WebMissouri Department of Transportaion/ Highway Patr (Employer PDP) 015574 ASPROD1 MISSOURI DEPARTMENT OF TRANSPORTATION E7316 UNION PACIFIC RAILROAD EMPLOYES HEALTH SYSTEMS The UPREHS Prime Medicare Plan (Employer PDP) 610011 UE7316 Union Pacific Railroad Employes Health Systems E7848 OMES … WebOther Payer Amount Paid (COB Section) 431-DV Required if other payer has approved payment for some/all of the billing Other Payer Reject Count (COB Section) 471-5E Required if Other Payer Reject Code (472- 6E) is used Other Payer Reject Count (COB Section) 472-6E Required when this prior payer has REJECTED the claim to indicate …

BIN 610315 PAYER SHEET REFERENCE KEY - RxAdvance

WebNCPDP Version D.0 Payer Sheet MEDICARE ONLY Payer Name: OptumRx Date: 10/1/2024 OptumRx Part-D and MAPD Plans BIN: 610097 PCN: 9999 ... Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER See Above M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M 1Ø3-A3 TRANSACTION CODE B1, B3 M 1Ø4-A4 PROCESSOR … WebIt is important to always refer to the current Provider Manual for the most up-to-date guidance, payer sheets, and other important information. You may locate the current manual at www.ventegra.com/provider/VentegraProviderManual.pdf General questions can be referred to Ventegra, Inc., 450 North Brand Boulevard Suite 600, Glendale, CA 91203 orange dipped in chocolate

CVS Caremark Payer Sheet Commercial Primary

WebNCPDP Version D.0 Payer Sheet COMMERCIAL AND MEDICAID Payer Name: OptumRx Date: 01/01/2024 Commercial and Medicaid BIN: 610494 PCN: 9999 ... 34Ø-7C OTHER PAYER ID R Other payer BIN 443-E8 OTHER PAYER DATE R 341-HB OTHER PAYER AMOUNT PAID COUNT Maximum count of 9. RW Required if Other Payer Amount Paid … WebPharmacies will be paid only for claims in which a prescription for a covered item is written by a prescriber for an eligible person and is dispensed to that person. Please refer to Medica member's identification card for all required information to submit a claim. WebThis payer sheet refers to Primary Commercial Billing. Refer to www.caremark.com under ... Added new BIN/PCN combination: BIN 025201 PCN MOHMKP. 12/01/2024 Page 4 of … orange disney castle logo