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CLICK on an error to see if you found the mistake (1 error per prescription) |
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Rx# |
8394722 |
Written Date |
3/2/20XX |
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Rx Expires |
1 year |
Name |
Don Q. Wright |
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Original Prescription |
DOB |
6/9/XXXX |
Age |
69 |
Ht/Wt |
174 lbs |
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 |
Address |
902 Princeton Blvd. |
Phone |
785-555-3714 |
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Product/Quantity/Refills/SIG |
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Prescribed |
Calan SR |
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Strength |
240 mg |
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Dispensed |
Tiazac 240 SR Capsule |
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Pres Qty |
30 |
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Dis Qty |
30 |
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Day Supply |
30 |
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Refills |
5 |
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SIG |
Take 1 capsule by mouth once daily for heart. |
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Pill Image & Dispensing Notes |
DAW |
0 |
Origin Code |
4 |
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Pill Image |
 |
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Name |
Carolyn Abman |
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Address |
1315 W. 12th Street |
Fax |
785-555-3477 |
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DEA |
BA4132647 |
NPI |
9999999999 |
Phone |
785-555-3470 |
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Dispensing Notes |
Tiazac is preferred diltiazem SR product on patient insurance. |
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