(V2) Product Verification Queue

ELECTRONIC PRESCRIPTION

Date: 10/13/2025 at 11:04 PM

Patient: Alexander Williams

Address: 1405 W. 12th Street

Drug: Celexa 30 mg Capsule

Dispense: 3-week supply

SIG: i po QD for panic disorder

Refills: 1

DAW: generic okay

Prescriber: Norman Keyes

Address: 4-G Medical Arts Building

DEA#: AK4132647


`Rx#`	7931122	`Written Date`	10/13/2025

`Name`	Alexander Williams
`DOB`	4/30/1976		`Age`	49
`Address`	1405 W. 12th Street		`Phone`	(785) 555-0036
`Allergies`	Esomeprazole (rash, lip swelling)

`Prescriber`	Norman Keyes		`Practice`	Uptown Family Practice
`Address`	4-G Medical Arts Building		`Fax`	(785) 555-3239
`DEA`	AK4132647	`NPI`	3816380925	`Phone`	(785) 555-3238

`Dispensed`	Citalopram 30 mg Capsule
`NDC #`	52427-0691-30		`Mfg`	Almatica
`Pres Qty`	21	`Dis Qty`	21	`Day Supply`	21
`Refills`	1	`DAW`	0	`Origin Code`	3

`Instructions`	Take 1 capsule by mouth once daily for panic disorder.

`Dispensing Notes`

Product Verification

Bag Tag

Counting Verification

Patient Name: Alexander Williams
Address: 1405 W. 12th Street

Stock Bottle

52427-0691-30

NDC: 52427-0691-30

Lot #: 292302
Exp Date: 9/26/2026

Pharmacist Action