HISTORY OF PRE-OP OPIOID USE PATIENT NUMBER INITIAL OPIOID PRESCRIBED AND QUANTITY OF TABLETS DISPENSED NUMBER OF REFILLS REQUESTED NAME AND QUANTITY OF TABLETS DISPENSED TOTAL NUMBER OF OPIOID TABLETS DISPENSED POST-
OPERATIVELY
No #6 Tramadol HCL 50 mg, 30 tablets 1 Tramadol HCL 50 mg, 10 tablets 40 tablets
No #16 Tramadol HCL 50 mg, 10 tablets 3 Refill #1 -
Tramadol HCL 50 mg, 10 tablets
40 tablets
Refill #2 -
Tramadol HCL 50 mg, 10 tablets
Refill #3 -
Tramadol HCL 50 mg, 10 tablets
No #26 Tramadol HCL 50 mg, 10 tablets 1 Tramadol HCL 50 mg, 10 tablets 20 tablets
No #38 Tramadol HCL 50 mg, 10 tablets 2 Refill #1- Oxycodone 5 mg, 5 tablets 25 tablets
Refill #2-
Oxycodone 5 mg, 10 tablets
No #40 Tramadol HCL 50 mg, 10 tablets 1 Tramadol HCL 50 mg, 10 tablets 20 tablets
No #42 Tramadol HCL 50 mg, 10 tablets 2 Refill #1-
Oxycodone 5 mg, 20 tablets
40 tablets
Refill #2-
Oxycodone 5 mg, 10 tablets
Yes #47 Oxycodone HCL (IR) 5 mg, 10 tablets 1 Oxycodone HCL (IR) 5 mg, 10 tablets 20 tablets
No #58 Tramadol HCL 50 mg, 10 tablets 2 Refill #1-
Tramadol HCL 50 mg, 10 tablets
30 tablets
Refill #2-
Tramadol HCL 50 mg, 10 tablets
No #67 Oxycodone HCL (IR) 5 mg, 10 tablets 1 Tramadol HCL 50 mg, 10 tablets 20
No #75 Oxycodone HCL (IR) 5 mg, 10 tablets 3 Refill #1-
Tramadol HCL 50 mg, 10 tablets
40 tablets
Refill #2-
Tramadol HCL 50 mg, 10 tablets
Refill #3-
Tramadol HCL 50 mg, 10 tablets
No #77 Tramadol HCL 50 mg, 10 tablets 1 Oxycodone HCL (IR) 5 mg, 10 tablets 20 tablets
No #79 Oxycodone HCL (IR) 5 mg, 10 tablets 1 Oxycodone HCL (IR) 5 mg, 20 tablets 30 tablets
No #81 Tramadol HCL 50 mg, 10 tablets 1 Tramadol HCL 50 mg, 10 tablets 20 tablets
No #89 Tramadol HCL 50 mg, 10 tablets 3 Refill #1-
Tramadol HCL 50 mg, 10 tablets
40 tablets
Refill #2-
Tramadol HCL 50 mg, 10 tablets
Refill #3-
Tramadol HCL 50 mg, 10 tablets
No #91 Tramadol HCL 50 mg, 10 tablets 2 Refill #1-
Oxycodone HCL (IR) 5 mg, 20 tablets
40 tablets
Refill #2-
Oxycodone HCL (IR) 5 mg, 10 tablets
No #95 Tramadol HCL 50 mg, 10 tablets 1 Tramadol HCL 50 mg, 10 tablets 20 tablets
No #106 Oxycodone HCL (IR) 5 mg, 10 tablets 1 Oxycodone HCL (IR) 5 mg, 10 tablets 20 tablets
No #109 Tramadol HCL 50 mg, 10 tablets 1 Tramadol HCL 50 mg, 10 tablets 20 tablets
No #111 Tramadol HCL 50 mg, 10 tablets 1 Tramadol HCL 50 mg, 10 tablets 20 tablets
No #124 Tramadol HCL 50 mg, 10 tablets 1 Tramadol HCL 50 mg, 10 tablets 20 tablets
Yes #131 Tramadol HCL 50 mg, 10 tablets 4 Refill #1-
Tramadol HCL 50 mg, 30 tablets
70 tablets
Refill #2-
Tramadol HCL 50 mg, 10 tablets
Refill #3-
Tramadol HCL 50 mg, 10 tablets
Refill #4-
Tramadol HCL 50 mg, 10 tablets
Yes #132 Tramadol HCL 50 mg, 10 tablets 1 Tramadol HCL 50 mg, 10 tablets 20 tablets
No #146 Oxycodone HCL (IR) 5 mg, 30 tablets 1 Oxycodone HCL (IR) 5 mg, 30 tablets 60 tablets
No #150 Tramadol HCL 50 mg, 10 tablets 2 Refill #1-
Oxycodone HCL (IR) 5 mg, 10 tablets
30 tablets
Refill #2-
Oxycodone HCL (IR) 5 mg, 10 tablets