diff --git a/backend/pmr_api.py b/backend/pmr_api.py
index 06d6326..4361388 100644
--- a/backend/pmr_api.py
+++ b/backend/pmr_api.py
@@ -188,7 +188,10 @@ def get_prescription_detail(prescription_id):
             return jsonify({'success': False, 'error': '처방전을 찾을 수 없습니다'}), 404
         
         # 처방 약품 목록 (PS_sub_pharm + CD_GOODS + CD_MC JOIN)
+        # PS_Type: 0,1=일반, 4=대체조제(실제), 9=대체조제(원본)
         medications = []
+        original_prescriptions = {}  # PS_Type=9인 원본 처방 저장
+        
         cursor.execute("""
             SELECT 
                 s.DrugCode,
@@ -197,6 +200,7 @@ def get_prescription_detail(prescription_id):
                 s.QUAN_TIME,
                 s.PS_Type,
                 s.INV_QUAN,
+                s.SUB_SERIAL,
                 g.GoodsName,
                 g.SUNG_CODE,
                 m.PRINT_TYPE,
@@ -208,10 +212,30 @@ def get_prescription_detail(prescription_id):
             ORDER BY s.SUB_SERIAL
         """, (prescription_id,))
         
-        for row in cursor.fetchall():
+        all_rows = cursor.fetchall()
+        
+        # 1차: PS_Type=9 (원본 처방) 수집 - 인덱스로 저장
+        for i, row in enumerate(all_rows):
+            if row.PS_Type == '9':
+                original_prescriptions[i] = {
+                    'drug_code': row.DrugCode or '',
+                    'drug_name': row.GoodsName or row.DrugCode or '',
+                    'add_info': row.PRINT_TYPE or row.SIM_EFFECT or ''
+                }
+        
+        # 2차: 실제 조제약만 추가 (PS_Type != 9)
+        for i, row in enumerate(all_rows):
+            if row.PS_Type == '9':
+                continue  # 원본 처방은 스킵
+            
             # 효능: PRINT_TYPE > SIM_EFFECT > 없음
             add_info = row.PRINT_TYPE or row.SIM_EFFECT or ''
             
+            # 대체조제 여부 확인: PS_Type=4이고 바로 다음이 PS_Type=9
+            # 순서: 4(대체) → 9(원본)
+            is_substituted = row.PS_Type == '4' and (i + 1) in original_prescriptions
+            original_drug = original_prescriptions.get(i + 1) if is_substituted else None
+            
             medications.append({
                 'medication_code': row.DrugCode or '',
                 'med_name': row.GoodsName or row.DrugCode or '',
@@ -221,7 +245,10 @@ def get_prescription_detail(prescription_id):
                 'duration': row.Days or 0,
                 'total_qty': float(row.INV_QUAN) if row.INV_QUAN else 0,
                 'type': '급여' if row.PS_Type in ['0', '4'] else '비급여' if row.PS_Type == '1' else row.PS_Type,
-                'sung_code': row.SUNG_CODE or ''
+                'sung_code': row.SUNG_CODE or '',
+                'ps_type': row.PS_Type or '0',
+                'is_substituted': is_substituted,
+                'original_drug': original_drug
             })
         
         # 나이/성별 계산
diff --git a/backend/templates/pmr.html b/backend/templates/pmr.html
index cce6b7f..15d3e93 100644
--- a/backend/templates/pmr.html
+++ b/backend/templates/pmr.html
@@ -942,6 +942,47 @@
         tr.row-removed { background: #fef2f2 !important; opacity: 0.7; }
         tr.row-changed { background: #fffbeb !important; }
         
+        /* 대체조제 표시 */
+        .subst-badge {
+            display: inline-block;
+            background: linear-gradient(135deg, #f59e0b, #d97706);
+            color: white;
+            padding: 1px 5px;
+            border-radius: 4px;
+            font-size: 0.65rem;
+            font-weight: 700;
+            margin-right: 4px;
+            vertical-align: middle;
+        }
+        .original-rx {
+            margin-top: 4px;
+            font-size: 0.75rem;
+        }
+        .original-rx summary {
+            cursor: pointer;
+            color: #6b7280;
+            user-select: none;
+        }
+        .original-rx summary:hover {
+            color: #4b5563;
+        }
+        .original-drug-info {
+            margin-top: 4px;
+            padding: 6px 10px;
+            background: #fef3c7;
+            border-radius: 4px;
+            border-left: 3px solid #f59e0b;
+        }
+        .orig-name {
+            display: block;
+            font-weight: 500;
+            color: #92400e;
+        }
+        .orig-code {
+            font-size: 0.7rem;
+            color: #b45309;
+        }
+        
         .change-arrow {
             color: #94a3b8;
             margin: 0 4px;
@@ -1362,12 +1403,23 @@
                                 </thead>
                                 <tbody>
                                     ${data.medications.map(m => `
-                                        <tr data-add-info="${escapeHtml(m.add_info || '')}">
+                                        <tr data-add-info="${escapeHtml(m.add_info || '')}" ${m.is_substituted ? 'class="substituted-row"' : ''}>
                                             <td><input type="checkbox" class="med-check" data-code="${m.medication_code}" ${m.is_auto_print ? 'checked' : ''}></td>
                                             <td>
-                                                <div class="med-name">${m.med_name || m.medication_code}</div>
+                                                <div class="med-name">
+                                                    ${m.is_substituted ? '<span class="subst-badge" title="대체조제">대)</span> ' : ''}${m.med_name || m.medication_code}
+                                                </div>
                                                 <div class="med-code">${m.medication_code}</div>
                                                 ${m.add_info ? `<div style="font-size:0.75rem;color:#6b7280;">${escapeHtml(m.add_info)}</div>` : ''}
+                                                ${m.is_substituted && m.original_drug ? `
+                                                    <details class="original-rx">
+                                                        <summary>원처방 보기</summary>
+                                                        <div class="original-drug-info">
+                                                            <span class="orig-name">${escapeHtml(m.original_drug.drug_name)}</span>
+                                                            <span class="orig-code">${m.original_drug.drug_code}</span>
+                                                        </div>
+                                                    </details>
+                                                ` : ''}
                                             </td>
                                             <td>${m.formulation ? `<span class="med-form">${m.formulation}</span>` : '-'}</td>
                                             <td><span class="med-dosage">${m.dosage || '-'}</span></td>