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 000000780632 MR001622560003/18/202103/18/202103/19/202168001000501METHYLPREDNISOLONE 4 MG DOSEPK4 MGTAB DS PK2121628.57100Replenished 1001830087 3050733659
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780632 MR001622560003/18/202103/18/202103/19/202168001000501METHYLPREDNISOLONE 4 MG DOSEPK4 MGTAB DS PK21211571.42900Replenished 1001828853 3050481048