VA102815 (1695)    PLAN (366.03)

Name Value
ID VA102815
NAME WYOMING MEDICAID
NAME - SHORT WY MED
REGION WY
DATE/TIME CREATED 2004-02-13 22:26:07
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 610084
PROCESSOR CONTROL NUMBER (PCN) DRWYPROD
NCPDP PROCESSOR NAME ACS
ENABLED? Yes
BILLING PAYER SHEET NAME ACSWYB1
REVERSAL PAYER SHEET NAME ACSWYB2
REBILL PAYER SHEET NAME ACSWYB1
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 14:52:39
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-15 14:52:39