VA102176 (1228)    PLAN (366.03)

Name Value
ID VA102176
NAME MISSOURI MEDICAID
NAME - SHORT MO MED
REGION MO
DATE/TIME CREATED 2004-02-13 21:43:30
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 004047
NCPDP PROCESSOR NAME GTE MO
ENABLED? Yes
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 11:55:23
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-15 11:55:23