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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 000000779509 MR001982700001/28/202101/28/202101/29/202151672403901ENALAPRIL MALEATE 10 MG TAB10 MGTABLET1006060100.00000Replenished 1001816771 988000091
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780149 MR001982700002/24/202102/24/202102/25/202151672403901ENALAPRIL MALEATE 10 MG TAB10 MGTABLET100603050.00000Replenished 1001816771 988000091
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780149 MR001982700002/24/202102/24/202102/25/202151672403901ENALAPRIL MALEATE 10 MG TAB10 MGTABLET100603050.00000Replenished 1001854421 3055134799
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000781730 MR001982700005/06/202105/06/202105/07/202151672403901ENALAPRIL MALEATE 10 MG TAB10 MGTABLET100601016.66700Replenished 1001854421 3055134799
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000781730 MR001982700005/06/202105/06/202105/07/202151672403901ENALAPRIL MALEATE 10 MG TAB10 MGTABLET100605083.33300Replenished 1001870132 3057844319
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000783094 MR001982700007/06/202107/06/202107/07/202151672403901ENALAPRIL MALEATE 10 MG TAB10 MGTABLET1006060100.00000Replenished 1001899296 3063578940
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000784496 MR001982700009/02/202109/02/202109/03/202151672403901ENALAPRIL MALEATE 10 MG TAB10 MGTABLET1006060100.00000Replenished 1001935866 3069727219
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000785231 MR001982700010/04/202110/04/202110/05/202151672403901ENALAPRIL MALEATE 10 MG TAB10 MGTABLET100601016.66700Replenished 1001935866 3069727219
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000785231 MR001982700010/04/202110/04/202110/05/202151672403901ENALAPRIL MALEATE 10 MG TAB10 MGTABLET100605083.33300Replenished 1001974055 3077028456
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000792745 MR001954630009/07/202209/07/202209/10/202251672403901ENALAPRIL MALEATE 10 MG TAB10 MGTABLET1003030100.00000Replenished 1002114625 3108158138