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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 000000778524 MR002564910101/22/202101/22/202101/23/202162332014231CELECOXIB 200 MG CAPSULE200 MGCAPSULE10068811.76500Replenished 1001819373 988099025
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000778524 MR002564910101/22/202101/22/202101/23/202162332014231CELECOXIB 200 MG CAPSULE200 MGCAPSULE100686088.23500Replenished 1001800608
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000778128 MR000272440201/26/202101/26/202101/27/202162332014231CELECOXIB 200 MG CAPSULE200 MGCAPSULE1003030100.00000Replenished 1001819373 988099025
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000779594 MR001542460002/01/202102/01/202102/02/202162332014231CELECOXIB 200 MG CAPSULE200 MGCAPSULE1003030100.00000Replenished 1001819373 988099025
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000779983 MR001584550002/18/202102/18/202102/19/202162332014231CELECOXIB 200 MG CAPSULE200 MGCAPSULE1003030100.00000Replenished 1001819373 988099025
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000778128 MR000272440303/01/202103/01/202103/02/202162332014231CELECOXIB 200 MG CAPSULE200 MGCAPSULE1003030100.00000Replenished 1001819373 988099025
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780229 MR002564910003/01/202103/01/202103/02/202162332014231CELECOXIB 200 MG CAPSULE200 MGCAPSULE1006822.94100Replenished 1001819373 988099025
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780229 MR002564910003/01/202103/01/202103/02/202162332014231CELECOXIB 200 MG CAPSULE200 MGCAPSULE100682638.23500Replenished 1001835626 3051655272
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780229 MR002564910003/01/202103/01/202103/02/202162332014231CELECOXIB 200 MG CAPSULE200 MGCAPSULE100684058.82400Replenished 1001819373 988099025
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780232 MR001542460003/01/202103/01/202103/02/202162332014231CELECOXIB 200 MG CAPSULE200 MGCAPSULE1003030100.00000Replenished 1001819373 988099025