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Customer number: 21322 0
<br />Store number: 16639
<br />Batch number: 147
<br />Account number: 008-030510
<br />Name: DEUEL VOCATIONAL
<br />INSTITUTION
<br />CURA PHARM
<br />.LCldYYt11 teed
<br />11 etarrrase�.
<br />Credits passed through: 21322
<br />Customer reference number: GRX21322147
<br />Service Date: 08/02/2006
<br />Non -Returnable Report
<br />!`int Date:
<br />9/20/2006
<br />Phone:
<br />(916)928-0641
<br />Wholesaler: AMERISOURCEBERGEN-008
<br />Address:
<br />1325 WEST STRIKER AVENUE
<br />RC3ode
<br />SACRAMENTO, CA 95834
<br />rug zl ,,,
<br />;,4uantiti,
<br />Sizg,r
<br />tt nC�
<br />tin -Pee
<br />(0, <;Class
<br />P,r7ca .t..
<br />�r-PCile �'
<br />RC3ode
<br />Lot Num`er
<br />Bx r die"'
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />10MG/NL 409610202 R
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />02
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />0.040
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />10MG/NL 409610202 R
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />02
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />0.040
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />10MG/NL 409610202 R
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />02
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />0.040
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />tOMG/NL 409610202 R
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />02
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />0.100
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />160MG 00074401390 R
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />01
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />10/05
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />1.000
<br />CEFAZOLIN FOR INJECTION
<br />0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />1:1,000 00074724101 R
<br />CEFAZOLIN FOR INJECTION
<br />.0.040
<br />25.00
<br />1 GRAM
<br />6686000203
<br />R
<br />0.30
<br />02
<br />C3788
<br />02
<br />Total:
<br />25.000
<br />EPINEPHRINE HCL
<br />0.040
<br />25.00
<br />1:,1,000 00074724101 R
<br />7.50
<br />01
<br />063353A
<br />07/05
<br />ETH EX
<br />0 `-s�brugt�arit ,,, : 'GYganJit�r, ,Sfze,• ,+ „�p� 1P4ngth �. ''N�11�Nb.�,,,,`.a r;laa '� 'I rl' _ '� �RCode =yLct',�Iuint4a"r ,tExpira�¢atg
<br />PANGESTYME 0.250 100.00 N/A 56177002804 R 21.83 02 1 59384
<br />NITROQUICK 0.030 100.00 0.4MG 58177032418 R 0.38 01 47384 01/05
<br />Total: 1 2.0001 122.211 1 1 d
<br />FOREST PHARM.
<br />QrugName Quantity:,
<br />Size-«?
<br />t „5„trepgth,,,,
<br />NDGNO , ,,,,
<br />Mass
<br />P,r7ca .t..
<br />RCode
<br />a„;. LolNlart�tiar, g , Explre;CSafe<
<br />LEXAPRO 0.150
<br />CELEXA 0.250
<br />100.00
<br />100.00
<br />5 MG 1
<br />40MG
<br />4562005011
<br />00456404001
<br />R
<br />R
<br />1 32.21
<br />1 64.18
<br />05
<br />05
<br />P07572
<br />M0306H
<br />Total: 2.0001
<br />0.040
<br />1 1
<br />10MG/NL 409610202 R
<br />1
<br />1 96.391
<br />23365DK
<br />1
<br />G&W
<br />a ..tuantttje Siten's titTAhgttt e N�46, t 7 a-C1PZss s,�...: RFs.., F, :RCo[Ca ,. , , Lot, i�A xpife Dt6 .
<br />PROCHLORPERAZINE 0.750 12.001 25MG 1 007130135121 R 1 19.551 02 1013504013
<br />Total: 1 1.0001 1 1 1 1 19.55
<br />GLOBAL PHARM.
<br />TERBUTALINE
<br />0.300
<br />100.00 5MG
<br />; �Slaas, , , ;drfis z „�;.Rq¢da ,fit, '` L9iN4mEeY <;;r'Ezlilis�a"�e•I
<br />00115262201 R 14.13 02 1 4010181
<br />„'.Price "RCoae
<br />Total:
<br />1.000
<br />I I
<br />I 1 14.13
<br />0.040
<br />HOSPIRA WORLDWIDE (Direct)
<br />D "'
<br />rug Name ,
<br />Quaint ,
<br />ty'
<br />., ;8ize
<br />5trsngth Nt1CNCt„ Class
<br />„'.Price "RCoae
<br />tot'Nyir6ar, ? s ss
<br />EzpirDate'
<br />LIDOCAINE HCL
<br />0.040
<br />25.00
<br />2% 00409427701 R
<br />0.34
<br />02
<br />332690K
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />23365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />25365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />25365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />I0MG/NL 409610202 R
<br />0.43
<br />02
<br />25365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />25365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />25365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />25365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />25365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />23365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />25365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />25365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />25365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />25365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />25365DK
<br />FUROSEMIDE
<br />0.040
<br />25.00
<br />10MG/NL 409610202 R
<br />0.43
<br />02
<br />23365DK
<br />FUROSEMIDE
<br />0,040
<br />25.00
<br />tOMG/NL 409610202 R
<br />0.43
<br />02
<br />26365DK
<br />LIDOCAINE/DEXTROSE
<br />0.042
<br />24.00
<br />0.4% 00074793124 R
<br />8.84
<br />02
<br />19584FW
<br />LIDOCAINE/DEXTROSE
<br />0.042
<br />24.00
<br />0.4% 00074793124 R
<br />8.84
<br />02
<br />19584FW
<br />LORAZEPAM
<br />0.500
<br />10.00
<br />2 MG/ML 00074198530 4
<br />10.95
<br />Ot
<br />1552038
<br />03/06
<br />LORAZEPAM
<br />0.100
<br />10.00
<br />2 MG/ML 00074198530 4
<br />2.19
<br />01
<br />1152538
<br />11/05
<br />TRICOR
<br />0.750
<br />90.00
<br />160MG 00074401390 R
<br />190.01
<br />02
<br />109952E21
<br />LIDOCAINE HCL
<br />0.080
<br />50.00
<br />2% 00074427701 R
<br />0.66
<br />01
<br />01/06
<br />EPINEPHRINE HCL
<br />0.040
<br />25.00
<br />1:1,000 00074724101 R
<br />0.44
<br />01
<br />104603A
<br />10/05
<br />EPINEPHRINE HCL
<br />0.040
<br />25.00
<br />1:1,000 00074724101 R
<br />0.44
<br />02
<br />192053A
<br />EPINEPHRINE HCL
<br />1.000
<br />25.00
<br />1:1,000 00074724101 R
<br />11.00
<br />04
<br />240853A
<br />EPINEPHRINE HCL
<br />0.040
<br />25.00
<br />1:1,000 00074724101 R
<br />0.44
<br />01
<br />073203A
<br />07/05
<br />EPINEPHRINE HCL
<br />0.160
<br />25.00
<br />1:1,000 00074724101 R
<br />1.76
<br />02
<br />181953A
<br />EPINEPHRINE HCL
<br />0.040
<br />25.00
<br />1:,1,000 00074724101 R
<br />0.44
<br />01
<br />063353A
<br />07/05
<br />EPINEPHRINE HCl
<br />0.200
<br />25.00
<br />1:1,000 00074724101 R
<br />2.20
<br />02
<br />484953A
<br />EPINEPHRINE HCl
<br />0.080
<br />25.00
<br />1:1,000 00074724101 R
<br />0.88
<br />02
<br />181953A
<br />EPINEPHRINE HCL
<br />0.200
<br />25.00
<br />1:1,000 00074724101 R
<br />2.20
<br />01
<br />09/05
<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 10 of 16
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