VA103469 (6444)    PLAN (366.03)

Name Value
ID VA103469
NAME PHARMACY GOLD
NAME - SHORT PHARGOLD
REGION ALL
DATE/TIME CREATED 2004-02-14 16:09:31
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 610455
PROCESSOR CONTROL NUMBER (PCN) PGIGN
NCPDP PROCESSOR NAME PRIME THER
ENABLED? Yes
BILLING PAYER SHEET NAME PRIMEV5
REVERSAL PAYER SHEET NAME PRIMEV5
REBILL PAYER SHEET NAME PRIMEV5
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 14:24:58
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-15 14:24:58