(V2) Product Verification Queue

ELECTRONIC PRESCRIPTION

Date: 10/13/2025 at 04:18 AM

Patient: Daniel Day

Address: 899 Oak Street

Drug: Urocit-K 15 mEq ER Tablet

Dispense: 15

SIG: i po TID for hypokalemia

Refills: 0

DAW: generic okay

Prescriber: Samuel Bernstein

Address: 3-C Medical Arts Building

DEA#: AB1294824


`Rx#`	9732677	`Written Date`	10/13/2025

`Name`	Daniel Day
`DOB`	7/30/1977		`Age`	48
`Address`	899 Oak Street		`Phone`	(785) 555-0734
`Allergies`

`Prescriber`	Samuel Bernstein		`Practice`	Internal Medicine Associates
`Address`	3-C Medical Arts Building		`Fax`	(785) 555-8679
`DEA`	AB1294824	`NPI`	7759028783	`Phone`	(785) 555-8678

`Dispensed`	Potassium Citrate 15 mEq Extended-Release Tablet
`NDC #`	00591-2742-01		`Mfg`	Actavis
`Pres Qty`	15	`Dis Qty`	15	`Day Supply`	5
`Refills`	0	`DAW`	0	`Origin Code`	3

`Instructions`	Take 1 tablet by mouth 3 times daily for low potassium.

`Dispensing Notes`

Product Verification

Bag Tag

Counting Verification

Patient Name: Danielle Day
Address: 989 Pine Street

Stock Bottle

00591-2742-01

NDC: 00591-2742-01

Lot #: 799213
Exp Date: 6/11/2026

Pharmacist Action