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Information for Pharmacists and Health Care Professionals.

Contact information, forms, Medicare and Medicaid training, provider credentialing, and more.

Emergency Response Documents

Download PDFs of the emergency response documents you need.

Information for Pharmacists and Medical Professionals.

We provide health professionals with easy access to CVS Caremark® Mail Service for processing your patients’ new prescriptions. For immediate processing, simply submit a prescription using your ePrescribing tool.

Use Your ePrescribing Tool

To ePrescribe:

CVS Caremark Mail Service Pharmacy
NCPDP ID: 0322038
9501 E. Shea Blvd.
Scottsdale, AZ 85260

For Specialty prescriptions choose:

CVS Specialty
NCPDP ID 1466033
800 Biermann Court
Mount Prospect, IL 60056

For ePrescribing questions, call us at 1-877-864-7744 (TTY: 711). 
Monday through Friday
9 a.m. to 7:30 p.m. (ET)

Fax in the Prescription:

Download the mail service prescription fax form*, complete it and fax it to 1-800-378-0323 (TTY: 711)
*This form is for health professionals only.

For Specialty prescriptions choose:

CVS Specialty
NCPDP ID #1466033

Fax: 1-800-323-2445 (TTY: 711)
Phone: 1-800-237-2767 (TTY: 711)
Mail: 800 Bierman Ct., Mount Prospect, IL 60056

Specialty Hours of Operations: Monday to Friday, 7:30 AM to 7:30 PM (local time)

Learn how to submit electronic prior authorization information, get important information and view frequently asked questions.

View Electronic Prior Authorization Information 

We’re here to help. For questions related to processing a retail pharmacy prescription claim, call the toll-free number listed below.

Bin #               Phone Number

004336            1-800-364-6331 TTY: 711

610415            1-800-364-6331 TTY: 711

610239            1-800-364-6331 TTY: 711

610591            As communicated by plan or refer to ID card

610502            1-800-238-6279 TTY: 711

020099            1-800-296-5037 TTY: 711

020115            1-800-296-5037 TTY: 711

020107            1-800-296-5037 TTY: 711

020123            1-800-296-5038 TTY: 711

020388            1-800-296-5038 TTY: 711

020396            1-800-296-5038 TTY: 711

021007            1-800-296-5038 TTY: 711

021338            As communicated by plan or refer to ID card

610084            As communicated by plan or refer to ID card

Hours of Operation

24 Hours a Day / 7 Days a Week / 365 Days a Year

Helpful information for Retail Providers

Verification of Eligible Persons

Providers will be paid only for claims in which a prescription for a covered item is written by a prescriber for an eligible person and is dispensed to that person. CVS Caremark and/or plan sponsors will provide eligible persons with identification cards. Providers must request the ID card from the eligible person and utilize the information on the card to submit claims. Providers will not be paid for providing pharmacy services related to covered items to an eligible person whose eligibility was not correctly submitted.

Here at CVS Caremark, your needs are important to us. Please do not hesitate to call us directly.

New Mail Rx Number

1-800-378-5697 TTY: 711

Monday through Friday
8 a.m. to 6:30 p.m. CT

Find links to up-to-date, reliable drug information.

View Clinical Drug Information

FAQs for Prescribers Office Staff

CVS Caremark helps more than 100 million members get the medications they need by working with their plan sponsors to provide cost effective, comprehensive prescription benefit plans. We offer the convenience of a nationwide network of more than 68,000 pharmacies and the option of Rx Delivery by Mail through CVS Caremark Mail Service Pharmacy.

Rx Delivery by Mail is a convenient and cost-effective way for your patients to fill up to a 90-day supply of eligible long-term medications with no-cost shipping. With most prescription plans, members save money when they fill by mail.

Because it takes 7 to 10 business days to process a mail service prescription, you may wish to write an additional 30-day prescription that your patient can fill at retail pharmacy right away. Mail service prescriptions are typically written for up to a 90-day supply with three refills.

RxSavingsPlus provides eligible participants with savings of up to 80% on generic drugs and up to 40% on brand name drugs* at 65,000 participating pharmacies nationwide. Participants without health benefits can also save at MinuteClinic, with up to 15% off health services or screenings. It’s available to patients without prescription coverage or to patients taking medications that are not covered by their prescription plan. For more information, visit RxSavingsPlus.com or call 1-877-673-3688 TTY: 711.

*Average savings of 55% for generics and 24% for brands.

FAQs for Pharmacists and Pharmacy Staff

If a member’s eligibility information is incorrect and a provider submits a claim using the correct information, the claim will reject. In most cases, we can assist the provider at the point of service. Please advise your customers that they should inform their plan sponsors of any incorrect information and remind them that claims will continue to reject until it is corrected.

The identification number can be found on the member’s ID card. The Help Desk is not able to provide identification numbers.

The RXGRP number and other data can be found on the member’s ID card. Please be sure to check both sides of the card for the necessary information.

Yes. If there is an RXPCN number on the member’s ID card it must be submitted exactly as it appears on the card. If there is no RXPCN, submit the default number according to the Banking Identification Number (RXBIN) listed in the appropriate Payer Sheet.

Submit the claim through the claims system to receive the adjudicated response, which will include the amount owed by the member, as well as information on eligibility, plan coverage, pricing, and applicable clinical programs and services. The Help Desk is not able to provide this information.

Many plan sponsors allow members to receive an early refill for vacation. Submit the claim as usual and contact the Help Desk for coverage verification if the claim rejects. If the plan sponsor allows vacation supplies, the representative will provide a prior authorization code.

Providers should note the adjudication response, which typically includes online re-transmission instructions or the appropriate contact information.

Submit a claim through the claims system to receive an adjudicated response, which will include messaging about plan coverage. The Help Desk cannot provide this information.

The Help Desk will help providers determine which data fields should be used for specific data whenever possible. Because there are many different types of software, however, representatives may not be familiar with your system setup. Providers should consult their software vendor or chain headquarters for technical assistance.

Press 0 at any time during the call to connect with a representative.

Unless otherwise specified, use RXBIN 004336. In most cases, the RXBIN is on the member’s ID card.

Guides, Alerts and Lists

Downloadable drug lists and guides

View and download standard and specialty drug lists, prescribing guides and other formulary information.

Please note that custom drug lists that are not included here.

Members should register or sign in at Caremark.com to check drug costs and coverage.

View drug lists and guides

Get details on current and past drug safety alerts and recalls issued by the US Food and Drug Administration (FDA)

View drug safety alerts

View and download the CVS Caremark Opioid Quantity Limits Pharmacy Reference Guide.

View the opioid reference guide

Digital Enrollment Forms

Request enrollment in CVS Caremark Med D networks online.

Start the enrollment process

Pharmacists and pharmacy managers can complete the pre-enrollment questionnaire online. This is the first step to requesting enrollment in CVS Caremark pharmacy networks.

Complete pre-enrollment questionnaire

Access the pharmacy change form, the pharmacy provider question form, FAQs, and client-reported pharmacy updates.

Go to enrollment self service

State Specific Forms & Guides

Medicare and Medicaid Compliance Training for Pharmacy Staff

View and download the CVS Health Code of Conduct for colleagues and business partners.

View the Code of Conduct

View and download Medicare Parts C and D General Compliance Training Course 

View Medicare Parts C and D General Compliance Training

View and download Combating Medicare Parts C and D Fraud, Waste, and Abuse Web-Based Training Course

View CMS Combating FWA Training

Provider Credentialing

Log in and complete the online Standard Re-Credentialing form.

Go to the Standard Re-Credentialing form

Log in and complete the online ACA 42 CFR 455 Re-Credentialing form.

Go to the ACA 42 CFR 455 Re-Credentialing form

Complete the State of New York Americans with Disabilities Act Attestation online.

Go to the State of NY ADA Attestation form

Note to Pharmacies:

For IngenioRx claims or for BIN 610502 claims, please refer to the CVS Caremark® payer sheets.
Download PDFs of the emergency response documents you need.

Primary Claim NCPDP Version D.0 Payer Sheets

View and download the Medicare Primary Payer Sheet.

Medicare Primary Payer Sheet 

View and download the Medicaid Primary Payer Sheet.

Medicaid Primary Payer Sheet

View and download the Commercial Primary Payer Sheet.

Commercial Primary Payer Sheet

COB Claim NCPDP Version D.0 Payer Sheets

View and download the payer sheets based on the applicable supplemental plan.

Supplemental Plan: Medicaid

Medicaid COB – OPAP

Medicaid COB – OPPR
 

Supplemental Plan: Commercial

Supplemental to MEDD – OPAP

Supplemental to MEDD – OPPR
 

Supplemental Plan: ADAP/SPAP

MEDD ADAP/SPAP – OPPR

View and download the payer sheets based on the applicable supplemental plan.

Supplemental Plan: Commercial

Commercial COB – OPAP

Commercial COB – OPPR

View and download the payer sheets based on the applicable supplemental plan.

Supplemental Plan: Med D

Medicare as Secondary Payer Sheet
 

Supplemental Plan: Medicaid

Medicaid COB – OPAP

Medicaid COB – OPPR

Supplemental Plan Commercial:

Commercial COB – OPAP

Commercial COB – OPPR

NCPDP Pharmacy Reject Code Reference

View and download the Pharmacy Reject Code Reference Payer Sheet

Pharmacy Reject Code Reference Payer Sheet