Managed Care Organization & Fee-For-Service Billing Code

 Managed Care Organization (MCO)

  • The claim requires the BIN, PCN, and Group number for each specific MCO for correct processing.
  • Possible previous billing codes are not listed. Please contact specific MCO for past billing codes.
  • For possible changes since this posting, please reach out to each MCO.
Primary MCO Plan NameSecondary MCO Plan Name 
MCO Payer Billing Information RXBINMCO Payer Billing Information RXPCNMCO Payer Billing Information RXGRP
Aetna Better Health of Kansas
(CVS - PBM)		N/A610591N/ARX8849
Other Primary - Medicare Part DAetna Better Health of
Kansas		012114N/ARX8849
Other Primary - Commercial PlanAetna Better Health of
Kansas		013089N/ARX8849
Sunflower Health Plan
(Envolve/CVS - PBM)		N/A004336N/ARX5457
Other Primary - Medicare Part DSunflower Health Plan012114N/ARX5457
Other Primary - Commercial PlanSunflower Health Plan013089N/ARX5457
United Healthcare Community Plan of Kansas
(Optum Rx - PBM)		N/A6104949999ACUKS
Other Primary - Medicare Part DUnited Healthcare Community Plan of Kansas6104944848ACUKS
Other Primary - Commercial PlanUnited Healthcare Community Plan of Kansas6104949999ACUKS
Other Primary - Dual Complete (H5322-029)United Healthcare Community Plan of Kansas6100979999MPDCSKS
Other Primary - Dual Complete (H0169-004)United Healthcare Community Plan of Kansas6100979999MPDCSP


For Fee-for-Service (FFS)

Plan NameRXBINPCNRXGROUP
FFS Standard Processing - COB Scenario 3610517No PCNNo Group
FFS Medicare Part D Copay Assistance/Patient Responsibility - COB Scenario 2610517MEDDNo Group





Last updated March 2023