VA102389 (1354)    PLAN (366.03)

Name Value
ID VA102389
NAME MAINE MEDICAID TUBERCULOSIS CONTROL
NAME - SHORT MMTUBCNT
REGION ME
DATE/TIME CREATED 2004-02-13 21:54:40
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 003573
PROCESSOR CONTROL NUMBER (PCN) MEPOPTB
NCPDP PROCESSOR NAME ME MED
ENABLED? Yes
BILLING PAYER SHEET NAME MEPOPTB1
REVERSAL PAYER SHEET NAME MEPOPTB2
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 12:05:59
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-15 12:05:59