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 000000790932 MR001924100006/16/202206/16/202206/17/202265862020901MINOCYCLINE 50 MG CAPSULE50 MGCAPSULE1009090100.00000Replenished 1002100079 3104971541
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000790932 MR001924100109/01/202209/01/202209/02/202265862020901MINOCYCLINE 50 MG CAPSULE50 MGCAPSULE100901011.11100Replenished 1002100079 3104971541
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000790932 MR001924100109/01/202209/01/202209/02/202265862020901MINOCYCLINE 50 MG CAPSULE50 MGCAPSULE100908088.88900Replenished 1002142782 3114755273
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000790932 MR001924100212/01/202212/01/202212/03/202265862020901MINOCYCLINE 50 MG CAPSULE50 MGCAPSULE100902022.22200Replenished 1002142782 3114755273
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000790932 MR001924100212/01/202212/01/202212/03/202265862020901MINOCYCLINE 50 MG CAPSULE50 MGCAPSULE100907077.77800Replenished 1002179310 3123694460
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000790932 MR001924100302/15/202302/15/202302/16/202365862020901MINOCYCLINE 50 MG CAPSULE50 MGCAPSULE100903033.33300Replenished 1002179310 3123694460