• RX Transfer Form

  • Patient's Information

  • Pharmacy's Information

  • RX Insurance and Medical Insurance examples

  • For the RX Insurance card, they generally have the following information: RX BIN#, RX PCN#, RX GROUP#, RX MEMBER ID#.

    You can see some examples at:
    https://escopharmacy.nyc/pages/medical-insurance-example


    For Medical Insurance, you can find example at the link here:
    https://escopharmacy.nyc/pages/medical-insurance-examples.

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  • Doctor's Information

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