Pharmacy Resources
This page provides easy access to key pharmacy resources designed to support safe and efficient pharmacy management for Blue Cross Complete members.
Preferred drug list
A printable version is available by clicking the Preferred Drug List (PDF).
Online drug list
A searchable version is available by searching our online drug list.
The searchable version of the drug list provides additional details regarding quantity limits, prior authorizations or other coverage details not available on the printable version. This includes guidance for obtaining specialty medications.
Pharmacy Reference Guide
Refer to the Pharmacy Reference Guide (PDF) for a quick reference about pharmacy provider services, prior authorizations, member copays, durable medical equipment covered under pharmacy and recipient restrictions.
Medicaid Drug Rebate Program Labeler List
Blue Cross Complete participates in the Medicaid Health Plan Common Formulary. Under the Common Formulary, Medicaid Health Plan formulary coverage only includes products with a National Drug Code from manufacturers who participate in the Medicaid Drug Rebate Program. View the Medicaid Drug Rebate Program Labeler List (PDF).
Pharmacy billing
The PerformRx Pricing Administration Department calculates generic Maximum Allowable Cost and money paid to participating pharmacies. MAC prices are updated each week. To ask for a MAC pricing review, email the PerformRx Pricing Administration Department. You can also call PerformRx Pharmacy Provider Services at 1-888-989-0057.
The electronic processing of retail pharmacy claims requires a NCPDP processor ID number, also known as a BIN, and a processor control number, or a PCN, for plan identification. Blue Cross Complete's D.0 Payer Sheet (PDF) contains our BIN (019595), PCN (PRX00621), member services number, field definitions and other helpful information for pharmacy claim billing and rebilling.