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334 <br />® RETURN GOOD S <br />gr_whtrn-storiasr <br />Page: <br />Cust . 4: 5152 <br />1 <br />"�'``� <br />[,i <br />DEVOS LTD., DBA GUARANTEED RETURNS <br />Store #; 5793 <br />_ a _ <br />�` � <br />L <br />'� <br />100 Colin Drive <br />� <br />ch #: 147 <br />ri_. <br />Holbrook, NY 11741-9306 <br />t. #: 805663 <br />(DEA#: <br />RD0188311 EPA#: NY0000997692 <br />j Print Date <br />Nov <br />5, <br />2004 <br />Phone: <br />(209) <br />835-4141 <br />C er: 0 VOCATIONAL <br />INSTITUTION <br />RE <br />U7ABLES <br />Ate. ss 2350LASSON <br />ROAD <br />P.O. BOX <br />400 - PHARMACY <br />DEPT. <br />Credits <br />passed through: 15152 Wholesaler: MCKESSON-26 <br />TRACY, CA <br />95376 <br />Cust <br />Ref #/Debit#: GRX15152147 <br />Address: 3775 <br />SEAPORT <br />BLVD. <br />Contact ESPERANZA <br />Service <br />Date: 10/19/04 <br />182-W. <br />SACRAMENTO, <br />CA 94403 <br />Dea # AV3309831 <br />QUANTITY <br />DEA <br />VENDOR <br />F P <br />SIZE <br />STRENGTH <br />DRUG NAME <br />NDCNO <br />CLASS <br />PRICE <br />FLEET <br />1.000 <br />1.00 <br />N/A <br />FLEET PREP FIT #3 W/ PHOSPHO-SODA <br />13:.021201 <br />5.60 <br />J & J, CONSUMER <br />2.000 <br />150.00 <br />K -Y LUBRICATING JELLY <br />8137008942 <br />21.34 <br />MAJOR <br />1.000 <br />150.00 <br />600 MG <br />CALCIUM CARBONATE <br />904323392 <br />3.05 <br />MAJOR <br />1.000 <br />90.00 <br />625MG <br />FIBER -TABS <br />904250091 <br />5.79 <br />PADDOCK <br />1.000 <br />1.00 <br />25 GM <br />ACTIDOSE-AQUA <br />574012174 <br />11.20 <br />QUALITEST <br />1.000 <br />1.00 <br />10% <br />BENZOYL PEROXIDE <br />603771082 <br />6.54 <br />ABBOTT PHARM <br />1.000 <br />100.00 <br />125 MG <br />DEPAKOTE <br />74621213 <br />R <br />48.77 <br />AKORN <br />2.000 <br />1.00 <br />0.1% <br />AK -CON <br />17478021612 <br />R <br />9.50 <br />AKORN <br />1.000 <br />1.00 <br />0.1% <br />AK -CON <br />17478021612 <br />R <br />4.75 <br />ANORN <br />1.000 <br />1.00 <br />0.1% <br />AK -CON <br />17478021612 <br />R <br />4.75 <br />A.KORN <br />1.000 <br />1.00 <br />3 MG/GM <br />GENTAK <br />17478028435 <br />R <br />6.25 <br />ALCON <br />1.000 <br />1.00 <br />4 % <br />PILOCARPINE HYDROCHLORIDE OPHALMIC 6131420615 <br />R <br />4.90 <br />ALCON <br />1.000 <br />1.00 <br />4 % <br />PILOCARPINE HYDROCHLORIDE OPHALMIC 6131420615 <br />R <br />4.90 <br />ALCON <br />1.000 <br />1.00 <br />CILOXAN <br />65065625 <br />R <br />20.40 <br />ALCON <br />1.000 <br />1.00 <br />CILOXAN <br />65065625 <br />R <br />20.40 <br />ALCON <br />1.000 <br />1.00 <br />2% <br />ISOPTO HOMATROPINE <br />998031105 <br />R <br />16.65 <br />ALLERGAN <br />1.000 <br />1.00 <br />0.2%-10% <br />BLEPHAMIDE <br />11980002205 <br />R <br />32.45 <br />ALLERGAN <br />1.000 <br />1.00 <br />0.2%-10% <br />BLEPHAMIDE <br />11980002205 <br />R <br />32.45 <br />ALLERGAN <br />1.000 <br />1.00 <br />0.2%-10% <br />BLEPHAMIDE <br />11980002205 <br />R <br />32.45 <br />AMERICAN PHARM. INC. <br />1.000 <br />25.00 <br />1000MCG <br />CYANOCOBALAMIN <br />6332304401 <br />R <br />1.44 <br />AMERICAN PHARM. INC. <br />1.000 <br />1.00 <br />300MG <br />NEBUPENT <br />6332387715 <br />R <br />79.00 <br />/Z,ENECA <br />1.000 <br />100.00 <br />3MG <br />ENTOCORT EC <br />186070210 <br />R <br />197.87 <br />/ZENECA <br />1.000 <br />100.00 <br />10 MG <br />PLENDIL <br />186045258 <br />R <br />185.64 <br />A72ENECA <br />.200 <br />30.00 <br />10 MG <br />PLENDIL, <br />186045231 <br />R <br />10.50 <br />AST; NECA <br />^xA800 <br />100.00 <br />3MG <br />ENTOCORT EC <br />186070210 <br />R <br />158.30 <br />ASTR- .:NECA <br />.130 <br />106.00 <br />20 MG <br />ZESTRIL <br />310013239 <br />R <br />1_'.19 <br />AVENTIS PHARM. <br />4.000 <br />1.00 <br />10 GM <br />NASACORT <br />75150543 <br />R <br />191.52 <br />BAUSCH LOMB PHARM. <br />1.000 <br />1.00 <br />1% <br />ATROPINE SULFATE <br />24208075006 <br />R <br />2.16 <br />BAUSCH LOMB PHARM. <br />1.000 <br />1.00 <br />1% <br />ATROPINE SULFATE <br />24208075006 <br />R <br />2.16 <br />BAUSCH LOMB PHARM. <br />1.000 <br />1.00 <br />1°% <br />PILOSTAT <br />24208067615 <br />R <br />2.67 <br />BAUSCH LOMB PHARM. <br />1.000 <br />1.00 <br />2% <br />PILOCARPINE HYDROCHLORIDE <br />2420868115 <br />R <br />3.43 <br />90EHRINGER <br />.500 <br />4.00 <br />0.3 MG <br />CATAPRES-TTS-3 <br />597003334 <br />R <br />56.70 <br />BRISTOL/SQUIBB/NOVO <br />1.000 <br />60.00 <br />150MG <br />SERZONE <br />87003931 <br />R <br />87.80 <br />BRISTG/SQUIBB/NOVO <br />.500- <br />60.00 <br />150MG <br />SERZONE <br />87003931 <br />R <br />43.90 <br />BRISTOL/SQUIBB/NOVO <br />.417 <br />60.00 <br />100MG <br />SERZONE <br />87003231 <br />R <br />35.94 <br />BR;STOL/SQUIBB/NOVO <br />.500 <br />60.00 <br />100MG <br />SERZONE <br />87003231 <br />R <br />43.09 <br />T_Y <br />1.000 <br />25.00 <br />0.6% <br />METAPROTERENOL SULFATE <br />49502067603 <br />R <br />8.90 <br />t.)i3Y <br />4.000 <br />25.00 <br />0.6°% <br />METAPROTERENOL SULFATE <br />49502067603 <br />R <br />35.60 <br />F'CiUGERFi <br />1.000 <br />1.00 <br />.05% <br />CLOBETASOL PROPIONATE TOPICAL SOL <br />168026950 <br />R <br />32.00 <br />FOUGERA <br />1.000 <br />1.00 <br />0.01% <br />FLUOCINOLONE ACETONIDE <br />168005815 <br />R <br />1.25 <br />FOUGERA <br />1.000 <br />1.00 <br />0.01% <br />FLUOCINOLONE ACETONIDE <br />168005815 <br />R <br />1.25 <br />FUJISAWA HEALTHCARE <br />2.000 <br />1.00 <br />3 MG/ML <br />ADENOCARD <br />469823412 <br />R <br />65.50 <br />GENEVA PHARM <br />1.000 <br />100.00 <br />200 MG <br />THIORIDAZINE HCL <br />781167401 <br />R <br />82.55 <br />GENEVA PHARM <br />1.000 <br />100.00 <br />1 MG <br />WARFARIN SODIUM <br />781035207 <br />R <br />39.82 <br />GENEVA PHARM <br />1.000 <br />100.00 <br />25 MG <br />THIORIDAZINE HCL <br />781162401 <br />R <br />25.71 <br />GLADES PHARM <br />1.000 <br />1.00 <br />2 % <br />ERYTHROMYCIN <br />5936624623 <br />R <br />12.54 <br />GLAXO WELLCOME <br />.250 <br />60.00. <br />500 MG <br />CEFTIN <br />173039442 <br />R <br />123.60 <br />IVAX <br />1.000 <br />100.00 <br />500 MG -0 <br />PROBENECID W/COLCHICINE <br />172219360 <br />R <br />57.99 <br />IVAX <br />1.000 <br />100.00 <br />0 <br />B-PLEX <br />182406201 <br />R <br />26.19 <br />I`JAY. LABORATORIES <br />3.000 <br />1.00 <br />0.08 MG/ <br />QVAR <br />59310017780 <br />R <br />172.08 <br />1. <br />1.00 <br />0.04 MG/ <br />QVAR <br />59310017640 <br />R <br />45.52 <br />JANSSENJORTHO/MCNEIL <br />..000 <br />5.00 <br />100 MG/M <br />HALDOL DECANOATE <br />45025414 <br />R <br />343.55 <br />JI?DIS6 c[v`/ORTHO/MCNEIL <br />.500 <br />50.00 <br />200 MG <br />FLOXIN <br />62154002 <br />k <br />112.58 <br />L:' -LY <br />.500 <br />60.00 <br />2.5 MG <br />ZYPREXA <br />2411260 <br />R <br />1338.91 <br />MAJOR <br />2.000 <br />100.00 <br />IMG <br />DOXAZOSIN MESYLATE <br />904552260 <br />R <br />50.00 <br />' t & CO. INC. <br />1.000 <br />1.00 <br />2% <br />TRUSOPT <br />6351936 <br />R <br />46.57 <br />& CO. INC. <br />1.000 <br />1.00 <br />2% <br />TRUSOPT <br />6351936 <br />R <br />46.57 <br />CO. INC. <br />.500 <br />100.00 <br />5 MG <br />MEPHYTON <br />6004368 <br />R <br />26.13 <br />PHARM <br />1.000 <br />10.00 <br />600,000 <br />BICILLIN L-A <br />61570014710 <br />R <br />314.25 <br />MrjN7-_.._, PHARM <br />..000 <br />10.00 <br />600000 U <br />BICILLIN L-A <br />61570014810 <br />R <br />643.94 <br />MONARCH PHARM <br />1.000 <br />10.00. <br />600,000 <br />BICILLIN L-A <br />61570014710 <br />R <br />314.25 <br />--4ORTON GROVE PHzRM <br />--000 <br />1.00 <br />2 °% <br />LIDOCAINE HCL <br />6043246400 <br />R <br />7.10 <br />MYLAN <br />_.005 <br />_000.00 <br />5 MG <br />HALOPERIDOL <br />378032710 <br />R <br />780.00 <br />334 <br />