For Pharmacists

Claims Information

The following information will assist you in submitting claims to PBM Plus.

• Claim adjudication requires any NCPDP Version 3 or Version 5 transaction.
• The BIN (Bank Identification Number) is 610106.
• PBM Plus has distinct lines of business requiring the use of different Processor Control Numbers. Please refer to the PCN printed on the member's ID card.
• The member's ID Number is printed on the ID card. If a person code is listed, it should be placed in the Person Code Field. If letters are listed they should be included in the ID Number.
• Date of birth is required.
• Gender is required.
• Group Numbers are occasionally required and therefore should be submitted. If not required, an invalid group number will not cause the claim to reject.
• Pharmacy questions can be directed to 1-866-618-3494.
   

You may also need:

5.1 Payer Sheet (pdf)
HP RxCard (jpg)
HP Compound List (pdf)