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medlink Pharm
Flap Redemption Program - Drugstores
Products Drugstore Name Actual # Rate of flaps per flap Total Reference Amount Invoice
medlinkPharmils.,Inc
Buscomed Amp Pediazith Susp Pediacef Susp Pediaclav Susp Medivasc Alloprim
GLUCOMED
Received by:
________________________________ Name & Signature/ Date Notes: Charging of flaps through the ER must be at least one month after date of invoice. This slip has to be returned to the office together with your next ER. Failure to attach this in your next ER means you cannot charge further FRP.
medlinkPharmils.,Inc
medlinkPharmils.,Inc
Buscomed Amp Pediazith Susp Pediacef Susp Pediaclav Susp Medivasc Alloprim
Romamed
Received by:
________________________________ Name & Signature/ Date Notes: Charging of flaps through the ER must be at least one month after date of invoice. This slip has to be returned to the office together with your next ER. Failure to attach this in your next ER means you cannot charge further FRP.
m ed l i nk m ed l i nk
P h a r m a P h i l s . ,
I n c .
P h a r m a P h i l s . ,
I n c .
medlink PharmaPhils.,Inc.