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Accumulator - View By Claim

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Health Center:
Pharmacy:
Capture Date :
To:


Health
Center
Pharmacy
ShipTo
Claim
Type
RX
Number
Member ID
Fill
Fill Date
Adjud
Date
Captured
Date
NDC
Drug
Name
Strength
Form
Pkg
Size
QTY
Disp
Curr
QTY
% of
Claim
Status
Status
Date
Order
Wholesaler
Invoice
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000779925 MR002290390002/15/202102/15/202102/16/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1003030100.00000Replenished 1001824882 3049647435
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780688 MR002290390003/22/202103/22/202103/23/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1003030100.00000Replenished 1001843888 3053146133
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000782414 MR002044000006/04/202106/04/202106/05/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE100562951.78600Replenished 1001869532 3057728431
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780450 45160003/12/202103/12/202103/13/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1002828100.00000Replenished 1001843888 3053146133
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000782113 MR002044000005/21/202105/21/202105/22/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1002828100.00000Replenished 1001869532 3057728431
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000779232 MR000684920001/15/202101/15/202101/16/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE100402665.00000Replenished 1001824882 3049647435
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000779883 MR001272790002/12/202102/12/202102/13/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1002121100.00000Replenished 1001824882 3049647435
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000798970 MR000852540007/05/202307/05/202307/06/202365862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1002121100.00000Replenished08/28/2023 1002263052 3144881029
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000799134 MR002965900007/13/202307/13/202307/14/202365862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1002121100.00000Replenished08/28/2023 1002263052 3144881029
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000799492 MR001697170008/01/202308/01/202308/02/202365862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1002121100.00000Replenished08/28/2023 1002263052 3144881029