Web610239 FEPRX 65006500 . Anthem..o TEGAN THOMAS Grtxo No RXPCN R,GRP 0318090S6H 062 004338 AOV RX4750 CVS) STATE OF CONNECnCUT STATE POE. HEP STATE BLUECARE Anthem BlueShieId CRISTINA CIBOROWSKI . Author: Brinkmann, Emily Created Date:

OptumRx NCPDP Version D.0 Payer Sheet COMMERCIAL AND …

Web2024 OptumRx BIN 610279 Payer Sheet. This document provides information on electronic claims processing, specific to NCPDP defined fields and requirements, for OptumRx … WebNovember 2024 ***OFFICIAL RELEASE*** National Council for Prescription Drug Programs, Inc. 2 . cards. 3. Complete electronic transaction routing information. impact yoga

FEP Prior Approval Lists and Forms FEP Premera Blue Cross

WebRX BIN # RX BIN # 610239: RX PCN # RX PCN # Feprx: Group # Group # 65006500: Effective Date: 03/01/2000: Effective Date: 09/20/2024: Expiration Date: 03/01/2001: Expiration Date: 09/20/2024: Product(s)/Services(s) received: Del: RecID: Product Name: Date of service: No. of Units: Diagnosis Code: Procedure Code 1 (for vaccine) WebPBM BINs Help Desk 4D Management Systems, Inc. 600428 800-522-7487 Agelity, Inc. 009265, 610198, 012965 800-837-0581 Applied Underwriters, Inc 13329 877-234-4420 … WebFor Washington and Alaska Prior approval lists by plan. Standard and Basic Option prior approval list FEP Blue Focus prior approval list. Prior approval/pre-service request forms for services provided in Alaska or Washington only impactyn apk