• Show Items ID Program Department Status Delivery Method Order Requested Method Authorization Code Expiration Date Another Authorized Vendor Rx Paid in Full Cancellation Date Cancellation Reason
    Show 1160 1 DME active vendor phone       no no    
    ID Kind Of Sale Type Equipment Description Inventory Item Serial Number Quantity HCPCS Code HCPCS Conversion Customary Cost Charge Vendor Billed Paid DOS 1 DOS 2
    194 Old Item Drop Ship Compression bandage 133330 322990 3 327.0             2007-12-26  
    195 Old Item Drop Ship Compression bandage 133331 322991 4 327.1             2007-12-27  
    196 New Item Drop Ship Compression bandage 133332 322992 5 327.2             2007-12-28  
    197 New Item Drop Ship Compression bandage 133333 322993 4 327.1             2007-12-29  
    198 New Item Drop Ship Compression bandage 133334 322994 5 327.0             2007-12-30