Plan Lists


the Professional. Service Code field. Plan Name /. Network Name. Network or. Attachment. Region. BIN, PCN or Group. Help Desk/. Notes. Member Health ...

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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