(V2) Product Verification Queue

ELECTRONIC PRESCRIPTION

Date: 10/13/2025 at 10:50 PM

Patient: Stanley M. Bontrager

Address: 421 E. 21st Street

Drug: Crestor 20 mg Tablet

Dispense: 30

SIG: i po QD for high cholesterol

Refills: 3

DAW: substitution permitted

Prescriber: George Platz

Address: 908 Concord

DEA#: AP7323013


`Rx#`	2383053	`Written Date`	10/13/2025

`Name`	Stanley M. Bontrager
`DOB`	7/11/1992		`Age`	33
`Address`	421 E. 21st Street		`Phone`	(316) 555-4551
`Allergies`	Fish (omega-3 fatty acids) and shellfish (rash, swelling)

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

`Dispensed`	Rosuvastatin 20 mg Tablet
`NDC #`	13668-0181-05		`Mfg`	Torrent
`Pres Qty`	30	`Dis Qty`	22 (low stock, owe 8)	`Day Supply`	30
`Refills`	3	`DAW`	0	`Origin Code`	3

`Instructions`	Take 1 tablet by mouth once daily for high cholesterol.

`Dispensing Notes`

Product Verification

Bag Tag

Counting Verification

Patient Name: Stanley M. Bonder
Address: 420 W. 21st Street

Stock Bottle

13668-0181-05

NDC: 13668-0181-05

Lot #: 104814
Exp Date: 11/3/2026

Pharmacist Action