Prescription Intake — ScriptRelay

PDF, JPG, PNG, or fax image. Up to 10 MB. AI extracts patient name, prescriber NPI, HCPCS codes, ICD-10 codes, insurance info, and more in seconds.

Reading document

Extracting patient data

Validating codes

Patient

Physician

Device

Review

⚠ Please fix the errors above and try again.

Patient Information

First Name * Required

Last Name * Required

Date of Birth * Required

Insurance Member ID * Required

Phone Number

Delivery Address

New Prescription Order