Patient record
| Payer | Plan | Member ID | Group ID | Relationship | Primary |
|---|---|---|---|---|---|
| PRIVATE | PR | Secondary |
PSB F6 E1 · Manual exception
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.
| Result | Mode | Actor | Response | Recorded |
|---|---|---|---|---|
| No E1 eligibility evidence recorded. | ||||
| Medication | Sig | Qty / days supply | Refills remaining | Last fill | Next due | Status |
|---|---|---|---|---|---|---|
| WARFARIN 7.5MG TAB 7.5MG 00555083402 · Rx 36727 |
— | 1 / 1 days | 1 of 1 | 2026-04-24 | 2026-04-25 | Overdue |
| ARIPIPRAZOLE 20MG TAB 20MG 76282004830 · Rx 36111 |
— | 7 / 7 days | 3 of 3 | 2025-11-12 | 2025-11-19 | Overdue |