Commercial Plan List

Commercial Plan List

Plan Name /

Network Name

PBM/

Processor

Region

BIN

PCN/

Group

Help Desk

4D Pharmacy NetworkManaged Phy Network

4D

National

600429

1990000

888-378-4743

Anderson Corporation

4D Pharmacy NetworkManaged Choice

4D

National

600429

1990000

888-378-4743

Anthem Rx Network

4D Pharmacy Network Traditional

4D

National

600429

1990000

888-378-4743

Express

Scripts

National

003858

gp- ESI

800/763-5550 or

800-776-8735

ABC Disposal Services

MedImpact

MA

003585

35026

800-788-2949

ABI - Besly

Products Corp

Med Impact

FL

003585

23121

800/788-2949

Aetna US Healthcare

Aetna

National

610502

00670000

800/238-6279

Aetna US

Healthcare-APNA

Aetna

National

610502

670000

800-238-6279

Aetna Member's Plan

Aetna

National

610502

AARP (United

HealthCare Senior)

Aetna W/Comp (AWCA)

800-238-6279

Aetna

National

610502

NO PCN

800/238-6206

MEDE

America

National

600426

Call H/desk

631/755-0029

Agelity

National

WHI/WHP

IL &

National

603286

gp 514694

800/207-2568

Med Impact

NY

003585

31905

800/788-2949

MaxorPlus

TX

005377

8253

800-687-0707

AHC

National

610118

AHC

800/872-8276

American Medical

Society

Pres Solutions

National

610494

9999, Grp

AMS

800/788-7871

AmeriChoice

Pres Solutions

NY/NJ

610494

9999, AMNY/

AMNS

800/788-7871

SXC

National

610593

See Card

800-454-3730

AmeriHealth

Caremark/

PCS

NJ, PA

004336

CMDRUG

800/364-6331

Amerihealth Mercy

Perform Rx

National

600428

1940000

800-555-5690

Ameriscript

Ameriscript

National

610640

AMER9999

800-681-6912

Ancira Auto Group

MaxorPlus

Texas

005377

10000019

800-687-0707

Affinity Cash

Discount (APN)

Agelity Prescription

Plans

Allied Benefits

Allied International Union

Alpha Barnes

American Health Care

Amerigroup Community

Care

Plan Name /

Network Name

PBM/

Processor

Region

BIN

PCN/

Group

Help Desk

Pharmacare

National

610468

HP, Gr

60351000

800-777-1023

Anthem

National

610575

00890000 or

00990000

800/662-0210

ANA - 1 Network

Argus

National

600428

Call h/desk

800/522-7487

ANA - 2 Network

Argus

National

600428

Call h/desk

800/522-7487

ANA - 3 Network

Argus

National

600428

Call h/desk

800/522-7487

ANA - 4 Network

Argus

National

600428

Call h/desk

800/522-7487

ANA - 5 Network

Argus

National

600428

Call h/desk

800/522-7487

ANA - 35 Network

Argus

National

600428

Call h/desk

800/522-7487

APS - Atlantic

Prescription Svs

Managed Care

SXC Health

National

610704

APSRX

877-277-7934

APS - Discount Rx Card

Network

SXC Health

National

610704

APSRX

877-277-7934

Applied Underwriters

Relay Health

National

013329

APP

402-827-3424

Argus

National

600428

Call h/desk

800/522-7487

Caremark

National

610029

ATTRX

800-421-2342

Argus Health Systems

AT&T

009265

AG

800-847-7147

Atlantis Health Plan

Catalyst Rx

National

005947

claimcr

888-341-8570

Auto Rx

Auto Rx

NY/NJ/PA

W/comp

Call h/desk

888/791-3389

Avmed

Catalyst Rx

FL

005947

See Card

866-643-6681

BCBSAZ

AZ/CA

603017

BAZ

800/364-6332

Preferred Care

Svs

National

004915

Call h/desk

800/216-9920

BCBS of Florida

Prime

Therapeutics

FL

012833

FLBC

888-877-6323

BCBS of Illinois

(bluescript and PPO)

Prime

Therapeutics

IL

011552

ILSC

800-821-4795

BCBS of Kansas

Prime

Therapeutics

National

610455

KSBCS

800/821-4795

BCBS of Massachusetts

Express

Scripts

MA/CT/VT

003858

gp- ESI

800/892-5120

BCBS of Michigan/Blue

Care

Med Impact

National

003585

use gp #

800/748-6277

BCBS of Minnesota

Prime

Therapeutics

National

610455

PGIGN

800/821-4795

BCBS of Arizona (City of

Phoenix)

BCBS of Alabama

Commercial Plan List

Plan Name /

Network Name

PBM/

Processor

Region

BIN

PCN/

Group

Help Desk

BCBS of MO

Anthem/

Wellpoint

MO

610575

00890000 or

00990000

800/662-0210

BC BS of Nevada

Anthem/

Wellpoint

NV

610053

See Card

800-777-1023

BCBS of New York

BSNY/Argus

NY

600428

1910000

800/522-7487

BCBS of Oklahoma

Prime

Therapeutics

Oklahoma

011552

1215

877-353-0992

BCBS of Rhode Island

BCBS of South Carolina

BCBS of WI

Benecard

BeneScript Services

Best Overnight Express

Beyond-Rx

Bioscrip

Plan Name /

Network Name

PBM/

Processor

Region

BIN

PCN/

Group

004336

Help Desk

800-364-6331

800002

008514

004816

006350

610502

Caremark RxClusive

Consumer Card

BX/WellPoint

National

610468

use gp #

800/777-1023

Medical Matrix

National

004992

PCN-599

800/880-1396

Wellpoint

WI

610053

GP-RVA

800-662-0210

Argus

National

600428

02480000

800/522-7487

BeneScript

National

003452

Call h/desk

800-345-3189

California Service

Employees Health &

Welfare Trust

AHC

CA

610118

AHC, GR

8168

800/872-8276

Beyond-Rx

National

610641

PB

Rx America

OH, MI

610473

0797 or 0798

866-669-0321

Pres Solutions

CA

610494

9999 CSE

800/797-9791

Capital BlueCross

Express

Scripts

PA

003858

gp- ESI

800/824-0898

866/247-9996

Capital Health Plan

Caremark

National

004336

gp - RX1004

800-364-6331

Carpenters Health &

Welfare Trust

Express

Scripts

CA/AZ

003858

gp- ESI

800/824-0898

SXC

National

005947

See Card

888-869-4600

PCNCLAIMCR,

GR HEREIU

888-869-4600

Bioscrip

National

900020

See card

800-230-8187

Blue Cross/Blue Shield

WellPoint/

Unicare

IL

610053

Call h/desk

800/962-7378

Blue Cross/WellPoint

WellPoint

National

610053

Call h/desk

800-962-7378

Bluegrass Family Health

Procare Rx

National

008878

Call h/desk

800/699-3542

Blue Shield of Calfornia

Argus

CA

600428

1910000,

PDP

03510000

800/522-7487

Blue Shield of Texas HMO Blue

Prime

Therapeutics

TX

011552

BCTX

800-821-4795

Brighton Best Socket

Innoviant

National

610127

01960000

877-559-2955

Brownsville Doctors

Hospital

Innoviant

National

610127

0196000,

GR01960430

877-559-2955

Cal-Optima

Wellpoint

CA

610575

See card

800-962-8192

Care First Health Plan

MedImpact

CA

003585

50280

800/788-2949

Caremark (Cash

Discount)

Caremark/

PCS

National

Variable

Call h/desk

800-421-2342

Caremark/PCS

Caremark/

PCS

National

CareSource

610415

Catalyst Rx W/C

Catalyst Rx

SXC

National

005947

Catalst Rx IPA

Catalyst Rx

New York

005947

CatalystScripts

Emdeon

National

004682

Call h/desk

631/755-0029

Restat

National

600471

7777

877-228-7909

Med Impact

CA

003585

50125

800/788-2949

NMHCRx

NY area

610527

Use gp

800/510-8980

SXC

National

610593

VA, Grp RVA

888-546-5503

Chesapeake Health

MedImpact

National

003585

48110

800/788-2949

Child Health Plus (Health

Plus of NY)

MedImpact

NY

003585

58005

800/788-2949

Choice90- 90 day Maint

Plan

MedImpact

National

003585

Call h/desk

800/788-2949

Argus

CA,IL,TX

600428

00600000

800/522-7487

Caterpillar Group

Central Health Medicare

Plan

Centruss (PSCNY)

ChampVA

610029

Variable

800-421-2342

Variable:

Call h/desk

480-614-7972

610415

use gp #

800-345-5413

Cigna Healthcare

CA , IL and TX area

must call for contract

860-226-8072

888-869-4600

Commercial Plan List

Plan Name /

Network Name

PBM/

Processor

Region

BIN

PCN/

Group

Help Desk

City of Effingham

WHI/WHP

IL

603286

01410000,

GR 514572

800/207-2568

City of Garfield

Maxor Plus

NJ

005377

See card

Innoviant

National

610127

City of Kingman

City of Phoenix- BC/BS

of AZ

City of Sparks

Caremark/

PCS

Catalyst Rx

AZ/CA

NV

PBM/

Processor

Region

BIN

PCN/

Group

Help Desk

Dept of Defense (DoD

Tricare)

Express

Scripts

National

003858

gp- ESI

866/684-4466

800-687-0707

Destination Rx - Agelity

Agelity

National

010439

AG

800-847-7147

02330000

877-559-2955

Diversified Pharm Svcs

(DPS)

Express

Scripts

National

003858

gp- ESI

877/776-8735

004337

RX1245,

ADV

800/364-6332

Driscoll Children's Health

Plan

Express

Scripts

TX only

003858

gp- ESI

361/904-0955

005947

CLAIMCR,

CDS

888-869-4600

Eastern Kentucky

University

Express

Scripts

KY

003858

gp- EKUA

877-776-8735

800/207-2568

EBRx - Standard

Network

Catalyst Rx

National

610560

95

800/406-0015

800/777-1023

Express

Scripts

IL only

003858

gp- ESI

800/235-4357

EHIM

NE

005285

See card

248-948-9900

WHI/WHP

National

603286

01410000,

GP 516225

800/207-2568

National

Envision

009893

ROIRX

800-361-4524

WHI/WHP

National

610652

82260000,

GP

UHCMAPD

800-207-2568

ExpressComp-WC

Express

Scripts

National

003858

gp- ESI

888/201-5389

Express Scripts-Express

Net 50

Express

Scripts

National

003858

gp- ESI

888/201-5389

Express Scripts (PBM)

Express

Scripts

National

003858

gp- ESI

800-763-5550

Express Scripts Express

Comp

Express

Scripts

National

003858

gp-ESI

800-763-5550

Family Health Plus Health Plus of NY

Med Impact

NY

003585

58005

800/788-2949

Federal Employees

Group (FEP)

Caremark/

PCS

National

Variable

Call h/desk

800/614-7972

Federal Employees

Group (FEP)

Caremark/

PCS

National

610415

65006500

800/614-7972

WHI/WHP

IL

603286

01410000,

GR 514441

ClaimsPro Preferred

Network

PharmaCare

National

004245

Member ID

ClaimsPro Managed

Care Nwk

PharmaCare

National

'004245

Member ID

800/777-1023

Community First Health

Plan-CFHSPECIAL

MedImpact

National

003585

59090

800/788-2949

Community Health

Group (CHG)

MedImpact

National

003585

Community Plus

Pharmacy Network

BCBSMS

National

004583,

'004084

City of Springfield

Consolidated Rx

Services

Plan Name /

Network Name

Egyptian Area Schools

CHG01

800/788-2949

EHIM - Employee Health

Ins Mgmt

Empire Wholesale

Lumber

Envision HPP Private

Label Savings Card

800-551-5258

Evercare- United Health

WebMD

National

005947

Call h/desk

888/722-4652

Corporate Services, Inc

WHI/WHP

IL

603286

01410000,

GP 514694

800/207-2568

County Medical Svcs

Program-ODS

MedImpact

CA

003585

50145,

38021

800/788-2949

Covalence Specialty

Materials

Express

Scripts

LA,MA,

MN,NJ

003858

V2CA

800-763-5550

Covenant Health Plans

WHI/WHP

National

603286

01410000,

GP 516282

800/207-2568

Cox Health Plans

Catalyst Rx

MO

005947

ClaimCr

888-341-8578

Cracker Barrel

Catalyst Rx

National

005947

CBOCS

800-997-3784

AHC

FL

610118

AHC, GR

5311

800/872-8276

Curtis Gunn

Innoviant

National

610127

PCN

'02330000

877-559-2955

Cypress Care (W/comp)

Emdeon

National

010876

W/comp

800/419-7102

Federated Department

Stores

Express

Scripts

National

003858

gp-FDSA

888-201-5389

Data Rx

Data Rx

National

610568

DRX

877-823-1273

First Health Rx/Coventry

Coventry

National

002286

6000

800-844-9636

Cross Company

Commercial Plan List

Plan Name /

Network Name

Fiserv Health Plans

PBM/

Processor

Region

BIN

PCN/

Group

Help Desk

Innoviant

National

610127

01960000

877-559-2955

Fishing Partnership

Health Plan

MedImpact

MA

003585

Grp 35026

800-788-2949

FlexScripts

WHI/WHP

TX/FL

603286

01410000,

GP 513274

800/207-2568

See Card

585-327-7530

FLRx

Fox Insurance

Fretz Construction

GHI (Gp Health

Incorporated-City of NY)

Goellner, Inc

Goldline

Gold PN2 Network

Great West Healthcare

Great West Life &

Annuity

pcn: AHC"

Harvard Pilgrim

Healthcare

Health Alliance Medical

Plans

FLRx

National

610475

Procare Rx

National

014194

603286

877-447-6335

01410000,

GP 512235

800/207-2568

Plan Name /

Network Name

HealthTrans UNA Cash

Discount-Free Drug

Card

Health Xcellence (HBRx)

PBM/

Processor

Region

BIN

PCN/

Group

Help Desk

HealthTrans

National

009992

Gr

HTAWEST01,

HTAPORT01,

USPG0023

866-257-1419

Call h/desk

800/282-3232

SXC

National

Health Net

Caremark/

PCS

National

004336

ID Card

800/364-6331

Health Net of Arizona

Caremark/

PCS

AZ

004336

ID Card

800/364-6332

SXC

CA

005947

See card

800-282-3232

MedImpact

TX

003585

45510

800/788-2949

WHI/WHP

National

Express

Scripts

NY/NJ/

CT/PA/FL/

CA

003858

gp- ESI

877/534-3682

H.E.B. Grocery

Company

MedImpact

IL

003585

34004

800-788-2949

MEDE

America

HIP/Vytra

NY area

400023

ID number

646-447-1245

National

600426

Call h/desk

631-755-0029

HIP-Health Ins Plan of

Greater NY

PharmaCare

National

610468

Member ID

800/777-1023

GHI/Uniformed

Sanitationmen

HIP/Vytra

NY area

013865

See card

877-444-3786

Express

Scripts

National

003858

gp-ESI

800/235-4357

Hoag Memorial Hospital

AHC

CA

610118

AHC, GP

8115

800/872-8276

AHC

MD & WV

610118

"gp-5681

Houghton International

Maxor Plus

PA

005377

10000019

800-687-0707

Ideal Scripts (NEBCO)

HealthTrans

National

011289

Call h/desk

800/950-9120

800/777-1023

800-872-8276

MedImpact

Nat'l

003585

gp number

Health Plan of San

Mateo

Illinois Farm Bureau

PharmaCare

IL

610468

PC2, GP

CBDILFB

Independent Health

Independent

Health

National

004626

None

716-631-2927

SXC

National

See card

See card

800-282-3232

Argus

CA

600428

02550000

800/522-7487

800/788-2949

MedImpact

IL &

National

003585

gp number

800/788-2949

Health Alliance Of

Michigan

MedImpact

IL &

National

003585

gp number

800/788-2949

Inland Empire Health

Plan (IEHP)

Health Alliance Plan Choice 90

MedImpact

IL &

National

003585

gp number

800/788-2949

Innoviant Inc

SXC

National

610127

02330000,

01960000

877/559-2955

Integrated Prescription

Managemeent (IPM)

IPM

National

014658

IPM,

IPMCOB

877-860-8846

Joliet Junior College

WHI/WHP

IL area

603286

gp 514864

800/207-2568

Med Impact

TX

003585

36440

800/788-2949

MedImpact

National

003585

variable

800/788-2949

Innoviant

National

610127

01960000

877-559-2955

Health Plus of NY

MedImpact

NY area

003585

HNY/58005

800/788-2949

Healthsource Rx

Argus (Cigna)

National

600428

006000000

800/522-7487

Argus

National

600428

See card

Health Springs

Informed Rx

HealthTrans National

Network

HealthTrans

National

600428

See card

800-950-9120

JP Farley: Lone Star

Heat

HealthTrans LTC

Network

HealthTrans

National

600428

See card

800-950-9120

Kaiser Permanente

Health Plan

HealthTrans (W/Comp)

HeatlhTrans

National

009992

W/Comp

800/950-9120

Killam Oil Co

Commercial Plan List

Plan Name /

Network Name

PBM/

Processor

Region

BIN

PCN/

Group

Help Desk

Plan Name /

Network Name

PBM/

Processor

Region

BIN

PCN/

Group

Help Desk

Kohl's Department

Stores

Pres Solutions

National

610494

9999, GR:

KOHLS

800/788-7871

MedE Therapy First Plus

Network

Emdeon

National

009265

Call h/desk

800-768-7272

KPS Health Plans

MedImpact

National

003585

49100

800/788-2949

MedE National Network

Emdeon

National

009265

Call h/desk

800-768-7272

Kroger Plans

MedImpact

National

003585

Call h/desk

800/788-2949

MedE Patient Choice

Network

Emdeon

National

009265

Call h/desk

800-768-7272

Kroger - Sr Advantage

Plus

MedImpact

National

003585

30919

800/788-2949

MedE Preferred Network

Emdeon

National

009265

Call h/desk

800-768-7272

LA Rx Prescription Card

Envision Rx

Options

National

009893

ROIRX

330-405-8080

MedE W/C Network

Emdeon

National

009265

Call h/desk

800-768-7272

MedE Self Pay Network

Emdeon

National

009265

Call h/desk

800-768-7272

LA United School District

Express

Scripts

CA

003858

gp-ESI

800/776-8735

WHI/WHP

FL &

National

603286

516295 or

01410000

800/207-2568

Lake Havasu Emp

Benefit Trust

Innoviant

National

610127

02330000

877-559-2955

Medical Matrix

National

004992

Call h/desk

800/880-1396

LDI - Basic Network

SXC

National

800010

LDI

800/652-9550

MediCoreRx

WHI/WHP

National

603286

516290

800/207-2568

LDI - Select Network

SXC

National

800010

LDI

800/652-9550

MedImpact Choice 90

MedImpact

National

003585

Call h/desk

800/788-2949

LDI - Select/Preferred

Network

SXC

National

800010

LDI

800/652-9550

MedImpact Community

Health

MedImpact

National

003585

Call h/desk

800-788-2949

Catalyst Rx

National

005947

Lear

888-209-5707

MedImpact Health

Alliance

MedImpact

National

003585

Call h/desk

800-788-2949

Innoviant

National

610127

0233000,

01960428

866-800-4321

MedImpact MedCare

Network

MedImpact

CA

003585

call h/desk

800/788-2949

MedImpact Pref 1

Network

MedImpact

National

003585

Call h/desk

800/788-2949

Lear Corporation

LFD Homefurnishings

Local 237

Medica Healthcare Plans

Medical Matrix

HIP/Vytra

NY area

010991

ID number

646-447-1245

Mafco Worldwide

MedImpact

NJ

003585

See card

800-788-2949

Mail Handlers' Health

Plan

First Health

National

002286

6000002286

800/992-7763

MedImpact Pref II

Network

MedImpact

National

003585

Call h/desk

800/788-2949

Mariner Health Plan/

SaveSeniorCare

Express

Scripts

FL/TX

003858

gp-ESI

800/235-4357

MedImpact Standard

Network

MedImpact

National

003585

Call h/desk

800/788-2949

MedImpact - National

Select

MedImpact

National

003585

Call h/desk

800/788-2949

MedImpact - ODS

Health

MedImpact

National

003585

Call h/desk

800/788-2949

SXC

National

610705

PCNMEDSCRIPT

866-715-0876

Med Standard Gold

MedImpact

CA, TX

003585

11012

800/788-2949

(Alliance Health Card Melaleuca)

MedImpact

FL,GA

003586

1A1ABC111A

MedStar Health

MedImpact

National

610029

MSTRX

800-421-2342

MedTrak

National

800004,

'001659

008126

800/771-4648

Marion General Hospital

Innoviant

National

610127

01960000

877-559-2955

Pres Solutions

National

610494

9999 gp mhc

800/788-7871

MaxorPlus National

Network

Maxor

National

005377

10000019

800/687-0707

MaxorPlus Preferred

Network

Maxor

National

005377

10000019

800/687-0707

MaxorPlus Select

Network

Maxor

National

005377

10000019

800/687-0707

MaxorPlus FirstCare

Maxor

National

005377

McGuire Bearing

Company

WHI/WHP

OR

603286

01410000,

GR 512320

800/207-2568

MDNY Healthcare

MedImpact

NY area

003585

Call h/desk

800/788-2949

Matria Healthcare

800-687-0707

MedScript

MedTrak Pharmacy

Services

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