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Customer number: 21322
<br />Store number: 16639
<br />Batch number: 147
<br />Account number: 008-030510
<br />Name: DEUEL VOCATIONAL
<br />INSTITUTION
<br />aat�r^rarz tc',Lr1
<br />e:ttrrxiv� `
<br />Credits passed through: 21322
<br />Customer reference number: GRX21322147
<br />Service Date: 08/02/2006
<br />Non -Returnable Report
<br />AMERICAN REGENT LABS (Direct)
<br />int Date: 9/20/2006
<br />hone: (916)928-0641
<br />Wholesaler: AMERISOURCEBERGEN-008
<br />Address: 1325 WEST STRIKER AVENUE
<br />SACRAMENTO, CA 95834
<br />,pwg Nan'ia ;`„ ,., .:,; ; _„
<br />. Quantity",
<br />-,� 9ize,
<br />'�7 .:Strerigih- , 1
<br />;% . ;NDQNO , . :'.
<br />-Maas
<br />, ;::Price „;
<br />RCode
<br />" LatN4mber"
<br />'Expire Date .
<br />DEXAMETHASONE SODIUM PHOSPHATE
<br />0.040
<br />25.00
<br />4 MG/ML
<br />00517490125
<br />R
<br />0.87
<br />01
<br />3159
<br />03/06
<br />DEXAMETHASONE SODIUM PHOSPHATE
<br />0.040
<br />25.00
<br />4 MG/ML
<br />00517490125
<br />R
<br />0.87
<br />01
<br />3159
<br />03/06
<br />DEXAMETHASONE SODIUM PHOSPHATE
<br />0.040
<br />25.00
<br />4 MG/ML
<br />00517490125
<br />R
<br />0.87
<br />01
<br />3159
<br />03/06
<br />HYDROXYZINE HCL
<br />0.040
<br />25.00
<br />50 MG/ML
<br />00517560125
<br />R
<br />0.71
<br />02
<br />3496
<br />.�:
<br />HYDROXYZINE HCL
<br />0.040
<br />25.00
<br />50 MG/ML
<br />00517560125
<br />R
<br />0.71
<br />02
<br />3496
<br />HYDROXYZINE HCL
<br />0.040
<br />25.00
<br />50 MG/ML
<br />00517560125
<br />R
<br />0.71
<br />02
<br />3496
<br />J3Ai76
<br />J3A176
<br />HYDROXYZINE HCL
<br />0.040
<br />25.00
<br />50 MG/ML
<br />00517560125
<br />R
<br />0.71
<br />02
<br />3496
<br />1.22
<br />HYDROXYZINE HCL
<br />0.040
<br />25.00
<br />50 MG/ML
<br />00517560125
<br />R
<br />0.71
<br />02
<br />3496
<br />HYDROXYZINE HCL
<br />0.040
<br />25.00
<br />50 MG/ML
<br />00517560125
<br />R
<br />0.71
<br />02
<br />3496
<br />., Side .,,
<br />HYDROXYZINE HCL0.040
<br />NpfNC7. �_-
<br />25.00
<br />50 MG/ML
<br />00517560125
<br />R
<br />0.71
<br />02
<br />3496
<br />1 0.3001
<br />Total:
<br />32.000
<br />1051R
<br />114.39
<br />02
<br />130.25
<br />ANDRX PHARMACEUTICAL
<br />-Drug Name:
<br />GLIPIZIDE
<br />AonTFY rnRP
<br />Quaniiiq `.
<br />xe
<br />Streri h. ; ',
<br />.aDCN4„ ..,Claes'
<br />�"Pr%e, ;; s -R_ Cade ' Lot Number Expire.Aate
<br />PAROXETINE HCL 0.300
<br />PAROXETINE HCL 0.750
<br />1000.00
<br />1000.00
<br />10 MG
<br />10 MG
<br />60505009704 R
<br />60505009704 R
<br />569.90 01 GM2846 01/06
<br />1424.75 01 GM2846 01/04
<br />Total: 1 2.0001
<br />NDCNQ,.:
<br />1
<br />1 1
<br />1994.65
<br />ASTRA/ZENECA
<br />I,_; .Size IStrength. �, , NDPNO; ;-„ Glass ..Price,
<br />1.001 102.501 21 126N3251
<br />Total: 1 1.0001
<br />1 1 1 102.501 1
<br />Total: 2.000
<br />1.05
<br />- - '- Drug Name - -
<br />Quantity
<br />Site
<br />Strength
<br />NDCNQ,.:
<br />SEROQUEL (SAMPLE__
<br />1Price -
<br />6.000
<br />__ 4.00
<br />200MG
<br />K�j1GNa",
<br />Glass>,,_��P,rfpe
<br />25.00
<br />tCoda.
<br />..;;:, :�Lot.Namber.,,.,,. •,.:
<br />;ExPlreDafaj
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />Total:
<br />6.000
<br />R
<br />0.30 02 C3788
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />0.11
<br />1 GRAM 6686000203
<br />R
<br />0.30 02 C3788
<br />NY Division: 100 Colin Drive, Holbrook,
<br />B. BRAUN MEDICAL
<br />Midwest Division: 100
<br />Teduke
<br />Court, St Charles, MO 63301, Phone: 1-800-729-3279
<br />Page 9 of 16
<br />. QrtZg'�7ama
<br />.�:
<br />Qtfantity .
<br />tSixe ..
<br />. ; . trsn9th �:'
<br />NDCNQ:-
<br />Glass
<br />.; Price -;; `
<br />l Code,
<br />:." • ;-.:.Lot Number .,..t '? .';
<br />,expire Pate
<br />SODIUM CHLORIDE SOLUTION
<br />SODIUM CHLORIDE SOLUTION
<br />0.063
<br />0.063
<br />16.00
<br />16.00
<br />0.9%
<br />0.9%
<br />00264220110
<br />00264220110
<br />R
<br />R
<br />0.61
<br />0.61
<br />06
<br />O6
<br />J3Ai76
<br />J3A176
<br />.
<br />Total:
<br />1 2.0001
<br />1.22
<br />BARR
<br />tllianf7,
<br />ty'
<br />., Side .,,
<br />..tre!t;dth-,r"i
<br />NpfNC7. �_-
<br />Gla&; .";{�Ficg, ;,
<br />;iCode
<br />?. :�otN�mber .,.'-`:;'
<br />Expirepate
<br />WARFARIN SODIUM TABLETS
<br />1 0.3001
<br />1000.001
<br />1051R
<br />114.39
<br />02
<br />408334037
<br />Total:
<br />1 1.000
<br />114.39
<br />BAUSCH LOMB PHARM.
<br />Quantity,,,, ,. $t
<br />•Strength' �.', . r :".HD D . "Glass ,, "<'Price -< ^ RCode . ;=. Lot Number E* lrapato
<br />DESMOPRESSIN1.000 1.00 .01 24208034205 R 96.64 Ot 12/04
<br />LEVOBUNOLOL HCL 1.000 1.00 0 24208050505 R 4.65 01 59571 10/04
<br />Total: 1 2.0001 1 1 1 101,291 1
<br />BAYER/MILES PHARM. (Direct)
<br />;; I . Quantity„
<br />BAYGAM 1 1.0001
<br />I,_; .Size IStrength. �, , NDPNO; ;-„ Glass ..Price,
<br />1.001 102.501 21 126N3251
<br />Total: 1 1.0001
<br />1 1 1 102.501 1
<br />BOEHRINGER
<br />;Mrug Name
<br />MIRAPEX
<br />BRECKENRIDGE
<br />-,DrugNarra, ,'Givandfy
<br />Size., -Strength NDGNO ,, "Class Price -= RCode Lot Number Expire Date
<br />PROCHLORPERAZINE 0.100
<br />PROCHLORPERAZINE 0.350
<br />100.00 SMG 5199119601 R 0.23 02 4CO01
<br />100.00 5MG 5199119601 R 0.82 02 40002
<br />Total: 2.000
<br />1.05
<br />BRISTOLISQUIBB/NOVO (Direct)
<br />Drug Name
<br />COUMADIN
<br />CHIRON THERAPUETIC
<br />Drug Name _ .'Quantity, I , Size' . Strength NDCNQ ', -Class ; -.Price , I RCode Lot.Number Expire Date
<br />FL VIRIN 0.1001 10.00 N/A 6652110810 R 4.84 02 61998
<br />FLUVIRIN 0.100 10.00 N/A 6652110810 R 4.84 02 61998
<br />Total: 2.0001 1 9.681 J
<br />L.UKA VHAKM
<br />- - '- Drug Name - -
<br />Quantity
<br />Site
<br />Strength
<br />NDCNQ,.:
<br />Class
<br />1Price -
<br />RCode
<br />LotNumber,- -
<br />Expire Date
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM 6686000203
<br />R
<br />0.30 02 03788
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM 6686000203
<br />R
<br />0.30 02 C3788
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM 6686000203
<br />R
<br />0.30 02 C3788
<br />NY Division: 100 Colin Drive, Holbrook,
<br />NY 11741, Phone: 1-800-473-2138;
<br />Midwest Division: 100
<br />Teduke
<br />Court, St Charles, MO 63301, Phone: 1-800-729-3279
<br />Page 9 of 16
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