Rx30
| General Field Name |
Rx30 Field Name |
| Date Dispensed |
FILLDATE |
| Patient Date of Birth |
PATDOB |
| Directions |
DIRECTION 1 |
| Directions |
DIRECTION 2 |
| Directions |
DIRECTION 3 |
| Directions |
DIRECTION 4 |
| Directions |
DIRECTION 5 |
| Gender |
GENDER |
| Patient Address/Household |
PATADD1 |
| Patient Address/Household | PATADD2 |
| Insurance Status |
PAYTYPE |
| Medication Days Supply |
DS |
|
Medication Indication ICD10
|
RXDIAG 1 |
| Medication Name |
DRUG NAME |
| Medication Origin |
RXORIGIN |
| NDC |
NDC |
| Patient ID |
PATKEY |
| Prescription Number |
RXNBR |
| Quantity Dispensed |
QTY DSP |
| Patient Zip Code |
PATZIP |
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