Patient record

EONDEOPOAR, FREACKOADEO #2468

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Demographics

DOB1959-03-21
SexM
Address8565 EACKEOW CT, EONG AZ 25842
Phone5555454533
FacilityGROUP HOME
StatusActive
AllergiesP HX OF MALIGNANT NEOPLASM

Coverage

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PayerPlanMember IDGroup IDRelationshipPrimary
PRIVATE PR Secondary

PSB F6 E1 · Manual exception

Eligibility checks

Routine B1 processing uses active coverage already on file and does not call E1. Use this manual check only when eligibility is uncertain. Results are coverage proposals; applying coverage remains a separate user decision.

ResultModeActorResponseRecorded
No E1 eligibility evidence recorded.

Current medications & upcoming refills

MedicationSigQty / days supplyRefills remainingLast fillNext dueStatus
No prescriptions on file for this patient.

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