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® <br />RETURN GOODS <br />gr_whtrn-storl.asr <br />Page: 335 <br />Cust . # : 15152 <br />DEVOS <br />LTD., DBA GUARANTEED RETURNS <br />Store #: 5793 <br />31 <br />100 Colin Drive <br />tch #: 147 <br />Holbrook, NY 11741-4306 <br />t. #: 805663 <br />(DEA#: <br />RD0188311 EPA#: NY0000997692 <br />) Print Date <br />Nov 5, <br />2004 <br />Phone: <br />(209) 835-4141 <br />C !er: DEUEL VOCATIONAL INSTITUTION <br />RETURNABLE <br />S <br />Ac. ss 23500 KASSON <br />ROAD <br />P.O. BOX 400 <br />- PHARMACY DEPT. <br />Credits <br />passed through: 15152 Wholesaler: MCKESSON-26 <br />TRACY, CA 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 />Lea 0 AV3309831 <br />QUANTITY <br />DEA <br />VENDOR <br />F P <br />SIZE <br />STRENGTH <br />DRUG NAME <br />NDCNO <br />CLASS <br />PRICE <br />MYLAN <br />.900 <br />100.00 <br />60 MG <br />DILTIAZEM HYDROCHLORIDE TABLET <br />378606001 <br />R <br />67.93 <br />MYLAN <br />.500 <br />100.00 <br />2.5 MG <br />FLUPHENAZINE HCL <br />378600901 <br />R <br />41.75 <br />MYLAN <br />1.000 <br />4.00 <br />0.1MG <br />ESTRADIOL TRANSDERMAL SYSTEM <br />378335299 <br />R <br />26.25 <br />MYLAN <br />.500 <br />1000.00 <br />50 MG <br />DOXEPIN HCL <br />378425010 <br />R <br />297.93 <br />MYLAN <br />1.000 <br />100.00 <br />2.5 MG <br />FLUPHENAZINE HCL <br />378600901 <br />R <br />83.50 <br />MYLAN <br />1.000 <br />100.00 <br />0.025 MG <br />LEVOTHYROXINE SODIUM <br />378180001 <br />R <br />23.75 <br />MYLAN <br />1.000 <br />100.00 <br />2.5 MG <br />LISINOPRIL <br />378207201 <br />R <br />64.20 <br />MYLAN <br />1.000 <br />100.00 <br />0.025 MG <br />LEVOTHYROXINE SODIUM <br />378180001 <br />R <br />23.75 <br />NOVARTIS PHARM. <br />.833 <br />120.00 <br />100 MG <br />GLEEVEC <br />78037366 <br />R <br />1703.28 <br />NOVARTIS PHARM. <br />1.000 <br />120.00 <br />100 MG <br />GLEEVEC <br />78037366 <br />R <br />2044.75 <br />NOVARTIS PHARM. <br />.350 <br />100.00 <br />10/20 <br />LOTREL <br />78036405 <br />R <br />77.06 <br />r'r'IZER.635 <br />63.00 <br />0.125 MG <br />MIRAPEX <br />- 9000202 <br />R <br />33.01 <br />PFIZER <br />1.000 <br />100.00 <br />2MG <br />CARDURA <br />49276041 <br />R <br />95.14 <br />PFIZER <br />.867 <br />90.00 <br />.5MG <br />MIRAPEX <br />9000802 <br />R <br />144.71 <br />PFIZER <br />.900 <br />100.00 <br />250MG <br />DIPENTUM <br />13010501 <br />R <br />102.60 <br />QUALITEST <br />1.000 <br />1.00 <br />2% <br />PILOCARPINE HCL OPTH SOLUTION <br />603724941 <br />R <br />4.72 <br />QUALITEST <br />1.000 <br />100.00 <br />1/100 GR <br />COLCHICINE <br />603305221 <br />R <br />10.39 <br />ROCHE/SYNTEX <br />1.000 <br />180.00 <br />200MG <br />FORTOVASE <br />4024648 <br />R <br />200.27 <br />ROCHE/SYNTEX <br />1.000 <br />180.00 <br />200MG <br />FORTOVASE <br />4024648 <br />R <br />200.27 <br />ROCHE/SYNTEX <br />.900 <br />180.00 <br />200MG <br />FORTOVASE <br />4024648 <br />R <br />180.24 <br />ROCHE/SYNTEX <br />.900 <br />180.00 <br />200MG <br />FORTOVASE <br />4024648 <br />R <br />180.24 <br />1.000 <br />100.00 <br />15 MG <br />PROPANTHELINE BROMIDE <br />54472125 <br />R <br />58.66 <br />0E <br />ING <br />595 <br />42.00 <br />200 MG <br />REBETOL <br />85132704 <br />R <br />264.80 <br />S R -\IG <br />.333 <br />6.00 <br />5 MIL IU <br />INTRON A (SOLUTION FOR INJECTION) <br />85123501 <br />R <br />162.70 <br />SCH1 <br />1.000 <br />42.00 <br />200 MG <br />REBETOL <br />85132704 <br />R <br />445.04 <br />SCH6. .- <br />1.500 <br />4'-.00 <br />200 MG <br />REBETOL <br />85132704 <br />R <br />667.56 <br />SK BEECHAM/CONS <br />1.000 <br />1.00 <br />0.05% <br />TEMOVATE <br />173043201 <br />R <br />60.91 <br />SOLVAY PHARM <br />1.000 <br />100.00 <br />100 <br />LUVOX <br />32421001 <br />R <br />270.01 <br />SOMERSET <br />.667 <br />60.00 <br />5 MG <br />ELDEPRYL <br />39506001125 <br />R <br />82.21 <br />TARO PHARMACUETICALS <br />.250 <br />100.00 <br />50 MG <br />CLOMIPRAMINE HYDROCHLORIDE <br />5167240121 <br />R <br />9.33 <br />TEVA PHARM. <br />1.000 <br />60.00 <br />500 MG <br />DIFLUNISAL <br />93075506 <br />R <br />63.30 <br />UNITED RESEARCH <br />1.000 <br />1000.00 <br />65/MG <br />THYROID TABLETS <br />677165810 <br />R <br />8.99 <br />UPSHER-SMITH <br />.900 <br />1000.00 <br />2 MG <br />BENZTROPINE MESYLATE <br />832108210 <br />R <br />104.25 <br />UPSHER-SMITH <br />.500 <br />100.00 <br />25 MG <br />CHLORPROMAZINE HCL <br />832030100 <br />R <br />12.48 <br />WATSON PHARMA. INC. <br />.300 <br />1000.00 <br />120 MG <br />VERAPAMIL HCL <br />52544034510 <br />R <br />20.60 <br />WATSON PHARMA. INC. <br />1.000 <br />100.00 <br />20 MG <br />PREDNISONE <br />591544301 <br />R <br />6.95 <br />WATSON PHARMA. INC. <br />1.000 <br />100.00 <br />20 MG <br />PREDNISONE <br />591544301 <br />R <br />6.95 <br />WATSON PHARMA. INC. <br />1.000 <br />100.00 <br />20 MG <br />PREDNISONE <br />591544301 <br />R <br />6.95 <br />WATSON PHARMA. INC. <br />.004 <br />100.00 <br />20 MG <br />PREDNISONE <br />591544301 <br />R <br />.03 <br />WATSON PHARMA. INC. <br />.100 <br />100.00 <br />20 MG <br />PREDNISONE <br />591544301 <br />R <br />.70 <br />WATSON P;iARMA. INC. <br />i.000 <br />100.00 <br />30MG <br />DILTIAZEM HYDROCHLORIDE <br />5254477501 <br />R <br />4.29 <br />WYETH/AYERST/LEDERLE <br />.600 <br />100.00 <br />250MG <br />ANTABUSE <br />6547370601 <br />R <br />67.39 <br />WYETH/AYERST/LEDERLE <br />.650 <br />100.00 <br />37.5MG <br />EFFEXOR <br />8083701 <br />R <br />151.32 <br />TOTAL COST <br />OF RETURNABLE <br />PRODUCT: 13042.96 <br />CREDIT ISSUED <br />DIRECT <br />FROM <br />VENDORS: -5990.55 <br />MAJOR <br />58.84 <br />ABBOTT PHARM <br />48.77 <br />AMERICAN PHARM,. <br />INC. <br />80.44 <br />BRISTOL/SQUIBB/NOVO <br />210.73 <br />LILLY <br />138.91 <br />MYLAN <br />1409 06 <br />NOVARTIS PHARM. <br />3825.09 <br />G%TYE -' AY E..Z'T.)E <br />RLE <br />218.71 <br />16.0% <br />SERVICE <br />FEE: -2086.87 <br />ESTIMATED Cii HDI"' <br />ISSUED <br />FROM WHOLESALER: 4965.54 <br />® <br />Total <br />_tems: <br />119 <br />*Ple- contact ABBOTT (PPD, <br />L, 800-255-5162 <br />for credit <br />details. <br />