Search published routes by BIN, PCN, payer, plan, state, or program. The directory covers dated public sources, not every client-specific combination. For a live claim, use the current card, eligibility response, coupon, or payer instruction.
On a smaller screen, scroll the table to see the processor, RxGroup, and published source columns.
| RX BIN | Published PCN examples | Processor or program | RxGroup | Published source |
|---|---|---|---|---|
| CVS Caremark | ||||
| 004336 | ADV, RXSADV, DCADV, WAL | Legacy ADV commercial routes | Card; required | Commercial v2.0.8 |
| 004336 | MEDDADV, 77993322 | Medicare Part D routes | Card or E1 response | Medicare v2.0.7, Jan. 2026 |
| 020099 | AC, CH, WG, FC, WK, WP, IS, CS | Commercial client routes | Card; required | Commercial v2.0.8 |
| 020123 | IRXCOMM | Commercial client routes | Card; required | Commercial v2.0.8 |
| 021338 | ADV, RXSADV, DCADV | Commercial client routes | Card; required | Commercial v2.0.8 |
| 025201 | MOHMKP | Molina client route | Card; required | Commercial v2.0.8 |
| 026150 | SSRX50 | ScriptServ client route | Card; required | Commercial v2.0.8 |
| 027547 | SSRX42 | Named health-system route | Card; required | Commercial v2.0.8 |
| 027555 | SSRX42 | Named health-system route | Card; required | Commercial v2.0.8 |
| 027570 | SSRX42 | Named health-system route | Card; required | Commercial v2.0.8 |
| 028406 | OSCAR | Oscar client route | Card; required | Commercial v2.0.8 |
| 028512 | SSRX42 | Named health-system route | Card; required | Commercial v2.0.8 |
| 610239 | FEPRX | Federal Employee Program | 65006500 | Commercial v2.0.8 |
| 610415 | PCS, ADV | Legacy PCS routes | Card; required | Commercial v2.0.8 |
| 610502 | 00670000, AETCRXC | Aetna commercial routes | Card; required | Commercial v2.0.8 |
| 610502 | MEDDAET, PARTBAET | Aetna Medicare Part D and Part B | Card or E1 response | Medicare v2.0.7, Jan. 2026 |
| 610591 | MEDDADV | Medicare Part D routes | Card or E1 response | Medicare v2.0.7, Jan. 2026 |
| 020388 | IRXMEDD, IRXMAON, IRXPARTB | Caremark Medicare Part D and Part B routes | Card or E1 response | Medicare v2.0.7, Jan. 2026 |
| 028272 | MOHMCARE, MOHPARTB | Molina Medicare Part D and Part B routes | Card or E1 response | Medicare v2.0.7, Jan. 2026 |
| OptumRx | ||||
| 001553 | TNM, CKDS | TennCare client routes | See source | Commercial and Medicaid 2026 |
| 011172 | SCCMS | Kaiser Southern California Medicare | Card or E1 response | CMS July 2026 extract |
| 011214 | Regional PCN in source | Kaiser Medicare regional route | Card; required | Medicare 2026 |
| 011222 | Regional PCN in source | Kaiser Medicare regional route | Card; required | Medicare 2026 |
| 011230 | NWCMS | Kaiser Northwest Medicare | Card or E1 response | CMS July 2026 extract |
| 011255 | COCMS | Kaiser Colorado Medicare | Card or E1 response | CMS July 2026 extract |
| 011842 | NCCMS | Kaiser Northern California Medicare | Card or E1 response | CMS July 2026 extract |
| 011859 | MACMSA | Kaiser Mid-Atlantic Medicare | Card or E1 response | CMS July 2026 extract |
| 011933 | IAPOP | Iowa Medicaid client route | See source | Commercial and Medicaid 2026 |
| 013170 | Not required | Seniorscript Medicare route | Card | Medicare 2026 |
| 014293 | WYOPOP | Wyoming Medicaid client route | See source | Commercial and Medicaid 2026 |
| 015789 | CTRXMEDD and named client PCNs | Medicare client routes | Card; required | Medicare 2026 |
| 015855 | UTPOP | Utah Medicaid client route | See source | Commercial and Medicaid 2026 |
| 016580 | Not published | MedalistRx client route | Card | Commercial and Medicaid 2026 |
| 017522 | AC | Ascella client route | Card; required | Commercial and Medicaid 2026 |
| 019827 | HT | MedlessRx client route | Card; required | Commercial and Medicaid 2026 |
| 021692 | CTRXMEDD | BlueCross BlueShield of South Carolina Medicare | Card; required | Medicare 2026 |
| 022485 | STL | CerpassRx client route | Card; required | Commercial and Medicaid 2026 |
| 023153 | HT | SavaScript client route | Card; required | Commercial and Medicaid 2026 |
| 025771 | RX42AS | BlueCross BlueShield of South Carolina route | Card; required | Commercial and Medicaid 2026 |
| 025796 | Varies by client | CareCard routes | Card; required | Commercial and Medicaid 2026 |
| 220026 | EMRXMA | BCBS Michigan Emergient Medicare route | Card; required | Medicare 2026 |
| 262400 | RXBCMA | BCBS Michigan SHS Medicare route | Card; required | Medicare 2026 |
| 610011 | Varies by named client | Commercial and Medicare client routes | Card; required | Medicare 2026 |
| 610097 | 9999, 7777 | Part D and MAPD routes | Card; required | Medicare 2026 |
| 610097 | 8888, 8500 | Part D wrap routes | Card; required | Medicare 2026 |
| 610127 | 04000001, 04000002, and other wrap PCNs | Commercial coordination-of-benefits routes | Card; required | COB payer sheet 2026 |
| 610279 | 9999, CONTRAC, 7777 | UHC employer, contraceptive-only, and exchange routes | Card; required | UHC 610279 sheet 2026 |
| 610494 | 9999, 2417, and state client PCNs | Commercial and Medicaid routes | Card; required | Commercial and Medicaid 2026 |
| 610494 | 2222 | UnitedHealthcare government programs | Card; required | Medicare 2026 |
| 610593 | HNEMEDD, SXCFLH | Medicare client routes | Card; required | Medicare 2026 |
| 610613 | 2417 | Community Health client route | Card; required | Commercial and Medicaid 2026 |
| 610652 | Varies by plan | AARP client routes | Card; required | Commercial and Medicaid 2026 |
| Prime Therapeutics | ||||
| 004915 | Not required, WRI, CPAL | BCBS Alabama and named commercial routes | Card; required | Commercial sheet, Dec. 2025 |
| 610455 | KSBCS, BCBSKS, LGHIBRX, SEIBRX, NY1000 | Kansas and EmblemHealth commercial routes | Card; required | Commercial sheet, Dec. 2025 |
| 610455 | NY4000, NY4020 | EmblemHealth Medicare and prescription carveout routes | Card; required | Prime Perspective, Dec. 2025 |
| Additional PBMs and processors | ||||
| 610602 | From card; NVTD, MCD, and NVT examples | Navitus commercial, Medicare, and Medicaid client routes | Card or program instruction | Navitus manual v202601 |
| 012312 | PARTD | MedImpact-administered route used by multiple current Part D sponsors | Card or E1 response | CMS July 2026 extract |
| 015574 | ASPROD1 | MedImpact Part D route in current CMS plan records | Card; required | CMS 2026 BIN/PCN file |
| 020040 | Multiple client PCNs | MedImpact route for legacy Archimedes clients | Card; required | Legacy Elixir sheet, Apr. 2025 |
| 020594 | Multiple client PCNs | MedImpact route for legacy Archimedes clients | Card; required | Legacy Elixir sheet, Apr. 2025 |
| 023491 | Multiple client PCNs | MedImpact route for legacy Archimedes clients | Card; required | Legacy Elixir sheet, Apr. 2025 |
| 610852 | CHM or client-specific | Judi Rx, formerly Capital Rx, commercial routes | Card; required | Judi Rx pharmacist resources |
| 610770 | CAPLRX or client-specific | Judi Rx commercial routes | Card; required | Judi Rx pharmacist resources |
| 610770 | CRXMD | Judi Rx Medicare route in current CMS plan records | Card; required | CMS 2026 BIN/PCN file |
| 610674 | Client-specific; abarcaD Medicare example | Abarca commercial, Medicaid, and Medicare routes | Card; required | Abarca provider manual |
| Current independent PBM payer sheets | ||||
| 015433 | SSN | Liviniti commercial pharmacy claims | Current card | Liviniti pharmacy manual, Mar. 2026 |
| 021882 | 201907 | SmithRx route | Current card | SmithRx payer sheet, Oct. 2025 |
| 019025 | 8001002, 5289 | SmithRx routes | Current card | SmithRx payer sheet, Oct. 2025 |
| 024368 | 3207, 3208, 3210, 3211, 3212, or plan-specific | SmithRx routes | Current card | SmithRx payer sheet, Oct. 2025 |
| 023211 | WMHRX | SmithRx route | Current card | SmithRx payer sheet, Oct. 2025 |
| 024789 | WMHRX | SmithRx route | Current card | SmithRx payer sheet, Oct. 2025 |
| 028017 | 4001 | SmithRx route | Current card | SmithRx payer sheet, Oct. 2025 |
| 028025 | 4002 | SmithRx route | Current card | SmithRx payer sheet, Oct. 2025 |
| 028363 | 4003 | SmithRx route | Current card | SmithRx payer sheet, Oct. 2025 |
| 028371 | 4004 | SmithRx route | Current card | SmithRx payer sheet, Oct. 2025 |
| 028389 | 4005 | SmithRx route | Current card | SmithRx payer sheet, Oct. 2025 |
| 028397 | 4006 | SmithRx route | Current card | SmithRx payer sheet, Oct. 2025 |
| 008878 | WDRX, NETCARD, TCN, UFCW, or card-specific | WellDyne commercial routes | Current card | WellDyne payer sheet, Oct. 2025 |
| 015723 | TRIADCR | WellDyne Triad Care | Current card | WellDyne payer sheet, Oct. 2025 |
| 019173 | Not required | WellDyne Eagle Pharmacy / Knipper Health | Current card | WellDyne payer sheet, Oct. 2025 |
| 015962 | PDC | WellDyne Palliative Drug Care Rx | Current card | WellDyne payer sheet, Oct. 2025 |
| 024433 | Card-specific | WellDyne PDCRxMX / Medalist Rx | Current card | WellDyne payer sheet, Oct. 2025 |
| 024441 | Card-specific | WellDyne PDCRx | Current card | WellDyne payer sheet, Oct. 2025 |
| 025036 | ORX26 | WellDyne OrchestraRx | Current card | WellDyne payer sheet, Oct. 2025 |
| 025219 | WDBRx | WellDyne BESTRx | Current card | WellDyne payer sheet, Oct. 2025 |
| 025359 | SELECT | WellDyne Select | Current card | WellDyne payer sheet, Oct. 2025 |
| 025961 | SRXLB, SELECTRX | WellDyne SelectRx limited-benefit routes | Current card | WellDyne payer sheet, Oct. 2025 |
| 026142 | SSRX42 | WellDyne Children’s Nebraska / ScriptServ | Current card | WellDyne payer sheet, Oct. 2025 |
| Medicare and federal program routes | ||||
| 610097 | 9999 | OptumRx Part D and Medicare Advantage prescription drug records | Card or E1 response | CMS 2026 extract |
| 015581 | 03200000 | Broadly reused Part D route; group and member ID remain plan-specific | Card or E1 response | CMS 2026 extract |
| 610502 | MEDDAET | Aetna Medicare processing through CVS Caremark | Card or E1 response | CMS 2026 extract |
| 004336 | MEDDADV | CVS Caremark Medicare Part D records | Card or E1 response | CMS 2026 extract |
| 610014 | MEDDPRIME | Express Scripts-administered route reused by Wellcare, Express Scripts Medicare, Highmark, and other sponsors | Card or E1 response | CMS 2026 extract |
| 020115 | IS | CVS Caremark Medicare route used by multiple sponsors | Card or E1 response | CMS 2026 extract |
| 017010 | CIMCARE | Cigna Medicare prescription drug records | Card or E1 response | CMS 2026 extract |
| 003858 | MD | Express Scripts-administered route used by multiple Medicare sponsors | Card or E1 response | CMS 2026 extract |
| 610011 | CTRXMEDD | OptumRx Medicare client records | Card or E1 response | CMS 2026 extract |
| 610602 | NVTD | Navitus-administered route used by Geisinger, Moda, and other sponsors | Card or E1 response | CMS 2026 extract |
| 610455 | AHPPARTD | Alignment Health Plan Medicare route processed by Prime Therapeutics | Card or E1 response | CMS 2026 extract |
| 611791 | CARELONRX | CarelonRx Part D records | Card or E1 response | CMS 2026 extract |
| 610674 | abarcaD | Abarca Medicare records | Card or E1 response | CMS 2026 extract |
| 015581 | 03200008 | CarePlus Medicare plans; do not substitute for the more widely reused 03200000 route | Card or E1 response | CMS 2026 extract |
| 026696 | 77993322 | Blue Shield of California Medicare plans | Card or E1 response | CMS 2026 extract |
| 012635 | NA | Independent Health and Pharmacy Benefit Dimensions Medicare plans | Card or E1 response | CMS 2026 extract |
| 610674 | PHPMEDDRX | Prominence Health Plan Medicare records | Card or E1 response | CMS 2026 extract |
| 012833 | MedDPrime | Florida Blue and BlueMedicare records; preserve the PCN casing returned by the card or E1 response | Card or E1 response | CMS 2026 extract |
| 015938 | 7463 | Select Health Medicare records | Card or E1 response | CMS 2026 extract |
| 610455 | SOMAPD | Solis Health Plans Medicare records | Card or E1 response | CMS 2026 extract |
| 020388 | IRXMEDD | CVS Caremark-administered Medicare Part D route used by multiple sponsors | Card or E1 response | CMS 2026 extract |
| 610455 | NY4000 | EmblemHealth Medicare records | Card or E1 response | CMS 2026 extract |
| 014897 | MBG | Blue Cross and Blue Shield of Alabama Blue Advantage records | Card or E1 response | CMS 2026 extract |
| 610455 | EMNH5959 | Blue Cross and Blue Shield of Minnesota Medicare Advantage records | Card or E1 response | CMS 2026 extract |
| 015905 | HMONC | Blue Cross and Blue Shield of North Carolina Blue Medicare HMO records | Card or E1 response | CMS 2026 extract |
| 610602 | EGWP | Navitus MedicareRx employer group records | Card or E1 response | CMS 2026 extract |
| 610455 | KSPDP | Blue Cross and Blue Shield of Kansas Blue MedicareRx PDP records | Card or E1 response | CMS 2026 extract |
| 004336 | ADV | Legacy ADV Part B route | Card or payer instruction | Caremark Medicare v2.0.7 |
| 004336 | PARTBADV | Legacy ADV Part B route | Card or payer instruction | Caremark Medicare v2.0.7 |
| 610502 | PARTBAET | Aetna Part B route | Card or payer instruction | Caremark Medicare v2.0.7 |
| 020115 | NS | Caremark-published Part B route | Card or payer instruction | Caremark Medicare v2.0.7 |
| 020388 | IRXMAON | Caremark-published Part B route | Card or payer instruction | Caremark Medicare v2.0.7 |
| 020388 | IRXPARTB | Caremark-published Part B route | Card or payer instruction | Caremark Medicare v2.0.7 |
| 028272 | MOHPARTB | Molina Part B route effective January 1, 2026 | Card or payer instruction | Caremark Medicare v2.0.7 |
| 004336 | 77993355 | Caremark-published Part B route | Card or payer instruction | Caremark Medicare v2.0.7 |
| 0022188 | PSTMEDD | PACE records across many organizations; this is a seven-character processor ID or IIN | Current PACE card or E1 response | CMS July 2026 extract |
| 024748 | GRNMEDD | PACE records across multiple organizations | Current PACE card or E1 response | CMS July 2026 extract |
| 016110 | PACE | PACE records across multiple organizations | Current PACE card or E1 response | CMS July 2026 extract |
| 610097 | MPPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610649 | MPPP7777 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610502 | MPPPOR | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 004336 | MPPPOR | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610014 | MPPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 020115 | MPPPOR | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 017010 | MPPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 003858 | MPPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610011 | MPPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 027133 | MPPPPROD1 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 011552 | MPPPHCSC | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 027100 | MPPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPPARTD | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 012312 | MPPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 611791 | MPPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610674 | MPPPTSSADV | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPCAP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610649 | MPPP8888 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 011842 | MPPPNC | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 012833 | MPPPFL | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 024896 | MPPP65 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 026696 | MPPP3322 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610674 | MPPPPROD1 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 011859 | MPPPMA | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610623 | MPPP021000 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610770 | MPPPCRX | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 027357 | MPPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPSO | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 004336 | MPPOR | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 011255 | MPPPCO | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 011172 | MPPPSC | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 0022188 | PSTMEDD | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 020388 | MPPPOR | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610011 | MPPPWA | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPPARTDG | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 016499 | MPPPNJ | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 600428 | MPPP0299 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 015905 | MPPPNC | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPRI | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 021692 | MPPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPMN | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 004336 | MEDDADV | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 011214 | MPPPHI | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 011222 | MPPPGA | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPKS | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPMAPD | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610953 | MPPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPNE | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 011230 | MPPPNW | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 024748 | GRNMEDD | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPHCSC | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 014897 | MPPPMBG | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 024756 | ASCHMEDD | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPCHP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPCS | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610623 | MPPP021100 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 014897 | MPPPPLX | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 027133 | MPPPPROD01 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPCHPG | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPPB | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610593 | MPPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610623 | MPPP021200 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 014897 | MPPPRD | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 015574 | MPPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 019439 | MPPP3000 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 019439 | MPPP3841 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 019587 | MPPP0619 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 019587 | MPPP11802 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 020289 | MPPPEH | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 022118 | PSTMEDD | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610011 | CTRXMEDD | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPPDP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610591 | MPPPPOR | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 0022188 | PSTNEDD | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 012312 | MPPPE1 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 015905 | MPPPNCS | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 017010 | MPP | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 019587 | MPPP11819 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 019587 | MPPP11820 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 027133 | MPPPPROD | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 027174 | MPPPRXA | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 600428 | MPPP0333 | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPGCMAPD | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610455 | MPPPSB | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 610591 | MPPPOR | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 611139 | MPPPOR | Medicare Prescription Payment Plan COB route | Paid primary response supplies the route | CMS July 2026 extract |
| 003858 | A4 | TRICARE pharmacy program | DODA | TRICARE FAQ, Oct. 2024 |
| 015599 | 05440000 | Medicare LI NET | May be blank | CMS LI NET resources |
| 028918 | MEDDGLP1BR | Medicare GLP-1 Bridge, effective July 2026 | Program-specific | CMS pharmacy instructions, July 2026 |
| State Medicaid fee-for-service and managed-care routes | ||||
| 004146 | Not used | Alabama Medicaid FFS | Not used | Alabama NCPDP companion guide, May 2026 |
| Not published | Not published | Alaska Medicaid | Not published | Alaska Medicaid pharmacy resources |
| 001553 | AZM | Arizona AHCCCS FFS | Blank | 2026 AHCCCS route table |
| 017606 | P027017606 | Arkansas Medicaid FFS | ARMEDICAID | Arkansas pharmacy document library |
| 022659 | 6334225 | California Medi-Cal Rx | See program field rules | May 2026 payer specification |
| 018902 | P303018902 | Colorado Medicaid FFS | COMEDICAID | Colorado Medicaid payer sheet, effective April 2026 |
| No BIN | No PCN | Connecticut HUSKY Health | Not applicable | HUSKY Health FAQ |
| Plan-specific | Plan-specific | Delaware Medicaid managed care | Plan-specific | State plan table, revised December 21, 2023 |
| 018407 | DCMC018407 | District of Columbia FFS and Alliance | Alliance ICP | D.C. Transmittal 25-22 |
| 013352 | P035013352 | Florida Medicaid FFS | FLMEDICAID | Florida NCPDP payer specification |
| 001553 | GAM | Georgia Medicaid FFS | Not required | Georgia FFS payer sheet |
| 610084 | DRHIPROD | Hawaii Med-QUEST FFS | HAWAII1000; HAWAII2000 for OYS | Hawaii Medicaid payer sheet |
| 014864 | P043014864 | Idaho Medicaid FFS | IDMEDICAID | Idaho claims manual |
| 017804 | ILPOP | Illinois Medicaid FFS, ILPOP | Blank | Illinois payer sheet |
| 001553 | INM | Indiana Medicaid FFS | Not published | Indiana pharmacy services |
| 610517 | Blank | Kansas Medicaid FFS | Blank | Kansas FFS and MCO billing page |
| 026309 | KYPROD1 | Kentucky Medicaid FFS | KYF01 | Kentucky route table |
| 610514 | LOUIPROD | Louisiana Medicaid FFS | Blank | Louisiana Informational Bulletin 25-27 |
| 005526 | MEPOP | MaineCare FFS | Blank | April 2026 MaineCare provider newsletter |
| 610084 | DRMDPROD | Maryland Medicaid FFS | MDMEDICAID | Maryland state route notice |
| 009555 | MASSPROD | MassHealth FFS and PCC | MassHealth | MassHealth Pharmacy Facts 264 |
| 009737 | P008009737 | Michigan Medicaid FFS | MIMEDICAID | Michigan pharmacy benefit page |
| 026787 | 5309662024 | Minnesota state-administered pharmacy | Blank | Minnesota payer specification |
| 025151 | DRMSPROD | Mississippi Medicaid | Blank | Mississippi Medicaid pharmacy |
| 004047 | 43-1754897 | MO HealthNet FFS | Blank | MO HealthNet payer sheets |
| 610084 | DRMTPROD | Montana Medicaid FFS | 1509040; 0064206420 for MHSP | Montana payer sheet |
| 013766 | P063013766 | Nebraska Medicaid FFS | NEBMEDICAID | Nebraska payer specification |
| 024888 | 683377 | Nevada Medicaid FFS | NVMEDICAID | Nevada pharmacy provider FAQ |
| 009513 | P002002286 | New Hampshire Medicaid FFS | ALL | New Hampshire provider notice |
| 610515 | SUPP NJ | New Jersey Medicaid FFS | Not used | New Jersey pharmacy training Q&A |
| 028165 | DRNMPROD | New Mexico Medicaid FFS | See payer sheet | New Mexico FFS payer sheet |
| 004740 | Pharmacy-specific ETIN/PIN | New York Medicaid NYRx | Not used | NYRx provider guidance |
| 610242 | 781640064 | North Carolina Medicaid Direct | Blank | North Carolina pharmacy services |
| 601364 | DRNDPROD | North Dakota Medicaid FFS | NDMEDIFFS | North Dakota payer sheet |
| 024251 | OHRXPFFS | Ohio Medicaid FFS | Blank | Ohio SPBM FFS vendor specification v4.1, June 2026 |
| 010579 | OKA01 | Oklahoma SoonerCare | Pharmacy's 10-digit pay-to NPI | Oklahoma NCPDP payer sheet |
| 014203 | ORDHSFFS | Oregon Health Authority open card | Blank | Oregon pharmacy quick reference |
| 600760 | Not applicable | Pennsylvania Medicaid FFS | Not applicable | Pennsylvania pharmacy guidance |
| 610471 | MCAID1293 | Rhode Island Medicaid FFS | Not published | Rhode Island provider update |
| 009745 | P006009745 | South Carolina Medicaid FFS | SCMedicaid or SOC01 | South Carolina pharmacy provider portal |
| 601574 | Blank | South Dakota Medicaid FFS | Blank | South Dakota payer sheet |
| 001553 | TNM | Tennessee TennCare | Not applicable | TennCare pharmacy provider portal |
| 610084 | DRTXPROD | Texas Medicaid non-managed care | MEDICAID | Sample Your Texas Benefits card |
| 017795 | VTPOP | Vermont Medicaid | See program rules | Vermont pharmacy provider manual |
| 010900 | 8263342243 | Virginia Medicaid FFS | VAMEDICAID | Virginia NCPDP payer sheet |
| 024822 | DRWAPROD | Washington Apple Health FFS | CAID | Washington plan billing information |
| 610164 | DRWVPROD | West Virginia Medicaid | Blank | West Virginia pharmacy services |
| 610499 | Program-specific or blank | Wisconsin Medicaid and BadgerCare Plus | TXIX | ForwardHealth pharmacy claim specification |
| 610494 | 4100 | Arizona · UnitedHealthcare Community Plan (Acute, CRS, DD and LTC) | ACUAZ | AHCCCS route table |
| 003858 | MA | Arizona · Care1st | 2DVA | AHCCCS route table |
| 610591 | ADV | Arizona · Mercy Care DCS CHP, ACC, DD and LTC | RX8805 | AHCCCS route table |
| 001553 | AZMDDD | Arizona · Division of Developmental Disabilities FFS | Blank | AHCCCS route table |
| 004336 | MCAIDADV | Arizona · BCBAZ Health Choice Arizona | RX3898 | AHCCCS route table |
| 003858 | MA | Arizona · Arizona Complete Health | 2DZA | AHCCCS route table |
| 004336 | MCAIDADV | Arizona · Molina Healthcare | RX21EJ | AHCCCS route table |
| 004336 | MCAIDADV | Arizona · Molina KidsCare | RX21BE | AHCCCS route table |
| 004336 | MCAIDADV | Arizona · Molina Dual Eligible Plan | RX51BI | AHCCCS route table |
| 610014 | MA | Arizona · Banner University Family Care | BANBUHP | AHCCCS route table |
| 003858 | MA | Arizona · Banner University Family Care (alternate published BIN) | BANBUHP | AHCCCS route table |
| 610591 | ADV | Arizona · Mercy Care RBHA | RX8822 | AHCCCS route table |
| 020107 | IN | Indiana · Anthem | WKXA | Indiana pharmacy services |
| 003858 | MA | Indiana · CareSource | RXINN01 | Indiana pharmacy services |
| 610649 | 03191506 | Indiana · Humana PathWays | 28968 | Indiana pharmacy services |
| 003858 | MA | Indiana · MHS | 2EKA | Indiana pharmacy services |
| 610494 | 4841 | Indiana · UnitedHealthcare | ACUIN | Indiana pharmacy services |
| 020107 | IRXKS | Kansas · Healthy Blue Kansas | RX8481 | KanCare billing codes |
| 003858 | MA | Kansas · Sunflower Health Plan | 2ELA | KanCare billing codes |
| 610494 | 9999 | Kansas · UnitedHealthcare Community Plan | ACUKS | KanCare billing codes |
| 610591 | MCAIDADV | Louisiana · Aetna Better Health | RX881J | Louisiana pharmacy billing table |
| 019595 | 06030000 | Louisiana · AmeriHealth Caritas | Blank | Louisiana pharmacy billing table |
| 020107 | LA | Louisiana · Healthy Blue | RX8482 | Louisiana pharmacy billing table |
| 610649 | 03191502 | Louisiana · Humana Healthy Horizons | LAM01 | Louisiana pharmacy billing table |
| 003858 | MA | Louisiana · Louisiana Healthcare Connections | 2ENA | Louisiana pharmacy billing table |
| 610011 | IRX | Massachusetts · Fallon Health–Atrius, Berkshire Fallon, and Fallon 365 Care | FCHPMCD | MassHealth Pharmacy Facts 264 |
| 610593 | MHP | Massachusetts · Be Healthy Partnership Plan (HNE) | HNEMH | MassHealth Pharmacy Facts 264 |
| 610011 | ORX | Massachusetts · Mass General Brigham Health Plan with Mass General Brigham ACO | RX1653 | MassHealth Pharmacy Facts 264 |
| 610011 | IRX | Massachusetts · Tufts Health Together with CHA and UMass Memorial Health | RXMCDMA | MassHealth Pharmacy Facts 264 |
| 003858 | MA | Massachusetts · WellSense ACO partnerships and Essential MCO | MAHLTH | MassHealth Pharmacy Facts 264 |
| 610591 | ADV | Michigan · Aetna Better Health | RX8826 | Michigan health-plan route table |
| 019595 | PRX00621 | Michigan · Blue Cross Complete | Blank | Michigan health-plan route table |
| 003858 | MA | Michigan · HAP CareSource | CSHAPMI | Michigan health-plan route table |
| 017142 | ASPROD1 | Michigan · McLaren Health Plan | ML108; ML110; ML284; ML329 | Michigan health-plan route table |
| 003858 | MA | Michigan · Meridian Health Plan | 2EPA | Michigan health-plan route table |
| 004336 | MCAIDADV | Michigan · Molina Healthcare | RX0506 | Michigan health-plan route table |
| 003858 | MA | Michigan · Priority Health Choice | PHMEDCD | Michigan health-plan route table |
| 610494 | 4242 | Michigan · UnitedHealthcare Community Plan | ACUMI | Michigan health-plan route table |
| 003858 | MA | Michigan · Upper Peninsula Health Plan | UPHPMDC | Michigan health-plan route table |
| 019595 | PRX00801 | North Carolina · AmeriHealth Caritas | Blank | North Carolina pharmacy services |
| 020107 | NC | North Carolina · Healthy Blue and Healthy Blue Care Together | 8473 | North Carolina pharmacy services |
| 003858 | MA | North Carolina · Carolina Complete Health | 2ERA | North Carolina pharmacy services |
| 610494 | 4949 | North Carolina · UnitedHealthcare | ACUNC | North Carolina pharmacy services |
| 610602 | MCD | North Carolina · Alliance tailored plan | TPMC | North Carolina pharmacy services |
| 025052 | MCAIDADV | North Carolina · Partners tailored plan | RX22AC | North Carolina pharmacy services |
| 019595 | PRX10811 | North Carolina · Trillium tailored plan | Blank | North Carolina pharmacy services |
| 610602 | MCD | North Carolina · Vaya tailored plan | VAYARX | North Carolina pharmacy services |
| 024251 | OHRXPROD | Ohio · AmeriHealth, Anthem, Buckeye, CareSource, Humana, Molina and UnitedHealthcare | Blank | Ohio managed-care route guide |
| 003585 | 38900 | Oregon · Advanced Health | Blank | Oregon pharmacy quick reference |
| 003585 | 38060 | Oregon · AllCare | Blank | Oregon pharmacy quick reference |
| 003585 | 38960 | Oregon · Cascade Health Alliance | Blank | Oregon pharmacy quick reference |
| 610011 | IRX | Oregon · Columbia Pacific, Health Share–CareOregon and Jackson Care Connect | CORMCAID | Oregon pharmacy quick reference |
| 610602 | MCD | Oregon · Eastern Oregon CCO | 10009552 | Oregon pharmacy quick reference |
| 003585 | 70000 | Oregon · Health Share–Kaiser Permanente | KP007 | Oregon pharmacy quick reference |
| 004336 | ADV | Oregon · Health Share–Legacy/PacificSource and PacificSource Community Solutions | RX6156 | Oregon pharmacy quick reference |
| 017142 | ASPROD1 | Oregon · Health Share–OHSU Health | OHU01 | Oregon pharmacy quick reference |
| 600428 | 07870000 | Oregon · Health Share–Providence | 100598 | Oregon pharmacy quick reference |
| 610011 | IRX | Oregon · InterCommunity Health Network | SAMCAID | Oregon pharmacy quick reference |
| 610602 | NVT | Oregon · Moda Health OHP Dental (COFA and Veteran Dental) | COFAV | Oregon pharmacy quick reference |
| 003858 | MA | Oregon · Trillium Lane and Tri-County | 2EZA | Oregon pharmacy quick reference |
| 003585 | 38920 | Oregon · Umpqua Health Alliance | 38920 | Oregon pharmacy quick reference |
| 600428 | 07870000 | Oregon · Yamhill Community Care | YCCOPHTK | Oregon pharmacy quick reference |
| 019595 | 01940000 | Pennsylvania · AmeriHealth Caritas Pennsylvania and Keystone First | Blank | Pennsylvania FFS/MCO table |
| 019595 | 07630000 | Pennsylvania · AmeriHealth and Keystone First Community HealthChoices | Blank | Pennsylvania FFS/MCO table |
| 026010 | MCDG | Pennsylvania · Geisinger Health Plan | Blank | Pennsylvania FFS/MCO table |
| 004336 | MCAIDADV | Pennsylvania · Health Partners of Philadelphia | RX3892 | Pennsylvania FFS/MCO table |
| 004336 | MCAIDADV | Pennsylvania · Highmark Wholecare (Medicaid primary) | RX2338 | Pennsylvania FFS/MCO table |
| 003858 | MA | Pennsylvania · Pennsylvania Health & Wellness | 2FBA | Pennsylvania FFS/MCO table |
| 610494 | 4200 | Pennsylvania · UnitedHealthcare Community Plan | ACUPA | Pennsylvania FFS/MCO table |
| 610591 | ADV | Virginia · Aetna | RX8837 | Virginia health-plan route table |
| 020107 | FM | Virginia · Anthem | WQVVA | Virginia health-plan route table |
| 610649 | 03191507 | Virginia · Humana | VAM01 | Virginia health-plan route table |
| 003858 | MA | Virginia · Sentara | OHPMDCD; VPMMDCD; SHPMDCD | Virginia health-plan route table |
| 610494 | 4900 | Virginia · UnitedHealthcare | ACUVA | Virginia health-plan route table |
| 003858 | MA | Washington · Coordinated Care | 2FEA | Apple Health billing table |
| 003858 | APHE | Washington · Coordinated Care, Apple Health Expansion | AP2FEA | Apple Health billing table |
| 004336 | MCAIDADV | Washington · Molina Apple Health Integrated Managed Care | RX0540; RX0542; RX0543; RX0828; RX0574 | Apple Health billing table |
| 004336 | MCAIDWA | Washington · Molina Apple Health Expansion | RX51BP | Apple Health billing table |
| 610494 | 4600 | Washington · UnitedHealthcare Apple Health Integrated Managed Care | ACUWA | Apple Health billing table |
| 610494 | 4600 | Washington · UnitedHealthcare Apple Health Expansion | ACUWAAPL | Apple Health billing table |
| 020107 | CM | Washington · Wellpoint | WKHA | Apple Health billing table |
| 020107 | IRXCOBOPPR | Kansas · Healthy Blue secondary to Medicare Part D | RX8481 | KanCare billing codes |
| 020107 | IRXCOBOPAP | Kansas · Healthy Blue secondary to commercial coverage | RX8481 | KanCare billing codes |
| 003858 | KSMEDD | Kansas · Sunflower secondary to Medicare Part D | 2ELA | KanCare billing codes |
| 610494 | 4848 | Kansas · UnitedHealthcare secondary to Medicare Part D | ACUKS | KanCare billing codes |
| 610097 | 9999 | Kansas · UnitedHealthcare Dual Complete H0169-004 | MPDCSP | KanCare billing codes |
| 610097 | 9999 | Kansas · UnitedHealthcare Dual Complete H5322-029 | MPDCSKS | KanCare billing codes |
| 610517 | MEDD | Kansas · FFS Medicare Part D copay assistance, COB scenario 2 | Blank | KanCare billing codes |
| 012114 | MCAIDADV | Pennsylvania · Highmark Wholecare secondary to Medicare | RX2338 | Pennsylvania FFS/MCO table |
| 013089 | MCAIDADV | Pennsylvania · Highmark Wholecare secondary to commercial insurance | RX2338 | Pennsylvania FFS/MCO table |
| 012114 | COBADV | Washington · Molina secondary to Medicare Part D | RX0540; RX0542; RX0543; RX0828; RX0574 | Apple Health billing table |
| 013089 | COMADV | Washington · Molina secondary to commercial coverage | RX0540; RX0542; RX0543; RX0828; RX0574 | Apple Health billing table |
| Workers' compensation and first-fill routes | ||||
| 610566 | Blank | Washington L&I State Fund | Not used | Washington L&I payer sheet |
| 014658 | WSI | North Dakota WSI, LucyRx | 8001 | North Dakota WSI pharmacy services |
| 024004 | NVTWC | Oregon SAIF, Navitus | SAIF | SAIF medication instructions |
| 610235 | WRK | New York State Insurance Fund, CVS Caremark | NYSIF | NYSIF claimant guide and temporary form |
| 610084 | DRWDPROD | U.S. DOL DCMWC and DEEOIC, Conduent | Authorization-specific | DOL OWCP pharmacy portal |
| 004261 | CAL | Optum Tmesys, direct route | Client-specific | OptumRx pharmacy provider manual |
| 002538 | CAL | Optum Tmesys, Envoy route | Client-specific | OptumRx pharmacy provider manual |
| 004261 | CAL | Texas Mutual, Optum Tmesys | TXSMFF | Texas Mutual first-fill form |
| 003858 | WC | California State Fund, myMatrixx | CSCIF | California State Fund temporary card |
| 003858 | WC | Montana State Fund, myMatrixx | K9JA | Current Montana State Fund first-fill page |
| 019082 | MPS | KEMI, ScriptAdvisor | MPS001591TC | KEMI first-fill form |
| 023377 | MPS | CNA, ScriptAdvisor | 001731TC | CNA first-fill form |
| 003858 | WC | Chesapeake Employers or IWIF, myMatrixx | IWIF | Chesapeake first-fill page |
| 003858 | WC | Workers' Compensation Trust, myMatrixx | ESR3050 | WC Trust first-fill page |
| 003858 | WC | Universal Risk Services, myMatrixx | 77NA | Universal Risk first-fill page |
| 003858 | WC | Third Coast Underwriters, myMatrixx | KQTA | AF Group first-fill form |
| 004336 | ADV | CorVel, MEMIC named 2026 form | RXFFWC8757788 | MEMIC CorVel first-fill form |
| Prescription discount-card examples | ||||
| 019520 | NMeds | NeedyMeds standard card | DRUGCARD | Current NeedyMeds card |
| 006053 | MSC | ScriptSave WellRx | 8602 | Current WellRx coupon example |
| 019363 | 7283 | Inside Rx, people | SVECARD | Inside Rx card data |
| 019363 | 7283 | Inside Rx, pets | SVECD99 | Inside Rx card data |
| 003585 | 91200 | America's Pharmacy | ARX0302 | America's Pharmacy card |
| 003585 | ASPROD1 | Sam's Club Rx Savings, powered by America's Pharmacy | ALLMBR | Sam's Club card pass |
| 028257 | RXCO | RX.co | 2001 | RX.co discount card |
| 023252 | WCH, WDN, CHRX | WellDyne discount-card routes | Current card | WellDyne, Oct. 2025 |
| 008878 | WDN, WTZH | WellDyne and Waltz Health discount routes | Current card | WellDyne, Oct. 2025 |
| 020586 | WDN or card-specific | ChicagoRx Card and WellCardRx discount routes | Current card | WellDyne, Oct. 2025 |
| 014856 | Not required | RXDC discount route | Current card | WellDyne, Oct. 2025 |
| 018042 | Card-specific | RXDC discount route | Current card | WellDyne, Oct. 2025 |
| 020578 | Card-specific | RXDC discount route | Current card | WellDyne, Oct. 2025 |
| 017564 | Card-specific | RXDC discount route | Current card | WellDyne, Oct. 2025 |
| 017571 | Card-specific | RXDC discount route | Current card | WellDyne, Oct. 2025 |
| 018034 | WDF or card-specific | RxMedSaver discount route | Current card | WellDyne, Oct. 2025 |
| 018794 | Not required | Connect Health Solutions discount route | Current card | WellDyne, Oct. 2025 |
| 018506 | Not required | Connect Health Solutions discount route | Current card | WellDyne, Oct. 2025 |
| 022287 | WDN, 8969, or card-specific | CoastalRx discount routes | Current card | WellDyne, Oct. 2025 |
| 022725 | WDN | Discount Rx Savings route | Current card | WellDyne, Oct. 2025 |
| 021429 | FMC | Financial Marketing Concepts discount route | Current card | WellDyne, Oct. 2025 |
| 023070 | BRX or card-specific | Better Rx discount route | Current card | WellDyne, Oct. 2025 |
| 023534 | PRX or card-specific | PirateRx discount route | Current card | WellDyne, Oct. 2025 |
| 024334 | WDINT or card-specific | AffordableMeds discount route | Current card | WellDyne, Oct. 2025 |
| 024301 | WDN or card-specific | RxNxt discount route | Current card | WellDyne, Oct. 2025 |
| 024319 | WDN or card-specific | Crumdale Partners discount route | Current card | WellDyne, Oct. 2025 |
| 025367 | WDN or card-specific | Savascript Value Services discount route | Current card | WellDyne, Oct. 2025 |
| 022501 | WDN or card-specific | Savascript Value Services discount route | Current card | WellDyne, Oct. 2025 |
| 639858 | Named cash-card PCNs in source | Waltz Health Cash Card discount routes | Current card | WellDyne, Oct. 2025 |
When the directory and card disagree
NCPDP explains that it assigns processor BINs but does not track each number's later history. Processors publish current combinations through payer sheets, while plans communicate client-specific routes through cards and eligibility systems.
- The processor may have retired an older BIN or PCN after a directory source was published.
- The plan may use a client-specific PCN or group that is absent from a processor's public summary.
- The patient's profile may still contain a prior-year route after a plan change.
When the directory and a current payer response conflict, use the current response and document where the replacement route came from. For field behavior and routing rejects, use the RX BIN, PCN, and group guide. For the returned code itself, use the pharmacy claim reject-code reference.
Sources23 linked sources
- CVS Caremark commercial payer sheet v2.0.8, effective January 2026
- CVS Caremark Medicare payer sheet v2.0.7, effective January 2026
- OptumRx commercial and Medicaid payer sheet, effective January 2026
- OptumRx Medicare payer sheet, effective January 2026
- OptumRx UnitedHealthcare BIN 610279 payer sheet, effective January 2026
- OptumRx coordination-of-benefits payer sheet, effective January 2026
- Prime Therapeutics commercial payer sheet, published December 2025
- Prime Perspective fourth quarter 2025, published December 2025
- Navitus pharmacy provider manual v202601
- MedImpact legacy Elixir comprehensive payer sheet, April 2025
- CMS contract-plan BIN and PCN file, effective July 2026
- CMS Medicare Limited Income NET resources
- CMS Medicare GLP-1 Bridge pharmacy instructions, July 2026
- Judi Rx pharmacy resources
- Abarca pharmacy provider manual
- Liviniti pharmacy resources and Pharmacy Services Manual, March 2026
- SmithRx payer sheet, effective October 2025
- WellDyne current pharmacy resource page and commercial and discount payer sheet, dated October 2025
- MassHealth Pharmacy Facts 264, corrected 2026 BIN, PCN, and group list
- TRICARE pharmacy BIN, PCN, and group FAQ, October 2024
- NCPDP, Processor ID (BIN), assignment and tracking limits
- Medi-Cal Rx, Appendix D, NCPDP reject codes, April 2026