C01368;TA103315;90001M115;1;;Carl Ortega;Haag Pharmacy;1400 W12th Ave;Emporia;KS;66801;01/21/25
C01368;TA103315;TDIWM115;3;;Carl Ortega;Haag Pharmacy;1400 W12th Ave;Emporia;KS;66801;01/21/25
