02. Have them call the phone number on the back of their Cigna ID card. Medicare MSA Plans do not cover prescription drugs. 0000002142 00000 n Solar noon: 12:02PM. hbbd``b`AR 6H da@D`m@\Y6 $Ma}d100RN2@ 8 2. endstream endobj 249 0 obj <>stream 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. The plan deposits The BIN/IIN and PCNs are listed on the PBM/processor/plans Payer Sheets for trading partners to know the proper identifiers for routing transactions. NCPDP issues the Processor ID Number (BIN). 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. Those who disenroll Payer/Carrier BIN/PCN Date Available Vendor Certification ID *Humana LI NET 015599/05440000 Current 601DN30Y *Humana Part D . Providers who do not contract with the plan are not required to see you except in an emergency. Sunrise, sunset, day length and solar time for Stockholm County. BANBUHP Express Scripts. Refer to above list or what is printed on ID card . Become a Member, PRIVACY POLICY UPDATE Effective February 11, 2021 Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. 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. 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. Medicare has neither reviewed nor endorsed the information on our site. 0000002482 00000 n 0000004285 00000 n General information is available in Resource Topic-Guidance Documentsunder the "Pharmacy and Healthcare Identification Cards" banner. 610014 800-824-0898 Integrated Prescription Management (IPM) 014658 877-860-8846 LDI Integrated Pharmacy Services 800010 800-652-9550 Magellan Health Services (Includes: Kentucky Passport) 015053, 016523 800-790-1631 McKesson Specialty 610524 800-657-7613 *Independently Contracted. TTY users should call, 1-800-325-0778; or your state Medicaid Office. 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. 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 . 0000001415 00000 n We are an independent education, research, and technology company. Credit/debit cards that are involved in banking transactions contain a BIN on magnetic stripe. 0000007555 00000 n xref 0000001623 00000 n HWr+S&M,N&H MRRgRIsin9ad_%^!c/$I &juN$WfOT^nvZd%w-17/0P}2EdN/[xnEZgcEir7x!%? 0000000016 00000 n Cigna may not control the content or links of non-Cigna websites. 0000016714 00000 n BIN 610239 PCN: FEPRX RxGrp: 65006500 3. money from Medicare into the account. The PCN, like the BIN/IIN appears on the pharmacy ID card, in accordance with the rules defined in theNCPDP Pharmacy ID and Combination Card Implementation Guide. The Rx BIN # 610014 The PCN is MEDDPRIME The Rx Group number as listed below The member's ID number (format listed below) Note: Medco anticipates members will have their newly issued ID cards, but to assist members and pharmacy in the event that not every member has the new ID card, Medco is supplying members of the enhanced NCPDP provides a service to those health plans that do not use magnetic stripe cards. Some health plans decided to use magnetic stripe cards, some did not. 0000033238 00000 n 0000001465 00000 n 0000005422 00000 n 0000001711 00000 n Puget Sound High Value Network (UMP Plus-PSHVN) UW Medicine Accountable . 01 M/I BIN 101-A1 04 M/I PCN 104 -A4 06 M/I GROUP NUMBER 301 -C1 07 M/I CARDHOLDER ID 301 -C2 Additional messaging will provide the correct BIN and PCN to use. We are not compensated for Medicare plan enrollments. What BIN/PCN/group number should I be entering in the Third Party section of my patient profile? In January 2017, the IIN length changed from a 6-digit number to an 8-digit number. 0000001856 00000 n P6mh7 quSOARI 4:,i}2Bzd93$g]Mc#. 0000006462 00000 n We do not sell leads or share your personal information. 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 M (BIN 6156 only . 109-A9 Transaction count 1 to 4 M Up to 4 0000006921 00000 n 0000100252 00000 n Group ID will be ignored by the processor. 0000002203 00000 n The NCPDP Processor BIN, while NCPDP assigns it, is only a number inside the pharmacy industry. Star Ratings are calculated each year and may change from one year to the next. 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 The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change. 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. 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 gcse.src = (document.location.protocol == 'https:' ? The PCN is alphanumeric as defined by the PBM/processor. 0000032580 00000 n Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. 0000012195 00000 n This includes accounts for Grandfathered members. 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 . ;;_XKkMUsZWPTdyRWp :{j dac{U|U|Y1~x^_$^4M}]Y>qP7CuH2xzR7bX" w-@yt 1;|hq=Z2C:n{g` Sunrise: 07:50AM. Your Premera provider network: What's 'in' it for you? The plan deposits However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. (function() { 0000005387 00000 n If they have bookmarked their old account, this will NOT show 2020 plan information. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. 58 D-MEDCO 610014(`1589) MEDCO MEDICARE PDP 5.1 57 CATALYST RX(`1306) 1/3/2012ps Page 2 3. 0000028726 00000 n If you forget if you need a group number or not, use the third party inquiry. 0000005958 00000 n a listing of the legal entities 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 Medicare MSA Plans do not cover prescription drugs. {hBIsS6U6,Q{O|+x`o~{>+W Od^.+mB:rNlHi} *"d\Q*\ZMW% Ffa3Y!G'[71c4)0 | Renew memberhip. AHCCCS FFS 001553 AZM OptumRx 855-577-6310 . 0000002830 00000 n area. 0000038251 00000 n Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. 0000012588 00000 n 74 0 obj <> endobj Members may enroll in a Medicare Advantage plan only during specific times of the year. 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. Some entities may use the Group ID; still others may not need this level of differentiation. Box 7012 Downey, CA . Members are instructed to show both ID cards before receiving health care services. Edit your form online Type text, add images, blackout confidential details, add comments, highlights and more. 'https:' : 'http:') + Beyond the initial assigning of the BIN, NCPDP does not formally or informally track the history of the number. Have them call the phone number on the back of their Cigna ID card. Your medical benefits allow you 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. 0 })(); Chart of 2022 BIN and PCN values for each Medicare Part D prescription drug plan Part 6 of 6 (H9699 through S9701). 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. 3424 0 obj <> endobj 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 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). We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. 0000023131 00000 n 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 Rx Information: MEDCO 1-800-842-2038 . '//cse.google.com/cse.js?cx=' + cx; 0000003383 00000 n MedImpact (Includes: Excellus/ FLRx) 8289 0 obj <>stream 0000011095 00000 n 0 0000009374 00000 n BIN: 610014 PCN: MEDDPRIME Group: RXINN03 Phone: 1-800-416-3628 Accredo Specialty Pharmacy Phone: 1-800-803-2523 . The above chart is the fifth page of the 2021 Medicare Part D pharmacy BIN and PCN list (H8634 - S9701). The BIN/IIN is a field in the Telecommunication Standard that is used for the routing and identification in pharmacy claims. startxref 24 hours a day/7 days a week or consult, When enrolling in a Medicare Advantage plan, you must continue to pay your. 0000001469 00000 n You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. UMP Plus (SEBB) 2021 Quick Start Guide. Because of this, every member must create a new account regardless of whether they are renewing or not. As of January 1, 2021, all Cigna Commercial pharmacy plans and Cigna Medicare claims are adjudicating on the Express Scripts systems. 0000000016 00000 n Op!> =bLxT_W\h%H,8)1mhT@(\ 3850 0 obj <>stream 0000006674 00000 n 0000028672 00000 n 0000001040 00000 n <<0F6188EC756C624CBAA438B0D92726A7>]>> 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. What is BIN/PCN and Group number needed to submit a BC/BS FEP prescription drug claim? Please do not turn the customer away if you receive a rejected claim. 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 . 0000001448 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. Sign Up To Receive Emails For Events, News & General NCPDP Information. The pharmacy system then includes this BIN/IIN in the electronic transaction the pharmacy sends to the payer for the prescription. What is the BIN, PCN, and RxGROUP number for my Medicare Part D prescription drug plan? Click here to let us know, UNITEDHEALTHCARE INSURANCE CO OF THE RIVER VALLEY. gcse.async = true; 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. Sign-up for our Medicare Part D Newsletter, Have a question? MeridianRx PCN Phone Fax Email MHPILMCD (Medicaid) 855 -580 -1688 855 -580 -1695 info@meridianrx.com . To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). 0000011029 00000 n U6E6hlhwElgf\0 $M[T=w"RnKPmH~g;~'-W99g/j730ePkxYj7 % "iU|5*hu88mG?K5rS0Q+C@^5k;5o^dM0&s o*e1gq~8F+aNc>CV} ${ *#. HWYkH+( !8 BaX<>b/]%Ys,Mw_W}U.UVpTEdOb 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. The IIN structure is defined within the international standard ISO/IEC 7812-1,Identification cards - Identification of issuers - Part 1: Numbering system. All calls are toll-free. Below are some tips to help you get the most out of your benefits and save money. The above chart is the sixth (final) page of the 2022 Medicare Part D pharmacy BIN and PCN list (H9699 - S9701). 0000011550 00000 n Star Ratings are calculated each year and may change from one year to the next. The Centers for Medicare & Medicaid Services (CMS) released a compilation of the BIN and PCN values for each 2021 Medicare Part D plan sponsor. 0000008305 00000 n Please contact the plan for further details. These numbers commonly begin with "61" as in "610014". 0000001020 00000 n One piece of information is the name of the health plan/PBM. 0000032773 00000 n gcse.src = (document.location.protocol == 'https:' ? )!VZ*'kwBFIh\|#_`\8J5l}iYM NU(9p5i'#DsmZo;vqO?w *. \h%.=Of (%7j a5}s"rOTu.y=D#R_6IS.,Kmk?' z7F@s"WoM 0000003944 00000 n money from Medicare into the account. 8254 0 obj <> endobj Your membership is expired. 0000033180 00000 n 0000016527 00000 n 610014 003858 MA . 106 0 obj <>stream Our. 'https:' : 'http:') + 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. 0000002289 00000 n 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. Hb```?@(AEs,Pp IG1~D&t The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. Not a Member? To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). 0000046944 00000 n The application and registration procedures are identified in ISO/IEC 7812-2. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). 0000021562 00000 n 0000028775 00000 n The benefit information provided is a brief summary, not a complete description of benefits. Medicare evaluates plans based on a 5-Star rating system. 0000009281 00000 n 0000001602 00000 n var gcse = document.createElement('script'); trailer trailer Our Privacy Policy is now easier to read and better organized. For more information contact the plan. contains Blue Cross Complete's BIN (600428), PCN (06210000), member : services number, field definitions and other helpful information for pharmacy claim billing and . If you continue to browse or use this website, you agree to this updated Privacy Policy. You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. var s = document.getElementsByTagName('script')[0]; %PDF-1.5 % 0000004060 00000 n gcse.async = true; 0000013064 00000 n 0000002685 00000 n 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 In certain situations, you can. 0000010641 00000 n Limitations, copayments, and restrictions may apply. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. 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. 0000003518 00000 n The ISO/IEC 7812 Registration Authority (the American Bankers Association) issues the IIN. Please enter the information that appears on the Selecting these links will take you away from Cigna.com to another website, which may be a non-Cigna website. 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. The benefit information provided is a brief summary, not a complete description of benefits. 74 33 The current local time in Stockholm County is 2 minutes ahead of apparent solar time. 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 0000003144 00000 n It is important to understand the difference between the ISO/IEC 7812 IIN and NCPDP Processor ID Number (BIN) before applying for a Processor ID Number (BIN). wG4jZG5\s.Wu=]qjLH CDPHP (800) 388-2994. 0000002073 00000 n Share your form with others Send it via email, link, or fax. BIN Number Additional Information Required for Pharmacy Processing; Affinity Health Plan (866) 247-5678; CVS Caremark (800) 364-6331 . Emblem Health (800) 447-8255. 0000005026 00000 n DownloadtheNCPDP Payer Sheet Template, more information is available by selecting Resource Topic - "HIPAA". 0000014626 00000 n Once new versions of the standards are adopted, truncation will no longer be necessary. 0 %%EOF 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 TTY users should call, 1-800-325-0778; or your state Medicaid Office. Health insurance can seem complicated, especially if you're new to the plan. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). 0000019345 00000 n 0000004799 00000 n In certain situations, you can. ?rXWK k(`8dB=k&y(~{p{V@ [ Hz)"oz ) Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). 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. 01. 0000007443 00000 n 2389 38 NCPDP has recently updated our Privacy Policy. Ut JJ`&PXIIaAAq0. during the calendar year will owe a portion of the account deposit back to the plan. *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 YOUR PROVIDERS. 0000033095 00000 n })(); Chart of 2021 BIN and PCN values for each Medicare Part D prescription drug plan Part 5 of 5 (H8634 through S9701). We are an independent education, research, and technology company. All the information you need to properly process prescription claims with Cigna. We do not reuse numbers. 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. var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; 0000001867 00000 n All insurance policies and group benefit plans contain exclusions and limitations. The ISO/IEC 7812 IIN is a number used throughout electronic routing. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. 0000006077 00000 n 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 610014, 610031, 610084/PRODUR1 Current UDO Medi-Care First 012353/03030000 Current 601DN30Y MercyCare Insurance Corporation 600428/02740000 Current 601DN30Y 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. The application and registration procedures are identified in ISO/IEC 7812-2. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. LINA and NYLGICNY are not affiliates of Cigna. 0000002069 00000 n D_j:i4 [lL@o?e}otGFsLH arXeq 0000008238 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. 0000009092 00000 n RX Bin: 610014 . Author: Kelly Wilson Created Date: We are not compensated for Medicare plan enrollments. The Privacy Policy has also been updated to better clarify what information we collect and how we use it. The Processor Control Number (PCN) is a secondary identifier that may be used in routing of pharmacy transactions. The IIN structure is defined within the international standard ISO/IEC 7812-1,Identification cards - Identification of issuers - Part 1: Numbering system. 0000029111 00000 n TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. xref BRIGHT HEALTH INSURANCE COMPANY OF OHIO, INC. LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP, LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION. Sign it in a few clicks Draw your signature, type it, upload its image, or use your mobile device as a signature pad. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC. GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC, VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK. Managed care pharmacy identification. UMP Plus networks. 0000002463 00000 n Type of GHP: W United HealthCare Optimum Choice claims address: PO Box 740825 Atlanta, GA 30374 Rx Information: MEDCO 1-800-842-2038 . 0000006324 00000 n Contact the Medicare plan for more information. 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. 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). %PDF-1.4 % endstream endobj 2426 0 obj<>/W[1 1 1]/Type/XRef/Index[124 2265]>>stream Joined Feb 3, 2010 Messages 2 . x1 04HKl\GMyC. xb```b````c` |, ,,2g]>%Ad`B. 3=Three Occurrences . xref 2391 0 obj<>stream %PDF-1.6 % %%EOF 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. The term BIN is synonymous with the ISO/IEC 7812 IIN. We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. }|a3M3J=/`zy[X >]!/c 5'{ Xri endstream endobj 73 0 obj 336 endobj 47 0 obj << /Type /Page /Parent 42 0 R /Resources 48 0 R /Contents 56 0 R /MediaBox [ 0 0 612 792 ] /CropBox [ 0 0 612 792 ] /Rotate 0 >> endobj 48 0 obj << /ProcSet [ /PDF /Text /ImageC ] /Font << /TT2 53 0 R /TT4 52 0 R /TT6 51 0 R /TT8 57 0 R /TT10 60 0 R /TT12 61 0 R >> /XObject << /Im1 63 0 R >> /ExtGState << /GS1 66 0 R >> /ColorSpace << /Cs6 55 0 R >> >> endobj 49 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 0 /Descent -216 /Flags 34 /FontBBox [ -568 -307 2000 1007 ] /FontName /FHGHLD+TimesNewRoman /ItalicAngle 0 /StemV 0 /FontFile2 67 0 R >> endobj 50 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 0 /Descent -216 /Flags 34 /FontBBox [ -558 -307 2000 1026 ] /FontName /FHGHND+TimesNewRoman,Bold /ItalicAngle 0 /StemV 133 /FontFile2 68 0 R >> endobj 51 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 32 /Widths [ 250 ] /Encoding /WinAnsiEncoding /BaseFont /FHGHND+TimesNewRoman,Bold /FontDescriptor 50 0 R >> endobj 52 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 49 /Widths [ 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 ] /Encoding /WinAnsiEncoding /BaseFont /FHGHLD+TimesNewRoman /FontDescriptor 49 0 R >> endobj 53 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 119 /Widths [ 352 0 0 0 0 0 0 0 0 0 0 0 364 0 364 454 636 636 0 0 636 0 0 636 0 0 0 0 0 0 0 0 0 0 0 0 771 0 575 0 751 421 455 0 557 843 748 0 603 0 0 684 0 0 0 0 0 0 0 0 0 0 0 0 0 601 0 521 623 596 0 0 633 274 0 592 274 973 633 607 623 0 427 521 394 633 592 818 ] /Encoding /WinAnsiEncoding /BaseFont /FHGHKH+Verdana /FontDescriptor 54 0 R >> endobj 54 0 obj << /Type /FontDescriptor /Ascent 1005 /CapHeight 0 /Descent -209 /Flags 32 /FontBBox [ -50 -207 1447 1000 ] /FontName /FHGHKH+Verdana /ItalicAngle 0 /StemV 96 /FontFile2 65 0 R >> endobj 55 0 obj [ /ICCBased 64 0 R ] endobj 56 0 obj << /Length 1929 /Filter /FlateDecode >> stream ;nq*DEhw x~iW}W7#WrL/F6geO6UNHZMS u|Z)/ZE,PK3G}E,8-1|_bF6? 0000019138 00000 n var s = document.getElementsByTagName('script')[0]; Updated Privacy Policy, Documents | Guides and Templates | Informational. Sunset: 04:14PM. In order to develop the most comprehensive beneficial standards for the healthcare industry we gather input, expertise, advocacy & leadership from our NCPDP members. 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?. Group number: Make sure the group number is populated on page 4 in RPMS Patient .