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In order to develop the most comprehensive beneficial standards for the healthcare industry we gather input, expertise, advocacy & leadership from our NCPDP members. The benefit information provided is a brief summary, not a complete description of benefits. 0000016527 00000 n endstream endobj startxref 0000002073 00000 n {hBIsS6U6,Q{O|+x`o~{>+W Od^.+mB:rNlHi} *"d\Q*\ZMW% Ffa3Y!G'[71c4)0 0000016122 00000 n Rx Information: MEDCO 1-800-842-2038 . All insurance policies and group benefit plans contain exclusions and limitations. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan. 0000003383 00000 n Share your form with others Send it via email, link, or fax. 0 Your membership is expired. gcse.type = 'text/javascript'; PDF Acute Care Plans - azahcccs.gov endstream endobj 75 0 obj <. Members may enroll in a Medicare Advantage plan only during specific times of the year. <]>> PDF Payer Sheet - WellDyne MCAIDADV RX5443. Your Premera provider network: What's 'in' it for you? Since 8 digit IINs are now being assigned, use the first 6 digits of the IIN as the BIN even if the first digit(s) is a zero. 0000000975 00000 n PCN GROUP : Type Network: Location Help Desk Number: ARGUS 1.1.2015 HealthCare Corp of America /Prescription Corp of America HCA-PCA 340 Basics 600428 06730000 Medicaid: National 1-800-309-1603: ARGUS 1.1.2015 Health Network Dscnt Card 600428: 1HEALTH Commercial: National 1-866-921-7286: ARGUS 1.1.2015 Health Options 600428: 07130000 Commercial . The PCN is defined by the PBM/processor as this identifier is unique to their business needs. 0000028775 00000 n The ISO/IEC 7812 IIN is a number used throughout electronic routing. var gcse = document.createElement('script'); 0000013064 00000 n Edit your form online Type text, add images, blackout confidential details, add comments, highlights and more. Rx PCN: N/A 24 hours a day/7 days a week or consult, When enrolling in a Medicare Advantage plan, you must continue to pay your. 0000004060 00000 n 20200903T55 Sh: 0 Bin 2 J008 Env [1] CSets 1 of 2. 3440 0 obj <>/Filter/FlateDecode/ID[<83A1511E809EEA4884A369FF9F7C8102>]/Index[3424 33]/Info 3423 0 R/Length 84/Prev 249481/Root 3425 0 R/Size 3457/Type/XRef/W[1 2 1]>>stream 0000006077 00000 n 0000008305 00000 n PDF EFFECTIVE 07.27.2015 Subject to Change BIN Type Network - RxHope 0000014626 00000 n %%EOF Medicare has neither reviewed nor endorsed the information on our site. Og%$pB1 o:er1?P_ojKuK3L 9H(! Contact the plan provider for additional information. EmblemHealth (888 . TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. RX Bin: 610014 . TTY users should call, 1-800-325-0778; or your state Medicaid Office. Read latest notifications, file pricing appeals and search Express Scripts claims and patient coverage for your Pharmacy customers. Plan Name/Group Name: MI01/MIMEDICAID BIN:009737 PCN: P008009737 Processor: Processor/Fiscal Intermediary Effective as of: 01/01/2012 NCPDP Telecommunication Standard Version/Release #: D.0 NCPDP Data Dictionary Version Date: 10/2017 NCPDP External Code List Version Date: 10/2017 0000019345 00000 n Some entities may use the Group ID; still others may not need this level of differentiation. 0000002333 00000 n gcse.src = (document.location.protocol == 'https:' ? 0000008161 00000 n 4U;i^7.,HCa?dm3Yv qS,)@ 0"Jw4Utt0w Tt4VE2$ c4C)iG/Y88. RX BIN: 610114, PCN: PV 8009333734 Pharmacy Help 8669509949 www.pharmavail.com PharmAvail 3380 Trickum Road Building 400, Unit 100 Woodstock, GA 30188 HCC Pharmacy Onsite Pharmacy and 90day/Mail Order Prescriptions 8668278975 9196788261 Fax: 9196788159 TTY users should call, 1-800-325-0778; or your state Medicaid Office. var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; If using IE11, please consider using an alternative browser. If the health plan uses theNCPDP Pharmacy ID and Combination Card Implementation Guidethat NCPDP members have created, the BIN/IIN is clearly shown on the card. 0000001867 00000 n If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. UMP Plus networks. PDF IMPORTANT PROVIDER NOTICE Medicare Part D Information - PBA Health wG4jZG5\s.Wu=]qjLH In approximately 1989 the pharmacy services sector began using electronic processing for pharmacy claims. PCN: Varies by plan - refer to ID card. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). There is no registry of PCNs. We do not reuse numbers. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. At home, across the country, and around the worldthe power of Blue is with you. hbbd``b`AR 6H da@D`m@\Y6 $Ma}d100RN2@ 8 All calls are toll-free. %PDF-1.5 % 0000028275 00000 n What is BIN/PCN and Group number needed to submit a BC/BS FEP prescription drug claim? 0000100252 00000 n a listing of the legal entities 0000002463 00000 n Sunset: 04:14PM. 0000009092 00000 n 0000003136 00000 n 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 Tax ID: 94-1340523 COB Address: P.O. Medicare evaluates plans based on a 5-Star rating system. You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. PDF Medco manages the prescription drug benefit for many of your customers If you continue to browse or use this website, you agree to this updated Privacy Policy. 0000005958 00000 n However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service 0000007096 00000 n PDF Certified Payors - McKesson 0000032580 00000 n If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. 0000000016 00000 n BIN 610239 PCN: FEPRX RxGrp: 65006500 3. PDF OptumRx NCPDP Version D.0 Payer Sheet COMMERCIAL AND MEDICAID How to bill retail rx to Tricare? : r/pharmacy - reddit To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). BIN# 610014 BCBS 430 Date Printed 12/22/2014. U6E6hlhwElgf\0 $M[T=w"RnKPmH~g;~'-W99g/j730ePkxYj7 % "iU|5*hu88mG?K5rS0Q+C@^5k;5o^dM0&s o*e1gq~8F+aNc>CV} ${ *#. Rx BIN: 019059 Rx PCN: 07570000 Rx Group: HTH ID number - the pharmacy will need to submit the CURRENT ID number used for 2021 in January 2022 Customer Service/Pharmacy Help Desk: 844-373-0970 Self-Funded Group - Renown Health - HometownRx powered by Maxor Rx BIN: 019059 Rx PCN: 07570000 Rx Group: HTH '//cse.google.com/cse.js?cx=' + cx; 0000005854 00000 n 11-A1 BIN Number See BIN/PCN table, above M 12-A2 Version Release Number D=Version D.0 M 13-A3 Transaction Code B1=Billing M 14-A4 Processor Control Number As indicated above M 19-A9 Transaction Count 1=One Occurrence 2=Two Occurrences 3=Three Occurrences 4=Four Occurrences M (BIN 6156 only allows TRANS COUNT = 1). Become a Member, PRIVACY POLICY UPDATE Effective February 11, 2021 Sunrise, sunset, day length and solar time for Stockholm County. %%EOF Find a 2023 Medicare Advantage Plan (Health and Health w/Rx Plans), Browse Any 2023 Medicare Plan Formulary (or Drug List), Q1Rx Drug-Finder: Compare Drug Cost Across all 2023 Medicare Plans, Find Medicare plans covering your prescriptions, Medicare plan quality and CMS Star Ratings, Understanding Your Explanation of Benefits, IRMAA: Higher premiums for higher incomes, 2023 Medicare Advantage Plans State Overview, 2023 Medicare Advantage Plan Benefit Details, Find a 2023 Medicare Advantage Plan by Drug Costs. PDF NCPDP Version D.0 Payer Sheet - EpiphanyRx DownloadtheNCPDP Payer Sheet Template, more information is available by selecting Resource Topic - "HIPAA". trailer SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC. HEALTH NET COMMUNITY SOLUTIONS OF ARIZONA, INC. WELLCARE HEALTH INSURANCE OF TENNESSEE, INC. FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY, BRIGHT HEALTH INSURANCE COMPANY OF NEW YORK, COMPCARE HEALTH SERVICES INSURANCE CORPORATION, BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY, CENTRAL VALLEY MEDICAL SERVICES CORPORATION, CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC, WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC, CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. 0000029834 00000 n Chart of 2022 BIN and PCN values for each Medicare Part D prescription Please note, the data below is Part 5 of 5 (H8634 - S9701) with links to Parts 1 through 4. YOUR PROVIDERS. All existing six-digit IINs were converted into a block of one hundred eight-digit IINs. *hE\gUk~4>nmSLz~d}ICbQ>9MGZ,*:1E[&{nM)mB5})vB^1+g< 'DgrKZEU @kTHP"8\P*:C (W PYa+B .@.&n9i O|i2G/Xy3|`(pn|`;&30ax a= LcqOb.g`a G5'00gd8gf)g]X)5iG@ P 0000003632 00000 n Pharmacy :: The Health Plan 0000006589 00000 n Details. M (BIN 6156 only . RX Group: UHEALTH . For more information contact the plan. 0000002215 00000 n This website is not intended for residents of New Mexico. 0000005253 00000 n 58 D-MEDCO 610014(`1589) MEDCO MEDICARE PDP 5.1 57 CATALYST RX(`1306) 1/3/2012ps Page 2 3. ngRH);HRsZ.>@qTi-(0Q\{*`*5&he%fJ`B49Pe(h\#70 #8:(7Q)7mW:R,ATp$&Oz5$;X\MV&N2Z%s6GzMC"C&tcz=8j 11'H[/).R(k9FMfFU%g^|Vk&q/=~CC#Pe[?0gYvnF&9,g8iVIF;>v.fcIt(W=7YKF%ej>-T7WvR"B>]D.by%z"lhhnP7 jP6@{6Ap+t fzWGD\N|@wLL5 BIN/PCN/Group Numbers for ACOs, MCOs and PCC Plan The three tables below shows the correct combinations effective March 1, 2018, for pharmacies to use when submitting MassHealth ACO/MCO/FFS pharmacy claims. Bank identification number (BIN): 600428: Processor control number (PCN): 06210000: Pharmacy directory: Click on : Participating pharmacy: or go to : mibluecrosscomplete.com . Those health plans that did not have a business reason for creating pharmacy benefit cards with a magnetic stripe were in need of a number, because they still needed to process electronic pharmacy claims. 0000002330 00000 n Hb```?@(AEs,Pp IG1~D&t var gcse = document.createElement('script'); BT4'j7k?pj|q)@@ i3ao>V|tCJ?a|$FY.^a%>]q!N6# PDF Group Health Plan Information for IRS/SSA/CMS Data Match 0000007679 00000 n In certain situations, you can. 0000011949 00000 n Express Scripts resources for pharmacists. 0000002706 00000 n The Rx BIN # 610014 The PCN is MEDDPRIME The Rx Group number as listed below The member's ID number (format listed below) Note: Medco anticipates members will have their newly issued ID cards, but to assist members and pharmacy in the event that not every member has the new ID card, Medco is supplying members of the enhanced Without these codes, All the information you need to properly process prescription claims with Cigna. Click here to let us know, CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA, Highmark Blue Cross Blue Shield of Western New York and Highmark Blue Shield of Northeastern New York, BlueCross BlueShield: Empire, Excellus, WNY & NENY, Health Alliance Medicare Prescription Plan, Blue Cross and Blue Shield of North Carolina, Blue Cross and Blue Shield of IL, NM, OK, TX, Blue Cross and Blue Shield of Kansas or Blue KC, Regence BlueShield of Idaho and Regence BC BS Utah, Horizon Blue Cross Blue Shield of New Jersey, 001-012, 014-034, 070, 105, 106, 121-137, 801, 802, 808. 0000002142 00000 n Both in Stockholm and Finland, an e 'https:' : 'http:') + Not a Member? You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. 0000005086 00000 n 0000007215 00000 n What is the BIN, PCN, and RxGROUP number for my Medicare Part D prescription drug plan? Please enter the information that appears on the gcse.src = (document.location.protocol == 'https:' ? In January 2017, the IIN length changed from a 6-digit number to an 8-digit number. 0000002851 00000 n 0000012588 00000 n Payer/Carrier BIN/PCN Date Available Vendor Certification ID *Humana LI NET 015599/05440000 Current 601DN30Y *Humana Part D . Those who disenroll 0000007028 00000 n Ut JJ`&PXIIaAAq0. %%EOF Limitations, copayments, and restrictions may apply. during the calendar year will owe a portion of the account deposit back to the plan. PDF ATTACHMENT 2 PLAN CONTACT AND BILLING INFORMATION - New York State We do not sell leads or share your personal information. xref We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. Accountable Care Partnership Plans MCO Partner PBM BIN PCN Group BMC HealthNet Plan Community Alliance We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. PDF SAS Benefit Vendor Contact Information The Bank Identification Number (BIN) is a term commonly used in the credit card industry. 0000007668 00000 n 0000006674 00000 n Rx PCN: N/A The TIN for Optimum Choice HMO is: 52-1518174 Group ID Number: 717578 . 0000034997 00000 n ;nq*DEhw x~iW}W7#WrL/F6geO6UNHZMS u|Z)/ZE,PK3G}E,8-1|_bF6? Plans that use cards with a magnetic stripe should use the recommended ISO/IEC 7812 Issuer Identifier Number (IIN) for processing electronic pharmacy claims. 0000009374 00000 n Please renew your membership to login.