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n <br />Customer number: 21322 <br />Store number: 16639 <br />Batch number: 153 <br />Account number: 008-030510 <br />Name: DEUEL VOCATIONAL <br />INSTITUTION <br />xeia rrz:es Pc�c td <br />t'ttai7xa:"' ` <br />Credits passed through: 21322 <br />Customer reference number: GRX21322153 <br />Service Date: 01/22/2007 <br />Int Date: 2/16/2007 <br />one: (916)928-0641 <br />Wholesaler: AMERISOURCEBERGEN-008 <br />Address: 1325 WEST STRIKER AVENUE <br />SACRAMENTO, CA 95834 <br />- eturnable Report <br />SCHERING <br />�. .,,,1?lu9Na ga .,.yam :.. , f . r ,. .. ;,:.: „_..,70uantlt <br />;`','; Size,'= <br />r _< SIX.e,.,. %. <br />_ ,.-Strengtry <br />::.N[iCNO = <br />Class <br />,.. a'icQ..�. <br />ELOCON <br />1 00 <br />1.00 <br />0.1% <br />00085056701 <br />R <br />20.52 <br />ELOCON <br />1.000 <br />1.00 <br />0.1% <br />00085056701 <br />R <br />20:52 <br />ELOCON <br />1.000 <br />1.00 <br />0.1% <br />00085056701 <br />R <br />20.52 <br />PEG -INTRON <br />1.000 <br />1.00 <br />0.118 MG <br />00085129101 <br />R <br />345.06 <br />Total: <br />4.000 <br />10.00 <br />50MG/ML <br />00703701103 <br />R <br />406.62 <br />nuw o�ew rn crir wi e <br />ArugNamo! Qgantlty_ <br />;`','; Size,'= <br />Strength <br />NDCNQr Glasa_%1, <br />NDNQ <br />ACETAZOLAMIDE1000 <br />ACETAZOLAMIDE 1.000 <br />100.00 <br />100.00 <br />250MG <br />125MG <br />51672402301 R <br />51672402201 R <br />18.00 <br />10.00 <br />Total: 1 <br />00093032001 <br />R <br />60.79 <br />1 28.00 <br />�rprug Name <br />Quantity <br />;Size < <br />Strength <br />NDNQ <br />Class <br />Arlce-`"' `� <br />DILTIAZEM HCL <br />1.000 <br />100.00 <br />90 MG <br />00093032001 <br />R <br />60.79 <br />PROCHLORPERAZINE MALEATE <br />1.000 <br />100.00 <br />10 MG <br />00172369160 <br />R <br />9.85 <br />PROMETHAZINE HYDROCHLORIDE INJ. <br />1.000 <br />25.00 <br />50MG/ML <br />703220104 <br />R <br />60.00 <br />ETODOLAC <br />1.000 <br />100.00 <br />400 MG <br />00093089201 <br />R <br />88.08 <br />HALOPERIDOL <br />1.000 <br />10.00 <br />50MG/ML <br />00703701103 <br />R <br />61.00 <br />Total: <br />5.000 <br />Total: <br />11.000 <br />R <br />279.72 <br />Drug Name; ?.. �,.uantity <br />Size ..:. <br />;.Strength ,.�. Nt1CMq , , , '; Glge;<-. <br />CHLORPROMAZINE HCL <br />0 990 100.00 <br />25 MG 00832030100 R 24.70 <br />CHLORPROMAZINE HCL <br />0.500 100.00 <br />100 MG 00832030300 R 20.09 <br />0.250 <br />Total: 2.0001 <br />1 44.79 <br />WATSON PHARMA. INC. <br />ISPIRONE HCL <br />:SODIOL <br />®ESTRABENZAPRINE HCL <br />ESTRADIOL <br />NORTRIPTYLINE HCL <br />NORTRIPTYLINE HCL - NORTRIPTYLINE HCL <br />HCL <br />ALORA <br />PREDNISONE <br />PREDNISONE <br />591315901 <br />0.400 <br />100.00 <br />5 MG <br />Service Fee <br />0.990 <br />100.00 <br />300 MG <br />4.69 <br />0.250 <br />100.00 <br />10 MG <br />- - <br />0.250 <br />100.00 <br />1 MG <br />- <br />0.750 <br />100.00 <br />25 MG <br />" <br />1.000 <br />100.00 <br />25 MG <br />0.500: <br />100.00 <br />25 MG <br />- - <br />1.000 <br />8.00 <br />- .IMG <br />0.500 <br />100.00 <br />20 MG <br />R.. <br />0.750 <br />100.00 <br />20 MG <br />00591544301 <br />0.500 <br />100.00 <br />20 MG <br />Total: <br />11.000 <br />R <br />591315901 <br />R <br />Credits to be Issued Direct from Vendors* <br />192.45 <br />Service Fee <br />00591565801 <br />R .: <br />$9,732.84 <br />4.69 <br />119 <br />00591048701 <br />R <br />_ _ 3.67- <br />00591578701 <br />R <br />7.13 <br />00591578701 <br />R <br />-9.50 <br />00591578701 <br />R <br />4.75 <br />- -- <br />52544047308 <br />R <br />34.99 <br />- <br />00591544301 <br />R.. <br />- <br />3.48 <br />00591544301 <br />R- <br />-7 5.21 <br />00591544301 <br />R <br />.3.48 <br />- <br />277.25 <br />Total Estimate of Returnable Products <br />$11,783.09 <br />Credits to be Issued Direct from Vendors* <br />$164.96 <br />Service Fee <br />$1,885.29 <br />Estimated Credit Issued by Wholesaler <br />$9,732.84 <br />Total Items: <br />119 <br />NY Division: 100 Colin Drive, Holbrook, NY 11741, Phone: 1-800-473-2138; Midwest Division: 100 Teduke Court, St Charles, MO 63301, Phone: 1-800-729-3279 <br />Page 5 of 11 <br />