VA100717 (4622)    PLAN (366.03)

Name Value
ID VA100717
NAME MISSISSIPPI MEDICAID
NAME - SHORT MISS MED
REGION MS
DATE/TIME CREATED 2004-02-14 13:23:57
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 610084
PROCESSOR CONTROL NUMBER (PCN) DRMSPROD
NCPDP PROCESSOR NAME ACS
ENABLED? Yes
BILLING PAYER SHEET NAME ACSMSB1
REVERSAL PAYER SHEET NAME ACSMSB2
REBILL PAYER SHEET NAME ACSMSB1
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 20:05:02
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-14 20:05:02