TwinFyRxLive Data
PBM Intelligence
From opaque BIN/PCN routing codes to PBM market intelligence — covering 49,000+ Medicare Part D plans. Attribution, market share, competitive switching.
The Routing Problem
CMS publishes BIN/PCN routing for every Medicare Part D plan. But which PBM processes each one?
| BIN | PCN | Contract | PBP | Sponsor | PBM |
|---|---|---|---|---|---|
| 004336 | MEDDADV | H5521 | 044 | Aetna | ? |
| 610014 | BINNRX | H5226 | 001 | Centene / WellCare | ? |
| 610127 | ORXMA | H0543 | 003 | UnitedHealthcare | ? |
| 017010 | ESI | H3931 | 107 | Cigna | ? |
| 011552 | BCRX | H2172 | 001 | Blue Cross MN | ? |
| 015581 | HMANP | H1036 | 170 | Humana | ? |
| 003858 | MEDIM | H5425 | 010 | Scan Health Plan | ? |
| 012312 | PARTD | S5596 | 019 | Elixir Insurance | ? |
CMS publishes the BIN/PCN → Contract/PBP mapping quarterly. But nowhere in this data is the processing PBM identified. A pharmacy receiving BIN
004336 and PCN MEDDADV cannot determine from CMS data alone whether CVS Caremark, Express Scripts, or OptumRx processes that claim.1 / 5