ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJAKALAMANAOAPAQARASATAUAVAWAXAYAZBABBBCBDBEBFBGBHBIBJBKBLBMBNBOBPBQBRBSBTBUBVBWBXBYBZCACBCCCDCECFCGCHCI
1
NDCDrugPrimary Payer BINPrimary Payer BIN
***Duplicates have been removed
2
NDC 73308040760Amcinonide610011Catamaran
3
NDC 73308040760Amcinonide610014ESI
4
NDC 73308040760Amcinonide3858ESI
5
NDC 73308040760Amcinonide610279OptumRx
6
NDC 73308040760Amcinonide610455Prime
7
NDC 69499034430Azesco17010Catamaran
8
NDC 69499034430Azesco4336CVS Health
9
NDC 69499034430Azesco610014ESI
10
NDC 69499034430Azesco3585MedImpact
11
NDC 69499034430Azesco11552Prime
12
NDC 69499034430Azesco610852Capital Rx
13
NDC 69499034430Azesco610011Catamaran
14
NDC 69499034430Azesco21684Catamaran / Optum
15
NDC 69499034430Azesco23575Medimpact
16
NDC 69499034430Azesco610494OptumRx
17
NDC 69499034430Azesco17366OptumRx
18
NDC 69499033060Chlorzoxazone1729017290
19
NDC 69499033060Chlorzoxazone26696BCBS of California
20
NDC 69499033060Chlorzoxazone610011Catamaran
21
NDC 69499033060Chlorzoxazone17010Catamaran
22
NDC 69499033060Chlorzoxazone610591CVS
23
NDC 69499033060Chlorzoxazone4336CVS Health
24
NDC 69499033060Chlorzoxazone3858ESI
25
NDC 69499033060Chlorzoxazone610014ESI
26
NDC 69499033060Chlorzoxazone17449Magellan
27
NDC 69499033060Chlorzoxazone15581MedImpact
28
NDC 69499033060Chlorzoxazone610494OptumRx
29
NDC 69499033060Chlorzoxazone610279OptumRx
30
NDC 69499033060Chlorzoxazone610097OptumRx
31
NDC 69499033060Chlorzoxazone11552Prime
32
NDC 69499040360Coxanto610852Capital RxCOXANTO
33
NDC 69499040360Coxanto610011CatamaranSTATEPLANBINPCNRX Group
34
NDC 69499040360Coxanto17010CatamaranTXCVS4336ADV
35
NDC 69499040360Coxanto23286CVSGAPrime610455AHA, NEHM
36
NDC 69499040360Coxanto610502CVSMSBCBS of MS4583(blank)
37
NDC 69499040360Coxanto4336CVS HealthNYESI3858A4 (SC when secondary to Medicare)
38
NDC 69499040360Coxanto3858ESIESI60014MEDDPRIME / MAC2FFA
39
NDC 69499040360Coxanto610014ESIESI/EmblemHealth13865Not Required
40
NDC 69499040360Coxanto13865ESIPrime16499PPOBH / PPOBHG / PDPNJ / PDPNJG / DSNPPRI
41
NDC 69499040360Coxanto610279OptumRxCVS4336ADV
42
NDC 69499040360Coxanto610494OptumRxOptum Rx6102799999
43
NDC 69499040360Coxanto17366OptumRxCVS/Aetna610502AETCRXC
44
NDC 69499040360Coxanto610455PrimeOptum Rx173669999
45
NDC 69499040360Coxanto16499PrimeLifetime HealthcareTier 3 PA required
46
NDC 69597036230GLP-DLax17010CatamaranExcellus BCBS610475FLRXTier 3 PA required
47
NDC 69597036230GLP-DLax4336CVS HealthUnivera Healthcare4740Tier 3 PA required
48
NDC 69597036230GLP-DLax610014ESI
Lifetime Benefit Solutions
(not public)Tier 3 PA required
49
NDC 69597036230GLP-DLax3585MedImpact
MedAmerica Insuranc Co
15460Tier 3 PA required
50
NDC 69597036230GLP-DLax11552PrimeCigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
51
NDC 69597036230GLP-DLax610852Capital RxHighmark610014Tier 3 PA required
52
NDC 69597036230GLP-DLax610011CatamaranPACVS4336ADV
53
NDC 69597036230GLP-DLax21684Catamaran / OptumCVS610502AETCRXC
54
NDC 69597036230GLP-DLax23575MedimpactCapital Rx6108522001
55
NDC 69597036230GLP-DLax610494OptumRx
56
NDC 69597036230GLP-DLax17366OptumRx
57
NDC 73308043530
Griseofulvin Ultramicrosize
4336CVS Health
58
NDC 73308043530
Griseofulvin Ultramicrosize
16499Prime
59
NDC 73308043530
Griseofulvin Ultramicrosize
12833Prime
60
NDC 73308035530Imubolic23575Medimpact
61
NDC 73308035530Imubolic24368SmithRx
62
NDC 69597030130Ortho DF17010Catamaran
63
NDC 69597030130Ortho DF4336CVS Health
64
NDC 69597030130Ortho DF610014ESI
65
NDC 69597030130Ortho DF3585MedImpact
66
NDC 69597030130Ortho DF11552Prime
67
NDC 69597030130Ortho DF610852Capital Rx
68
NDC 69597030130Ortho DF610011Catamaran
69
NDC 69597030130Ortho DF21684Catamaran / Optum
70
NDC 69597030130Ortho DF23575Medimpact
71
NDC 69597030130Ortho DF610494OptumRx
72
NDC 69597030130Ortho DF17366OptumRx
73
NDC 73308040360Oxaprozin610502CVSOXAPROZIN
74
NDC 73308040360Oxaprozin610029CVSSTATEPLANBINPCNRX Group
75
NDC 73308040360Oxaprozin4336CVS HealthCACVS/Aetna610502AETCRXC
76
NDC 73308040360Oxaprozin3858ESICigna Advantage170100215COMM
77
NDC 73308040360Oxaprozin610014ESICigna123533490000
78
NDC 73308040360Oxaprozin610279OptumRxCigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
79
NDC 73308040360Oxaprozin610455PrimeFLOptumRx6102799999
80
NDC 73308040360Oxaprozin11552PrimeCigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
81
NDC 73308040360Oxaprozin18893VentegraGAESI3858A4 (SC when secondary to Medicare)
82
NDC 69597035230ProbiChew747474747474CVS4336ADV
83
NDC 69597035230ProbiChew603286CatamaranPrime610455AHA, NEHM
84
NDC 69597035230ProbiChew610011CatamaranCVS/Aetna610502AETCRXC
85
NDC 69597035230ProbiChew610593CatamaranCigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
86
NDC 69597035230ProbiChew15284Citizen RxILPrime11552305667
87
NDC 69597035230ProbiChew17688Empirx HealthCigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
88
NDC 69597035230ProbiChew23575MedimpactKYCVS4336ADV
89
NDC 69597035230ProbiChew3585MedImpactCigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
90
NDC 69597035230ProbiChew24624MedOneNYESI3858A4 (SC when secondary to Medicare)
91
NDC 69597035230ProbiChew610602NAVITUSCVS4336ADV
92
NDC 69597035230ProbiChew5947OptumRxLifetime HealthcareTier 3 PA required
93
NDC 69597035230ProbiChew17366OptumRxExcellus BCBS610475FLRXTier 3 PA required
94
NDC 69597035230ProbiChew610862Rightway HealthcareUnivera Healthcare4740Tier 3 PA required
95
NDC 69597035230ProbiChew14798Script Care
Lifetime Benefit Solutions
(not public)Tier 3 PA required
96
NDC 69499035230Xybiotic603286Catamaran
MedAmerica Insuranc Co
15460Tier 3 PA required
97
NDC 69499035230Xybiotic747474747474Highmark610014Tier 3 PA required
98
NDC 69499035230Xybiotic610011CatamaranCigna Legacy17010
0215COMM; 0518GWH
Tier 3 PA required
99
NDC 69499035230Xybiotic610593CatamaranMagellan17449UNION
100
NDC 69499035230Xybiotic15284Citizen RxESI Medicare610014MEDDPRIME / MAC2FFA