VA98017 (721)    PLAN (366.03)

Name Value
ID VA98017
NAME INTERGROUP KMART
NAME - SHORT INTERKMT
REGION CA
DATE/TIME CREATED 2004-02-13 20:57:32
PHARMACY BENEFITS MANAGER NAME NONE
BANKING IDENTIFICATION NUMBER 003585
PROCESSOR CONTROL NUMBER (PCN) 46002
NCPDP PROCESSOR NAME MEDIMPACT
ENABLED? Yes
BILLING PAYER SHEET NAME MDMPCTB1
REVERSAL PAYER SHEET NAME MDMPCTB2
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 09:37:45
    DEACTIVATED?:   No
    DATE/TIME CREATED:   2004-02-15 09:37:45