(V2) Product Verification Queue

ELECTRONIC PRESCRIPTION

Date: 10/12/2025 at 03:49 PM

Patient: Evelyn Johnson

Address: 1426 Pinecone Drive

Drug: Decara 10,000 unit Capsule

Dispense: 28

SIG: i po QD for vitamin D deficiency

Refills: 0

DAW: do not substitute

Prescriber: Carolyn Abman

Address: 1315 W. 12th Street

DEA#: BA4132647


`Rx#`	8768959	`Written Date`	10/12/2025

`Name`	Evelyn Johnson
`DOB`	9/20/1948		`Age`	77
`Address`	1426 Pinecone Drive		`Phone`	(785) 555-3113
`Allergies`

`Prescriber`	Carolyn Abman		`Practice`	Family Practice Physician Group
`Address`	1315 W. 12th Street		`Fax`	(316) 555-3278
`DEA`	BA4132647	`NPI`	1269594188	`Phone`	(316) 555-3277

`Dispensed`	Decara 250 mcg Capsule
`NDC #`	67112-0903-50		`Mfg`	Medecor
`Pres Qty`	28	`Dis Qty`	14 (pt request 2 week supply)	`Day Supply`	14
`Refills`	1	`DAW`	1	`Origin Code`	3

`Instructions`	Take 1 capsule by mouth once daily for vitamin D deficiency.

`Dispensing Notes`	Note: 1 mcg cholecalciferol = 40 units vitamin D

Product Verification

Bag Tag

Counting Verification

Patient Name: Evelyn Johnson
Address: 1426 Pinecone Drive

Stock Bottle

67112-0903-50

NDC: 67112-0903-50

Lot #: 645186
Exp Date: 12/4/2026

Pharmacist Action