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Get Form 13a

Lication for Provider Enrollment (MEDCO-13A). This form is only applicable to providers who are not required to become BWC certified (see Medco-13 application if your provider type is not listed in section 1.) Note to pharmacy providers: Pharmacies must apply directly with BWC s current pharmacy benefits manager (PBM) to be issued a BWC provider number. Our current PBM is Catamaranrx. You may contact it through email at provider.contracting catamaranrx.com or at www.sxc. com/pharmacies, or cal.

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