VA96581 (3549)    PLAN (366.03)

Name Value
ID VA96581
NAME FRED MEYER MAIL ORDER
NAME - SHORT FMMO
REGION ALL
DATE/TIME CREATED 2004-02-14 11:46:16
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 003585
PROCESSOR CONTROL NUMBER (PCN) 38702
NCPDP PROCESSOR NAME MEDIMPACT
ENABLED? Yes
BILLING PAYER SHEET NAME MDMPCTB1
REVERSAL PAYER SHEET NAME MDMPCTB2
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:   2004-02-14 18:09:08
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-14 18:09:08