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Customer number: 21322 <br />Store number: 16639 <br />Batch number: 153 <br />Account number: 008-030510 <br />Name: DEUEL VOCATIONAL <br />INSTITUTION <br />rrrtrczst fr'eri <br />fi'�ICYJFBe <br />Credits passed through: 21322 <br />Customer reference number: GRX21322153 <br />Service Date: 01/22/2007` <br />Non -Returnable Report <br />MYLAN (Direct) <br />Orint Date: 2/16/2007 <br />Phone: (916)928-0641 <br />Wholesaler: AMERISOURCEBERGEN-008 <br />Address: 1325 WEST STRIKER AVENUE <br />SACRAMENTO. CA 95834 <br />NOVO•NORDISK <br />prug Name ,=;. '�.; .:";'. <br />, "Quantity <br />02 117692701 <br />DOXEPIN HCL 0.100 100.00 100 MG <br />NDCND . .,,.: <br />Class <br />. =:;,%rice ,,.E <br />.RGode <br />.:._. •:-Lot-Nutnbet ,,.;,.;,-Expire,Clate,< <br />LEVOTHYROXINE SODIUM <br />0.200 <br />1'00.00 <br />0.175 MG <br />00378181701 <br />R <br />3.61 <br />02 <br />1N0543 <br />HALOPERIDOL - <br />0.200 <br />- 100.00 <br />0.5 MG <br />00378035101 <br />R <br />-" 2.05 <br />02 <br />1102389 <br />METHOTREXATE <br />0.750 <br />100.00 <br />2.5 MG <br />00378001401 <br />R <br />110.26 <br />02 <br />3MO581 <br />HALOPERIDOL <br />0.500 <br />100.00 <br />1 MG <br />00378025701 <br />R <br />7.25 <br />02 <br />1M1598 <br />Total: <br />5.000 <br />30.00 <br />300 MG <br />00781207731 <br />R <br />126.24 <br />02 <br />4751A1 <br />NOVO•NORDISK <br />prug Name ,=;. '�.; .:";'. <br />, "Quantity <br />02 117692701 <br />DOXEPIN HCL 0.100 100.00 100 MG <br />Total: 1.000 <br />1.031 <br />1 <br />RCode <br />.; ,,, LotNutnbe(": `; <br />NOVOLIN R <br />1. 000 <br />1.00 <br />100 U/ML <br />00169183311 <br />R <br />27.67 <br />04 <br />SZF0059 <br />NOVOLIN 70/30 <br />1.000 <br />1.00 <br />100 U/ML <br />00169183711 <br />R <br />27.67 <br />04 <br />SZF0045 <br />NOVOLIN 70/30 <br />1.000 <br />1.00 <br />100 U/ML <br />00169183711 <br />R <br />27.67 <br />04 <br />SZF0108 <br />Total: <br />3.000 <br />100.00 <br />25 MG <br />00781162401 <br />R <br />83.01 <br />02 <br />141790 <br />OVATION PHARMACEUTIC <br />PAR PHARM <br />PHARMACEUTICAL ASSC. <br />PLIVA INC <br />QUALITEST <br />RICHARDS PHARM <br />` Drug Name ,° .`. �s._. Quantity °.,.: <br />PERPHENAZINE 0.980 <br />49884022101 R 1.031 <br />02 117692701 <br />DOXEPIN HCL 0.100 100.00 100 MG <br />Total: 1.000 <br />1.031 <br />1 <br />PHARMACEUTICAL ASSC. <br />PLIVA INC <br />QUALITEST <br />RICHARDS PHARM <br />` Drug Name ,° .`. �s._. Quantity °.,.: <br />PERPHENAZINE 0.980 <br />SfzA ,.Stiangth ., !:R4DCNO r>>".:'Clasa �., �:'Price�'� "�" Rdotle LotNumber,';ExplreLYafe__ <br />100.00 BMG 05473855201 R 4.56 06 C0790804A <br />Total: 1.000 <br />4.561 1 <br />SANDOZ SERVICES INC. <br />Orug Name <br />�. ..* --- _ <br />Quantify <br />�� Six <br />;.$tran�th , <br />; NOCNO - <br />-Class <br />�', , Price <br />RCode <br />.; ,,, LotNutnbe(": `; <br />Ezj3itysgate <br />METOPROLOL TARTRATE <br />0.417 <br />12.00 <br />5 MG/ML <br />00781307075 <br />R <br />16.10 <br />02 <br />S3A035G <br />METOPROLOL TARTRATE <br />0.167 <br />12.00 <br />5 MG/ML <br />00781307075 <br />R <br />6.45 <br />02 <br />50007 <br />THIOTHIXENE <br />0.400 <br />100.00 <br />5 MG <br />00781222801 <br />R <br />11.07 <br />02 <br />144121 <br />THIORIDAZINE HCL <br />0.200 <br />100.00 <br />25 MG <br />00781162401 <br />R <br />5.14 <br />02 <br />141790 <br />RIFAMPIN <br />0.333 <br />30.00 <br />300 MG <br />00781207731 <br />R <br />15.08 <br />02 <br />4751A1 <br />Total: <br />5.000 <br />100.00 <br />400 MG <br />00093089201 <br />R <br />53.84 <br />02 <br />673021 <br />SKY PHARMACEUTICALS <br />TARO PHARMACUETICALS <br />TEVA PHARM. <br />Drug Name , ," ,; - <br />`Quantity;" <br />•,. Size,; <br />-Strength: <br />NDCNO 1,,. <br />Class <br />,- "Pi7ce <br />f'tCode <br />>%LotNum_beY r. <br />Expirebate2 <br />VERAPAMIL HCL <br />0.500 <br />100.00 <br />240 <br />00172428060 <br />R <br />18.50 <br />02 <br />135580 <br />BUPROPION HYDROCHLORIDE <br />0.750 <br />100.00 <br />100 M/G <br />00093029001 <br />R <br />43.27 <br />02 <br />101172 <br />OMEPRAZOLE <br />0.900 <br />100.00 <br />10 MG <br />93521001 <br />R <br />199.79 <br />02 <br />4052032 <br />ACYCLOVIR <br />0.500 <br />500.00 <br />200MG <br />00172426670 <br />R <br />25.00 <br />02 <br />A02417 <br />ACYCLOVIR <br />0.750 <br />500.00 <br />200MG <br />00172426670 <br />R <br />37.50 <br />19 <br />DAMAGED <br />ETODOLAC <br />0.750 <br />100.00 <br />400 MG <br />00093089201 <br />R <br />66.06 <br />02 <br />673021 <br />CALCITRIOL <br />0.950 <br />100.00 <br />0.5 MCG <br />00093065801 <br />R <br />110.22 <br />02 <br />313074 <br />FLUMAZENIL <br />0.100 <br />10.00 <br />0.1 MG/M <br />703208503 <br />R <br />49.50 <br />02 <br />04K110 <br />FLUMAZENIL <br />0.100 <br />10.00 <br />0.1 MG/M <br />703208503 <br />R <br />49.50 <br />02 <br />041<110 <br />PROMETHAZINE HYDROCHLORIDE [NJ. <br />0.200 <br />25.00 <br />50MGIML <br />703220104 <br />R <br />12.00 <br />02 <br />055129 <br />DILTIAZEM HCL <br />0.500 <br />100.00 <br />60MG <br />00093031901 <br />R <br />22.24 <br />02 <br />939035 <br />DILTIAZEM HCL <br />0.500 <br />100.00 <br />90 MG <br />00093032001 <br />R <br />30.40 <br />02 <br />253045 <br />PENICILLIN -VK <br />0.500 <br />1.00 <br />250MG <br />00093412774 <br />R <br />1.21 <br />02 <br />409760B <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 8 of 11 <br />El <br />7 <br />v <br />