Meritain prior authorization list

specific CPT’s requiring Prior Authorization by each health plan. The information provided is only a general summary of information from publicly available sources and is not intended to be an updated and comprehensive list of all CPT’s where a Prior Authorization is required. The recipient is encouraged to review

We would like to show you a description here but the site won’t allow us.Botulinum-Toxins-Request-Form-MD-4.1.2020. completed prior authorization request form to 877-270-3298 or submit Electronic Prior Authorization through CoverMyMeds® or SureScripts. requested data must be provided. Incomplete forms or forms without the chart notes will be returned. Pharmacy Coverage Guidelines are available at www ...New Authorizations: New authorizations are triggered by member eligibility. Please use the Sentara Health Plans authorization process. Authorizations Temporarily Not Viewable Sentara Health Plans is undergoing a system conversion for our Medicaid line of business. Authorization requests submitted between November 22, 2023 to December 6, 2023 ...Welcome to Meritain Health. At Meritain Health, we create unrivaled connections. We’re a proud subsidiary of Aetna ® and CVS Health ®. This means we can connect you to over 700,000 providers nationwide, unmatched network discounts and one of the largest pharmacies. Combined with our own in-house products and valued vendor partnerships, our ...Request for predetermination form. Bariatric predetermination form. Injectable infusion authorization form. We're here for you. Prompt claims payment. You’ll benefit from our …

2022 Outpatient Prior Authorization Fax Submission Form (PDF) - last updated Dec 16, 2022. Authorization Referral. 2020 MeridianComplete Authorization Lookup (PDF) - last updated Sep 10, 2021. Behavioral Health Discharge Transition of Care Form (PDF) - last updated.2022 CareSource Prior Authorization List. Prior authorization is the process used by us to determine whether the services listed below meet evidence based criteria for Medical Necessity. Your provider must get prior authorization for the listed services in order for you to receive benefits under your plan. If you see a provider who is not part ...To locate a physician or facility for treatment participating with Meritain: ONLY USE UNTIL 6/30/2024. Please call Meritain Health at 1-800-343-3140 for help finding an in-network provider. Providers should also contact Meritain Health at the same phone number if they have a dispute regarding the contracted fee.Non-Specialty drug Prior Authorization Requests Fax: 1-877-269-9916. Specialty drug Prior Authorization Requests Fax: 1-888-267-3277. Request for Prescription. OR, Submit your request online at: www.availity.com.Easily sign the meritain health prior authorization form with your finger. Send filled & signatures meritain prior authorized or save. Quick guide on how to complete meritain health prior permission mold pdf. Forget about scanning and printing out forms. Use in detailed useful to filling out and eSign your documents online.Pharmacy Prior Authorization Form - Priority Health. Health (2 days ago) WebPharmacy Prior Authorization Form. Fax completed form to: 877.974.4411 toll free, or 616.942.8206. This form applies to: Urgent means the standard review time may … Priorityhealth.com . Category: Pharmacy Detail Health Prior Authorization Check. Health (6 days ago) WebIf you are uncertain that prior authorization is needed, please submit a request for an accurate response. For information on MeridianComplete and other … All attempts are made to provide the most current information on the Pre-Auth Needed Tool. A prior authorization is not a guarantee of payment. Payment may be denied in accordance with Plan’s policies and procedures and applicable law. For specific details, please refer to the provider manual. If you are uncertain that prior authorization is ...

Spinraza (nusinersen) — precertification required and effective 7/1/2021 site of care required. Spravato (esketamine) Synagis (palivizumab) Tegsedi (inotersen. Treanda (bendamustine HCl) Trodelvy (sacituzumab govitecan-hziy) Ultomiris (Ravulizumab-cwvz) — precertification for the drug and site of care required. Prior Authorization Submission Methods. Fax: 515-725-1356. Phone: 888-424-2070 (Toll Free) Email: [email protected]. The Quality Improvement Organization (QIO) will review the prior authorization request for medical necessity, and the outcome of that review will be faxed to the provider who submitted the request.For most UMR plans. a UMR-administered group health care plan. Prior Authorization requirements for UMR members vary by plan. Sign in. here via Member search FIRST to confirm member specific requirements. Learn more. Select the Get started button to begin the prior authorization process.Some services that do not need a Prior Authorization are: Primary care; In-network specialist; Family planning; WHCP services (you must choose doctors in the network) Emergency care; Review the Certificate of Coverage starting on page 3. It has a full list of covered services and if a Prior Authorization is needed.

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Prior Authorization may be required. If you have any questions about authorization requirements or need help with the search tool, contact Aetna Better Health Provider Relations at 1-855-364-0974. ALL inpatient confinements require PA and usually ALL services provided by non-participating providers require PA.Prior authorization isn't required for sleep studies performed at home. This program applies to fully-insured members and is an optional add-on for Administrative Services Only (ASO). You can verify benefits and request prior authorization at Availity.com anytime day or night OR fax completed form to Commercial Utilization Management at 1-866 ..."Drone delivery has been a loose cannon in general with very limited real adoption and therefore making a business case on costs is very difficult." Four years ago, a Mumbai-based ...Modifier Usage Related to Orthoses Items on the Required Prior Authorization List During the Temporary Gap Period of the Competitive Bid Program. Effective January 1, 2024, there will be a temporary gap period in the DMEPOS Competitive Bidding Program (CBP) for off-the-shelf back and knee braces. As such, prior …

We would like to show you a description here but the site won't allow us.Health. (9 days ago) WEBIf you need prior authorization for your medication, your doctor can fax the Global Prior Authorization Form to 888-836-0730. Your doctor can also call 800-294-5979 to …. Paypalbenefits.com. Category: Doctor Detail Health.Please be advised that we are currently experiencing longer than normal hold times when calling our Medical Management Department at 1-833-863-1310. The preferred method for submitting authorizations is through the Secure Provider Portal at provider.ambetterofnorthcarolina.com. Once you submit your Prior Authorization request, the quickest ...Submit Prior Authorization. If a service requires authorization, submit via one of the following ways: SECURE WEB PORTAL. Provider.mhsindiana.com. This is the preferred and fastest method. PHONE. 1-877-687-1182. After normal business hours and on holidays, calls are directed to the plan’s 24-hour nurse advice line.It takes only a couple of minutes. Follow these simple instructions to get Meritain Health Inc.Travel Authorization Form - Wiki Bssd prepared for sending: Select the form you require in the collection of templates. Open the template in our online editor. Read through the recommendations to find out which details you will need to give.Prior Authorization Grids. The Prior Authorization Grids are your source for determining what medications and services require Prior Authorization. Be sure to reference the date of the grid since revisions to the grid may occur. Pharmacy Prior Authorization Grid | Effective 5/15/2024. Pharmacy Prior Authorization Grid | Effective 1/1/2024.Modifier Usage Related to Orthoses Items on the Required Prior Authorization List During the Temporary Gap Period of the Competitive Bid Program. Effective January 1, 2024, there will be a temporary gap period in the DMEPOS Competitive Bidding Program (CBP) for off-the-shelf back and knee braces. As such, prior authorization requirements for ...If you have any questions, please contact the SDS support team Monday - Friday, 8 a.m. - 5 p.m. ET at [email protected] or 855-297-4436. For trading partners that have not yet completed the transition. Highmark, Inc. (Highmark) currently provides the Highmark EDI Gateway to handle EDI transactions on behalf of Independence Administrators.April-June 2023 (Physician-Administered Drug Prior Authorization Required List) List of procedures that require prior authorization. April-June 2023 (Medi-Cal) List of procedures that require prior authorization, effective 03/01/2023-04/30/2023.Precertification List with High-Cost Drug Management You can help make sure you and your family get quality health care when and where you need it. The Meritain Health® Medical Management Program is designed to ensure you and your eligible dependents receive the right health care while avoiding unnecessary costs. All inpatient admissions {AcuteWelcome to Meritain Health's Aetna DocFind site. This site has been specially designed to provide quick and easy access to the Aetna provider directory. This Aetna provider directory includes all Aetna participating providers, including both medical providers and dental providers. Please note that providers listed in this directory may perform ...

Medical necessity review of both inpatient and outpatient procedures. American Health's URAC-accredited Utilization Management program provides medical necessity reviews that ensure members receive appropriate care while maximizing opportunities for cost savings. Members benefit from our program's registered nurse reviewers, American Health ...

Welcome to Meritain Health's Aetna DocFind site. This site has been specially designed to provide quick and easy access to the Aetna provider directory. This Aetna provider directory includes all Aetna participating providers, including both medical providers and dental providers. Health. (4 days ago) WebIf you have questions about what is covered, consult your Provider Manual or call 1-855-456-9126. Remember, prior authorization is not a guarantee of payment. Unauthorized …. discover Meritain Health Pre Auth List. Find articles on fitness, diet, nutrition, health news headlines, medicine, diseases.Update 5/13/2021: CMS is temporarily removing CPT codes 63685 and 63688 from the list of OPD services that require prior authorization. The only service that will require prior authorization for implanted spinal neurostimulators is CPT code 63650. Providers who plan to perform both the trial and permanent implantation procedures using CPT code ...Instructions for Submitting Requests for Predeterminations. Complete and return to: Meritain Health® P.O. Box 853921 Richardson, TX 75085-3921 Fax: 716.541.6735. Email: [email protected]. Please note: sending anything other than a predetermination request will delay the review of your information.Your patient’s health and your ability to access their information is important to us. If you have questions about claims or benefits, we’re happy to help. For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. To reach us by phone, dial the toll-free number on the back of the patient’s ID card.Home Health/Home Infusion Therapy/Hospice: 888-567-5703. Inpatient Clinical: 800-416-9195. Medical Injectable Drugs: 833-581-1861. Musculoskeletal (eviCore): 800-540-2406. Telephone: For inquiries that cannot be handled via the online provider portal, call the appropriate Clinical Services number, which can be found here.Service authorization forms. Send forms via secure fax: Inpatient notifications: 612-288-2878 ǀ Service authorizations: 612-677-6222. Continuity of care (COC) - Out-of-network providers complete this form to continue services if they provided them prior to a member's eligibility with Hennepin Health. Services are reviewed for continuity of ...Prior authorization We make it easier to manage your treatment requests. Submit your prior authorization requests electronically and view updates online. Get started Claims submission Sign in for a simpler way to stay on top of your recent claims. Get updates on your claims status, view payments and more. ...April-June 2023 (Physician-Administered Drug Prior Authorization Required List) List of procedures that require prior authorization. April-June 2023 (Medi-Cal) List of procedures that require prior authorization, effective 03/01/2023-04/30/2023.Fax Requests for Medical Prior Authorization for All Plans to: 775-982-3744 Fax Requests for Mental Health & Substance Abuse for the following plans to 775-551-7000 If this request is for a medication, please ensure which benefit (Medical or Pharmacy) is responsible for coverage. & Family Plan

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Botulinum-Toxins-Request-Form-MD-4.1.2020. completed prior authorization request form to 877-270-3298 or submit Electronic Prior Authorization through CoverMyMeds® or SureScripts. requested data must be provided. Incomplete forms or forms without the chart notes will be returned. Pharmacy Coverage Guidelines are available at www ...The Prescription Drug Prior Authorization form may be completed by the prescriber and faxed to Magellan Rx Management at 800-424-3260. For drug specific forms please see the Forms tab under Resources. Please alert the member that the above steps will take additional time to complete. If this is an urgent prescription, have the member call ...Transforming health care, together. Banner|Aetna aims to offer access to more efficient and effective member care at a more affordable cost. We join the right medical professionals with the right technology, so members benefit from quality, personalized health care designed to help them reach their health ambitions. Contact us.You'll want to get prior authorization for these medications. Fax the PA form to 1-855-799-2554. Or you can call Member Services to ask for PA. Be sure to submit all required clinical information on the form. Member Services: Medicaid MMA: 1-800-441-5501 (TTY: 711) Florida Healthy Kids: 1-844-528-5815 (TTY: 711)Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit. If you believe you've been wrongly billed, you may contact the following federal resources: No Surprises Help Desk (NSHD) Call 1-800-985-3059 for more information about your rights under federal law.Submit Prior Authorization. If a service requires authorization, submit via one of the following ways: SECURE WEB PORTAL. Provider.mhsindiana.com. This is the preferred and fastest method. PHONE. 1-877-687-1182. After normal business hours and on holidays, calls are directed to the plan's 24-hour nurse advice line.Feb 23, 2024 · Effective immediately, outpatient high-tech radiology services will no longer require prior authorization. This includes cardiac nuclear stress tests, CT and CTA, MRI and MRA, and PET scan. Hysteroscopies will require prior authorization. Effective March 1, 2024, many services will be removed from the prior authorization list for commercial ... Opioid treatment information. Pharmacy prior authorizations are required for pharmaceuticals that are not in the formulary, not normally covered, or which have been indicated as requiring prior authorization. For more information on the pharmacy prior authorization process, call the Pharmacy Services department at 1-866-610-2774.Gastric Surgery/Therapy/Durable Medical Equipment/Outpatient Procedures: 888-236-6321. Home Health/Home Infusion Therapy/Hospice: 888-567-5703. Inpatient Clinical: 800-416-9195. Medical Injectable Drugs: 833-581-1861. Musculoskeletal (eviCore): 800-540-2406. Telephone: For inquiries that cannot be handled via the online provider portal, call ...The Centers for Medicare & Medicaid Services (CMS) recently released its Advancing Interoperability and Improving Prior Authorization Processes final rule. We sat down with Chief Medical Officer Eric Gratias, M.D., to talk about how well prepared EviCore by Evernorth® is for the rule and what it means for patients, providers and payers.Prior authorization We make it easier to manage your treatment requests. Submit your prior authorization requests electronically and view updates online. Get started Claims submission Sign in for a simpler way to stay on top of your recent claims. Get updates on your claims status, view payments and more. ... ….

Prior authorization. Pharmacy prior authorizations are required for pharmaceuticals that are not in the formulary, not normally covered, or which have been indicated as requiring prior authorization. For more information on the pharmacy prior authorization process, call the Pharmacy Services department at 1-888-674-8720.Meritain Health is the benefits administrator for more than 2,400 plan sponsors and close to 1.5 million members. Our trusted partnership will afford you and your practice a healthy dose of advantages. Prompt claims payment. You'll benefit from our commitment to service excellence. In 2020, we turned around 95.6 percent of claims within 10 ...Meritain Health partners with Caremark to administer pharmacy solutions to employer groups. Our role is to work with you to ensure your benefits perform to your satisfaction. The team includes experienced, ... a prior authorization on any compound medication costing more than $299.99. Compounds must meet certain criteria for treatingInstructions for Submitting Requests for Predeterminations. (3 days ago) WEBMeritain Health® P.O. Box 853921 Richardson, TX 75085-3921 Fax: 716.541.6735 Email: [email protected] .To submit a request that does not use the portal, download a prior authorization request form. HIPAA Statement; Forms & Resources; Press; Careers; Feedback; Sitemap; 2024 - First Choice Health. FCH Providers portal provides access to benefits and eligibility, status of claims and payments, payor search, provider update form, and more. ...For precertification call: Meritain Health Medical Management at 800-242-1199. Detailed information regarding precertification requirements and penalties for failure to comply can be found in the Medical Management section. Participating Provider Organization (PPO) The Plan includes an arrangement with a Participating Provider Organization (PPO).preauthorization list eff. Aug. 1, 2023 Simple Cataract Surgery 66982 Remove July 1, 2023 Aug. 1, 2023 These codes will be removed from the preauthorization list eff. Aug. 1, 2023 Complex Cataract Surgery 66984 Remove July 1, 2023 Aug. 1, 2023 These codes will be removed from the preauthorization list eff. Aug. 1, 2023Registration. I am a. Member. Provider. Producer. Each member may setup a Login for themselves as well as any minor children covered by the plan. For privacy purposes, the member's spouse and adult dependents, covered by the plan, must each establish logins to access their individual information.Effective immediately, outpatient high-tech radiology services will no longer require prior authorization. This includes cardiac nuclear stress tests, CT and CTA, MRI and MRA, and PET scan. Hysteroscopies will require prior authorization. Effective March 1, 2024, many services will be removed from the prior authorization list for commercial ...Precertification lookup tool. Please verify benefit coverage prior to rendering services. Inpatient services and non-participating providers always require prior authorization. Providers: Select Hoosier Care Connect in the Line of Business field whenever applicable. See provider bulletin for more information. Please note: Meritain prior authorization list, Providers are encouraged to review the Prior Authorization List frequently for changes. Please contact Quartz Customer Success at (608) 881-8271 or (800) 897-1923 with specific code information to determine if an item or service requires prior authorization. Prior authorization is not a guarantee of payment. Coverage is determined by the terms ..., IMPORTANT PREDETERMINATION REMINDERS. Please note: surgery should not be scheduled prior to determination of coverage. Always verify eligibility and benefits first. …, Handle meritain prior authorization form on any platform with airSlate SignNow Android or iOS apps and alleviate any document-based operation today. How to modify and eSign meritain mednecessity without breaking a sweat. Find meritain health prior authorization form pdf and click Get Form to get started. , 2. Read the authorization, and sign and date this part of the form. If the patient is age 17 or older, he or she must also sign and date this form. 3. Give the form to the patient's out-of-network treating doctor or healthcare provider, who will complete section 4 and fax, mail or email the completed form to Meritain Health. 1. Employer ..., "Drone delivery has been a loose cannon in general with very limited real adoption and therefore making a business case on costs is very difficult." Four years ago, a Mumbai-based ..., Meritain Health Prior Authorization Form - signNow. Health (6 days ago) Meritain Health Prior Authorization. Check out how easy it is to complete and eSign documents online using fillable templates and a powerful editor. Get everything done in minutes. formr authorizationth prior authorization … Url: Visit Now . Category: Health Detail Drugs, Precertification List with High-Cost Drug Management You can help make sure you and your family get quality health care when and where you need it. The Meritain Health® Medical Management Program is designed to ensure you and your eligible dependents receive the right health care while avoiding unnecessary costs. All inpatient admissions {Acute, Health. (6 days ago) WEBNon-Specialty drug Prior Authorization Requests Fax: 1-877-269-9916. Specialty drug Prior Authorization Requests Fax: 1-888-267-3277. Request for Prescription., Prior Authorization You can look up CPT or HCPCS codes to determine if a medical, surgical, or diagnostic service requires prior authorization for members insured by Horizon BCBSNJ or Braven Health as noted on the member ID Card. This application only applies to Commercial Fully Insured, New Jersey State Health Benefits Program (SHBP) or School ..., Prior Authorization. The Texas Medicaid formulary includes some drugs subject to one or both types of prior authorization, clinical and non-preferred. Prior authorization must be approved before the drug is dispensed. Prior authorization is not a guarantee of payment. Even if a drug has been prior authorized, reimbursement can be affected for a ..., Edit your meritain health prior authorization form online. Type text, add images, blackout confidential details, add comments, highlights and more. 02. Sign it in a few clicks. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. 03. Share your form with others, Prior Authorization Requirements1 Authorization does not guarantee benefits or payment. Benefits are based on eligibility at the time the service is rendered and are subject to any applicable contract terms. Please see the combined prior authorization list for code-specific prior authorization requirements. Effective January 1, 2024 1. All:, 1. Member Information. 2. Employee Information (Please complete this section if the employee is not the member whose records are being requested.) 3. I authorize the individual(s) or company(ies) identified below to receive PHI pertaining to the member identified in Section 1 above.*. 4. Purpose(s) for this Authorization., Oct 11, 2022 · Welcome to Meritain Health. At Meritain Health, we create unrivaled connections. We’re a proud subsidiary of Aetna ® and CVS Health ®. This means we can connect you to over 700,000 providers nationwide, unmatched network discounts and one of the largest pharmacies. Combined with our own in-house products and valued vendor partnerships, our ... , Prior Authorization You can look up CPT or HCPCS codes to determine if a medical, surgical, or diagnostic service requires prior authorization for a Horizon member. Enter a CPT or HCPCS Code: This application only applies to Commercial Fully Insured, New Jersey State Health Benefits Program (SHBP) or School Employees' Health Benefits Programs ..., Some procedures, tests and prescriptions need prior approval to be sure they're right for you. In these cases, your doctor can submit a request on your behalf to get that approval. This is called prior authorization. You might also hear it called "preapproval" or "precertification". This extra check connects you to the right treatment ..., This list contains a summary of changes made to the current copy of the Medicare Medical Preauthorization and Notification List. At Humana, we are dedicated to ensuring every business decision ... Humana does not require prior authorization for basic Medicare benefits during the first 90 days of a new member's enrollment for active courses of ..., Members: 1-855-323-4578 (TTY 711) 8 a.m. to 8 p.m., seven days a week. On weekends and on state or federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. Providers: 1-855-323-4578 (TTY 711) Monday-Friday, 8am to 8pm EST., To speak with someone live, you can call Monday through Friday, 8 AM to 5 PM ET. For after hours or weekend questions, you can leave a voicemail. Medicaid Managed Medical Assistance (MMA): 1-800-441-5501 (TTY: 711) Florida Healthy Kids (FHK): 1-844-528-5815 (TTY: 711) Long-Term Care (LTC): 1-844-645-7371 (TTY: 711) Members of the UM team …, Health. (4 days ago) WebTo schedule transportation, please call us at least three days in advance of your scheduled appointment at 1-855-456-9126. You may reach us Monday through Friday, from 8 a.m. …. discover Aetna Meritain Health Pre Authorizations. Find articles on fitness, diet, nutrition, health news headlines, medicine, diseases., Precertification List with High-Cost Drug Management You can help make sure you and your family get quality health care when and where you need it. The Meritain Health® Medical Management Program is designed to ensure you and your eligible dependents receive the right health care while avoiding unnecessary costs. All inpatient admissions {Acute, January 2017 Formulary List - Meritain. Health (9 days ago) WebIf your doctor believes you have a specific clinical need for one of these products or is seeking a prior authorization for medical necessity, he or she should contact the … Content.meritain.com . Category: Doctor, Medical Detail Health, 2022 Outpatient Prior Authorization Fax Submission Form (PDF) - last updated Dec 16, 2022. Authorization Referral. 2020 MeridianComplete Authorization Lookup (PDF) - last updated Sep 10, 2021. Behavioral Health Discharge Transition of Care Form (PDF) - last updated., Authorization Instructions Prior Authorization. For prescriptions, please visit our Pharmacy page.; For mental health/substance abuse services for Generations Advantage Plan members call BHCP at 1-800-708-4532.; For mental health/substance abuse services for US Family Health Plan members call BHCP at 1-888-812-7335.; …, Please go to HERE for a list of codes that require prior authorization. Care Management Web: https://login.coherehealth.com All contracted providers need to submit via the web. Only non-contracted providers can submit via fax. Fax: 1 -877 321 6664 or Prior Approval Form Diagnostic Radiology/Imaging (Outpatient) Imaging Computed Tomography (CT), If you need prior authorization for your medication, your doctor can fax the Global Prior Authorization Form to 888-836-0730. Your doctor can also call 800-294-5979 to provide the information over the phone. If your prior authorization request is denied, you’ll need to change to a covered medication. , To contact the Gulf Coast Medical Management team directly: RN Case Managers. (941) 917-4326. Pharmacy Case Manager. [email protected]. Chronic Disease Case Manager. [email protected]. SMH Care offers self-insured health plans to its employees and their dependents. SMH Care is contracted with Meritain, a third party payor to pay ..., Member services. Pharmacy benefit coordination. Claims processing and investigation. Medical record review. Retirement plan administration. Premium billing and collection. Monthly reporting. Meritain Health offers additional services to support your employee health plan needs, including business process outsourcing and more., General Drug Prior Authorization Form. Rational Drug Therapy Program WVU School of Pharmacy PO Box 9511 HSCN Morgantown, WV 26506 Fax: 1-800-531-7787, WellNet builds and optimizes smarter self‑funded health plans for companies across the nation with 100 to 5,000 employees. Taking risk and leveraging our patented technology stack, we fix the unaffordable healthcare mess with ongoing education, stronger advocacy, and aligned incentives to combat the vested interests of traditional health ..., We would like to show you a description here but the site won't allow us., If you’re an aspiring author or a seasoned writer, having your book featured on the prestigious New York Times Best Seller list is a dream come true. Not only does it provide valid..., PRIOR AUTHORIZATION REQUIREMENTS. Blue Best Life Classic (HMO) H002-006 in Maricopa and Pinal counties. M2K. AZ Blue (and eviCore) AZ Blue Prior Authorization List Part D Formulary. Blue Best Life Plus (HMO) H0302-001 in Maricopa and Pinal counties. Blue Best Life Classic (HMO) H0302-008 in Pima County. BlueJourney (PPO) H5140-001 or H5140-002 ...