Pharmacy Companion Guide

Pharmacy Companion Guide - (Forms/Publications)
Document Information
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Title   Pharmacy Companion Guide (314 KB PDF)
Description 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)
Detail
Form number F245-400-000
Availability
Online only. See document above to download.
Keywords 835, 835 Payment Advice, 835 Remittance Advice, Pharmacy Remittance Advice, Remittance Advice
Languages English
Valid dates 03-2007
Contact information Electronic Billing
Web pages Electronic Billing

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