C01368;TA113823;BCO3;1;Grider;Diane Grider;Newman Community Rx;1400 W12th Ave;Emporia;KS;66801;07/15/25
C01368;TA113823;80021XW090;1;Grider;Diane Grider;Newman Community Rx;1400 W12th Ave;Emporia;KS;66801;07/15/25
C01368;TA113823;COMP;No
