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Get 005947 Bin
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Easily sign the form with your finger
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How to fill out the 005947 Bin online
Filling out the 005947 Bin form online is an essential step for ensuring your pharmacy services are covered. This guide provides clear instructions for users on how to accurately complete the form to facilitate their prescription needs.
Follow the steps to effectively complete the 005947 Bin form.
- Click ‘Get Form’ button to access the form and open it in the editor.
- Begin by entering your personal details, including your full name, address, and the Plan Member ID located at the top of the reference document.
- Provide your Social Security number in the designated field to confirm your eligibility and benefits.
- For pharmacy services, input the Rx Bin number: 005947 and the Rx Group number: WELLRX in their respective fields.
- Fill in the patient's date of birth to ensure proper identification and processing of prescriptions.
- Review all entered information for accuracy to prevent any delays in service.
- Once you have confirmed that all fields are correctly completed, you may save your changes, and download or print the form for your records.
Complete your documents online today for seamless access to your pharmacy services.
� Submit claims online to HDS (Bin#610500). � For assistance with inquiries, contact HDS at 800.750. 9835.
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