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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 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 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 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 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 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 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 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 000000780688 MR002290390003/22/202103/22/202103/23/202165862001901CEPHALEXIN 500 MG CAPSULE500 MGCAPSULE1003030100.00000Replenished 1001843888 3053146133