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aPhils., Inc.

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.

Flap Redemption Program - Drugstores


Products Drugstore Name Actual # Rate of flaps per flap Total Reference Amount Invoice

medlink PharmaPhils., Inc.

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.

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