VA102515 (1480)    PLAN (366.03)

Name Value
ID VA102515
NAME MAINE MEDICAID GENERAL ASSISTANCE
NAME - SHORT MMGENAST
REGION ME
DATE/TIME CREATED 2004-02-13 22:05:59
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 003573
PROCESSOR CONTROL NUMBER (PCN) MEPOPGA
NCPDP PROCESSOR NAME ME MED
ENABLED? Yes
BILLING PAYER SHEET NAME MEPOPGB1
REVERSAL PAYER SHEET NAME MEPOPGB2
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 12:16:40
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-15 12:16:40