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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 . 02. RX Group: UHEALTH . 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. 0000012195 00000 n
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x1 04HKl\GMyC. 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 . 03. 3456 0 obj
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(function() { BIN: 610014 PCN: COPAY Reimbursement is Based on the Other Payer Patient Paid (COPAY ONLY) Plan Name/Group Name: MEDICARE PART D AS PAYER BIN: 610014 PCN: MEDDPRIME Plan Name/Group Name: SECONDARY to MEDICARE BIN: 610031 PCN: MEDDCOBSEG PART D COBSEG OTHER PAYER PRIMARY Plan Name/Group Name: SECONDARY to MEDICARE BIN: 610031 PCN: MEDDCOPAY 0000008161 00000 n
gcse.src = (document.location.protocol == 'https:' ? 7914 (after-hours: 1.304.639.8591) or email us at pharmacyservices@healthplan.org. Medicare evaluates plans based on a 5-Star rating system. Contact the Medicare plan for more information. 0000000016 00000 n
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. Author: Kelly Wilson Created Date: Sunrise: 07:50AM. Healthcare coverage wherever you go. gcse.type = 'text/javascript'; You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. 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. 0000016616 00000 n
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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. Members are instructed to show both ID cards before receiving health care services. 0000009323 00000 n
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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. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 0000005958 00000 n
var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; Solar noon: 12:02PM. Update on Premera Individual Medical and LifeWise Individual Medical If you have questions or concerns processing claims, you can call 1.800.624.6961, ext. Chart of 2021 BIN and PCN values for each Medicare Part D prescription 0000003944 00000 n
NCPDP provides a service to those health plans that do not use magnetic stripe cards. Joined Feb 3, 2010 Messages 2 . Details. xref
PDF SAS Benefit Vendor Contact Information JE?/=lx3Gi8>lp9.lHAT1m~&jcLTj}~`R$/#`Wret"XZ7;Dkts465e,sTXzI#Ve6\E`(&E^DXox._ C!ka7
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 You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. var s = document.getElementsByTagName('script')[0]; Existing six-digit IINs were converted into a block of one hundred eight-digit IINs. 0000002142 00000 n
PDF Michigan NCPDP D.0 Payer Specifications - Magellan Rx Management Become a Member, PRIVACY POLICY UPDATE Effective February 11, 2021 0000023131 00000 n
%%EOF
TTY users should call, 1-800-325-0778; or your state Medicaid Office. 20200903T55 Sh: 0 Bin 2 J008 Env [1] CSets 1 of 2. gcse.async = true; 0000003632 00000 n
Please renew your membership to login. 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. Group ID will be ignored by the processor. 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. Administrator, BIN, PCN, Group, and telephone number Specialty Pharmacy name and telephone number Website address for pharmacy information Buckeye Health Plan RxAdvance . It refers to a six-digit number that is assigned to banks for electronic routing of transactions. Puget Sound High Value Network (UMP Plus-PSHVN) UW Medicine Accountable . To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). The benefit information provided is a brief summary, not a complete description of benefits. 0000003516 00000 n
Cigna may not control the content or links of non-Cigna websites. *hE\gUk~4>nmSLz~d}ICbQ>9MGZ,*:1E[&{nM)mB5})vB^1+g<
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The IIN structure is defined within the international standard ISO/IEC 7812-1,Identification cards - Identification of issuers - Part 1: Numbering system. {hBIsS6U6,Q{O|+x`o~{>+W Od^.+mB:rNlHi}
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Please do not turn the customer away if you receive a rejected claim. 0000030450 00000 n
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WQqiT/ Y* T/q)~Z? Contact the plan provider for additional information. A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Click here to let us know, UNITEDHEALTHCARE INSURANCE CO OF THE RIVER VALLEY. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan. Because of this, every member must create a new account regardless of whether they are renewing or not. If you forget if you need a group number or not, use the third party inquiry. 0000034997 00000 n
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The benefit information provided is a brief summary, not a complete description of benefits. PDF Group Health Plan Information for IRS/SSA/CMS Data Match However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. PCN: Varies by plan - refer to ID card. 0000013064 00000 n
800-922-1557 Mercy Care LTC 610591 ADV RX8805 CVS- Caremark 855-548-5646 Arizona Complete Health (formerly Health Net & Cenpatico) 004336. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). M (BIN 6156 only . XLS Home - Centers for Medicare & Medicaid Services | CMS money from Medicare into the account. 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. 0000011029 00000 n
All existing six-digit IINs were converted into a block of one hundred eight-digit IINs. Updated Privacy Policy, Documents | Guides and Templates | Informational. We are not compensated for Medicare plan enrollments. %PDF-1.6
%
Both in Stockholm and Finland, an e %PDF-1.3
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Pharmacies can also check a member's enrollment with a West Virginia Medicaid MCO by calling 888-483-0793 . Not all entities use the PCN to differentiate plans. 0000033180 00000 n
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RX Group: UHEALTH . r 13+o6xip#Db,8>*$?HeRF 9QPf00C%:`"PE
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+. 58 D-MEDCO 610014(`1589) MEDCO MEDICARE PDP 5.1 57 CATALYST RX(`1306) 1/3/2012ps Page 2 3. 0000007215 00000 n
The above chart is the sixth (final) page of the 2022 Medicare Part D pharmacy BIN and PCN list (H9699 - S9701). U6E6hlhwElgf\0 $M[T=w"RnKPmH~g;~'-W99g/j730ePkxYj7
% "iU|5*hu88mG?K5rS0Q+C@^5k;5o^dM0&s o*e1gq~8F+aNc>CV} ${ *#. 0000019287 00000 n
PCN List for BIN 610241 MeridianRx PCN Group ID Line of Business MHPILMCD N/A Medicaid Pharmacy Help Desk Information Inquiries to MeridianRx may be directed to our 24 hour Pharmacy Assistance Center. There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. RX Bin for GuideStone Health Plans Except for Secure Health (No PCN Number required) 610014; Rx Bin for Secure Health TM Plans 003858 ; PCN Number for Secure Health TM Plans A4; You can also visit GuideStoneHealth.org and create an account to print a temporary ID card on or after your health plan effective date. 0000011550 00000 n
Share your form with others Send it via email, link, or fax. 0000001081 00000 n
PDF OptumRx NCPDP Version D.0 Payer Sheet COMMERCIAL AND MEDICAID '//cse.google.com/cse.js?cx=' + cx; PDF UMP Plus (SEBB) 2021 Quick Start Guide - hca.wa.gov 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. The term BIN is synonymous with the ISO/IEC 7812 IIN. Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see 0000007668 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. As of January 1, 2021, all Cigna Commercial pharmacy plans and Cigna Medicare claims are adjudicating on the Express Scripts systems. The plan deposits 0000012588 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. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. Limitations, copayments, and restrictions may apply. xb```b````c` |,
,,2g]>%Ad`B. PDF commercial payer sheet - Express Scripts trailer
0000032580 00000 n
On the ANSI web page, enter "IIN" in the Search box. You can position the text box anywhere in the document. | Renew memberhip. 0000005026 00000 n
Rx PCN: N/A When a patient requests a prescription to be filled at the pharmacy, the pharmacy collects pertinent information on their prescription benefit program. trailer
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Bank identification number (BIN): 600428: Processor control number (PCN): 06210000: Pharmacy directory: Click on : Participating pharmacy: or go to : mibluecrosscomplete.com . s.parentNode.insertBefore(gcse, s); 0000019138 00000 n
3=Three Occurrences . (function() { that insure or administer group HMO, dental HMO, and other products or services in your state). RX Bin # 610014 RX Group # BCWAPDP The member portal is new as well. UMP Plus (SEBB) 2021 Quick Start Guide. 0000007555 00000 n
We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. Refer to above list or what is printed on ID card . 0000007096 00000 n
These numbers commonly begin with "61" as in "610014". All calls are toll-free. <<5F4BCB39515F55479546A7F5DAE5B678>]>>
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c4C)iG/Y88. Sign it in a few clicks Draw your signature, type it, upload its image, or use your mobile device as a signature pad. Plans that use cards with a magnetic stripe should use the recommended ISO/IEC 7812 Issuer Identifier Number (IIN) for processing electronic pharmacy claims. BIN: 610014 PCN: MEDDPRIME Group: RXINN03 Phone: 1-800-416-3628 Accredo Specialty Pharmacy Phone: 1-800-803-2523 . UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC. GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC, VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK. Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT); (ii) Life Insurance Company of North America (LINA) (Philadelphia, PA); or (iii) New York Life Group Insurance Company of NY (NYLGICNY) (New York, NY), formerly known as Cigna Life Insurance Company of New York. This includes accounts for Grandfathered members. Your Premera provider network: What's 'in' it for you? The NCPDP Processor BIN is a six-digit sequential number we assign that begins with "0" as in "000010". 74 33
In certain situations, you can. We do not sell leads or share your personal information. In January 2017, the IIN length changed from a 6-digit number to an 8-digit number. Have them call the phone number on the back of their Cigna ID card. startxref
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'https:' : 'http:') + 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). 01. A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. PDF NCPDP Version D.0 Payer Sheet - EpiphanyRx 0000001868 00000 n
0000028275 00000 n
Call 1-866-447-9717 Customer Service: 1-877-344-7364 (TTY/TDD: 711) Emblem Behavioral Health Services . 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 'https:' : 'http:') + 0000002463 00000 n
var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; PDF Certified Payors - McKesson %%EOF
PDF Acute Care Plans - azahcccs.gov TTY users should call, 1-800-325-0778; or your state Medicaid Office. 0000005086 00000 n
Use the Drawing Tools tab to change the formatting of the pull quote text box.] CO. OF NY, BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA, MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK, 001, 002, 003, 004, 005, 006, 007, 008, 009, 010, 011, 012, 014, 015, 016, 017, 018, 019, 020, 021, 022, 023, 024, 025, 026, 027, 028, 029, 030, 031, 032, 033, 034, 070, 105, 106, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 801, 802, 808. 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. 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) RX Bin: 610014 . 0000011095 00000 n
;nq*DEhw x~iW}W7#WrL/F6geO6UNHZMS u|Z)/ZE,PK3G}E,8-1|_bF6? But that's pure memorization. bin 610014 pcn peu - Julio Carmona 0000006324 00000 n
CVS Caremark (866) 693-4611; ADV XXXXXX; Group: RXCDPHP. Limitations, copayments, and restrictions may apply. startxref
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. Please do not turn the customer away if you receive a rejected claim. Once verified, ANSI will submit the application to the ISO/IEC 7812 Registration Authority for assignment of an IIN. <<0F6188EC756C624CBAA438B0D92726A7>]>>
%%EOF
There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. We are not compensated for Medicare plan enrollments. hbbd``b`AR 6H da@D`m@\Y6
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AHCCCS FFS 001553 AZM OptumRx 855-577-6310 . 0000008305 00000 n
0000006921 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). General information is available in Resource Topic-Guidance Documentsunder the "Pharmacy and Healthcare Identification Cards" banner. DownloadtheNCPDP Payer Sheet Template, more information is available by selecting Resource Topic - "HIPAA". BIN Number Additional Information Required for Pharmacy Processing; Affinity Health Plan (866) 247-5678; CVS Caremark (800) 364-6331 . 0000001020 00000 n
What is a Take-Home Drug? Sign Up To Receive Emails For Events, News & General NCPDP Information. Op!> =bLxT_W\h%H,8)1mhT@(\ 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. 0000033095 00000 n
Please note, the data below is Part 5 of 5 (H8634 - S9701) with links to Parts 1 through 4. Og%$pB1 o:er1?P_ojKuK3L 9H(! 0000007028 00000 n
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. 610014, 610031, 610084/PRODUR1 Current UDO Medi-Care First 012353/03030000 Current 601DN30Y MercyCare Insurance Corporation 600428/02740000 Current 601DN30Y PDF Commercial Plan List We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. BCBS of MI BIN: 610011 PCN: Varies - Never "IRX" 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 04000013 LDI / CastiaRx BIN: 020321 BIN: 800010 PCN: COM PCN: LDI SavaScript Value . Our. Medicare MSA Plans do not cover prescription drugs. 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. HWr+S&M,N&H MRRgRIsin9ad_%^!c/$I &juN$WfOT^nvZd%w-17/0P}2EdN/[xnEZgcEir7x!%? 0000002215 00000 n
The above chart is the fifth page of the 2021 Medicare Part D pharmacy BIN and PCN list (H8634 - S9701). Chart of 2022 BIN and PCN values for each Medicare Part D prescription