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 000000780228 4900003/01/202103/01/202103/02/202100378075701ATENOLOL 100 MG TABLET100 MGTABLET100601525.00000Replenished 1001824202 3049524740
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780228 4900003/01/202103/01/202103/02/202100378075701ATENOLOL 100 MG TABLET100 MGTABLET100604575.00000Replenished 1001846719 3053644954
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000779215 MR000130120102/17/202102/17/202102/18/202100378075701ATENOLOL 100 MG TABLET100 MGTABLET1006060100.00000Replenished 1001824202 3049524740
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000779215 MR000130120304/20/202104/20/202104/21/202100378075701ATENOLOL 100 MG TABLET100 MGTABLET100605591.66700Replenished 1001846719 3053644954
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000777534 4900201/04/202101/04/202101/05/202100378075701ATENOLOL 100 MG TABLET100 MGTABLET100602541.66700Replenished 1001824202 3049524740
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000777534 4900201/04/202101/04/202101/05/202100378075701ATENOLOL 100 MG TABLET100 MGTABLET100603558.33300Replenished 1001802067