| SR# | DESCRIPTION | NDC | PKG SIZE | RX INS NAME | RX INS BIN | FILLED QTY | PURCHASED QTY | DIFFERENCE | STATUS | INS PAID ($) | SUPPLY COST ($) |
|---|
| Sr# | Description | NDC | Package Size | Rx Ins Name | Rx Ins BIN | Rx Qty Filled Total | Purchase Quantity | Difference | Status | INS PAID ($) | SUPPLY COST ($) |
|---|