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qr whrrn-storlasr RETURN GOODS page! CustII; 15152 DEV09 LTD., DSA GUARANTEED RETURNS Store µ: 5793 100 Colin Drive NC 11 #: 147 Holbrook, NY 11741-4306 p: 205663 (ARA#: M0188311 EPA$; NY0000997692 ) Print D*to ; Doc 16, 2004 Phone: (209) 835-4141 Customer; DEUEL VOCATIONAL INSTITUTION y Address 23500 ICASSON ROAD RErpt1 .LIES P.O. BOX 400 - PHARMACY DEPT. Credits passed through: 15152 Whole-2?lor: MCKESSON-26 TRACY, CA 95376 Cust Ref #/Debit#° QRXIS152141 Address: 3775 SEAPORT BLVD. Contact ESPERANZA Service Datr.: .10/19/04 182-W. SACRAMENTO, CA 94403 Dea h ; AV3309831 QUANTITY 08A VENDOR F P SIZE STREWTH DRUG NAME NDCNO CLASS PRICE ---- ------ MYLAN .900 '1.00.00 60 MG DILTIAZEM HYDROCHLORIDR TABLET 370606001 R 67.93 MYLAN .500 100.00 2.5 MG FLUPHENAZINE HCL 378600901 R 41-75 MYLAN 1.000 4.00 0.1MG ESTRADIOL TRANSDERMAL SYSTEM 378335299 R 26.25 MYLAN .500 1000.00 50 MG DOXEPIN HCL 378425010 R 297.93 MYLAN 1.000 100 -no 2.5 MG FLUPHENAZINE HCL 378600901 R 83-50 MYLAN 1.000 100.00 0.025 MG LEVOTHYROXINR 80DSUM 378190001 R, 23.75 MYLAN 1.000 100.00 2.5 MG LISINOPRIL 378207201 R 64.20 MYLAN 1.000 100.00 0.025 MG LEVOTHYROXINE SODIUM 378180001 R 23.75 NOVARTIS PHARM. .833 120.00 100 MC GTEEVEC 78037366 R 1703.29 NOVARTIS PIVUZM. 1.000 120.00 5.00 Mr GLEEVEC 78037366 R 2044.75 NOVARTIS PHJ%RM. _350 100.00 10/20 LOTREL 78036405 R 77.06 PFIZER .625 63.00 0.125 MG MIRAPEX 9000202 R 33-01 PFIZER 1.000 100.00 2MG CARDURA 49276041 R 95.14 PFIZER .267 90.00 -5MG MIRAPEX 9000R02 R 144.71 PFIZER. .900 1.00.00 250MG DIPENTUM 13010501 R 102.60 QUALITEST 1.000 1100 2$ PILOCARPINE 11CL OPTH SOLUTION 603724941 R 4.72 QUALITEST 1.000 100.00 1/100 GR COLC14ICINE 603305221 R 10.39 ROUIE/SYNTEX 1.000 180.00 200MG FORTOVASF 4024648 R 200.27 ROCHE/SYNTEX 1.000 180.00 200MG FORTOVASE 4024648 R 200.27 ROCHE/SYNT1i.X ,900 180.00 20OMG FORTOVASE 4024648 R 180.24 ROCHE/SYNTZX 900 180.00 200MO, FORTOVASE 4024649 R 180.24 R E 1.000 100.00 15 MC PROPANTHELINE BROMIDE; 5447212$ R 58.66 'G .595 42.00 200 MG REBETOL 85132704 R 264.80 $, eG .333 6.00 5 MIL IU INTRON A (SOLUTION FOR INJECTION) 851.23501 R 162.70 ACHERING 1.000 42.00 200 MG REBETOL 85132704 R 445-04 SCHERING 1.Sn0 42.00 200 MG REBETOL 85132704 R 667.56 6K EEECKAM/CONS 1.000 1.00 0.05 TF,MOVATE 173043201. R 60.91 SOLVAY PHARM 1.000 100.00 3.00 LUVOX 32421001 R 270.01 SOMERSET GG7 60.00 5 MG ELDEPRYL 35506001125 R 82.21 TARO PHARMA=, ICALS .250 7100.00 50 MG CLOMIDRAMINE %IYDROCHLORIDE 5167240121 K 9,33 TEVA PHARM. 1.000 60.00 500 MG DIFLUNISAL 93075506 R 63.30 UNITED RESEARCH 1.000 1000.00 65/MCI THYROID TABLETS 677165810 R 8.99 UPSHER-SMITH 900 1000.00 2 MC BENZTROPINE MESYLATE 832108210 R 104.25 UPSHER-SMITH .500 100.00 25 MG CHLORPROMAZXNR HCL 832030100 R 12.48 WATSON PHARMA. INC. .300 1000.00 120 MG VERAPAMIL HCL 52544034510 R 20,60 WATSON PHARMA. INC. 1.000 X00.00 20 MG PREDNTAONE 591544301 R 6.95 WATSON PBARMA, INC. 1.000 100.00 20 MG PREDNISONE 591544301 R 6.95 WATSON PHARMA, INC. 1.000 100,00 20 MO PREDNISONE 593.544301 R 6.95 WATSON PI•lARMA. INC. .004 100.00 20 MC PREDNISONE 591544301 R .03 WATSON PHARMA. INC. 100 100.00 20 MG PREDNISONE 591547301 R 70 WATSON PHARMA. TNC• 1.000 100.00 30MG DILTIA22M HYDROCHLORIDE 5254477501 R 4.29 WYETH/AYERS'['/LEDERLE .600 1.00-00 250MG ANTAHUSE 6547370601 R 67.39 WYETH/AYP,RST/LEDERLE .650 100,00 37.SMG 1?FFEXOR 8083701 R 7,51.32 TOTAL COST OF RRTURNAPLE PRODUCT: 13042.96 CREDIT ISSUED DIRRCT FROM VENDORS: -5990.55 MAJOR 58.84 A13BOTT PHARM 48.77 AMERICAN PHARM. INC, 80.44 BRISTOL/AQUI$R/NOVO 210.73 LILLY 139.91 MYLAN 1409-06 NOVARTIS PHARM. 3825,09 WYETH/AYERAT/LEDERLE 219.71 16.01 SERVICE FEE; -2086.87 ESTIMATED CREDIT ISSUED FROM WHOLI,8ALER; 4965.94 Total Item;: 119 .0. contact Ap730TT (FFD) 0 200-235-51.62 for credit dr..tails,