ISA*00*          *00*          *11*712333444      *ZZ*LOOKUP         *180612*1757*U*00401*000003847*0*P*>
GS*SH*3004*1204*20180612*175748*9847*X*004010
ST*856*0001
BSN*00*20180612063132*20180612*065738*0001*AS
HL*1**S*1
TD1*CTN*1****G*12*LB
TD5*O*2*FXFE*M*FedEx*CC
REF*BM*9064789820
REF*2I*947381294837612
PER*PL*Customer Service*TE*781.555.5622*EM*support@claramanufacturing.com
DTM*011*20180612*110001
DTM*017*20180613*152108
DTM*067*20180613*152108
N1*ST*Wilbur Pharmaceutical Imports*11*412333444
N3*154 Broadway
N4*Somerville*MA*02145*US
N1*SF*Clara Manufacturing*11*712333444
N3*10 Welsh St
N4*Malden*MA*02148*US
N1*BY*Wilbur Pharmaceutical Imports*11*412333444
N3*154 Broadway
N4*Somerville*MA*02145*US
N1*SE*Clara Manufacturing*11*712333444
N3*10 Welsh St
N4*Malden*MA*02148*US
YNQ**Y***The entity transferring ownership of the product in this transaction states that it is in compliance with 21 U.S.C. 360eee(27).*Seller has complied with each applicable subsection of FDCA Sec. 581(27)(A)-(G).*As indicated below, product was purchased directly from the manufacturer, manufacturer's exclusive distributor or repackager who purchased directly from a manufacturer*99*TS
YNQ**Y***This change of ownership is authorized as required under the Drug Supply Chain Security Act.*The entity transferring ownership of the product received the product from a person that is authorized as required under the Drug Supply Chain Security Act.*The entity transferring ownership of the product received transaction information and a transaction statement from the prior owner of the product, as required under section 582.*99*TS
YNQ**Y***The entity transferring ownership of the product did not knowingly alter the transaction history.*The entity transferring ownership of the product did not knowingly ship a suspect or illegitimate product.*The entity transferring ownership of the product had systems and processes in place to comply with verification requirements under section 582 at the time of the shipment.*99*TS
YNQ**Y***The entity transferring ownership of the product did not knowingly provide false transaction information.***99*TS
YNQ**Y***As indicated below, product was purchased directly from the manufacturer, manufacturer's exclusive distributor or repackager who purchased directly from a manufacturer***99*DPS
HL*2**O*1
PRF*PO654321***20180610
REF*IV*987654321
HL*3**P*1
MAN*GM*005434.40000000019
HL*4**I
LIN*0010*N4*05552-5500-10*LT*PPP555**************
SN1**500*EA*****
PID*F*ITQ***30
PID*F*TRN***GenericDrugRx
PID*F*GEN***50 MG
PID*F*91***150
PID*F*DF***TABS
DTM*208*20200612
YNQ**Y******99*RDPS
CTT*4
SE*35*0001
GE*1*1
IEA*1*000000001