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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.

Payer/Processor Name: CVS Caremark® Plan Name/Group Name: All . Effective as of: October 2Ø2Ø ... 3Ø9-C9 Eligibility Clarification Code RW Required when necessary for plan ... 465-EY Provider ID Qualifier Ø2 R Ø2 – State License Number

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