VA102616 (1756)    PLAN (366.03)

Name Value
ID VA102616
NAME CONNECTICUT MEDICAID
NAME - SHORT CONN MED
REGION CT
DATE/TIME CREATED 2004-02-13 22:31:49
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 610480
PROCESSOR CONTROL NUMBER (PCN) 445266162
NCPDP PROCESSOR NAME CT MED
ENABLED? Yes
BILLING PAYER SHEET NAME CTMEDBIL
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 12:17:45
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-15 12:17:45