Transcription of South Carolina D.0 Payer Specification
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South Carolina D.0 Payer Specification
Proprietary & Confidential Page 1 of 66 2011, Magellan Medicaid Administration, Inc. All Rights Reserved. Revision Date: November 10, 2011 South Carolina Payer Specification NCPDP Version D Claim Billing/Claim Re-bill Template Request Claim Billing/Claim Re-bill Payer Sheet Template **Start of Request Claim Billing/Claim Re-bill (B1/B3) Payer Sheet Template** General Information Payer Name: South Carolina Medicaid Date: 04/29/2011 Plan Name/Group Name: SOCO1 / SCMedicaid BIN: 009745 PCN: P006009745 Processor: Processor/Fiscal Intermediary Effective as of: TBD NCPDP Telecommunication Standard Version/Release #: NCPDP Data Dictionary Version Date: June 2010 NCPDP External Code List Version Date.
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