| Wattasmattau Pharmacy Benefits Management Company |
| EXAM - Prescription Claims |
| Online Systems Status : |
Access Granted |
| Audit Report Generated On : |
01/01/2026, at 07:17 am |
| VIEW |
Rx Number |
Patient Name |
Medication Billed |
Claim Amount |
View
|
301421 |
Mary F. Mott |
Aldara 5% Topical Cream |
$254.35 |
View
|
841231 |
Evelyn Johnson |
Boniva 3 mg/3 mL Injection |
$528.73 |
View
|
903322 |
Hilda R. Morgan |
Novolog 100 units/mL FlexPen |
$615.55 |
View
|
748873 |
Roberta Roberts |
Penlac 8% Nail Lacquer |
$350.82 |
View
|
445634 |
Edward M. Miller |
Percocet 5 |
$16.03 |
View
|
690122 |
Charles O. Elder |
Pulmozyme 2.5 mg/2.5 mL Inhalation Solution |
$3190.45 |
|