VA101860 (1170)    PLAN (366.03)

Name Value
ID VA101860
NAME MARYLAND MEDICAID COORDINATED PRODUR
NAME - SHORT MDMEDCPD
REGION MD
DATE/TIME CREATED 2004-02-13 21:38:15
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 800002
PROCESSOR CONTROL NUMBER (PCN) P011800002
NCPDP PROCESSOR NAME FHEALTH
ENABLED? Yes
BILLING PAYER SHEET NAME FHMDB1V5
REVERSAL PAYER SHEET NAME FHMDB2V5
MAXIMUM NCPDP TRANSACTIONS 4
APPLICATION
  • E-PHARM
    NATIONAL ACTIVE?:   Active
    LOCAL ACTIVE?:   Not Active
    USER EDITED LOCAL:   INTERFACE,IB EIV
    DATE/TIME LOCAL EDITED:   2006-05-25 15:17:30
    DATE/TIME NATIONAL EDITED:   2004-02-15 12:50:05
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-15 12:50:05