800 788 7871 - OptumRx Provider Manual: 2016 2nd edition 4 The information contained in this document is proprietary and confidential to OptumRx. B. Images used in the PM Friendly FYI for our valued Network Pharmacy Providers

 
All other Plans: 800-788-7871 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field ... . Ge 6 device universal remote control 33712 code list

Allied International Union Med Impact NY 003585 31905 800/788-2949 Alpha Barnes MaxorPlus TX 005377 8253 800-687-0707 American Health Care 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 Amerigroup ...All other Plans: 800-788-7871 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field ...Aug 10, 2022 · Service Number: 800-788-7871 : United Healthcare PPO: Rx Supplier: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871 : United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Reports Rx Grp: UHEALTH Service Number: 800-788-7871 : Western Your Advantage: Rx Vendor: OptumRx Rx BIN 610011 ... Optum Rx Pharmacy Helpdesk at (800) 788-7871 at the time they are filling the prescription for a one time override.- Optum Rx has partnered with CoverMyMeds to receive prior authorization requests saving you time and often delivering real -time determinations. OptumRx: 800-788-7871 FlexScripts: 800-603-7796 ProAct: 877-635-9545 MedalistRx: 855-633-2579 Other versions supported: ONLY D.0 CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER (see above) M Coast Longshore Division Caucus unanimously votes to send tentative agreement to membership Kaiser Permanente – Northern CA. HMO Rx BIN: 3585 Rx Group: Not Required Tax ID: 94-1340523 Medicare Part D Rx BIN: 11842 Rx Group: NC Tax ID: 94-1340523 COB Address P.O. Box 7012 Downey, CA 90242. Rx PCN for MMA: NCCMS Rx PCN for HDHP: NCHDP Rx PCN for HMO: 70000. Kaiser Permanente – Southern CA.See the benefits. Our research shows Optum Home Delivery reduces medication adherence barriers, drives greater health outcomes and lowers total cost of care.. Higher medication adherence - We analyzed 3 chronic conditions; participants had a 20%+ higher medication adherence with home delivery 90-day vs. 30-day supply at retail.Phone (toll-free): 800-357-0978 Mon-Fri: 8am to 8pm (Eastern) Website: www.myuhc.com United Healthcare, Attn: Claims PO Box 30555 Salt Lake City, UT 84130 Fax: 801-567-5499 OptumRx Customer Service (toll-free): 800-788-7871 • Claim & Benefit Questions • Verify Eligibility • Request ID Cards • Physician Verification1-234-201. Mahoning. Youngstown. Cellco Partnership Dba Verizon Wireless - Oh. 1-234-202. Summit. Akron. Cellco Partnership Dba Verizon Wireless - Oh. 1-234-203.Area Code & Prefix Service Provider Location Effective; 502-698: TELEPORT COMMUNICATIONS AMERICA, LLC - KY: Shepherdsville, KY: Oct 02, 2023: 346-691: CELLCO PARTNERSHIP DBA VERIZON WIRELESS - TXService Number: 800-788-7871 : United Healthcare PPO: Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871 : United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871 : Western Health Advantage: Rx Vendor: OptumRx Rx BIN 610011 ...If the patient is not able to meet the above standard prior authorization requirements, please call 1-800-711-4555. For urgent or expedited requests please call 1-800-711-4555. This form may be used for non-urgent requests and faxed to 1-844-403-1028.1-800-464-4000 (English) 1-800-788-0616 (Spanish) Appointments and Nurse Advice Line: ... 1-800-788-7871: iphone. Android. Teamsters’ Assistance Program (TAP) Websitecalling 1-800-788-7871. Generic drugs $12 copay/prescription. Deductible does not apply. Not covered. • You must use a Participating Pharmacy listed in the UFCW Participating Pharmacy Directory of the Southern California Drug Benefit Fund or no coverage. • Your cost sharing applies to the prescription drug out- A reverse phone lookup is an excellent tool for figuring out who called you. Whether it's a missed call, a blocked number or a wrong number. Who Called Me is a free reverse phone lookup tool and website that allows users to look up the telephone number of the person who called them. It searches millions of records to identify that caller's name ... OptumRx: 800-788-7871. FlexScripts: 800-603-7796. ProAct: 877-635-9545. MedalistRx: 855-633-2579. Other versions supported: ONLY CLAIM BILLING/CLAIM REBILL TRANSACTION. Transaction Header Segment Claim Billing/Claim Rebill Payer Field # NCPDP Field Name Value Payer Situation Usage 1 1-A1 BIN NUMBER (see above) M.Read more than 2 user reviews and security ratings for number 8007887871 / +1 800-788-7871, mostly rated as negative Unsolicited call. Get our Free protection against unwanted calls.call 1-800-788-7871. Generic drugs $12 copay / prescription Deductible does not apply. Not Covered • You must use a Participating Pharmacy listed in the UFCW Participating Pharmacy Directory of the Southern California Drug Benefit Fund or no coverage. • Your cost sharing applies to the prescriptionRx Vendor: OPTUMRx Rx BIN: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871 : United Healthcare PPO : Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871 : United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871LiveHealth Online: 24/7 video chat access to doctors and therapists from the comfort of your home. 100% coverage for preventive care when you see Anthem network doctors (including routine preventive health screenings, immunizations, and routine annual exams) A wealth of tools and resources available to help you live your healthiest life.o For Pharmacists – 800-788-7871 • Member Name . ID CARDS . You may also print a temporary ID card beginning August 1, 2015 by registering and logging onto .1-800-788-7871 or 1-800-797-9791 This plan: uses a provider network. You will pay less if you use a provider in the plan’s network. You will pay the most if you use ...See the benefits. Our research shows Optum Home Delivery reduces medication adherence barriers, drives greater health outcomes and lowers total cost of care.. Higher medication adherence - We analyzed 3 chronic conditions; participants had a 20%+ higher medication adherence with home delivery 90-day vs. 30-day supply at retail.For urgent or expedited requests please call 1-800-711-4555. This form may be used for non-urgent requests and faxed to 1-844-403-1028. ______________________________________________________________________________________________________________Jul 13, 2015 · 800-788-7871 Paramount Rx Inc National Funded Network, National Non Funded Network 610210 800-928-4301 PBM Plus, Inc. National and Limited Networks 610106 800-263-2178 PerformRx National Network, Medicare D, LA Medicaid, Keystone Mercy 012353, 600428 800-684-5502 Pharmacy BenefitDirect-PDMI National Networks, Restricted Networks, Catamaran/Optum at 1-800-788-7871. Mail Order. Active mail order prescriptions • Existing mail order prescriptions will automatically transfer to PrimeMail, but patients will need to create a new mail order account with Prime in order to ensure payment and delivery. Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value 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 800-788-7871 Paramount Rx Inc National Funded Network, National Non Funded Network 610210 800-928-4301 PBM Plus, Inc. National and Limited Networks 610106 800-263-2178 PerformRx National Network, Medicare D, LA Medicaid, Keystone Mercy 012353, 600428 800-684-5502 Pharmacy BenefitDirect-PDMI National Networks, Restricted Networks,OptumRx: 800-788-7871 FlexScripts: 800-603-7796 ProAct: 877-635-9545 MedalistRx: 855-633-2579 Other versions supported: ONLY D.0 CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER (see above) M For urgent or expedited requests please call 1-800-711-4555. This form may be used for non-urgent requests and faxed to 1-844-403-1028. This document and others if attached contain information that is privileged, confidential and/or may contain protected health information (PHI).800-788-7871, Consider Naloxone for safety Reject code(s): 88+922 If the pharmacist recently consulted with the prescriber and has up-to-date clinical information (e.g., Prescription Drug Monitoring Program (PDMP) system or other records), we don’t expect additional consultation with the prescriber. Prescriber consultation: Enter HD-M0-1G.Preferred Care Partners: 1 -800 591 6144 Medica Healthcare Plans: 1 -866 273 9444 All other plans: 1 -800 788 7871. Author: SYSTEM Created Date:Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value 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 OptumRx Address: 3515 Harbor Boulevard Costa Mesa, CA 92626-0000 Website: https://WWW.RXSOLUTIONS.COM Telephone: 800-788-7871 Fax 714-825-3608 Mail Order Disposable Medical Supplies All other Plans: 800-788-7871 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION : Transaction Header Segment Claim Billing/Claim Rebill ...You may be the target of a "one-ring" phone scam. One-ring calls may appear to be from phone numbers somewhere in the United States, including three initial digits that resemble U.S. area codes. But savvy scammers often use international numbers from regions that also begin with three-digit codes – for example, "232" goes to Sierra Leone and ...Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value 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 please have the patient’s pharmacy contact the OptumRx Pharmacy Helpdesk at (800) 788- 7871 at the time they are filling the prescription for a one-time override. Are there any other comments, diagnoses, symptoms, medications tried or failed, and/or any other information the physician feels is important toPharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 Transaction Header Segment NCPDP Field Name Claim Billing/Claim Rebill Field # Value Payer Payer Situation Usage M M M M M M M 1Ø1-A1 BIN NUMBER VERSION/RELEASE NUMBER TRANSACTION CODE PROCESSOR CONTROL NUMBER TRANSACTION COUNT SERVICE PROVIDER ID QUALIFIERPharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER (see above) M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M 1Ø3-A3 TRANSACTION CODE B1, B3 M800-788-7871 Paramount Rx Inc 610210 800-928-4301 PBM Plus, Inc. 610106 800-263-2178 PerformRx (Includes: LA Medicaid and Keystone Mercy) 012353, 600428 800-684-5502 Pharmacy BenefitDirect-PDMI 610020, 014955 800-800-7364 Prime Therapeutics 610455, 004915, 012833, 011552, 015905, 014897, 800-821-4795 ProCare Rx 009430, 013501, 014310, 014194 ...Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1 -A1 BIN NUMBER (see above) M 1Ø2 -A2 VERSION/RELEASE NUMB ER DØ M 1Ø3 -A3 TRANSACTION CODE B1, B3 M (800) 788-7871 (for coverage verification) (888) 543-1369 or www.optumrx.com (Customer Service) 4 NCDS Healthcare Plan (Rev. January 2021) SUMMARY SCHEDULE OF BENEFITS Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value 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 LiveHealth Online: 24/7 video chat access to doctors and therapists from the comfort of your home. 100% coverage for preventive care when you see Anthem network doctors (including routine preventive health screenings, immunizations, and routine annual exams) A wealth of tools and resources available to help you live your healthiest life.Administrative Office (707) 864-3300 Toll Free 1-888-245-5005. Amplifon Hearing Health Care 888-417-5097 TTY:711 www.amplifonusa.com/lp/norcalcementmasonsPreferred Care Partners: 1 -800 591 6144 Medica Healthcare Plans: 1 -866 273 9444 All other plans: 1 -800 788 7871. Author: SYSTEM Created Date:All other Plans: 800-788-7871 Please Distribute Immediately. Thank you. Title: HI QExA Notification ICD9 Author: RxSolutions Created Date:Oct 13, 2022 · Read more than 2 user reviews and security ratings for number 8007887871 / +1 800-788-7871, mostly rated as negative Unsolicited call. Get our Free protection against unwanted calls. If you are covered under an Anthem Blue Cross Indemnity medical plan option, please refer to your Summary Plan Description (SPD), contact the Trust Fund Office or contact OptumRx at 800-788-7871 to determine the exact amount of your prescription co-pays.For urgent or expedited requests please call 1-800-711-4555. This form may be used for non-urgent requests and faxed to 1-844-403-1028. ______________________________________________________________________________________________________________Nov 4, 2022 · PCN: ADV. Total Benefit Solutions (Aetna International) 610502 (Aetna) PCN: 00670000. United Healthcare HMO. Rx Vendor: OPTUMRx Rx BIN: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871. United Healthcare PPO. Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871. Pharmacy Help Desk must be contacted for assistance at 800-788-7871, available 24 hours a day, 7 days a week. The help desk can also assist in initiating a request for OptumRx to research the prescriber’s DEA license in question and perform a data validation and update. This process should be followed for those Prescribers who would like their exceeding 4 grams per day, please have the patient’s pharmacy contact the OptumRx Pharmacy Helpdesk at (800) 788- 7871 at the time they are filling the prescription for a one-time override. Are there any other comments, diagnoses, symptoms, medications tried or failed, and/or any other information the physician feels is important to Jul 13, 2015 · 800-788-7871 Paramount Rx Inc National Funded Network, National Non Funded Network 610210 800-928-4301 PBM Plus, Inc. National and Limited Networks 610106 800-263-2178 PerformRx National Network, Medicare D, LA Medicaid, Keystone Mercy 012353, 600428 800-684-5502 Pharmacy BenefitDirect-PDMI National Networks, Restricted Networks, o For Pharmacists – 800-788-7871 • Member Name . ID CARDS . You may also print a temporary ID card beginning August 1, 2015 by registering and logging onto .OptumRx: 800-788-7871 FlexScripts: 800-603-7796 ProAct: 877-635-9545 MedalistRx: 855-633-2579 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTIONHealth Care Plans United Healthcare (PPO, EPO, or HDHP) – 877-440-5982 www.myuhc.com MPS Group Medicare Advantage Plan – 866-487-9303 www.UHCRetiree.com Prescription Drugs OptumRX – 800-788-7871 www.optumrx.com Vision Insurance National Vision […]Pharmacy Help Desk OptumRx 800-788-7871 MedalistRx Help Desk 855-633-2579 Pharmacy Help Desk FlexScripts 800-603-7796 Other versions supported: ONLY D.0 Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1 -A1 BIN NUMBER (see above) M The Official Whitepages. Area Code 323 phone numbers . State: California . In service since: 1998 Landlines: 572 Wireless prefixes: 206 Carriers: 40 Counties: 3 ZIP codes: 37 Major cities: Los Angeles, Torrance, Burbank, South El Monte, Santa Ana Medical Plans. Phone: Please check the number on the back of the health plan ID card. Online: myuhc.com. Technical Support: 1-877-844-4999. Behavioral Health: myuhc.com or liveandworkwell.com 1-800-842-2065. OptumRx®. Phone: 1-800-788-7871. Authorization: 1-800-711-4555. Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871. United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871. Western Health Advantage. Rx Vendor: OptumRx Rx BIN 610011. PCN: IRX.Or call 1-800-788-7871. Preventive care drugs No charge, deductible does not apply. Not covered You must use a Participating Pharmacy listed in the UFCW Participating Pharmacy Directory of the Southern California Drug Benefit Fund or no coverage. You must have a prescription or no coverage. Coverage is for generic drugs Rx Vendor: OPTUMRx Rx BIN: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871 Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871. UnitedHealthcare PPO. UnitedHealthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999. Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871. United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871. Western Health Advantage. Rx Vendor: OptumRx Rx BIN 610011. PCN: IRX.exceeding 4 grams per day, please have the patient’s pharmacy contact the OptumRx Pharmacy Helpdesk at (800) 788-7871 at the time they are filling the prescription for a one-time override. Are there any other comments, diagnoses, symptoms, medications tried or failed, and/or any other information the physician feels is important to this review?800-788-7871 800-603-7796 ProAct Pharmacy Help Desk: 877-635-9545 MedalistRx Help Desk 855-633-2579 Transaction Header Segment NCPDP Field Name Claim Billing/Claim Rebill Field # Value Payer Payer Situation Usage M M M M M M M 1Ø1-A1 BIN NUMBER VERSION/RELEASE NUMBER TRANSACTION CODE PROCESSOR CONTROL NUMBER TRANSACTION COUNTPharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER (see above) M 1Ø2-A2 VERSION/RELEASE NUMBER DØ MPreferred Care Partners: 1 -800 591 6144 Medica Healthcare Plans: 1 -866 273 9444 All other plans: 1 -800 788 7871. Author: SYSTEM Created Date:See the benefits. Our research shows Optum Home Delivery reduces medication adherence barriers, drives greater health outcomes and lowers total cost of care.. Higher medication adherence - We analyzed 3 chronic conditions; participants had a 20%+ higher medication adherence with home delivery 90-day vs. 30-day supply at retail. Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER (see above) M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M (800) 788-7871 (for coverage verification) (888) 543-1369 or www.optumrx.com (Customer Service) 4 NCDS Healthcare Plan (Rev. January 2021) SUMMARY SCHEDULE OF BENEFITS Administrative Office (707) 864-3300 Toll Free 1-888-245-5005. Amplifon Hearing Health Care 888-417-5097 TTY:711 www.amplifonusa.com/lp/norcalcementmasonsPharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER (see above) M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M The phone number 800-788-7871 is used by PRESCRIPTIONS SOLUTIONS located in CYPRESS, CA If you have received, or continue to receive, unwanted phone calls or text messages from 800-788-7871, please take a minute and let us know . This phone number can appear in different ways, such as +1 800-788-7871 or (800) 788-7871 or simply just 8007887871 .OptumRx Provider Manual: 2016 2nd edition 4 The information contained in this document is proprietary and confidential to OptumRx. B. Images used in the PM Friendly FYI for our valued Network Pharmacy Providers OptumRx Provider Manual: 2016 2nd edition 4 The information contained in this document is proprietary and confidential to OptumRx. B. Images used in the PM Friendly FYI for our valued Network Pharmacy Providers exceeding 4 grams per day, please have the patient’s pharmacy contact the OptumRx Pharmacy Helpdesk at (800) 788- 7871 at the time they are filling the prescription for a one-time override. Are there any other comments, diagnoses, symptoms, medications tried or failed, and/or any other information the physician feels is important to exceeding 4 grams per day, please have the patient’s pharmacy contact the OptumRx Pharmacy Helpdesk at (800) 788-7871 at the time they are filling the prescription for a one-time override. Are there any other comments, diagnoses, symptoms, medications tried or failed, and/or any other information the physician feels is important to this review?All other Plans: 800-788-7871 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION : Transaction Header Segment Claim Billing/Claim Rebill ...Service Number: 800-788-7871 United Healthcare PPO Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871 United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871 Western Health Advantage Rx Vendor: OptumRx RX BIN 610011 PCN: IRX 800-788-7871 Paramount Rx Inc 610210 800-928-4301 PBM Plus, Inc. 610106 800-263-2178 PerformRx (Includes: LA Medicaid and Keystone Mercy) 012353, 600428 800-684-5502 Pharmacy BenefitDirect-PDMI 610020, 014955 800-800-7364 Prime Therapeutics 610455, 004915, 012833, 011552, 015905, 014897, 800-821-4795 ProCare Rx 009430, 013501, 014310, 014194 ...800-788-7871 800-603-7796 ProAct Pharmacy Help Desk: 877-635-9545 MedalistRx Help Desk 855-633-2579 Transaction Header Segment NCPDP Field Name Claim Billing/Claim Rebill Field # Value Payer Payer Situation Usage M M M M M M M 1Ø1-A1 BIN NUMBER VERSION/RELEASE NUMBER TRANSACTION CODE PROCESSOR CONTROL NUMBER TRANSACTION COUNT

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800 788 7871

Other ways to submit a prior authorization. Having difficulties with ePA? You can submit a verbal PA request. Call 1-800-711-4555, 5 a.m. – 10 p.m. PT, Monday-Friday and 6 a.m. – 3 p.m. PT, Saturday. If you cannot submit requests to the OptumRx® PA department through ePA or telephone, click here. Top. Delta Dental 800-765-6003 www.deltadentalins.com HMC HealthWorks 866-268-2510 https://hmc.personaladvantage.com (Access Code: SCDBF) Kaiser 800-464-4000 www.kp.org OptumRx 800-788-7871 www.optumrx.com Podiatry Plan, Inc. 800-367-7762 www.podiatryplan.com United Concordia 800-937-6432 www.unitedconcordia.comAll other Plans: 800-788-7871 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION : Transaction Header Segment Claim Billing/Claim Rebill ...Nov 4, 2022 · Rx Vendor: OPTUMRx Rx BIN: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871 : United Healthcare PPO : Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871 : United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871 OptumRx: 800-788-7871 FlexScripts: 800-603-7796 ProAct: 877-635-9545 MedalistRx: 855-633-2579 Other versions supported: ONLY D.0 CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER (see above) MRx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871. United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871. Western Health Advantage. Rx Vendor: OptumRx Rx BIN 610011. PCN: IRX.Read more than 2 user reviews and security ratings for number 8007887871 / +1 800-788-7871, mostly rated as negative Unsolicited call. Get our Free protection against unwanted calls.(800) 788-7871 (for coverage verification) (888) 543-1369 or www.optumrx.com (Customer Service) 4 NCDS Healthcare Plan (Rev. January 2021) SUMMARY SCHEDULE OF BENEFITSplease have the patient’s pharmacy contact the OptumRx Pharmacy Helpdesk at (800) 788- 7871 at the time they are filling the prescription for a one-time override. Are there any other comments, diagnoses, symptoms, medications tried or failed, and/or any other information the physician feels is important toOptumRx Provider Manual: 2016 2nd edition 4 The information contained in this document is proprietary and confidential to OptumRx. B. Images used in the PM Friendly FYI for our valued Network Pharmacy Providers Service Number: 800-788-7871 UnitedHealthcare PPO Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871 UnitedHealthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871 Western Health Advantage Rx Vendor: OptumRx RX BIN 610011 PCN: IRX OptumRx: 800-788-7871. FlexScripts: 800-603-7796. ProAct: 877-635-9545. MedalistRx: 855-633-2579. Other versions supported: ONLY CLAIM BILLING/CLAIM REBILL TRANSACTION. Transaction Header Segment Claim Billing/Claim Rebill Payer Field # NCPDP Field Name Value Payer Situation Usage 1 1-A1 BIN NUMBER (see above) M.All other Plans: 800-788-7871 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field ... Pharmacy Help Desk OptumRx 800-788-7871 MedalistRx Help Desk 855-633-2579 Pharmacy Help Desk FlexScripts 800-603-7796 Other versions supported: ONLY D.0 Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1 -A1 BIN NUMBER (see above) M call 1-800-788-7871. Generic drugs $12 copay / prescription Deductible does not apply. Not Covered • You must use a Participating Pharmacy listed in the UFCW Participating Pharmacy Directory of the Southern California Drug Benefit Fund or no coverage. • Your cost sharing applies to the prescriptionFor technical website issues or password resets:1-800-788-4863 TTY (for the hearing impaired): 711 Physician Contacts: Prior authorization or exception request: 1-800-711-4555, option 2 If you are having a medical crisis, please call 911, or contact your local emergency assistance service immediately.Medical Plans. Phone: Please check the number on the back of the health plan ID card. Online: myuhc.com. Technical Support: 1-877-844-4999. Behavioral Health: myuhc.com or liveandworkwell.com 1-800-842-2065. OptumRx®. Phone: 1-800-788-7871. Authorization: 1-800-711-4555. Administrative Office (707) 864-3300 Toll Free 1-888-245-5005. Amplifon Hearing Health Care 888-417-5097 TTY:711 www.amplifonusa.com/lp/norcalcementmasonsOptumRx: 800-788-7871 FlexScripts: 800-603-7796 ProAct: 877-635-9545 MedalistRx: 855-633-2579 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION.

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