| Wattasmattau Pharmacy Benefits Management Company |
| PRACTICE - 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
|
236559 |
Julie Mott |
Amoxicillin 400 mg/5 mL Suspension |
$21.75 |
View
|
198459 |
Margaret Morgan |
Buspar 10 mg Tablet |
$82.75 |
View
|
598779 |
Mary F. Mott |
Risperdal 2 mg Tablet |
$229.75 |
View
|
802369 |
Mrs. Harold Elder |
TMP/SMX DS Tablets |
$27.23 |
View
|
784119 |
James R. Hanson |
Xyzal 0.5 mg/mL Solution |
$103.87 |
View
|
541231 |
Evelyn Johnson |
Actonel 35 mg Tablet |
$145.63 |
View
|
255988 |
Teresa C. Sykes |
Ambien 5 mg Tablet |
$140.35 |
View
|
963442 |
Janet T. Jones |
Byetta 10 mcg/dose Pen |
$9459.55 |
View
|
210035 |
Edward G. Mott |
Captopril 50 mg Tablet |
$246.55 |
View
|
298748 |
Robbie Roberts |
Concerta 27 mg Tablet |
$193.15 |
View
|
784033 |
John R. Morgan |
Lipitor 10 mg Tablet |
$143.35 |
View
|
874112 |
Edward M. Miller |
Lovenox 40 mg Injection |
$994.05 |
View
|
665997 |
Betty L. Moore |
Metoclopramide 10 mg Tablet |
$34.15 |
View
|
158421 |
Hilda R. Morgan |
Neurontin 300 mg Capsules |
$135.75 |
View
|
369551 |
Elizabeth A. Wright |
Prednisolone 1% Oph. Susp. |
$44.35 |
|