{% extends "site.html" %} {% block head %} {{ block.super }} {% endblock %} {% block pagehead %} {% include 'pagehead.html' %} {% endblock %} {% block content %} {% include 'topnav.html' %} {% include report_template %} {% include 'bottomnav.html' %}
{% csrf_token %}
{% if ndc_9_match %}
  • WARNING - NDC-9 Match found for other drug entry marked as NDC-11 Strict Match!
{% endif %}
{% if allow_drug_img_upload %} {% endif %}
{% if drugnum_type == 'NDC' %} {% else %} {% endif %}
Drug Number: - -    
Manually enter NDC # (5-4-2, 4-4-2, 5-4-1, or 5-3-2). DO NOT scan a Stock Bottle barcode in this field
Drug Number:    
 
Pharmaceutical:
Displayed As: {{ authorityData.pharmaceutical.drug_name.label_name }} {{ authorityData.pharmaceutical.strength.label_name }} {{ authorityData.pharmaceutical.unit.label_name }} {{ authorityData.pharmaceutical.form.label_name }}       
Alt. Id:     Black Box Warning?    {% if show_secure_drug_add %} Secured?   {% endif %}
 
Manufacturer Information
Manufacturer Shape Color Front Imp. Back Imp. Pill Cost Dist. Num. High Cost Max QTY. Per Canister
Stock Bottle Information
Quantity Barcode
Upload Drug Imaqe
{% csrf_token %}
 
Pharmaceutical:       
Displayed As: {{ authorityData.pharmaceutical.drug_name.label_name }} {{ authorityData.pharmaceutical.strength.label_name }} {{ authorityData.pharmaceutical.unit.label_name }} {{ authorityData.pharmaceutical.form.label_name }}              {% if authorityData.pharmaceutical.schedule.tag != 'UNKNOWN' %} Schedule: {{ authorityData.pharmaceutical.schedule.name }} {% endif %}
Alt. Id:     Black Box Warning?    {% if show_secure_drug %} Secured?   {% endif %}
 
{% for inst in instanceData %} {% endfor %}
Manufacturer Information {% if drugnum_type == 'NDC' %}{% if allow_multiple_instance %} {% endif %}{% endif %}
Manufacturer Shape Color Front Imp. Back Imp. Pill Cost Dist. Num. High Cost Max QTY. Per Canister
{% if mfq_enabled %} {% endif %}
{% if drugnum_type == 'NDC' %} {% endif %} {% for pack in packagingData %} {% if drugnum_type == 'NDC' %}{% if forloop.first %} {% endif %} {% else %} {% endif %} {% endfor %}
Stock Bottle Information {% if drugnum_type == 'NDC' %} {% endif %}
Drug NumberPack CodeQuantity Barcode
- -
{% csrf_token %}
Loading Instance Data...
{% csrf_token %}
Loading Instance Data...
{% endblock %}