Back

Accumulator - View By Claim

Export to Excel

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 000000778905 MR000443660304/07/202104/07/202104/08/202116729017001ESCITALOPRAM 20 MG TABLET20 MGTABLET100301033.33300Replenished 1001839075 3052306186
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000778905 MR000443660304/07/202104/07/202104/08/202116729017001ESCITALOPRAM 20 MG TABLET20 MGTABLET100302066.66700Replenished 1001871163 3057980095