Transcription of CVS CAREMARK PAYER SHEET
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CVS CAREMARK PAYER SHEET
CVS CAREMARK PAYER SHEET Commercial Primary Table of Contents HIGHLIGHTS Updates, Changes & Reminders .. 3 PART 1: GENERAL INFORMATION .. 4 Pharmacy Help Desk Information .. 4 PART 2: BILLING TRANSACTION / SEGMENTS AND FIELDS .. 5 PART 3: REVERSAL TRANSACTION .. 11 PART 4: PAID (OR DUPLICATE OF PAID) RESPONSE .. 13 PART 5: REJECT RESPONSE .. 18 APPENDIX A: BIN / PCN COMBINATIONS .. 22 Primary BIN and PCN Values .. 22 APPENDIX B: Sales Tax Submission .. 23 Sales Tax Billing Claim Submission .. 23 APPENDIX C: VACCINE PROCESSING .. 24 Commercial Vaccine Processing .. 24 APPENDIX D: COMPOUND BILLING .. 25 Route of Administration Transition .. 25 10/02/2020 Page 2 of 25 HIGHLIGHTS Updates, Changes & Reminders This PAYER SHEET refers to Primary Commercial Billing.
Aetna 610502 1-8ØØ-238-6279 IngenioRX : 020099 020123 1-833-296-5037 1-833-296-5038 CVS Caremark® ... Order / Specialty is submitting sales tax 10/02/2020 Page 7 of 25 . Pricing Segment: Mandatory ... 45Ø-EF Compound Dosage Form Description Code M 451-EG Compound Dispensing Unit Form …
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