0 NCPDP Data Dictionary Version Date: October 2019 NCPDP External Code List Version Date: October 2019Bank Identification Number (BIN) and Processor Control Number (PCN): For submitting FFS claims to Medicaid via NCPDP D. Ø NCPDP Data Dictionary Version Date: October 2016 NCPDP External Code List Version Date: October 2016 Contact Information Source: Girija Karri (GKarri The electronic processing of retail pharmacy claims requires a NCPDP processor ID number, also known as a BIN, and a processor control number, or a PCN, for plan identification. m. Indiana Health Coverage Programs (IHCP) pharmacy benefits are administered as follows: The individual managed care entities (MCEs) serving Healthy Indiana Plan (HIP), Hoosier Care Connect and Hoosier Healthwise members contract with designated pharmacy benefit FFS Pharmacy Prior Auth. The Florida Medicaid Preferred Drug List has been updated to reflect these BIN; PCN; Group ID (as applicable); Customer service phone number (the Yes. Plan Name/Group Name BIN PCN Legacy ESI Medicaid ØØ3858 A4 (or as assigned by ESI) SC (Use when secondary to Medicare Part D only) MA (refer to member's card) Legacy Medco Medicaid 61ØØ14 As provided on card or anything except zeros Legacy Medco - Secondary to Medicare Part D Medicaid 010900 8263342243 VAMEDICAID CCC Plus Health Plans RxBIN RxPCN RxGRP Aetna Better Health of VA 1-866-386-7882 610591 ADV RX8837 Anthem HealthKeepers 1-855-323-4687 020107 FM WQWA Magellan Complete Care 1-800-424-4524 016523 62282 VAMLTSS Optima Family Care 1-866-244-9113 HAP Empowered has a unique set of BIN/PCN numbers for processing Medicaid pharmacy claims. N/A. Indiana Health Coverage Programs (IHCP) pharmacy benefits are administered as follows: The individual managed care entities (MCEs) serving Healthy Indiana Plan (HIP), Hoosier Care Connect and Hoosier Healthwise members contract with designated pharmacy benefit Use this worksheet to help with any issues you might have while transmitting to New York Medicaid. Pregnancy & Prenatal. 12. Illinois has adopted one or more of the targeted enrollment strategies Arkansas Medicaid PA edits approved at the Arkansas Medicaid DUR Board April 17, 2019 meeting and PDL changes approved by the PDL Review Committee meeting May 8, 2019: Download: Fee Schedules Procedure Code Tables. 4. Louisiana Medicaid Single Preferred Drug List (PDL) Pharmacy Facts: Program Updates from Louisiana Medicaid BIN: 020107; PCN: FG; Group: WKLA. Preferred Drug List / Drug Information / DUR. Premier Health Plan (800) 724-5033 FLRx (800) 788-2949 74000 003585 Fidelis Care (888) 343-3547 CVS Caremark (800) 364-6331 Healthfirst (855) 298-2485 CVS Caremark (800) 364-6331Payer Name: Florida Medicaid Date: 05/13/2011 Plan Name/Group Name: FL100/FLMedicaid BIN: Ø13352 PCN: PØ35Ø13352 Processor: Magellan Medicaid Administration Effective as of: TBD NCPDP Telecommunication Standard Version/Release #: D. Prescription drugs and vaccines. Clinical and Prior Authorization support. 0, the BIN The goal of the Idaho Medicaid Pharmacy Program is to provide quality care to Idaho Medicaid Preferred Drug List with prior authorization criteria. There is a simple way to do this in the BestRx system. ADV. 0 SERVICES: GENERAL PROVISIONS; 3. Network. 1 Amount, Duration, and Scope of Services; 3. 7691. Ø NCPDP Data Dictionary Version Date: July 2ØØ7 NCPDP External Code List Version Date: October 2Ø14Medicaid insurance Medicaid is a health insurance program for individuals who meet the income and eligibility requirements. " Providers will receive this EOB in the following situations: • When a BIN/PCN is not received on a claim for a SeniorCare participant with income over 200 percent of the FPL. – Press 1 if you are a Medicaid beneficiary, or if you are calling on behalf of a Medicaid beneficiary; – Press 2 if you are a provider calling regarding pharmacy prior authorizations for the Change Healthcare pharmacy prior authorization line, or you may call Change Healthcare email protected] Health (9 days ago) Following are billing instructions for the Medicaid Plans: BIN: 004336, PCN: MCAIDADV GRP: RX0546, RX6422, RX6423 Following are billing instructions for the Essential Plans: BIN: 004336, PCN: ADV GRP: RX6424 NCPDP D. 0 NCPDP Data Dictionary Version Date: June 2010 NCPDP External Code List Version Date: June 2010MCO Payer Billing Information RXPCN. Idaho Medicaid Pharmacy call center. The clinical and PA support line will open January 1 Louisiana Medicaid Single Preferred Drug List (PDL) BIN: 019595; PCN: 06030000; Healthy Blue. ILLINOIS MEDICAID QUICK REFERENCE GUIDE NOTE: This guide is not intended to be an all-inclusiv e list of covered services underHarmony Health Plan, Inc. Primary Care Network. 0 Payer Sheet (PDF) contains our BIN (600428), PCN (06210000), member services number, field definitions and other helpful information for RX Bin#: BIN3 RX PCN#: PCN3 RX Group: RxGroup3 Primary Care Provider Phone: (003) 003-0003 This is a really long PCP name to test for wrapping of the PCP name 3 Medicaid IL Card Member ID: 00000004 Primary Care Provider: Member: THIS IS A REALLY LONG NAME OF A MEMBER 4 Date of Birth: 07/31/1963 08/04/1993 RX Bin#: BIN4 RX PCN#: PCN4 RX Group Presbyterian Centennial Care is designed to keep you in good health. MCOs* PBM BIN PCN Group BMC HealthNet Health Plan Envision 610342 BCAID MAHLTH Tufts Health Together Caremark 004336 ADV RX1143 *Members of the Lahey Clinical Performance Network ACO should submit claims to the appropriate MCO using the information above. STAKEHOLDER MEETINGS AND COMMENT PERIOD1) Addition of Health Exchange Marketplace as a Payer Type 2) Addition of 2 new Bins: 017142 - Medicaid, 017168 - Commercial December 23, 2013 V 2. Clinical Services. (CST) See http://ncpdp. Centers for Medicare and Medicaid Services (CMS) - This site has a wealth of information concerning the Medicaid Program. The following list provides important identification numbers for this program: ANSI BIN # 001553 Processor Control # NVM Provider ID # National Provider Identifier Cardholder ID # NV Medicaid Pharmacy ID Number Prescriber ID # National Provider Identifier Product Code National Drug Code (NDC)Kentucky Medicaid MCO Single PBM Program Goes Live 7/1/2021. 7 Medicaid Furnished Out of State; 3. 0 PCN List for BIN 610241 MeridianRx PCN Group ID Line of Business HPMMCD N/A Medicaid Pharmacy Help Desk Information Inquiries to MeridianRx may be directed to our 24-hour Pharmacy Assistance Center Medicaid bin pcn list Oct 11, 2021 뜀 Previously, the status was only updated if the prescriber responded with an electronic message. Vision and hearing care. 3 mg 2-Pak and EpiPen® Jr. Completed UCFs should be mailed to: PerformRx, P. 0 January 1, 2019 017142 ASPROD1 ML284 Medicaid D. Medicaid 010900 8263342243 VAMEDICAID CCC Plus Health Plans RxBIN RxPCN RxGRP Aetna Better Health of VA 1-866-386-7882 610591 ADV RX8837 Anthem HealthKeepers 1-855-323-4687 020107 FM WQWA Magellan Complete Care 1-800-424-4524 016523 62282 VAMLTSS Optima Family Care 1-866-244-9113 610011 OHPMCAID N/A UnitedHealthcare 1-855-873-3493Rx Bin: The RX Bin is used to identify how a prescription drug will be reimbursed and where a pharmacy can send a reimbursement claim to. Optum Rx. 16. STAR members get their services through health plans they choose. The above chart is the fifth page of the 2021 Medicare Part D pharmacy BIN and PCN list (H8634 - S9701). New PCN (Transitioned Group). (800) 962-8074. Indiana Health Coverage Programs (IHCP) pharmacy benefits are administered as follows: The individual managed care entities (MCEs) serving Healthy Indiana Plan (HIP), Hoosier Care Connect and Hoosier Healthwise members contract with designated pharmacy benefit Payer Name: Alaska Medicaid Plan Name/Group Name: ALK001/AKMEDICAID BIN: 009661 PCN: P013009661 Processor: Processor/Fiscal Intermediary Effective as of: TBD NCPDP Telecommunication Standard Version/Release #: D. gov Timothy McCormick IA IA ADAP Erica S. 8. Our strong network of hospitals, doctors, clinics and pharmacies helps our Members live as healthy as possible through education, support, and quality programs. The PDL was authorized by the NC General Assembly Session Law 2009-451, Sections 10. This website can help you find all of the materials you need to understand your PCN for Medicaid recipient or SeniorCare participant at or below 200% FPL. BIN: 004626. BIN Number. 610602 MCD EPF 877-908-6023 . 0801. BIN: 61Ø48Ø PCN: vendor-specific PCN Plan Name/Group Name: All Programs with primary coverage other than Medicare Part D BIN: 61Ø48Ø PCN: vendor-specific PCN Plan Name/Group Name: ConnPACE*/CADAP** when Medicare Part D is primary *Program terminated 12/31/2013 **Effective for dates of service November 1, 2018 andOver-the-counter (OTC) COVID-19 tests covered for Apple Health (Medicaid) clients. Rev. The Alaska Medicaid State Plan is available on this web site. A list of the BINs and PCNs used to adjudicate claims through 2020. michigan. A pregnant woman. 2. 610591. Ø NCPDP Data Dictionary Version Date August of 2007 NCPDP External Code List Version Date October 15, 2020 Contact/Information Source www. This webpage is designed to provide easy access for members and providers looking for information on the drugs and supplies covered by Michigan Medicaid Health Plans. O. comYou may be able to fill your specialty prescriptions at our Humana Specialty Pharmacy®. AmeriHealth Caritas Pennsylvania. PCN: ROIRX. We have cared for New Mexico's Medicaid members since 1997. Gateway Health Plan (Medicaid Primary) (End Date 12/31/2021) 004336. Effective Date Range. 610154, DRWVPROD BIN. BIN: 601574. Members previously enrolled in PCN were automatically enrolled in Medicaid. 012114. Group Number. IME POS. For questions regarding claims, call 800-222-3986. Pharmacies can also check a member's enrollment with a West Virginia Medicaid MCO by calling 888-483-0793 . 3mg and 0. Phone: (601) 359-5253. Following are billing instructions for the Molina Healthcare Medicaid Plans: BIN: 004336, PCN: ADV GRP: RX0546, RX6422, RX6423Plan Name/Group Name: VDCRX BIN: 009893 PCN: ROIRX Plan Name/Group Name: Careington BIN: 610303 PCN: AE02 Plan Name/Group Name: Cogent Works BIN: 017134 PCN: ROIRX Plan Name/Group Name: Medicaid BIN: 610342 PCN: ROIRX Plan Name/Group Name: Bridgeport Claims BIN: 019272 PCN: ROIBPC Plan Name/Group Name: OneRx BIN: 637639 PCN: ROIRX/ AE02. To: All District Medicaid Pharmacy Providers by requesting their new ID card which will contain the information (BIN, PCN and Group). DMS Address. 004336 MCAIDADV RX5435 Molina coordination of benefits (COB) members 013089 COMESEGADV Group per Molina plans listed below Last updated: April 22, 2021. Please contact specific MCO for past billing codes. Aetna Better Health of Kansas. On Sept. Your PMP will work with you and be your primary contact when making medical decisions. 07630000. 2021. Your plan includes online health tools, award-winning customer service, health and wellness programs, travel coverage, and many more benefits and services. pharmacy may submit the claim to Magellan Medicaid Administration and a reject message will note the patient's new plan name, identii cation number, group number (if needed) BIN, PCN numbers. 695. X-rays and lab tests. A letter was mailed to each member with more information. 610649. PCN:MEPOP. Ø NCPDP Data Dictionary Version Date: July 2ØØ7 NCPDP External Code List Version Date: April 2Ø18Effective January 1, 2007 the Georgia FFS Medicaid Pharmacy Program with have a new Pharmacy Benefit Manager. , Eastern time. 0 NCPDP Data Dictionary Version Date: 06/2010 NCPDP External Code List Version Date: 06/2006 Contact/Information Source:Health, BIN 61Ø455, PCN ADV This is required when Covered Person's of BCBSND have secondary coverage with BCBS of ND, BIN 61Ø455, PCN NDCOM This is required when Covered Person's of BCBSNE have secondary coverage with BCBS of NE, BIN 61Ø455, PCN RXNEB This is required when Covered Person's of Highmark have secondary coverage with Highmark,Bin: 600428; PCN: 07710000 Highmark Health Options: 1-844-325-6253 Bin: 004336; PCN: MCAIDDE There may be a small population of members who are NOT enrolled in a managed care program. com Rx Group: HEALT001 Bin #: 004758 PCN: NPS Person Code: 00 Rx Group: HEALT002 Bin #: 004758 PCN: NPS Person Code: 00 MolinaBIN; PCN; Group ID (as applicable) 2015 meeting, to add Auvi-Q® 0. Contact Us. Prescribers are encouraged to write prescriptions for "preferred" products. Claim PCN. BIN. 4345 N Lincoln Blvd. 2 Coordination of Medicaid with Medicare Part B; 3. BIN: ШШ5526. 19. 800. This notice is to remind providers that the Illinois Department of Healthcare and Family Services has adjusted the implementation date and time for the new Pharmacy Alabama Medicaid Pharmacy Program - (334) 242-5050. 0. The PCN (Processor Control Number) is required to be submitted in field 104-A4. 5. BIN: 610494. There is a new Medicaid Medicaid 010900 8263342243 VAMEDICAID CCC Plus Health Plans RxBIN RxPCN RxGRP Aetna Better Health of VA 1-866-386-7882 610591 ADV RX8837 Anthem HealthKeepers 1-855-323-4687 020107 FM WQWA Magellan Complete Care 1-800-424-4524 016523 62282 VAMLTSS Optima Family Care 1-866-244-9113 610011 OHPMCAID N/A UnitedHealthcare 1-855-873-3493Magellan Medicaid Administration, Inc. 3. Bill OHA (FFS) for: Carve-out drugs for CCOs, drugs for OHP fee-for-service ("open card") clients, drugs not covered by Medicare Part D, and drugs not included in the long-term care facility's bundled rate. P. Works Health Indiana Plan (HIP) Traditional Medicaid. Customer service (800) 422-4641 EmailPlan Name/Group Name: Massachusetts Medicaid (MassHealth) BIN: 61Ø342 PCN: BCAID Plan Name/Group Name: Total Health Care Medicaid and Healthy Michigan Plan BIN: 61Ø342 PCN: ROIRX Plan Name/Group Name: Medicaid BIN: 61Ø342 PCN: ROIRX Plan Name/Group Name: New Benefits BIN: 61Ø346 PCN: N/A Plan Name/Group Name: Bridgeport Claims BIN: Ø19272 *The claim requires the BIN, PCN, and Group number for each specific MCO for correct processing. Information can be found on the South Dakota Medicaid Drug Rebate program. MCAIDADV MCAIDADV. Members in the STAR program can get Medicaid benefits like: Regular checkups with the doctor and dentist. 1. There is a new Medicaid health care services to Medicaid and PeachCare for Kids Program Member ID Required BIN PCN Group Processor/Helpdesk # Amerigroup Member or Medicaid ID 003858 MA WKJA Express Scripts/ 1-844-367-6112 CareSource Member or Medicaid ID 004336 MCAIDADV RX0835 CVS Caremark/ 1-844-441-8024 Peach You may be able to fill your specialty prescriptions at our Humana Specialty Pharmacy®. : Rx BIN: Rx PCN: PBM: 011552 TXCAID PRIMEAn individual 18 years of age or younger. 0 Payer Specification: 02/18/2021 2012 Alaska Medicaid Cost of Dispensing Survey - Final Report: 08/17/2012 Current Pharmacy Carrier List: Preferred Drug List - Alaska Division of Health Care Services Web site: Preferred Drug List Effective 11/01/2021Hawaii Medicaid . Fax Number. 0 Oct 01, 2020 · This link contains a list of Medicaid Health Plan BIN, PCN and Group Information. Iowa Total Care works with Envolve Pharmacy Solutions to administer pharmacy benefits, including the Prior Authorization process. DMS Phone Number. www. Texas Drug Code Formulary. July 2018 – Utah PCN: GAM. NCPDP External Code List Version Date: following programs: BadgerCare Plus, Wisconsin Medicaid, SeniorCare, Wisconsin Chronic Use BIN Number. To: Participating Pharmacies, Physicians, Dentists, Podiatrists, Optometrists, Hospitals, Advanced Practice Nurses, and Physician Assistants. BIN: 014203 PCN: ORDHSFFSBIN/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. The plan information listed here is for informational purposes only, and is not legally binding. For those hoping to qualify for Medicaid and looking for assistance with the application process, it is important to recognize that the state is not always the best resource for application assistance. For Medicaid Managed Care, providers are not allowed to use 340b product. 15mg 2-Pak auto-injectors from the PDL. 2022. The Rhode Island Medicaid Program structures benefits available to Medicaid clients in a manner that promotes access to medically necessary and cost-effective care. AMERIGROUP NJ. , closed on federal and state holidays) Fax: 800-327-5541. KY. MassHealth PBM BIN PCN Group Primary Care Clinician (PCC) PlanPayer Name: Mississippi Division of Medicaid Date: December 28, 2020 Plan Name/Group Name: MS Medicaid Fee For Service BIN: 610084 PCN: DRMSPROD Plan Name/Group Name: MS Medicaid Fee For Service (test) BIN: 610084 PCN: DRMSTEST Processor: Conduent Effective as of: 12/28/2020 NCPDP Telecommunication Standard Version/Release #: D. Resources & Links. 0 NCPDP Data Dictionary Version Date: October, 2007 NCPDP External Code List Version For most health care services, you must use the health care providers who are in your health plan. 0, the BIN number is required in field 101-A1 and is "004740". 4040. We hope to be able to answer your questions and help you find links to valuable resources. 18 1) Addition of Bin number 006053 for ScriptSave transition to MedImpact February 21, 2014 V 2. Most people who have Medicaid in Texas get their coverage through the STAR managed care program. Any other pharmacy-related questions can be directed to the Medicaid Pharmacy Program at 1-800-437-9101. People with Medicare can qualify for Medicaid in various ways, but not through Heritage Health Adult . Virginia enacted a budget bill in May 2018 Ohio Medicaid Managed Care Plan Pharmacy Benefit Administrator, BIN, PCN, and Group Specialty Pharmacy name and telephone number Website address for pharmacy information Aetna Better Health CVS/ Caremark 1-855-364-2975 Medicare/Medicaid Members BIN: 610591 PCN: MEDDADV Group: RX8812 Medicaid Only Members BIN: 610591 PCN: ADV Group: RX 8810Benefits under STAR. Please pause transaction submissions during this window. Unit (CHC). General Provider Issues - Call Provider Relations - 1-844-521-6942;email protected] Health (9 days ago) Following are billing instructions for the Medicaid Plans: BIN: 004336, PCN: MCAIDADV GRP: RX0546, RX6422, RX6423 Following are billing instructions for the Essential Plans: BIN: 004336, PCN: ADV GRP: RX6424 NCPDP D. Bin Number: 004740 . **Possible previous billing codes are not listed. MassHealth PBM BIN PCN Group Primary Care Clinician (PCC) PlanPCC Plan PBM BIN PCN Group Pharmacy Help Desk Primary Care Clinician (PCC) Plan Conduent 009555 MASSPROD MassHealth (866) 246-8503 (Conduent/POPS) (800) 745-7318 (DUR) SCO Plan- Medicaid Only PBM BIN PCN Group Pharmacy Help Desk Commonwealth Care Alliance Navitus 610602 MCD MHO (877) 908-6023 Senior Whole Health CVS CaremarkBin: 600428; PCN: 07710000 Highmark Health Options: 1-844-325-6253 Bin: 004336; PCN: MCAIDDE There may be a small population of members who are NOT enrolled in a managed care program. Pharmacy Providers should use the following BIN/PCN/Group when billing MedImpact: BIN = 023880. Number. BIN Cigna Texas Medicare-Medicaid Plan (TXMMP). Plan/Group. The Centers for Medicare & Medicaid Services (CMS) released a compilation of the BIN and PCN values for each 2021 Medicare Part D plan sponsor. • 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. S. For more information, call: Humana Specialty Pharmacy. 1, 2019 a new Medicaid Managed Care contract will go into effect. Rx Bin: The RX Bin is used to identify how a prescription drug will be reimbursed and where a pharmacy can send a reimbursement claim to. Processor: Magellan Medicaid Administration NCPDP External Code List Version Date: October 2016 1Ш1-A1 BIN NUMBER. PCN: 9999. 9. PCN: Plan Name/Group Name: BIN: Payer: Please list each transaction supported with the segments, fields, 2021. Plan Name/Group Name: Medicaid. The BIN is on the SPAP / ADAP table with a blank PCN and the BIN is unique to the SPAP / ADAP, or. (PCN). PCN: The Following lists the segments and fields in a Claim Reversal Transaction for the NCPDP 2022. Medicaid Income Limits. Cigna International. [email protected] Plan Name/Group Name: Medicaid. IA Health Link. 877-908-6023 . The Transaction Facilitator and CMS PCN List for BIN 610241 MeridianRx PCN Group ID Line of Business HPMMCD N/A Medicaid Pharmacy Help Desk Information Inquiries to MeridianRx may be directed to our 24-hour Pharmacy Assistance Center. Both of these values are provided by NY Medicaid. R -- Patient Segment Questions Check Claim Billing/Claim Rebill If Situational, Payer Situation This Segment is always sent . Program. The PCN has two formats, which are comprised of 10 characters:Plan Name/Group Name: MS Medicaid Fee For Service BIN: 610084 PCN: DRMSPROD Plan Name/Group Name: MS Medicaid Fee For Service (test) BIN: 610084 PCN: DRMSTEST Processor: Conduent Effective as of: 12/28/2020 NCPDP Telecommunication Standard Version/Release #: D. 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. Under managed care, beneficiaries enroll in a health plan or managed care organization (MCO) which coordinates their members' healthcare and offers special services in Medicaid. RI EOHHS Fee-for-Service (FFS) Medicaid program allows enrolled pharmacy providers to CMS List of Rebateable Drug Manufacturers; Can pharmacies bill for MEDIMPACT PHARMACY: 888-648-6769 | Rx BIN: 003585 | Rx PCN: 28914 The formulary is the list of medications chosen by a committee of doctors and Medicaid covers most prescription drugs, with exceptions outlined in this provider manual and the DVHA preferred drug list, which can be found. As a UPMC Health Plan member, you have access to much more than top-ranked care. 22. 24. During this time, all Provider Web Services will be unavailable. This pharmacy will fill and mail your specialty prescription to your house. Louisiana. 7. 0email protected] Health (9 days ago) Following are billing instructions for the Medicaid Plans: BIN: 004336, PCN: MCAIDADV GRP: RX0546, RX6422, RX6423 Following are billing instructions for the Essential Plans: BIN: 004336, PCN: ADV GRP: RX6424 NCPDP D. 19BIN_PCN E0654 IBT VOLUNTARY EMPLOYEE BENEFITS TRUST 801 IBT Voluntary Employee Benefits Trust (Employer PDP) 610097 9999 TEAMStar Medicare Part D Prescription Drug Program 802 803 E2630 C AND O EMPLOYEES' HOSPITAL ASSOCIATION C and O Employees Hospital Association (Employer PDP) C and O Employees Hospital Association E3014 PSERS HOP PROGRAMBIN. Anthem Blue Cross and Blue Shield Healthcare Solutions. PCN. This list is reviewed by doctors and pharmacists regularly to make sure only the safest and most effective drugs are on the list. It includes all medicines covered by Medicaid and Child Health Plus (CHPlus). Nebraska Total Care covers prescription medications and certain over-the-counter medications with a written order from a Nebraska Total Care provider. • The 340B ceiling price of the drug, plus a fixed dispensing fee. BIN: 004336 | PCN: MCAIDADV | Group: RX5439 Choice Change PeriodWellCare CVS/Caremark Medicaid/PeachCare for Kids: 1-866-231-1821 BIN: 004336 | PCN: MCAIDADV | Group: 726257 Planning for Healthy Babies (P4HB): 1-877-379-0020 BIN: 004336 | PCN: MCAIDADV | Group: 736257 Providers should always contact their CMO for questions or concerns. Claim BIN. [email protected] Primary BIN and PCN Values . PLAN BIN PCN GROUP NUMBER Amerigroup 020107 CM WKHA Apple Health Fee-For-Service (FFS) 610706 WAPROD N/A Community Health 003858 A4 CHWA Coordinated Care of Washington, Inc. 21. FF. Saturday, 8 a. Pharmacy claims for Iowa Medicaid members should be billed to the Processor. Enrollees receive services through either managed In 1995, New Jersey began moving Medicaid beneficiaries from a traditional fee-for-service health coverage program, where providers bill Medicaid directly, to managed care. Virginia enacted a budget bill in May 2018 Bill Medicaid (OHA or the CCO) last for all services except for Vaccines for Children administrations. The following BIN and PCN combination are required to successfully transmit claims effectivMS Medicaid pharmacy contact and billing information (PCN/BIN) - effective Nov. Y Y. Payer Name: Maine Medicaid. Effective as of July 1, 2021 NCPDP Telecommunication Standard Version D. 452. You can change your MCO annually during Open Enrollment. PCN: DRNMACCP (after 1/1/2012) PCN: DRNMDV5S (thru 12/31/2011 for D. The pharmacy program does not cover all medications. PCN: PIN + 3 or 4 character ETIN. GU GUAM ADAP Guam ADAP Bernie Schumann bernadette. PCC Plan PBM BIN PCN Group Pharmacy Help Desk Primary Care Clinician (PCC) Plan Conduent 009555 MASSPROD MassHealth (866) 246-8503 (Conduent/POPS) (800) 745-7318 (DUR) SCO Plan- Medicaid Only PBM BIN PCN Group Pharmacy Help Desk Commonwealth Care Alliance Navitus 610602 MCD MHO (877) 908-6023 Senior Whole Health CVS CaremarkPlan Name/Group Name: Vermont Medicaid BIN: Ø17795 PCN: VTPOP Processor: Change Healthcare (CH) Effective as of: September 21, 2Ø2Ø NCPDP Telecommunication Standard Version/Release #: D. 10. Medicaid Unique BIN_PCN. The decision the member receives from the fair hearing officer will be final. 15. – 8 p. medimpact. 0 January 1,Medicaid Managed Care BIN, PCN, and Group 1/1/2019 through 12/31/2019 (pharmacy services carved out of managed care starting 1/1/2020) BIN 610011, PCN IRX, Group SHNNDMEDI If you have pharmacy questions, you may email them to [email protected] For these members, the drug benefit will be processed under Delaware Medical Assistance Program (DMAP)/Traditional Fee-for-Service (FFS) Medicaid. M -- 301-C1 GROUP ID For Medicaid, HELP or Healthy Montana Kids (HMK) use 1509040. Florida Medicaid has set one Single Preferred Drug List (SPDL) for all Table 13-12: Results of BIN / PCN / Group ID Identification for 2020. Members are instructed to show both ID cards before receiving health care services. D. 11. (844) 396-2329. Nebraska Medicaid provides for health care services to eligible elderly and disabled individuals and SC Medicaid is always the payer of last resort. Other Primary- Medicare Part D. When the pharmacy claims processing system is operational (no later than 6 a. The medications on the Nebraska Medicaid Preferred Drug List (PDL) are covered by Nebraska Total Care. Identification. Please call a Health Program Representative (HPR) at 1-866-608-9422 with Medicaid benefit questions. South Dakota Medicaid’s processor BIN number is 601574. Verify member eligibility and the MCO enrollment Use BIN Number Ø16929 for ADAP claims. Fee for. Use this worksheet to help with any issues you might have while transmitting to New York Medicaid. The PCN has two formats, which are comprised of 10 characters:Medicaid Unique BIN_PCN RX BIN Number RX PCN RX Group Line of Business NCPDP Version Effective as of 017142 ASPROD1 ML108 Medicaid D. gov Erica Carrick ID ID ADAP Bebe Thompson thompsob Plan Name/Group Name: Illinois Medicaid BIN: Ø178Ø4 PCN: ILPOP Processor: Change Healthcare (CHC) Effective as of: March 27, 2Ø17 NCPDP Telecommunication Standard Version/Release #: D. • The actual acquisition cost, plus a fixed The Client Identification Number or CIN is a unique number assigned to each Medicaid recipient. Primary or Specialty Medical Providers: When you are enrolled in a managed care program, you will choose a Primary Medical Provider, often called a PMP. Payer Name: Alaska Medicaid Plan Name/Group Name: ALK001/AKMEDICAID BIN: 009661 PCN: P013009661 Processor: Processor/Fiscal Intermediary Effective as of: TBD NCPDP Telecommunication Standard Version/Release #: D. • Leading zeroes in the NCPDP Processor BIN are significant. Plan Name/Group Name: Vermont Medicaid. 86% since the first Marketplace Open Enrollment Period and related Medicaid program changes in October 2013. Plan Name/Group Name: All Groups BIN: 601364 PCN: DRNDPROD Processor: State of North Dakota - Medicaid Effective as of: September 8, 2021 NCPDP Telecommunication Standard Version/Release #: D. BIN: Ш17795. RX PCN. GENERAL INFORMATION Payer Name: Hawaii Medicaid Fee for Service Date: Date of Publication of this Template Plan Name/Group Name: Hawaii Medicaid BIN: 61ØØ84 PCN: DRHIPROD = Production Plan Name/Group Name: Hawaii Medicaid (test) BIN: 61ØØ84 PCN: DRHIACCPDØ = D. MeridianRx PCN Phone Fax Email HPMMCD (Medicaid) 866-984-6462 877-355-8070 [email protected] S. 0531. Your doctor will use the PDL to choose the best medicine to treat you. Rx8813. BIN Ø12833, PCN FLBC This is required when Covered Person’s of Bridgespan Idaho have secondary coverage with Bridgespan Idaho, BIN 61Ø212, PCN Ø23ØØØØØ This is required when Covered Person’s of Bridgespan Oregon have secondary coverage with Bridgespan Oregon, BIN 61Ø212, PCN Ø232ØØØØ This is required when Covered Person’s ofMCO Payer Billing Information RXPCN. RX8849. Reimbursement. RX Group. Through managed care, New Jersey beneficiaries have better access to healthcare providers and care coordination than they would have through Medicaid's Plan Name BIN PCN BCBS of Texas Medicaid CHIP and STAR Ø11552 TXCAID BCBS of Texas Medicaid STAR Kids Processor Effective as of: Ø9/Ø1/2Ø11 NCPDP Telecommunication Standard Version/Release #: D. Anthem Fact Sheet. ***For possible changes since this posting, please reach out to each MCO. 13. The 340B discount is calculated using the Medicaid rebate formula and is and assigning a unique BIN/PCN/Group number to the MCO's Medicaid line of 2020. PCN: 826334223. 6. BIN/PCN Info for all Medicaid Plans. & Medicaid Services (CMS) 1, 2016 Medicare Contract/Plan and BIN/PCN Combinations Kaiser Permanente, Senior Advantage Medicare Medicaid Plan (HMO SNP), 011222, GACMS. The Health Plan requires the completion of the prenatal risk screening instrument (PRSI) upon the initial encounter when the EDC date is determined for all MHT and WVHB members receiving maternity services. Please note the bank identification number (BIN) and processor control number (PCN) in Table 1. Online Drug Search Links. 019595. 23. Alaska Medicaid D. the processor specifies in writing that a commercial BIN and blank PCN is solely for plans Supplemental to Part D, or. All plans must at a minimum cover the drugs listed on the Medicaid Health Plan Common Formulary. 0 Payer Specification: 02/18/2021 2012 Alaska Medicaid Cost of Dispensing Survey - Final Report: 08/17/2012 Current Pharmacy Carrier List: Preferred Drug List - Alaska Division of Health Care Services Web site: Preferred Drug List Effective 11/01/2021The BIN/IIN field willeither be filled with the ANSI IIN or the NCPDP Processor BIN, depending on which one the health plan has obtained. - 8:30 p. 20107. *The 2011 National Summary of State Medicaid Managed Care Programs reports that the Regional Care Collaborative Organizations and Accountable Care Collaborative program began in March 2011, which was the that the program was implemented, according to the state. Effective in March of 2020, TennCare's Prescriber Attestation List was added to the Automatic Exemption List , so medications posted on this list Provider Notice Issued 03/20/2017. STAR covers low-income children, pregnant women and families. PCN: A processor control number (PCN) is another identifier used to route pharmacy reimbursements. The Agency for Health Care Administration has accepted the P&T Committee's Indiana Medicaid for Providers. A parent or caretaker. HAP Empowered has a unique set of BIN/PCN numbers for processing Medicaid Medicaid Drug Rebate Program Labeler List Reference - To help you more easily Name, Bin #, Group #, PCN Medicaid Administered through Molina Medicaid Solutions - 1. Insurance companies list the type of plan on your ID card to help while Medicaid and Child Health Plus cards will feature each program's 2022. MMP = Medicare-Medicaid Plan for dual-eligible members. If you do not know one of these values, you will need to contact NY Medicaid to obtain them. 0 January 1, 2019 017142 ASPROD1 ML109 Medicaid D. 302-C2 CARDHOLDER ID Use client's 7 -digit ID number, 9-digit SSN, or 9-digit HMK number. gov HI HI ADAP Tim McCormick timothy. Virginia enacted a budget bill in May 2018 Inventory List 5/12/2015 NYS Medicaid Managed Care Plan Contact and Billing Information 2015 BIN Number Additional Information Required for Pharmacy Processing;2. Virginia Medicaid Plans BIN: 010900 PCN: 8263342243 NEW! Processor: Magellan Medicaid Administration Effective as of: 10/01/2017 NCPDP Telecommunication Standard Version/Release #: D. Medicaid Health Plan Pharmacy Benefit. 800-486-2668 (TTY: 711) Monday - Friday, 8 a. com Member Customer Service 888–447–7364 Pharmacy Help Line 800–824–0898 BIN: 015748 PCN: 20111001 Managed Care Contact 800–447–8255: Hudson Health Plan: Y (Diabetic Supplies, Hearing Aid Batteries, Enteral Products, Medical Supplies) Y (Diabetic Supplies, Hearing Aid Batteries, Enteral Products, Medical Supplies)Office of Pharmacy Contact Information. Most people pay very little — and some pay nothing at all — for Medicaid. Payer Name: Michigan Medicaid. HPN Fact Sheet. Beginning 7/1/2021 Technical Call Center lines are open at (800) 210-7628 to answer your claim-related and other questions. Modified NPI Notes in the Virginia Medicaid Claims SPECIAL Changed value of Processor Control Number (PCN) BIN: 010900. as the Nebraska Pharmacy Benefits Administrator. You could not and no-one else going next book store or library or borrowing from your friends to gain access to them. Line of Business NCPDP External Code List Version Date: October 15, 2018. 0 NCPDP Data Dictionary Version Date: 06/2010 NCPDP External Code List Version Date: 06/2006 Contact/Information Source:PerformRx Rx BIN: 019595 Rx PCN: 06280000 Rx Grp: (Not Required) Medicaid Provider Services (PBM) 1 (888) 602-3741 Medicaid Enrollee Services 1 (888) 452-3647 Alliance Provider Services 1 (888) 987-5821 Alliance Enrollee Services 1 (888) 987-5806 CareFirst Blue Cross Blue Shield Community Health Plan Abarca RX BIN: 610674 Rx PCN: ABARCAMCOs* PBM BIN PCN Group BMC HealthNet Health Plan Envision 610342 BCAID MAHLTH Tufts Health Together Caremark 004336 ADV RX1143 *Members of the Lahey Clinical Performance Network ACO should submit claims to the appropriate MCO using the information above. Medicaid, Dual SNP UnitedHealthcare Community Plan / AZ, Long Term Care, Children's Rehabilitative Services (CRS) 03432. Recipient Questions - Drug Information. BIN*: 022659 NEW! PCN*: 6334225 SB393 Drug Inquiry Pricing Request NEW! BIN*: 022667 NEW! PCN*: 393 Processor: Magellan Medicaid Administration Effective as of: 1/1/2022 NCPDP Telecommunication Standard Version/Release #: D. For Members. There are 4 fields that are required to process a Medicaid COB claim: Other Coverage Code (OCC) (NCPDP field # 308-C8)Adult enrollees are able to exceed the monthly 5 prescription or 2 brand limits for certain medications in high risk situations with any medication that is posted on the Automatic Exemption List. Virginia enacted a budget bill in May 2018 For most health care services, you must use the health care providers who are in your health plan. Iowa Medicaid IME POS. This link contains a list of Medicaid Health Plan BIN, PCN Banking. Aetna Better Health. In addition, CMS included the following disclaimer in regards to this data:Medicaid Managed Care BIN, PCN, and Group 1/1/2019 through 12/31/2019 (pharmacy services carved out of managed care starting 1/1/2020) BIN 610011, PCN IRX, Group SHNNDMEDI ; If you have pharmacy questions, you may email them to [email protected] iowa. Your RX BIN is a 6 digit number. 1Ø2 -A2 VERSION/RELEASE NUMBER DØ M 1Ø3 -A3 TRANSACTION CODE B1 M 1Ø4 -A4 PROCESSOR CONTROL NUMBER Enter “WIPARTD” for SeniorCare , Wisconsin Chronic Disease Program (WCDP ), and AIDS/HIV Drug Assistance Program (ADAP) member s that are also enrolled in a MedicareManaged care pharmacy identification. PCN: BCAID. · Prescription Drug Transition Policy · Medication Therapy 2020. RxBIN: 003858 RxPCN: MA RxGRP: HAPMCD. PCN = KYPROD1 GRP = This section has approved drug lists and other regulations. 2016 BIN/PCN Listing. Medications on the formulary (drug list) that are Plan Name/Group Name: Total Health Care Medicaid and. Number (BIN). Use BIN Number Ø16929 for ADAP claims. Find income limits for each Medicaid program to help you decide on any services you would like to receive. (BIN). com. Author: jessica. Over the Counter (OTC) · Mail Order Prescription Services · Drug List (Formulary). The Primary Care Network (PCN) program closed on March 31, 2019. Call: 208-364-1829 OR toll free 866-827-9967 (Monday through Friday 8 a. Box 516, Essington, PA 19029. Plan Name/Group Name: MI01/MIMEDICAID. BIN: 014203 PCN: ORDHSFFS340B entity pharmacies may submit claims to fee-for-service MHCP at their usual and customary rate. BIN: 61Ш342. is the Idaho Medicaid Pharmacy Benefit Management contractor. For more general information on Michigan Medicaid Health Plans, visit www. Health Plan of Nevada. Magellan Medicaid Administration, Inc. com Rx Group: HEALT001 Bin #: 004758 PCN: NPS Person Code: 00 Rx Group: HEALT002 Bin #: 004758 PCN: NPS Person Code: 00 MolinaBIN: 610494. Medicaid BIN# 019595 PCN 06180000 Medicare BIN# 019587 PCN 06190000. Oklahoma City, OK 73105Medicaid Unique BIN_PCN RX BIN Number RX PCN RX Group Line of Business NCPDP Version Effective as of 017142 ASPROD1 ML108 Medicaid D. RX2338 Gateway Health Plan (Medicaid Primary (800) 388-2994 CVS Caremark (866) 693-4611 ADV XXXXXX Group: RXCDPHP Emblem Health (800) 447-8255 EmblemHealth (888) 447-7364 0020111001 015748 Excellus Health Plan,Inc. ID. - 6 p. 483. Plan Name/Group Name: Medi-Cal Rx NEW! BIN*: 022659 NEW! PCN*: 6334225 Processor: Magellan Medicaid Administration Effective as of: 01/01/2021 NCPDP Telecommunication Standard Version/Release #: D. Virginia enacted a budget bill in May 2018 Indiana Medicaid for Providers. The team oversees the Georgia Medicaid and PeachCare for Kids® programs. The following list provides important identification numbers for this program: ANSI BIN # 001553 Processor Control # NVM Provider ID # National Provider Identifier Cardholder ID # NV Medicaid Pharmacy ID Number Prescriber ID # National Provider Identifier Product Code National Drug Code (NDC)• The NYS Medicaid Pharmacy List of Reimbursable Drugs can be found on the eMedNY site Affinity by Molina Healthcare Customer Service: For questions regarding policy and coverage information, call 1-800-223-7242. org/Resources/SPAP-ADAP-BIN-PCN for instructional BIN PCN LIST DC Department of Health, Attn: ADAP & Medicaid Division Manager 2019. 0 January 1, 2019 017142 ASPROD1 ML329 Medicaid D. Presbyterian Healthcare Services has served New Mexicans for more than 110 years. The Alabama Medicaid Agency pays for most medicines legally prescribed by a doctor or authorized health professional when dispensed by a licensed doctor or pharmacist in accordance with state and federal laws. [email protected] Name. Individuals who are pregnant, children, adults, and people with disabilities may qualify for this type of health coverage. This section lists additional changes made to this October 2021 Version of the through the New Jersey Medicaid Management Information System (NJMMIS). EST on the implementation date), providers should direct pharmacy claims to the BIN/PCN combination shown in the following table. emblemhealth. Healthy Michigan Plan. Iowa Medicaid. P022011529. 4 Special Requirements Applicable to Sterilization ProceduresFor most health care services, you must use the health care providers who are in your health plan. 866-525-5826. (CVS- PBM) N/A. Kentucky. Following are billing instructions for the Molina Healthcare Medicaid Plans: BIN: 004336, PCN: ADV GRP: RX0546, RX6422, RX6423A BIN / PCN combination where the PCN is blank and. com AHCCCS Health Plans BIN PCN Group Number PBM Phone Number AHCCCS FFS 001553 AZM OptumRx 855-577-6310 AHCCCS FFS - Secondary to Commercial 001553 AZM OptumRx 855-577-6310 AHCCCS FFS - Dual Eligibles for Covered OTC Prescriptions 001553 AZM OptumRx 855-577-6310 United Healthcare Community Plan (Acute, CRS, DD, LTC) 610494 4100 ACUAZ OptumRx Payer Name: Nebraska Medicaid Plan Name/Group Name: NEB01/NEBMEDICAID BIN: 013766 PCN: P063013766 Processor: Magellan Medicaid Administration Effective as of: 01/01/2012 NCPDP Telecommunication Standard Version/Release #: D. The General Guidelines manual contains basic information for all providers on enrollment, EDI enrollment, and claims processing. Box 629, Bin #34. They are: Aetna. EFFECTIVE 7/1/2021: BIN 023880; PCN KYPROD1; GROUP KYM01. Medicaid Information 1-800-662-9651 or (801) 538-6155 Provider Enrollment (801) 538-9050Medicaid with a Heart MPC provides free, quality health care services to Maryland's HealthChoice enrollees by extending the full benefits of Medicaid. Medicaid ID Card Member name: Your name goes here Member ID (tvþdiæid ID): 999999999 Issuer ID: (80840) 9999999999 RxPCN: ADV RxGRP: RX1234 card sent: 06/0112011 Rx Group No. [email protected] Accountable Care Partnership Plans MCO Partner PBM BIN PCN Group BMC HealthNet Plan Payer Name: Iowa Medicaid Enterprise Date: August 14, 2Ø2Ø Plan Name/Group Name: Iowa Medicaid BIN:Ø11933 PCN:IAPOP Processor: IME POS Unit (CHC) Effective as of September 21, 2Ø2Ø NCPDP Telecommunication Standard Version/Release #: D. Bin #: 610011 PCN: HCUMCAID Person Code: 000 Rx Group: TRAD Bin #: 610011 PCN: HCUMCAID Person Code: 000 Healthy U Providers: 877-895-7159 Members: 888-271-5870 PA: 877-895-7159 www. Exactus™ Pharmacy Solutions 1-866-458-9246 . SD Medicaid. The two dedicated phone lines for the Georgia Medicaid FFS account at SXC are as follows: Technical Support. Providers wishing to check eligibility, receive other insurance information or determine if service limits have been reached are advised to use the automated Voice Response BIN/PCN Table . the blank PCN has more than 50 records. 855-425-3247 (STAR/Hidalgo) El Paso First Premier . Member and eligibility questions. 0 NCPDP Data Dictionary Version Date: October 2019 NCPDP External Code List Version Date: October 2019Regular weekly maintenance window occurs on Sundays from 1:00 AM-5:00 AM ET. Ø Testing PCN: DRHIACCP all testing after 1/1/2012Plan Name BIN PCN BCBS BluePlus of Minnesota Blue Advantage (PMAP/MSC Plus) 61Ø455 MHCPBCBS BluePlus of Minnesota MN Care Processor Effective as of: Ø9/Ø1/2Ø11 NCPDP Telecommunication Standard Version/Release #: D. 30. 0 NCPDP Data Dictionary Version Date: 06/2010 NCPDP External Code List Version Date: 06/2006 Contact/Information Source:PLAN BIN PCN GROUP NUMBER Amerigroup 020107 CM WKHA Apple Health Fee-For-Service (FFS) 610706 WAPROD N/A Community Health 003858 A4 CHWA Coordinated Care of Washington, Inc. gov/managedcare. RxBIN: 003858 Medicaid Drug Rebate Program Labeler List Reference - To help you more easily identify Medicaid rebatable NDCs, we are posting a monthly reference list here. Group: ACULA. PCN: 2021. Bayou Health HealthyLouisiana. Date: March 3Ш, 2Ш21. Employer Group Services: 1-888-499-6922. CLAIM BILLING/CLAIM REBILL PAID (OR DUPLICATE OF PAID) RESPONSE. CLAIM BILLING/CLAIM REBILL CAPTURED (OR DUPLICATE OF CAPTURED) RESPONSE. Access to medical specialists and mental health care. TTY: 711. For MHSP use 0064206420 . 0215COMM. 1Ø2 -A2 VERSION/RELEASE NUMBER DØ M 1Ø3 -A3 TRANSACTION CODE B1 M 1Ø4 -A4 PROCESSOR CONTROL NUMBER Enter “WIPARTD” for SeniorCare , Wisconsin Chronic Disease Program (WCDP ), and AIDS/HIV Drug Assistance Program (ADAP) member s that are also enrolled in a MedicareTEXAS MEDICAID/CHIP VENDOR DRUG PROGRAM Page 1 OF 2 Effective Date Pharmacy Assistance Chart 12/01/2015 * MCO has unique requirements regarding coverage of Family Planning products. Prescription and certain over-the-counter medicines are covered. 3191501. BIN: 014203 PCN: ORDHSFFSUnited Healthcare Community Plan of Indiana BIN: 610494 PCN: 4841 United Healthcare Community Plan of Texas BIN: 610494 PCN: 4400 United Healthcare Community Plan of Arizona BIN: 610494 PCN: 4100 United Healthcare Community Plan of Virginia BIN: 610494 PCN 4900 UnitedHealthcare Community and State of MN BIN: 610494 PCN: 4846 UHCGP BIN: 610494 AHCCCS FFS and MCO Contractors BIN, PCN and Group ID's effective 1/1/2022; AHCCCS FFS and MCO Contractors BIN, PCN and Group ID's effective 4/1/2021; AZ SPA #16-003: Vaccines and Immunizations Cover Letter SPA 16-003 Vaccines and Imms; SPA pages 05/02/2016; SPA pages clean 05/12/2016; 179 Form Vaccines and ImmsThe following Medical Assistance (MA) Bulletin applies to 340B covered entities that bill the MA Fee-for-Service (FFS) program and/or a MA Program managed care organization (MCO) for drugs purchased under the 340B Drug Pricing Program and dispensed to MA program beneficiaries: MAB 99-13-08: 340B Drug Pricing Program Provider Requirements and Oklahoma Health Care Authority. 66 (a)- (d). Current: Pharmacy Benefits. However, according to the approved State Plan Amendment, theseThank you to our medical providers and welcome to the PCN provider's web page. comPharmacy and Durable Medical Equipment (DME) services are administered by Medicaid's Clinical Services and Support Division. 2017. Prior Authorization Fax: 1-833-404-2392. BIN/PCN combination BIN: 004519 PCN: GA01AP will still be in effect for non-Part D claims. Ø 1Ø3-A3 Transaction Code B1 M Billing TransactionBIN Information BIN Number Effective Date NCPDP Version 610241 January 1, 2021 D. NCPDP External Code List Version Date: 06/2006 . Unintentional overdose deaths are associated with methadone and other Plan Name/Group Name: Massachusetts Medicaid (MassHealth) BIN: 61Ø342 PCN: BCAID Plan Name/Group Name: Total Health Care Medicaid and Healthy Michigan Plan BIN: 61Ø342 PCN: ROIRX Plan Name/Group Name: Medicaid BIN: 61Ø342 PCN: ROIRX Plan Name/Group Name: Bridgeport Claims BIN: Ø19272 PCN: ROIBPCThe BIN/IIN field willeither be filled with the ANSI IIN or the NCPDP Processor BIN, depending on which one the health plan has obtained. 1Ø1-A1 BIN Number 610415, 004336 610029, 610468 006144, 004245 610449, 610474 603604, 007093 610473, 601475 012189, 013303 014046, 600042 610130, 610477 610239, 021007 610084, 610591 021338, 020099 020123, 610502 M 1Ø2-A2 Version/Release Number DØ M NCPDP vD. 610494. - 8 p. Also beginning 7/1/2021 the Clinical Call Center lines are open at (844) 336-2676 for PA requests and WV Medicaid The Health Plan is one of three managed care organizations approved by the Bureau for Medical Services (BMS) to provide services to West Virginia Medicaid recipients. 01940000. The PDL is a list of drugs that we prefer you use Medicaid will no longer pay for these drugs without the signed form 2011. 0 NCPDP Data Dictionary Version Date: October 2019 NCPDP External Code List Version Date: October 2019For KHC drug claims, the BIN is 610084, the PCN is DRTXPRODKH and the Group is KHC. email protected] Health (9 days ago) Following are billing instructions for the Medicaid Plans: BIN: 004336, PCN: MCAIDADV GRP: RX0546, RX6422, RX6423 Following are billing instructions for the Essential Plans: BIN: 004336, PCN: ADV GRP: RX6424 NCPDP D. Refer to the MCO Provider Manual for details. If you have pharmacy billing questions, please contact provider relations at (701) 328-7098. A BIN and PCN are required when adjudicating claims through the POS system . 15mg (epinephrine auto-injectors) to the Florida Medicaid Preferred Drug List (PDL) and to remove EpiPen® 0. pti-nps. Medicaid participants enroll in the Healthy Connections Primary Care Program to achieve the best health outcomes. Service. This link contains a list of Medicaid Health Plan BIN, PCN and Group Information. Processor. AmeriHealth Community Health Choices. Bookmark this page so you can check it frequently. Iowa. The UPHP wants to help keep you and your family healthy. AmeriHealth Caritas NH will be joining the two existing health plans NH Healthy Families and Well Sense Health Plan. Medicaid Managed Care BIN, PCN, This list was developed by UPMC for You doctors and pharmacists and includes the most commonly used drugs. A federal government website managed and paid for by the U. 0 January 1, 2019 017142 ASPROD1 ML110 Medicaid D. The following lists the segments and fields 2020. Nebraska Total Care is committed to providing appropriate, high-quality, and cost-effective drug therapy to all Nebraska Total Care members. CIMCARE. Centers for Medicare & Medicaid Services. Each plan will follow the state's Preferred Drug List. 0 NCPDP Data Dictionary Version Date: June 2010 NCPDP External Code List Version Date: June 2010Plan Name/Group Name: Medi-Cal Rx NEW! BIN*: 022659 NEW! PCN*: 6334225 Processor: Magellan Medicaid Administration Effective as of: 01/01/2021 NCPDP Telecommunication Standard Version/Release #: D. Control. MCO Payer Billing Information RXGRP. Go to your MCOs website to find a provider. Individuals with disabilities who apply for Medicaid may also have to apply for disability benefits. Highmark BCBSWNY has a preferred drug list (PDL), also called a formulary. 27. com Member Customer Service 888–447–7364 Pharmacy Help Line 800–824–0898 BIN: 015748 PCN: 20111001 Managed Care Contact 800–447–8255: Hudson Health Plan: Y (Diabetic Supplies, Hearing Aid Batteries, Enteral Products, Medical Supplies) Y (Diabetic Supplies, Hearing Aid Batteries, Enteral Products, Medical Supplies)PCC Plan PBM BIN PCN Group Pharmacy Help Desk Primary Care Clinician (PCC) Plan Conduent 009555 MASSPROD MassHealth (866) 246-8503 (Conduent/POPS) (800) 745-7318 (DUR) SCO Plan- Medicaid Only PBM BIN PCN Group Pharmacy Help Desk Commonwealth Care Alliance Navitus 610602 MCD MHO (877) 908-6023 Senior Whole Health CVS CaremarkThe Rhode Island Medicaid Program structures benefits available to Medicaid clients in a manner that promotes access to medically necessary and cost-effective care. Processor: Processor/Fiscal Intermediary. Aetna Better Health - Pharmacy Claims Billing information. Learn about outpatient prescription drug coverage, what falls under Medicare Part B. Treatment of special health needs and pre-existing For KHC drug claims, the BIN is 610084, the PCN is DRTXPRODKH and the Group is KHC. for members in managed care organizations (MCOs) need to use the MCO's identification bin and PCN information. Non preferred drugs on this list may be covered when It's called a Preferred Drug List (PDL). Plan Name/Group Name: Independent Health. – 6 p. 800-486-2668 (TTY: 711) Monday – Friday, 8 a. Medicaid Fee. KanCare Medical Assistance Program. Keep your KHC Client ID ready when calling. COBSEGADV. Box 1437, Slot S401 Little Rock, AR 72203-1437. 0 NCPDP Data Dictionary Version Date: October 2019 NCPDP External Code List Version Date: October 2019Use BIN Number Ø16929 for ADAP claims. Initiate prior authorization requests. Please note, the data below is Part 1 of 5 (E0654 - H2235) with links to Parts 2 through 5. If members do not have their MCO card available, ask the member which MCO he or she is enrolled in and submit the claim using the BIN/PCN/GroupRx information listed above. BIN:009737. Carrick erica. AHCCCS FFS and MCO Contractors BIN, PCN and Group ID's effective 4/1/2021 AZ SPA #16-003: Vaccines and Immunizations Cover Letter SPA 16-003 Vaccines and ImmsBIN 610591 20107 610649 4336 4336 610494 11529 PCN ADV KY 3191501 MCAIDADV MCAIDADV 4040 P022011529 GROUP RX8831 WKVA RX5035 RX8893 ACUKY KY Medicaid PBM CVS Caremark IngenioRx Humana Pharmacy Solutions CVS Caremark CVS Caremark Optum Rx Magellan Kentucky Medicaid Bin/PCN/Group Numbers Effective 1/1/2021. gov. Bill OHA (FFS) for: Carve-out drugs for CCOs, drugs for OHP fee-for-service (“open card”) clients, drugs not covered by Medicare Part D, and drugs not included in the long-term care facility’s bundled rate. Verify member eligibility and the MCO enrollment BIN Ø12833, PCN FLBC This is required when Covered Person’s of Bridgespan Idaho have secondary coverage with Bridgespan Idaho, BIN 61Ø212, PCN Ø23ØØØØØ This is required when Covered Person’s of Bridgespan Oregon have secondary coverage with Bridgespan Oregon, BIN 61Ø212, PCN Ø232ØØØØ This is required when Covered Person’s ofIndiana. 4336. Please contact individual health plans to verify their most current BIN, PCN and Group Information. • Bank Identification Number (BIN) and Processor Control Number (PCN): For submitting FFS claims to Medicaid via NCPDP D. Fee-For-Service. Medical Assistance (Medicaid) Programs Families and Children (PMAP) MinnesotaCare Changes to the RI FFS Medicaid Payer Sheet Effective 2/23/2021 RI FFS Medicaid, in order to support the Comprehensive Addiction and Recovery Act (CARA) of 2016, is adding 2 additional field requirements to the payer sheet for submission of pharmacy claims. Plan Name/Group Name: Total Health Care Medicaid and PCN: N/A and Group listing for applicable Group Number, BIN and PCN 2020. The following table lists the segments available in a Billing Transaction. PCN: P008009737. Medicaid - PMAP, 018315, MNM. Call: 208-364-1829 OR toll free 866-827-9967 (Monday Clarification of Unique BIN (or BIN/PCN) Requirements as of January 1, 2012. We appreciate you and the service you render to our PCN recipients. Ø17Ø1Ø. If you're new to STAR, you'll choose a health plan from the ones available Bill Medicaid (OHA or the CCO) last for all services except for Vaccines for Children administrations. gov . SXC will be taking over all services previously provided by Express Scripts for FFS Medicaid. The following table lists the segments available in a Billing below list the mandatory data fields. Plan Lists Plan Name / Network Name Network or Attachment Region BIN, PCN or Group Help Desk/ Notes Caremark Medicaid Amerigroup National2018. 2021 Medicare Prescription Drug Plan Pharmacy BIN and PCN Numbers: Contract ID: Contract Name: BIN Number PCN Group Number; Fee for Service (Medicaid Direct) NCTracks: 610242: 781640064: 2022 Medicare Prescription Drug Plan Pharmacy BIN and PCN Numbers: Contract ID: Contract Name: The Centers for Medicare & Medicaid Services (CMS) released a compilation of the BIN and PCN BIN 610591 20107 610649 4336 4336 610494 11529 PCN ADV KY 3191501 MCAIDADV MCAIDADV 4040 P022011529 GROUP RX8831 WKVA RX5035 RX8893 ACUKY KY Medicaid PBM CVS Caremark IngenioRx Humana Pharmacy Solutions CVS Caremark CVS Caremark Optum Rx Magellan Kentucky Medicaid Bin/PCN/Group Numbers Effective 1/1/2021BIN_PCN E0654 IBT VOLUNTARY EMPLOYEE BENEFITS TRUST 801 IBT Voluntary Employee Benefits Trust (Employer PDP) 610097 9999 TEAMStar Medicare Part D Prescription Drug Program 802 803 E2630 C AND O EMPLOYEES' HOSPITAL ASSOCIATION C and O Employees Hospital Association (Employer PDP) C and O Employees Hospital Association E3014 PSERS HOP PROGRAMBIN. The PCN has two formats, which are comprised of 10 characters:2016 Medicare Contract/Plan and BIN/PCN Combinations BIN/PCN Data Disclaimer The Centers for Medicare & Medicaid Services (CMS) has made a reasonable effort to ensure that the provided data are a true and accurate representation of the data on file at CMS at the time of disclosure. State Drug Utilization Data (SDUD) has been reported by states since the start of the Medicaid Drug Rebate Program for covered outpatient 2021. 0 MeridianRx Medicare PCN List for 2021 MeridianRx - Medicare PCN Plan/Group Group ID Line of Business Description MHPILCOMP MeridianComplete N/A Medicare/Medicaid MeridianComplete (MMAI) for Illinois MHPILCOMPB M eridianComplet N/A Adjudication Medicare/Medicaid B Commercial Plan List Plan Name / Network Name PBM/ Processor Region BIN PCN/ Group Help Desk City of Effingham WHI/WHP IL 603286 01410000, GR 514572 800/207-2568 City of Garfield Maxor Plus NJ 005377 See card 800-687-0707 City of Kingman Innoviant National 610127 02330000 877-559-2955 City of Phoenix- BC/BS of AZ Caremark/ PCS AZ/CA 004337 New York Managed Medicaid Plans processed by Caremark will cover COVID-19 specimen collection or CLIA waived COVID-19 testing at pharmacies in accordance with the New York Governor's Executive Order #202. Welcome to the website for the Nebraska Medicaid Pharmacy Program - Point of Sale System (POS). 12/22/2021 txvendordrug. Please ask your doctor or pharmacist if you have any questions about your medicines. PCN: NYS Medicaid ID. Ø NCPDP Data Dictionary Version Date: July 2ØØ7 NCPDP External Code List Version Date: October 2Ø14Payer Name: Nebraska Medicaid Plan Name/Group Name: NEB01/NEBMEDICAID BIN: 013766 PCN: P063013766 Processor: Magellan Medicaid Administration Effective as of: 01/01/2012 NCPDP Telecommunication Standard Version/Release #: D. A former foster care youth. 5297. Click here for the first page (E0654 - H2235), second page (H2237 - H3959), third page (H3962 - H5928) and fourth page (H5928 - H8634). Click here for the first page (E0654 - H2235), third page (H3962 - H5928) , fourth page (H5928 - H8634) and fifth page (H8634 - S9701). Medicaid Pharmacy List of Reimbursable Drugs and durable Bank Identification Number (BIN) and Processor Control Number (PCN): For Preferred Drug List (PDL) Search Kentucky Medicaid PDL and drug coverage status. Also beginning 7/1/2021 the Clinical Call Center lines are open at (844) 336-2676 for PA requests and Medicaid managed care, and HIV Special Needs Plan members have a right to a fair hearing from New York State when the health plan decides to deny, reduce or end their health care or does not make a decision in a reasonable amount of time. What is a preferred drug list? A Arizona Complete Health-Complete Care Plan covers prescription medication when: Your medication is on one of our preferred drug lists; You get your 2017. 501-682-8292 Fax: 501-682-1197 Alaska Medicaid D. In the table below are direct links to each states' Medicaid office website. MHCP will pay the lower of the following rates for 340B entity pharmacy claims: • The pharmacy's usual and customary charge. 527. Get info about which drugs apply under certain conditions. The official plan is maintained by the Alaska Department of Health & Social Services Commissioner's Office. X --BIN/PCN Info for all Medicaid Plans. Ø NCPDP Data Dictionary Version Date: July 2ØØ7 NCPDP External Code List Version Date: July 2Ø13 Contact/Information Source: 1-877-782-5565Pharmacy Benefit Administrator, BIN, PCN, Group, and telephone number Specialty Pharmacy name and telephone number Website address for pharmacy information Aetna Better Health CVS/ Caremark Phone: 1-855-364-2975 Medicare/Medicaid Members BIN: 610591 PCN: MEDDADV Group: RX8812 Medicaid Only Members BIN: 610591 PCN: ADV Group: RX8810Ohio Medicaid Managed Care Plan Pharmacy Benefit Administrator, BIN, PCN, and Group Specialty Pharmacy name and telephone number Website address for pharmacy information Aetna Better Health CVS/ Caremark 1-855-364-2975 Medicare/Medicaid Members BIN: 610591 PCN: MEDDADV Group: RX8812 Medicaid Only Members BIN: 610591 PCN: ADV Group: RX 8810The Preferred Drug List (PDL) is a list of covered medicines. The Nebraska Department of Health and Human Services, Medicaid and Long Term Care division has contracted with Magellan Medicaid Administration, Inc. Medicaid Publication Date June 1, 2021 BIN(s) 023880 PCN(s) KYPROD1 Processor MedImpact Healthcare Systems, Inc. • When a pharmacy claim is received for a Medicaid recipient or SeniorCareMedicaid State Plan. The following lists the State's Preferred Drug List (PDL)* the Medicaid card. , but it substantially provides current referral and prior authorization Rx BIN Rx PCN Rx GRP; 004336 MCAIDADV RX8891. Your doctor may need to get preapproval for some drugs Plan Name/Group Name: NM Medicaid Fee For Service (test), BIN: 610084. 20. We can help you if you are healthy or if you have special needs or need complex healthcare services. Prior Authorization / Overrides - Recipient Calls - May also call (800) 362-1504. Texas Drug Code Formulary On the Vendor Drug Program webpage you can search the Texas Drug Code Formulary, contracted KHC pharmaciesThe NC Medicaid Preferred Drug List (PDL) allows NC Medicaid to obtain better prices for covered outpatient drugs through supplemental rebates. Pharmacy Claims. Billing Information Effective 9/1/2019: NH Medicaid Prescription POS Billing Information BIN PCN Group NH Managed Care Medicaid:Read Book Read Updated Bin Pcn List Feb13 Read Updated Bin Pcn List Feb13 Getting the books read updated bin pcn list feb13 now is not type of inspiring means. comBill Medicaid (OHA or the CCO) last for all services except for Vaccines for Children administrations. If a patient has an existing, currentMedical care in managed care covered areas is provided by the MCOs listed below. Medicaid Primary BIN and PCN Values . Browse 2022 Medicare Part D prescription drug plans Browse 2022 Medicare Advantage plans (MAPD)For more general information on Michigan Medicaid Health Plans, visit www. Hoosier Healthwise Hoosier Care Connect M. This is an no question simple means to specifically acquire lead by The Provider Web Portal server maintenance is scheduled from midnight to 8:00AM on Sunday, May 8, 2022. UnitedHealthcare Community Plan. Create a dummy prescriber, giving it whatever name you want (such as NYMED, OTC). The complete list of items subject to the Pharmacy Benefit Carve-Out can be reviewed (PCN): For submitting FFS claims to Medicaid via NCPDP D. hawaii. The Upper Peninsula Health Plan (UPHP) is a managed care organization for people covered by Michigan Medicaid, MIChild, Children's Special Health Care Services, and the Healthy Michigan Plan. 600760. BIN/PCN. South Dakota Medicaid's processor BIN number is 601574. Once a vendor has developed a program following the guidelines stated in this manual, they must test the program for approval. WellCare. For KHC drug claims, the BIN is 610084, the PCN is DRTXPRODKH and the These lists inform patients and providers of the drugs reimbursable under the 2021. An adult age 19-64. 866-525-5827 (phone) 888-491-9742 (fax) The technical support line at SXC opened for pharmacists on December 18, 2006. GROUP. For Service. Medicaid, Dual SNP * change or addition to previously published list Medical Payer ID applies to Professional (CMS-1500) and/or Institutional (UB-04) claims. Signature requirements for delivery of prescribed medications during COVID-19 pandemic; Health advisories. Payer/Carrier. 0 NCPDP Data Dictionary Version Date: June 2010 NCPDP External Code List Version Date: June 2010The goal of the Idaho Medicaid Pharmacy Program is to provide quality care to Medicaid participants with the most effective drug at the right price. the Medicaid card. Pharmacies are required. FFS Pharmacy Billing Reference. View Medicaid income limits. Hospital care and services. Navitus . 888. Horizon NJ Health. PerformRx Rx BIN: 019595 Rx PCN: 06280000 Rx Grp: (Not Required) Medicaid Provider Services (PBM) 1 (888) 602-3741 Medicaid Enrollee Services 1 (888) 452-3647 Alliance Provider Services 1 (888) 987-5821 Alliance Enrollee Services 1 (888) 987-5806 CareFirst Blue Cross Blue Shield Community Health Plan Abarca RX BIN: 610674 Rx PCN: ABARCABIN: 610494. 004336 MCAIDADV RX5435 Molina coordination of benefits (COB) members 013089 COMESEGADV Group per Molina plans listed below Molina: MOLINA WA - AHFAM/IMCManaged care pharmacy identification. The chart below is the second page of the 2021 Medicare Part D pharmacy BIN and PCN list covering prescription drug plans from contracts H2237 through H3959. guam. enrolled in and submit the claim using the BIN/PCN/GroupRx information listed above. 3 Medicaid for Individuals Age 65 or Over in Institutions for Mental Diseases; 3. The Illinois Medicaid program covers prescription drugs, as well as some over-the-counter (OTC) Presentation · AHCCCS Preferred Drug List Class Recommendations AHCCCS FFS and MCO Contractors BIN, PCN and Group ID's effective 1/1/2022 2021. Click below to view the manual:email protected] Health (9 days ago) Following are billing instructions for the Medicaid Plans: BIN: 004336, PCN: MCAIDADV GRP: RX0546, RX6422, RX6423 Following are billing instructions for the Essential Plans: BIN: 004336, PCN: ADV GRP: RX6424 NCPDP D. 7500 Security Boulevard, Baltimore, MD 21244. RX2338 Gateway Health Plan (Medicaid Primary) (Effective 1/1/2022) 004336: MCAIDADV RX2338com BIN: 004336 PCN: ADV Group: RX0714 Pharmacy Help Desk: 1-800-364-6331 OptumRx Pharmacy Help Desk: 1-877-889-6510 Medicare/Medicaid Members BIN: 610097 PCN: 8500 Group: MMPOH Medicaid Only Members BIN: 610494 PCN: 9999 Group: ACUOHMMP Pharmacy Benefit Administrator, including BIN, PCN, Group and telephone number. 340B Contract pharmacies must carve out ND Medicaid. To report an issue, please contact Provider Services at: 800-925-1706 Monday - Friday, from 8am to 5pm. All Medicaid recipients are assigned a unique CIN even if they are enrolled in a Medicaid managed care (MMC) plan. This number is used by the pharmacy and other providers to submit claims to Medicaid fee-for-service (FFS). Blue Cross Complete's D. Kansas. On the Vendor Drug Program webpage you can search the Texas Drug Code Formulary, contracted KHC pharmacies, learn about claims information The following Medical Assistance (MA) Bulletin applies to 340B covered entities that bill the MA Fee-for-Service (FFS) program and/or a MA Program managed care organization (MCO) for drugs purchased under the 340B Drug Pricing Program and dispensed to MA program beneficiaries: MAB 99-13-08: 340B Drug Pricing Program Provider Requirements and Bank Identification Number (BIN) and Processor Control Number (PCN): For submitting FFS claims to Medicaid via NCPDP D. 0 NCPDP Data Dictionary Version Date: April 2012 NCPDP External Code List Version Date: April 2012Kentucky Medicaid MCO Single PBM Program Goes Live 7/1/2021. 866-247-5678. Physicians are asked to complete the prenatal risk screening form and fax it to The Health Plan at 740. Learn more. E. 1Ø2 -A2 VERSION/RELEASE NUMBER DØ M 1Ø3 -A3 TRANSACTION CODE B1 M 1Ø4 -A4 PROCESSOR CONTROL NUMBER Enter "WIPARTD" for SeniorCare , Wisconsin Chronic Disease Program (WCDP ), and AIDS/HIV Drug Assistance Program (ADAP) member s that are also enrolled in a MedicareTEXAS MEDICAID/CHIP VENDOR DRUG PROGRAM Page 1 OF 2 Effective Date Pharmacy Assistance Chart 12/01/2015 Plan PBM RxBIN PCN RxGRP Pharmacy Prior Authorization Member . 1, 2019 Mississippi Preferred Drug List (PDL) Opioid Frequently Asked Questions (FAQs)Medicaid Provider Manual. 2022 Pennsylvania Medical Assistance BIN/PCN/Group Numbers Gateway Health Plan (Medicaid Secondary to Medicare). Plan Name/Group Name: Maine Medicaid (MEPOP). updating the list below with the BIN information and date of availability. 11529. Apple Health (Medicaid) pays for drugs that are preferred on the Apple Health Preferred Drug List. Pharmacists and pharmacies may bill for COVID-19 testing beginning January 1, 2021. Ш testing). PCN: A processor control number (PCN) is another identifier used to route pharmacy reimbursements. 0 NCPDP Data Dictionary Version Date: June 2010 NCPDP External Code List Version Date: June 2010The Medical Assistance Plans Division at the Georgia Department of Community Health advances the health, wellness and independence of those we serve by providing access to quality, free and low-cost health care coverage. Clinical Hours: Monday - Friday 7 a. As of November 2021, Illinois has enrolled 3,516,323 individuals in Medicaid and CHIP — a net increase of 33. to 5 p. The following fields have been added to the payer sheet. Mental Health Quality Advisory Committee (MHQAC); Preferred Diabetes Supply List (PDSL); Medicare prescription drug coverage; Therapeutics Committee (OptumRx) Drug PA Fax: (858) 357-2612. The Health Plan's Provider Manual contains comprehensive information related to best practices for the care of this population. Plan Name/Group Name: IronRx BIN: 019819 PCN: SX Plan Name/Group Name: US-RxCare BIN: 021783 PCN: AE02 Plan Name/Group Name: Elixir BIN: 021072 PCN: DCAE1/ ROIRX Plan Name/Group Name: Elixir BIN: 021791 PCN: DCAE1/ ROIRX Plan Name/Group Name: USA Rx BIN: 610306 PCN: DCAE1 Plan Name/Group Name: Exemplar Health U50 BIN: 610748 PCN: PRORXNew York Managed Medicaid Plans processed by Caremark will cover COVID-19 specimen collection or CLIA waived COVID-19 testing at pharmacies in accordance with the New York Governor’s Executive Order #202. Ø 1Ø3-A3 Transaction Code B1 M Billing TransactionA BIN / PCN combination where the PCN is blank and. E-mail text: This to inform Part D Sponsors and pharmaceutical manufacturers that the Centers for Medicare. 0 NCPDP Data Dictionary Version Date: October 2019 NCPDP External Code List Version Date: October 2019Five health plans (also known as MCOs) participate in New Jersey's NJ FamilyCare Medicaid program. Ø NCPDP Data Dictionary Version Date: July 2ØØ7 NCPDP External Code List Version Date: October 2Ø11 Contact/Information Source:Payer Name: Kentucky Medicaid Plan Name/Group Name: KYSTD001 / Kentucky Standard Plan BIN: 011529 PCN: P022011529 Processor: Processor/Fiscal Intermediary Effective as of: 01/01/2012 NCPDP Telecommunication Standard Version/Release #: D. The Transaction Facilitator and CMS HAP Empowered has a unique set of BIN/PCN numbers for processing Medicaid pharmacy claims. PAGE 3 OF 23. 17. Illinois has expanded coverage to low-income adults. RX BIN. Plan Name/Group Name: VDCRX BIN: 009893 PCN: ROIRX Plan Name/Group Name: Careington BIN: 610303 PCN: AE02 Plan Name/Group Name: Cogent Works BIN: 017134 PCN: ROIRX Plan Name/Group Name: Medicaid BIN: 610342 PCN: ROIRX Plan Name/Group Name: Bridgeport Claims BIN: 019272 PCN: ROIBPC Plan Name/Group Name: OneRx BIN: 637639 PCN: ROIRX/ AE02The following list provides important identification numbers for this program: ANSI BIN # 001553 Processor Control # NVM Provider ID # National Provider Identifier Cardholder ID # NV Medicaid Pharmacy ID Number Prescriber ID # National Provider Identifier Product Code National Drug Code (NDC)Medicaid Help Desk 1-866-935-8874 Medicare Help Desk 1-866-935-6681. All calls are toll-free. When a SC Medicaid beneficiary has other insurance coverage, pharmacy providers are required to bill all other insurance carriers before billing SC Medicaid. PCN: VTPOP. tools available to providers at Gateway Health including resources, coverage details, forms, and Medicare / Medicaid drug lists. Conduent. jump Created Date:)

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Medicaid bin pcn list