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Rx#
883922
Written Date
10/13/2025
Patient Information
 
Rx Expires
10/13/2026
Name
Richard T. Hanson
Original Prescription
DOB
11/22/1991
Age
34
Ht/Wt
at 4:49, eRx #: 8085222
ELECTRONIC PRESCRIPTION
Richard T. Hanson
1205 Edgewood Lane
Date: 10/13/2025
Lasix 40 mg Tablet
Dispense 30
Sig: i po qAM for HTN
Refills: 4
Dr. Samuel Bernstein
3-C Medical Arts Building
AB1294824
DAW: substitution permitted
Address
1205 Edgewood Lane
Phone
(785) 555-3521
Product/Quantity/Refills/SIG
Prescribed
Lasix 40 mg Tablet
Strength
40 mg
 
Dispensed
Furosemide 40 mg Tablet
Pres Qty
30
 
Dis Qty
30
 
Day Supply
 
Refills
4
 
SIG
Take 1 tablet by mouth every morning for hight blood pressure.
Pill Image & Dispensing Notes
RPh Note:
DAW
0
Origin Code
3
 
Pill Image
Prescriber Information
Name
Samuel Bernstein
Address
3-C Medical Arts Building
Fax
(785) 555-8678
DEA
AB1294824
NPI
7759028783
Phone
(785) 555-8678
DUR ALERT
 
There is a PROFILE ALERT for Richard T. Hanson taking Lasix 40 mg Tablet
 

Alert Concern: Pharmacist Action: Proposed Change: