№ files_lp_3_process_9_32025
Administrative form outlining procedures for injured workers and pharmacists to process first-fill Workers’ Compensation prescriptions through the CorVel pharmacy network under parameters established by CHUBB.
Organization: CorVel Pharmacy Solutions
Phone: (800) 563-8438
Associated Company: CHUBB
Document Type: Workers’ Compensation Prescription Form
Program: CorVel Pharmacy Program
Purpose: Processing of approved Workers’ Compensation prescriptions
Eligible Person: Injured Worker
Identification Requirement: Social Security Number and Date of Injury
Member ID Format: 9 digit SSN plus 8 digit Date of Injury (MMDDYYYY)
BIN: 004336
PCN: ADV
RxGroup: RXFFWC695
Medication Supply Limit: 7 or 14 day supply
Cost to Injured Worker: No costs or co-pays at participating pharmacies
Participating Network: Over 72,000 pharmacies
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

Don’t have cryptocurrency yet?

You can still complete your purchase in a few minutes:
  1. Buy Crypto in a trusted app (Coinbase, Kraken, Cash App or any similar service).
  2. In the app, tap Send.
  3. Select network, paste our wallet address.
  4. Send the exact amount shown above.
After sending, paste your TXID (transaction ID) and your email to receive the download link. Need help? Contact support and we’ll guide you step by step.