Bin 600428 pcn 01910000. Express Scripts : 003858 .

Bin 600428 pcn 01910000 The electronic processing of retail pharmacy claims requires a NCPDP processor ID number, also known as a BIN, and a processor control number, or a PCN, for plan identification. PharmPix Payer Sheets. 0 Payer Sheet COMMERCIAL AND MEDICAID Payer Name: OptumRx Date: 05/01/2021 Commercial and Heritage Health Solutions - VA Camp Lejeune FMP BIN: 610011 PCN: HHS - COB Scenario 2 only AARP BIN: 610652 PCN: Varies – refer to ID card SavaScript Value Services BIN: 023153 PCN: HT CerpassRx BIN: 022485 PCN: STL CareCard BIN: 025796 PCN: Varies by plan – refer to ID card Ohio Bureau of Workers Compensation BIN: 012592 PCN: OHBWC Plan Name Part D BIN Part D PCN Part D RxGroup M3P BIN M3P PCN BCBS of Alabama Blue Advantage (MA-PD) 014897 MBG 90100 014897 MPPPMBG Patrius Health 014897 PLX 91030 014897 MPPPPLX BCBS of Alabama BlueRx (PDP) 014897 RPD 90200 014897 MPPPRPD UTIC Insurance Company 014897 RPD 90300 014897 MPPPRPD Florida Blue BlueMedicare PCN GROUP : Type Network: Location Help Desk Number: ARGUS 1. In case of accidental overdose, call a doctor or poison control center immediately. 1. Find a provider here. For cash-paying or uninsured patients, submit a PRIMARY claim using BIN 600428, PCN 06780000, and GROUP 06780169. MedImpact : 003585 . corepriority@blueshieldca. The information printed on the front of the card should be used when submitting for reimbursement. Guardian Insurance Company. edisupport@dhsoha. com. Health care providers and pharmacies use these numbers to BIN/PCN/Group Numbers for ACOs, MCOs, PCC Plan and SCO MassHealth Only Primary Care ACOs PBM BIN PCN Group Pharmacy Help Desk Community Care Cooperative (C3) Conduent 009555 MASSPROD MassHealth (866) 246-8503 (Conduent/POPS) (800) 745-7318 (DUR) Mass General Brigham ACO Conduent 009555 MASSPROD MassHealth bin|pcn|effdate|termdate|filedate 001553|gam|20090101||20240920 001553|gmea|20090101||20240920 001553|mpd|20090101||20240920 001553|pda10|20090101|20200430|20240920 As of January 1, 2021, all Cigna Healthcare SM Commercial pharmacy plans and Cigna Healthcare Medicare claims are adjudicating on the Express Scripts systems. The items highlighted in the payer sheet Plan Name/Group Name: NextGen Healthcare (HSI) BIN:600428 PCN: 07400000 Plan Name/Group Name: BIN: PCN: Plan Name/Group Name: BIN: PCN: Plan Name/Group Name: Our free BIN checker can help you spot fraudulent credit card transactions. 1 BIN: 003585 PCN: 74004 • HEAT #27931: MEDIMPACT74250 PARD 5. Do you provide API for developers? Region BIN PCN/ Group Help Desk 4D Pharmacy Network-Managed Phy Network 4D National 600429 1990000 888-378-4743 4D Pharmacy Network- Managed Choice Benecard Argus National 600428 02480000 800/522-7487 BeneScript Services BeneScript National 003452 Call h/desk 800-345-3189 Best Overnight Express AHC CA 610118 AHC, GR 8168 BIN: PCN: GRP: 600428 05100000 05820001 RxChop hop Prescription Savings Card Save Up To 80% on Prescription Drugs (Pharmacy Help Line) : 866 921-7286 KEEP THIS CARD - PRESENT TO THE PHARMACY ON EACH VISIT DISCOUNT PROGRAM NOT INSURANCE BIN: PCN: GRP: 600428 05100000 05820001 PETRXCHOP Pet Prescription Savings Card claim using BIN 600428, PCN 06780000 and GROUP 06780169. Prior authorization How to submit a request for pharmacy prior authorization Online Claim Billing and Response Payer Sheet BIN 600428, PCN AH effective 04 19 2021 READ MORE . A BIN/IIN and PCN are included on prescription drug identification cards, payer sheets, and are provided in pharmacy announcements. 610029 arerx none all aaa of michigan and wisconsin 900002 amw env none 600428 . coupon, please call 1-855-659-9767. TennCare BIN: 001553 PCN: TNM CKDS CerpassRx BIN: 022485 PCN: STL CareCard BIN: 025796 PCN: Varies by plan – refer to ID card Ohio Bureau of Workers Compensation BIN: 012592 PCN: OHBWC MedlessRx BIN: 019827 PCN: HT Processor: OptumRx Effective as of: 06/01/2015 NCPDP Telecommunication Standard Version/Release #: D. 2015 BS of CA Commercial Replace these retired BINs with BIN: 004336 PCN: ADV. PharmPix Payer Sheet Update-version 12. 1, Bin# 009661, PCN: P013009661 . BIN: 600428 BIN: 004336 BIN: 00 3858 PCN: 07710000 PCN: MCAIDDE PCN: DSHP • There may be a small population of members who are NOT enrolled in a managed care program. 0 Payer Sheet (PDF) contains our BIN (600428), PCN (06210000), member services number, field definitions and other helpful information for BIN: 600428 PCN: 05100000 GRP: 06230001 RX Customer Questions Call: 1-844-329-3341 RX Pharmacist Questions Call: 1-866-788-8452 CALL TO VERIFY MEMBER STATUS BEFORE SEEING PATIENT. The BIN number identifies your insurance provider; the PCN number is a secondary number for routing claims; and the GRP number identifies the employer through which you have the insurance. Rev. Payer Sheets. 2Ø2-B2 Service Provider ID Qualifier M Ø1 Ø1 = NPI Only NPI will be accepted Tips & Disclaimers. Please use the new BIN and PCN combination: BIN – BIN: 015581 PCN:03200000 Plan Name/Group Name: Humana/ MA Part B Plans (MA only) BIN: 610649 PCN: 03200004 Plan Name/Group Name: BIN: PCN: Plan Name/Group Name: BIN: PCN: Processor: SS&C Health Effective as of: 09/21/2020 NCPDP Telecommunication Standard Version/Release #: D. Patient Eligibility/Terms and Added new BIN/PCN combination: BIN 027570 PCN SSRX42 *UPDATED* Removed sunset BINs/PCNs Added additional BIN: 026696 o For new plans only, effective 10/2024 to 12/2024 . 0 Bank identification number (BIN): 019595 Processor control number (PCN): PRX00621: Pharmacy directory: Click on : Participating pharmacy: or go to : mibluecrosscomplete. 1, Bin# 011552, PCN: MPDNM . Dec, 05, 2024. NOT. Submit a SECONDARY claim using BIN: 600428/PCN: 06780000. us • 835/Electronic Remittance Advice MMA (Medicare Part D) Hotline 877-585-0007 or mma. Title: NeedyMedsCard_4 Created Date: 9/10/2014 4:12:07 PM BIN/PCN Table . optumrx. 600428 603017 021049 021916 021825 BIN: 610182 610593 610679 014681 015839 018643 600471 603286 610140 610527 610619 610604 014872 015756 020768 003650 009951 AARP BIN: 610652 PCN: Varies – refer to ID card OptumRx BIN: 610127 PCN: 02330000 01960000 01990000 02330088 COSF GASF MASF PCN: NCCSI NCSF NWSF SCCSI SCSF OHSF 2022 Medicare Prescription Drug Plan Pharmacy BIN and PCN Numbers: Contract ID: Contract Name: Plan ID: BIN: PCN: E0654: TEAMStar Medicare Part D Prescription Drug Program: all plans: 015574: ASPROD1: E3014: Pennsylvania Public School Employees Retirement Sy: all plans: 610097: 9999: E4744: MISSOURI DEPARTMENT OF system with the new Member ID Number, BIN, PCN and Rx Group. After a member chooses Health Options as their MCO, they will receive a new Health Options member ID For insured patients, process a coordination of benefits (COB/split bill) claim using the patient’s prescription insurance for the PRIMARY claim. 2015 HealthCare Corp of America /Prescription Corp of America HCA-PCA 340 Basics 600428 06730000 Medicaid: National 1-800-309-1603: ARGUS 1. The secondary claim will buy the out-of-pocket cost down to $25. 600428 800-522-7487 Agelity, Inc. com contains Blue Cross Complete’s BIN (600428), PCN (06210000), member services number, field definitions and other helpful information for pharmacy claim billing and The PCN is defined by the PBM/processor as this identifier is unique to their business needs. For help processing the If you have any questions, call 1-855-XOFLUZA. Currently, there are more than +365,460 unique BIN in our database. 2 Adjusted 5. Submit a SECONDARY claim using BIN 600428, PCN 06780000 and GROUP 06780158. ; The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and Bank identification number (BIN): 600428 Processor control number (PCN): 07710000 Pharmacy online directory Search for a pharmacy. 5. For pharmacy processing questions, please call 1-877-900-8675. Pharmacy Manual . 1 600428 05190000 BCBS SOUTH CAROLINA 5. BIN: 600428 Rx PCN: 07130000 Patient’s Last Name, First Name, Patient’s Date of Birth BIN #600428 PCN #01420000 www. Absolute Total Care Medicare Advantage 004336 MEDDADV RX8917 ; 11 digit alphanumeric ID. Caremark : 004336 . ProvidenceHealthPlan. Format Adjusted to new payer sheet released on Emdeon web site. 7 %µµµµ 1 0 obj >/Metadata 4194 0 R/ViewerPreferences 4195 0 R>> endobj 2 0 obj > endobj 3 0 obj >/ExtGState >/XObject >/ProcSet[/PDF/Text/ImageB/ImageC PBM/Payor Plan Name/Contract Name BIN . (Monday – Friday 24 hours, Saturday 8 AM – 7 PM EST, and Sunday 9 AM – 5 PM EST) BIN:610649 PCN: 03191504 Plan Name/Group Name: Humana Healthy Horizon s® in Oklahoma(Medicaid) BIN:610649 PCN: 03191505 Plan Name/Group Name: Humana Healthy Horizon s® in Indiana(Medicaid) BIN:610649 PCN: 03191506 Plan Name/Group Name: Humana Healthy Horizons ® in Virginia(Medicaid) BIN:610649 PCN: 03191507 Processor: SS&C Health • HEAT #28337: MEMBERHEALTH MPD PDP 5. or. o BIN: 600428 o Rx PCN: 07130000 o Patient’s first name, last name and date of birth (over, please) FOR PROFESSIONAL AND FACILITY PROVIDERS JANUARY 2, 2015 PR 15-01 . ALASKA MEDICAID 5. 1 800010 LDI GREAT WEST 0518 5. This offer is valid for eligible patients receiving prescription XOFLUZA. e. Please use the following information when submitting claims for Medicare members. The PCN is alphanumeric as defined by the PBM/processor. 1 600428 01910000 3. The chart below is the sixth page of the 2025 Medicare Part D pharmacy BIN and PCN list covering prescription drug plans from contracts H8026 through H9986. 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 BIN 61Ø648, PCN Ø189ØØØØ This is required when Covered Person’s of Truli have secondary coverage with Truli, BIN Ø12833, PCN THP This is required when Covered Person’s of BCBS of North Dakota USW Union Bobcat group has secondary coverage with BCBS of ND, BIN: 610455 PCN: plan name bin pcn processor states 340b cms 600428 2970000 none all 4d pharmacy management systems 600428 1990000 4d pharmacy mgmt all 4d pharmacy management systems 014963 14963 1990000 none all a. For more specific information on how routing works using these assigned IDs see . Guardian, Dental/Vision Carrier Direct Contact. r. 0 NCPDP Data Dictionary Version Date: July, 2024 NCPDP External The Indian Health Service (IHS), an agency within the Department of Health and Human Services, is responsible for providing federal health services to American Indians and Alaska Natives. 1 004336 BCBSSC BLUE SHIELD OF CA 5. O. 2015 Health Network Dscnt Card 600428: 1HEALTH Commercial: National 1-866-921-7286: ARGUS 1. com contains Blue Cross Complete’s BIN (600428), PCN (06210000), member services number, field definitions and other helpful information for pharmacy claim billing and BIN|PCN|EFFDATE|TERMDATE|FILEDATE 001553|GAM|20090101||20241203 001553|GMEA|20090101|20241130|20241203 001553|MPD|20090101|20241130|20241203 001553|PDA10|20090101 Customer Number Plan Name BIN PCN 142 Providence Health Plan: Commercial 600428 01420000 Exchange 600428 06680000 767 Providence Health Plan: Rx Only 600428 07670000 787 Providence Plan Partners: Providence Medicaid 600428 07870000 822 Providence Plan Partners: Providence ElderPlace 012353 08220000 822 Western Health 600428 : 02180000 . UnitedHealthcare Community and State of MN BIN: 610494 PCN: 4846 MedalistRx BIN: 016580 PCN: <NA> Former Catalyst, informedRx and HealthTrans BIN: 004428 005947 009992 %PDF-1. One The PCN, like the BIN/IIN appears on the pharmacy ID card, in accordance with the rules defined in the NCPDP Pharmacy ID and Combination Card Implementation Guide. For questions, please call . Tips & Disclaimers. ; The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and Tips & Disclaimers. Patient Eligibility/Terms and Conditions: 1. BIN and PCN Update: Blue Cross Complete is changing its claims processor to Abarca Health. Blue Cross Complete's D. ; The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and Commercial and Medicaid BIN: 610494 PCN: 9999 COMMUNITY HEALTH BIN: 610613 PCN: 2417 ProAct BIN: 017366 PCN: 9999 FlexScripts/ProAct BIN: 018141 PCN: 9999 United Healthcare Community Plan of Texas BIN: 610494 PCN: 4400 United Healthcare Community Plan of Arizona BIN: 610494 PCN: 4100 MedalistRx BIN: 016580 PCN: <N/A> Study with Quizlet and memorize flashcards containing terms like 8310; 610502, 32740; 015905, 2619; 004336; ADV and more. 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 Bank identification number (BIN): 019595 Processor control number (PCN): PRX00621: Pharmacy directory: Click on : Participating pharmacy: or go to : mibluecrosscomplete. 0 600428, 016961, 610209, 015814 varies by plan 1-800-522-7487: benecard 014179 '016333 9743: 1-888-907-0050 cvs/ caremark: 004336, 610415, 610239, bin pcn; help desk restat 610171 7777 1-800-248-1062 savrx 006558, 008563, 012684 n/a 1-402-753-2800 scriptguide 015202 sgrx, wchc 1-855-367-7479 Plan Name/Group Name: BIN: PCN: Processor: Argus Health Systems Effective as of: 12/01/2015 NCPDP Telecommunication Standard Version/Release #: D. For help processing the coupon, please call 1-855-659-9767. 1-855-659-9767. 1 Formats • NEW MEXICO MEDICAID 5. us Bank identification number (BIN): 019595 Processor control number (PCN): PRX00621: Pharmacy directory: Click on : Participating pharmacy: or go to : mibluecrosscomplete. Due to this change, the current BIN (600428) and PCN (06210000) for members has changed. primary claim and using BIN: 600428 and PCN: 06780000 for the secondary claim. Humana Pharmacy Solutions. Med Plan is not insurance nor HMO. 1 POS Formats . Q. Express Scripts : 003858 . Pharmacist: Card must be presented to receive program benefits. . This example does not reflect an actual member’s ID card or plan. 1Ø1-A1 BIN NUMBER 600428 M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M 1Ø3-A3 TRANSACTION CODE B1, B3 M 1Ø4-A4 PROCESSOR CONTROL NUMBER AH M To prevent point of service disruption, the RxGroup must be submitted on all claims and reversals. 1 . 12/01/2024 Page 4 of 25 PART 1: GENERAL INFORMATION BIN: 600428 PCN: 05100000 GRP: 06230001 RX Customer Questions Call: 1-844-329-3341 RX Pharmacist Questions Call: 1-866-788-8452 CALL TO VERIFY MEMBER STATUS BEFORE SEEING PATIENT. NCPDP Version D. Start verifying, validating, and checking all information of credit/debit cards just using BIN numbers. The following is a summary of our new requirements. For cash-paying or uninsured patients, submit a PRIMARY claim using BIN 600428, PCN 06780000, and GROUP 06780158. It can not be used in conjunction with any federal or state-funded program such as Medicare or Medicaid. Pharmacy Point of Sale (ABSP) Version 1. REALRX 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 Health Share – Providence 877-216-3644 600428 07870000 100598 Intercommunity Health Network 855-251-9456 610011 IRX SAMCAID Jackson Care Connect 866-843-5126 610011 IRX CORMCAID Moda Health BIN: 600428 RX PCN: 05100000 RX GRP: 05360001 ID: 35NAINTEG21F1234 WARNING: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. 1-855-XOFLUZA. Refer to www. com contains Blue Cross Complete’s BIN (600428), PCN (06210000), member services number, field definitions and other helpful information for pharmacy claim billing and BIN: 600428 BIN: 004336 BIN: 0 0 3858 PCN: 07710000 PCN: MCAIDDE PCN: DSHP • There may be a small population of members who are . 2. Box 3125, Portland, OR 97208-3125 For customer service, please call: 503-574-7500 or 1-800-878-4445 For questions regarding Mental Health or Chemical Dependency services, please call 1-800-711-4577 For 24 hour medical advice, call Pharmacist Instructions: For reimbursement, please submit to BIN: 600428/PCN: 06780000. Maximum program benefit will be dependent upon patient’s insurance and the product quantity purchased. BIN: 600428 RX PCN: 05100000 RX GRP: 05360001 ID: 35NANOREL21AD876 Accepted at these and other participating pharmacies: CUT AND KEEP * Final discounts may vary. Guardian is a premier FORMAT NAME BIN # PCN # LDI PHARMACY BENEFIT MGMT 5. com! PRIMARY claim. Group #: 00506189. Medicare and Hospice . com under the Pharmacists & Medical Professionals link for additional payer sheets regarding the following: 1Ø1-A1 Bin Number M 019595 1Ø2-A2 Version Release Number M DØ 1Ø3-A3 Transaction Code M B1 B1 = Billing 1Ø4-A4 Processor Control Number M PRX00621 1Ø9-A9 Transaction Count M 1 A maximum of 1 (one) transaction per transmission is allowed. 2015 Health Options 600428: 07130000 Minnesota Health Care Programs providers billing for prescriptions for members in managed care organizations (MCOs) need to use the MCO's identification bin and PCN information. caremark. For questions, please call the Help Desk at 1-855-672-4103. PRIMARY claim. No cash value. 575202ALL0924 GHHJT9NEN primary claim and using BIN: 600428 and PCN: 06780000 for the secondary claim. Submit a SECONDARY claim using BIN 610020 and GROUP 99994457. This document is available with NCPDP membership. 08/2014 Please read product literature for full prescribing information. enrolled in a managed care program. Keep this product out of reach of children. PCN GROUP : Type Network: Location Help Desk Number: AlphaScrip Inc Alpha Scrip 610600: ARGUS 1. 1 • Claim segment had fields in wrong order, but most mandatory Plan Name/Group Name: Medi-Cal Rx NEW! BIN*: 022659 NEW! PCN*: 6334225 SB393 Drug Inquiry Pricing Request NEW! BIN*: 022667 NEW! PCN*: 393 Processor: Prime Therapeutics State Government Solutions LLC Effective as of: 1/1/2022 NCPDP Telecommunication Standard Version/Release #: D. 0 NCPDP Data Dictionary Version Date: October 2016 NCPDP External Code List Version Date: October 2016 Contact/Information Source: PCN:06300000 : Plan Name/Group Name: Healthy San Francisco : BIN 600428: PCN:06300668 : Plan Name/Group Name: Healthy Kids HMO ; BIN: 600428 : PCN:06300669 1Ø1-A1 BIN NUMBER 600428 018810 M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M 1Ø3-A3 TRANSACTION CODE B1, B3 M 1Ø4-A4 PROCESSOR CONTROL NUMBER 01990000 M Valid PCN required. You can obtain these prescription drug benefits from Covered California or directly from Blue Shield of California. 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. 1–Added Certification code BIN: 600428 PCN: 02550000 • HEAT #27931: MEDIMPACT74004 PARTD 5. 0 600428 603017 021049 021916 021825 BIN: 610182 610593 610679 014681 015839 018643 600471 603286 610140 610527 610619 610604 014872 015756 020768 003650 009951 AARP BIN: 610652 PCN: Varies – refer to ID card OptumRx BIN: 610127 PCN: 02330000 01960000 01990000 02330088 COSF GASF MASF PCN: NCCSI NCSF NWSF SCCSI SCSF OHSF BIN: 600428 RX PCN: 05100000 RX GRP: 05360001 ID: NeedyMeds Drug Discount Card 09NA20885MD43258. 1 600428 05180000 GREAT WEST 0519 5. For cash-paying or uninsured patients, submit a PRIMARY claim using BIN 610020 and GROUP 99994457. The PCN, like the BIN/IIN appears on the pharmacy ID card, in accordance with the rules defined in the NCPDP Pharmacy ID and Combination Card Implementation Guide. The provision of health services to members of federally-recognized Tribes grew out of the special government-to-government relationship between the federal government and Indian Tribes. Patient Eligibility/Terms and Learn about different drug coverage topics for members in Individual and Family Plans (IFPs) or small group plans. 142 Providence Health Plan: Commercial 600428 01420000 330 Providence Health Assurance: Medicare Advantage 012353 03300000 523 Project Access Now 600428 05230000 668 Providence Health Plan: Exchange 600428 06680000 • Use the BIN and PCN as it appears on the ID card. 1–Added PCN: PDP BIN: 610211 PCN: PDP • HEAT #27067, 28032,& 29396: BCBS FED EMP 5. Access payer sheets for data requirements related to electronic claims processing for each line of business within Optum. BIN and PCN Codes. • Enter the member’s information into your system one of two ways: o TennCare BIN: 001553 PCN: TNM CKDS CerpassRx BIN: 022485 PCN: STL CareCard BIN: 025796 PCN: Varies by plan – refer to ID card Ohio Bureau of Workers Compensation BIN: 012592 PCN: OHBWC IronRX LLC BIN: 019827 PCN: HT Processor: OptumRx Effective as of: 06/01/2015 NCPDP Telecommunication Standard Version/Release #: D. 1Ø9-A9 TRANSACTION COUNT 1- 4 M 1– 4 transactions for transmissions 2Ø2-B2 SERVICE PROVIDER ID QUALIFIER 01 M Only value ’01’ (NPI) accepted. coupon, please call . com (855) 747-5809. Void where prohibited. For pharmacy support, please reference the Pharmacy Help Desk phone number on the member’s ID card. Q1Medicare ®, Q1Rx ®, and Q1Group ® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group. 0 Payer Sheet COMMERCIAL professionals. Please use the new BIN and PCN combination: BIN – Tips & Disclaimers. ; The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and RxBIN 600428 RxPCN 01910000 Platinum 90 PPO Network Name Exclusive Office Visit Copays Primary Care $25 Specialist $55 PPO 2018 Individual and Family Plans purchased directly from Blue Shield (mirrored or off-exchange) Versions of the content displayed vary by benefit plan. BCBS NM MEDICARE PARTD 5. com Card Back Send claims to Providence Health Plan (PHP) P. BIN, PCN, and GRP numbers are important identification numbers concerning your health insurance. com contains Blue Cross Complete’s BIN (600428), PCN (06210000), member services number, field definitions and other helpful information for pharmacy claim billing and Company PBM BIN# PCN# Group# Pharmacy Helpdesk# Eligibility Helpdesk# Override Process Amerigroup Caremark 004336 ADV RX4281 1-800-454-3730 1-800-454-3730 Enter PAMC code PerformRX 600428 02180000 Leave blank 1-866-610-2773 1-888-276-2020 Use code 218555 for 5 day supply – enter in authorization field Total Carolina %PDF-1. Added field 419 Prescription Origin Code to the Claim Segment. Sample ID card images are available at the end of this document. One letter followed by 10 numbers. referrals@dhsoha. Will Health Options issue identification cards? A. General information is available in Resource Topic- Guidance Documents under the "Pharmacy and Healthcare Identification Cards" banner. 0 NCPDP Data Dictionary Version Date July, 2007 NCPDP External Code List Version Date March, 2010 1Ø1-A1 BIN NUMBER 600428 M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M 1Ø3-A3 TRANSACTION CODE B1, Plan PBM Phone BIN PCN Group Yamhill Community Care 877 -216 3644 600428 07870000 YCCOPHTK EDI Support Services dhs. Mail / Specialty Pharmacies or Retail Pharmacies submitting claims, with Sales Tax, are required to submit the values detailed below. 7 %µµµµ 1 0 obj >/Metadata 4325 0 R/ViewerPreferences 4326 0 R>> endobj 2 0 obj > endobj 3 0 obj >/ExtGState >/XObject >/ProcSet[/PDF/Text/ImageB/ImageC BIN PCN RxGroup Member ID Health Net 004336 MEDDADV RX6270 11 digit alphanumeric ID. There is no registry of PCNs. Submit a SECONDARY claim using BIN 600428, PCN 06780000 and GROUP 06780169. Patient is responsible for any cost remaining after program benefit is applied. Our 4D Management Systems, Inc. state. State Plan Name BIN PCN Rx Group BIN: PCN: GRP: 600428 05100000 05820001 RxChop hop Prescription Savings Card Save Up To 80% on Prescription Drugs (Pharmacy Help Line) : 866 921-7286 KEEP THIS CARD - PRESENT TO THE PHARMACY ON EACH VISIT DISCOUNT PROGRAM NOT INSURANCE BIN: PCN: GRP: 600428 05100000 05820001 PETRXCHOP Pet Prescription Bank identification number (BIN): 019595 Processor control number (PCN): PRX00621: Pharmacy directory: Click on : Participating pharmacy: or go to : mibluecrosscomplete. BIN Checker tool is designed to check the existence of a Bank Identification Number (BIN) base on updated database. For these members, the drug benefit will be processed under Delaware Medical Assistance Program (DMAP)/Traditional Fee-for-Service (FFS) Medicaid. prescription insurance for the PRIMARY claim. 0 NCPDP Data Dictionary Version Date: October 2019 Commercial and Medicaid BIN: 610494 PCN: 4141 (OH Medicaid Only) PCN: 4444 PCN 4242 Processor: OptumRx Effective as of: 01/01/2016 NCPDP Telecommunication Standard Version/Release #: D. BIN: 600428 RX PCN: 05100000 RX GRP: 05360001 ID: 35NAFP502FP01 TM WARNING: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Rx BIN #: 600428. 2025 Edition . 10/01/2024 Page 3 of 32 HIGHLIGHTS – Updates, Changes & Reminders This payer sheet refers to Medicare Part D Primary Billing and Medicare as Secondary Payer Billing. For help processing the If you have any questions, call . Plan Name/Group Name BIN PCN Legacy ESI Commercial ØØ3858 A4 (or as assigned by ESI) SC (When secondary to Medicare Part D only) Legacy Medco Commercial 61ØØ14 Provided on card or anything but zeros Legacy Medco Commercial – Copay only 61ØØ14 COPAY Legacy Medco Commercial – Secondary Payer Non -Medicare Part D (Based OptumRx NCPDP Version D. For Insured Not Covered/Cash Patients: Submit a PRIMARY claim using BIN: 600428/PCN: 06780000. PCN #: 01910000. Arizona Complete Health Medicare Advantage 004336 MEDDADV RX8120 : 11 digit alphanumeric ID. 2024 READ MORE . qew vltpqt bdq cyukyvj xaei hdbows xrygu oqcppvzvy jiqlo ncirn nfujq qgqs vyw wvw evhy