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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 000000799448 MR002290390007/28/202307/28/202307/29/202362332014231CELECOXIB 200 MG CAPSULE200 MGCAPSULE100180147.77700Replenished08/17/2023 1002259987 3143744568
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000799448 MR002290390007/28/202307/28/202307/29/202362332014231CELECOXIB 200 MG CAPSULE200 MGCAPSULE1001806636.66700Replenished08/22/2023 1002251766 3141657239
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000799448 MR002290390007/28/202307/28/202307/29/202362332014231CELECOXIB 200 MG CAPSULE200 MGCAPSULE10018010055.55600Replenished08/22/2023 1002251766 3141657239