CLICK on an error to see if you found the mistake (1 error per prescription) |
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Rx# |
9123044 |
Written Date |
2/26/20XX |
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Rx Expires |
1 year |
Name |
Bob O. Sykes |
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Original Prescription |
DOB |
7/5/XXXX |
Age |
75 |
Ht/Wt |
162 lbs |
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Address |
832 Missouri Street |
Phone |
785-555-6403 |
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Product/Quantity/Refills/SIG |
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Prescribed |
Lanoxin Tab |
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Strength |
125 mcg |
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Dispensed |
Lanoxin 0.125 mg Tablet |
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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 |
6 |
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SIG |
Take 1 tablet by mouth once daily every morning. |
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Pill Image & Dispensing Notes |
DAW |
1 |
Origin Code |
3 |
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Pill Image |
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Name |
Sandra Jones |
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Address |
2300 Clinton Parkway Ct. |
Fax |
785-555-4199 |
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DEA |
BJ1234563 |
NPI |
999999999 |
Phone |
785-555-4195 |
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Dispensing Notes |