Information for 340B Covered Entities
The following Medical Assistance (MA) Bulletin applies to 340B covered entities that bill the MA Fee-for-Service (FFS) program and/or a MA Program managed care organization (MCO) for drugs purchased under the 340B Drug Pricing Program and dispensed to MA program beneficiaries:
The following MA Bulletins apply to 340B covered entities that bill the MA FFS program for 340B purchased drugs:
2024 Pennsylvania Medical Assistance BIN/PCN/Group Numbers
FFS/MCO
|
BIN
|
PCN
|
Group Number
|
Fee-For-Service
|
600760
|
N/A
|
N/A
|
AmeriHealth Caritas Pennsylvania
|
019595
|
01940000
|
N/A
|
AmeriHealth Community Health Choices
|
019595
|
07630000
|
N/A
|
Geisinger Health Plan (Effective 1/1/2024)
|
026010
| MCDG
|
N/A
|
Health Partners of Philadelphia
|
004336
|
MCAIDADV
|
RX3892
|
Highmark Wholecare (Medicaid Primary)
| 004336
| MCAIDADV
| RX2338
|
Highmark Wholecare (Medicaid Secondary to Medicare)
| 012114
| MCAIDADV
| RX2338
|
Highmark Wholecare (Medicaid Secondary to Commercial Insurance)
| 013089
| MCAIDADV
| RX2338
|
Keystone First Community Health
Choices
|
019595
|
07630000
|
N/A
|
Keystone First
|
019595
|
01940000
|
N/A
|
Pennsylvania Health & Wellness (Effective 1/1/2024)
| 003858
|
MA
| 2FBA
|
United Healthcare Community Plan
|
610494
|
4200
|
ACUPA
|
UPMC for You
|
003858
|
A4
|
PMDM
|