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 000000780656 MR002232670003/19/202103/19/202103/20/202168001041504DULOXETINE HCL DR 60 MG CAP60 MGCAPSULE DR30603050.00000Replenished 1001834470 3051403572
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000780656 MR002232670003/19/202103/19/202103/20/202168001041504DULOXETINE HCL DR 60 MG CAP60 MGCAPSULE DR30603050.00000Replenished 1001834470 3051403572