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/A610591ADVRX8849
Other Primary- Medicare Part DAetna Better Health of
Kansas
012114COBADVRX8849
Other Primary- Commercial PlanAetna Better Health of
Kansas
013089COMSEGADVRX8849
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 of the Midwest
(Optum Rx - PBM)
N/A6104949999ACUKS
United Healthcare of the Midwest (Optum Rx - PBM)United Healthcare of the Midwest6100979999MPDCSKS
Other Primary - Medicare Part DUnited Healthcare of the Midwest6104944848ACUKS
Other Primary - Commercial PlanUnited Healthcare of the Midwest6104949999ACUKS


For Fee-for-Service (FFS)

No PCN is required for processing.

Plan NameRXBINPCNRXGROUP
FFS610517No PCNNo Group