FALLON HEALTH PLAN (359) PAYER (365.12)
Name
Value
PAYER NAME
FALLON HEALTH PLAN
VA NATIONAL ID
VA83
EDI ID NUMBER - PROF
SX072
EDI ID NUMBER - INST
22254
APPLICATION
EIV
NATIONALLY ENABLED: Not Enabled
*AUTO-ACCEPT: NO
*IDENT REQUIRES SUBSCRIBER ID: YES
*TRANSMIT SSN: NO
DATE/TIME CREATED: 2016-10-28 15:06:21
*FUTURE SERVICE DAYS: 9999
*PAST SERVICE DAYS: 9999
AUTO-UPDATE: NO
270 REQUIRES SUB ID: YES
FUTURE SERVICE DAYS: 9999
PAST SERVICE DAYS: 9999
