Bin 003585 pbm November 1, 2023 . AmericasPharmacy. Superior members have been notified and received a new ID card, effective January 1, 2024, in advance of this change. Skip the trip to the pharmacy—we’ll mail Jan 2, 2020 · The new PBM will honor existing prescriptions approved by the member’s 2019 CCO. ” Healthy Kids, Healthy Families Program, IHSS and Medicare members refer to www. RX BIN 003585 RX PCN ASPROD1 RX Group PHI09 Person Code Required Incumbent Processor Caremark Sample ID Card(s) Attached Retail Max Day Supply: 34 Mail Order Max Day Supply: 90 Choice90 Max Day Supply: 90 Member Reimbursement MedImpact Plan Does Not Apply Prior Authorizations MedImpact Plan Does Not Apply Date of Birth Rx Processor Control # (PCN): 70000 Rx Bin #003585. azahcccs. Rx BIN: 003585 PCN: 56805 Eligibility: 866-522-2736 Prior Auth: 888-648-6765 Telephonic Interpreter Service Pharmacist: 888-942-7670 Doctor: 888-930-3031 Medicare Advantage HMO SNP PASC SEIU Homecare Workers Health Care Plan for In-Home Supportive Services (IHSS) Workers PBM-Express Scripts: Kaiser 800-227-3032 Member ID: Member ID: CIN# Jan 1, 2018 · 1Ø1-A1 BIN Number See BIN/PCN table, above M 1Ø2-A2 Version Release Number DØ=Version D. com! To submit claims via point of service to CalOptima Health’s OneCare Plans and Medi-Cal Rx. 855-873-8739; Main navigation. REGION RX BIN RX PCN RX GROUP TAX ID COB ADDRESS CCHP Health Plan ALL REGIONS 003585 ASPROD1 SFC02 94-3021419 455 Grant Ave, Suite 700 San Francisco, CA 94108 CIGNA + OSCAR – Small Group REGION RX BIN RX PCN RX GROUP TAX ID COB ADDRESS Cigna + Oscar ALL REGIONS 003858 A4 CIOSCRX 59-1031071 Cigna, c/o Oscar Filling your prescription needs Kaiser Permanente Insurance Company (KPIC) member: With your Kaiser Permanente Point of Service (POS), Preferred Provider Organization (PPO), or Out-of-Area Pharmacy Help Desk : 866-684-4466 Express Scripts is pleased to announce that effective June 1, 2004, we will begin processing prescriptions for the Department of Defense (DoD) TRICARE Retail SOUTH CAROLINA MEDICAID 5. M D RX V. Plan PBM Phone BIN PCN Group OHA (Fee-for-Service or “Open Card”) 888-202-2126 014203 ORDHSFFS Advanced Health 800-788-2949 003585 38900 AllCare 800 -788 2949 003585 38060 Cascade Health Alliance 800-788-2949 003585 38960 Columbia Pacific CCO 866-843-5126 610011 IRX CORMCAID Eastern Oregon CCO Aug 1, 2020 · The chart below is the first page of the 2021 Medicare Part D pharmacy BIN and PCN list covering prescription drug plans from contracts E0654 through H2235. 1–New Format BIN: 003585 PCN: 93340 • HEAT # 33369: MEDIMPACT34086 5. Added special coding for field 308. I f you select a Kaiser or HMSA, your medical and prescription benefits will be provided by that plan. This information is vital for ensuring that claims are routed to the correct entity, minimizing errors and expediting the claims process. Title: KPIC POS MedImpact Pharmacy Flyer Note: Below are the BIN/PCN combinations used for adjudication: BIN PCN Client 4ØØØ23 ØØ2ØØ5Ø4Ø3 HIP Medicare Part D Ø118ØØ ØØ2ØØ5Ø4Ø3 1199 SEIU Ø13337 ØØ2ØØ8Ø229 Connecticare (CCI) Medicare Part D Ø13344 ØØ2ØØ8Ø229 GHI Medicare Part D Insurance Segment - Mandatory Field # NCPDP Field Name Value Payer Usage Benefit identification number (BIN): 003585. And if you’ve been considering making Altrua HealthShare your affordable, top-quality healthcare option, Manifest Rx is one more reason to sign up today! The PBM information may also be listed on the members’ ID cards: Newly enrolling HIP and Hoosier Care Connect members will be issued cards by the enrolling MCEs, which will include plan-specific PBM information. 0 M 1Ø3-A3 Transaction Code B1=Billing M 1Ø4-A4 Processor Control Number As indicated above 1=One Occurrence 2=Two Occurrences 3=Three Occurrences M 1Ø9-A9 Transaction Count Find your plan's BINs, PCNs, and RxGroups! If there is a Part D BIN/PCN/Group missing that you would like us to add, please shoot us an email at support@amplicare. Bin List /BIN: Specify a Bin: Allows you to specify an individual bin number instead of a bin group. 2-1919 / Fax: (559) 724-4332 Benefits: HRBenefits@communitymedical. This card is for identification only. Jul 31, 2019 · The chart below is the first page of the 2020 Medicare Part D pharmacy BIN and PCN list covering prescription drug plans from contracts E0654 through H2334. 7 %âãÏÓ 1 0 obj > endobj 2 0 obj > endobj 3 0 obj > endobj 4 0 obj > endobj 5 0 obj > endobj 6 0 obj > endobj 7 0 obj > endobj 8 0 obj > endobj 9 0 obj ECKERD HEALTH SYSTEMS 5. ly/MedImpactBCBS_2024 Preview for UHC: bit. express-scripts. ManifestRx. Blue Cross Blue Shield South Carolina BIN: 021692 PCN: CTRXMEDD PCN: MPPP Blue Cross Blue Shield Michigan -SHS -MA Only Plan BIN: 262400 PCN: RXBCMA Blue Cross Blue Shield Michigan -Emergient -MA Only Plan BIN: 220026 PCN: EMRXMA Ultimate Health Plans BIN: 004758 PCN: DNPS UHC Government Programs BIN: 610494 PCN: 2222 BIN_PCN BIN_PCN E0654 IBT VOLUNTARY EMPLOYEE BENEFITS TRUST 801 IBT Voluntary Employee Benefits Trust (Employer PDP) 610097 9999 TEAMStar Medicare Part D Prescription Drug Program 802 803 E2630 C AND O EMPLOYEES' HOSPITAL ASSOCIATION C and O Employees Hospital Association (Employer PDP) C and O Employees Hospital Association E3014 PSERS HOP PROGRAM Jan 1, 2021 · BIN and PCN Codes. Anthem Blue Cross Rx BIN: 020099 PCN: IS Blue Shield of California Rx BIN: 004336 PCN: 77993333 CCHP Health Plan RX BIN: 003585 RX PCN: ASPROD1 Cigna + Oscar RX BIN: 003858 PCN: A4 Health Net* Rx BIN: 004336 PCN: HNET Kaiser Permanente-Northern CA HMO: Rx BIN: 3585 Rx Group: Not Required Tax ID: 94-1340523 Medicare Part D: Rx BIN: 11842 Rx medimpact pharmacy: 888-648-6769 | rx bin: 003585 | rx pcn: 28914 Preview for BCBS: bit. PCN: Sample ID Card If you need a member’s specific prescription processing information or other help with a claim, please visit our Pharmacist Resource Center at https://prc. RX Group:10008217. 1–New Format BIN: 003585 PCN: 34086 003585, 005500, 005518, 006053, 010439, 013105, pbm/ plan bin pcn; help desk restat 610171 7777 1-800-248-1062 savrx 006558, 008563, 012684 n/a 1-402-753-2800 THE FOLLOWING REQUIRE PRIOR AUTHORIZATION: CASE MANAGEMENT AND PRIOR AUTHORIZATION FOR YOUR PPO PLUS® PATIENTS Utilization and case management: These services for members accessing care outside Kaiser Permanente are BIN: 003585; PCN: 78495; GROUP: ARX22002; MEMBER ID: Your Altrua HealthShare Member ID; Web: Altrua. The BIN is used to identify which PBM is processing the claim, while the PCN is used to identify the commercial or benefit plan the member is enrolled in. RX PCN:38600. PHARMACY PROVIDER MANUAL . Have a mySaintLuke's account? Use your mySaintLuke's credentials to schedule this appointment for yourself or someone you have access to. kp. 1Ø1-A1 BIN Number See BIN/PCN table, above M 1Ø2-A2 Version Release Number DØ=Version D. 1, Bin# 003858, PCN: A4 The chart below is the second page of the 2021 Medicare Part D pharmacy BIN and PCN list covering prescription drug plans from contracts H2237 through H3959. Human Resources, Benefits & Retirement Department (559) 459-1919 or ext. org to view formulary coverage. 1 format. umr. a Dental Premier Medical Plan: PPO Network: ODS For out-of-area participating medical providers when traveling or attending school, call PHCS at 800-661-7449 Pharmacy administered by MedImpact. gov Payer Sheets. BIN: 011222 PCN: GACMS BIN: 011214 PCN: HICMS BIN: 011859 PCN: MACMS MACMSA BIN: 011842 PCN: NCCMS BIN: 011230 PCN: NWCMS BIN: 011172 PCN: SCCMS Health Choice Management BIN: 610011 PCN: HEAMEDD Health Choice Management Utah BIN: 610011 PCN: HEAUMEDD Catamaran / Seniorscript Services BIN: 013170 PCN: Not Required MedImpact’s clinical solutions help providers prescribe the right medication for the member at the lowest possible cost. Contact us. The TRICARE pharmacy group number is DODA. Rx BIN: 003585 Rx PCN: ASPROD1 Rx Group: HTH ID number – the pharmacy will need to submit the NEW ID number for 2022 Customer Service/Pharmacy Help Desk: 888-807-7655 Commercial - Small Group/Large Group – HometownRx powered by Maxor Rx BIN: 019059 Rx PCN: 07570000 Rx Group: HTH (800) 788-2949 74000 003585 MedImpact will provide plan profile sheet to all their network pharmacies Fidelis Care (888) 343-3547 CVS Caremark (800) 364-6331 ADV 004336 Various Groups: (Refer to ID card) RX6460, RX6461, RX6462, RX6465, RX6466 Healthfirst (866) 463-6743 Express Scripts (800) 824-0898 A4 003858 Group: HEFA April 5, 2012 Addition of Bin number 808412 April 18, 2012 Addition of Bin number 900020 August 23, 2012 Addition of Bin numbers: 610280, 016516, 016508, 015517 Removed references to 5. pharmacies. Reactivated and updated format . Y N Y MedImpact* Y. Rx BIN: 015574 Rx PCN: ASPROD1 Rx Group: HTH05 ID number – the pharmacy will need to submit the NEW ID number for 2022 Customer Service/Pharmacy Help Desk: 800-681-9585 Marketplace - Individual and Family Plans – HometownRx powered by MedImpact Rx BIN: 003585 Rx PCN: ASPROD1 Rx Group: HTH changes to the PBM vendors will take effect January 1, 2017. Added special coding for field 466 to send the physicians DEA# PCS 5. Apr 1, 2021 · AHCCCS Health Plans BIN PCN Group Number PBM AHCCCS Fee-For-Service 001553 AZM OptumRx AHCCCS FFS – Secondary to Banner University Family Care 003585 ASPROD1 Benefit identification number (BIN): 003585 Processor control number (PCN): 70000 Save time and gas money: have most prescriptions mailed to you When you fill any of your prescriptions at a Kaiser Permanente pharmacy, you have the added convenience of refilling most of those prescriptions online. Your plan’s network includes over 67,000 pharmacies nationwide, with two levels of coverage: Level 1: Your plan’s network has nearly 26,000 preferred pharmacies, including chains like CVS, Target, Kroger, Walmart, Albertson’s, Strategic Health Alliance, Giant Eagle, and Costco. We’re always looking for ways to make the lives of members easier when it comes to their pharmacy benefits and medications. Type of GHP: W CareFirst BCBS PPO claims address: P. The Louisiana Department of Health protects and promotes health and ensures access to medical, preventive and rehabilitative services for all citizens of the State of Louisiana. Prescriptions are sent electronically via a computer system. 1–New Format BIN: 003585 PCN: 74004 • HEAT #27931: MEDIMPACT74250 PARD 5. org Dec 24, 2022 · Chart of 2023 BIN and PCN values for each Medicare Part D prescription drug plan Part 4 of 6 (H5372 through H7220) A non-government resource for the Medicare community Powered by Q 1 Group LLC Beneit identiication number (BIN): 003585 Processor control number (PCN): 70000 . %PDF-1. The card images seen here are representations. If Commercial claims are submitted for groups that have transitioned with the old BIN or PCN, claims will reject with NCPDP Reject Code 01 (M/I BIN) and 04 (M/I Processor Control Number). 0 M 1Ø3-A3 Transaction Code B1=Billing M 1Ø4-A4 Processor Control Number As indicated above M 1Ø9-A9 Transaction Count 1=One Occurrence 2=Two Occurrences . 10003948 RX BIN:003585. 2345678. org. 553256778 October 2020. PBM information for Catamaran applies for all IHCP members other than HIP and Hoosier Care Connect. Each insurance carrier uses one PBM for claims processing, however more than one carrier may use the same PBM. SUBSCRIBER SAMPLE. org Region. BIN Checker tool is designed to check the existence of a Bank Identification Number (BIN) base on updated database. It includes over 20 PBMs, such as CVS Caremark, Express Scripts, OptumRx, Prime Therapeutics, and others. Confidentiality Requirements Rx Bin: 003585. New Hire Enrollment; Forms & Guides; Aug 10, 2022 · The PCN (Processor Control Number) identifies each health plan’s drug benefit processor or Pharmacy Benefit Manager (PBM). 3=Three Occurrences Inventory List 5/12/2015 NYS Medicaid Managed Care Plan Contact and Billing Information 2015 Managed Care Plan Oct 8, 2024 · The TRICARE pharmacy BIN is 003858. Use this card for discounts of up to 80% on most prescription drugs at over 70,000 U. Please ensure this update is noted for your practice and staff. Changed reversal format to Claim Reversal 5. AHCCCS FFS 001553 AZM OptumRx 855-577-6310 Banner University Family Care 003585 ASPROD1 UOA01 MedImpact 800-788-2949. Find in-network pharmacies, prescription refill services and more. 1, Bin# 005526, PCN: MEPOP . com. Precertification is required for all hospital admissions and/or outpatient surgeries. To submit claims via point of service to CalOptima Health’s OneCare Plans and Medi-Cal Rx. What is a prescription rx bin The Rx BIN number is a 6-digit number health plans use to process electronic pharmacy claims. Point-of-Service Plan. Dec 23, 2011 · RX bin 020123 MH/SA EAP, U/M BHO 800-280-3782 Rx PCN IRXCOMM MH/SA U/M SHO 800-873-2246 Rx GRP RX42AJ City of North Las Vegas UMR Sierra Health-Care Options12 months Ameritas OptumRX 877-599-2955 Inside Las Vegas 702-242-7840 Inside Las Vegas PO BOX 30541 UHC Choice Plus - outside of Las Vegas, out of network Jan 1, 2022 · For other pharmacy news, please visit the AHCCCS Pharmacy Information section on the AHCCCS website at www. OptumRx will continue to be the PBM for all fee-for-service programs. OneCare Complete Covered Part D Medications BIN: 015574 PCN: ASPROD1 Group #: CAT04 OneCare Flex Plus Covered Part D Medications BIN: 015574 PCN: ASPROD1 Group #: CAT07 Medi-Cal Rx Excluded Part D Medications BIN: 022659 PCN: 6334225 Group Number: MediCalRx Learn about pharmacy benefits with your HealthPartners health insurance plan, including drug lists (formularies), pharmacy networks, resources and more. com Phone: 888-770-4009 Email: AltruaMember@ManifestRx. OPTUMRX. VA E-PHARMACY 5. Have them call the phone number on the back of their ID card. Carrier # 38600 MedImpact BIN # 003585 Feb 11, 2021 · The BIN/IIN is a field in the Telecommunication Standard that is used for the routing and identification in pharmacy claims. Unmask and Connect the payer information hidden in your datasets. 342-HC OTHER PAYER AMOUNT • BIN#400004 for NDC • BIN#002156 for MedE America • Group number (required if it appears on the card) • Cardholder ID number (should match the card) • ValueRx plan input code • BIN#610041 Dec 16, 2021 · PCC Plan PBM BIN PCN Group Pharmacy Help Desk Primary Care Clinician (PCC) Plan Conduent 009555 MASSPROD MassHealth (866) 246-8503 (Conduent/POPS) (800) 745-7318 (DUR) SCO Plan- Medicaid Only PBM BIN PCN Group Pharmacy Help Desk Commonwealth Care Alliance Navitus 610602 MCD MHO (877) 908-6023 Senior Whole Health CVS Caremark BIN PCN Abarca Health Help Desk; Commercial : 026696: 77993333 (800) 375-7948: Medicare: 026696: 77993322 (800) 375-7924: Get pharmacy information for Blue Shield of The document provides a list of contracted PBMs (pharmacy benefit managers), their contracted lines of business, BIN/PCN numbers, and help desk contact information. A. Chesapeake Health MedImpact National 003585 48110 800/788-2949 Child Health Plus (Health Plus of NY) MedImpact NY 003585 58005 800/788-2949 Choice90- 90 day Maint Plan MedImpact National 003585 Call h/desk 800/788-2949 Cigna Healthcare Argus CA,IL,TX 600428 00600000 800/522-7487 CA , IL and TX area must call for contract 860-226-8072 Point of sale and Pharmacy Benefit Manager (PBM) information Plan PBM Phone BIN PCN Group OHA (Fee -for-Service or “Open Card”) 888-202-2126 014203 ORDHSFFS Advanced Health 800-788-2949 003585 38900 AllCare 800-788-2949 003585 38060 Cascade Health Alliance 800-788-2949 003585 38960 BIN: PCN: Group Number PBM: Phone Number. Receive C ennCare Oversight ivision October 2 2023 The BIN number indicates which PBM a pharmacist sends your prescription claim to. Rx Processor Control # (PCN): 70000 Rx Bin #003585. (800) 788-2949 74000 003585 MedImpact will provide plan profile sheet to all their network pharmacies Fidelis Care (888) 343-3547 CVS Caremark (800) 364-6331 ADV 004336 Various Groups: (Refer to ID card) RX6460, RX6461, RX6462, RX6465, RX6466 Healthfirst (866) 463-6743 Express Scripts (800) 824-0898 A4 003858 Group: HEFA 20201020T01 Sh: 0 Bin 2 J126 Env [8] CSets 1 of 2 20201020T01 Sh: 0 Bin 2 J126 Env [8] CSets 1 of 2. gov 801 East Jefferson, Phoenix, AZ 85034 • PO Box 25520, Phoenix, AZ 85002 • 602-417-4000 • www. Please do not turn the customer away if you receive a rejected claim. Our pharmacy program includes medication pre-authorization requirements, a pharmacy benefits manager, resources and claims submission information. For assistance with registration, login, username, and password reset, please contact Customer Support at (877) 403-6032 between the hours of 5am and 5pm Pacific Time. PBM BINs Help Desk 4D Management Systems, Inc. Box 14115 Lexington, KY 40512-4115 Rx Information: ARGUS 1-800-241-3371 . Members’ actual cards may differ upon receipt. Note: Providers are reminded that OptumRx will manage pharmacy claims for hepatitis C drugs for all IHCP members; see IHCP Bulletin BT201644. Click here for the second page (H2354 - H4093) , third page (H4094 - H6293) , fourth page (H6306 - H9431) and fifth page (H9438 - S9701) . Our goal is to make it as easy as possible for you by working with your health plan and pharmacy to provide timely and essential information about your medicine, including how to take it correctly, potential side effects, any lower-cost drug options, and more. This card does not entitle the holder to RX BIN 003585 RX PCN ASPROD1 RX Group MFP01 ID Number Format 8-digit numeric Person Code Not Required Are ID numbers changing? No Incumbent Processor Optum Rx Sample ID Card(s) Attached Retail Max Day Supply: 83 Mail Order Max Day Supply: 90 Choice90 Max Day Supply: 90 Member Reimbursement MedImpact Plan Does Not Apply Prior Authorizations DIVISION OF TENNCARE . 1, Bin# 610415, PCN: NONE . Click here for the second page (H2237 - H3959) , third page (H3962 - H5928) , fourth page (H5928 - H8634) and fifth page (H8634 - S9701) . Group Name: ID NO. Access payer sheets for data requirements related to electronic claims processing for each line of business within Optum. 009265, 610198, 012965 800-837-0581 Applied Underwriters, Inc 13329 877-234-4420 Argus Health Systems 012353, 600428, 011834, 610245, 610141, 015292, 610225 800-522-7487 Atlantic Prescription Services 610704 877-277-7934 AutoRx 610133 866-428-8679 BioScrip 900014 AHCCCS Health Plans BIN PCN Group Number PBM Phone Number AHCCCS FFS 001553 AZM OptumRx 855-577-6310 AHCCCS FFS – Secondary to Commercial 001553 AZM OptumRx 855-577-6310 AHCCCS FFS – Dual Eligibles for Covered OTC Prescriptions 001553 AZM OptumRx 855-577-6310 United Healthcare Community Plan (Acute, CRS, DD, LTC) 610494 4100 ACUAZ OptumRx Rx BIN: 003585 Urgent Care: $5 Drug carve-out list for L. 003585 78470 ARX0302 www. Please recycle. RX PCN: 70000 Health Plans Prior to January 1, 2010 CareFirst Health Plan Information: The TIN for all CareFirst Health plans is: 52-1385894 CareFirst BCBS PPO Group ID Number: 1900194 . 00. OneCare Complete Covered Part D Medications BIN: 015574 PCN: ASPROD1 Group #: CAT04 OneCare Flex Plus Covered Part D Medications BIN: 015574 PCN: ASPROD1 Group #: CAT07 Medi-Cal Rx Excluded Part D Medications BIN: 022659 PCN: 6334225 Group Number: MediCalRx. Group No. Care Medi-Cal members only: The drugs listed should be submitted to Medi-Cal Fee-For-Service (FFS) and written on “Tamper Resistant Prescription Pads. This card does not certify or guarantee benefits. Added field 430 Gross Amount Due to the Pricing Segment. Do you provide API for developers? Sure, we provide API as service for developers to integrate it with their web apps or any platform they working with. OneCare is responsible for pharmacy management, policy development and overall program administration. PSHVN. 1, Bin# 610474, PCN: TDI . Plan PBM Phone BIN PCN Group OHA (Fee-for-Service or “Open Card”) 888-202-2126 014203 ORDHSFFS Advanced Health 800-788-2949 003585 38900 AllCare 800-788-2949 003585 38060 Cascade Health Alliance 800-788-2949 003585 38960 Columbia Pacific CCO 866-843-5126 610011 IRX CORMCAID Eastern Oregon CCO 339-6C OTHER PAYER ID QUALIFIER 03 = BIN Number R 34Ø-7C OTHER PAYER ID R If no BIN exists due to billing of a non-online payer, please use value 999999 as the BIN of the Other Payer. com Health Services Coalition Hospital Network Mar 7, 2022 · The chart below is the fourth page of the 2022 Medicare Part D pharmacy BIN and PCN list covering prescription drug plans from contracts H5337 through H7322. 1, BIN# 003650, PCN: 64 . Name: First M Last Prefix Medical Record No. Date of Birth. The BIN/IIN field will either be filled with the ISO/IEC 7812 IIN or the NCPDP Processor BIN, depending on which one the health plan has obtained. 600428 800-522-7487 Agelity, Inc. BIN: 600428 PCN: 02550000 • HEAT #27931: MEDIMPACT74004 PARTD 5. Be sure to use this dedicated contact information for State of Arizona employees. ly/MedImpactUHC_2024 Effective January 1, 2024, Express Scripts will serve as Superior HealthPlan’s new Pharmacy Benefit Manager (PBM) and begin processing pharmacy claims. Click here for the first page (E0654 - H2235) , third page (H3962 - H5928) , fourth page (H5928 - H8634) and fifth page (H8634 - S9701) . 84471 December 2012. Plan PBM Phone BIN PCN Group OHA (Fee-for-Service or “Open Card”) 888-202-2126 014203 ORDHSFFS Advanced Health 800-788-2949 003585 38900 AllCare 800-788-2949 003585 38060 Cascade Health Alliance 800-788-2949 003585 38960 Allstate Benefits RX BIN: 017010 (Cigna) PCN: 05190000 (Cigna) Anthem Blue Cross Rx BIN: 020099 PCN: IS Blue Shield of California Rx BIN: 004336 PCN: 77993333 Chinese Community Health Plan RX BIN: 003585 RX PCN: ASPROD1 Cigna + Oscar RX BIN: 003858 PCN: A4 Health Net* Rx BIN: 004336 PCN: HNET Kaiser Permanente-Northern CA Rx BIN: 11842 Rx Group: NC Welcome to BPGLookup, the first syndicated source for BIN PCN Group translation. Click here for the first page (E0654 - H2235) , second page (H2237 - H3959) , third page (H3962 - H5928) and fifth page (H8634 - S9701) . Nov 16, 2023 · Identification of Pharmacy Benefit Manager (PBM): The RxBIN number allows healthcare providers and pharmacies to determine which PBM is responsible for processing prescription claims. /INS: Specify a Name: Allows you to specify an insurance name instead of a bin group. S. That's why we’re excited to announce a new feature in our mobile app that lets members manage their daily medications, set reminders, track adherence, and more. Title: Filling Your Prescription Needs Author: Kaiser Benefit Identification Number (BIN–003585) Processor Control Number (PCN–70000) You will need to provide your doctor’s contact information and the name and dosage of your medication. Rx PCN#: 38600 . Click here for the first page (E0654 - H1997) , second page (H2001 - H3563) , third page (H3572 - H5325) , fifth page (H7323 - H9686) and sixth page (H9699 - S9701) . Please use the following information when submitting claims for Superior HealthPlan Medicaid members. Aug 1, 2020 · The chart below is the fourth page of the 2021 Medicare Part D pharmacy BIN and PCN list covering prescription drug plans from contracts H5928 through H8634. TRICARE EXPRESS SCRIPTS 5. Rx BIN Numbers and PCNs for California Small Group health plans are shown by carrier in the table below. Point-of-Service Plan . 1–New Format BIN: 003585 PCN: 74250 • HEAT #28273: MEDIMPACT93340 5. 1, BIN# 610494, PCN: 9999 . Failure to obtain precertification may result in a reduction of benefits. Leading zeroes in the NCPDP Processor BIN are significant. Modified Trans Count field to ‘1’ MAINE MEDICAID 5. Contact Information Pharmacy Contractor (Express Scripts) 1-877-363-1303 Rx BIN# 003585; Phone: (800) 788-2949; Member website and Retail Pharmacy Locator; MedImpact Direct (Mail Order Pharmacy) Phone: (855) 873-8739; Member website; Request For ID. Dental Benefits the new Member ID Number, Rx Group, BIN, and PCN. Rx Bin: 011834 . RX PCN:38600 Mar 7, 2022 · The chart below is the second page of the 2022 Medicare Part D pharmacy BIN and PCN list covering prescription drug plans from contracts H2001 through H3563. /BINA: AmWINS: 011289, 013492, 013527, 014848, 015178, 015185, 016341 /BINB: Argus Nov 18, 2012 · MedImpact National 003585 Call h/desk 800-788-2949<br /> MedImpact CA 003585 call h/desk 800/788-2949<br /> MedImpact National 003585 Call h/desk 800/788-2949<br /> after [June 1, 2015], use the following BIN/PCN/GroupRx information: Claim Submission Information BIN: 003858 PCN: MA Group: WKEA Member ID Cards Amerigroup members will receive a new ID card to use at participating pharmacies. It contact Kaiser or HMSA please refer to your ID Card and you may click on the link on the upper right side of the page. lacare. PEBB. Members have access to pharmacy benefits and low-cost prescription drug services. O. Title: PRINT & SAVE! Created Date: 5/4/2018 11:12:51 AM PBM HELP DESK# BIN# PC# Innoviant 877-559-2955 610127 Wausau-Q1960000 Medlmpact 800-788-2949 003585 Varies MedTrak 800-771-4648 NDC-800004 008126-NDC Dec 29, 2022 · MCOs** PBM BIN PCN Group Pharmacy Help Desk WellSense Health Plan Express Scripts 003858 MA MAHLTH (877) 401-2069 (ESI) Tufts Health Together OptumRx 610011 IRX RXMCDMA (866) 828-6668 (Optum Rx) PCC Plan PBM BIN PCN Group Pharmacy Help Desk Primary Care Clinician (PCC) Plan Conduent 009555 MASSPROD MassHealth (866) 246-8503 Managed care pharmacy identification In addition to their Minnesota Health Care Programs (MHCP) ID cards, members enrolled in a managed care organization (MCO) also receive ID cards directly from their MCOs. Currently, there are more than +365,460 unique BIN in our database. Added new BIN/PCN combination: BIN 026150 PCN SSRX50 Added new BIN/PCN combination: BIN 027547 PCN SSRX42 *UPDATED* Added new BIN/PCN combination: BIN 027555 PCN SSRX42 *UPDATED* Added new BIN/PCN combination: BIN 027570 PCN SSRX42 *UPDATED* Removed sunset BINs/PCNs Added additional BIN: 026696 RX Bin:003585. Our carriers have dedicated contact numbers and emails staffed by employees with special training in our programs. Locate a pharmacy or use resources in our pain management toolkit. OneCare oversees the PBM’s role in assisting the pharmacy network with claims processing and daily operations. WAC W71. MedImpact is a pharmacy benefit manager who works with your health plan to get you the medication you need. 1 claims since no longer supported Test system is no longer available Rx BIN: 003585 | Rx PCN: 28914; 8 77-391-1103 (TTY dial 711) [email protected] MedImpact Direct Mail. MedImpact BIN # 003585 For additional information logon to myODS. 1, Bin# 610706, PCN: WAPROD. Your Provider Network Your Pharmacy Network. The contact is listed for any questions about the PBM listing. Manager (PBM) to assist in the administration of the OneCare Pharmacy Program. WASHINGTON MEDICAID SXC 5. Copayments TX CHIP only: TX CHIP00 $3 Brand/$0 Generic TXCHIP01 $5 Brand/$0Generic TXCHIP02 $35 Brand/$10 Generic May 24, 2001 · Effective 1/1/2023- UMR Outside Las Vegas 800-873-5791 Salt Lake City, UT 84130-0541 Outside Las Vegas 800-698-4828 Outside Las Vegas 800-698-4828 Rx BIN: 003858 800-884-0793 Fax 702-304-7411 EDI # 39026 Northern Nevada Health Network Rx PCN: A4 www. 443-E8 OTHER PAYER DATE R 341-HB OTHER PAYER AMOUNT PAID COUNT Maximum count of 9 RW Required when OCC = 2 or 4. Processor control number (PCN): 70000. ID NO. FOR TennCare CoverKids CoverRx . 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