STATE MUTUAL MED SUPP (284)    PAYER (365.12)

Name Value
PAYER NAME STATE MUTUAL MED SUPP
VA NATIONAL ID VA2035
EDI ID NUMBER - PROF 75300
EDI ID NUMBER - INST 75300
APPLICATION
  • EIV
    NATIONALLY ENABLED:   Enabled
    *AUTO-ACCEPT:   NO
    *IDENT REQUIRES SUBSCRIBER ID:   YES
    *TRANSMIT SSN:   NO
    DATE/TIME CREATED:   2016-10-28 15:06:21
    *FUTURE SERVICE DAYS:   0
    *PAST SERVICE DAYS:   0
    AUTO-UPDATE:   NO
    270 REQUIRES SUB ID:   YES
    FUTURE SERVICE DAYS:   0
    PAST SERVICE DAYS:   0