(V2) Product Verification Queue

ELECTRONIC PRESCRIPTION

Date: 10/12/2025 at 09:01 PM

Patient: Hilda R. Morgan

Address: 1824 New York Street

Drug: Glumetza 1,000 mg Tablet

Dispense: 20

SIG: i po QD for diabetes

Refills: 5

DAW: substitution permitted

Prescriber: George Platz

Address: 908 Concord

DEA#: AP7323013


`Rx#`	1185710	`Written Date`	10/12/2025

`Name`	Hilda R. Morgan
`DOB`	8/14/1967		`Age`	58
`Address`	1824 New York Street		`Phone`	(785) 555-7474
`Allergies`

`Prescriber`	George Platz		`Practice`	Certified Internal Medicine Practice
`Address`	908 Concord		`Fax`	(316) 555-7794
`DEA`	AP7323013	`NPI`	7036888798	`Phone`	(316) 555-7793

`Dispensed`	Metformin 1,000 mg Extended-Release Tablet
`NDC #`	68180-0339-09		`Mfg`	Lupin
`Pres Qty`	20	`Dis Qty`	20	`Day Supply`	20
`Refills`	5	`DAW`	0	`Origin Code`	3

`Instructions`	Take 1 tablet by mouth once daily for diabetes.

`Dispensing Notes`

Product Verification

Bag Tag

Counting Verification

Patient Name: Hilda R. Morgan
Address: 1824 New York Street

Stock Bottle

68180-0339-09

NDC: 68180-0339-09

Lot #: 641517
Exp Date: 1/24/2024

Pharmacist Action