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) 59746021601SPIRONOLACTONE 25 MG TABLET25 MGTABLET1000450.00000Suspended 1001782104
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 27241012403SILDENAFIL 20 MG TABLET20 MGTABLET900200.00000Suspended 1001711128
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505450409ROSUVASTATIN CALCIUM 20 MG TAB20 MGTABLET900300.00000Suspended 1001242293
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 60505313001QUETIAPINE FUMARATE 25 MG TAB25 MGTABLET1000300.00000Suspended 1000905285
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
Memorial Hospital**Trapp Pharmacy (#1)**Trapp Pharmacy (#1) 00228277911PROPRANOLOL ER 80 MG CAPSULE80 MGCAP.SA 24H1000400.00000Suspended 1001335840
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) 55513071001PROLIA 60 MG/ML SYRINGE60 MG/MLDISP SYRIN1010.00000Suspended 1001483941