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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 000000788883 MR003404930003/11/202203/11/202203/12/202262332003231ROPINIROLE HCL 1 MG TABLET1 MGTABLET100451533.33300Replenished 1002018687 3086273043
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000788883 MR003404930003/11/202203/11/202203/12/202262332003231ROPINIROLE HCL 1 MG TABLET1 MGTABLET100453066.66700Replenished 1002045985 3091824990
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780234 MR002341130003/01/202103/01/202103/02/202162332003231ROPINIROLE HCL 1 MG TABLET1 MGTABLET100270103.70400Replenished 1001835626 3051655272
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780234 MR002341130003/01/202103/01/202103/02/202162332003231ROPINIROLE HCL 1 MG TABLET1 MGTABLET1002706022.22200Replenished 1001819373 988099025
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780234 MR002341130003/01/202103/01/202103/02/202162332003231ROPINIROLE HCL 1 MG TABLET1 MGTABLET10027010037.03700Replenished 1001819373 988099025
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780234 MR002341130003/01/202103/01/202103/02/202162332003231ROPINIROLE HCL 1 MG TABLET1 MGTABLET10027010037.03700Replenished 1001819373 988099025
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780234 MR002341130106/01/202106/01/202106/02/202162332003231ROPINIROLE HCL 1 MG TABLET1 MGTABLET100270207.40700Replenished 1001867724 3057523425
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780234 MR002341130106/01/202106/01/202106/02/202162332003231ROPINIROLE HCL 1 MG TABLET1 MGTABLET1002705018.51900Replenished 1001874393 3058663336
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780234 MR002341130106/01/202106/01/202106/02/202162332003231ROPINIROLE HCL 1 MG TABLET1 MGTABLET10027010037.03700Replenished 1001867724 3057523425
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780234 MR002341130106/01/202106/01/202106/02/202162332003231ROPINIROLE HCL 1 MG TABLET1 MGTABLET10027010037.03700Replenished 1001867724 3057523425