Mary Claire Smallwood in Bainbridge, Georgia

Payments Total: $29

Number of Payments:: 1

Form of Payment: In-kind items and services

Record ID:: 796057783

Being Disputed:: No

Product Related: Yes

Drug or Biological: Drug

Product Category #1: ANTI-INFECTIVE

Name of Drug #1: DALVANCE

Open Associated Drug #1: 57970-100-01

Payments Total: $12

Number of Payments:: 1

Form of Payment: In-kind items and services

Third party is a Charity:: No

Record ID:: 818609921

Being Disputed:: No

Product Related: Yes

Drug or Biological: Drug

Product Category #1: Diabetes

Name of Drug #1: TRULICITY

Open Associated Drug #1: 0002-1433-80

Drug or Biological: Drug

Product Category #2: Diabetes

Name Of Drug #2:: JARDIANCE

Associated Drug #2: 0597-0152-37

Payments Total: $13

Number of Payments:: 1

Form of Payment: In-kind items and services

Record ID:: 811177943

Being Disputed:: No

Product Related: Yes

Drug or Biological: Drug

Product Category #1: Diabetes

Name of Drug #1: RYBELSUS

Open Associated Drug #1: 0169-4303-13

Drug or Biological: Drug

Product Category #2: Diabetes

Name Of Drug #2:: Ozempic

Associated Drug #2: 0169-4132-12

Payments Total: $23

Number of Payments:: 1

Form of Payment: In-kind items and services

Record ID:: 811331099

Being Disputed:: No

Product Related: Yes

Drug or Biological: Drug

Product Category #1: Diabetes

Name of Drug #1: Ozempic

Open Associated Drug #1: 0169-4132-12

Drug or Biological: Drug

Product Category #2: Diabetes

Name Of Drug #2:: RYBELSUS

Associated Drug #2: 0169-4303-13

Payments Total: $20

Number of Payments:: 1

Form of Payment: In-kind items and services

Third party is a Charity:: No

Record ID:: 813273627

Being Disputed:: No

Product Related: Yes

Drug or Biological: Drug

Product Category #1: CARDIOVASCULAR

Name of Drug #1: ENTRESTO

Open Associated Drug #1: 0078-0659-20

Payments Total: $20

Number of Payments:: 1

Form of Payment: In-kind items and services

Record ID:: 835342165

Being Disputed:: No

Product Related: No

Payments Total: $13

Number of Payments:: 1

Form of Payment: In-kind items and services

Record ID:: 842233239

Being Disputed:: No

Product Related: Yes

Drug or Biological: Drug

Product Category #1: ANTI-DEPRESSION

Name of Drug #1: SERTRALINE HCL

Open Associated Drug #1: 52427-664-30

Drug or Biological: Drug

Product Category #2: ANTI-ANXIETY

Name Of Drug #2:: LOREEV XR

Associated Drug #2: 52427-658-30

Drug or Biological #3:: Drug

Product Category #3: POSTHERPETIC NEURALGIA

Name of Drug: GRALISE

Name Of Drug #3: 52427-803-90

Payments Total: $15

Number of Payments:: 1

Form of Payment: In-kind items and services

Record ID:: 842233229

Being Disputed:: No

Product Related: Yes

Drug or Biological: Drug

Product Category #1: ANTI-ANXIETY

Name of Drug #1: LOREEV XR

Open Associated Drug #1: 52427-658-30

Drug or Biological: Drug

Product Category #2: POSTHERPETIC NEURALGIA

Name Of Drug #2:: GRALISE

Associated Drug #2: 52427-803-90

Payments Total: $23

Number of Payments:: 1

Form of Payment: In-kind items and services

Third party is a Charity:: No

Record ID:: 848381043

Being Disputed:: No

Product Related: Yes

Drug or Biological: Drug

Product Category #1: INFECTIOUS DISEASE

Name of Drug #1: DIFICID

Open Associated Drug #1: 52015-080-01

Drug or Biological: Drug

Product Category #2: INFECTIOUS DISEASE

Name Of Drug #2:: RECARBRIO

Associated Drug #2: 0006-3856-02

Drug or Biological #3:: Biological

Product Category #3: INFECTIOUS DISEASE

Name of Drug: ZINPLAVA

Name Of Drug #3: 0006-3025-00

Payments Total: $25

Number of Payments:: 1

Form of Payment: In-kind items and services

Third party is a Charity:: No

Record ID:: 763371074

Being Disputed:: No

Product Related: Yes

Drug or Biological: Drug

Product Category #1: DIABETES

Name of Drug #1: JARDIANCE

Open Associated Drug #1: 0597-0152-30