Use this worksheet to help with any issues you might have while transmitting to New York Medicaid. Bill Medicaid (OHA or the CCO) last for all services except for Vaccines for Children administrations. If you do not know one of these values, you will need to contact NY Medicaid to obtain them. Both of these values are provided by NY Medicaid. The Centers for Medicare & Medicaid Services (CMS) released a compilation of the BIN and PCN values for each 2020 Medicare Part D plan sponsor. 1Ø1-A1 BIN Number See BIN/PCN table, above M 1Ø2-A2 Version Release Number DØ=Version D.0 M 1Ø3-A3 Transaction Code B1=Billing M 1Ø4-A4 Processor Control Number As indicated above 1=One Occurrence 2=Two Occurrences 3=Three Occurrences M 1Ø9-A9 Transaction Count These counts do not include the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) Health Plan Survey 5.0H – Child Version Including Medicaid and Children with Chronic Conditions … In federal fiscal year (FFY) 2019, reported of 22 frequently reported health care quality measures in the CMS Medicaid/CHIP Child Core Set. Child Quality Measure Data. BIN: 014203 PCN: ORDHSFFS Most national software vendors have previously certified with Magellan Medicaid Administration. This number must be included on the transaction header segment. Accountable Care Partnership Plans MCO Partner PBM BIN PCN Group Berkshire Fallon Health Collaborative ACO Fallon Caremark 004336 ADV RX6429 Hennepin Health: RxBIN: RxPCN: Medicaid - PMAP: 018315: MNM: Medicare Prime - PMAP: 018315: MNM: SNBC Non-integrated: 018315: MNM: SNBC Medicaid: 018315: MNM Bill OHA (FFS) for: Carve-out drugs for CCOs, drugs for OHP fee-for-service (“open card”) clients, drugs not covered by Medicare Part D, and drugs not included in the long-term care facility’s bundled rate. Pharmacy Benefit Administrator, BIN, PCN, and Group Specialty Pharmacy name and telephone number Website address for pharmacy information Aetna Better Health CVS/ Caremark 1-855‐364‐2975 Medicare/Medicaid Members BIN: 610591 PCN: MEDDADV Group: RX8812 Medicaid Only Members BIN: 610591 PCN: ADV Group: RX 8810 Bin Number: 004740 . software vendor will receive a number upon certification with Magellan Medicaid Administration. If questions or if certification is required, please call 804-217-7900. In addition, CMS included the following disclaimer in regards to this data: MS Medicaid pharmacy contact and billing information (PCN/BIN) – effective Nov. 1, 2019 Mississippi Preferred Drug List (PDL) Opioid Frequently Asked Questions (FAQs) Please note, the data below is Part 1 of 5 (E0654 - H2334) with links to Parts 2 through 5. PCN: PIN + 3 or 4 character ETIN. 1Ø2 -A2 VERSION/RELEASE NUMBER DØ M 1Ø3 -A3 TRANSACTION CODE B1 M 1Ø4 -A4 PROCESSOR CONTROL NUMBER Enter “WIPARTD” for SeniorCare , Wisconsin Chronic Disease Program (WCDP ), and AIDS/HIV Drug Assistance Program (ADAP) member s that are also enrolled in a Medicare Commercial and Medicaid BIN: 610494 PCN: 9999 Community Health BIN: 610613 PCN: 2417 ProAct BIN: 017366 PCN: 9999 FlexScripts/ProAct BIN: 018141 PCN: 9999 United Healthcare Community Plan of Texas BIN: 610494 PCN: 4400 ... 1Ø1-A1 BIN NUMBER (see above) M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M 1Ø3-A3 TRANSACTION CODE B1, B3 M 1Ø4-A4 … Pharmacy Facts, Number 110 (updated) Page 2 of 2 If you have questions or comments, or want to be removed from this fax distribution, please contact Victor Moquin at Conduent at 617-423-9830. Use BIN Number Ø16929 for ADAP claims.