Rx# |
873121 |
Written Date |
10/12/2025 |
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Rx Expires |
10/12/2026 |
Name |
Laurie N. Elder |
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Original Prescription |
DOB |
5/19/2012 |
Age |
13 |
Ht/Wt |
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Address |
940 Popular |
Phone |
(316) 555-2751 |
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Product/Quantity/Refills/SIG |
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Prescribed |
Depakote ER 250 mg Tablet |
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Strength |
250 mg |
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Dispensed |
Depakote ER 250 mg Tablet |
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Pres Qty |
90 |
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Dis Qty |
90 |
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Day Supply |
30 |
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Refills |
3 |
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SIG |
Take 1 tablet by mouth 3 times daily for focal onset seizures. |
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Pill Image & Dispensing Notes |
DAW |
1 |
Origin Code |
4 |
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Pill Image |
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Name |
Harold L. Green |
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Address |
2-G Medical Arts Building |
Fax |
(785) 555-7718 |
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DEA |
AG1294230 |
NPI |
5946269224 |
Phone |
(785) 555-7718 |
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DUR ALERT |
There is a DOSING ALERT for Laurie N. Elder taking Depakote ER 250 mg Tablet with the instructions: Take 1 tablet by mouth 3 times daily for focal onset seizures. |
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