If you forget if you need a group number or not, use the third party inquiry. We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. In January 2017, the IIN length changed from a 6-digit number to an 8-digit number. There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. 0000002830 00000 n gcse.type = 'text/javascript'; Rx PCN: N/A The TIN for Optimum Choice HMO is: 52-1518174 Group ID Number: 717578 . Please do not turn the customer away if you receive a rejected claim. endstream endobj 249 0 obj <>stream var s = document.getElementsByTagName('script')[0]; Sign Up To Receive Emails For Events, News & General NCPDP Information. 0 Plans that use cards with a magnetic stripe should use the recommended ISO/IEC 7812 Issuer Identifier Number (IIN) for processing electronic pharmacy claims. Please do not turn the customer away if you receive a rejected claim. Providers who do not contract with the plan are not required to see you except in an emergency. Group ID will be ignored by the processor. What BIN/PCN/group number should I be entering in the Third Party section of my patient profile? %PDF-1.6 % International Organization for Standardization / International Electrotechnical Commission, (ISO/IEC) Joint Technical Committee (JTC) 1, Contact NCPDP Provider Services Department at 480.734.2870 or. xref EmblemHealth (888 . A PBM/processor/plan may choose to differentiate different plans/benefit packages with the use of unique PCNs. 0 If you continue to browse or use this website, you agree to this updated Privacy Policy. PCN GROUP : Type Network: Location Help Desk Number: ARGUS 1.1.2015 HealthCare Corp of America /Prescription Corp of America HCA-PCA 340 Basics 600428 06730000 Medicaid: National 1-800-309-1603: ARGUS 1.1.2015 Health Network Dscnt Card 600428: 1HEALTH Commercial: National 1-866-921-7286: ARGUS 1.1.2015 Health Options 600428: 07130000 Commercial . For more information contact the plan. Find a 2023 Medicare Advantage Plan (Health and Health w/Rx Plans), Browse Any 2023 Medicare Plan Formulary (or Drug List), Q1Rx Drug-Finder: Compare Drug Cost Across all 2023 Medicare Plans, Find Medicare plans covering your prescriptions, Medicare plan quality and CMS Star Ratings, Understanding Your Explanation of Benefits, IRMAA: Higher premiums for higher incomes, 2023 Medicare Advantage Plans State Overview, 2023 Medicare Advantage Plan Benefit Details, Find a 2023 Medicare Advantage Plan by Drug Costs. The ISO/IEC 7812 Registration Authority (the American Bankers Association) issues the IIN. 0000012588 00000 n 11-A1 BIN Number See BIN/PCN table, above M 12-A2 Version Release Number D=Version D.0 M 13-A3 Transaction Code B1=Billing M 14-A4 Processor Control Number As indicated above M 19-A9 Transaction Count 1=One Occurrence 2=Two Occurrences . HWr+S&M,N&H MRRgRIsin9ad_%^!c/$I &juN$WfOT^nvZd%w-17/0P}2EdN/[xnEZgcEir7x!%? Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. All insurance policies and group benefit plans contain exclusions and limitations. This includes accounts for Grandfathered members. 0000001711 00000 n 0000001081 00000 n Your membership is expired. 0000002289 00000 n 800-922-1557 Mercy Care LTC 610591 ADV RX8805 CVS- Caremark 855-548-5646 Arizona Complete Health (formerly Health Net & Cenpatico) 004336. These standards are developed by theInternational Organization for Standardization / International Electrotechnical Commission(ISO/IEC) Joint Technical Committee (JTC) 1,Information Technology, Subcommittee (SC) 17,Cards and personal identification, Working Group (WG) 5. 8254 36 0000002851 00000 n TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. 2. MCAIDADV RX5443. AHCCCS FFS 001553 AZM OptumRx 855-577-6310 . To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. 'https:' : 'http:') + ANSI is responsible for making certain the application has been properly completed and that all appropriate fees and attachments have been collected. 0000002034 00000 n We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. 0000001020 00000 n Find a 2023 Medicare Advantage Plan (Health and Health w/Rx Plans), Browse Any 2023 Medicare Plan Formulary (or Drug List), Q1Rx Drug-Finder: Compare Drug Cost Across all 2023 Medicare Plans, Find Medicare plans covering your prescriptions, Medicare plan quality and CMS Star Ratings, Understanding Your Explanation of Benefits, IRMAA: Higher premiums for higher incomes, 2023 Medicare Advantage Plans State Overview, 2023 Medicare Advantage Plan Benefit Details, Find a 2023 Medicare Advantage Plan by Drug Costs, Sign-up for our Medicare Part D Newsletter, Have a question? Use the Drawing Tools tab to change the formatting of the pull quote text box.] For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), UNIVERSITY OF MARYLAND HEALTH ADVANTAGE, INC. GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC, VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. 0000006921 00000 n var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; The application and registration procedures are identified in ISO/IEC 7812-2. Bank identification number (BIN): 600428: Processor control number (PCN): 06210000: Pharmacy directory: Click on : Participating pharmacy: or go to : mibluecrosscomplete.com . These standards are developed by theInternational Organization for Standardization / International Electrotechnical Commission (https://www.iso.org/home.html) (ISO/IEC) Joint Technical Committee (JTC) 1,Information Technology, Subcommittee (SC) 17,Cards and personal identification, Working Group (WG) 5. For more information contact the plan. 0000006026 00000 n Your medical benefits allow you 0000009977 00000 n The Processor Control Number (PCN) is a secondary identifier that may be used in routing of pharmacy transactions. 0000001448 00000 n Medicare evaluates plans based on a 5-Star rating system. Healthcare coverage wherever you go. The new third party function where you can input the bin and pcn directly from the patient's profile is WAY helpful tho! 0000034997 00000 n 0000033180 00000 n Systems for register-based monitoring of vaccine effectiveness (VE) against laboratory-confirmed influenza (LCI) in real time were set up in Stockholm County, Sweden, and Finland, before start of the 2016/17 influenza season, using population-based cohort studies. RX Bin for GuideStone Health Plans Except for Secure Health (No PCN Number required) 610014; Rx Bin for Secure Health TM Plans 003858 ; PCN Number for Secure Health TM Plans A4; You can also visit GuideStoneHealth.org and create an account to print a temporary ID card on or after your health plan effective date. Click here to let us know, CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA, Highmark Blue Cross Blue Shield of Western New York and Highmark Blue Shield of Northeastern New York, BlueCross BlueShield: Empire, Excellus, WNY & NENY, Health Alliance Medicare Prescription Plan, Blue Cross and Blue Shield of North Carolina, Blue Cross and Blue Shield of IL, NM, OK, TX, Blue Cross and Blue Shield of Kansas or Blue KC, Regence BlueShield of Idaho and Regence BC BS Utah, Horizon Blue Cross Blue Shield of New Jersey, 001-012, 014-034, 070, 105, 106, 121-137, 801, 802, 808. 0000016616 00000 n All existing six-digit IINs were converted into a block of one hundred eight-digit IINs. Box 7012 Downey, CA . As of January 2017, the IIN length has changed from a 6-digit number to an 8-digit number. 3424 0 obj <> endobj 0000004285 00000 n 0000011949 00000 n The PCN is defined by the PBM/processor as this identifier is unique to their business needs. Those health plans that did not have a business reason for creating pharmacy benefit cards with a magnetic stripe were in need of a number, because they still needed to process electronic pharmacy claims. 0000008238 00000 n %%EOF However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service BANBUHP Express Scripts. When applicable, the Pharmacy Providers should update impacted members profiles with the new processing information. var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; var gcse = document.createElement('script'); The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change. 0000002142 00000 n There is a fee to obtain a number. Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. Members may enroll in a Medicare Advantage plan only during specific times of the year. 0000003018 00000 n 0000006077 00000 n For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. The PCN, like the BIN/IIN appears on the pharmacy ID card, in accordance with the rules defined in theNCPDP Pharmacy ID and Combination Card Implementation Guide. 0000033095 00000 n MedImpact (Includes: Excellus/ FLRx) BIN and PCN Codes If Commercial claims are submitted for groups that have transitioned with the old BIN or PCN, claims will reject with NCPDP Reject Code 01 (M/I BIN) and 04 (M/I Processor Control Number). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. 'https:' : 'http:') + Medicare has neither reviewed nor endorsed the information on our site. 0000010641 00000 n 0000070373 00000 n 0000011626 00000 n Medicare MSA Plans do not cover prescription drugs. 4=Four Occurrences. gcse.src = (document.location.protocol == 'https:' ? Links will appear for the application process. a listing of the legal entities When a patient requests a prescription to be filled at the pharmacy, the pharmacy collects pertinent information on their prescription benefit program. Call 1-866-447-9717 Customer Service: 1-877-344-7364 (TTY/TDD: 711) Emblem Behavioral Health Services . hbbd``b`AR 6H da@D`m@\Y6 $Ma}d100RN2@ 8 If they have bookmarked their old account, this will NOT show 2020 plan information. 0000004526 00000 n {hBIsS6U6,Q{O|+x`o~{>+W Od^.+mB:rNlHi} *"d\Q*\ZMW% Ffa3Y!G'[71c4)0 0000006589 00000 n To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. 0000028672 00000 n RX Bin: 610014 . 01 M/I BIN 101-A1 04 M/I PCN 104 -A4 06 M/I GROUP NUMBER 301 -C1 07 M/I CARDHOLDER ID 301 -C2 Additional messaging will provide the correct BIN and PCN to use. Emblem Health (800) 447-8255. %PDF-1.5 % 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. '//cse.google.com/cse.js?cx=' + cx; 0000014836 00000 n Refer to above list or what is printed on ID card . area. 0000002203 00000 n PCN List for BIN 610241 MeridianRx PCN Group ID Line of Business MHPILMCD N/A Medicaid Pharmacy Help Desk Information Inquiries to MeridianRx may be directed to our 24 hour Pharmacy Assistance Center. Plug . 0000004060 00000 n 20200903T55 Sh: 0 Bin 2 J008 Env [1] CSets 1 of 2. s.parentNode.insertBefore(gcse, s); 8254 0 obj <> endobj Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. The NCPDP Processor BIN, while NCPDP assigns it, is only a number inside the pharmacy industry. 0000003547 00000 n Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home. 0000002715 00000 n UMP Plus networks. 0000014626 00000 n Author: Kelly Wilson Created Date: Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). Existing six-digit IINs were converted into a block of one hundred eight-digit IINs. Read latest notifications, file pricing appeals and search Express Scripts claims and patient coverage for your Pharmacy customers. Our Privacy Policy is now easier to read and better organized. 0000002685 00000 n 0000001465 00000 n Sunrise: 07:50AM. BIN: PCN: Group Number PBM: Phone Number. Our. BT4'j7k?pj|q)@@ i3ao>V|tCJ?a|$FY.^a%>]q!N6# The NCPDP Processor ID Number (BIN) is a six-digit number that health plans can use to process electronic pharmacy claims if they do not use pharmacy benefit cards with a magnetic stripe. We do not reuse numbers. MeridianRx PCN Phone Fax Email MHPILMCD (Medicaid) 855 -580 -1688 855 -580 -1695 info@meridianrx.com . You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. BIN PCN RxGrp 610011 CTRXMEDD MDCMEDD [Type a quote from the document or the summary of an interesting point. BIN 610239 PCN: FEPRX RxGrp: 65006500 3. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. LINA and NYLGICNY are not affiliates of Cigna. s.parentNode.insertBefore(gcse, s); 0000001868 00000 n 0000014560 00000 n The IIN structure is defined within the international standard ISO/IEC 7812-1,Identification cards - Identification of issuers - Part 1: Numbering system. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. 0000002069 00000 n Rx Information: MEDCO 1-800-842-2038 . endstream endobj 2426 0 obj<>/W[1 1 1]/Type/XRef/Index[124 2265]>>stream xref })(); Chart of 2021 BIN and PCN values for each Medicare Part D prescription drug plan Part 5 of 5 (H8634 through S9701). What is a Take-Home Drug? Because of this, every member must create a new account regardless of whether they are renewing or not. 0000011029 00000 n gcse.async = true; Have them call the phone number on the back of their Cigna ID card. BIN/PCN/Group Numbers for ACOs, MCOs and PCC Plan The three tables below shows the correct combinations effective March 1, 2018, for pharmacies to use when submitting MassHealth ACO/MCO/FFS pharmacy claims. 0000028726 00000 n 0000005422 00000 n 0000007443 00000 n Anthem Blue Cross Rx BIN: 020099 PCN: IS Blue Shield of California Rx BIN: 004336 PCN: 77993333 Chinese Community Health Plan RX BIN: 003585 RX PCN: ASPROD1 Cigna + Oscar RX BIN: 003858 PCN: A4 Health Net* Rx BIN: 004336 PCN: HNET Kaiser Permanente-Northern CA Rx BIN: 11842 Rx Group: NC Tax ID: 94-1340523 COB Address: P.O. %PDF-1.6 % Contact the Medicare plan for more information. Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see Cigna may not control the content or links of non-Cigna websites. I was doing an amox script for a dude who shows up with nothing but his wife's military ID and know they go through express scripts so I searched for plans by using BIN 610014 and entering the SSN but no matter what I tried it just would not go through. CDPHP (800) 388-2994. Medicare has neither reviewed nor endorsed the information on our site. The plan deposits 0000006462 00000 n xref 0000000927 00000 n 0000003944 00000 n YOUR PROVIDERS. Selecting these links will take you away from Cigna.com to another website, which may be a non-Cigna website. But that's pure memorization. Visit our Cigna Pharmacy Resourcespage to be connected to Express Scriptsresources. x1 04HKl\GMyC. DownloadtheNCPDP Payer Sheet Template, more information is available by selecting Resource Topic - "HIPAA". We do not sell leads or share your personal information. RX Group: UHEALTH . Og%$pB1 o:er1?P_ojKuK3L 9H(! The term BIN is synonymous with the ISO/IEC 7812 IIN. Medicare evaluates plans based on a 5-Star rating system. 0000007215 00000 n 2389 0 obj<> endobj If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. 0000010471 00000 n 24 hours a day/7 days a week or consult, When enrolling in a Medicare Advantage plan, you must continue to pay your. 0000001415 00000 n Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition. Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. BIN number See above M Pages 1 and 2 for BIN/PCN : 102-A2 : Version/Release number D.0 M : 103-A3 : Transaction code B1, B3 M : 104-A4 : Processor control number : M . The above chart is the sixth (final) page of the 2022 Medicare Part D pharmacy BIN and PCN list (H9699 - S9701). SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC. HEALTH NET COMMUNITY SOLUTIONS OF ARIZONA, INC. WELLCARE HEALTH INSURANCE OF TENNESSEE, INC. FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY, BRIGHT HEALTH INSURANCE COMPANY OF NEW YORK, COMPCARE HEALTH SERVICES INSURANCE CORPORATION, BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY, CENTRAL VALLEY MEDICAL SERVICES CORPORATION, CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO, ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC, WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC, CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA. Express Scripts resources for pharmacists. Details. Some health plans decided to use magnetic stripe cards, some did not. 0000009323 00000 n 0000038251 00000 n This document is available with NCPDP membership. Accountable Care Partnership Plans MCO Partner PBM BIN PCN Group BMC HealthNet Plan Community Alliance However, it is highly encouraged that the Group ID is submitted for all Part D claims. 0000032330 00000 n U6E6hlhwElgf\0 $M[T=w"RnKPmH~g;~'-W99g/j730ePkxYj7 % "iU|5*hu88mG?K5rS0Q+C@^5k;5o^dM0&s o*e1gq~8F+aNc>CV} ${ *#. 3456 0 obj <>stream Sign-up for our Medicare Part D Newsletter, Have a question? To obtain an IIN, please contact the American National Standards Institute (ANSI) at www.ansi.org. BIN: 610014 PCN: MEDDPRIME Plan Name/Group Name BIN: PCN: Plan Name/Group Name: BIN: PCN: Plan Name/Group Name: BIN: PCN: Processor: TelePAID System Effective as of: 12/08/2011 NCPDP Telecommunication Standard Version/Release #: D.0 NCPDP Data Dictionary Version Date: 07/01/2007 NCPDP External Code List Version Date: 10/01/2009 Managed care pharmacy identification. 0000009374 00000 n Both in Stockholm and Finland, an e At home, across the country, and around the worldthe power of Blue is with you. Western NY (877) 327-1395; Express Scripts (866) 544-7948 610014; Group: HNRXS. ?rXWK k(`8dB=k&y(~{p{V@ [ Hz)"oz ) BIN# 610014 BCBS 430 Date Printed 12/22/2014. (function() { Once new versions of the standards are adopted, truncation will no longer be necessary. 0000046944 00000 n <<0F6188EC756C624CBAA438B0D92726A7>]>> Please note, the data below is Part 5 of 5 (H8634 - S9701) with links to Parts 1 through 4. 0000028275 00000 n RX Bin: 610014 . var gcse = document.createElement('script'); Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition. 0000022896 00000 n 0000028633 00000 n RX Bin # 610014 RX Group # BCWAPDP The member portal is new as well. All the information you need to properly process prescription claims with Cigna. 0000007450 00000 n 0000009092 00000 n ;nq*DEhw x~iW}W7#WrL/F6geO6UNHZMS u|Z)/ZE,PK3G}E,8-1|_bF6? You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The BIN/IIN is a field in the Telecommunication Standard that is used for the routing and identification in pharmacy claims. 0000009281 00000 n 610014 MEDDPRIME BUCKEYE COMMUNITY HEALTH PLAN, INC. 001 012353 03200000 002 003 004 Humana Medicare Employer (HMO) CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY Care Improvement Plus Medicare Advantage (PPO) Care Improvement Plus 014 H0104 BLUE CROSS AND BLUE SHIELD OF ALABAMA 010 014897 MBG Blue Advantage (PPO) RPD 011 804 gcse.type = 'text/javascript'; 0000001647 00000 n 0000007668 00000 n Solar noon: 12:02PM. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. Members are instructed to show both ID cards before receiving health care services. Your Dental Benefits 610014 800-824-0898 Integrated Prescription Management (IPM) 014658 877-860-8846 LDI Integrated Pharmacy Services 800010 800-652-9550 Magellan Health Services (Includes: Kentucky Passport) 015053, 016523 800-790-1631 McKesson Specialty 610524 800-657-7613 *Independently Contracted. Joined Feb 3, 2010 Messages 2 . Please renew your membership to login. A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. We are an independent education, research, and technology company. Type of GHP: W United HealthCare Optimum Choice claims address: PO Box 740825 Atlanta, GA 30374 Rx Information: MEDCO 1-800-842-2038 . <<5F4BCB39515F55479546A7F5DAE5B678>]>> In certain situations, you can. 0000002215 00000 n The term BIN is synonymous with the ISO/IEC 7812 IIN. %%EOF Contact the plan provider for additional information. 0000004577 00000 n 8289 0 obj <>stream Have them call the phone number on the back of their Cigna ID card. Credit/debit cards that are involved in banking transactions contain a BIN on magnetic stripe. Plans that use cards with a magnetic stripe should use the recommended ISO/IEC 7812 Issuer Identifier Number (IIN) for processing electronic pharmacy claims. Beyond the initial assigning of the BIN, NCPDP does not formally or informally track the history of the number. cyU>]s#~e{0Bb'Su[4E(/0PS_5]bmE k!Nb%Lx@b,/c7RL Xg29jA8Ruk1  fRBYoD0F9%e=E>e?-"{wQD ?c['l|S_R "qQKMF4B6B] o)/+jtqGOfPN-H ni;9uE%[7 aX4wve.\FPDvY '}Aj(bsgZJLi|]&:{|r2+>p#+Y31D|nGPrtqp\R]oMDl${mI15R/,;$5#]_zK>%,u$xwO@B,UlCt MOkd?X?. Limitations, copayments, and restrictions may apply. CO. OF NY, BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA, MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK, 001, 002, 003, 004, 005, 006, 007, 008, 009, 010, 011, 012, 014, 015, 016, 017, 018, 019, 020, 021, 022, 023, 024, 025, 026, 027, 028, 029, 030, 031, 032, 033, 034, 070, 105, 106, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132, 133, 134, 135, 136, 137, 801, 802, 808. We are not compensated for Medicare plan enrollments. 0000028775 00000 n Sign it in a few clicks Draw your signature, type it, upload its image, or use your mobile device as a signature pad. All calls are toll-free.
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