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Customer number: 21322 0 <br />Quantity <br />rint Date: <br />Ophone: <br />2/16/2007 <br />Store number: 16639 <br />Batch number: 153 <br />MA <br />Wholesaler: <br />(916) 928-0641 <br />AMERISOURCEBERGEN-008 <br />Account number: 008-030510 <br />100.00 <br />Address: <br />1325 WEST STRIKER AVENUE <br />Name: DEUEL VOCATIONAL <br />893.06 <br />ADENOCARD <br />SACRAMENTO, CA 95834 <br />INSTITUTION <br />3 MG/ML <br />00469823412 <br />R <br />22.03 <br />Credits passed through: 21322 <br />2.000 <br />1.00 <br />3 MG/ML <br />Customer reference number: GRX21322153 <br />R <br />44.06 <br />ADENOCARD <br />Service Date: 01/22/2007 <br />1.00 <br />3 MG/ML <br />00469823412 <br />Returnable Report <br />22.03 <br />ADENOCARD <br />AKORN <br />1.00 <br />3 MG/ML <br />00469823412 <br />IkILLERGAN <br />D Qu NDCNO 'Clast Price <br />Drug Name rt- 0C <br />iALPHAi�AN P 1.0001 1.001 "" '$0�1'M% 38.82 <br />1 1.0001 1 136.821 <br />AMGEN <br />ASTELLAS PHARMA INC. <br />Drug Narne,,, <br />Quantity <br />Size <br />Strength, <br />NDCNO, <br />Class <br />Price - <br />PROGRAF <br />1.000 <br />100.00 <br />5 M <br />00469065773 <br />R <br />893.06 <br />ADENOCARD <br />1.000 <br />1,00 <br />3 MG/ML <br />00469823412 <br />R <br />22.03 <br />ADENOCARD <br />2.000 <br />1.00 <br />3 MG/ML <br />00469823412 <br />R <br />44.06 <br />ADENOCARD <br />1.000 <br />1.00 <br />3 MG/ML <br />00469823412 <br />R <br />22.03 <br />ADENOCARD <br />1.000 <br />1.00 <br />3 MG/ML <br />00469823412 <br />R <br />22.03 <br />ADENOCARD <br />1.000 <br />1.00 <br />3 MG/ML <br />00469823412 <br />R <br />22.03 <br />Total: <br />7.000 <br />10.00 <br />80MG/0.8 <br />00075062280 <br />R <br />1,025.24 <br />113." FiIffalu <br />Drug Name <br />Quantity", $!z6i� <br />strenottif <br />�44IJCNO' <br />ATROPINE SULFATEt <br />ATROPINE SULFATE <br />CASODEX <br />0.333 30.00 <br />50 MG <br />003100705301 R 1 <br />128.03 <br />CASODEX <br />1.000 30.00 <br />50 MG <br />003100705301 R 1 <br />384.48 <br />Total: <br />1 2.0001 <br />30 MG <br />1 1 <br />512.51 <br />AVENTIS PHARM. <br />BAUSCH LOMB PHARM. <br />Drug Name <br />Size <br />Quantity SI I I , Strength <br />NDCNO class <br />Price <br />ATROPINE SULFATEt <br />ATROPINE SULFATE <br />Cias <br />24208075006 R <br />24208075006 R <br />LOVENOX <br />1.000 <br />10.00 <br />30 MG <br />00075062430 <br />R <br />178.40 <br />LOVENOX <br />0.400 <br />10.00 <br />30 MG <br />00075062430 <br />R <br />71.36 <br />LOVENOX <br />0.300 <br />10.00 <br />30 MG <br />00075062430 <br />R <br />53.52 <br />LOVENOX <br />1.000 <br />10.00 <br />30 MG <br />00075062430 <br />R <br />-178.40 <br />LOVENOX <br />1.000 <br />10.00 <br />30 MG <br />00075062430 <br />R <br />178.40 <br />LOVENOX <br />0.100 <br />10.00 <br />100MG/1. <br />00075062300 <br />R <br />59.54 <br />LOVENOX INJECTION <br />0.300 <br />10.00 <br />80MG/0.8 <br />00075062280 <br />R <br />148.60 <br />LOVENOX INJECTION <br />0.100 <br />10.00 <br />80MG/0.8 <br />00075062280 <br />R <br />49.53 <br />LOVENOX INJECTION <br />0.300 <br />10.00 <br />80MG/0.8 <br />00075062280 <br />R <br />148.60 <br />LOVENOX INJECTION <br />1.000 <br />10.00 <br />80MG/0.8 <br />00075062280 <br />R <br />495.34 <br />LOVENOX INJECTION <br />1.000 <br />10.00 <br />80MG/0.8 <br />00075062280 <br />R <br />495.34 <br />LOVENOX INJECTION <br />0.500 <br />10.00 <br />80MG/0.8 <br />00075062280 <br />R <br />247.67 <br />LOVENOX INJECTION <br />0.200 <br />10.00 <br />80MG/0.8 <br />00075062280 <br />R <br />99.07 <br />Total: <br />13.0001 <br />i <br />i 2,403.771 <br />BAUSCH LOMB PHARM. <br />Drug Name <br />Size <br />Quantity SI I I , Strength <br />NDCNO class <br />Price <br />ATROPINE SULFATEt <br />ATROPINE SULFATE <br />- 0001 1.001 1% <br />1.000 1.00 1 % <br />24208075006 R <br />24208075006 R <br />2.16 <br />2.16 <br />Total: <br />1 2.0001 1 <br />N/A <br />4.32 <br />BAYER CORP. <br />Drug Name <br />Quantltv <br />I Size <br />I r StrenatK <br />NDCNIDQz� <br />91 <br />Price 4, <br />DOMEBORO <br />1.000 <br />12,00 <br />N/A <br />16500023240 <br />R <br />5.32 <br />DOMEBORO <br />1.000 <br />12.00 <br />NIA <br />16500'23240 <br />R <br />5.32 <br />DOMEBORO <br />1.000 <br />12.00 <br />� <br />NIA <br />1 0 <br />0 <br />61111232�4 <br />R <br />5.32 <br />VIDEX EC <br />3.000 <br />30.00 <br />125MG <br />00087667117 <br />R <br />15.96 <br />BRISTOL/SQUIBB/NOVO <br />DrugName= <br />Quantity = <br />Size'; <br />strength <br />NDGNO',", <br />91 <br />Total: 1 2.0001 <br />VIDEX <br />0.983 <br />60.00 <br />100 MG <br />00011665201 <br />R <br />12062 <br />VIDEX <br />0.983 <br />60.00 <br />100 MG <br />00087665201 <br />R <br />120.62 <br />CEFZIL <br />1.000 <br />1.00 <br />250 MG/5 <br />00087771962 <br />R <br />51.06 06 <br />VIDEX EC <br />0.967 <br />30.00 <br />125MG <br />00087667117 <br />R <br />87.44 <br />Total: <br />4.000 <br />1 379.74 <br />DAVA <br />Drug Name Quantity Size , <br />Strength' NOCNO,z <br />Class Price <br />PYRAZINAMIDE <br />PYRAZINAMIDE <br />J1100 <br />R 96.44 <br />R 96.44 <br />Total: 1 2.0001 <br />1 j192.88 <br />DEY <br />NY Division: 100 Colin Drive, Holbrook, NY 11741, Phone: 1-800-473-2138; Midwest Division: 100 Teduke Court, St Charles, MID 63301, Phone: 1-800-729-3279 <br />Page 2 of 11 <br />Ell <br />