info

Created By/On:Devel# 11/26/2015 | 5:23:47 AM

Maintained By/On: Jayden Smith 02/12/2018 | 5:06:479 AM

Patient History

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Patient Info
Doe, John
Age: 36
Date of Birth: 10/07/1976
MRN: 7320524611
A/R Total Balance: $0.00
Diseases:Typhoid/Paratyphoid Fev
Allergies: Abilify
New Commercial Plan, Primary Plan, Doe John
Avia Corporate Plan, Secondary Plan, Doe John
Nimbus Prima Plan, Tertiary Plan, Doe John
Patient Notes
Patient is diagnosed with hyper tension.
06/11/2017
Reported alergy with anitibiotic over 500 mg dose.
06/05/2018
Requested only to dispense generic drug, please check before dispensing.
02/06/2018
Rx Pharm Status Fill Product Date Written Date Filled Refills Auth Refils Remain QTY Prescd QTY Disp QTY Rem Prescriber Pat Pay Next Fill Date % Util First Allowed Date Sig Inactivated Date Pickup Date Signature Relationship Primary Plan
51235830-000 0 Pending Fill 1 Boniva Tablet 150 MG 06/27/2018 07/12/2018 2 2 2.000 4.000 30 Hernandez Maria 23.00 07/22/2018 07/12/2018 One Prim
51235836-000 0 New 0 D 1000 Capsule 1000 Unit 09/21/2016 11/27/2016 6 5 7.000 11.000 20 Rodriguez Maria 20.00 11/27/2017 100 One Prim
51235210-000 0 Refill 0 Aspirin Adult Low Strength 81 MG Tablet DR 03/11/2017 07/05/2017 4 3 6.000 3.000 50 Smith Mary 40.00 07/05/2017 100 One Prim
51235255-000 0 On File 0 Boniva Tablet 150 MG 04/13/2018 07/21/2018 3 3 10.000 7.000 30 Johnson James 45.00 04/13/2018 100 One Prim