| CPRS ORDER NUMBER | PRESCRIPTION NUMBER | DEA # | DETOX # | PROVIDER NAME | PROVIDER ADDRESS #1 | PROVIDER ADDRESS #2 | PROVIDER ADDRESS #3 | PROVIDER CITY | PROVIDER STATE | PROVIDER ZIP+4 | PATIENT NAME | PATIENT | DIG SIG HASH | ICN | PATIENT ADDRESS #1 | PATIENT ADDRESS #2 | PATIENT ADDRESS #3 | PATIENT CITY | PATIENT STATE | PATIENT ZIP+4 | # OF REFILLS | DISPENSE DRUG | DEA SCHEDULE | PROVIDER | ISSUANCE DATE | SOURCE | STACK | DRUG NAME | QTY PRESCRIBED | DIRECTIONS FOR USE (SIG) |
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