Insurance CompanyExtract the insurance company/carrier name...
Plan NameExtract the plan name or type...
Member NameExtract the member/subscriber name...
Member IDExtract the member ID number...
Group NumberExtract the group number...
BIN NumberExtract the RxBIN number for pharmacy...
PCNExtract the PCN (Processor Control Number)...
RxGroupExtract the Rx Group number...
Copay - PCPExtract primary care physician copay amount...
Copay - SpecialistExtract specialist copay amount...
Copay - ERExtract emergency room copay amount...
Copay - RxExtract prescription copay amounts (generic/brand)...
Effective DateExtract effective date if shown. Return in YYYY-MM...
Customer Service PhoneExtract customer service phone number...
Claims AddressExtract claims submission address if shown...