800 788 7871 - 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. ______________________________________________________________________________________________________________

 
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 QUALIFIER. Column

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 ...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 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 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) Mcall 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 Prescription Solutions. (800) 788-7871. This website is intended to be accessible and usable by people with and without disabilities. 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 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 drugso 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 .Aug 10, 2022 · 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 ... 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 ...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) Website Coast Longshore Division Caucus unanimously votes to send tentative agreement to membershipPharmacy 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 QUALIFIER 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) Websiteor 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: 1-800-638-3120OptumRx 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 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 QUALIFIER Health 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 […]Mailing 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 ... All other Plans: 800-788-7871 Please Distribute Immediately. Thank you. Title: HI QExA Notification ICD9 Author: RxSolutions Created Date: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 or 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 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 QUALIFIERFax: 1-800-311-0185. Find contact information for immunoglobulin experts Contact our dedicated immunoglobulin team: Phone: 1 ...9665 Rockside Road, Valley View, Ohio 44125 Pension: 216-781-6869 H&W: 216-781-6858A 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 ... 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.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 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. 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 MOptumRx: 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 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.All other Plans: 800-788-7871 Please Distribute Immediately. Thank you. Title: HI QExA Notification ICD9 Author: RxSolutions 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 NUMB ER DØ M 1Ø3 -A3 TRANSACTION CODE B1, B3 M 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 Fax: 1-800-311-0185. Find contact information for immunoglobulin experts Contact our dedicated immunoglobulin team: Phone: 1 ... 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 MOptum 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. 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 QUALIFIER 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.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) 877-7195All 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 ...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 ...Coast Longshore Division Caucus unanimously votes to send tentative agreement to membership 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 .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). 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.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?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.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 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 MFor 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.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 QUALIFIERThe 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 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. 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 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 QUALIFIER 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 ... 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.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.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.comRx 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: 800-788-7871Health 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 […]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) 877-7195Delta 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.comA 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 ...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) WebsiteFor 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. ______________________________________________________________________________________________________________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 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 MPHARMACY BIN & PCN NUMBERS The Rx BIN number is a 6-digit number health plans use to process electronic pharmacy claims. Rx BIN and PCN numbers are used by new members to pick up a new prescription (or refill) prior to having a new ID card or showing up in the new Carrier’s Rx system.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.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 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 drugso 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 . 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. 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 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 VerificationOptumRx: 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

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. Handwerkzeuge

800 788 7871

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 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).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 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. 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 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. 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?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.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. 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 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, 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 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 this review?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 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 .

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