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Original Prescription
at 9:15, eRx #:51216
ELECTRONIC PRESCRIPTION
Jim O. Mott
906 Harvard
Date: 2/7/20XX
Prednisone 1 mg Tablet
Dispense 20
Sig: 1,PO,BID,X10DAYS
Refills: 0
Dr.
DAW: substitution permitted
Pharmacist Notes:
Patient Profile
Name: Mott, Jim O.
Address: 906 Harvard
Age: 20
Gender: M
Chronic Illness:
Allergies:
OTC Drugs:
Doctor Information
Name:
Practice:
Address:
DEA Number:
DAW Codes
DAW 0 - NO DISPENSE AS WRITTEN
(substitution allowed or no generic on market)
 
DAW 1 - PHYSICIAN writes DISPENSE AS WRITTEN
 
DAW 2 - PATIENT REQUESTED BRAND
 
DAW 3 - PHARMACIST SELECTED BRAND
 
DAW 4 - GENERIC NOT IN STOCK
 
DAW 5 - BRAND DISPENSED, PRICED AS GENERIC
 
DAW 6 - OVERRIDE
 
DAW 7 - SUBSTITUTION NOT ALLOWED BY LAW
 
DAW 8 - GENERIC NOT AVAILABLE
 
DAW 9 - OTHER
Insurance Card
United Blue Expressmark
Prescription Drug Card
Member Name:  Edward G. Mott
Member ID:  268117904
Person Code:  00 Edward G., 01 Mary F., 02 Jim O., 03 Jill S., 04 Tim D., 05 Julie
RxBIN:  769555
RxPCN:  NTZQQY
RxGROUP:  2DO6HH8K