20016200113184SS Insulin Directions:ABBL2122082000001010000000000000001010Arial80001110000000000200162001131840000000000000000000000000000000000000000000000200162001131840126//5FAG4AdABlAHIAIABTAGwAaQBkAGkAbgBnACAAUwBjAGEAbABlACAASQBuAHMAdQBsAGkAbgA6 AA==0010000000000000000000000000000000000000000000000801000000000000911981420016200113184000000000000000000000000000000000000000000020016200113184804-1-1SS Insulin Directions20016200113077ACAA1281286425525525500000000000000001105251020001Arial1400501018421504000000000200162001130770000000000000000000000000000000000000000000000200162001130770001000000000000000000000000000000000000000000000000001000000000000000020016200113077000000000000000000000000000000000000000000020016200113072^ Change DoseIA==ACAB224224175000000000000000000002551000Arial80000018421504000000000200162001130720000000000000000000000000000000000000000000000200162001130720000000000000000000000000000000000000000000000000000409601000000000000000020016200113072000000000000000000000000000000000000000000020016200113073^ Change RouteACAC224224175000000000000000000002551000Arial80000018421504000000000200162001130730000000000000000000000000000000000000000000000200162001130730126//5DAGgAbwBvAHMAZQAgAFIAbwB1AHQAZQA6AA==100000000000000000000000000000000000000000000000013421772901000000000000522531820016200113073000000000000000000000000000000000000000000020016200113124^ Change Sliding ScaleACAD224224175000000000000000000002551000Arial80000018421504000000000200162001131240000000000000000000000000000000000000000000000200162001131240126//5FAG4AdABlAHIAIABTAGwAaQBkAGkAbgBnACAAUwBjAGEAbABlACAASQBuAHMAdQBsAGkAbgA6 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Duration200162001132231200162001127012001620011322322001620011271120016200113159Duration:ACAQ2122082000001010000000000000001000Arial8000001797457400000000020016200113159000000000000000000000000000000000000000000000020016200113159000001000000000000800000000000000000000000000000000013421773601000000000000114111420016200113159000000000000000000000000000000000000000000020016200113159804-1-1Duration2001620011270NoneACAR025525500000100100000000001105251020000Arial8000001797457400000000020016200112700000000000000000000000000000000000000000000000200162001127000010000000000000000000100000000000000000000000000001342177360100000000000000002001620011270000000000000000000000000000000000000000000020016200112701200162001127032001620011270220016200111021200162001127012001620011270320016200112702200162001110212001620011271Select Start & End 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ScaleACBM02552550000010010000000000000000Arial80000017974574000000000200162001132260000000000000000000000000000000000000000000000200162001132260001000000000000000000010000000000000000000000000000001000000000000000020016200113226000000000000000000000000000000000000000000020016200113226120016200114531200162001132262200162001149120016200113226320016200114541200162001132264200162001146212001620011322652001620011455120016200113226620016200114641200162001132267200162001145612001620011322682001620011465120016200113226920016200114571200162001132261020016200114671200162001132261120016200114581200162001132261220016200114681200162001132261320016200114591200162001132261420016200114691200162001132261520016200114601200162001132261620016200112746120016200113226172001620011470120016200113226120016200114531200162001132262200162001149120016200113226320016200114541200162001132264200162001146212001620011322652001620011455120016200113226620016200114641200162001132267200162001145612001620011322682001620011465120016200113226920016200114571200162001132261020016200114671200162001132261120016200114581200162001132261220016200114681200162001132261320016200114591200162001132261420016200114691200162001132261520016200114601200162001132261620016200112746120016200113226172001620011470120016200113227High Resistance ScaleACBN02552550000010010000000000000000Arial8000001797457400000000020016200113227000000000000000000000000000000000000000000000020016200113227000100000000000000000001000000000000000000000000000000100000000000000002001620011322700000000000000000000000000000000000000000002001620011322712001620011453120016200113227220016200114912001620011322732001620011454120016200113227420016200114621200162001132275200162001145512001620011322762001620011465120016200113227720016200114561200162001132278200162001146712001620011322792001620011457120016200113227102001620011468120016200113227112001620011458120016200113227122001620011469120016200113227132001620011459120016200113227142001620011274612001620011322715200162001146012001620011322716200162001127451200162001132271720016200114701200162001132271200162001145312001620011322722001620011491200162001132273200162001145412001620011322742001620011462120016200113227520016200114551200162001132276200162001146512001620011322772001620011456120016200113227820016200114671200162001132279200162001145712001620011322710200162001146812001620011322711200162001145812001620011322712200162001146912001620011322713200162001145912001620011322714200162001127461200162001132271520016200114601200162001132271620016200112745120016200113227172001620011470120016200113228Low Resistance ScaleACBO02552550000010010000000000000000Arial800000179745740000000002001620011322800000000000000000000000000000000000000000000002001620011322800010000000000000000000100000000000000000000000000000010000000000000000200162001132280000000000000000000000000000000000000000000200162001132281200162001145312001620011322822001620011491200162001132283200162001145412001620011322842001620011462120016200113228520016200114551200162001132286200162001127691200162001132287200162001145612001620011322882001620011464120016200113228920016200114571200162001132281020016200112767120016200113228112001620011458120016200113228122001620011465120016200113228132001620011459120016200113228142001620011276512001620011322815200162001146012001620011322816200162001146712001620011322817200162001147012001620011322812001620011453120016200113228220016200114912001620011322832001620011454120016200113228420016200114621200162001132285200162001145512001620011322862001620011276912001620011322872001620011456120016200113228820016200114641200162001132289200162001145712001620011322810200162001127671200162001132281120016200114581200162001132281220016200114651200162001132281320016200114591200162001132281420016200112765120016200113228152001620011460120016200113228162001620011467120016200113228172001620011470120016200113079ADAA1281286425525525500000000000000001105251020001Arial1400501018421504000000000200162001130790000000000000000000000000000000000000000000000200162001130790001000000000000000000000000000000000000000000000000001000000000000000020016200113079000000000000000000000000000000000000000000020016200113071^ Change FrequencyADAB224224175000000000000000000002551000Arial80000018421504000000000200162001130710000000000000000000000000000000000000000000000200162001130710126//5DAGgAbwBvAHMAZQAgAEYAcgBlAHEAdQBlAG4AYwB5ADoA1000000000000000000000000000000000000000000000000001000000000000551571520016200113071000000000000000000000000000000000000000000020016200113074^ Change PRN FrequencyADAC224224175000000000000000000002551000Arial80000018421504000000000200162001130740000000000000000000000000000000000000000000000200162001130740126//5DAGgAbwBvAHMAZQAgAFAAUgBOACAARgByAGUAcQB1AGUAbgBjAHkAOgA=100000000000000000000000000000000000000000000000000100000000000070171920016200113074000000000000000000000000000000000000000000020016200113075^ Change PRN Neb FrequencyADAD224224175000000000000000000002551000Arial80000018421504000000000200162001130750000000000000000000000000000000000000000000000200162001130750126//5DAGgAbwBvAHMAZQAgAFAAUgBOACAATgBlAGIAIABGAHIAZQBxAHUAZQBuAGMAeQA6AA==1000000000000000000000000000000000000000000000000001000000000000731731020016200113075000000000000000000000000000000000000000000020016200113343^ Change Rate (continuous)ADAE224224175000000000000000000002551000Arial80000018421504000000000200162001133430000000000000000000000000000000000000000000000200162001133430126//5FAG4AdABlAHIAIABSAGEAdABlADoA10000000000000000000000000000000000000000000000000010000000000009911001020016200113343000000000000000000000000000000000000000000020016200113360^ Change Rate (IVPB/Int.)ADAF224224175000000000000000000002551000Arial80000018421504000000000200162001133600000000000000000000000000000000000000000000000200162001133600126//5FAG4AdABlAHIAIABSAGEAdABlADoA100000000000000000000000000000000000000000000000000100000000000010311031020016200113360000000000000000000000000000000000000000000020016200113361^ Change Rate (PCA)ADAG224224175000000000000000000002551000Arial80000018421504000000000200162001133610000000000000000000000000000000000000000000000200162001133610126//5FAG4AdABlAHIAIABBAHAAcAByAG8AcAByAGkAYQB0AGUAIABSAGEAdABlACAASQBuAGYAbwBy 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Not FillADAK2122082000001010000000000000001000Arial8000001797457400000000020016200113171000000000000000000000000000000000000000000000020016200113171000001000000000000100000000000000000000000000000000080000000000000083483620016200113171000000000000000000000000000000000000000000020016200113171804-1-1Do Not Fill20016200113172Pharmacy Notes:ADAL21220820000010100000000000001105251021000Arial8000001797457400000000020016200113172000000000000000000000000000000000000000000000020016200113172014//5QAGgAYQByAG0AYQBjAHkAIABOAG8AdABlAHMA0010000000000001000000000000000000000000000000000800000000000000000020016200113172000000000000000000000000000000000000000000020016200113172804-1-1Pharmacy Notes20016200113173No SubstitutionsADAM2122082000001010000000000000001000Arial80000017974574000000000200162001131730000000000000000000000000000000000000000000000200162001131730000010000000000001000000000000000000000000000000000800000000000000000020016200113173000000000000000000000000000000000000000000020016200113173804-1-1No Substitutions20016200113390Change Order Number:ADAN2122082000001010000000000000001000Arial80000017974574000000000200162001133900000000000000000000000000000000000000000000000200162001133900129001000000000000100000000000000000000000000000000080000000000000083483620016200113390000000000000000000000000000000000000000000020016200113390804-1-1Change Order Number20016200113363RefillsADAO2122082000001010010000000000001000Arial8000001797457400000000020016200113363000000000000000000000000000000000000000000000020016200113363000101000000000000100001000000000000000000000000000080000000000000000002001620011336300000000000000000000000000000000000000000002001620011336312001620011381200162001133631200162001138120016200113363804-1-1Refills20016200113174NoneADAP02552550000010000000000000000000Arial80000017974574000000000200162001131740000000000000000000000000000000000000000000000200162001131740001000000000000000000000000000000000000000000000000801000000000000000020016200113174000000000000000000000000000000000000000000020016200113174804-1-1none20016200113364--- AutoDocs ---ADAQ255255255128646400000000000000001105251020000Arial80001010000000000200162001133640000000000000000000000000000000200000000000001101110000000000000000000000000000000020016200113364000000000000000000000000000000020000000000000110111000000000000000000000000000000002001620011336400000000000000000000000000000000000000000000002001620011336400010000000000000000000000000000000000000000000000000010000000000000000200162001133640000000000000000000000000000000000000000000200162001115Dispense #:ADAR2122082000001010001000000000001000Arial80000017974574000000000200162001115000000000000000000000000000000000000000000000020016200111501-1RW50ZXIgdGhlIE51bWJlciBvZiBQaWxscyB0byBEaXNwZW5zZQ==00100000000000000000010000000000000000000001000008010000000000000000200162001115000000000000000000000000000000000000000000020016200111512001620011382001620011151200162001138200162001138# Refills:ADAS2122082000001010000000200000001000Arial80000017974574000000000200162001138000000000000000000000000000000000000000000000020016200113801-1RW50ZXIgdGhlIE51bWJlciBvZiBSZWZpbGxz001000000000000000000000000000000000000000010000080100000000000000002001620011380000000000000000000000000000000000000000000200162001146**SPLIT ORDER**ADAU2122082000001010000000000000001000Arial800000179745740000000002001620011460000000000000000000000000000000000000000000000200162001146000001000000000000000000000000000000000000000000000000100000000000000002001620011460000000000000000000000000000000000000000000200162001146804-1-1**SPLIT ORDER**20016200113175Controlled Substance?ADAW25525500001000000000000000001010Arial80001110000000000200162001131750000000000000000000000000000000000000000000000200162001131750120//5JAHMAIAB0AGgAaQBzACAAYQAgAEMAbwBuAHQAcgBvAGwAbABlAGQAIABTAHUAYgBzAHQAYQBu 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OrderADBC02552550000010000000000000000000Arial8000001797457400000000020016200113392000000000000000000000000000000000000000000-1000200162001133920000000000000000000000000000000000000000000000000000001000000000000000020016200113392000000000000000000000000000000000000000000020016200113392801-1-1VT20016200113392804-1-1Verbal Telephone Order2001620011105Verbal In-Person OrderADBD02552550000010000000000000000000Arial800000179745740000000002001620011105000000000000000000000000000000000000000000-1000200162001110500000000000000000000000000000000000000000000000000000010000000000000000200162001110500000000000000000000000000000000000000000002001620011105801-1-1VI2001620011105804-1-1Verbal In-Person Order2001620011107Written 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MethodADBG02552550000010000000000000000000Arial800000179745740000000002001620011117000000000000000000000000000000000000000000-1000200162001111700000000000000000000000000000000000000000000000000000010000000000000000200162001111700000000000000000000000000000000000000000002001620011117801-1-1OM2001620011117804-1-1Other Method20016200112790ADBK1281286425525525500000000000000001105251020001Arial140001018421504000000000200162001127900000000000000000000000000000000000000000000000200162001127900001000000000000000000000000000000000000000000000000001000000000000000020016200112790000000000000000000000000000000000000000000020016200113078AEAA1281286425525525500000000000000001105251020001Arial1400501018421504000000000200162001130780000000000000000000000000000000000000000000000200162001130780001000000000000000000000000000000000000000000000000001000000000000000020016200113078000000000000000000000000000000000000000000020016200113070^ Change TimeAEAB224224175000000000000000000002551000Arial80000018421504000000000200162001130700000000000000000000000000000000000000000000000200162001130700126//5TAGUAbABlAGMAdAAgAFQAaQBtAGUAKABzACkAIABhAG4AZAAgAEEAcABwAHIAbwBwAHIAaQBh AHQAZQAgAE0AQQBSAC0AcwBwAGUAYwBpAGYAaQBjACAATwB0AGgAZQByACAAVwBvAHIAZABzAA== 1000000000000000000000000000000000000000000000000001000000000000591681920016200113070000000000000000000000000000000000000000000020016200113088^ Change DurationAEAC224224175000000000000000000002551000Arial80000018421504000000000200162001130880000000000000000000000000000000000000000000000200162001130880120//5DAGgAbwBvAHMAZQAgAEQAdQByAGEAdABpAG8AbgA6AA==1000000000000000000000000000000000000000000000000134217728010000000000000000200162001130880000000000000000000000000000000000000000000200162001130881200162001127012001620011308822001620011315912001620011308832001620011271120016200113377^ Add DurationAEAD224224175000000001000000000002551000Arial8000001842150400000000020016200113377000000000000000000000000000000000000000000000020016200113377000100000000000000000001000000000000000000000000000013421772801000000000000000020016200113377000000000000000000000000000000000000000000020016200113377120016200113158120016200113377120016200113158120016200113089^ Change First DateAEAE224224175000000000000000000002551000Arial8000001842150400000000020016200113089000000000000000000000000000000000000000000000020016200113089012//5GAGkAcgBzAHQAIABEAGEAdABlADoA1000000000000000000000000000000000000000000000000001000000000000000020016200113089000000000000000000000000000000000000000000020016200113090^ Change End DateAEAF224224175000000000000000000002551000Arial8000001842150400000000020016200113090000000000000000000000000000000000000000000000020016200113090012//5FAG4AZAAgAEQAYQB0AGUAOgA=10000000000000000000000000000000000000000000000001677721601000000000000000020016200113090000000000000000000000000000000000000000000020016200113376^ Add End DateAEAG224224175000000001000000000002551000Arial800000184215040000000002001620011337600000000000000000000000000000000000000000000002001620011337600010000000000000000000100000000000000000000000000000010000000000000000200162001133760000000000000000000000000000000000000000000200162001133761200162001110312001620011337612001620011103120016200112931PharmacyAEAI1281286425525525500000000000000001105251020001Arial140001018421504000000000200162001129310000000000000000000000000000000000000000000000200162001129310001000000000000000000000000000000000000000000000000001000000000000000020016200112931000000000000000000000000000000000000000000020016200113179Pharmacy 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20016Physician Orders25525525511Arial1010

10466Medical Condition/Diagnosis Required91010466111046611110001046612211001046611120016200114-1-1-1-11046611220016200113166-1-1-1-110466121-1-1-1-1-1-1-1IND:-110470Pharmacy Required in the Entry91010470111047011110001047012211001047011120016200113179-1-1-1-110470121-1-1-1-1-1-1-1PHM:-110464DEA Drug - ORDER MUST BE FAXED910104641110464201046411110001046412211001046421501001046411120016200111-1-1-1-110464121-1-1-1-1-1-1-1WRN:9 LVL:110464122-1-1-1-1-1-1-1WRN:9 LVL:210464123-1-1-1-1-1-1-1WRN:9 LVL:310464124-1-1-1-1-1-1-1WRN:9 LVL:410464125-1-1-1-1-1-1-1WRN:9 LVL:51046421120016200111-1-1-1-110465Compound Drug NARCOTIC - Order Must Be Faxed91010465111046511110001046512211001046511120016200111-1-1-1-110465121-1-1-1-1-1-1-1GPI:000000000000001046512220016200113176-1-1-1-1