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 000000782895 MR001901990006/25/202106/25/202106/26/202100378023101ATENOLOL 50 MG TABLET50 MGTABLET100901011.11100Replenished 1001880371 3059776595
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1)Third Party – Captured 000000782895 MR001901990006/25/202106/25/202106/26/202100378023101ATENOLOL 50 MG TABLET50 MGTABLET100908088.88900Replenished 1001897770 3062993331