© 1990-2006

Insurance Plan Information


Modem Numbers
Envoy 1-800-669-8555 or 1-800-683-3437
1-800-669-0099 1-800-854-5417 AT&T emergence number
PCS 1-800-433-5976
1-800-826-8741
1-800-942-2173
NDC 1-800-654-4518
GCC 1-800-331-1286
DataRx 1-800-958-5517
Ins. HELP Line 1-877-823-1273 ..Thomas Wilson
ProCare Help desk... 1-800-377-1037
Claims 1-888-821-5518

Help Phone Numbers:        
NDC Easy Claim Help Desk 800-388-2316 First Call Help line 800-895-0333 for Corp. Acct. Claims troubleshooting & payor/plan inf. Fax 404-728-3318 Attn: Wendy Stewart Omnilink 800-750-9836 Danielle Jess 415-983-9377 fax 415-732-2594 or Valerie Orinsbery 415-983-8859 To get a claim to bypass Omnilink . Go resend and in the Prior Arthorization type in 19999 or 19995 or 19997 & it will go directly to insurance company bypassing Omnilink.
ENVOY 800-333-6869 BCBS of Texas 800-521-2227
DIVERSIFIED 800-824-0898 ADVANCE Presc. Management 800-364-6331
ProClaim 1-800-377-1037 Internet Claims Processing... 1-800-377-1037
Provider Advantage 1-503-690-9716 EXPRESS SCRIPT 800-763-5550
ProServ (Wellpoint) 800-962-7378 ARGUS 800-522-7487
Prior Authorization numbers MUST start with a 1 in front of the number they give you to signal the Ins. Co. that it is a prior-authorization number and not something else. PCS 800-345-5413
Our new processor control # ###

Envoy Plan Code NDC Bin Proc. Control Insurance Name Facts
002930 400004 ENV 900002 UHC ENV UHC**HTY AARP Health Care Options Goes to United Health Care. Processed by DPS 1-800-824-0898. ID=8digit (omit the dashes) last 2 digits is per code. NO Group #. AARP member services 1-800-523-5800.
001091 OLD NEW 003273 003858 OLD NEW 900014 A4 OLD NEW CLAIMRX*** Access GHP….MedPlus/TennCare 6/99 Changed from Express Script to MIM Health Plans (formerly known as ProMark) 1-800-213-5640
OLD 006089 OLD 004286 OLD 29 Activa by CompScript 2/1/98 This plan was DEACTIVATED Call 1-800-309-4244 inf.
000968 600426 54 American Trust/Select Script Select Script 1-800-521-4548 MediAmerica 1-800-433-4893
003664 610029 AMOCO Amoco Processor Caremark 800-421-2342. Could be put on regular Caremark with AMOCO in the Group.
005772 603017 ENV 603017 BAZ ENV BAZ**TQC BCBS of Arizona Processor Comcotec 1-800-325-1810
004552 004336 BCAR BCBS of ARKANSAS through Advance ParadigM 1-800-364-6331 This was processed under bin# 006260 Envoy with HATS in the processor control. Now has it's own processor control of BCAR.
000064 004336 OSE OK. State Employees through---Advance ParadigM 1-800-364-6331 Okla. State Employees they were with DPS Get a reject code 17 put 00 in refills. Per Code is [01], instead of 00.
004084 004583 No Control Advance Health Systems/AHS Community Plus Pharmacy Network BCBS of Mississippi 1-800-551-5258 NDC 1-800-388-2316 10/99 Inaccurate group will be rejected. Patient ID do not put in any Alpha characters. Compounds no longer accepted with 9's in NDC# must use a valid NDC # for one of the ingredients.
003748 OLD 004336 OLD NASE OLD Advance ParadigM 1-800-364-6331 Was NASE card National Association of Self Employed or NASE (3/1/00 SOME of the patients have new cards, the new card will have MEDCO on the card which is Merck Medco which is mail order.)
005366 004336 RX Advance Rx 1-800-364-6331 Can send only 1 claim at a time
002447 004336 APM Advance Main Used Processor Control Usually the card has Advantage on it Advance ParadigM 1-800-364-6331
006260 004336 HATS Advanced Prescription Management Advanced ParadigM 1-800-364-6331.
  008563 No Control Advantage Save Rx Sav-Rx 1-800-388-2316 Not the same as regular Sav-Rx this takes a different contract.
000722 610502 00670000 Aetna (Generic) not HMO Aetna 888-792-8742
003622 001884 HMO Aetna HMO Goes to US Healthcare 1-800-441-1910 ID looks like a group #. Everyone is a cardholder
002301 610036 ALS Alpha Script's FAX 602-852-3664 1-800-433-3894 Coupons: Cardholder ID SS# or all 9's, the number on the coupon is a prior authorization #
002437 002286 6000 AltaRx /Medicare Secure Choice/NOW is First Health Rx AltaRx 1-800-992-7763 On 3/1/97 NDC Bin# changed to 002286 w/proc. Control 6000 if that doesn't work put 6000002286 First Health Rx 1-800-844-9636
000093 600685 No Control Allied National HCPP In'97 became Provantage 1-800-784-0881
003105 610494 0111****** Allied National on it and/or Rx Solution for Prescription Solution Prescription Solutions 1-800-788-7871
005430 006144 AL ALLscript / Networks Processor MedeAmerica 1-800-433-4893
000154 006022 OLD New 000240 006128 OLD NEW 003585 No Control OLD NEW 45700 AmCare Health Plans (OK, LA, TX) State Employees This was Foundation If using the ENV. BIN 000240 you MUST have 45700 in the Group # field. Medimpact 1-800-788-2949 MedCare Pharmacy Network 10/1/99 Members will not have their new cards & old info. in computer with their Foundation will not be right! Patient ID = Starts with 60,000
006012 610453 APB America Pharmacy Benefits ID is 11 digit; last 2 digit must reflect relationship to member. Do not link dependents to member. APB 1-800-358-2722
002075 OLD NEW 001465 600685 No Control American Medical Security 10-01-96 Provantage became processor instead of Restat. Provantage 1-800-784-0881
002164 610053 ENV 610053 7Q*7700700 ENV AMERIPLN AmeriPlan USA / Wellpoint ProServ Wellpoint/ProServ 1-800-962-7378 Put 005 in front of the group#.
000700 610020 No Control AmeriScript/Pharmacy Data Management PDM 1-800-767-4226
004346 610575 00890000 Anthem-Community Mutual General Anthem 1-800-662-0210
002303 610093 AK000008 Arkansas Medicaid Version 32 not 3A Dr. ID must be set at 3 for alt. ID
000066 OLD NEW 004182 610077 No Control Associated Prescription Services Group# 0117 or may need to put 01170000 in Proc. Cont. Processor now Perform 1-800-726-7220
001191 600426 33 ASN---Automated Script Network/Net Express MedeAmerica 1-800-433-4893 Automated Scripts Network 1-800-944-2668
005742 900020 CLAIMWT*** OR CLAIMNE*** Automative Scripts Network / MIM ProMark 1-800-213-5640 or 1-800-944-2668 Group will be letters from the card standing for insured company
000235 OLD Now Paid 610014 ENV 610014 HCB******* ENV No Control Avesis NOW National Insurance Services GOES TO PAID 10-1-96 NOW send to PAID Envoy Bin # 000011. Call Paid for help 1-800-922-1557.
005570 003585 54600 BBI/Bergen Good Neighbor Pharmacy Discount Card Medimpact 1-800-788-2949
000580 610053 ENV 610053 7Q*7700700 ENV BC*WNY BC WNY (Western New York, Inc) /Community Blue Home Plan 301 Processor Pro Serv 1-800-962-7378. Group # must begin with 301 the plan code.
001751 004915 ENV 004915 *****HCB** ENV *****HTY** BCBS of Alabama 1-800-216-9920
006260 OLD NEW 004552 004336 BCAR BCBS of Arkansas OLD ENV. BIN # Now processor control must be BCAR Advance ParadigM 1-800-364-6331
000011 610014 ENV 610014 HCB******* ENV FLBCS***** BCBS of Florida Processor PAID 1-800-922-1557 Group #: FLBCS
005018 or 004729 610053 ENV 610053 7Q*7700700 ENV BCBSOGA BCBS OF GEORGIA Has 2 Envoy Bin # 005018 or 004729 Pro-Serv/Wellpoint 1-800-962-7378 Group # Must begin w/plan code 100, even if the card has plan code as 601 or 101.
002447 004336 APM BCBS of Iowa (Wellmark) Advance ParadigM 1-800-364-6331
003332 600428 01820000 BCBS of Idaho Processor Argus 1-800-522-7487 If having trouble try [blank,blank] in per code
000007 610053 ENV 610053 7Q*7700700 ENV IB******** BCBS ILL Plan 621 ProServ of IL1-800-962-7378. Group # needs to start with this 3 digit# plan code.
000105 OR 000011 610014 ENV 610014 HCB******* ENV No Control BCBS of Kansas GOES to PAID PAID 1-800-922-1557 Group #: KANSAS1 (run together) This is different from BCBS of Kansas City, it has its own bin# and processor control #. Look Below !!
003825 600428 01690000 BCBS of Kansas City Pharmalink 1-800-228-1436 Processor is Argus 1-800-522-7487
001091 003558 A4 BCBS of Massachusetts/MEDEX BCBS of MA 1-800-892-5120 Processor Express Script 1-800-235-4357 Group #: MAS ID: 9 numeric digits only, no alpha
001880 600428 00940000 BCBS of Memphis Processor Argus 1-800-522-7487
000011 610014 ENV 610014 HCB******* ENV No Control BCBS of Michigan NOW GOES ON PAID 1-800-922-1557
000152 610455 PGIGN BCBS of Minnasota Processor Goldnet 1-800-858-0723 ProPar 1-800-821-4795
004084 004583 No Control BCBS of Mississippi/Advance Health System Community Plus Pharmacy Network 1-800-551-5258 NDC 1-800-388-2316 10/99 Inaccurate group will be rejected. Patient ID do not put in any Alpha characters. Compounds no longer accepted with 9's in NDC# must use a valid NDC # for one of the ingredients.
000797 400004 ENV 900002 DPS or use BMT for ENV also BCBS of Montana DPS 1-800-824-0898
001175 610455 RXNE BCBS of Nebraska / Prime Therapeutics Pro-Par 1-800-821-4795 ID=SSN No Group#
005631 610455 BCCNE BCBS of Nebraska Blue Care Choice Pro-Par 1-800-821-4795
004346 610575 00890000 BCBS of New Hampshire Processor Anthem 1-800-662-0210
002612 003585 33000 BCBS of New York Medimpact 1-800-788-2949
007290 610455 NDBCS BCBS of North Dakota Pro Par 1-800-821-4795
PCS 610415 3211501824 BCBS of Oregon PCS 1-800-345-5413
001091 003858 A4 BCBS PPO with PERX on card Express Script 1-800-763-5550 ID has letters at front put '0' zeroes for each letter, then the numbers. Group = ARQ, not the long number on the card. Per Code in F4 must be [00].
PCS 610415 3211501824 BCBS of Tenn. Processed by PCS 1-800-345-5413
006260 004336 ENV 004336 HATS ENV HATS****** BCBS of Texas (Some say BCBS of Tx and they really mean Health Select of Texas & the card may say MEDCO, they now goes to PAID) Advance ParadigM 1-800-364-6331
003932 600428 01890000 BCBS of Utah Processor Argus 1-800-522-7487
005318 800001 WYBCS BCBS of Wyoming / RxCare Also has Prime Therapeutics on card Processor GoldNet 1-800-858-0723
001465 600685 No Control BCM( Bravell Claims Management) Now Provantage 1-800-784-0881
004946 600428 01068860 Beech Street Corporation Argus 1-800-522-7487
000246 005145 No Control Behrens Inc. / MPB Processed by MPB 1-800-672-9540
000319 003452 No Control Benescript 1-800-345-3189 Processor NDC 1-800-388-2316
005751 006558 ENV 006558 *****HCB** ENV *****HDN** Best Benefits/Sav Rx Sav-Rx 1-800-872-7471
005257 610435 1215****** VERSION 32 Blue Choice of OKLA---this is Blue Lincs This is just a new looking card Same old Blue Lincs though!!!! Dr. ID is [2] instead of [1]. LINCS 1-918-560-3388 or 1-800-722-3730 Group # 1215
000098 610053 ENV 610053 7Q*7700700 ENV BCOCAL Blue Cross of California Processor ProServ as of 1-1-97 use Plan Code 040 Group # must begin with this Plan Code. Take the alpha characters off of the ID, use only the #'s
008006 610053 ENV 610053 7Q*7700700 ENV 7Q*7700630 Blue Cross of Idaho Business ProServ/Wellpoint 1-800-962-7378 MUST USE VERSION 32
001080 600428 01910000 Blue Shield of California NOT SAME AS BLUE CROSS OF CALIF. Processor Argus 1-800-522-7487
005257 610435 1215****** version 32 Blue Lincs Senior Everything the same way as regular Blue Lincs Group # must be 3607 Lincs 1-800-722-3730
005257 610435 1215****** version 32 Blue Lincs (Welfare) BCBS of OK (HMO) Rename DHS BLLINC to get pre-printed Prior-Authorization letters HELP# 1-800-722-3730 1-918-560-3388 IF HAVING TROUBLE GETTING A CLAIM TO GO THROUGH AND NOT GETTING A VALID RESPONSE CHECK ADDRESS FOR GARBAGE (City, State Zip) Group# must be 3607 if that doesn't work try 0795. The ID is like 443560971*01 drop star & run together-Doctor's ID# is a [2] for State Lic.# Compound all 9's NDC# and a [C] in DAW at Edit Prescription. Will fill ONLY for HMO doctor. Now will give you an override number that you put in the doctors State Lic. #. Then MUST remember to change it back to his real State Lic. #. If you get a reject CODE 25—DD means the doctor is not on the HMO Plan.
000693 610020 No Control Braums Card/ has Health Source on it/PDM Processor PDM Pharmacy Data Management 1-800-767-4226
001091 003858 A4 Care Choices Senior Plan/Express Script Processor Express Script 1-800-235-4357
003140 610029 CRK Caremark (Generic) Help# 1-800-421-2342 Key to this is the right group# will be letters standing for the company being Insured i.e. CRKPAY DROP THE CRK put the rest in Group# Per Code in F4 [blank, blank] May have to send only 1 claim at a time.
008434 610544 ********** needs all blanks Care Partners/MPB Processor Managed Pharmacy Benefits 1-800-672-9540 Group: CAREPAR
002786 005947 CLAIMCR** Catalyst Rx ProMark 1-800-213-5640 or 1-888-869-4600
002548 610029 CRK Central SW Utilities NOW A CAREMARK Caremark 1-800-421-2342
006239 610473 No Control Certus Healthcare Rx America 1-800-770-8014
003046 004492 599 Champus V. A. Processor Medical Matrix 1-800-880-1390
001185 400004 ENV 900002 CHC ENV CHC Choice Care Processor DPS 1-800-824-0898
002407 003573 CRX Choice Rx 1-800-743-1720 TCS (Timeshare) 1-800-333-3672
000723 600428 00600000 Cigna 1-800-821-4695 Processor ARGUS 1-800-522-7487
002538 004261 CAL******* Cigna Irving/Tmesys Tmesys 1-800-964-2531 ID=15digit Patient ID Version=32 Number Claims Send=1
002358 004245 ENV 004245 *****HCB** ENV No Control Claimspro Claimspro 1-800-837-9600 SEND 1 CLAIM
007844 600426 CI Co- Health Processed by MediAmerica (GCC) 1-800-433-4893
005419 007060 MEDIPROD Colorado Medicaid (Welfare) Must have COLORADO in the Group# Effective 6/30/98 Colorado Medicaid will be processed by ConSulTec using Bin# 007060. Changing from Bin# 610457 through EDS.
000262 OLD NEW 000586 600426 OLD NEW 003592 CP OLD NEW No Control Columbia Pharmacy Solutions effective 3/1/98 plans will be moving to RxNet Envoy Bin# 000586 or NDC Bin# 003592 All should be moved by end of month. RxNet 1-888-318-2589 Use Cardholder ID + 2 digit per code from card, that they are not going to have yet. HA! HA!
005561 005384 004238 OLD New 008006 003585 OLD NEW 610053 ENV 610053 37000 OLD NEW 7Q*7700700 ENV 7Q*7700630 Community Care HCPP or HMO 1/1/99 (COMMERCIAL) OK State Employees Was through Medimpact Bin # 003585 w/ processor control of 37000 1/99 Wellpoint/ProServ 1-800-962-7378 Community Care HMO 1-800-900-2690 Home Plan Code: 003 Put this in front of the group# DO NOT put the A9 on the ID.
001755 OLD 7/1/00 New 008006 600428 OLD New 610053 00410000 OLD NEW 7Q*7700700 ENV 7Q*7700630 Community Care HMO (Welfare) SoonerCare Plan 877-293-8628 Rename to DHS Comm to get pre-printed Prior-Authorization letters. *For member's eligibility status* call 1-800-900-2690 Wellpoint/ProServ 1-800-962-7378 Group # will need the 3 digit home plan code of (008) or (003) in front of the group # from the card. [Y] Usual & Customary ID# Will be SSN or special assigned number off of card Version: 32
002447 004336 APM Community Health Network Advance ParadigM 1-800-364-6331
004084 004583 No Control Community Plus Pharmacy Network Advance Health System/AHS/BCBS of MS 1-800-551-5258 NDC 1-800-388-2316 11/99 Inaccurate group will be rejected. Patient ID do not put in any Alpha characters. Compounds no longer accepted with 9's in NDC# must use a valid NDC # for one of the ingredients.
003230 600428 00890000 Community Rx / Community Mutual General /Anthem Only call Anthem as a last resort 1-800-662-0210 or 1-800-522-7487
001336 400004 ENV 900002 COM ENV COM Complete Health Processor DPS 1-800-824-0898
  006284 No Control Computer-Rx Cash account Set Fee at $100.00
008120 005780 No Control Consolidated Prescription Services Consolidated 1-888-722-4652 ProCare 1-800-388-2316 MediAmerica 1-800-433-4893
002241 610084 PDCSPROD Or PBMXPROD Consultec Commercial---Sooner Health Plan Also HPS Health Plan Services Some STATE EMPLOYEES. Processor Consultec 1-800-365-4944 Fax 1-800-793-2305
001881 610083 45130 Corum Prescription Services/CURAFLEX Processor CURAFLEX 1-800-798-1109
000014 610077 0112 CPN or Complete Pharmacy Network Processor Perform 1-800-726-7220
003105 610494 0111****** DAC / Diversified Administration Corp. Generic Prescription Solution 1-800-788-7871
PCS 610415 3211501824 Delta Faucet / NGS America also Private Healthcare Services Private Healthcare Services is a PCS plan PCS 1-800-345-5413
005720 004303 TELE Diabetic Supplies on –line/ CareClaim HELP LINE Omnisys 1-800-666-4797 Send 1 claim Version 32 F4 Person Code First space in patients middle initial second space is Generation (1-3=I-III, 4=Jr., 5=Sr)
000797 400004 ENV 900002 DPS ENV DPS DPS or Diversified 1-800-824-0898 Do not pay for Compounds! Even if patient pays cash & files himself! Can put in C for compound put in NDC# Will pay on that one NDC# and a fee. Diversified —ID is 3 digit plan # + SSN# + per code. Group# is 5 digit. CH=00, Spouse=01, etc.. Relationship Code: Other------Eligibility Clarification 3= Full time Student 4= Disabled Dependent 5= Dependent Parent 6= Significant Other
003105 610494 0111****** Dreyer Health Plans has the name Allied on it or Rx Solution DHP must be in the Group# (processor is Prescription Solutions) 1-800-788-7871
      Eagle Managed Care 1-800-545-5591 12/15/99 No longer adjudicate claims Ask patient for their New Card
005786 003573 EBMS EBMS/ Employee Benefit Management Services Processor TCS 1-800-541-5234
001205 005285 ENV 005285 *****HCB** ENV *****HTY** EHIM/Employee Health Ins. Management  
002923 OLD NEW 004993 610474 TDI EHS Eckerd Health Services or Retried Florida Employees “The Right Solution” American Marketing Processor is TDI 1-800-244-5800
002612 003585 33000 Empire BCBS Processor Medimpact 1-800-788-2949
001070 OLD Now PCS 610415 3211501824 Employers Health Ins. (MPS) This is one plan that has changed from MPS to going through PCS as their Processor. Members will be getting new cards until then GOOD LUCK Has MPS on card. MPS 1-800-759-6959 Call PCS for members ID 1-800-345-5413 Try Group# OK050685 for now
003241 004527 EHO Employers Health Option If having trouble send 1 claim at a time. EHO 1-800-650-1817 or NDC 1-800-388-2316 7/1/2000 May get back reject messages saying that they need date of injury, then use version 3B, then must setup patient in Workers Comp and have injury date in their information in this.
000968 600426 54 EPA/Executive Pharmacy Administrators New plan w/MedeAmerica as processor 1-800-433-4893.
001091 003858 A4 Express Script Prior-Auth Phone # 1-800-816-6549 ID is SSN. In F4 Per Code [00] or try [01]. Express Script 1-800-235-4357
003561 004682 ENV 004682 *****HCB** ENV *****HTY** FEISCO Stockton Group 1-800-331-7108 MUST HAVE Group # 10061001
005350 004816 FFIRX FFI or Rx Managed Care also sometimes has KeppKard on the insurance card. FFI 1-800-699-7857 or ComCoTec 1-800-325-1810
005604 004816 FFIWC FFI Worker's Comp Version 32 send only 1 at a time. FFI 1-800-699-7857 or ComCoTec 1-800-325-1810
006008 OLD NEW 002447 006152 OLD NEW 004336 No Control OLD NEW APM FHS Health & Life (formerly QualMed Health & Life) Processor Advance ParadigM 1-800-364-6331
001091 003858 A4 First Care / Express Script Plan First Care CHIP will need Group#: FTC PERX/Express Script 1-800-235-4357
002437 002286 6000 First Health Rx formerly Alta-Rx First Health Rx 1-800-844-9636
006240 610475 No Control FLRX Fingers Lakes BCBS FLRX 1-800-724-5033
006642 400004 Env. Bin 900002 DPS or FOR or TIC SAME for Env. Fortis Processor DPS 1-800-824-0898. Strange ID has letters and #'s.
000154 006022 OLD New 000240 006128 OLD NEW 003585 No Control OLD NEW 45700 Foundation Health (IPS) for State Emp. 10/1/99 Will be Called AmCare Health Plans (OK, LA, TX) If using the ENV. BIN 000240 you MUST have 45700 in the Group # field. Medimpact 1-800-788-2949 MedCare Pharmacy Network 10/1/99 Members will not have their new cards & old info. in computer with their Foundation will not be right! Patient ID = Starts with 60,000
000031 OLD     Foundation Health (Welfare) Contract with DHS ends 6/30/98 Patients put on Blue Lincs, Community Care or Heartland.
000138 005260 7010005260 GEM First Health Service Corp. plan. Processor IPS 1-800-600-0180
007322 600428 01410000 Globe Savers Plus (DISCOUNT CARD) Really WHP Health which is on the card also. Processor Argus 1-800-522-7487
000152 610455 PGIGN Gold Net (BCBS) BCBS plans GOLDNET should be on the card GoldNet 1-800-858-0723 ProPar 1-800-821-4795
006282 007382 SHS Golden Choice/TX Health Choice Comcotec 1-800-325-1810
005570 003585 54600 Good Neighbor Pharmacy Discount Card (Bergen Pluscare) Medimpact 1-800-788-2949
001269 610086 No Control GPP---General Prescription Programs GPP 1-800-341-2234 or NDC 1-800-388-2316
005175 003585 23100 Great Lakes Blue Cross Processor Medimpact 1-800-788-2949
005561 610053 ENV 610053 7Q*7700700 ENV 7Q*7700630 HCPP (Fox 001739) Community Care HMO Wellpoint/ProServ 1-800-962-7378 Must put 003 in front of group #. Need to take the A9 out of the ID.
007726 610500 ENV 610500 *****HCB** ENV *****HDN** HDS (Coupon card to order drug) This use to be the PCS plan change on 8/2/99 . McKesson Healthcare Delivery Systems Prior-Auth# or Help line 1-800-750-9835 or 1-800-590-6342 Use Version 3A or 32 Dr. ID=1 (DEA)
004950 600428 00440000 Health Alliance 1-800-851-3379 Argus Health/ Robertson Co. on card. Must have blank, blank in the per code. Processor Argus 1-800-522-7487
001081 003650 No Control Health Card or National Medical Health Card Systems (NMHC) NMHC 1-800-645-3332 Processor NDC 1-800-388-2316
006776 400004 ENV 900002 HCO ENV HCO**HTY Healthcare Okla. (The Good New Choice) 34 days supple or 100 which ever is less, i.e.180 being a 30 day supple, they will fill for only 100. Processor is Diversified to sign up for this plan call Diversified at 1-800-824-0898. Place last 2 digits of ID in F4 per code
004018 400004 ENV 900002 COR ENV COR**HTY Healthcare of Texas DPS 1-800-824-0898
003561 004682 ENV 004682 *****HCB** ENV *****HTY Healthchoice Cares—Group #10441002 Processor The Stockton Group 1-800-577-6484 This was a restat plan.
002447 004336 APM Health Choice (OK Emp. Was DPS plan Now Advance ParadigM 1-800-364-6331
005258 600426 CV Health Connections from Sears MedeAmerica 1-800-433-4893
008427 OLD NEW 002447 006350 OLD NEW 004336 No Control OLD NEW APM Health Net Health Net 1-800-548-5524 Option 2 Processor Advance ParadigM 1-800-364-6331
000039 600428 01630000 or 01030001 Health Partners of Alabama Argus 1-800-522-7487
000011 610014 ENV 610014 HCB******* ENV No Control Health Select of Texas (9/99 NO LONGER GOES TO ADVANCE PARADIGM) Other names on the Card: MEDCO BCBS of Texas Processed by PAID Card has MEDCO on it this is the mail-order patient can get 3 months with mail-order. In very small print is PAID On-line to PAID can get only 1 month. The ID on the card has letters and then numbers just put in the numbers leave off the letters. Group # MUST be: 38000
000693 610020 No Control Health Source PDM Pharmacy Data Management 1-800-767-4226
005258 600426 CV Health Trend GCC MedeAmerica 1-800-433-4893
004075 OLD NEW 001091 400004 OLD NEW 003858 HPO OLD NEW A4 Heartland (Welfare) 1-405-239-2030 Rename to DHS Heart to get pre-printed Prior-Authorization letters. HELP---OKC 239-2030 or 1-800-492-7639 EXPRESS SCRIPT DHS Processor Express Script 1-800-763-5550 Version [32], instead of [3A]. Dr. ID [2], instead of [1] Group MUST be DNS Patient ID=Medicaid # with per code on end. IN F4 must have per code [00] Dr. Dummy ID # 0000001, if non-participating Dr. Only 5 days supply
004525 005260 6300005260 HELIX First Health 1-800-359-0776 ID# is 12 digit Group# is HELIX Relationship 1=Cardholder 3=Newborn Doctor ID= Medicaid ID #
000694 601577 0038*HCB Heritage National/PAI Pharmacy Associates, Inc. 1-800-880-1188
002241 610084 PDCSPROD Or PBMXPROD HPS Health Plan Service Consultec 1-800-365-4944
004507 005260 6310005260 HMA by First Health First Health 1-800-359-0776 ID#=Medicaid ID# Group# is HMA000 Relationship 1=Cardholder 3=Newborn Doctor ID= State License# so a [2], instead of [1]
004980 600428 GROUP # On card Home Life/National Health Care Alliance Processor Argus 1-800-522-7487
PCS 610415 3211501824 HUMANA/ Preferred Community Choice PCS 1-800-345-5413 Group #: HUMA0001 MUST HAVE THIS in GROUP!
002673 004469 INT Inteq Group Inc. Inteq 1-800-324-2200
002682 003573 PMPTULOK Interchange PMP same as Reg. Old PMP Provider Medical Pharmaceutical 1-800-364-6440
001026 005559 No Control International Pharmacy Management Processor NDC 1-800-388-2316 IPM 1-800-476-3784
008360 005260 8700005260 JAI Medical Systems First Health 1-800-359-0776 or 1-804-965-7781 Group#: Q9016 Patient ID: 11 digit NO Per Code Relationship 1=Cardholder 3=Newborn
004993 610474 TDI JC Penney Plan Plus was an AltaRx plan Now TDI 1-800-244-5800
  008358 No Control John Deere 1-800-325-1975 Benescript 1-800-345-3180 Version 32
OLD 004547 NEW 002077 610053 ENV 610053 7Q*7700700 ENV 7Q*7700630 John Hancock the card also has on it Pharmacy Benefits Wellpoint/ProServ 1-800-962-7378 Version: 32
000011 PAID 610014 ENV SAME HCB******* ENV No Control Kansas Medicaid Processed by PAID 1-800-922-1557
005604 004816 FFIRX KeppKard or Rx Managed Care or FFI FFI1-800-699-7857 or ComCoTec 1-800-325-1810
002538 004261 CAL******* Liberty Mutual Workman's Comp. Processor TMSYS 1-800-964-2531 Version=32 Number Claims Send=1
005257 610435 1215****** version 32 LINCS (BCBS of OK) If the Pharmacy is having trouble getting a claim processed and not getting a response they understand Check the ADDRESS (MUST be City, State 2 Capital letters and 5 digit ZIP) i.e. DUNCAN, OK 73533 Must use Version 32 instead of 3A Lincs 1-918-560-3388 Fax 1-918-560-3535 Help 1-800-722-3730
000246 OLD NEW 008434 005145 OLD NEW 610544 No Control OLD NEW No Control Managed Pharmacy Benefits MPB help line1-800-672-9540 The Signature Group Plan is one of the plans they process. 1-800-672-9540 1-800-585-5051 Must have [Y] for U&C or comes back collect '0' and looks like its been paid, but if you are looking at computer screen it tells you '0' PAID. ID has letters at beginning looks more like a group#. You may have to call for a group# because some cards don't have one on the card, but you need one.
000968 600426 54 Managed Prescription Network or Prescription Drug Service (Calf. Ironfield Workers) or Select Scripts or Pharmacy Benefit Management ALL PLANS needing PROCESSOR CONTROL 54 Managed Prescription Network 1-800-713-1983 Select Script 1-800-521-4548 Processor GCC 1-800-433-4893
OLD 002506 New 006931 005377 10000016 Maxor Plus 1-800-687-0707 This was formerly The Gilliland Group Groups 1650 & 1651, Plan C-CAR Qualipharm 1-800-947-6709 1651 Performance Dodge 16519 Performance Nissan 1651C Benji Cobra 1651H Benji Holding Group
007726 610500 ENV 610500 *****HCB** ENV *****HDN** McKesson Healthcare Delivery Systems/HDS If using Envoy w/Bin # 610500 you will need *****HDN** in Processor Control McKesson Healthcare Delivery Systems/HDS 1-800-590-6342 or 1-800-750-9835
001091 003858 A4 Med-Advantage Processor Express Script 1-800-235-4357 Group # MUST BE = MX
000154 006022 OLD New 000240 006128 OLD NEW 003585 No Control OLD NEW 45700 MedCare Pharmacy Network AmCare Health Plans (OK, LA, TX) State Employees This was Foundation If using the ENV. BIN 000240 you MUST have 45700 in the Group # field. Medimpact 1-800-788-2949 MedCare Pharmacy Network 10/1/99 Members will not have their new cards & old info. in computer with their Foundation will not be right! Patient ID = SSN of Cardholder + 2 digit specific suffix Cardholder = SSN + 00(Male) or 10(Female) Spouse=CardholderSSN+ 20-29(Male)or30-39(Female) You get the picture, almost no way to know ID. Nothing in the Per Code field.
000011 PAID 610014 ENV 610014 HCB******* ENV No Control MEDCO (Mail Order part of Health Select Tx) Other name on the Card: Health Select of Texas Processed by PAID Card has MEDCO on it this is the mail-order patient can get 3 months with mail-order. In very small print is PAID On-line to PAID can get only 1 month. The ID on the card has letters and then numbers just put in the numbers leave off the letters. Group # MUST be: 38000
000968 600426 54 Mede America Mede America 1-800-433-4893
000968 600426 54 Mede Select (same as above) Mede America 1-800-433-4893
001091 003858 A4 MEDEX Card Processor Exoress Scripts 1-800-235-4357 Group # MUST be: MDX ID= 9 numeric, no alpha the card has both leave off the letters.
005522 006053 MSC Medical Security Card Co. / MSC 1-800-700-3957 Processor Health Trans.com DISCOUNT CARD. Medical Security will Invoice you back for $1.00 for each claim you send.
002437 002286 6000 Medicare Secure Choice/AltaRx AltaRx 1-800-992-7763
001659 800004 No Control MedTrack Services  
PCS 610415 3211501824 Met-Life This is a PCS Plan must call Met-Life give customer ID# and they will give you a group#, then you can send it through PCS.
001089 600428 00770000 METRAHEALTH 1-800-797-7427 Plan A Travelers The card will either say Plan A or TRV in small letters in lower right corner of the card. Processor Argus 1-800-522-7487
PCS 610415 3211501824 METRAHEALTH 1-800-797-7427 Plan P or PCS may be on the card PCS 1-800-345-5413
002930 400004 ENV 900002 UHC ENV UHC**HTY METRAHEALTH 1-800-797-7427 Rx Plan D United Healthcare United HealthCare processed by Diversified DPS 1-800-824-0898
005742 900020 ENV 900020 CLAIMWT** ENV CLAIMNE** MIM Automative Scripts Network/ProMark MIM is on the card, there are many plans under MIM. ProMark 1-800-213-5640 The group# will be letters from the card standing for the plan they are on. i.e. PLICO ID = 11 digit # + per code
007322 603286 01410000 Moore City Employees 7/1/98 now WHP Health WHP Health Initiative 1-800-207-2568 Must submit the 6-digit group# found on the card.
001344 OLD     MPS Managed Prescription Services Most plans went to Express Script or PCS There is not a MPS any more MPS, since 12-1-98
001176 400004 ENV 900002 MOO ENV MOO Mutual of Omaha Mutually Preferred Processor DPS 1-800-824-0898 Goes to DPS but needs a special processor control of MOO Cardholder ID do not tag a person code on beginning or end. Brithdate i.e. 09/07/1961
003140 610029 CRK NALC/ National Association of Letter Carriers Processor CareMark 1-800-933-NALC In Group# must have NALC
003748 OLD 004336 OLD NASE OLD National Association of Self Employed or NASE 3/1/00 Most patients were given new MEDCO cards which is Merck Medco mail order. Was through Advance ParadigM
000612 610494 0111****** National Assured PPO/ RXNAP Processor Prescription Solutions 1-800-788-7871 Group: NAP (required)
000968 600426 54 National Health Plan Select Script plan Processor MedeAmerica 1-800-433-4893
001081 003650 No Control National Medical Health Card System NMHC this is on the card. NMHC 1-800-645-3332 Processor NDC 1-800-388-2316
OLD 002550 NEW 001460 004758 NPS******* National Pharmaceutical Services Inc/ NPS NPS 1-800-546-5677 “SISCO” AND “NPS” plans are no longer separate. As of 2/15/98 all plans will use NPS in the processor control field.
001610 600568 0000001462 National Prescription Administrators NPA 1-800-467-2006 or 1-800-526-7813
000968 600426 54 National Prescription Card Should have Select Script on it. Processor Mede America 1-800-433-4893
001081 003650 No Control Nationwide Prescription Drug Program / National Medical Health Card (NMHC) NMHC 1-800-645-3332 Processor NDC 1-800-388-2316
000722 610502 00670000 NEIC / Aetna card Aetna 1-888-792-8742
001191 600426 33 Net Express/Automated Scripts Network Automated Scripts 1-800-944-2668 MedeAmerica 1-800-433-4893
OLD 002550 NEW 001460 004758 NPS******* NPS/ National Pharmaceutical Services Inc. NPS 1-800-546-5677 “SISCO” AND “NPS” plans are no longer separate. As of 2/15/98 all plans will use NPS in the processor control field.
002342 610453 NBN**TQC Northwest Pharmacy Service Teamsters Fund 21 Processor Comcotec 1-800-325-1810
  800007 A4 Oklahoma AIDS Program ProCare thru Mede America 1-800-433-4893
006260 004336 HATS Okla. DHS Rehab. Services (DRS) Processor Advance ParadigM 1-800-364-6331
006239 610477 No Control Open Pharmacy Network or Rx America (was PDN) OPN 1-800-736-4179
000952 610494 0083****** Pacificare of California NOW Prescription Solutions of Ca.1-800-788-7871
000073 610494 2570****** Pacificare of Colorado Prescription Solution 1-800-788-7871
000040 610494 0068****** Pacificare of Okla Now Prescription Solutions of OK. Prescription Solution 1-800-799-7871
002902 610494 0087****** Pacificare of TX Now Prescription Solutions of TX. Prescription Solution 1-800-799-7871
003070 610494 0088****** Paicificare of Washington Prescription Solution 1-800-799-7871
001319 610494 0111****** Prescription Solution (Generic) Bin and proc. Control Note—all stores do not have a contract & contract must be gotten in advance.
000694 601577 ENV 601577 0038*HCB ENV 0038*TQC PAI –Pharmacy Associates Inc 800-880-1188 Relationship to cardholder must go in the relationship field in F4. Each patient has a different ID.
000011 PAID 610014 ENV 610014 HCB******* ENV No Control PAID Group# important. Paid 1-800-922-1557
005174 610504 300039 PBA Pharmacy Benefits Association 1-800-325-1810
001460 004758 NPS******* PBA Pharmacy Business Associates NPS 1-800-546-5677
000041 610478 No Control PBM Plus NDC 1-800-388-2316 Serv-U prescription Plan is now the adjudicator & will maintain the helpline for PBM 414-223-7795 Processor
000588 OLD Now PCS 610415 3211501824 PCA of Texas PPC of TX 1-800-234-7912 Processor PCS 1-800-345-5413 Group #: HUMA0001
007270 OLD Now PCS 610415 3211501824 PCA of Texas PPC of TX 1-800-234-7912 Processor PCS 1-800-345-5413 Group #: HUMA0001
000101 610011 PARC PCN Pharmaceutical Care Network Plans group# is the carrier # + the 3 digit plan # from the card. Processor PCN 1-800-777-0074
610415 610415 3211501824 PCS PCS 1-800-345-5413
006239 610477 No Control PDN now Open Pharmacy Network or Rx America OPN 1-800-736-4179
001411 OLD NEW 000797 400004 ENV 900002 DPS ENV DPS PDS Prescription Delivery Systems Processor is NOW DPS 1-800-824-0898 Can now send this under regular DPS Envoy Bin# 000797
000963 610077 No Control Perform (Generic#) Diagnostex is now Perform/ValueRx 1-800-726-7220 Perform has been bought by ValueRx Pioneer Life Plans that went to Perform NOW go to ValueRx on Envoy Bin# 000004 NDC Bin# for ValueRx is 610041 w/ no proc contol
001091 003858 A4 PeRx is Express Script 1-800-763-5550 or 1-800-235-4357 Cardholder ID is SSN# Person Code is [00]
002437 002286 6000 Plan Plus Processor AltaRX 1-800-998-5033
005742 900020 CLAIMWT** OR CLAIMNE** PLICO just on of the plans for MIM MIM/Automative Scripts Network Processor ProMark 1-800-213-5640 The group# for this plan is PLICO in capital letters.
005532 610468 PC2 PharmaCare PC2 1-800-792-7587 Or 1-800-777-1023 If this doesn't work for NDC try HP*** in the processor control.
002077 610053 ENV 610053 7Q*7700700 ENV UNMASS Pharmacy Access/ a Unicare Plan Ver. 32 Wellpoint/ProServ 1-800-962-7378 Plan Code from the card goes in front of the Group # This Plan Code is 008.
001460 004758 NPS******* Pharmacy Business Associates NPS 1-800-546-5677
004919 005757 No Control Pharmacy Services Group/PSG ProCare Rx 1-800-345-3189 Mede America 1-800-433-4893
003825 600428 01690000 Pharmalink Group 0001,02,03&04 Pharmalink 1-800-228-1436 Argus 800-522-7487
003400 004591 No Control Pharma-Script 3-1-97 will be called PPS/Medical Marketing Group Pharma-Script 1-800-732-8420 are COUPONS from drugs Companies. ID any 9 digit number like SSN# of patient, the group# is the 14 digit ref.# on the coupon.
  400004 ENV 900002 PHS ENV PHS PHS/Preferred Health Systems, Inc. HMO #718 DPS 1-800-824-0898
008443 610453 PIN Physicians Incorporated ComCoTec 1-800-325-1810
000004 610041 No Control Pioneer Life of Illinois THIS WAS ON PERFORM Now goes to ValueRx all patients have new ID's MUST call ValueRX 1-800-347-8777.
000513 600471 7777 Pioneer Life TX---PPO Oklahoma Processor RESTAT 1-800-248-1062
002682 003573 PMPTULOK PMP Provider Medical Pharmaceutical Interchange PMP HELP DESK 1-800-364-6440 Processor Timeshare 1-800-333-3672
003561 004682 ENV 004682 *****HCB** ENV *****HTY** PNNC Pharmacy Network National Corp. Prescript 1-800-557-6484 ID is i.e. 441348470-01 run this # all together, use no person code, they tell person by birthdate.
001755 600428 00410000 PPOK (for ALL PPOK PLANS) Pharmacy Provider of Okla. 528-3342 Processor Argus 1-800-522-7487
006015 600428 00410000 PPOK CMI. Send under Reg. PPOK Processor Argus 1-800-522-7487
002090 600428 00410000 PPOK Kempton Group Admin. Caddo County. Send under Reg. PPOK Processor Argus 1-800-522-7487
002969 600428 00410000 PPOK Kempton Obait (Bankers). Reg. PPOK Processor Argus 1-800-522-7487
001089 600428 00770000 PPOK Travelers Processor Argus 1-800-522-7487
000513 OLD NEW PCS 600471 OLD NEW 610415 7777 OLD NEW 3211501824 PPO OKLAHOMA (this is not the same as PPOK) Group# 1464 PCS 1-800-345-5413 PPO Okla. 521-1600
005546 004568 PPPN PPPN Prescription Plus Pharmacy Network PPPN 1-800-547-8262
000009 600428 01570016 PPSI Coupon 7 Free Adapex P. Argus 1-800-522-7487
003400 004591 No Control PPS Medical Marketing Group this was Pharma-Script Processor Pro-Care Rx 1-800-345-3189. You will now be billed for these transmissions.
002310 610096 PPSWC PPS Prescription Processing Services Worker's Comp. PPS 1-800-772-4640 Version [3B], instead of [3A] for Worker's Comp. Must put patient in [F8] Worker's Comp. and put in the injury date.
001751 004915 ENV 004915 *****HCB** ENV *****HTY** Preferred Care Services/BCBS Alabama Processor BCBS Alabama 1-800-216-9920
000319 003452 No Control Preferred Community Choice/Benescript Benescript 1-800-345-3189 Processor NDC 1-800-388-2316
PCS 610415 3211501824 Preferred Community Choice/HUMANA PCS 1-800-345-5413 Group #: HUMA0001 THIS MUST BE IN GROUP!!
  400004 PHS Preferred Health Systems, Inc. HMO #718 / PHS DPS 1-800-824-0898
001397 600518 No Control Premier Pharmacy Plan Processor Smith Data Processing 1-800-247-4526
008079 900020 PRESCRIPT Prescripta Processor Promark 1-800-230-8187 or 213-5640
003561 004682 ENV 004682 *****HCB** ENV *****HTY** Pre-Script Stockton Group or PSP 1-800-577-6484 ID is i.e. 441348470-00 run this # all together, use no person code, they tell person by birthdate.
000612 610494 0111****** Prescription Solutions (Generic) also called Rx Solution 1-800-788-7871 for all Prescription Solutions except for Ok. And Tx.
000040 610494 0068****** Prescription Solutions OKLA. Was Pacificare of OK Processor Prescription Solution HELP 1-800-788-7871
002902 610494 0087****** Prescription Solutions TEXAS Was Pacificare of TX Processor Prescription Solution HELP 1-800-788-7871
001755 600428 00410000 Prime Advantage HMO & Commercial Drug Plan #975. Send under Reg. PPOK 4-1-97 New PPOK plan 525-5248 Processor Argus 1-800-522-7487
OLD 000968 NEW 002437 002286 6000 Prime Extra / Alta Rx 1-800-992-7763 First Health (804) 273-6961, is currently in the process of consolidating Alta Rx and PrimeExtra under one agreement, using Alta Rx payor specifications Bin # 002286 and Proc. Cont. 6000.
      Prime Therapeutics BCBS of WHAT ??? Goldnet 1-800-858-0723 ProPar 1-800-821-4795
PCS 610415 3211501824 Private Healthcare Services PCS 1-800-345-5413
000968 600426 54 Private Healthcare Systems/SAI Plus Processor MedeAmerica 1-800-433-4893
000319 004725 03452 ProCare/Benescript Processor NDC 1-800-388-2316
008057 400015 PPBS Professional Pharmacy Benefit Services / PPBS PPBS 1-800-796-7369 Processor NDC 1-800-388-2316
008006 610053 ENV 610053 7Q*7700700 ENV 7Q*7700630 Pro-Serv/Wellpoint 1-800-962-7378 i.e. BCBS Wa & Al 430 is the plan code start the cardholders ID with the plan code.
001465 600685 No Control ProVantage—Prescription Benefit Management—this was Bravell Pro Vantage 1-800-784-0881
002918 600428 00289999 or 00930000 Prudential/Plus 1-800-416-3206 Provider Support 770-437-7878 Processor Argus 1-800-522-7487 GENERIC BIN NUMBER
004807 600428 01210000 Prue Care Argus 1-800-522-7487
004919 005757 No Control PSG / Pharmacy Services Group ProCare Rx 1-800-345-3189 Mede America 1-800-433-4893
006008 006152 No Control QualMed (IPS) / FHS Health & Life Integrated Pharmaceutical Services 1-800-600-0180 MedeAmerica 1-800-433-4893 QualMed and FHS Health have changed to IPS as their Processor IPS 1-800-600-0180
002447 004336 APM QualMed Colorado Advance ParadigM 1-800-364-6331
000511 003585 36300 Qualchoice Health Plan Medimpact 1-800-788-2949
002075 600471 7777 Restat (Generic) 1-800-248-1062 A 4 digit carrier or plan# needs to be in the group # field, not the long group # from the card.
006239 610473 No Control Rx America Processor NDC 1-800-388-2316 Rx America 1-800-770-8014
005318 800001 WYBCS RxCare / BCBS of Wyoming has Prime Therapeutics Goldnet 1-800-858-0723
000963 610077 No Control Rx Choice – Perform Processor Perform/Value Rx 1-800-726-7220
002792 610468 PC5 Rx Connection Processor PharmaCare 1-800-792-7587
004114 610536 No Control Rx Direct/PHI  
000586 003592 No Control Rx-Net 1-888-318-2589 Use Cardholder ID + 2 digit per code from card, that they are not going to have yet. HA! HA!
002657 600428 01060000 Rx Prime 1-800-821-4695 Processor Argus 1-800-522-7487
003105 610494 0111****** Rx Solution Same as Prescription Solution just a new name on the new cards. 1-800-788-7871
003243 610468 PC5 RxWatch PharmaCare 1-800-792-7587
000968 600426 54 SAI Plus/Private Healthcare Systems Processor MedeAmerica 1-800-433-4893
005751 006558 ENV 006558 *****HCB** ENV *****HTY** or *****HDN** SAV-RX This used to be a discount card only, but now they are processing for other companies SavRx 1-800-396-2219
  008563 No Control Sav-Rx Advantage This takes a different contract than regular Sav-Rx
000490 610056 No Control Scrip card Scrip card 1-800-872-7471
002941 004410 SCI Script Care Script Care 1-800-880-9988
005522 006053 MSC Scriptsave/MSC Medical Security Card 1-800-700-3957 Processor Health Trans.com DISCOUNT CARD !! Medical Security will Invoice you for $1.00 a claim.
005258 600426 CV Sears Health Connections Health Trends MedeAmerica 1-800-433-4893
000040 610494 0068****** Secure Horizons / Pacificare Prescription Solution 1-800-799-7871
004198 003585 37000 Select Care Medimpact 1-800-788-2949
000968 600426 54 Select Script/SRX 1-800-521-4548 (Mede Select) SRX may now be on new cards. MedeAmerica Select Script Super Carrier or Mede Select
003401 001553 SERVU Serv-U Processor Comcotex 1-800-325-1810
006282 007382 SHS Sierra Health Services/Texas Health Choice Processor Comcotex 1-800-325-1810
003464 005947 SIERRA Sierra Health Plan Processor ProMark
001591 610550 SMCRX SMCRx, Inc. 1-800-325-1810 Gold Net/Pharmacy Gold, Inc. 612-456-1000
PCS 610415 3211501824 Sooner Health This is the Patient's Major Medical Card ask for their PCS prescription card.
000968 600426 54 SRX Same as Select Script 1-800-521-4548
003561 004682 ENV 004682 *****HCB** ENV *****HTY** Stockton Group/Pre-Script Pre-Script 1-800-577-6484 Stockton 1-800-331-7108 ID is i.e. 441348470-01 run this # all together, use no person code, they tell person by birthdate.
000253 OLD NOW PAID 610014 ENV 610014 HCB******* ENV No Control Systemed was Insurx 5/1/97 NOW goes to PAID 1-800-922-1557
006260 004336 HATS Texas BCBS Advance Paradigm 1-800-364-6331
006282 007382 SHS Texas Health Choice/Sierra Health Services Comcotec 1-800-325-1810
002553 610098 110 Texas Welfare MUST NAME DHS (space) (space) TEXAS Texas Compounds for Welfare MUST name DHS (space) (space) TEXASC Version must be 4.0 must be named in 3rd Party Co. Inf. DHS (space) (space) Texas Dr. ID is [2] State Lic. Not [1] DEA To fill with Brand must put DAW=06 & Denial Override=07 Error Code #57 Limit of acute dosage override /Medical Certification #. Put a 2 in the Prior-Auth plus the #1 thru14 depending on the Drug classification.
005891 610474 TDI TDI Trust Managed Care Processor TDI 1-800-244-5800
004993 610474 TDI TDI Trust Managed Care Processor TDI 1-800-244-5800
002538 004261 CAL******* Tmesys Workers Comp. Program Tmesys 1-800-964-2531 ID=15 digit Patient ID Version=32 Number Claims Send=1
002729 OLD NEW 002777 3/1/2000 600428 OLD NEW 004336 01660000 Version 32 NEW 01660000 TriCare or Champus Okla. [Blank Blank] in the person code in F4 Must have complete address w\zip code in patient profile. Does not pay for all drugs. Error Code TQ= Phone Number API 1-800-600-0180 Advance ParadigM 1-800-364-6331 Patient ID: do not put a per code on end of ID # Group #: Try PRIME (If that doesn't work you will need to call API 1-800-600-0180) Number Claims Send: 1 Send First Name: N Version: 32 (instead of 3A) Doctor ID: 1
002777 004336 01660000 TriCare Texas or Champus Texas Same Info. as Tricare Okla. Above!!!
000004 610041 No control TriCare West (MO) Processor ValueRx 1-800-347-8777 Group#; TRIWEST
  003585 45000 Tropical Texas Medimpact 1-800-788-2949 Do Not use group # off of card. NO GROUP #
005765 006425 No control TXRX Processor NDC 1-800-388-2316
002077 610053 ENV 610053 7Q*7700700 ENV 7Q*7700630 UniCare Mass Mutual (Wellpoint) same as Pro Serv 1-800-227-3813 Plan code goes in front of Group#. Plan Code is usually 006 or 008 should be on the card. All UniCare Mass plans go under this Envoy bin#.
002745 610053 ENV 610053 7Q*7700700 ENV 7Q*7700630 UniCare of California (Wellpoint) same as Pro Serv 1-800-227-3813 Plan code goes in front of Group#. Plan Code is probably 040.
008006 610053 ENV 610053 7Q*7700700 ENV 7Q*7700630 UniCare of Texas (Wellpoint) Pro Serv 1-800-227-3813 Plan code goes in front of Group#. Plan Code is 006 or 008 should be on card.
PCS 610415 3211501824 United Benifit Life Ins. on front of card Sooner Health Plan & Community Choice HMO on back of card. This is the Health coverage card they should have a PCS prescription benefit card.
008372 004428 UDI United Drug Rx Care Program United Managed Care plan 1-800-364-8865 Processor (TCS) Timeshare 1-800-333-3672 Group #: PPP
002930 400004 ENV 900002 UHC ENV UHC**HTY United HealthCare United HealthCare 1-800-842-2038 Express Script 1-800-235-4357
004018 400004 ENV 900002 COR ENV COR**HTY United Healthcare of Texas Diversified (DPS) 1-800-824-0898 United HealthCare 1-800-842-2038
000379 004336 UMW United Mine Workers Now Advance ParadigM 1-800-364-6331
003239 004923 UMPB Universal Mamaged Prescription Benefit---Community Health Group 1 claim at a time PC Professionals, Inc. 402-597-8650
001330 *New* 610449 4516 UPS—United Provider Services, Inc. 1-800-618-4877 or 1-800-519-8374 UPS 1-800-618-4877
003622 001884 HMO US Healthcare (Aetna) US Healthcare 1-800-441-1910
003502 008019 No Control US Script US Script 1-800-460-8988
006012 610453 APB ValuScrip Am. Pharmacy Benefits 1-800-733-9470 Processor ComCoTec 1-800-325-1810
000004 610041 No Control Value Rx 1-800-347-8777 If having trouble with version (3A) try version (32) in 3rd Party info. on a compound instead of NDC# of highest price ingredient must put in at the NDC# (9999's) to fill field and an 8 as the last number.
000038 005038 No Control Vitas Vitas 404-888-5391 Processor NDC
007322 600428 01410000 Walgreen Health Plan / WHP Health Processor Argus 1-800-522-7487
001091 003858 A4 Wal-Mart plans that were processed by MPS Express Script 1-800-763-5550 or 1-800-235-4357
000968 600426 54 Web MD Mede America 1-800-433-4893
002763 004402 OKA01 Version 3C Welfare DHS for Okla. DHS 530-3420 UNISYS 841-3400 Do Not tag ID with per code at end. Put Per Code in at F4. Prior-Auth# 1+0+number they give you. OU 271-6349 Version is 3C not 32 Dr. ID [2] instead of 1. If name is initials only i.e. J.D. Hume MUST put in patient as Last name comma space first initial only
002553 610098 110 Welfare DHS for Texas 1-800-435-4165 Texas Compounds for Welfare MUST name DHS (space) (space) TEXASC Version must be 4.0 Must be named in 3rd Party Co. Inf. DHS (space) (space) Texas Dr. ID is [2] State Lic. Not [1] DEA To fill with Brand must put DAW=06 & Denial Override=07 Error Code #57 Limit of acute dosage override /Medical Certification #. Put a 2 in the Prior-Auth plus the #1 thru14 depending on the Drug classification.
007322 603286 01410000 WHP Health Walgreen Health Plan WHP Health Initiatives 1-800-207-2568 Must submit the 6-digit group# found on the card. City of Moore Employees are on this Ins. Co. now.
000797 400004 ENV 900002 DPS ENV DPS World Insurance of Omaha Diversified (DPS) 1-800-824-0898
001751 004915 ENV 004915 *****HCB** ENV *****HTY** Wrangler Card will be BCBS of Alabama or Preferred Care Services, Inc. Identify Wrangler members their Preferred Care Services card. The letters WRA will precede the contract number. This prefix must be keyed along w/contract number. 1-800-216-9920
001473 006160 No Control York Prescription Benefits ProCare Rx 1-800-345-3189