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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 000000772286 MR002561370201/15/202101/15/202101/16/202100378023101ATENOLOL 50 MG TABLET50 MGTABLET1009055.55600Replenished 1001835626 3051655272
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000777474 MR001741360307/28/202107/28/202107/29/202100378023101ATENOLOL 50 MG TABLET50 MGTABLET1009055.55600Replenished 1001897770 3062993331
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000781068 MR000305490004/08/202104/08/202104/09/202100378023101ATENOLOL 50 MG TABLET50 MGTABLET10030516.66700Replenished 1001850989 3054468652
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000785943 MR001741360011/01/202111/01/202111/02/202100378023101ATENOLOL 50 MG TABLET50 MGTABLET1009055.55600Replenished 1001951777 3072578295
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000777474 MR001741360204/30/202104/30/202105/01/202100378023101ATENOLOL 50 MG TABLET50 MGTABLET100901011.11100Replenished 1001860966 3056169530
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000782895 MR001901990006/25/202106/25/202106/26/202100378023101ATENOLOL 50 MG TABLET50 MGTABLET100901011.11100Replenished 1001880371 3059776595
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000785060 MR001901990009/27/202109/27/202109/28/202100378023101ATENOLOL 50 MG TABLET50 MGTABLET100901011.11100Replenished 1001928804 3069023028
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000779871 MR002980170002/12/202102/12/202102/13/202100378023101ATENOLOL 50 MG TABLET50 MGTABLET1001515100.00000Replenished 1001830991 3050869519
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000779871 MR002980170103/15/202103/15/202103/16/202100378023101ATENOLOL 50 MG TABLET50 MGTABLET1001515100.00000Replenished 1001835626 3051655272
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000779871 MR002980170204/19/202104/19/202104/20/202100378023101ATENOLOL 50 MG TABLET50 MGTABLET1001515100.00000Replenished 1001850989 3054468652