Limited Benefit Plan
Member: $agent_company
Member ID: $CQ_MBA_Group_Number
Pharmacy Help Desk: (855) 798-2538
Provider Locator Assistance: (877) 858 1036
Provider Locator Website: locateprovidersnow.com
Limited Benefit Plan
Member: $agent_company
Member ID: $CQ_MBA_Group_Number
Pharmacy Help Desk: (855) 798-2538
Provider Locator Assistance: (877) 858 1036
Provider Locator Website: locateprovidersnow.com
Rx Benefits
BIN: 006053
Contacts
Advocacy ID#: (855) 476-4060
Benefits/Eligibility: (480) 576-7122
Pharmacy Help Desk: (855) 798-2538
Physician mail order information:
Escribe: 04229971
Efax: (888) 870-3823
Electronic Medical Claims Submission
Player ID#: IHS24
This card is not guarantee that coverage
is in effect, or payment for the service or
procedure reviewed.
This plan has limited benefits and some
services may not be covered. Contact
the payor to determine coverage before
the services are rendered.
Limited Benefit Plan