[PDF]Plan Lists - Rackcdn.comec136126026ae0ee21c6-6b9280afdddbd69575967dcab27a2354.r32.cf2.rackcdn.co...
736 downloads
4240 Views
224KB Size
Plan Lists Plan Name / Network Name
Network or Attachment
Region
BIN, PCN or Group
Help Desk/ Notes
Network or Attachment
Region
4D Pharmacy Mangement Systems, Inc.
Preferred-Choice Pharmacy Network
National
BIN: 600428 PCN:1990000
866-849-4196
AmeriHealth Mercy Health Plan, Inc.
OTC Medications and Supplies
National
4D Pharmacy Mangement Systems, Inc.
Discount Drug Card
BIN: 600428 PCN: 1990000
866-849-4196
AmeriScript, Inc.
Retail
4D Pharmacy Mangement Systems, Inc.
Traditional Pharmacy Network
BIN: 600428 PCN: 1990000
866-849-4196
Applied Underwriters, Inc.
4D Pharmacy Mangement Systems, Inc.
Managed Choice Pharmacy Network
BIN: 600428 PCN: 1990000
866-849-4196
4D Pharmacy Mangement Systems, Inc.
Managed Pharmacy Network
BIN: 600428 PCN:1990000
866-849-4196
Agelity, Inc.
Pre Scripts
National
BIN: 004682
800-847-7147
Agelity, Inc.
Agelity Prescription Benefit Plan
National
BIN: 009265
800-847-7147
Agelity, Inc.
Agelity Prescription Drug Savings Program
National
BIN: 009265
800-847-7147
Agelity, Inc.
My Prescription Card
National
BIN: 600426
800-847-7147
Agelity, Inc.
Goldline
National
BIN: 600426
800-847-7147
Agelity, Inc.
SMCRx
National
BIN: 610550
800-847-7147
Agelity, Inc.
Agelity Affinity Cash Discount Card
National
BIN: 600426 PCN: 3A
800-433-4893
Agelity, Inc.
CatalystScripts
National
BIN: 004682
800-847-7147
Agelity, Inc.
PPSC Cash Network Cash Discount Card
National
BIN: 004682 PCN: SG
800-768-7272
American Health Care Administrative Services, Inc.
Medicare Part D National Network
National
American Health Care Administrative Services, Inc.
AHC Citizens Health
American Health Care Administrative Services, Inc.
Citizens Choice HealthPlan
National
American Health Care Administrative Services, Inc.
National Network
National
Americhoice NJ
Americhoice NJ
BIN, PCN or Group
Help Desk/ Notes
National
BIN: 610640 PCN: AMER9999
800-681-6912
Applied Workers' Compensation Network
National
BIN: 013329 PCN: APP
877-234-4420 Option 5
Applied Underwriters, Inc.
The Applied Network
National
BIN: 013329 PCN: APP
877-234-4420 Option 5
Argus Health Systems, Inc.
ANA - 60 90 day at Retail Program
90 days Retail
800-522-7487
Argus Health Systems, Inc.
ANA - 92 National Open Network
BIN: 600428
800-522-7487
Argus Health Systems, Inc.
LTC
National
BIN: 600428
800-522-7487
Argus Health Systems, Inc.
ANA - 91 Priority Health
National
BIN: 600428
800-522-7487
Argus Health Systems, Inc.
Argus Home Infusion
National
Argus Health Systems, Inc.
ANA - Nursing Home, Long Term Care And Assisted Living
National
BIN: 600428
800-522-7487
Argus Health Systems, Inc.
ANA - Hospice
National
BIN: 600428
800-522-7487
ANA - 5
National
BIN: 600428
800-522-7487
Argus Health Systems, Inc.
ANA - 4
National
BIN: 600428
800-522-7487
Argus Health Systems, Inc.
ANA - 3
National
BIN: 600428
800-522-7487
Argus Health Systems, Inc.
Vrx: Deseret Mutual Vaccine Administration
National
BIN: 610245. PCN: 05490000
888-635-8315
Argus Health Systems, Inc.
MedicisRx
National
BIN: 600428 PCN: 05080000 GRP: 05770131
855-479-7283
BIN: 610118
Argus Health Systems, Inc.
ANA - 54 Discount Card
National
BIN: 600428 PCN: 03020000
800-522-7487
BIN: 610118 PCN: AHC
Argus Health Systems, Inc.
ANA - 22 Health Partners of PA
NY, NJ, PA
BIN: 600428
800-522-7487
Argus Health Systems, Inc.
Retail Vaccine
National
BIN: 610649
800-522-7487
Argus Health Systems, Inc.
Gateway Health Plan Vaccine
NY, NJ, PA
Commercial BIN: 600428 PCN: 02710000 Medicare BIN: 012353 PCN: 03740000
Med Part D: 800-221-9537 Medicaid: 800-220-4532
Argus Health Systems, Inc.
ANA - 101 Uninsured Member Programs
National
BIN: 600428
800-522-7487
Argus Health Systems, Inc.
ANA - 69 Medicare Part D
BIN: 610118
BIN: 610097 PCN: 9999 AMCNJ
MAPD: 877-889-6510 All Others: 800-788-7871
BIN: 610494 PCN: 2300
Medicaid
AmeriHealth Mercy Health Plan, Inc.
Keystone Mercy Health Plan
National
AmeriHealth Mercy Health Plan, Inc.
Retail
National
National
Argus Health Systems, Inc.
BIN: 610118
Rx Solutions Medicare
Plan Name / Network Name
BIN: 600428 PCN: 01940000
800-522-7487
Plan Lists Plan Name / Network Name
Network or Attachment
Region
BIN, PCN or Group
Help Desk/ Notes
Argus Health Systems, Inc.
ANA - 98 Part D Vaccine
National
BIN: 610649
800-522-7487 Now handles all BSCA as Well
Argus Health Systems, Inc.
ANA - 87 Comp-Med Program
National
Argus Health Systems, Inc.
ANA - 98 Medicare Part D
Atlantic Prescription Services
Managed Care Network
Atlantic Prescription Services
Discount Rx Card Network
BC/BS of Alabama
BCBSAL Retail Specialty Pharmacy Medication
800-522-7487
Plan Name / Network Name
Network or Attachment
Region
Caremark
RxAmerica Zenith Insurance Company Network
National
Caremark
CareComp
National
Caremark
State of TN Extended Day Supply Network
KY
Caremark
CareValue3a Network
National
Caremark
CareValue3b Network
National
Caremark
Medicare Part D Retail Network 1
National
Caremark
Medicare Part D Retail Network 2
National
800-522-7487 National National
BIN: 004915 Medicare: 888-878-8668 Commercial National: 800-216-9920
Caremark
Horizon BCBSNJ
Caremark
RxClusive Consumer Card Savings Network
National
Caremark
PatientChoice 90 Network
National
BIN, PCN or Group
Help Desk/ Notes
BIN: 610029 PCN: STNRX
800-421-2342
BIN: 610415
800-364-6331
BCBSAL Medicare Products Pharmacy Network
National
BC/BS of Arizona
BCBSAZ In Arizona
CA, WA, AZ, NV
BIN: 603017 PCN: BAZ, TQC
Caremark
PreferredChoice Network
National
BC/BS of Arizona
BCBSAZ Out of Arizona
National
BIN: 603017 PCN: BAZ, TQC
Caremark
National
Benescript
Benescript Retail
National
BIN: 003452
800-345-3189
Medicare Part D Retail Extended Days Supply Network
Beyond Rx
Beyond Rx National Network
National
BIN: 610641 PCN: PB
866-247-9996
Caremark
BCBS RI Influenza Vaccine Administration Network
National
BIN: 610468
800-777-1023
Beyond Rx
Beyond Rx BRX Choice Network
National
BIN: 610641 PCN: PB
866-247-9996
Caremark
National
Beyond Rx
National
BIN: 610641 PCN: PB
866-247-9996
BIN: 004336 PCN: ADV Group: RX8579
866-469-7774
Beyond Rx VPN Network
Medicaid NY Presbyterian System SelectHealth
Beyond Rx
Beyond Rx Select Network II
National
BIN: 610641 PCN: PB
866-247-9996
Caremark
Medicaid MetroPlus Health Plan
National
BIN: 004336 PCN: ADV Group: RXMPHP
800-303-9626
Beyond Rx
Beyond Rx Select Network
National
BIN: 610641 PCN: PB
866-247-9996
Bio Scrip
BioScrip Medicaid Network
National
BIN: 900020
800-230-8187
Bio Scrip
BioScrip Affinity Program
National
BIN: 900020
800-230-8187
Bio Scrip
BioScrip Open Pharmacy Network
National
BIN: 900020
800-230-8187
BC/BS of Alabama
Bio Scrip
Medicaid Total Care
National
Caremark
LTC
National
BIN: 004915
BIN: 900020 PCN: CLAIMNE
315-634-5555
Caremark
Medicaid Fidelis Care
National
BIN: 0046366 PCN: ADV Groups: RX6460, RX6461, RX6462, RX6465, RX6466
Caremark
Medicaid CDPHP
National
BIN: 0046336 PCN: ADV Group: RXCDPHP
800-345-5413 800-388-2994
Caremark
Medicaid Affinity Health Plan
National
BIN: 0046336 PCN: ADV Group: RX4212
866-247-5678
Plan Lists Plan Name / Network Name
Network or Attachment
Region
BIN, PCN or Group
Help Desk/ Notes
Caremark
Medicaid Amerigroup
National
BIN: 0046336 PCN: ADV Group: RX4293
800-454-3730
Caremark
Caremark FEP Vaccine Administration Network
National
BIN: 610239, 610415 Carrier-Group: 65006500
Caremark
Caremark Vaccine Administration Network
National
Caremark
Coventry GHP Plans Retail Maintenance Provider Network 2
National
Caremark
Molina Healthcare of Ohio
Other
BIN: 002286 PCN: 6000
BIN: 610473 PCN: N/A Group: N/A Medicaid
Eligibility and Prior Authorization Rrequests: 800-642-4168 Non-clinical or technical: 800-364-6331
Coventry GHP Plans Retail Maintenance Provider Network 1
National
BIN: 002286 PCN:6000
800-844-9636
Caremark
CarePremier Network
National
BIN: 006350
800-364-6331
Caremark
Caremark Managed Cash Network
National
Caremark
Orange Count MSI
CA, WA, AZ, NV
Caremark
Retail 90 Program A
National
Caremark
Retail 90 Program B
National
Caremark
BCBS Association Provider Network
National
Caremark
AMERIGROUP Corporate Network Florida Plan
FL
Caremark
CareSelect Network
National
BIN: 004816, 610029 PCN: CRMPT
800-364-6331
NY, NJ, PA
BIN: 004336 PCN: ADV GRP: RXMPHP
Medicaid: 800-364-6331
MetroPlus Health Plan
Caremark (PCS Health Systems)
PCS RECAP Network
Caremark (PCS Health Systems)
PCS Plan Sponsor Network
Caremark (PCS Health Systems)
PCS National Network
Catalyst
Retail
Network or Attachment
Region
BIN, PCN or Group
Help Desk/ Notes
Catalyst
Medicaid WellCare Health Plans
National
BIN: 603286 PCN: 01410000 Group: 856257, 788257
800-288-5441
Catalyst
IPA Managed Care Organizations
NY, NJ, PA
BIN: 005947
888-869-4600
Catalyst
Sound Health & Wellness Retiree Trust
Catalyst
Health Alliance
Catalyst
WellCare of Kentucky Medicaid
Catalyst
Standard
Catalyst
Upper Peninsula Health Plan Plus HMO SNP Vaccine
FEP
National
BIN: 603286 PCN: 01410000 GRP: 476257
800-207-2568, DER Requests: 877-389-9457
Other
Part D - BIN: 005947 PCN: CLAIMCR GRP: UPHPMEDD Part B - Call 877-349-9324
Part D: 877-464-0073 Part B: 877-349-9324
BIN: 603286 PCN: 01410000 Group: 856257 Family Health Plus, Healthy Choice
DER Requests: 800-288-5441 Remittance Questions: 800-207-2568 DME Supply Questions: 800-288-5441
BIN: 603286 PCN: 01410000 Group: 716257
DER: 800-951-7719 Remittance: 800-207-2568
WellCare of New York
NY, NJ, PA
Catalyst
Sound Health & Wellness Trust
CA, WA, AZ, NV
Catalyst
WellCare of Ohio
Other
Catalyst
Catalyst Wellcare Vaccine
National
Catalyst
90 Day at Retail
National
CIGNA
CIGNA Specialty
National
BIN: 600428
CIGNA
CIGNA Pharmaceutical Services
National
BIN: 600428
CIGNA
CIGNA Med Part D
National
BIN: 600428
Community Care Rx-MTM
800-364-6331
KY
Catalyst
CIGNA
BIN: 610502
BIN: 005947
800-844-9636
Caremark
Caremark
Plan Name / Network Name
CIGNA LTC
BIN: 600428
MemberHealth LTC
National
Community Care Rx-MTM
CMTM Level 1
National
Community Care Rx-MTM
CMTM Services Declined
National
CPT Code 0115T
Plan Lists Plan Name / Network Name
Network or Attachment
Region
Community Care Rx-MTM
CMTM WMR Tasks
National
Community Care Rx-MTM
MemberHealth Regional A
Other
Community Care Rx-MTM
MemberHealth Region B
Other
Community Care Rx-MTM
CMTM Level 2
National
Community Plus Pharmacy Network - BCBSMS Advanced Health Systems
Community Plus Network
National
BIN for NDC: 004583 BIN for Envoy: 004084
Healthcare Solutions Workers Comp
National
National
Cypress Care (Healthcare Solutions) DataRx
DataRx Open Network
Emdeon
MedE Workers Compensation
Emdeon
MedE Therapy First Plus Network
Emdeon
MedE Preferred Network
National
Network or Attachment
Region
BIN, PCN or Group
Help Desk/ Notes
Envision Rx Options
Envision Managed HealthCare Services Company Network
National
BIN: 009893 PCN: ROIRX
800-361-4542
Envision Rx Options
Quality Health Plans
National
BIN: 015012 PCN: PARTD
800-361-4542
CPT Code 0115T + 0117T
Envision Rx Options
Envision LA Rx Presciption Savings Card
CA, WA, AZ, NV
BIN: 009893 PCN: ROIRX
800-361-4542
800-551-5258 or 601-932-9788
Envision Rx Options
Envision 2011-2012 Flu & Pneumonia
National
BIN: 004682 PCN: CC
Envision Rx Options
Envision Preferred HI Network
National
BIN: 012312 PCN: PARTD
800-361-4542
BIN: 610568, 610219, 014252, or 14236 PCN: DRX
Envision Rx Options
National
BIN: 012312 PCN: PARTD
800-361-4542
877-823-1273
Envision Preferred LTC Network
Envision Rx Options
Envision HPP Private Label Savings Card
National
BIN: 009893 PCN: ROIRX
800-361-4542
BIN: 009265
800-433-4893 Envision Rx Options
Envision National Network LTC
National
BIN: 012312 PCN: PARTD
800-361-4542
Envision Rx Options
Envision Preferred Network
National
BIN: 012312 PCN: PARTD
800-361-4542
Express Scripts, Inc.
EN40
National
BIN: 003858 PCN: A4, SC (only Med D)
Express Scripts, Inc.
ESI Med Part D Vaccine Administration Network
National
BIN: 003858 PCN: MD, SC (only Med D)
Express Scripts, Inc.
ESI Medicare Part D Retail Network
National
BIN: 003858 PCN: MD, SC (only Med D)
Express Scripts, Inc.
TRICARE Vaccination Program
National
BIN: 003858 OCBL A4, SC (Med D only),
Express Scripts, Inc.
ESI Vaccine Administration Network
National
Express Scripts, Inc.
BCBSLA Vaccination
Other
Express Scripts, Inc.
ExpressComp Network
National
BIN: 003858 PCN: A4, SC (only Med D)
Express Scripts, Inc.
EN50
National
BIN: 003858 PCN: A4, SC (only Med D)
Express Scripts, Inc.
Medicaid Amida Care
National
BIN: 003858 PCN: A4 Group: KJFA
BIN, PCN or Group
Help Desk/ Notes
National
BIN: 004682 PCN: CN
800-433-4893
National
BIN: 600426 PCN: 54
800-433-4893
Emdeon
MedE Patient Choice Network
National
BIN: 004682 PCN: CN
800-433-4893
Emdeon
MedE Self-Pay Network
National
BIN: 600426, 004682 PCN: 3A, CAT, 96
800-433-4893
Emdeon
MedE Therapy First Network
National
BIN: 004682 PCN: CN
800-433-4893
Emdeon
MedE National Network
National
BIN: 600426 PCN: 54
800-433-4893
Employee Health Ins Mgmt - EHIM
EHIM LTC Pharmacy Network
National
BIN: 005285
Employee Health Ins Mgmt - EHIM
EHIM Retail
National
BIN: 005285
Envision Rx Options
Envision Elderplan National Network
National
BIN: 012312 PCN: PARTD
800-361-4542
Envision Rx Options
Envision Fringe Benefit Management Company Network
National
BIN: 009893 PCN: ROIRX
800-361-4542
Ohio's Best Rx
IL, NY, NJ, PA, NE, NH, ME, KY, Other
BIN: 009893 PCN: ROIRX
800-361-4542
Envision Rx Options
Plan Name / Network Name
800-361-4542
800-824-0898
646-786-1800
Plan Lists Plan Name / Network Name
Network or Attachment
Region
BIN, PCN or Group
Help Desk/ Notes
Express Scripts, Inc.
Medicaid Healthfirst
National
BIN: 003858 PCN: A4 Group: HEFA
866-463-6743
Express Scripts, Inc.
Medicaid HIP Health Plan of New York Emblem Health
National
BIN: 015748 PCN: 20111001
800-447-8255
Express Scripts, Inc.
Medicaid Neighborhood Health Providers
National
BIN: 003858 PCN: A4 Group: KJBA
877-782-8655 800-826-6240
First Health
PRIMExtra Network
National
BIN: 610468
First Health
EPIC American Indian Health Program
National
BIN: 610468
First Health
ALTA Rx Network
National
BIN: 610468
First Health
Medicare Drug Discount Card Program
MI, MO, NY, PA
First Health
EPIC NY State Senior Prescription Plan
FLRx
FLRx Simply Prescriptions Medicare Part D Pharmacy Network
BIN: 610475
FLRx
FLRx Simply Prescriptions Medicare Retail Program for Specialty Drugs
BIN: 610475
FLRx
FLRx Pharmacy Network
National
FutureScripts
FutureScripts Medicare Part D
National
FutureScripts
FutureScripts Commercial
National
General Prescription Program
GPP Network
National
HealthTrans
Medicare Part D Programs
National
HealthTrans
HealthTrans Vaccine
National
HealthTrans
National Network
National
BIN: 600428
800-950-9120
HealthTrans
Worker's Compensation Network
National
BIN: 009992
800-950-9120
HealthTrans
Rx Discount 90 Day Network - FUNDED Business
NY, NJ, PA
National
Network or Attachment
Region
HealthTrans
90 Day Supply Network - 100% Cash Business
National
HealthTrans
Medicare Part D Programs RURAL
National
Pharmacy must reside at least 10 miles from a major metropolitan city.
HealthTrans
National RURAL Network
National
Pharmacy must reside at least ten miles from a major metropolitan city.
HealthTrans
Medicare Part D 90 Day Supply Network
National
HealthTrans
Prescription Discount Card Network
National
HealthTrans
LTC
National
BIN: 600428
800-950-9120
National
BIN: 009992 PCN: Gr HTAWEST01, HTAPORT01, USPG0023
866-257-1419
HealthTrans
BIN: 610468
BIN: 610475
Plan Name / Network Name
585-327-7530
UNA Cash Discount Network
BIN, PCN or Group
HealthTrans
Kaiser Permenente
National
BIN: 011172, 011842, 011230, 011859, 011248, 011214, 011222, 011255 PCN: NWCMS
HealthTrans
100% Cash Network
National
BIN: 010553
HIP
HIP LTC
NY, NJ, PA
BIN: 400023, 010033
HIP
HIP Medicare
NY, NJ, PA
BIN: 400023, 010033
HIP
HIP Medicare Extended Day Supply
NY, NJ, PA
BIN: 400023, 010033
HIP
HIP Vaccination
NY, NJ, PA
BIN: 400023, 010033
HIP
HIP Commercial
NY, NJ, PA
IdealScripts
IdealScripts Retail
National
BIN: 011289
IdealScripts
IdealScripts 90 Day at Retail
National
BIN: 011289
Help Desk/ Notes
Part B and Part D
Independent Health
Maintenance Drugs
National
BIN: 004626
Independent Health
Compounding
National
BIN: 004626
Independent Health
Medicaid Independent Health
National
BIN: 004626
800-993-9898
Retail
National
BIN: 004626
716-631-2927
Innoviant Part D 84Days or Greater Supply Retail
National
BIN: 610127 PCN: 02330000
800-794-1086
Independent Health Innoviant
716-631-2927
Plan Lists Plan Name / Network Name
Network or Attachment
Region
Innoviant
National 90-Day at Retail Network
National
Innoviant
National Open Network
National
Innoviant
Innoviant Part D 1-83 Days Supply Retail
Innoviant
Innoviant Home Infusion
BIN, PCN or Group
Help Desk/ Notes 877-559-2955
BIN: 610127 PCN: 02330000, 01960416 Wausau
877-559-2955
National
BIN: 610127 PCN: 02330000
800-794-1086
National
BIN: 610127 PCN: 02330000
800-794-1086
Innoviant
National Cash Discount Network
National
BIN: 610127 PCN: 02570000
Innoviant
Innoviant LTC
National
BIN: 610127 PCN: 02330000
800-794-1086
IPM
IPM Retail
National
BIN: 014658
877-860-8846
IPM
IPM GAP High Deductible Network
National
BIN: 014658
Keystone Mercy Health Plan
KMHP Retail
NY, NJ, PA
BIN: 600428
Keystone Mercy Health Plan
KMHP OTC
NY, NJ, PA
BIN: 600428
Maxor Plus
MaxorPlus Select Network
National
BIN: 005377 PCN: 10000019
Maxor Plus
Maxor Prime Network
National
Maxor Plus
Maxor Medicare Part D
National
Maxor Plus
Medicaid Hudson Health Plan
National
Plan Name / Network Name
Network or Attachment
Region
MedImpact
Excellus Home Infusion Network
NY, NJ, PA
MedImpact
Choice 90
National
MedImpact
Home Infusion
National
MedImpact
CRX 2009
National
MedImpact
Health Alliance
IL
800-339-4557
800-687-0707 800-687-0707
Help Desk/ Notes
BIN: 003585
800-788-2949
BIN: 003585 PCN: 14100
MedImpact
Choice 90 w MAC
National
BIN: 003585
MedImpact
Cash Discount CRX
National
BIN: 003585
MedImpact
Cash Discount Card Network
National
BIN: 003585 BIN: 003585, Medicaid Group: HCP9198, Family Health Plus Group: FHP9198 PCN: 58080 (HNY03-Health Plus NYS Medicaid)
MedImpact
Medicaid HealthPlus
NY, NJ, PA
MedImpact
Excellus Extended Supply Retail Medicare Part D Network
NY, NJ, PA
MedImpact
Excellus Commercial Employee Group
NY, NJ, PA
MedImpact
KPS Health Plan
MedImpact
Physicians of Douglas County
Other
MedImpact
Carolina Care MedWest Hospital
Other
BIN: 003585 PCN 34106
MedImpact
Apex Affinity Big Path AME Benefits Cash Discount Card
National
BIN: 015441 PCN: 11330 GRP: B033000000
800-687-0707
BIN: 005377, Medicaid Group: MDC, Family Health Plus Group: FHP. PCN: 10000019
BIN, PCN or Group
BIN: 003585 PCN: 49100
Maxor Plus
National
Maxor Plus
MaxorPlus Preferred Network
National
BIN: 005377 PCN: 10000019
Maxor Plus
Maxor FirstCare
National
BIN: 003858
Medical Security Card
ScriptSave Program Network
National
BIN: 006053 PCN: MSC, HDN
MedImpact
LA Care Health Plan
CA, WA, AZ, NV
Medical Security Card
RxA Programs Network
National
BIN: 006053 PCN: RXA
MedImpact
Health Plan Select Flu Vaccine
Other
Vaccine Admin
National
MedImpact
Influenza
National
MedImpact
FirstCarolinaCare Influenza Vaccination
National
PCN: 34400 BIN: 003585
MedImpact
Excellus Managed Medicaid Premier Health Plan
NY, NJ, PA
BIN: 003585 PCN: 74000 Family Health Plus
LTC
National
MedImpact
Excellus Retail
NY, NJ, PA
MedImpact
Excellus LTC
NY, NJ, PA
MedImpact
17 Retail
National
BIN: 003585
800-788-2949 800-788-2949
BIN: 005377 PCN: 10000019
MedImpact
800-300-8181
BIN: 003585 (610475) PCN: 74000 (FLRX), (Group: EXC)
MaxorPlus National Network
MedImpact
800-788-2949
888-942-7670 BIN: 003585 PCN: 11200
800-788-2949
800-724-5033
Plan Lists Plan Name / Network Name
Network or Attachment
Region
BIN, PCN or Group
Help Desk/ Notes
MedImpact
Medicaid Univera Community Health
National
BIN: 003585 PCN: 74000
800-724-5033
MedImpact
HEB Kingsville Independent School District
TX
BIN: 014988 PCNL: B22942 Group: KGVL1 (not required)
MedImpact
NY Medical and Surgical Supply Pharmacy Network
NY, NJ, PA
BIN: 003585 PCN: 58110, 58080
Health Plus of New York: 800-788-2949
MedImpact
Medicaid Health Plus of NY Family Health Plus
NY, NJ, PA
BIN: 003585 PCN: 58110, 58080
800-300-8181
MedImpact
HEB Hidalgo County
TX
BIN: 014988 PCN: B22942
800-788-2949
MedImpact
MedImpact Group Health
MedImpact
HealthPartners of Minnesota Vaccination
Other
BIN: 003585 PCN: 24002
800-788-2949
800-771-4648
800-771-4648
Medtrak Services
Medtrak National Network
National
Medtrak Services
MedTrak 90 Network
National
BIN: 800004
Medtrak Services
Performance 90 Pharmacy Network
National
Member Health
Member Health
Open Pharmacy Network MH-5 Sponsored Discount Programs
MH-4 Discount Network
Network or Attachment
Region
BIN, PCN or Group
Help Desk/ Notes
Member Health
AM-2 Network
National
BIN: 008324, 012304 PCN: MH
866-684-5395
Member Health
MemberHealth National Rural
National
Member Health
MemberHealth Fidelis Medicare Part D
National
Member Health
Mirixa
BIN: 800004 (NDC), 001659 (Envoy) PCN: 008126 (NDC), Call Envoy
Medtrak Services
Plan Name / Network Name
National
National
BIN: 008324 PCN: MH
888-868-5854
BIN: 008324, 012304 PCN: MH
Community Care Rx, Golden Buckeye Medicare, and Criterion Advantage: 866-684-5395
Member Health
MemberHealth Medicare Part D
National
Member Health
MemberHealth LTC
National
Member Health
MemberHealth Part B and Part D Vaccine Network
National
National
Community CCRx Welcome Program
National
Pharmacy will be paid $40.00 for each completed session with a patient.
National
Pharmacy will be paid $60.00 for each completed session with a patient, subject to adjustment for geographical region.
CCRx MTM Program
Mirixa
Medco SOCRxATES Program
IL
Initial session: $30 per care gap, follow up sessions: $15 per care gap per session, decline for patient refusal: $10 per patient, initial only
Mirixa
ESI 1:1 Pharmacy Outreach Program
National
Service Code: Face to Face - 99606, Phone (5-10 min): 98966, Phone (15 min) 98967
Navitus
Navitus Part D Vaccination
National
Navitus
Navitus Medicare Part D Retail
National
Navitus
Medicare Part D Retail
Navitus
90 Day Retail Network
National
Navitus
Long-Term Care
National
Navitus
Retail (31-90 Day Supply)
National
800-771-4648 BIN: 800004 (NDC), 001659 (Envoy) PCN: 008126 (NDC), Call Envoy
National
Mirixa
MemberHealth MTM Services
CPT Code: 99605+99607 (Face to Face new patient), 99606+99607 (Face to Face repeat Patient), 98968 (MTM via Phone), 99080 (Decline)
800-771-4648
Enter "1" in the DUR/PPS Code Counter field and "MA" into the Professional Service Code field
BIN: 610602 PCN: D1004
BIN: 610602 PCN: D1004
866-333-2757 or 800-279-1301
Plan Lists Plan Name / Network Name
Navitus
Network or Attachment
Compound Drugs Home Infusion
Region
BIN, PCN or Group
National
Contact DeanCare RX, 1-888-422-3326 for processing assistance in connection with compounds with ingredient costs exceeding $100.00.
Navitus
Retail (1-30 Day Supply)
National
Navitus
TX Medicaid
TX
Navitus
BadgerRx Gold
National
Net Card Systems Welldyne
Florida Medicaid Network
FL
BIN: 610602
BIN: 610602
Help Desk/ Notes
866-333-2757 or 800-279-1301
866-333-2757
Plan Name / Network Name
Network or Attachment
Region
Outcomes Pharmaceutical Health - MTM
MTM Pharmacists Mutual Employee Prescription Plan
Outcomes Pharmaceutical Health - MTM
MTM CarePro Health Services
National
Outcomes Pharmaceutical Health - MTM
MTM ChecKmeds NC Program
Other
Outcomes Pharmaceutical Health - MTM
MTM City of Ames, Iowa Employee Prescription Plan
Other
Outcomes Pharmaceutical Health - MTM
MTM Freedom Health Medicare Part D Plan
National
Outcomes Pharmaceutical Health - MTM
MTM Health Plan of San Mateo CareAdvantage Medicare Part D Plan
Outcomes Pharmaceutical Health - MTM
MTM Medica Health Plan Medicare Part D Plan
BIN, PCN or Group
BIN: 610011 PCN: HWJ, HPSM, TQC
NMHCRx
NMHCRx Workers Comp Network
National
BIN: 610011 PCN: NMHC
NMHCRx
NMHCRx Preferred Network
National
BIN: 610011 PCN: NMHC
NMHCRx
NMHCRx Select Network
National
BIN: 610011 PCN: NMHC
NMHCRx
NMHCRx Retail
National
BIN: 610011 PCN: NMHC
Outcomes Pharmaceutical Health - MTM
MTM Medi-CareFirst BCBS Medicare Part D Plan
National
NMHCRx
NMHCRx C&O Railroad Employees Hospital Association Retail
National
BIN: 610011
Outcomes Pharmaceutical Health - MTM
MTM Personal Pharmacist Program
National
NMHCRx
NMHCRx Neighborhood Health Providers
NY, NJ, PA
BIN: 610011 PCN: PCN Group: NHPLAN
Outcomes Pharmaceutical Health - MTM
MTM Partnership HealthPlan of CA Medicare Part D Plan
CA, WA, AZ, NV
NMHCRx
NMHCRx 100% Discount Card Network
National
BIN: 610011 PCN: NMHC
Outcomes Pharmaceutical Health - MTM
MTM Alameda Alliance for Health
National
BIN: 610011 PCN: AAH, TQC
NMHCRx
NMHCRx Child Health Plus
NY, NJ, PA
BIN: 610011 PCN: PCN Group: NHPLAN
Outcomes Pharmaceutical Health - MTM
MTM UAHC Health Plan of Tennesee Medicare Part D Plan
KY
BIN: 003585
NPS Processing
NPS Medicare Retail
National
BIN: 004758 PCN: DNPS
800-546-5677
Outcomes Pharmaceutical Health - MTM
MTM Optima Health Medicare Part D Plan
NPS Processing
NPS Medicare LTC
National
BIN: 004758 PCN: DNPS
800-546-5677
Outcomes Pharmaceutical Health - MTM
MTM Senior Whole Health Medicare Part D Plan
NPS Processing
NPS Retail
National
BIN: 004758 PCN: NPS
800-546-5677
Paramount Rx
Paramount Prescription Benefit Plan
National
BIN: 610210
NRxNetwork
NRxNetwork Retail
National
BIN: 001917
Ohio Best Rx
Ohio's Best Rx
OH
Paramount Rx
Paramount Prescription Drug Savings Program
National
BIN: 610210
Opus
OPUS Retail
National
BIN: 601341 PCN: OHS for Phy Claims, OHCP for Coupon Programs
800-364-4767 Option 1
Pharmacare
Partially Funded Network
Pharmacare
PharmaCare Preferred Network Card
Help Desk/ Notes
BIN: 600428 PCN: 01730001
National
BIN: 610468
800-777-1023
BIN: 610468, 610474 PCN: RI, TDI-PA
800-777-1023
Plan Lists Plan Name / Network Name
Network or Attachment
Region
BIN, PCN or Group
Help Desk/ Notes
Pharmacare
Independent - Oakland Pharmacy
800-777-1023
Pharmacare
Non-Funded Network
800-777-1023
Pharmacare
State of Connecticut Employees Network
Pharmacare
Indemnity Network
Pharmacare
CLAIMSPRO Managed Care
CT
National
Preferred Care
Preferred Care Retail Pharmacy Network
National
BIN: 004915
800-519-8378
BIN: 004245
800-777-1023
Preferred Care
Preferred Care Retail Specialty Network
National
BIN: 004915
800-519-8378
BIN: 610468
800-777-1023
Prime Therapeutics
PrimeStandard
National
Prime Therapeutics
BCBS of TX HMO Blue Network
TX
Prime Therapeutics
Medicare Part D Vaccine
National
Prime Therapeutics
PrimeExtended
National
Prime Therapeutics
BCBS of FL Medicare
FL, CC
Prime Therapeutics
Prime IL HMO 90-Day at Retail Network
IL
Prime Therapeutics
Prime 90-Day at Retail Extended Supply Network
National
Prime Therapeutics
Prime Limited Network
OK, NM
Prime Therapeutics
Prime Limited Network
BCBS TX
Prime Therapeutics
Prime Limited Network
Prime Therapeutics
BCBS of FL HMO & PPO
FL, CC
Prime Therapeutics
Prime BCBS TX HMO Blue Network
TX
Prime Therapeutics
Prime National
National
Prime Therapeutics
Prime Limited Network
IL
Prime Therapeutics
Prime Advantage
National
Prime Therapeutics
PrimeStandard Network Rates
National
Prime Therapeutics
PrimeStandard LTC Network
National
Specialty Network
BIN: 610468
800-777-1023
Pharmacare
Medicare Part D Pharmacy Network
BIN: 610449 PCN: MD2U. BIN: 004245 PCN: MD2C, BIN: 610468 PCN: MD2
610449: 800-519-8374 004245: 800-837-9600 610468: 800-777-1023
Pharmacare
CLAIMSPRO Preferred Program
National
Pharmacare
PharmaCare Benefit Plan
National
ADULTCARE MED D
Pharmacy Data Management - PDM
PDM Discount Card Programs - 100% member copay, Workers' Comp
Pharmacy Data Management - PDM
BIN: 004245
800-777-1023 800-777-1023
BIN: 610020 PCN: PBD09 GRP: 99990572 or 99990606
800-800-7364
BIN: 610020, 006012, 013535
800-767-4226
BIN: 610020 PCN: MEDDPDM GRP: 99990435
National
BIN: 610020, 006012, 013535
800-800-7364
800-767-4226
BIN: 011552 PCN: BCTX
BCBSTX - Pilgrim Pride Blue Select****
PNPS
BIN: 610020 PCN: PNPS
800-800-7364
Prime Therapeutics
Prime Plus Network
National
Pharmacy Data Management - PDM
TRUE RX
BIN: 014955 PCN: PDMI
800-800-7364
Prime Therapeutics
Prime Commercial Vaccine
National
Pharmacy Data Management - PDM
ABC Managed Care
BIN: 006012
800-800-7364
Prime Therapeutics
Prime Select Network
National
800-800-7364
800-777-1023
BIN: 610468
Pharmacare
Pharmacy Data Management - PDM
BIN: 610020 PCN: TLDRX GRP: 99990569
800-519-8378
800-777-1023
National
Help Desk/ Notes
BIN: 004915
Pharmacare
Funded Programs/ Vouchers/Patient Assistance
City of Toledo
BIN, PCN or Group
National
GOLD/PN2 Network
Pharmacy Data Management - PDM
Region
Preferred Care 90 Days at Retail
800-777-1023
Medicare Prescription Drug Discount Card and Transitional Assistance Network
Wooster Comm Hosp and Schnucks Plans
Pharmacy Data Management - PDM
Network or Attachment
Preferred Care
BIN: 610468, 610449
Pharmacare
Pharmacy Data Management - PDM
Plan Name / Network Name
BIN: 610455 PCN: PDPOK
888-229-2978
BCBS IL Non-HMO
BIN: 610455
800-693-6619
Plan Lists Plan Name / Network Name
Network or Attachment
Pro Care Rx
Managed Care Select Network
Pro Care Rx
Vaccine Services
Pro Care Rx
Region
Extended Day Supply
BIN, PCN or Group
Help Desk/ Notes
BIN: 018878, 010918
800-699-3542
BIN: 018878
800-699-3542
Plan Name / Network Name
Network or Attachment
Rx America
1-83 Day Supply Exclusive Retail
Rx America
Unison Affiliated Health Plans
Rx America
84 Day Supply or Greater Retail
Rx America
Medicare Long Term Care
Region
BIN, PCN or Group
Help Desk/ Notes
BIN: 012189 PCN: 5010, MISS-5025, AR-5024, TN5013, AR5024, MS5025, OH5026
800-770-8014
Pro Care Rx
Hospice Program
BIN: 009430
Quantities for Hospice patients are generally limited to a 15 day supply.
Pro Care Rx
Westmoreland Coal Company
BIN: 009430
800-352-8542
Pro Care Rx
Preferred Network
BIN: 018878, 010918
800-699-3542
Rx America
Molina Healthcare of California
BIN: 012189 PCN: 5001, 5031
877-279-0372
BIN: 004519 PCN: ADP VPC
888-311-7632
Rx America
Ucare Medicare Advantage
BIN: 012189 PCN: 5029, 5030
800-790-1698 877-279-0372
Rx America
Peoples Health Network
National
BIN: 012189 PCN: Medicaid- 5050, 5051, 5052, Medicare: 500
Medicaid 866-783-7041 Medicare 877-279-0372
RxSolutions dba Prescription Solutions
N1-P and N-1 Network
National
BIN: 610097
Ramsell Public Health Plan Independent
California ADAP Program
CA, WA, AZ, NV
Ramsell Public Health Plan Independent
National Network
National
Regence Rx
Immunization and OTC Medications
National
Regence Rx
Regence Retail
National
Restat, LLC
Open Network
Restat, LLC
Choice Plus Network
BIN: 600471 PCN: 7777
800-248-1062
RxSolutions dba Prescription Solutions
Vaccine/Immunization Injection Network
Restat, LLC
HAS/Member Pay Program
BIN: 600471 PCN: 7777
800-248-1062
RxSolutions dba Prescription Solutions
Medicare Part D Vaccination Program
Restat, LLC
Prime Network
BIN: 600471 PCN: 7777
800-248-1062
RxSolutions dba Prescription Solutions
N1 Network
BIN: 610097
Restat, LLC
Workers Compensation Network
BIN: 600471 PCN: 7777
800-248-1062
RxSolutions dba Prescription Solutions
Medicare Part D Network
BIN: 610494 PCN: 9999 FFS
Restat, LLC
Medicare Prescription Drug Benefit for Leon Medical Center
BIN: 600471 PCN: 7777
800-248-1062
RxSolutions dba Prescription Solutions
OPTIMA Network
Restat, LLC
Central Illinois Program
BIN: 600471 PCN: 7777
800-248-1062
BIN: 600471 PCN: 7777
Southern California Drug Fund Employers Benefit Plan
Restat, LLC
Medicare Prescription Drug Benefit for Union Pacific Railroad
RxSolutions dba Prescription Solutions
800-248-1062
BIN: 610473 PCN: 0797, 0798
Medicaid UnitedHealthcare
Rx America
Caresource Medicaid Plan
RxSolutions dba Prescription Solutions
866-669-0321
Rx America
Medicare Retail Network
RxSolutions dba Prescription Solutions
RxS Discount Network
Rx America
1-83 Day Supply Select Plus Retail
RxSolutions dba Prescription Solutions
RxS Narrow Network
BIN: 610622
888-437-1508 800-248-1062
Other
BIN: 012189 PCN: 5000
Sav-Rx
Quality Health Plans BIN: 011875 and 014848
MAPD: 877-889-6510 All others: 800-788-7871
BIN: 610494 PCN: 9999 GRP: RXS National
BIN: 610494 PCN: 9999 Group: ACUNY BIN: 610494 PCN: 9999 GRP: RXS
800-493-4647
Plan Lists Plan Name / Network Name
Network or Attachment
Region
BIN, PCN or Group
Help Desk/ Notes
Sav-Rx
Network B - Premier
National
BIN: 006558
402-753-2800
Sav-Rx
Advantage Pharmacy Network
National
Script Care
2011-2012 Pneumonia Vaccination
National
Script Care
SCL Prescription Drug Program
National
Script Care
2011-2012 Flu Vaccination
National
Script Save
RxA Program Network
Script Save
ScriptSave Program Network
Script Save
Immunization Network
BIN: 008563
402-753-2800
BIN: 004410 PCN: SCI, NDC
BIN: 00631 PCN: RXA, HDN
Serve You Custom Rx Mgmt
Serve You 90 Day Retail Network
National
BIN: 001553 PCN: SERVU
800-759-3203
Serve You Custom Rx Mgmt
Serve You Discount Card Network
National
BIN: 001553 PCN: SERVU
800-759-3203
Serve You Custom Rx Mgmt
Serve You Workers Compensation Network
National
BIN: 610548 PCN: 3WC GRP: UHS
800-759-3203
Serve You Custom Rx Mgmt
Serve You National Network
National
BIN: 001553 PCN: SERVU
800-759-3203
Stone River Workman's Comp
National
BIN: 005567, 003573 PCN: TPS
866-200-8393
SXC - informed Rx
TennCare Ambulatory Network
National
BIN: 001553 PCN: TENNCARE
866-434-5520
SXC - informed Rx
informedRx Consumer Card Network
National
BIN: See card
800-282-3232
SXC - informed Rx
Medicare Part D Retail Network
SXC - informed Rx
SXC Premier Network
SXC - informed Rx
informedRx Retail 90 Chain Network
Stone River W/C
National
BIN: See card
SXC - informed Rx
TennCare LTC
National
BIN: 001553 PCN: TENNCARE
866-434-5520
SXC - informed Rx
informedRx Choice 100 Network
BIN: See card
800-282-3232
SXC - informed Rx
UFCW Local 655 Network
IL
SXC - informed Rx
informedRx Select Network
National
BIN: See card
800-282-3232
SXC - informed Rx
informedRx Rural Pharmacy Network
National
BIN: See card
800-282-3232
SXC - informed Rx
TennCare Compounding
National
BIN: 001553 PCN: TENNCARE
866-434-5520
SXC - informed Rx
Health Xcellence Benefits Preferred Pharmacy Network
CA, WA, AZ, NV
800-282-3232
800-282-3232
SXC - informed Rx
TennCare Specialty
National
BIN: 001553 PCN: TENNCARE
866-434-5520
SXC - informed Rx
Health Plan of San Mateo Medi-Cal, Healthy Kids, Health Workers, and Healthy Family
National
BIN: 005947
800-282-3232
SXC - informed Rx
Health Plan of San Mateo Medicare Part D Retail
National
BIN: 005947
800-282-3232
SXC - informed Rx
Health Plan of San Mateo LTC
National
BIN: 005947
800-282-3232
SXC - informed Rx
informedRx Choice Plus 100 Network
National
BIN: See card
800-282-3232
National
BIN: 004261 Envoy: 002538 PCN: CAL Envoy: Account number
800-964-2531
888-880-8562
Medicare Part D
National
National
BIN: See Card
800-282-3232
BIN: See card
Chains with more than 50 pharmacies: 800282-3232
Help Desk/ Notes
SXC - informed Rx
800-347-5985
National
BIN, PCN or Group
Chains with less than 50 pharmacies and PSAOs: 800-282-3232
800-880-9988
BIN: 610621 PCN: SNT
Sierra Rx
Region
informedRx Retail 90 Independent and Small Chain Network
800-880-9988
BIN: 006053 PCN: MSC. GRP: 904
ScriptNet Retail
Network or Attachment
800-880-9988
National
ScriptNet
Plan Name / Network Name
TDI Managed Care Svc Inc
ChoiceAccess
TDI Managed Care Svc Inc
PreferredAccess
TDI Managed Care Svc Inc
Discount Card Programs
Tmesys
Plan # 2066.2
Plan Lists Plan Name / Network Name Tmesys
Tmesys
Tmesys
Tmesys
Network or Attachment
Region
BIN, PCN or Group
Help Desk/ Notes
Plan # 1009
National
BIN: 004261 Envoy: 002538 PCN: CAL Envoy: Account number
800-964-2531
National
BIN: 004261 Envoy: 002538 PCN: CAL Envoy: Account number
800-964-2531
National
BIN: 004261 Envoy: 002538 PCN: CAL Envoy: Account number
800-964-2531
National
BIN: 004261 Envoy: 002538 PCN: CAL Envoy: Account number
800-964-2531
800-964-2531
Plan # 1055
Plan # 2044
Plan #1005
Universal Care
Tmesys
Plan #1007
National
BIN: 004261 Envoy: 002538 PCN: CAL Envoy: Account number
Tmesys
Plan # 2066
National
BIN: 004261 Envoy: 002538 PCN: CAL Envoy: Account number
800-964-2531
800-964-2531
Tmesys
Plan # 1015
National
BIN: 004261 Envoy: 002538 PCN: CAL Envoy: Account number
Tmesys
Plan # 1021
National
BIN: 004261 Envoy: 002538 PCN: CAL Envoy: Account number
800-964-2531
Plan # 1029
National
BIN: 004261 Envoy: 002538 PCN: CAL Envoy: Account number
800-964-2531
Nationwide Network
National
BIN: 006524 PCN: TSCRIPT
800-752-2211
Tmesys
Total Script
Plan Name / Network Name
Network or Attachment
Region
Retail
BIN, PCN or Group
Help Desk/ Notes
BIN: 003585 PCN: 50110
800-748-6277
US Script
US Script Open Network and Medicare Part D Network
US Script
HD-Rx Network
US Script
Flu Immunization Network
National
US Script
Kentucky Spirit Health Plan Medicaid
KY
Ohio Medicaid
Other
Only applicable to Group Number 716257 BIN: 603286
800-207-2568
WHI
90 Day Program
National
BIN: 603286 PCN: 01410000
800-207-2568
WHI
Performance Network B
BIN: 603286 PCN: 01410000
800-207-2568
WHI
Value (Discount Card) Network
National
BIN: 610652 PCN: 82266461 GRP: 586461
800-207-2568
WHI
Medicare Part D Vaccine Network
National
BIN: 603286 PCN: 01410000
800-207-2568
WHI
County of Volusia & Daytona Beach Plan Sheet
FL
BIN: 603286 Group: 612081, 619218
800-207-2568
WHI
Plus Network
National
BIN: 603286 PCN: 01410000
800-207-2568
WHI
Palm Group Network
IL
BIN: 603286 PCN: 01410000
800-207-2568
WHI
Performance Network A
BIN: 603286 PCN: 01410000
800-207-2568
Wise Rx
National Retail Network
BIN: 610020
800-800-7364
Well Care Health Plans
National
BIN: 008019 PCN: 10 A/N BIN: 008019 PCN: 10 A/N
National
BIN: 008019 PCN: 10 A/N