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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 000000799979 MR002505580008/25/202308/25/202308/26/202365862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1001417.14300Replenished08/28/2023 1002263052 3144881029
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780422 MR003488500003/10/202103/10/202103/11/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE10021838.09500Replenished 1001843888 3053146133
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000781245 M8KG365D0004/15/202104/15/202104/16/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE10028828.57100Replenished 1001869532 3057728431
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000779970 MR001650040002/17/202102/17/202102/18/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1001010100.00000Replenished 1001824882 3049647435
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780422 MR003488500003/10/202103/10/202103/11/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE100211361.90500Replenished 1001824882 3049647435
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000779232 MR000684920001/15/202101/15/202101/16/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE100401435.00000Replenished 1001797497
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780646 MR000732600003/19/202103/19/202103/20/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1001414100.00000Replenished 1001843888 3053146133
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000781277 MR000757070004/16/202104/16/202104/17/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1001515100.00000Replenished 1001869532 3057728431
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000799555 MR001174460008/07/202308/07/202308/08/202365862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1001515100.00000Replenished08/28/2023 1002263052 3144881029
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000781245 M8KG365D0004/15/202104/15/202104/16/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE100282071.42900Replenished 1001843888 3053146133