@extends('layouts.app') @section('content')

Back to Prescriptions

Electronic Prescription (eRX)

eRX ID: {{ $prescription['erx_id'] }}

{{ $prescription['status'] }}

RXNetworx

Electronic Prescription System

789 Health Plaza, Los Angeles, CA 90017 • Phone: (555) 999-8888

eRX ID: {{ $prescription['erx_id'] }}

Date Issued: {{ \Carbon\Carbon::parse($prescription['date_approved'])->format('M d, Y g:i A') }}

Prescriber Information

Name

{{ $prescription['prescriber_name'] }}

NPI Number

{{ $prescription['prescriber_npi'] }}

DEA Number

{{ $prescription['prescriber_dea'] }}

Phone

{{ $prescription['prescriber_phone'] }}

Address

{{ $prescription['prescriber_address'] }}

Patient Information

Name

{{ $prescription['patient_name'] }}

Date of Birth

{{ $prescription['patient_dob'] }}

Phone

{{ $prescription['patient_phone'] }}

Address

{{ $prescription['patient_address'] }}

Prescription Details

Medication

{{ $prescription['medication'] }}

Quantity

{{ $prescription['quantity'] }}

Sig (Directions for Use)

{{ $prescription['sig'] }}

Refills

{{ $prescription['refills'] }}

Dispense As Written (DAW)

Substitution Permitted

@if($prescription['notes'] !== 'None' && !empty($prescription['notes']))

Clinical Notes

{{ $prescription['notes'] }}

@endif

Pharmacy

{{ $prescription['pharmacy'] }}

Electronically Signed By:

@if(!empty($prescription['signature_path']) && file_exists(public_path($prescription['signature_path'])))

Prescriber Signature

{{ $prescription['prescriber_name'] }}

{{ \Carbon\Carbon::parse($prescription['date_approved'])->format('F d, Y \a\t g:i A') }}

@else

{{ $prescription['prescriber_name'] }}

Digital signature on file

{{ \Carbon\Carbon::parse($prescription['date_approved'])->format('F d, Y \a\t g:i A') }}

@endif

Transmission Method: Electronic (NCPDP SCRIPT)
Verification Code: {{ strtoupper(substr(md5($prescription['erx_id']), 0, 8)) }}

Important: This is an electronic prescription. Tampering with or altering this prescription is illegal and subject to criminal prosecution. Federal law prohibits the transfer of this prescription to any person other than the patient for whom it was prescribed.

@endsection