DANIEL F GOULET
MedicationActionTiming
As written · eRx / NCPDP
CYCLOBENZAPRINE TAB 10MG TABS
NCPDP messageNew Rx
PrescriberBrittany Wadaga
Written2026-04-14
Sig1 tab(s) Oral tid,x30 day(s),PRN:as needed for spasm
Qty90
Refills1 authorized
Supply30-day
NDC00093342201
What to do
Insurance rejected the claim
resolve the reject before it can fill
Reject · code 75 (Prior Authorization Required)
Can ride along · due within 7 days