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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) 60505252906ZIPRASIDONE HCL 40 MG CAPSULE40 MGCAPSULE600600.00000Suspended 1001024027
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505253006ZIPRASIDONE HCL 60 MG CAPSULE60 MGCAPSULE600600.00000Suspended 1001326094
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505313001QUETIAPINE FUMARATE 25 MG TAB25 MGTABLET1000300.00000Suspended 1000905285
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505313001QUETIAPINE FUMARATE 25 MG TAB25 MGTABLET10001000.00000Suspended 1000970964
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505313001QUETIAPINE FUMARATE 25 MG TAB25 MGTABLET10001000.00000Suspended 1001020386
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505313001QUETIAPINE FUMARATE 25 MG TAB25 MGTABLET10001000.00000Suspended 1001067246
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505450409ROSUVASTATIN CALCIUM 20 MG TAB20 MGTABLET900300.00000Suspended 1001242293
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 61442012101FAMOTIDINE 20 MG TABLET20 MGTABLET100020.00000Suspended 1001340999
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 62037083201METOPROLOL SUCC ER 100 MG TAB100 MGTAB.SR 24H1000100.00000Suspended 1000583727
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 62175026137NIFEDIPINE ER 60 MG TABLET60 MGTAB ER2 241000500.00000Suspended 1001753044