Effective January 1, 2017, CVS Caremark® will begin to administer the prescription benefits for JBS. Please update or create plan member profiles to reflect the changes regarding the following new plan adjudicating through CVS Caremark.

RXBIN: 004336

RXPCN: ADV

RXGRP: RX0349

Member ID Format: 9 digits, numeric only

Person Code : 2 digits, required

Card images are not available at this time.

Patient Pay Amount                       Please rely on the claims system to determine the correct amount to collect from the plan member, if applicable

      Vaccine                                       JBS will participate in the CVS Caremark Vaccine Administration Network. The following vaccines will be covered:

                                                • Seasonal: Trivalent, Quadrivalent, Short Needle, Flublok, Fluzone

                                                            • Non-Seasonal: Zostavax, Pneumonia

Submit the proper "MA" code in field 440-E5 of the DUR/PPS Segment along with a positive incentive fee amount in Field 438-E3 of the Pricing Segment when administering vaccines.

Pursuant to state MAC regulations, please consider this to be notification that Tmesys has published a new MAC pricing list. 

Guidelines for Influenza Vaccinations

Please follow the guidelines below to administer influenza vaccinations for Blue Cross and Blue Shield of Texas Medicaid adults and CHIP Perinate mothers (age 18 and older):

• Follow the Texas State Board of Pharmacy rules related to certification to immunize and vaccinate (Texas Administrative Code, Title 22, Part 15, §295.15).
• Process these claims using the pharmacy‟s NPI.
• The pharmacy must be enrolled in the Vendor Drug Program (VDP) and be a member of an Express Scripts network.
• Use the same billing method as defined for Medicare Part D vaccine administration billing.
• For Submission Clarification Code field 420-DK, please enter "7"