)
P.O. Box 7149
Indianapolis, IN 46207-7149
| Dr. James Cope, Medical Director
State(s) Covered: MI | National Government Services, Inc. (00453, FI)
P.O. Box 7149
Indianapolis, IN 46207-7149
| Dr. James Cope, Medical Director
State(s) Covered: VA, WV | National Government Services, Inc. (00454, FI)
| State(s) Covered: AS, CA, GU, HI, NV, CNMI | National Government Services, Inc. (00270, FI)
P.O. Box 4846
Syracuse, NY 13221-4846
| Dr. George Costantino, Medical Diretor
State(s) Covered: NH, VT | National Government Services, Inc. (00180, FI)
P.O. Box 4846
Syracuse, NY 13221-4846
| Dr. George Costantino, Medical Director
State(s) Covered: ME, MA | National Government Services, Inc. (00181, FI)
P.O. Box 4846
Syracuse, NY 13221-4846
| Dr. George Costantino, Medical Director
State(s) Covered: ME, MA | National Government Services, Inc. (00130, FI)
P.O. Box 7138
Indianapolis, IN 46207-7138
| Richard K. Baer, MD, Senior Medical Director
State(s) Covered: IN | National Government Services, Inc. (00131, FI)
P.O. Box 7138
Indianapolis, IN 46207-7138
| Richard K. Baer, MD, Senior Medical Director
State(s) Covered: IL | National Government Services, Inc. (00160, FI)
P.O. Box 7138
Indianapolis, IN 46207-7138
| Richard K. Baer, MD, Senior Medical Director
State(s) Covered: KY | National Government Services, Inc. (00332, FI)
P.O. Box 7138
Indianapolis, IN 46207-7138
| Richard K. Baer, MD, Senior Medical Director
State(s) Covered: OH | Noridian Administrative Services (00323, FI)
| State(s) Covered: UT | Noridian Administrative Services, LLC (00325, FI)
901 40th Street South, Suite 1
PO Box 6722
Fargo, ND 58103
| Bernice Hecker, MD, MHA, FACC
State(s) Covered: ID, OR | Noridian Administrative Services, LLC (00322, FI)
901 40th Street South, Suite 1
PO Box 6722
Fargo, ND 58103
| Bernice Hecker, MD, MHA, FACC
State(s) Covered: AK, WA | Noridian Administrative Services, LLC (00320, FI)
901 40th Street South, Suite 1
PO Box 6722
Fargo, ND 58103
| Bernice Hecker, MD, MHA, FACC
State(s) Covered: MN | Palmetto GBA (00380, FI)
PO Box 100238
Columbia,, SC 29202-3228
| Stacey Brennan, MD
State(s) Covered: SC | Palmetto GBA (00382, FI)
PO Box 100238
Columbia, SC 29202-3228
| Stacey Brennan, MD
State(s) Covered: NC | Pinnacle Business Solutions, Inc. - Arkansas (00020, FI)
P.O. Box 1418
Little Rock, AR 72203
| Sidney P. Hayes, M.D., Contractor Medical Director
State(s) Covered: AR | Pinnacle Business Solutions, Inc. - Rhode Island (00021, FI)
P.O. Box 3470
Little Rock, AR 72203
| Sidney P. Hayes, M.D., Contractor Medical Director
State(s) Covered: RI | Premera Blue Cross (00430, FI)
| State(s) Covered: AK, MS, MO, TX, WA, WY | TrailBlazer Health Enterprises, LLC (00400, FI)
Medical Directors, Executive Center III
8330 LBJ Freeway
Dallas, AK 75243
| State(s) Covered: CO, NM, TX | TriSpan Health Services (00242, FI)
| State(s) Covered: MO | TriSpan Health Services (00230, FI)
3545 Lakeland Drive
Flowood, MS 39232
| Barry L. Whites, MD, FCCP, MSHA
State(s) Covered: LA, MS | Wheatlands Administrative Services, Inc. (00150, FI)
| State(s) Covered: KS | Wisconsin Physicians Service Insurance Corporation (52280, FI)
3333 Farnum
Omaha, NE 68131
| Olatokunbo Awodele, M.D, M.P.H., Contractor Medical Director
State(s) Covered: AL, AK, AS, AZ, AR, CA, CO, CT, DE, DC, FL, GA, GU, HI, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NC, ND, CNMI, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VI, VA, WA, WV, WI, WY |
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