VA100323 (4835)    PLAN (366.03)

Name Value
ID VA100323
NAME LOUISIANA MEDICAID
NAME - SHORT LA MED
REGION LA
DATE/TIME CREATED 2004-02-14 13:43:34
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 610514
PROCESSOR CONTROL NUMBER (PCN) LOUIPROD
NCPDP PROCESSOR NAME LA MED
ENABLED? Yes
BILLING PAYER SHEET NAME LAMDB1V5
REVERSAL PAYER SHEET NAME LAMDB2V5
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 20:19:43
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-14 20:19:43