ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJAKALAMANAOAPAQARASATAUAVAWAXAYAZBABBBCBDBEBFBGBHBIBJBKBLBMBNBOBPBQBRBSBTBUBVBWBXBYBZCACBCCCDCECFCGCHCI
1
NDCDrugPrimary Payer BINPrimary Payer BIN
***Duplicates have been removed
2
NDC 73308040760Amcinonide25201CVS / Ohio Medicaid
3
NDC 73308040760Amcinonide17010Catamaran / Optum
4
NDC 73308040760Amcinonide4336CVS Health
5
NDC 73308040760Amcinonide17688
EmpiRx Health/Benecard
6
NDC 73308040760Amcinonide610014ESI
7
NDC 73308040760Amcinonide400023ESI
8
NDC 73308040760Amcinonide3858ESI
9
NDC 73308040760Amcinonide610279OptumRx
10
NDC 73308040760Amcinonide610494OptumRx
11
NDC 73308040760Amcinonide610011
Catamaran / OptumRx
12
NDC 73308040760Amcinonide19876Hippo Discount Card
13
NDC 73308040760Amcinonide610455Prime Therapeutics
14
NDC 73308040760Amcinonide610239CVS
15
NDC 69499034430Azesco23575Medimpact
16
NDC 69499034430Azesco610279OptumRx
17
NDC 69499034430Azesco610852Capital Rx
18
NDC 69499034430Azesco610494OptumRx
19
NDC 69499034430Azesco21684OptumRx
20
NDC 69499034430Azesco610014ESI
21
NDC 69499034430Azesco17366Optum-ProAct
22
NDC 69499034430Azesco17010Catamaran / Optum
23
NDC 69499033060Chlorzoxazone17010Catamaran / Optum
24
NDC 69499033060Chlorzoxazone3858ESI
25
NDC 69499033060Chlorzoxazone610014ESI
26
NDC 69499033060Chlorzoxazone11552Prime
27
NDC 69499033060Chlorzoxazone17290Drexi
28
NDC 69499033060Chlorzoxazone610279OptumRx
29
NDC 69499033060Chlorzoxazone600471
OptumRx/Catamaran/Restat
30
NDC 69499033060Chlorzoxazone610011
Catamaran / OptumRx
31
NDC 69499033060Chlorzoxazone26696BCBS of California
32
NDC 69499033060Chlorzoxazone15581MedImpactCOXANTO
33
NDC 69499040360Coxanto4336CVS HealthSTATEPLANBINPCNRX Group
34
NDC 69499040360Coxanto610279OptumRxTXCVS4336ADV
35
NDC 69499040360Coxanto610011
Catamaran / OptumRx
GAPrime610455AHA, NEHM
36
NDC 69499040360Coxanto400023ESIMSBCBS of MS4583(blank)
37
NDC 69499040360Coxanto3858ESINYESI3858A4 (SC when secondary to Medicare)
38
NDC 69499040360Coxanto610455Prime TherapeuticsESI60014MEDDPRIME / MAC2FFA
39
NDC 69499040360Coxanto610014ESIESI/EmblemHealth13865Not Required
40
NDC 69499040360Coxanto610029CVSPrime16499PPOBH / PPOBHG / PDPNJ / PDPNJG / DSNPPRI
41
NDC 69499040360Coxanto610852Capital RxCVS4336ADV
42
NDC 69499040360Coxanto16499Horizon BCBS/PrimeOptum Rx6102799999
43
NDC 69499040360Coxanto610502Aetna-CVS HealthCVS/Aetna610502AETCRXC
44
NDC 69499040360Coxanto23286CVSOptum Rx173669999
45
NDC 69499040360Coxanto4336CVS CAREMARKLifetime HealthcareTier 3 PA required
46
NDC 69499040360Coxanto610502CVS CAREMARKExcellus BCBS610475FLRXTier 3 PA required
47
NDC 69499040360Coxanto3858EXPRESS SCRIPTSUnivera Healthcare4740Tier 3 PA required
48
NDC 69499040360Coxanto610014EXPRESS SCRIPTS
Lifetime Benefit Solutions
(not public)Tier 3 PA required
49
NDC 69499040360Coxanto400023EXPRESS SCRIPTS
MedAmerica Insuranc Co
15460Tier 3 PA required
50
NDC 69499040360Coxanto610279OPTUM RXCigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
51
NDC 69597036230GLP-DLax610144All Other VoucherHighmark610014Tier 3 PA required
52
NDC 69597036230GLP-DLax4336CVS HealthPACVS4336ADV
53
NDC 69597036230GLP-DLax3858ESICVS610502AETCRXC
54
NDC 69597036230GLP-DLax610014ESICapital Rx6108522001
55
NDC 69597036230GLP-DLax2190821908
56
NDC 69597036230GLP-DLax17010Catamaran / Optum
57
NDC 69597036230GLP-DLax3585BCBS AL Comm
58
NDC 69597036230GLP-DLax11552Prime
59
NDC 69597036230GLP-DLax20099IngenioRx
60
NDC 69597036230GLP-DLax610011
Catamaran / OptumRx
61
NDC 69597036230GLP-DLax23575Medimpact
62
NDC 69597036230GLP-DLax610494OptumRx
63
NDC 69597036230GLP-DLax603286Catamaran / Optum
64
NDC 69597036230GLP-DLax27497Retiree RxCare
65
NDC 69597036230GLP-DLax24649ArchimedesRx
66
NDC 69597036230GLP-DLax17366Optum-ProAct
67
NDC 69597036230GLP-DLax610502Aetna-CVS Health
68
NDC 69597036230GLP-DLax611790Capital Rx
69
NDC 69597036230GLP-DLax610852Capital Rx
70
NDC 69597036230GLP-DLax14179BeneCard
71
NDC 69597036230GLP-DLax610029CVS
72
NDC 69597036230GLP-DLax610455Prime Therapeutics
73
NDC 69597036230GLP-DLax610279OptumRxOXAPROZIN
74
NDC 69597036230GLP-DLax610593Catamaran / OptumSTATEPLANBINPCNRX Group
75
NDC 69597036230GLP-DLax610862Rightway HealthcareCACVS/Aetna610502AETCRXC
76
NDC 69597036230GLP-DLax9430PROCARE RXCigna Advantage170100215COMM
77
NDC 69597036230GLP-DLax9265PROCARE RXCigna123533490000
78
NDC 73308043530
Griseofulvin Ultramicrosize
4336CVS HealthCigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
79
NDC 73308043530
Griseofulvin Ultramicrosize
610279OptumRxFLOptumRx6102799999
80
NDC 73308043530
Griseofulvin Ultramicrosize
610011
Catamaran / OptumRx
Cigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
81
NDC 73308043530
Griseofulvin Ultramicrosize
400023ESIGAESI3858A4 (SC when secondary to Medicare)
82
NDC 73308043530
Griseofulvin Ultramicrosize
3858ESICVS4336ADV
83
NDC 73308043530
Griseofulvin Ultramicrosize
610455Prime TherapeuticsPrime610455AHA, NEHM
84
NDC 73308043530
Griseofulvin Ultramicrosize
610014ESICVS/Aetna610502AETCRXC
85
NDC 73308043530
Griseofulvin Ultramicrosize
610029CVSCigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
86
NDC 73308043530
Griseofulvin Ultramicrosize
610852Capital RxILPrime11552305667
87
NDC 73308043530
Griseofulvin Ultramicrosize
16499Horizon BCBS/PrimeCigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
88
NDC 73308043530
Griseofulvin Ultramicrosize
610502Aetna-CVS HealthKYCVS4336ADV
89
NDC 73308043530
Griseofulvin Ultramicrosize
23286CVSCigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
90
NDC 73308043530
Griseofulvin Ultramicrosize
4336CVS CAREMARKNYESI3858A4 (SC when secondary to Medicare)
91
NDC 73308043530
Griseofulvin Ultramicrosize
610502CVS CAREMARKCVS4336ADV
92
NDC 73308043530
Griseofulvin Ultramicrosize
3858EXPRESS SCRIPTSLifetime HealthcareTier 3 PA required
93
NDC 73308043530
Griseofulvin Ultramicrosize
610014EXPRESS SCRIPTSExcellus BCBS610475FLRXTier 3 PA required
94
NDC 73308043530
Griseofulvin Ultramicrosize
400023EXPRESS SCRIPTSUnivera Healthcare4740Tier 3 PA required
95
NDC 73308043530
Griseofulvin Ultramicrosize
610279OPTUM RX
Lifetime Benefit Solutions
(not public)Tier 3 PA required
96
NDC 69597030130Ortho DF610011
Catamaran / OptumRx
MedAmerica Insuranc Co
15460Tier 3 PA required
97
NDC 69597030130Ortho DF23575MedimpactHighmark610014Tier 3 PA required
98
NDC 69597030130Ortho DF610494OptumRxCigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
99
NDC 69597030130Ortho DF610014ESIMagellan17449UNION
100
NDC 69597030130Ortho DF603286Catamaran / OptumESI Medicare610014MEDDPRIME / MAC2FFA