VA100586 (3791)    PLAN (366.03)

Name Value
ID VA100586
NAME JORDAN RESES PRESCRIPTION MGT. SERVICE
NAME - SHORT JORDANRE
REGION ALL
DATE/TIME CREATED 2004-02-14 12:08:23
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 011065
NCPDP PROCESSOR NAME PROCARE RX
ENABLED? Yes
BILLING PAYER SHEET NAME PRCRBIL5
REVERSAL PAYER SHEET NAME PRCRREV5
REBILL PAYER SHEET NAME PRCRBIL5
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 18:57:25
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-14 18:57:25