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ID Card Sample
Front of Member Identification Card
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Member name: Sample Name
Member ID:
11111111
Health Plan (80840):
PCP Name:
PCP Phone:
RxBin: 012312
RxPCN: PARTD
RxGRP: H3067001
RxID: 11111111
Jones MD, Rebecca
123-456-7890
H3067-001
Back of Member Identification Card
For urgent or emergency care, dial 911 or go to the nearest urgent/emergency
facility.
If you need medical assistance after hours or on the weekend, call our NurseLine
at 1-800-256-1982.
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Member Service:
Website:
1-855-338-6467
www.vapremier.com/completecare
Send claims to:
CompleteCare Claims
PO Box 4468
Richmond, VA 23220