Pharmacy Companion Guide

Document Information
  How to complete a fillable form.
Title Pharmacy Companion Guide

This guide details the HIPAA ASC X12N 004010 format structure for 835 Pharmacy Remittance Advice and provides information regarding electronic billing to the department via Provider Express billing (PEB)

Document number F245-400-000
How to get this document
Alt Language(s)
Valid dates 03/2007
Contact information Electronic Billing
Websites Electronic Billing

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