| Contract Pharmacy
Accumulator - View By Claim
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Health Center:
Memorial Hospital
Pharmacy:
Trapp Pharmacy (#1)
Capture Date :
To:
Fetching results...
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
True
2933643
Memorial Hospital
**Trapp Pharmacy (#1)
**Trapp Pharmacy (#1)
00169183411
NOVOLIN N 100 UNIT/ML VIAL
100/ML
VIAL
10
0
10
0.00000
Suspended
1000367846
True
2933644
Memorial Hospital
**Trapp Pharmacy (#1)
**Trapp Pharmacy (#1)
00169183411
NOVOLIN N 100 UNIT/ML VIAL
100/ML
VIAL
10
0
10
0.00000
Suspended
1000367846
True
5730943
Memorial Hospital
**Trapp Pharmacy (#1)
**Trapp Pharmacy (#1)
00193731150
CONTOUR NEXT TEST STRIP
STRIP
50
0
50
0.00000
Suspended
1002010073
3084421077
True
2933642
Memorial Hospital
**Trapp Pharmacy (#1)
**Trapp Pharmacy (#1)
00228277911
PROPRANOLOL ER 80 MG CAPSULE
80 MG
CAP.SA 24H
100
0
40
0.00000
Suspended
1001335840
True
2933640
Memorial Hospital
**Trapp Pharmacy (#1)
**Trapp Pharmacy (#1)
00228277911
PROPRANOLOL ER 80 MG CAPSULE
80 MG
CAP.SA 24H
100
0
100
0.00000
Suspended
1001335840
True
2933636
Memorial Hospital
**Trapp Pharmacy (#1)
**Trapp Pharmacy (#1)
00378025701
HALOPERIDOL 1 MG TABLET
1 MG
TABLET
100
0
20
0.00000
Suspended
1000902944
True
2933633
Memorial Hospital
**Trapp Pharmacy (#1)
**Trapp Pharmacy (#1)
00378025701
HALOPERIDOL 1 MG TABLET
1 MG
TABLET
100
0
70
0.00000
Suspended
1000925060
True
6705725
Memorial Hospital
**Trapp Pharmacy (#1)
**Trapp Pharmacy (#1)
00378117591
BUSPIRONE HCL 30 MG TABLET
30 MG
TABLET
60
0
60
0.00000
Suspended
1002068507
3096751040
True
2933632
Memorial Hospital
**Trapp Pharmacy (#1)
**Trapp Pharmacy (#1)
00378207301
LISINOPRIL 5 MG TABLET
5 MG
TABLET
100
0
20
0.00000
Suspended
1001290521
True
2933630
Memorial Hospital
**Trapp Pharmacy (#1)
**Trapp Pharmacy (#1)
00409677802
LORAZEPAM 2 MG/ML VIAL
2 MG/ML
VIAL
10
0
10
0.00000
Suspended
1001067246