RxHelp.ca. RxHelp card programs allow patients to benefit from payment assistance on their medication. Let us Help choose the best card for you. New RxHelp mobile app! The RxHelp mobile app is easy-to-use and saves you money on prescriptions. Best of all, you always have the discount card on your phone.1-800-788-2949 MedImpact Greystone & Co., Inc 003585 ASPROD1 GRE01 Commercial VA 1-800-788-2949 MedImpact Tanner Health System 003585 ASPROD1 PHI03 Commercial Georgia 1-877-403-6031 1-800-729-1174 MedImpact 1.1.2015. EFFECTIVE 07.27.2015 Subject to Change Page 40PBM/Payor Plan Name/Contract Name BIN PCN GROUP Type Network Location Help Desk ...Pharmacy 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 QUALIFIERexceeding 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?Nov 5, 2022 · 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. 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 M1-800-788-7871 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 ...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: 800-788-7871All other Plans: 800-788-7871 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field ... 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 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 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 .Customer Service Center (877) 453-9198 Pharmacy (800) 788-7871 CCSB Agent Service Center (855) 777-6782 Group Service / Administration (800) 591-9911 CCSB New Business Sales (844) 332-8384 Enrollment & Eligibility Fax (866) 372-1316 Delta Dental VSP Member Services Member Services (800) 877-7195You 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 ...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?Customer Service Center (877) 453-9198 Pharmacy (800) 788-7871 CCSB Agent Service Center (855) 777-6782 Group Service / Administration (800) 591-9911 CCSB New Business Sales (844) 332-8384 Enrollment & Eligibility Fax (866) 372-1316 Delta Dental VSP Member Services Member Services (800) 877-7195exceeding 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 (for coverage verification) (888) 543-1369 or www.optumrx.com (Customer Service) 4 NCDS Healthcare Plan (Rev. January 2021) SUMMARY SCHEDULE OF BENEFITS 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.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 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 ...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 ... 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. Fax: 1-800-311-0185. Find contact information for immunoglobulin experts Contact our dedicated immunoglobulin team: Phone: 1 ... 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) 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: 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. ______________________________________________________________________________________________________________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:(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 BENEFITSor liveandworkwell.com 1-800-842-2065 OptumRx® • Phone: 1-800-788-7871 Authorization: 1-800-711-4555 • Online: optumrx.com Dental National Options PPO (10, 20 or 30) • Phone: 1-877-816-3596 • Online: myuhc.com California Select Managed Care DHMO • Phone: 1-877-813-4259 • Online: myuhc.com Vision • Phone: 1-800-638-3120Pharmacy 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 MOptumRx 800-788-7871 www.optumrx.com Podiatry Plan of California (PPOC) 800-367-7762 www.podiatryplan.com UnitedHealthcare (UHC) 800-624-8822 www.MyUHC.comPres Solutions National 610494 9999 800/788-7871<br /> PacificSource Health Caremark National 610415 Varies 800-345-5413<br /> Paradigm- Missouri<br />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 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 .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 ... 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 Jul 13, 2017 · Report the unwanted call to the FTC as soon as possible. If you want to report an unwanted sales calls coming from an actual human being, you must have been on the Do Not Call Registry for at least 31 days beforehand. For robocalls, however, you can report the call immediately, whether or not you are on the registry. 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: 800-788-7871Or 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 1-234-201. Mahoning. Youngstown. Cellco Partnership Dba Verizon Wireless - Oh. 1-234-202. Summit. Akron. Cellco Partnership Dba Verizon Wireless - Oh. 1-234-203.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: 800-788-7871 MedImpact Commercial 003585, 011917, P: 800-788-2949 Commercial Extended Day 012882, 014988, E: [email protected] Discount Card Programs 015400, 015441, Credentialing: [email protected] Medicaid 015517, 015574, Medicare D 015921, 017142, Medicare D Extended Day 018050, 018596, Medicare D LTC 018605, 020008 ...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. 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 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 COUNTJul 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, 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) Mexceeding 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 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 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.POS message: LA Opioid Dup Therapy, MD Cnslt: use TD-M0-1G; Exmpt:use PPS code; RxHelp 800-788-7871 Reject code: 88. Pharmacist conducts additional safety review to determine if the patient’s opioid use is safe and clinically appropriate. Use standard NCPDP PPS codes to resolve at POS. 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 MFor 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).All other Plans: 800-788-7871 Please Distribute Immediately. Thank you. Title: HI QExA Notification ICD9 Author: RxSolutions Created Date: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 Pharmacy Help Desk OptumRx 800-788-7871 MedalistRx Help Desk 855-633-2579 Pharmacy Help Desk FlexScripts 800-603-7796 Pharmacy Help Desk Cigna 8ØØ-244-6224 Other ... 800-788-7871. Get a call from 8007887871? Read comments below to find details about this number. Report unwanted calls to help identify who is calling.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.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 800-788-7871. Get a call from 8007887871? Read comments below to find details about this number. Report unwanted calls to help identify who is calling.Nov 5, 2022 · 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. RxHelp.ca. RxHelp card programs allow patients to benefit from payment assistance on their medication. Let us Help choose the best card for you. New RxHelp mobile app! The RxHelp mobile app is easy-to-use and saves you money on prescriptions. Best of all, you always have the discount card on your phone.Read more than 2 user reviews and security ratings for number 8007887871 / +1 800-788-7871, mostly rated as negative Scam call. Get our Free protection against unwanted calls.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). 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 VerificationMailing Address BOX 29044 Hot Springs, AR 71903. Member Website Medical & Pharmacy Member Service TFN 800-357-1371. UHC Provider Website UHC Provider TFN 877-842-3210. OptumRx Prior Auth TFN. 800-788-7871 (access to Prior Auth Tool via ). OptumRx Pharmacist TFN 800-788-7871. 800-788-7871 (access to Prior Auth Tool via www.unitedhealthcareonline ...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: 800-788-7871 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.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. Coast Longshore Division Caucus unanimously votes to send tentative agreement to membership 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 to800-788-7871, 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.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.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 prescriptionOptumRx: 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 TRANSACTIONPharmacy 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) 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.RxHelp.ca. RxHelp card programs allow patients to benefit from payment assistance on their medication. Let us Help choose the best card for you. New RxHelp mobile app! The RxHelp mobile app is easy-to-use and saves you money on prescriptions. Best of all, you always have the discount card on your phone.
1-234-201. Mahoning. Youngstown. Cellco Partnership Dba Verizon Wireless - Oh. 1-234-202. Summit. Akron. Cellco Partnership Dba Verizon Wireless - Oh. 1-234-203.. Hypothermia
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 ... Jul 28, 2021 · 800-788-7871. Get a call from 8007887871? Read comments below to find details about this number. Report unwanted calls to help identify who is calling. 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.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 ...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?Pharmacy Help Desk OptumRx 800-788-7871 MedalistRx Help Desk 855-633-2579 Pharmacy Help Desk FlexScripts 800-603-7796 Pharmacy Help Desk Cigna 8ØØ-244-6224 Other ...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.comPharmacy Help Desk OptumRx 800-788-7871 MedalistRx Help Desk 855-633 -2579 . Pharmacy Help Desk FlexScripts 800-603-7796 .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 ... 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 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 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 ....