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 000000777166 MR004015950303/30/202103/30/202103/31/202164980034214ALENDRONATE SODIUM 70 MG TAB70 MGTABLET444100.00000Replenished 1001835056 3051528184
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000778359 206790103/01/202103/01/202103/02/202164980034214ALENDRONATE SODIUM 70 MG TAB70 MGTABLET412433.33300Replenished 1001819373 988099025
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000778359 206790103/01/202103/01/202103/02/202164980034214ALENDRONATE SODIUM 70 MG TAB70 MGTABLET412433.33300Replenished 1001819373 988099025
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000778359 206790103/01/202103/01/202103/02/202164980034214ALENDRONATE SODIUM 70 MG TAB70 MGTABLET412433.33400Replenished 1001819373 988099025
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000778359 206790205/26/202105/26/202105/27/202164980034214ALENDRONATE SODIUM 70 MG TAB70 MGTABLET412433.33300Replenished 1001864958 3056990723
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000778359 206790205/26/202105/26/202105/27/202164980034214ALENDRONATE SODIUM 70 MG TAB70 MGTABLET412433.33300Replenished 1001864958 3056990723
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000778359 206790205/26/202105/26/202105/27/202164980034214ALENDRONATE SODIUM 70 MG TAB70 MGTABLET412433.33400Replenished 1001864958 3056990723
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000778359 206790310/05/202110/05/202110/06/202164980034214ALENDRONATE SODIUM 70 MG TAB70 MGTABLET412433.33300Replenished 1001936140 3069865653
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000778359 206790310/05/202110/05/202110/06/202164980034214ALENDRONATE SODIUM 70 MG TAB70 MGTABLET412433.33300Replenished 1001936140 3069865653
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000778359 206790310/05/202110/05/202110/06/202164980034214ALENDRONATE SODIUM 70 MG TAB70 MGTABLET412433.33400Replenished 1001936140 3069865653