RXBIN: 004336

RXPCN: ADV

RXGRP: RX0470

Member ID Format: 9 digits, numeric only

Person Code: not required

*Please see attached PDF for more information.

RXBIN: 004336

RXPCN: ADV

RXGRP: RX0419

Member ID Format: 11 digits, alphanumeric

Person Code: 2 digits, required

*Please see attached PDF for more information.

RXBIN: 004336

RXPCN: MEDDADV

RXGRP: RXCVSD

Member ID Format: 8-10 digits, alphanumeric

*Please see attached PDF for more information.

RXBIN: 004336

RXPCN: ADV

RXGRP: RX0424

Member ID Format: 9 digits, alphanumeric

Person Code : 2 digits, required

*Please see attached PDF for more information.

For most members in the following plans:

• AARP® MedicareRx
• AARP® MedicareComplete®
• UnitedHealthcare® MedicareComplete Plans
• United MedicareRx
• UnitedHealthcare MedicareRx Plans

Upon the release of the generic for the brand medication Zetia, the brand name version of Zetia will continue to be the preferred product. The generic Ezetimide will be a non-covered/non formulary drug.

Please continue to process claims for brand Zetia as it will process without any need of a prior authorization. The generic Ezetimide will be not be a covered drug and should reject as a non-covered/non formulary drug, if you get this reject, changing the drug back to brand Zetia will allow the drug to process.

In addition, if you get a paid claim for generic Ezetimide, please reverse the claim and continue to process for brand Zetia. You will see that as the brand Zetia is on the preferred tier, it will produce a lower copay amount for the member than processing the generic even if the generic pays.

TO REDUCE PROCESSING ERRORS, PLEASE CONFIRM THE INFORMATION ON MEMBER’S ID CARD PRIOR TO SUBMITTING PRESCRIPTION CLAIMS.

Should you have any questions or require assistance, please contact the OptumRx Help Desk, 24 hours a day, 7 days a week:

OptumRx Help Desk phone numbers:

• AARP® MedicareComplete® and UnitedHealthcare® MedicareComplete Plans: 877-889-6510  UnitedHealthcare® Medicaid Plans: 877-305-8952
• AARP® MedicareRx, United MedicareRx, UnitedHealthcare MedicareRx Plans: 877-889-6481
• All other Medicare Part D Plans: 800-788-7871