We are an independent education, research, and technology company. RX Bin: 610014 . Og%$pB1 o:er1?P_ojKuK3L 9H(! For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227. BIN Number Additional Information Required for Pharmacy Processing; Affinity Health Plan (866) 247-5678; CVS Caremark (800) 364-6331 . Plans that use cards with a magnetic stripe should use the recommended ISO/IEC 7812 Issuer Identifier Number (IIN) for processing electronic pharmacy claims. Medicare MSA Plans do not cover prescription drugs. 58 D-MEDCO 610014(`1589) MEDCO MEDICARE PDP 5.1 57 CATALYST RX(`1306) 1/3/2012ps Page 2 3. 0000007555 00000 n To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). 0000002069 00000 n The benefit information provided is a brief summary, not a complete description of benefits. Refer to above list or what is printed on ID card . 0000002706 00000 n Those health plans that did not have a business reason for creating pharmacy benefit cards with a magnetic stripe were in need of a number, because they still needed to process electronic pharmacy claims. P6mh7 quSOARI 4:,i}2Bzd93$g]Mc#. Those who disenroll Contact the Medicare plan for more information. area. contains Blue Cross Complete's BIN (600428), PCN (06210000), member : services number, field definitions and other helpful information for pharmacy claim billing and . Medicare has neither reviewed nor endorsed the information on our site. Your medical benefits allow you (function() { Joined Feb 3, 2010 Messages 2 . (function() { We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. This electronic processing of pharmacy claims meant the health plan (or their Pharmacy Benefit Manager/processor/payer on their behalf) needed a number for the electronic routing of transactions. gcse.src = (document.location.protocol == 'https:' ? International Organization for Standardization / International Electrotechnical Commission, (ISO/IEC) Joint Technical Committee (JTC) 1, Contact NCPDP Provider Services Department at 480.734.2870 or. TTY users should call, 1-800-325-0778; or your state Medicaid Office. 0000002685 00000 n What is BIN/PCN and Group number needed to submit a BC/BS FEP prescription drug claim? Limitations, copayments, and restrictions may apply. The ISO/IEC 7812 IIN is a number used throughout electronic routing. 2. 0000006248 00000 n Please note, the data below is Part 5 of 5 (H8634 - S9701) with links to Parts 1 through 4. This website is not intended for residents of New Mexico. 3456 0 obj <>stream For more information contact the plan. })(); Chart of 2021 BIN and PCN values for each Medicare Part D prescription drug plan Part 5 of 5 (H8634 through S9701). {hBIsS6U6,Q{O|+x`o~{>+W Od^.+mB:rNlHi} *"d\Q*\ZMW% Ffa3Y!G'[71c4)0 The IIN structure is defined within the international standard ISO/IEC 7812-1,Identification cards - Identification of issuers - Part 1: Numbering system. 'https:' : 'http:') + %%EOF Call 1-866-447-9717 Customer Service: 1-877-344-7364 (TTY/TDD: 711) Emblem Behavioral Health Services . Verify member eligibility and the MCO enrollment . If you forget if you need a group number or not, use the third party inquiry. Star Ratings are calculated each year and may change from one year to the next. As of January 2017, the IIN length has changed from a 6-digit number to an 8-digit number. 0000003518 00000 n 0000011550 00000 n Please enter the information that appears on the 0000003982 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 0000006324 00000 n Medicare MSA Plans do not cover prescription drugs. %%EOF 0000022896 00000 n To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). Accountable Care Partnership Plans MCO Partner PBM BIN PCN Group BMC HealthNet Plan Community Alliance Healthcare coverage wherever you go. 610014 MEDDPRIME BUCKEYE COMMUNITY HEALTH PLAN, INC. 001 012353 03200000 002 003 004 Humana Medicare Employer (HMO) CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY Care Improvement Plus Medicare Advantage (PPO) Care Improvement Plus 014 H0104 BLUE CROSS AND BLUE SHIELD OF ALABAMA 010 014897 MBG Blue Advantage (PPO) RPD 011 804 Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). 0000005854 00000 n 0000006259 00000 n Share your form with others Send it via email, link, or fax. 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 . To obtain an IIN, please contact the American National Standards Institute (ANSI) at www.ansi.org. 0000003136 00000 n 0000003344 00000 n ANSI is responsible for making certain the application has been properly completed and that all appropriate fees and attachments have been collected. 0000014626 00000 n gcse.src = (document.location.protocol == 'https:' ? We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. 0000011095 00000 n 109-A9 Transaction count 1 to 4 M Up to 4 This includes accounts for Grandfathered members. HWr+S&M,N&H MRRgRIsin9ad_%^!c/$I &juN$WfOT^nvZd%w-17/0P}2EdN/[xnEZgcEir7x!%? If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan. 0000028726 00000 n Existing six-digit IINs were converted into a block of one hundred eight-digit IINs. 0000010872 00000 n 0000003018 00000 n Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. 20200903T55 Sh: 0 Bin 2 J008 Env [1] CSets 1 of 2. 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. 0000008238 00000 n 0000005958 00000 n 0000001867 00000 n gcse.async = true; 0000033180 00000 n 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). UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC. GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC, VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK. startxref We do not reuse numbers. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. 0000012195 00000 n The NCPDP Processor BIN is a six-digit sequential number we assign that begins with "0" as in "000010". endstream endobj startxref plan name/group name: all plans bin: 020040 pcn: *n/a *for community health network only use pcn: ae7271 plan name/group name: all test claims bin: 020040 pcn: n/a . 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 0000002648 00000 n MedImpact (Includes: Excellus/ FLRx) ;;_XKkMUsZWPTdyRWp :{j dac{U|U|Y1~x^_$^4M}]Y>qP7CuH2xzR7bX" w-@yt 1;|hq=Z2C:n{g` Emblem Health (800) 447-8255. var s = document.getElementsByTagName('script')[0]; Become a Member, PRIVACY POLICY UPDATE Effective February 11, 2021 0000100252 00000 n 0000001602 00000 n 0000001868 00000 n The Bank Identification Number (BIN) is a term commonly used in the credit card industry. Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home. C. CPhT1969 New Member. enrolled in and submit the claim using the BIN/PCN/GroupRx information listed above. 0000001647 00000 n 0000004910 00000 n 0000004799 00000 n Our. BIN and PCN Codes 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). 0000070373 00000 n money from Medicare into the account. 0000028275 00000 n There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. But that's pure memorization. xb```b``bl,@0fAgXE#$3V(a (jt m=a(%sdA`i78*Lj7 MN 14000 Administrator, BIN, PCN, Group, and telephone number Specialty Pharmacy name and telephone number Website address for pharmacy information Buckeye Health Plan RxAdvance . hb```>>S~1A\pDKu;sH(1mA~>bN 24 hours a day/7 days a week or consult, When enrolling in a Medicare Advantage plan, you must continue to pay your. Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition. A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Sunset: 04:14PM. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). 0000002289 00000 n 0000003547 00000 n NCPDP has recently updated our Privacy Policy. The BIN/IIN is a field in the Telecommunication Standard that is used for the routing and identification in pharmacy claims. RX Group: UHEALTH . AHCCCS FFS 001553 AZM OptumRx 855-577-6310 . 3424 0 obj <> endobj I was doing an amox script for a dude who shows up with nothing but his wife's military ID and know they go through express scripts so I searched for plans by using BIN 610014 and entering the SSN but no matter what I tried it just would not go through. Our. 0000002215 00000 n YOUR PROVIDERS. 0000021734 00000 n We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. 0000028672 00000 n )!VZ*'kwBFIh\|#_`\8J5l}iYM NU(9p5i'#DsmZo;vqO?w *. \h%.=Of (%7j a5}s"rOTu.y=D#R_6IS.,Kmk?' z7F@s"WoM Puget Sound High Value Network (UMP Plus-PSHVN) UW Medicine Accountable . At home, across the country, and around the worldthe power of Blue is with you. 0000002073 00000 n Rx Information: MEDCO 1-800-842-2038 . var gcse = document.createElement('script'); Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. trailer 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. %PDF-1.6 % The above chart is the fifth page of the 2021 Medicare Part D pharmacy BIN and PCN list (H8634 - S9701). 0000013064 00000 n BIN: 610014 PCN: MEDDPRIME Plan Name/Group Name BIN: PCN: Plan Name/Group Name: BIN: PCN: Plan Name/Group Name: BIN: PCN: Processor: TelePAID System Effective as of: 12/08/2011 NCPDP Telecommunication Standard Version/Release #: D.0 NCPDP Data Dictionary Version Date: 07/01/2007 NCPDP External Code List Version Date: 10/01/2009 0000001415 00000 n var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; 0000019287 00000 n 0000011626 00000 n Payer/Carrier BIN/PCN Date Available Vendor Certification ID *Humana LI NET 015599/05440000 Current 601DN30Y *Humana Part D . Type of GHP: W United HealthCare Optimum Choice claims address: PO Box 740825 Atlanta, GA 30374 Rx Information: MEDCO 1-800-842-2038 . money from Medicare into the account. For more information contact the plan. that insure or administer group HMO, dental HMO, and other products or services in your state). The ISO/IEC 7812 Registration Authority (the American Bankers Association) issues the IIN. 0000007096 00000 n The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. LINA and NYLGICNY are not affiliates of Cigna. BIN number See above M Pages 1 and 2 for BIN/PCN : 102-A2 : Version/Release number D.0 M : 103-A3 : Transaction code B1, B3 M : 104-A4 : Processor control number : M . BIN 610239 PCN: FEPRX RxGrp: 65006500 3. The NCPDP Processor ID Number (BIN) is a six-digit number that health plans can use to process electronic pharmacy claims if they do not use pharmacy benefit cards with a magnetic stripe. PCN: Varies by plan - refer to ID card. JE?/=lx3Gi8>lp9.lHAT1m~&jcLTj}~`R$/#`Wret"XZ7;Dkts465e,sTXzI#Ve6\E`(&E^DXox._ C!ka7 0000004285 00000 n The term BIN is synonymous with the ISO/IEC 7812 IIN. 0000002715 00000 n The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. *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 0000038251 00000 n 0000008305 00000 n 0000007215 00000 n 0000009281 00000 n 0000033238 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, Limitations, copayments, and restrictions may apply. 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 The current local time in Stockholm County is 2 minutes ahead of apparent solar time. 0000046944 00000 n The Centers for Medicare & Medicaid Services (CMS) released a compilation of the BIN and PCN values for each 2021 Medicare Part D plan sponsor. %PDF-1.5 % })(); Chart of 2022 BIN and PCN values for each Medicare Part D prescription drug plan Part 6 of 6 (H9699 through S9701). What is the BIN, PCN, and RxGROUP number for my Medicare Part D prescription drug plan? 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. In certain situations, you can. during the calendar year will owe a portion of the account deposit back to the plan. Links will appear for the application process. startxref 0000010641 00000 n Contact the Medicare plan for more information. 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. hbbd``b`AR 6H da@D`m@\Y6 $Ma}d100RN2@ 8 It refers to a six-digit number that is assigned to banks for electronic routing of transactions. HealthNow Inc. (877) 327-1395 Medco Health Solutions (866) 544-7948 N/A 610014 Group: HNRXS HealthPlus (800) 300-8181 MedImpact Healthcare Systems, Inc. (800) 788-2949 58080 (HNY03-Health Plus NYS Medicaid) 003585 Medicaid Group: HCP9198, Family Health Plus Group: FHP9198 HIP Health Plan of New York (HIP) CDPHP (800) 388-2994. 0000001465 00000 n Read latest notifications, file pricing appeals and search Express Scripts claims and patient coverage for your Pharmacy customers. Your Dental Benefits Bank identification number (BIN): 600428: Processor control number (PCN): 06210000: Pharmacy directory: Click on : Participating pharmacy: or go to : mibluecrosscomplete.com . 0000009374 00000 n 106 0 obj <>stream 0000006026 00000 n s.parentNode.insertBefore(gcse, s); 0000000016 00000 n 0000000975 00000 n Express Scripts resources for pharmacists. 800-922-1557 Mercy Care LTC 610591 ADV RX8805 CVS- Caremark 855-548-5646 Arizona Complete Health (formerly Health Net & Cenpatico) 004336. 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 MeridianRx PCN Phone Fax Email MHPILMCD (Medicaid) 855 -580 -1688 855 -580 -1695 info@meridianrx.com . 0000002170 00000 n Solar noon: 12:02PM. UMP Plus (SEBB) 2021 Quick Start Guide. If they have bookmarked their old account, this will NOT show 2020 plan information. When a patient requests a prescription to be filled at the pharmacy, the pharmacy collects pertinent information on their prescription benefit program. These standards are developed by theInternational Organization for Standardization / International Electrotechnical Commission(ISO/IEC) Joint Technical Committee (JTC) 1,Information Technology, Subcommittee (SC) 17,Cards and personal identification, Working Group (WG) 5. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. All insurance policies and group benefit plans contain exclusions and limitations. Beyond the initial assigning of the BIN, NCPDP does not formally or informally track the history of the number. Health insurance can seem complicated, especially if you're new to the plan. We do not sell leads or share your personal information. General information is available in Resource Topic-Guidance Documentsunder the "Pharmacy and Healthcare Identification Cards" banner. There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. This document is available with NCPDP membership. 3850 0 obj <>stream 0000013525 00000 n 0000009323 00000 n 0000009977 00000 n We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. s.parentNode.insertBefore(gcse, s); Plans that use cards with a magnetic stripe should use the recommended ISO/IEC 7812 Issuer Identifier Number (IIN) for processing electronic pharmacy claims. 'https:' : 'http:') + 2391 0 obj<>stream When applicable, the Pharmacy Providers should update impacted members profiles with the new processing information. Group ID will be ignored by the processor. 2389 0 obj<> endobj Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at, Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the. If using IE11, please consider using an alternative browser. 11-a1 bin number (see above) m 12-a2 version/releasenumber d m 13-a3 transaction code b1, b3 m 14-a4 processor control number m . Ut JJ`&PXIIaAAq0. 0000001856 00000 n xref The NCPDP Processor BIN, while NCPDP assigns it, is only a number inside the pharmacy industry. Have them call the phone number on the back of their Cigna ID card. Have them call the phone number on the back of their Cigna ID card. %PDF-1.6 % 0000011949 00000 n For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227. The Processor Control Number (PCN) is a secondary identifier that may be used in routing of pharmacy transactions. Click here to let us know, UNITEDHEALTHCARE INSURANCE CO OF THE RIVER VALLEY. Your membership is expired. 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. If you have questions or concerns processing claims, you can call 1.800.624.6961, ext. EmblemHealth (888 . 610014, 610031, 610084/PRODUR1 Current UDO Medi-Care First 012353/03030000 Current 601DN30Y MercyCare Insurance Corporation 600428/02740000 Current 601DN30Y You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. Selecting these links will take you away from Cigna.com to another website, which may be a non-Cigna website. 0000008854 00000 n 74 0 obj <> endobj Members may enroll in a Medicare Advantage plan only during specific times of the year. WQqiT/ Y* T/q)~Z? 0 0000001081 00000 n BIN Number 610014 610014 003858 600428 PCN Number Per card, cannot be 0s 06330000Per card, cannot be 0s A4 . 7914 (after-hours: 1.304.639.8591) or email us at pharmacyservices@healthplan.org. Star Ratings are calculated each year and may change from one year to the next. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). Rx BIN#: 400023 Rx PCN#: 0020050403 Issuer#: (80840) CMS#:H3330-037-000 Plan Name Network: VIP Prime Comprehensive Dental X327934200116X 3 2 7 9 3 4 2 0 0 1 1 6 MEMBERS AND PROVIDERS: Network providers must provide or arrange nonemergency care. 45 0 obj << /Linearized 1 /O 47 /H [ 1020 449 ] /L 172513 /E 107663 /N 8 /T 171495 >> endobj xref 45 29 0000000016 00000 n 0000005253 00000 n CO. & UHC INS. cyU>]s#~e{0Bb'Su[4E(/0PS_5]bmE k!Nb%Lx@b,/c7RL Xg29jA8Ruk1 fRBYoD0F9%e=E>e?-"{wQD ?c['l|S_R "qQKMF4B6B] o)/+jtqGOfPN-H ni;9uE%[7 aX4wve.\FPDvY '}Aj(bsgZJLi|]&:{|r2+>p#+Y31D|nGPrtqp\R]oMDl${mI15R/,;$5#]_zK>%,u$xwO@B,UlCt MOkd?X?. 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 . 0000016616 00000 n area. var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; 0000001469 00000 n Our Privacy Policy is now easier to read and better organized. 0000014560 00000 n wG4jZG5\s.Wu=]qjLH Author: Kelly Wilson Created Date: The NCPDP Processor ID Number (BIN) is a six-digit number that health plans can use to process electronic pharmacy claims if they do not use pharmacy benefit cards with a magnetic stripe. Box 7012 Downey, CA . UMP Plus networks. 0000034997 00000 n 0000000016 00000 n Please renew your membership to login. 0000028633 00000 n 0000001745 00000 n 0000007443 00000 n The PCN, like the BIN/IIN appears on the pharmacy ID card, in accordance with the rules defined in theNCPDP Pharmacy ID and Combination Card Implementation Guide. Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). 0000033095 00000 n Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. One piece of information is the name of the health plan/PBM. Both in Stockholm and Finland, an e Western NY (877) 327-1395; Express Scripts (866) 544-7948 610014; Group: HNRXS. 0000001623 00000 n Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. xref Because of this, every member must create a new account regardless of whether they are renewing or not. %PDF-1.4 % 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. CVS Caremark (866) 693-4611; ADV XXXXXX; Group: RXCDPHP. The application and registration procedures are identified in ISO/IEC 7812-2. 0000010471 00000 n Region BIN PCN/ Group Help Desk Fiserv Health Plans Innoviant National 610127 01960000 877-559-2955 Fishing Partnership Health Plan MedImpact MA 003585 Grp 35026 800-788-2949 FlexScripts WHI/WHP TX/FL 603286 01410000, GP 513274 800/207-2568 FLRx FLRx National 610475 See Card 585-327-7530 0000000927 00000 n 0000021562 00000 n Please do not turn the customer away if you receive a rejected claim. 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. There is no registry of PCNs. endstream endobj 249 0 obj <>stream Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. 0000007668 00000 n 0000005422 00000 n Edit your form online Type text, add images, blackout confidential details, add comments, highlights and more. BRIGHT HEALTH INSURANCE COMPANY OF OHIO, INC. LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP, LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION. The application and registration procedures are identified in ISO/IEC 7812-2.
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