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Pharmskills Online - Remote Filling Verification - Practice Exams - Detail

FPV Practice Exam 1-09
James Warren
3-G Medical Arts Building, Anytown, ST 12345
Sylvia Jones
2032 Missouri Street
2/14/20XX
Hydrocodone w/APAP 5/325
Dispense 20  
Sig: i or ii po q6h prn HA
0
James Warren
AW1351977
DAW:
C
Pharmacist Notes:
75566921
2/14/20XX
Sylvia Jones
James Warren
Take 1 or 2 tablets by mouth every 6 hours as needed for headache.
Hydrocodone/APAP 5 mg/325 mg Tablet
30
0
2/14/20XX
Mallinckrodt
1 Year                                       RPh
Pharmacy Software System
Insurance Information

 
Rx Origin Code: 1
Pharmacy DAW Code: 0
Drug NDC: 00406-0365-01
Quantity: 30
Days Supply: 3
AWP Cost/Unit: $0.54
Total Drug Cost: $16.20
Dispensing Fee: $2.00
Total Billed: $18.20
Payer Code: 3-PARTY
Pharmacy Software System
Rx Documentation

 
Rx Number: 75566921
Dispensing Date: 2/14/20XX
Fill Type: New
Fill Number: 1
Last Fill Date: 2/14/20XX
Initials: RPh
Drug Manu: Mallinckrodt