Professional Documents
Culture Documents
Dinesh Shrestha Euro-D
Dinesh Shrestha Euro-D
*_ This document can’t be used for dispensing inside the emirate of Dubai.
*_ This document can be used for dispensing outside the emirate of Dubai with the proper stamps and signatures.
Details
Reference Prescription
ID: Plan: Member ID: Clinician ID:
Number Date:
Denial: Comments:
Diagnoses:
Type Diagnosis
Principal E55.9 - Vitamin D deficiency, unspecified
Showing 1 to 1 of 1 entries
Drugs:
Patient
ID Drug Status Denial Duration Qty Net Instructions ROA Refills
Share
0444-640412-
0971 - EURO- Take 1
D 50000 IU, BOTTLE(s), 1
15407945 15'S, 50000 IU, Approved - 60 1.00 5.10 0.00 Time(s) per ORAL 0
SOFT Week For 60
GELATIN Day(s).
CAPSULES
Total: 5.10 0.00
Showing 1 to 1 of 1 entries