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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) 60432062116VALPROIC ACID 250 MG/5 ML SOLN250 MG/5MLSOLUTION47304730.00000Suspended 1000934136
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 68001011707LEVETIRACETAM 500 MG TABLET500 MGTABLET12001200.00000Suspended 1001602316
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 00228277911PROPRANOLOL ER 80 MG CAPSULE80 MGCAP.SA 24H10001000.00000Suspended 1001335840
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 16571065710CEVIMELINE HCL 30 MG CAPSULE30 MGCAPSULE10001000.00000Suspended 1001965736 3075594883
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505018300CARBAMAZEPINE 200 MG TABLET200 MGTABLET10001000.00000Suspended 1001287036
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505018300CARBAMAZEPINE 200 MG TABLET200 MGTABLET10001000.00000Suspended 1001308866
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505018300CARBAMAZEPINE 200 MG TABLET200 MGTABLET10001000.00000Suspended 1001316498
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505313001QUETIAPINE FUMARATE 25 MG TAB25 MGTABLET10001000.00000Suspended 1000970964
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505313001QUETIAPINE FUMARATE 25 MG TAB25 MGTABLET10001000.00000Suspended 1001020386
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505313001QUETIAPINE FUMARATE 25 MG TAB25 MGTABLET10001000.00000Suspended 1001067246