VA102674 (1814)    PLAN (366.03)

Name Value
ID VA102674
NAME GUNDERSEN HEALTH PLAN
NAME - SHORT GUNDERHP
REGION WI
DATE/TIME CREATED 2004-02-13 22:36:50
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 900002
PROCESSOR CONTROL NUMBER (PCN) GHP ENV
NCPDP PROCESSOR NAME EXPRESS
ENABLED? Yes
BILLING PAYER SHEET NAME ESIB1V5
REVERSAL PAYER SHEET NAME ESIB2V5
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 14:19:12
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-15 14:19:12