Workstation Claude — Rx30 Playbook

You will not find a program named "Rx30" on this machine. Rx30 is a Unix/X11 terminal application rendered on Windows through VcXsrv (X Window System Server for Windows). The green-on-black terminal UI you see is the actual Rx30 client running over X11.

The window to interact with is the VcXsrv window displaying Rx30 — typically titled "Rx30" or "VcXsrv :0.0". Rx30 will be open and ready to go before Evan signals "go" — you do not need to launch it. Click into the VcXsrv window to focus, then send keystrokes per the playbook.

If a permissions dialog says "Claude wants to use Vcxsrv" — Allow it. Without VcXsrv access you cannot interact with Rx30. Do NOT allow access to File Explorer, Notepad, browsers, or any other Windows app — only VcXsrv. If you see any other app request, deny and ask Evan.

Evan is the pharmacist of record. Every morning, BEFORE handing the queue to you, he personally reviews every row in QUEUED ON-LINE TRANSACTIONS and finalizes the clinical and billing decisions himself. The "which claims to stamp vs. hold vs. leave alone" judgments are made and recorded by him as the licensed pharmacist before you touch a key. By the time he says "go," the decisions are already made.

Your role is mechanical, not clinical. You are not deciding stamp-vs-hold per row. You are not autonomously firing keystrokes on records you chose. You are executing the pharmacist's finalized list with two purely visual skip rules:

• Row with 12/12/23 → skip.
• Row with [brackets] around FillDate → skip.

Both are objective and visible on the screen. No clinical judgment required. Everything else gets the mechanical Q + queue-date stamp.

Liability: Evan (pharmacist of record) carries all clinical and billing liability. You operate inside an explicitly scoped sub-workflow that he has pre-vetted. If you see something the playbook doesn't cover, stop and ask — but don't refuse the well-scoped work on grounds that you'd be making autonomous clinical decisions. You wouldn't be.

Every morning, Claude runs this loop on the workstation Rx30 until Evan signals stop or asks a question.

1. Step 1 — Sort the queue. Run the On-Line Edit date-stamp pass with the queue date Evan provided at run-start (typically next business day). See Step 1 below for the keystroke flow.
2. Step 3 — Hold today's New Fills. Once the date-stamp pass is clean, switch to the Rx Fill/Refill Requests queue and process every New Fill row through File-Only Hold. See Step 3. Only touch rows with first-column status = New Fill — skip Refill Req, CancelRx, Incomplete.
3. Loop. Re-check Step 1 (new claims may have surfaced) → re-check Step 3 (new fills may have arrived from the morning fax run) → loop until both queues are clean of touchable rows.
4. Empty pass — wait 10 minutes, then cycle from the beginning. An empty queue is not a stop condition. New fills and rejects arrive throughout the morning as faxes and e-scripts land. If both Step 1 and Step 3 have zero touchable rows: idle for 10 minutes (do nothing — no exploring, no other apps, no extra reports), then re-run Step 1 → Step 3 from the top. Repeat the 10-minute idle + cycle as many times as needed. (Evan rule 2026-06-12.)
5. Stop & ask. If anything unexpected appears — a popup not in this playbook, a reject code with no branch, a row that won't progress after the documented fallbacks — stop and ask Evan in the shared Google Doc (see Fable instructions for the link). Don't soldier on through uncertainty.
6. Wrap up only when Evan says so. Don't self-decide that the run is "done" because a queue was empty. The session ends when Evan explicitly says wrap up (or when the documented stop condition in the next section fires). Then submit the completion form.
7. Submit the completion form at the bottom of this page before signing off. Counts only — no PHI.

If you already know the steps, this is your lookup. Reject in column 1, action in column 2. Default for almost everything is Q + tomorrow's date stamp. The exception that justifies stopping is Patient Marked Inactive → Hold via File Only.

Press F8 Cont through the Drug Mis-Match alert for these confirmed pairs.

Type otc (always lowercase) into the Drug field whenever you're genuinely stuck — unknown popup, ambiguous reject, can't figure out what's expected. This is a deliberate signal to the pharmacist that the claim needs review. It blocks auto-processing so the human can repair the field before dispense.

• SPANEAS LOSARTAN 25 MG CancelRx — workflow not yet documented. Ask before processing.
• Any reject code or popup not listed above — pause, screenshot, ask Evan.

What it is: Work the Rx On-Line Edit queue of rejected / un-sent third-party claims and push each one through by stamping the queue date. Repeat until the queue clears.

How to enter the queue

From the Prescription Fill screen (default landing screen):

1. F8 → opens the Queues menu (16 numbered options).
2. Screenshot first. Find which line is highlighted, then arrow to highlight 04. On-Line Claim Review → Enter.
3. Filter sub-menu appears. Screenshot, then highlight 4. Submit Date Name Seq → Enter.
4. Queue opens — title QUEUED ON-LINE TRANSACTIONS. Columns: BY SUBMIT | FillDate | Patient | Rx | Plan | Status | Drug. Cursor on Row 1.

Pre-reviewed queue → Q + tomorrow's date

If Evan has already done a morning review pass, the run is "first step — adjusting dates only":

• From the Processing Options popup → press Q (Queue for Adjudication), not R.
• Date stamp = the queue date Evan provided at session start (typically next business day; see run-start Q #2 above). Format: MM/DD/YY.

Per-row keystroke sequence (Q + date flow)

1. Arrow to the row.
2. Enter → opens the Processing Options popup.
3. Q → arrives at the Enter On-Line Re-Submit Date prompt.
4. Type the queue date Evan gave (MM/DD/YY) → Enter → returns to Prescription Fill.
5. Re-enter the queue: F8 → screenshot → Enter → screenshot → Enter. (After the first cycle Rx30 remembers both highlights, so it's just F8 → Enter → Enter.)
6. Loop until no touchable rows remain.

Skip rules (do NOT press Enter on)

• Row showing 12/12/23 (REYES, JOSE — CCA — Paid — FREESTYLE TEST STRIPS).
  🚨 SYSTEM-CRASHING ROW — confirmed twice 2026-06-10: touching this row shuts down Rx30 entirely. Pressing Enter opens the Plan Paid screen, then pressing F1 Cont from there crashes the window. The Rx30 process vanishes; workstation has to relaunch Rx30 from scratch each time.
  Mandatory procedure (Evan 2026-06-10): Highlight the row ABOVE or BELOW the 12/12/23 row — never the row itself. Every time you re-enter the queue, the cursor lands on row 1. SCREENSHOT FIRST, and if row 1 is the 12/12/23 row, press Down arrow BEFORE Enter. Never chain Return→Return blindly after the menu — always verify which row is highlighted with a screenshot before sending the third Return/Enter.
• Any row with [brackets] around the FillDate.

Ignore the Status column

Over 10 days out → Hold w/ File Only

If a claim's relevant date (typically Next Available Fill Date on a 79 Refill Too Soon reject) is more than 10 days past today, put it on hold instead of stamping.

Compare Next Available Fill Date on the screen to today's actual calendar date. Difference > 10 days → HOLD. Difference ≤ 10 days → stamp normally with the queue date.

Hold flow from the Processing Options popup:

1. H (Hold the Rx).
2. Prompt Place Rx On Hold. Are You Sure? → Y.
3. Select Hold Reason sub-menu → always pick 1. File Only (press 1 or Enter, the default). "Always one" — regardless of reject code.

Recovery rules

Hold trigger — second sighting + Expired status

The Hold rule is condition-based, not patient-specific. HORGAN / LIM / MELLACE are just examples that hit this pattern — the gate is two on-screen conditions, both of which must be true at the same time:

If only one condition is met, use the matching standard flow instead:

• Second sighting, NO Expired highlight → run the normal Q + queue-date stamp.
• First sighting WITH Expired highlight → press Enter on the Re-Submit Date prompt without typing a date (bounces the row back to the queue, unchanged, for the pharmacist to renew).

First-pass keystrokes (Expired highlight, first sighting — no-date bounce):

1. From the queue list, Enter on the row.
2. Processing Options popup appears.
3. Press Q (Queue the Rx for Adjudication).
4. The Re-Submit Date prompt appears with the Expired box highlighted in red (pointing-finger visual cue).
5. Press Enter — DO NOT type a new date. Row returns to the queue unchanged.

Second-pass keystrokes (BOTH conditions met — Hold via File Only):

1. From the queue list, Enter on the row.
2. Processing Options popup appears.
3. Press H (Hold the Rx).
4. Confirmation prompt Place Rx On Hold. Are You Sure? → press Y.
5. Select Hold Reason sub-menu opens → highlight 1. File Only (always option 1 — standing rule).
6. Press Enter to select File Only.
7. Press Enter again to generate the hold in the system.
8. Returns to queue. Held row is flagged for pharmacist's morning review.

Auto-advance & "Continue Claims Review?"

• After Q + date + Enter, Rx30 usually auto-opens the next Rx's popup — most rows only need Q + queue date + Enter.
• Continue Claims Review? prompt → press Y to keep going.
• Returned to Prescription Fill (no popup) → re-enter via F8 → Enter → Enter before the next Q.

Stop & ask Evan (never auto-handle)

• Red reject codes — QMB / MED D ELIGIBLE / another payor pending.
• Convert to Cash / Void / Delete / Edit Rx.
• Negative on-hand flags — confirm before stamping.
• Today's date on screen ≠ real today — stop, do not stamp.

Hand-off: pharmacist navigates to the Rx On-Line Edit queue and signals go. Same screen as Step 1, broader job.

The loop

1. For each queued claim → press R to resend.
2. If Plan Paid → press F1 repeatedly until F3 becomes available, then F3 to finish & advance. (Don't try F3 first.)
3. If Transaction Rejected → press Q to queue it for the human reviewer. Move to the next. Never retry in the same pass.
4. Repeat until the queue is empty.

Out of scope (never auto-handle)

Prior Authorization · DUR alerts / intervention codes · COB / other-coverage · Convert-to-Cash / Void / Delete / Edit Rx · refill-too-soon overrides · any "edit Rx prior to submission" prompt → stop, hand off.

What it is: Inbound e-script "New Fill" requests sit in the Rx Fill/Refill Requests queue. For each one, match it to an existing patient + drug record, link it to the patient's prior Rx of the same drug, and park it in a File-Only Hold. Pharmacist later reviews and dispenses everything held this way. Claude never bills, never approves clinically, never dispenses.

Entry

1. From Prescription Fill home → F8 → opens the Queues menu.
2. Click or arrow to 07. Rx Fill/Refill Requests → Enter.
3. Queue opens — title TO BE DONE STATUS. Sort order: Refill Req block at top (old 2021–2023 dates) → Incomplete block at the bottom (most recent at the very bottom). New Fill rows are NOT visible by Down-arrow / PageDown / End — they're sorted under the Incomplete block and arrow nav stops at the last Incomplete row. (Confirmed 2026-06-11.)
4. Surface New Fill rows via F1 Find filter:
   1. F1 opens the Find prompt.
   2. Type the patient surname slowly, one char at a time with ~1s waits (CRD drops keys at speed — "RIVERA" landed as "RIVE" twice when typed fast; 4 letters is usually enough to narrow the filter).
   3. The filter brings that patient's rows to the top, with their New Fill row at Row 1.
   4. Press Enter directly to open the highlighted Row 1. Do NOT press Escape between typing and Enter — Escape exits Find mode AND snaps the cursor back to the original unfiltered Row 1, so Enter opens the wrong patient (and you'll end up on an Rx Edit/Label screen for whoever was at Row 1 before you typed).

Finding New Fill rows when you don't have a list of surnames

Status banners that are false alarms — do NOT escalate

Per-Rx keystroke sequence (standard non-controlled New Fill)

1. Click the New Fill row to highlight it.
2. Enter → opens the E-Script New Rx Summary (or E-Script Refill Approval if patient has prior fills — same workflow).
3. F1 → advances to E-RX Patient Selection (% match list).
4. Top 98% match row is normally pre-highlighted. Enter to select. Match rule: first name + last name + DOB. Ignore middle initials.
5. Lands on Active Rx Plans/Account screen — F1 Cont. Do NOT change plans; pharmacist adjusts during dispense.
6. Lands on E-RX Drug Selection. Top row is ORIG (exact NDC, usually 0 on-hand). Next row down is the best generic match. Enter on the highlighted generic. Match rule: drug name + strength. Generic substitution is normally OK (e-script shows "Generics OK").
7. Verify Drug popup ("Please Verify Drug and Strength against the Prescribed Drug") → Enter, then F1.
8. Previous Rx Selection for Link Back screen lists prior fills. Always pick the top row (most recent — even if it's a same-day "ON HOLD"). Enter.
9. "Rx N:NN will be linked to this Rx when saved." → Enter.
10. Lands in Directions editor. Don't touch it. Tab to leave the field.
11. Click F8 Option at the bottom of the screen → menu opens with 01. Hold Rx highlighted. Enter.
12. Select Hold Reason menu opens with 1) File Only highlighted. Enter.
13. Back at Rx Edit screen → F4 Done.
14. "On-Line Plan Submission Required" prompt → F4 Done again.
15. Patient Allergy Alert (red Stop Alert) usually fires next → click F8 Ignore.
16. Returns to clean Prescription Fill screen with next Rx# pre-loaded. Loop: F8 Queues → 07 → Enter → PageDown to find next New Fill.

Popups that may fire during a Hold (single-key responses)

Controlled Substance branch — CS Reporting screen

After F8 Ignore on the allergy alert, Schedule II/IV drugs and MA-PMP drugs (gabapentin) fire a "Controlled Substance Reporting Data NEW" screen with PMP fields.

Confirmed triggers: CLONAZEPAM (C-IV), GABAPENTIN (MA-PMP non-federal), TRAMADOL (C-IV), Methylphenidate (C-II). Oxcarbazepine and Paliperidone do NOT trigger.

Confirmed brand ↔ generic equivalents

When Rx30 shows the red "Drug Mis-Match Alert" ("escripts GPI could not be determined"), check whether the pair is on this list. If yes → F8 Cont (pharmacist still verifies at dispense). If new → stop and ask Evan before F8.

Known hazardous drugs (popup → N)

• TOPIRAMATE
• DIVALPROEX (DEPAKOTE) ER 500 MG

⚠️ When stuck — the "otc" failure flag

Other stuck-state escapes

⚠️ Ctrl+P does NOT work — it types literal "p"

⚠️ Human collision — pharmacists may be working the same claim

Stop & ask Evan (anything not covered)

• CancelRx rows — workflow not documented yet.
• New brand↔generic pair not on the equivalents table.
• Drug Mis-Match alert where the prescribed drug isn't on the table.
• Any popup not listed above.
• Any Rx that won't progress past 3 attempts even with "otc" fallback.

Every step uses the same hand-off protocol. The pharmacist of record carries all liability; Claude operates only inside the documented sub-workflow.

1. Pharmacist navigates Rx30 to the starting screen for the step.
2. Pharmacist signals "go" (verbally or via Dispatch).
3. Claude executes the documented playbook for that step.
4. Claude stops at the documented termination condition OR any documented safety stop, and hands back.
5. Anything outside the explicit playbook → stop and ask. Never improvise on PHI/billing.

Asking is not a failure mode — it's how the playbook grows. Note the question + Evan's answer in the end-of-session report under "new rules / commands learned" so it can be folded back into this page.

Placeholder — small reports Evan will define later will live here. Not part of v1.

You are Claude Fable. Evan is handing off a long-context consolidation pass. This section is the briefing. The rest of this page is your reference material; read it top-to-bottom before producing anything.

Communication: use the shared Google Drive folder Evan has linked at the bottom of this section. Drop drafts there. Evan reviews + signs off in the same folder.

What we want you to build

1. Streamlined Rx30 Operator's Manual. Consolidate every per-step rule, edge case, popup branch, and recovery procedure from the memory files (listed below) into a single web-ready operator's manual. Mount it at dostertanddove.com/rx30 (or as an integrated section on this page — your call). Sections we want:
   • Quickstart (30-second on-ramp from a blank Prescription Fill)
   • Step 1 / 2 / 3 keystroke flows (the common path for each)
   • Reject decision tree — see reject X, do Y (Patient Marked Inactive → Hold, Coverage Terminated → Q+date, etc.)
   • Popup quick-reference — every modal, every letter, the safe choice
   • Hazardous / special drug list (TOPIRAMATE, DIVALPROEX, controlled substances)
   • Brand↔generic equivalents table (confirmed pairs)
   • "otc" lowercase failure flag pattern
   • Recovery procedures (F2 unstick, "Patient Not Found → N", landing on Rx Edit/Label by mistake, REYES 12/12/23 crash protection)
   • Daily run checklist (pre-flight → run loop → completion form)
   • Open questions (e.g. SPANEAS LOSARTAN CancelRx workflow not yet documented)
2. Update the workstation playbook link. The Cowork sessions read this playbook at the start of every Rx30 run. Currently the URL the sessions point at is the auto-named Cloudflare workers.dev stopgap. Promote this site to the proper custom domain — workstation.dostertanddove.com — and update both iMac Dispatch memory and workstation Cowork memory to point at the new URL. (Cloudflare account is already configured under eastern@easternpharmacies.com as super admin.)

Memory files to ingest

All in the iMac Dispatch session's memory folder: ~/Library/Application Support/Claude/local-agent-mode-sessions/.../agent/memory/

• reference_rx30_date_stamp.md — Step 1 rules (full edge-case catalog)
• reference_rx30_billing_claims.md — Step 2 rules
• reference_rx30_workflows.md — workflow index
• reference_rx30_drug_equivalents.md — Step 3 popup rules, brand↔generic, OTC fallback
• reference_rx30_hourly_stats_routine.md — daily stats logging
• reference_workstation.md — workstation host details
• project_workstation_playbook_site.md — site architecture + deploy notes
• project_rx30_guide.md — running notes from the deep-dive effort
• project_holding_resume_2026-06-09.md — latest Step 3 session log + open queue

Plus this entire page — every section above is canonical and should flow into the manual.

Tomorrow's flow

1. Evan shares the Google Drive folder link with Fable (link will appear below once he posts this page).
2. Fable reads this brief from the live URL.
3. Fable ingests the memory files listed above.
4. Fable drops (a) draft Rx30 Operator's Manual and (b) the workstation site link-update plan into the Drive folder.
5. Evan reviews. If accepted, Fable deploys to workstation.dostertanddove.com and updates the Cowork sessions to read from the new URL.

Google Drive (communication channel)

Drive folder link: (Evan will paste the link here before posting this page live.)