Rx# |
615011 |
Written Date |
10/13/2025 |
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Rx Expires |
04/13/2026 |
Name |
Mrs. Harold Elder |
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Original Prescription |
DOB |
2/12/1955 |
Age |
70 |
Ht/Wt |
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Address |
940 Oak Street |
Phone |
(316) 555-4156 |
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Product/Quantity/Refills/SIG |
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Prescribed |
Symbyax 12/25 Capsules |
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Strength |
12.5/25 mg |
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Dispensed |
Symbyax 12/25 Capsules |
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Pres Qty |
30 |
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Dis Qty |
30 |
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Day Supply |
30 |
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Refills |
2 |
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SIG |
Take 1 capsule by mouth every morning for depression. |
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Pill Image & Dispensing Notes |
DAW |
1 |
Origin Code |
2 |
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Pill Image |
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Name |
James T. Warren |
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Address |
3-G Medical Arts Building |
Fax |
(785) 555-5566 |
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DEA |
AW1351977 |
NPI |
6379131958 |
Phone |
(785) 555-5566 |
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DUR ALERT |
There is a DOSING ALERT for Mrs. Harold Elder taking Symbyax 12/25 Capsules with the instructions: Take 1 capsule by mouth every morning for depression. |
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