Pharmacy TPL Codes

Carrier Codes Numeric-Magellan CARRIER CARRIER NUM CARRIER CARRIER TPL NAME CARRIER ADDRESS LINE CARRIER CITY CARRIER ZIP CARRIER PHONE NO CODE CROSSWALK STATE 100 90303 AETNA US HEALTHCARE PO BOX 14079 LEXINGTON KY 40512 8003334432 101 90304 INTERNATIONAL CLAIMS SERVICES 27092 BURBANK ST FOOTHILL RANCH CA 92610 8779167920 102 90305 103 90306 UNITED CLAIMS SOLUTIONS 10835 N. 25TH AVE. 105 PHOENIX AZ 85029 8667448482 104 90307 KAISER FOUNDATION HEALTH PLAN OF SOUTHERN CA. P.O. BOX 7004 DOWNEY CA 90242 8003903510 105 90308 ATHENE ANNUITY AND LIFE ASSURANCE COMPANY POST OFFICE BOX 19038 GREENVILLE SC 29602 8646091000 106 90309 AMERICAN FIDELITY ASSURANCE BENEFITS POST OFFICE BOX 25160 OKLAHOMA CITY OK 731250160 8006548489 107 90310 MUTUAL OF OMAHA MUTUAL OF OMAHA PLAZA OMAHA NE 68175 8002289090 108 90311 METROPOLITAN LIFE INSURANCE COMPANY P.O. BOX 981282 EL PASO TX 79998 8006386626 109 90312 JEFFERSON PILOT INSURANCE COMPANY POST OFFICE BOX 26011 GREENSBORO NC 27420 3366913000 110 90313 AMERIHEALTH HMO, INC. P.O. BOX 41574 PHILADELPHIA PA 191011574 8886323862 111 90315 PRUDENTIAL INSURANCE COMPANY OF AMERICA 841 PRUDENTIAL DRIVE JACKSONVILLE FL 32207 8003463778 112 90316 TRAVELERS INSURANCE COMPANY P O BOX 473500 CHARLOTTE NC 282473500 7045443665 113 90317 UNITED HEALTHCARE PO BOX 740800 ATLANTA GA 303740800 8778423210 114 90318 CLAIMEDIX INC. P.O. BOX 140067 KANSAS CITY MO 64114 8009224262 115 90319 ALLSTATE INSURANCE P.O. BOX 7068 COLUMBIA SC 29202 8003668997 116 90320 WILLIS CORROON ADMINISTRATIVE SERVICES POST OFFICE BOX 305154 NASHVILLE TN 372305154 8002558109 117 90321 HEWITT COLEMAN AND ASSOCIATES P O BOX 6708 GREENVILLE SC 29606 8642405840 118 90322 AMERICAN HEALTH & LIFE INSURANCE 300 ST. PAUL PLACE BALTIMORE MD 21202 3013323000 119 90323 AMERICAN HERITAGE LIFE INSURANCE 1776 AMERICAN HERITAGE LIFE DRIVEJACKSONVILLE FL 32224 8005358086 120 90324 AMERICAN NATIONAL INSURANCE COMPANY P O BOX 1790 GALVESTON TX 77553 8008996803 121 90325 GREATER HEALTHCARE P.O. BOX 3400 MONROE NC 28110 7042258887 122 90326 ATLANTIC COAST LIFE INSURANCE COMPANY PO BOX 20010 CHARLESTON SC 294130010 8437638680 123 90327 BANKERS LIFE & CASUALTY PO BOX 66927 CHICAGO IL 606660927 8006213724 124 90328 UNITED COMMERCIAL TRAVELERS OF AMERICA P.O. BOX 159019 COLUMBUS OH 43215 8008480123 125 90329 AMERICAN TRAVELERS LIFE INSURANCE COMPANY 3220 TILLMAN DRIVE BEN SALEM PA 19020 2152441600 126 90330 HEALTH PLAN SERVICES (COVENTRY HEALTH CARE) P.O. BOX 24146 SEATTLE WA 98124 8008610056 127 90331 BENEFITSOURCE, INC P.O. BOX 240 MONROE MI 48161 8004231028 128 90332 CAPITOL LIFE INSURANCE COMPANY P.O. BXO 1200 DENVER CO 80201 8005252115 129 90333 INTERGROUP SERVICES CORPORATION 101 LINDENWOOD DR, STE 150 MALVERN PA 19355 8005379389 130 90334 EMPLOYERS LIFE INSURANCE COMPANY P.O. BOX 6305 SPARTANBURG SC 29304 8889628437 131 90335 USI POST OFFICE BOX 9888 SAVANNAH GA 31412 9126911551 132 90336 COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY POST OFFICE BOX 1365 COLUMBIA SC 29202 8037987000 133 90337 COMBINED INSURANCE COMPANY OF AMERICA PO BOX 6700 SCRANTON PA 18505 8002254500 134 90338 CIGNA P.O. BOX 182223 CHATTANOOGA TN 374227223 8008824462 135 90339 ALLIED NATIONAL, INC. P.O. BOX 419233 KANSAS CITY MO 641416233 8008257531 136 90340 CIGNA FLEXCARE P.O. BOX 30575 CHARLOTTE NC 282303211 137 90341 EDUCATORS MUTUAL LIFE INSURANCE COMPANY POST OFFICE BOX 3149 LANCASTER PA 17601 7173972751 138 90342 LIFEWELL HEALTH PLANS PO BOX 16203 LUBBOCK TX 79490 8775433935 139 90343 FISERV HEALTH P. O. BOX 30541 SALT LAKE CITY UT 841300541 8008269781 140 90344 STERLING OPTION I (PFFS) P.O. BOX 5348 BELLINGHAM WA 982270010 141 90345 NEOA HEALTH BENEFITS FUND 428 E SCOTT AVENUE - P O BOX 3070KNOXVILLE TN 37927 - 142 90346 SC DEPT OF DISABILITIES AND SPECIAL NEEDS P.O. BOX 4706 COLUMBIA SC 29240 8038989795 143 90347 UMR P.O. BOX 30541 SALT LAKE CITY UT 841300541 8008269781 144 90348 GLOBE LIFE & ACCIDENT INSURANCE 204 N. ROBINSON OKLAHOMA CITY OK 73102 9725406542 145 90349 GMP EMPLOYERS RETIREE TRUST 5245 BIG PINE WAY SE FORT MYERS FL 33907 9419366242 146 90350 HARTFORD INSURANCE GROUP P O BOX 25600 CHARLOTTE NC 28212 7045366230 147 90351 STATE MUTUAL INSURANCE P.O. BOX 10811 CLEARWATER FL 337578811 8887806388 148 90352 TRANSAMERICA PREMIER LIFE INSURANCE COMPANY POST OFFICE BOX 742502 CINCINNATI OH 45274 8004445431 149 90353 INSURANCE COMPANY OF NORTH AMERICA (INA) 195 BROADWAY 11TH FLOOR NEW YORK NY 100073100 2126184000 150 90354 AMERICAN GENERAL LIFE AND ACCIDENT INS CO P.O. BOX 1500 NASHVILLE TN 372021500 8008882452 151 90355 CARELINK P.O. BOX 7373 LONDON KY 40742 8003482922 152 90356 MEDICA P.O. BOX 30990 SALT LAKE CITY UT 84130 8009523455 153 90357 KANAWHA LIFE INSURANCE COMPANY POST OFFICE BOX 6000 LANCASTER SC 29721 8032862440 154 90358 CONSUMER DRIVEN BENEFITS ASSO. P.O. BOX 6080-228 MISSION VIEIO CA 926906080 8884114208 155 90359 CROSSAMERICA HEALTH PLAN P.O. BOX 5778 PARSIPPANY NJ 07054 8663027332 156 90360 LIFE INSURANCE COMPANY OF GEORGIA POST OFFICE BOX 105006 ATLANTA GA 303485006 7709805100 157 90361 LIFE INSURANCE COMPANY OF VIRGINIA, THE P O BOX 27601 RICHMOND VA 23230 8042816000 158 90362 LINCOLN NATIONAL LIFE INSURANCE COMPANY P O BOX 614008 ORLANDO FL 32861 8004232765 159 90363 MAKSIN MANAGMENT CORP CN98000 PENNSAUKEN NJ 08110 8002570625 160 90364 UNI-CARE HEALTH AND LIFE INSURANCE CO P.O. BOX 4458 CHICAGO IL 606804458 8772179677 161 90365 AMA INSURANCE AGNECY, INC. 200 N. LASALLE ST. SUITE 400 CHICAGO IL 606819785 8004585736 162 90366 HARVARD PILGRIM HEALTHCARE P.O.BOX 656653 SAN ANTONIO TX 82655 8004213550 163 90367 NATIONWIDE LIFE INSURANCE COMPANY POST OFFICE BOX 182202 COLUMBUS OH 432182202 6142497111 164 90368 AMERICAN PROGRESSIVE INSURANCE P.O. BOX 130 PENSACOLA FL 325910130 8006268913 165 90369 NEW YORK LIFE INSURANCE COMPANY POST OFFICE BOX 105095 ATLANTA GA 30348 8003884580 166 90370 CAPITOL AMERICAN LIFE INSURANCE COMPANY P.O. BOX 94953 CLEVELAND OH 441014953 2166966400 167 90371 AMERICAN INTERNATIONAL GROUP (AIG) ACCIDENT P.O. BOX 26050 OVERLAND PARK KS 66225 8887221668 168 90372 PRECISE BENEFIT ADMINISTRATORS P.O. BOX 9064 JERICHO NY 11753 5163906000 169 90373 CROWN CORK & SEAL COMPANY, INC. 930 BEAUMONT AVENUE SPARTANBURG SC 29303 8645856456 170 90374 OCCIDENTAL LIFE INSURANCE COMPANY OF NC PO BOX 10324 RALEIGH NC 27605 9198318189 171 90375 AON POST OFFICE BOX 66 WINSTON SALEM NC 27102 8003683804 172 90376 PAUL REVERE LIFE INSURANCE COMPANY P.O. BOX 15118 WORCESTER MA 016150118 5087994441 173 90377 PENNSYLVANIA LIFE INSURANCE COMPANY P.O. BOX 130 PENSACOLA FL 325910100 8002757366 174 90378 NMU PENSION & WELFARE FUND 360 WEST 31ST STREET, 3RD FL NEW YORK NY 10001 2123374900 175 90379 COLUMBIA UNIVERSAL LIFE INSURANCE CO. POST OFFICE BOX 200225 AUSTIN TX 787200225 5123453200 176 90380 GUIDESTAR HEALTH SYSTEMS P.O. BOX 35238 BIRMINGHAM AL 35238 8005956949 177 90381 CINERGY HEALTH PREFERRED PLAN 144 N BEVERWYCK RD #332 LAKE HIAWATHA NJ 080341997 8008471148 178 91191 INSURANCE & BENEFIT ADVOCATE, INC. 5838 W BRICK RD SUITE 106 SOUTH BEND IN 46628 8662006700 179 90382 DESERET MUTUAL BENEFIT ADMINISTRATOR P O BOX 45530 SALT LAKE CITY UT 84145 8007773622 180 90383 ESIS P O BOX 31122 TAMPA FL 33631 8008847975 181 90384 GROUP ADMINISTRATORS,LTD. 450 E. REMINGTON RD. SCHAUMBURG IL 60173 8475191880 182 90385 PENN TREATY NETWORK AMERICA INS. CO. P.O. BOX 7066 ALLENTOWN PA 181057066 8003620700 183 90386 GILSBAR INSURANCE COMPANY P O BOX 2947 COVINGTON LA 70434 8002342643 184 90387 SECURITY LIFE INSURANCE CO. OF AMERICA POST OFFICE BOX 82520 LINCOLN NE 68501 8003009566 185 90388 S&S HEALTHCARE STRATEGIES P.O. BOX 46511 CINCINNATI OH 45216 8888008717 186 90389 SOUTHLAND LIFE INSURANCE COMPANY POST OFFICE BOX 105006 ATLANTA GA 303485006 7709805100 187 90390 RELIANCE STANDARD LIFE INS. CO. P.O. BOX 82510 LINCOLN NE 68501 8004977044 188 90391 STANDARD LIFE & CASUALTY INSURANCE COMPANY POST OFFICE DRAWER 1514 FORT MILL SC 29716 8035483657 189 90392 INTERNATIONAL EDUCATION EXCHANGE SERVICES P.O. BOX 370 ITHACA NY 148510307 8664337462 190 90393 BOILERMAKERS NATIONAL HEALTH & WELFARE FUND 754 MINNESOTA AVENUE, SUITE 522KANSAS CITY KS 661012762 9133426555 191 90394 COVENTRY HEALTHCARE OF DELAWARE, INC. P O BOX 7713 LONDON KY 40742 8008337423 192 90395 CONVENTRY HEALTHCARE OF NEBRASKA, INC. P O BOX 7705 LONDON KY 40742 8002883343 193 90396 ALLSTATE WORKPLACE DIVISION P.O.BOX 853916 RICHARDSON TX 750853916 8009377039 194 90397 DAKOTACARE PO BOX 7406 SIOUX FALLS SD 571177406 8003255598 195 90398 UNION BANKERS INSURANCE COMPANY POST OFFICE BOX 655433 DALLAS TX 752655433 2149547840 196 90399 UNITED BENEFIT LIFE INSURANCE 3909 HULEN ST FT. WORTH TX 76107 8007320657 197 90400 RELIANCE STANDARD SPECIALTY PRODUCTS ADM 505 S LENOLA RD, SUITE 231 MOORESTOWN NJ 08057 8663750775 198 90401 UNIVERSAL FIDELITY LIFE INS. CO. P.O. BOX 1428 DUNCAN OK 735344 8003668355 199 90402 ALL OTHER CARRIERS ---- 200 90403 ALL AMERICAN LIFE INSURANCE CO. 8501 WEST HIGGINS ROAD CHICAGO IL 60631 7733996645 201 90404 HCH ADMINISTRATORS P.O. BOX 1986 PEORIA IL 61656 8003221516 202 90405 JOHN HANCOCK INSURANCE COMPANY P.O. BOX 852 BOSTON MA 02117 8002331449 203 90406 HEALTH CARE SUPPORT/PRIVATE HEALTH CARE SYSTEM 29 COLUMBIA HEIGHTS BROOKLYN NY 11201 8005544022 204 90407 SELF INSURED BENEFIT ADMINISTRATORS 18167 US HWY 19N CLEARWATER FL 33764 7275320400 205 90408 FIDELITY LIFE SECURITY 3130 BROADWAY KANSAS CITY MO 641112406 8006488624 206 90409 MED COST BENEFITS SERVICES P.O. BOX 25307 WINSTON SALEM NC 271145307 8007951023 207 90410 MEDICAL SAVINGS HEALTH PLAN 419 E. MAIN ST MIDDLETON NY 10940 3173298222 208 90411 SIEBA, LTD P.O. BOX 5000 ENDICOTT NY 13761 8002524624 209 90412 SUMMIT AMERICA INSURANCE SERVICES P.O. BOX 25936 OVERLAND PARK KS 662255936 8772466997 210 90413 AMERITAS LIFE INSURANCE P O BOX 82520 LINCOLN NE 68501 8002559678 211 90414 COORDINATED BENEFIT PLANS INC. P O BOX 853925 RICHARDSON TX 750853925 8007531000 212 90415 TRUSTMARK INSURANCE CO. P.O. BOX 2942 CLINTON IA 52733 8476151500 213 90416 COVENANT ADMINISTRATORS P.O.

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