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Pharmskills Online - (V1) Data Entry Verification - View Detail

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Rx#
6974474
Written Date
2/17/20XX
 
Rx Expires
1 year
Name
John R. Morgan
Original Prescription
DOB
6/6/XXXX
Age
66
Ht/Wt
73 inches, 214 lbs
at 17:53, eRx #: 5806
ELECTRONIC PRESCRIPTION
John Morgan
Date: 2/17/20XX
Norvasc 5 mg
Dispense 1 month supply
Sig: i po qd
Refills: 11
Dr. James T. Warren
DAW: do not substitute
Address
1824 New York Street
Phone
785-555-4102
Product/Quantity/Refills/SIG
Prescribed
Norvasc Tab
Strength
5 mg
 
Dispensed
Norvasc 5 mg Tablet
Pres Qty
30
 
Dis Qty
30
 
Day Supply
30
 
Refills
11
 
SIG
Take 1 tablet by mouth once daily.
Pill Image & Dispensing Notes
DAW
0
Origin Code
3
 
Pill Image
Name
James T. Warren
Address
3-G Medical Arts Building
Fax
785-555-4133
DEA
AW1351977
NPI
9999999999
Phone
785-555-4100
Dispensing
Notes