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Federal assistance in the United States / Presidency of Lyndon B. Johnson / Banking / National Council for Prescription Drug Programs / Health / Finance / Medical prescription / Medicaid / National Provider Identifier / Business / Healthcare reform in the United States / Payment systems


® SPARK-ITS New Mexico Medicaid D.0 FFS Payer Sheet B1-B3 Expert Mode (EM)
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Document Date: 2014-10-08 15:41:56

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File Size: 605,22 KB

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Company

Xerox Corporation / Design / /

Country

United States / /

Currency

USD / /

Event

FDA Phase / /

IndustryTerm

prescribed product / /

Organization

Medicaid Fee For Service / European Union / For Service / DRNMPROD For Service / /

Person

Christine Marshall / /

/

Position

physician / SERVICE PROVIDER ID QUALIFIER SERVICE / ORIGINALLY PRESCRIBED PRODUCT/SERVICE ID QUALIFIER / Payer Sheet GENERAL INFORMATION Payer Name / Amount Claimed Submitted Qualifier / Revision History Version Number Date Description Author / qualifier / CE REFERENCE NUMBER QUALIFIER PRESCRIPTION/SERVI CE REFERENCE NUMBER PRODUCT/SERVICE ID QUALIFIER / pharmacist / /

Product

Process CLARIFICATION CODE compound / /

ProgrammingLanguage

R / C / /

ProvinceOrState

New Mexico / /

Technology

1Ø1-A1 1Ø2-A2 1Ø3-A3 1Ø4-A4 Transaction Header Segment NCPDP Field Name BIN NUMBER VERSION/RELEASE NUMBER TRANSACTION CODE PROCESSOR / /

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