VA98015 (719)    PLAN (366.03)

Name Value
ID VA98015
NAME NEW HAMPSHIRE MEDICAID FIRST HEALTH
NAME - SHORT NHM FH
REGION NH
DATE/TIME CREATED 2004-02-13 20:57:21
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 009513
PROCESSOR CONTROL NUMBER (PCN) P002002286
NCPDP PROCESSOR NAME FHEALTH
ENABLED? Yes
BILLING PAYER SHEET NAME FHNHB1V5
REVERSAL PAYER SHEET NAME FHNHB2V5
MAXIMUM NCPDP TRANSACTIONS 1
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 09:37:33
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-15 09:37:33