Appendix_E-Sample_Claim_Report.pdf

Appendix E – RFP #HHS-ASPR-16-100-SOL-00006 EPAP Long Term Requirement

(Sample Claim Report)

Report for: ABC Company Group: 111

Period 1: 1/1/2006 through 2/28/2006 15544 prescriptions Period 2: 1/1/2007 through 2/28/2007 16460 prescriptions Total for Period 1 Total for Period 2 % Avg. per Rx in Avg. per Rx in % Change Period 1 Period 2 Change

A. Retail from Pharmacy w/o $1,548,692.58 $1,752,876.67 13% $99.63 $106.49 7%

PBM

B. Actual Drug Cost $1,219,513.63 $1,361,707.34 12% $78.46 $82.73 5%

C. Pharmacy Fees $26,594.25 $27,713.46 4% $1.71 $1.68 -2%

D. = B + C Prescription Price w/ PBM $1,246,107.88 $1,389,420.80 12% $80.17 $84.41 5%

E. = A - D Savings through PBM $302,584.70 $363,455.87 20% $19.47 $22.08 13%

F. Copay $393,267.78 $403,380.80 3% $25.30 $24.51 -3%

G. Tax $51,254.28 $55,712.23 9% $3.30 $3.38 3%

H. = D-F+G Your Prescription Cost $904,094.38 $1,041,752.23 15% $58.16 $63.29 9%

I. Avg. Total Enrollment 5,775.0 5,927.5 3% J. Avg. Cost Per Member Per Month $78.28 $87.87 12% K. Avg. # of Cardholders 3,692.5 3,791.5 3% L. Avg. Cost Per Cardholder Per Month $122.42 $137.38 12% M. Number of retail pharmacies enrolled

Brand vs. Generic Comparison Report

Report: ABC Company Period 1: 200601 Through 200602 Period 2: 200701 Through 200702

Group(s): 111

Period 1 Period 2 % Change

Monthly Average Enrollment Cardholders 3692.5 3791.5 2.7% Dependents 2082.5 2136.0 2.6% Total Members* 5775.0 5927.5 2.6%

Rx Total RX 15,544 16,460 5.9% Total Cost $904,094 $1,041,752 15.2%

Brand vs. Generic (By Rx) Brand w/o Generic 45.2% 42.0% -3.2% Brand w/ Generic 4.9% 4.1% -0.8% Generic 50.0% 54.0% 4.0%

Monthly Average Usage Per Cardholder $122.42 $137.38 12.2% Per Member $78.28 $87.87 12.3%

Brand Vs. Generic Utilization Summary

Group: 111

This is a summary of your Prescription Plan from 1/1/2007 through 2/28/2007 .

Average Brand w/o Brand w/ Generic Total Per Generic Generic Claim

Number of Claims 6,906 672 8,882 16,460 % of All Claims 41.96% 4.08% 53.96% 100.00%

Retail from Pharmacy w/o PBM $1,244,299.71 $64,906.96 $443,670.00 $1,752,876.67 $106.49 Actual Drug Cost $1,006,249.91 $48,981.77 $306,475.66 $1,361,707.34 $82.73 Pharmacy Fees $11,328.75 $1,108.50 $15,276.21 $27,713.46 $1.68 Prescription Price w/ PBM $1,017,578.66 $50,090.27 $321,751.87 $1,389,420.80 $84.41

Savings through PBM $226,721.05 $14,816.69 $121,918.13 $363,455.87 $22.08 % Saved over Retail 18.22% 22.83% 27.48% 20.73%

Copay $337,485.73 $24,013.62 $41,881.45 $403,380.80 $24.51 % of Total Drug Cost 31.85% 45.94% 12.57% 27.91% Tax $42,083.58 $2,183.99 $11,444.66 $55,712.23 $3.38 Your Prescription Cost $722,176.51 $28,260.64 $291,315.08 $1,041,752.23 $63.29

Total Employer Cost/Claim $104.57 $42.05 $32.80 $63.29 Cost/Per Cardholder Per Month $95.24 $3.73 $38.42 $137.38 Cost/Per Member Per Month $60.92 $2.38 $24.57 $87.87

Enrollment Cardholders Dependents Total Monthly Average Enrollment 3,791.5 2,136.0 5,927.5

Formulary Monthly Trends

Group: 111

This ia summary of your Prescription Plan from 1/1/2007 through 2/28/2007 .

Jan 2007 Feb 2007 Mar 2007 Apr 2007 May 2007 Jun 2007 Jul 2007 Aug 2007 Sep 2007 Oct 2007 Nov 2007 Dec 2007 YTD Claims Brand w/o Generic 3,477 3,429 6,906 Brand w/Generic 336 336 672 Generic 4,479 4,403 8,882 Total 8,292 8,168 16,460 Formulary Preferred 2,849 2,833 5,682 Non-preferred 964 932 1,896 Generic 4,479 4,403 8,882 Total 8,292 8,168 16,460 Enrollment Cardholders 3,795.0 3,788.0 3,791.5 Dependents 2,147.0 2,125.0 2,136.0 Total 5,942.0 5,913.0 5,927.5 Costs Billed from Pharmacy $889,520 $863,357 $1,752,877 Contract Price $688,634 $673,073 $1,361,707 Pharmacy Fee $13,871 $13,842 $27,713 PBM Price $702,505 $686,916 $1,389,421 Tax $27,764 $27,948 $55,712 Copay $238,870 $164,511 $403,381 Cost to Group $491,399 $550,353 $1,041,752 Savings $187,015 $176,441 $363,456 Utilization Claims/Cardholder 2.18 2.16 2.17 Claims/Member 1.40 1.38 1.39 Cost/Cardholder $129.49 $145.29 $137.38 Cost/Member $82.70 $93.08 $87.87 Generic Claims/Total 54.02% 53.91% 53.96% Generic Cost/Total 23.56% 22.75% 23.16%

Retail and Mail Order Utilization Summary

Group: 111

This is a summary of your Prescription Plan from 1/1/2007 through 2/28/2007 .

Average Retail Brand w/o Brand w/ Generic Total Per Generic Generic Claim

Number of Claims 6,855 661 8,843 16,359 % of Retail Claims 41.90% 4.04% 54.06% 100.00% Prescription Price w/ PBM $997,663.53 $48,961.09 $318,130.04 $1,364,754.66 $83.43 Copay $334,904.19 $23,354.61 $41,686.45 $399,945.25 $24.45 % of Total Drug Cost 32.21% 45.66% 12.65% 28.16% Tax $42,083.58 $2,183.99 $11,444.66 $55,712.23 $3.41 Your Prescription Cost $704,842.92 $27,790.47 $287,888.25 $1,020,521.64 $62.38 Employer Cost Per Claim $102.82 $42.04 $32.56 $62.38 Average Mail Order Brand w/o Brand w/ Generic Total Per Generic Generic Claim

Number of Claims 51 11 39 101 % of MO Claims 50.50% 10.89% 38.61% 100.00% Prescription Price w/ PBM $19,915.13 $1,129.18 $3,621.83 $24,666.14 $244.22 Copay $2,581.54 $659.01 $195.00 $3,435.55 $34.02 % of Total Drug Cost 12.96% 58.36% 5.38% 13.93% Tax $0.00 $0.00 $0.00 $0.00 $0.00 Your Prescription Cost $17,333.59 $470.17 $3,426.83 $21,230.59 $210.20 Employer Cost Per Claim $339.87 $42.74 $87.87 $210.20 Average Total Brand w/o Brand w/ Generic Total Per Generic Generic Claim

Number of Claims 6,906 672 8,882 16,460 % of All Claims 41.96% 4.08% 53.96% 100.00% Prescription Price w/ PBM $1,017,578.66 $50,090.27 $321,751.87 $1,389,420.80 $84.41 Copay $337,485.73 $24,013.62 $41,881.45 $403,380.80 $24.51 % of Total Drug Cost 31.85% 45.94% 12.57% 27.91% Tax $42,083.58 $2,183.99 $11,444.66 $55,712.23 $3.38 Your Prescription Cost $722,176.51 $28,260.64 $291,315.08 $1,041,752.23 $63.29 Employer Cost Per Claim $104.57 $42.05 $32.80 $63.29

Specialty Eligible Cost Comparison

Group: 111

Period 1: 1/1/2006 through 2/28/2006 98 net prescriptions Period 2: 1/1/2007 through 2/28/2007 86 net prescriptions Total for Period 1 Total for Period 2 % Avg. per Rx in Avg. per Rx in % Change Period 1 Period 2 Change

A. Retail from Pharmacy w/o $113,596.17 $138,166.42 22% $1,159.14 $1,606.59 39%

PBM

B. Actual Drug Cost $92,171.29 $109,159.48 18% $940.52 $1,269.30 35%

C. Pharmacy Fees $159.75 $148.25 -7% $1.63 $1.72 6%

D. = B + C Prescription Price w/ PBM $92,331.04 $109,307.73 18% $942.15 $1,271.02 35%

E. = A - D Savings through your PBM $21,265.13 $28,858.69 36% $216.99 $335.57 55%

F. Copay $4,892.29 $5,021.73 3% $49.92 $58.39 17%

G. Tax $3,426.45 $3,313.75 -3% $34.96 $38.53 10%

H. = D-F+G Your Prescription Cost $90,865.20 $107,599.75 18% $927.20 $1,251.16 35%

I. Avg. Total Enrollment 5,775.0 5,927.5 3% J. Avg. Cost Per Member Per Month $7.87 $9.08 15% K. Avg. # of Cardholders 3,692.5 3,791.5 3% L. Avg. Cost Per Cardholder Per Month $12.30 $14.19 15%

Specialty Pharmacy Utilization Summary

Group: 111

This is a summary of your Prescription Plan from 1/1/2007 through 2/28/2007 .

Average Average Average All Per Specialty Per Specialty Per Claims Claim Eligible* Claim Claims Claim

Number of Claims 16,460 84 ** 2 ** % of All Claims 100.00% 0.51% 0.01%

Retail from Pharmacy w/o PBM $1,752,876.67 $106.49 $134,102.64 $1,596.46 $4,063.78 $2,031.89 Actual Drug Cost $1,361,707.34 $82.73 $105,749.20 $1,258.92 $3,410.28 $1,705.14 Pharmacy Fees $27,713.46 $1.68 $144.25 $1.72 $4.00 $2.00 Prescription Price w/ PBM $1,389,420.80 $84.41 $105,893.45 $1,260.64 $3,414.28 $1,707.14

Savings through your PBM $363,455.87 $22.08 $28,209.19 $335.82 $649.50 $324.75 % Saved over Retail 20.73% 21.04% 15.98%

Copay $403,380.80 $24.51 $4,841.73 $57.64 $180.00 $90.00 % of Total Drug Cost 27.91% 4.43% 5.27% Tax $55,712.23 $3.38 $3,313.75 $39.45 $0.00 $0.00 Your Prescription Cost $1,041,752.23 $63.29 $104,365.47 $1,242.45 $3,234.28 $1,617.14 % of Total Cost 100.00% 10.02% 0.31%

Total Employer Cost/Claim $63.29 $1,242.45 $1,617.14 Cost/Per Cardholder Per Month $137.38 $13.76 $0.43 Cost/Per Member Per Month $87.87 $8.80 $0.27 *Excludes Specialty Claims **Net Claims

Enrollment Cardholders Dependents Total Monthly Average Enrollment 3,791.5 2,136.0 5,927.5

Specialty Drugs Monthly Trends

Group: 111

This is a summary of your Prescription Plan from 1/1/2007 through 2/28/2007 .

Jan 2007 Feb 2007 Mar 2007 Apr 2007 May 2007 Jun 2007 Jul 2007 Aug 2007 Sep 2007 Oct 2007 Nov 2007 Dec 2007 YTD

Enrollments Cardholders 3,795.0 3,788.0 3,791.5 Dependents 2,147.0 2,125.0 2,136.0 Total 5,942.0 5,913.0 5,927.5 All Claims Claims 8,292 8,168 16,460 Billed from Pharmacy $889,520 $863,357 $1,752,877 Contract Price $688,634 $673,073 $1,361,707 Pharmacy Fee $13,871 $13,842 $27,713 PBM Price $702,505 $686,916 $1,389,421 Savings $187,015 $176,441 $363,456

Copay $238,870 $164,511 $403,381 Tax $27,764 $27,948 $55,712 Cost to Group $491,399 $550,353 $1,041,752

Cost/Claim $59.26 $67.38 $63.29 Cost/Cardholder $129.49 $145.29 $137.38 Cost/Member $82.70 $93.08 $87.87 Cardholder Util 2,029 2,086 Member Util 2,829 2,916 Eligible Claims (not Specialty) Net Claims 50 34 84 Billed from Pharmacy $88,689 $45,414 $134,103 Contract Price $66,679 $39,070 $105,749 Pharmacy Fee $86 $58 $144 PBM Price $66,765 $39,128 $105,893 Savings $21,923 $6,286 $28,209

Copay $3,476 $1,366 $4,842 Tax $1,874 $1,440 $3,314 Cost to Group $65,164 $39,202 $104,365

Cost/Claim $1,303.27 $1,152.99 $1,242.45 Cost/Cardholder $17.17 $10.35 $13.76 Cost/Member $10.97 $6.63 $8.80 Cardholder Util 34 23 Member Util 47 32 Specialty Claims Net Claims 1 1 2 Billed from Pharmacy $2,032 $2,032 $4,064 Contract Price $1,705 $1,705 $3,410 Pharmacy Fee $2 $2 $4 PBM Price $1,707 $1,707 $3,414 Savings $325 $325 $650

Copay $140 $40 $180 Tax $0 $0 $0 Cost to Group $1,567 $1,667 $3,234

Cost/Claim $1,567.14 $1,667.14 $1,617.14 Cost/Cardholder $0.41 $0.44 $0.43 Cost/Member $0.26 $0.28 $0.27 Cardholder Util Member Util 1

ABC Company A013A - Cost Range Summary

A013A_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

Average % Cost Range # Claims Total Copay Amnt Paid Copay Copay Reversals 294 ($30,441.07) ($11,509.16) ($18,931.91) ($39.15) Less than $10.00 2679 $15,594.98 $12,064.93 $3,530.05 $4.50 77.36% $10.00 to $24.99 2753 $44,063.85 $18,668.89 $25,394.96 $6.78 42.37% $25.00 to $49.99 2979 $109,725.54 $42,572.36 $67,153.18 $14.29 38.80% $50.00 to $74.99 2007 $126,330.40 $56,182.93 $70,147.47 $27.99 44.47% $75.00 to $99.99 1497 $129,357.97 $60,971.10 $68,386.87 $40.73 47.13% $100.00 to $199.99 2498 $342,185.20 $124,624.73 $217,560.47 $49.89 36.42% $200.00 to $299.99 870 $212,451.37 $50,977.92 $161,473.45 $58.60 24.00% $300.00 to $399.99 471 $162,284.51 $24,171.81 $138,112.70 $51.32 14.89% $400.00 to $499.99 157 $69,583.23 $9,271.22 $60,312.01 $59.05 13.32% $500.00 to $599.99 85 $46,527.94 $5,250.14 $41,277.80 $61.77 11.28% $600.00 to $699.99 52 $33,531.76 $3,101.55 $30,430.21 $59.65 9.25% $700.00 to $799.99 16 $11,963.63 $734.84 $11,228.79 $45.93 6.14% $800.00 to $899.99 22 $18,698.18 $1,223.01 $17,475.17 $55.59 6.54% $900.00 to $999.99 9 $8,576.24 $320.00 $8,256.24 $35.56 3.73% $1000.00 to $1099.99 7 $7,410.38 $540.00 $6,870.38 $77.14 7.29% $1100.00 to $1199.99 4 $4,604.11 $280.00 $4,324.11 $70.00 6.08% $1200.00 to $1299.99 3 $3,653.11 $200.00 $3,453.11 $66.67 5.47% $1300.00 or more 57 $129,031.74 $3,734.53 $125,297.21 $65.52 2.89% Total 16460 $1,445,133.07 $403,380.80 $1,041,752.27 $24.51 27.91%

A016A - Days Supply Range Summary

A016A_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

Average % Days Supply # Claims Total Copay Amnt Paid Copay Copay 15 days or less 4768 $131,538.12 $52,788.97 $78,749.15 $11.07 40.13% 16-30 days 8430 $664,733.48 $226,596.68 $438,136.80 $26.88 34.09% 31-60 days 292 $46,549.04 $9,538.54 $37,010.50 $32.67 20.49% 61-90 days 2960 $600,943.55 $114,136.61 $486,806.94 $38.56 18.99% 91-120 days 10 $1,368.88 $320.00 $1,048.88 $32.00 23.38% Total 16460 $1,445,133.07 $403,380.80 $1,041,752.27 $24.51 27.91%

A009 - Group Summary

A009_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

Group Id Group Name # Scripts Billed Used Fee Copay Tax Amt Paid 111 ABC Company 1,195 $113,315.14 $89,431.80 $1,984.46 $30,478.71 $3,751.67 $64,689.22 111A ABC Company 15,265 $1,639,561.53 $1,272,275.54 $25,729.00 $372,902.09 $51,960.56 $977,063.05 Grand Total 16,460 $1,752,876.67 $1,361,707.34 $27,713.46 $403,380.80 $55,712.23 $1,041,752.27

A007 - Profile Analysis

A007_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

CardHolder Dependent Total Group Id # Scripts Copay Amt Paid # Scripts Copay Amt Paid # Scripts Copay Amt Paid 111 758 $18,659.54 $35,283.52 437 $11,819.17 $29,405.70 1,195 $30,478.71 $64,689.22 111A 11,284 $273,160.21 $709,020.22 3,981 $99,741.88 $268,042.83 15,265 $372,902.09 $977,063.05 12,042 $291,819.75 $744,303.74 4,418 $111,561.05 $297,448.53 16,460 $403,380.80 $1,041,752.27

A006B - Rx Provider Summary - Chain Totals

A006B_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

CHN NABP Pharm Name # Rx % Rx Cost Fee Tax Rx Price Copay Amt Paid % Ind

0421355 SULLIVAN MAIN 6 0.0% $186.40 $11.25 $0.00 $197.65 $41.60 $156.05 0.01%

0601294 REAMS PALACE 2 0.0% $66.88 $3.75 $0.00 $70.63 $13.52 $57.11 0.01%

0615229 ST VRAIN 3 0.0% $236.26 $6.00 $0.00 $242.26 $15.00 $227.26 0.02%

1902231 SOUTHLAND 253 1.5% $16,255.55 $392.25 $661.54 $17,309.34 $6,002.91 $11,306.43 1.09%

1902522 JEFFERSON 9 0.1% $566.82 $18.00 $18.24 $603.06 $45.00 $558.06 0.05%

1903586 BALDWIN DRUGS 6 0.0% $261.33 $11.50 $10.50 $283.33 $163.90 $119.43 0.01%

1904223 BERNICE 7 0.0% $385.45 $13.00 $24.11 $422.56 $209.74 $212.82 0.02%

1904691 DIXIE PHARMACY 1 0.0% $403.18 $1.75 $24.58 $429.51 $140.00 $289.51 0.03%

1905097 JAMES DRUG 7 0.0% $628.66 $12.25 $35.66 $676.57 $219.99 $456.58 0.04%

1905415 WALTER 2 0.0% $755.20 $3.50 $43.75 $802.45 $160.00 $642.45 0.06%

1905984 BROADMOOR 49 0.3% $5,159.62 $92.00 $231.62 $5,483.24 $1,656.81 $3,826.43 0.37% 1905984 BROADMOOR 867 5.3% $101,266.25 $1,583.50 $4,493.22 $107,342.97 $24,261.39 $83,081.58 7.98% 1906049 HAYDELS DRUG 21 0.1% $1,248.84 $40.25 $53.63 $1,342.72 $488.03 $854.69 0.08% 1906049 HAYDELS DRUG 375 2.3% $30,014.56 $700.75 $1,352.68 $32,067.99 $9,887.20 $22,180.79 2.13% 1906099 PEOPLES DRUG 476 2.9% $32,051.47 $827.25 $1,412.22 $34,290.94 $9,445.40 $24,845.54 2.38%

1906277 CASH DRUGS 2 0.0% $9.10 $4.00 $0.35 $13.45 $9.74 $3.71 0.00%

1907003 PITRES 24 0.1% $2,571.90 $45.00 $122.74 $2,739.64 $821.95 $1,917.69 0.18%

1907332 ELLIOTT 7 0.0% $284.48 $13.50 $10.89 $308.87 $145.00 $163.87 0.02%

1908170 M C CLINIC 2 0.0% $34.94 $4.00 $1.33 $40.27 $10.00 $30.27 0.00%

1910339 MEDI THRIFT 7 0.0% $381.69 $10.50 $19.80 $411.99 $285.46 $126.53 0.01%

1911393 D & M DRUG 10 0.1% $573.29 $16.75 $22.86 $612.90 $223.82 $389.08 0.04%

1911393 D & M DRUG 107 0.7% $7,456.18 $175.50 $300.28 $7,931.96 $2,565.65 $5,366.31 0.52%

1911862 VIALLON DRUG 4 0.0% $164.17 $7.50 $6.77 $178.44 $150.74 $27.70 0.00%

1915480 CLINIC DRUG 3 0.0% $311.25 $5.50 $11.76 $328.51 $165.00 $163.51 0.02%

1915618 DAVES VILLAGE 166 1.0% $14,636.69 $313.75 $646.76 $15,597.20 $4,174.95 $11,422.25 1.10%

1918133 ASSUMPTION 8 0.0% $145.20 $15.75 $6.36 $167.31 $90.81 $76.50 0.01%

1920873 SULLIVAN'S 11 0.1% $735.60 $20.75 $21.78 $778.13 $239.18 $538.95 0.05%

1920897 ACADIA PARK 5 0.0% $228.01 $9.75 $11.16 $248.92 $160.00 $88.92 0.01%

1922360 RAYMOND'S 2 0.0% $503.29 $3.75 $21.19 $528.23 $125.00 $403.23 0.04%

1924681 THE ORIGINAL 3 0.0% $240.34 $5.50 $8.12 $253.96 $145.00 $108.96 0.01%

1925962 J AND K DRUG 10 0.1% $468.99 $19.00 $24.03 $512.02 $190.00 $322.02 0.03%

1927396 ELLIOTT 1 0.0% $239.40 $2.00 $9.96 $251.36 $5.00 $246.36 0.02%

1928778 HAYDEL'S DRUG 11 0.1% $713.69 $20.50 $31.83 $766.02 $327.22 $438.80 0.04% 1928778 HAYDEL'S DRUG 172 1.0% $13,487.51 $323.00 $598.49 $14,409.00 $4,084.12 $10,324.88 0.99%

1929097 THE MEDICINE 2 0.0% $55.57 $3.75 $2.28 $61.60 $55.39 $6.21 0.00%

1929720 LLOYDS 4 0.0% $164.45 $7.75 $6.78 $178.98 $59.09 $119.89 0.01%

1929720 LLOYDS 175 1.1% $23,264.49 $327.75 $1,030.30 $24,622.54 $4,903.42 $19,719.12 1.89%

1929869 STEVEN'S 20 0.1% $957.26 $38.75 $48.32 $1,044.33 $292.35 $751.98 0.07%

1931458 F & M SPECIALTY 5 0.0% $3,263.84 $9.25 $155.31 $3,428.40 $170.00 $3,258.40 0.31% 1931751 HOUMA URGENT 20 0.1% $1,173.41 $33.00 $52.88 $1,259.29 $641.01 $618.28 0.06% 1931751 HOUMA URGENT 160 1.0% $10,600.20 $295.25 $451.05 $11,346.50 $3,234.38 $8,112.12 0.78%

1932917 THE MEDICINE 3 0.0% $94.41 $5.50 $3.72 $103.63 $76.56 $27.07 0.00%

2505456 CORNER DRUG 6 0.0% $421.82 $11.50 $0.00 $433.32 $160.00 $273.32 0.03%

A006B_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

CHN NABP Pharm Name # Rx % Rx Cost Fee Tax Rx Price Copay Amt Paid %

2516055 DIAMONDHEAD 9 0.1% $547.97 $17.00 $0.00 $564.97 $230.21 $334.76 0.03%

2520484 PMO PHARMACY 5 0.0% $289.27 $9.75 $0.00 $299.02 $140.00 $159.02 0.02%

2521044 F & M SPECIALTY 9 0.1% $2,496.37 $17.00 $0.00 $2,513.37 $105.00 $2,408.37 0.23% 2521272 TRANSCRIPT 14 0.1% $1,775.90 $26.50 $0.00 $1,802.40 $276.65 $1,525.75 0.15%

2990148 LIBERTY 3 0.0% $388.54 $5.50 $0.00 $394.04 $132.81 $261.23 0.03%

4436615 MEDFUSION RX 4 0.0% $6,202.79 $7.50 $0.00 $6,210.29 $50.00 $6,160.29 0.59% 4502313 LYNNS LA VEGA 7 0.0% $1,218.91 $13.25 $0.00 $1,232.16 $200.00 $1,032.16 0.10%

4541480 UTMDACC 6 0.0% $359.38 $12.00 $0.00 $371.38 $28.07 $343.31 0.03%

4572904 SOUTHBELT 1 0.0% $270.20 $1.75 $0.00 $271.95 $140.00 $131.95 0.01%

4580470 GOLIAD 16 0.1% $1,974.56 $21.75 $0.00 $1,996.31 $405.00 $1,591.31 0.15%

4582400 ST LUKES 1 0.0% $6.93 $2.00 $0.00 $8.93 $5.00 $3.93 0.00%

4591055 IVPCARE 5 0.0% $4,011.66 $5.25 $0.00 $4,016.91 $160.00 $3,856.91 0.37%

9999991 SELF PAY 23 0.1% $1,616.35 $1.75 $0.00 $1,618.10 $581.65 $1,036.45 0.10%

Ind Total 3,137 19.1% $293,826.47 $5,606.50 $11,988.85 $311,421.82 $78,715.72 $232,706.10 22.34%

Mail 1464700 DRUGSOURCE 101 0.6% $24,571.64 $94.50 $0.00 $24,666.14 $3,435.55 $21,230.59 2.04% Mail Total 101 0.6% $24,571.64 $94.50 $0.00 $24,666.14 $3,435.55 $21,230.59 2.04%

Spec 9999989 PRESCRIPTION 2 0.0% $3,410.28 $4.00 $0.00 $3,414.28 $180.00 $3,234.28 0.31% Spec Total 2 0.0% $3,410.28 $4.00 $0.00 $3,414.28 $180.00 $3,234.28 0.31%

1932070 CVS PHARMACY 16 0.1% $1,412.40 $24.75 $43.50 $1,480.65 $438.45 $1,042.20 0.10%

4220961 CVS PHARMACY 3 0.0% $83.41 $2.00 $0.00 $85.41 $15.00 $70.41 0.01%

4531097 CVS PHARMACY 1 0.0% $669.37 $1.75 $0.00 $671.12 $140.00 $531.12 0.05%

4531162 CVS PHARMACY 2 0.0% $206.52 $3.75 $0.00 $210.27 $99.03 $111.24 0.01%

039 Total 22 0.1% $2,371.70 $32.25 $43.50 $2,447.45 $692.48 $1,754.97 0.17%

1919438 KMART 18 0.1% $1,680.47 $33.75 $75.15 $1,789.37 $633.32 $1,156.05 0.11%

1919438 KMART 385 2.3% $28,958.49 $671.50 $1,297.79 $30,927.78 $9,915.78 $21,012.01 2.02% 110 Total 403 2.4% $30,638.96 $705.25 $1,372.94 $32,717.15 $10,549.10 $22,168.06 2.13%

0508652 SAV-ON DRUG 13 0.1% $1,968.01 $23.75 $0.00 $1,991.76 $300.00 $1,691.76 0.16% 156 Total 13 0.1% $1,968.01 $23.75 $0.00 $1,991.76 $300.00 $1,691.76 0.16%

A006B_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

CHN NABP Pharm Name # Rx % Rx Cost Fee Tax Rx Price Copay Amt Paid %

0114087 CVS PHARMACY 1 0.0% $159.36 $1.75 $0.00 $161.11 $140.00 $21.11 0.00%

0119796 CVS PHARMACY 1 0.0% $3.42 $2.00 $0.00 $5.42 $5.00 $0.42 0.00%

3663348 CVS PHARMACY 1 0.0% $39.65 $2.00 $0.00 $41.65 $5.00 $36.65 0.00%

177 Total 3 0.0% $202.43 $5.75 $0.00 $208.18 $150.00 $58.18 0.01%

0589791 RITE-AID 1 0.0% $111.67 $1.75 $0.00 $113.42 $113.42 $0.00 0.00%

1900706 RITE-AID 1 0.0% $18.20 $2.00 $0.63 $20.83 $5.00 $15.83 0.00%

1900782 RITE-AID 6 0.0% $230.04 $11.50 $8.08 $249.62 $140.00 $109.62 0.01%

1900819 RITE-AID 2 0.0% $24.58 $4.00 $0.94 $29.52 $10.00 $19.52 0.00%

1900895 RITE-AID 36 0.2% $3,226.02 $68.25 $138.71 $3,432.98 $879.07 $2,553.91 0.25% 1900895 RITE-AID 345 2.1% $36,067.69 $606.75 $1,584.87 $38,259.31 $9,882.82 $28,376.49 2.72%

1901049 RITE-AID 1 0.0% $7.94 $2.00 $0.42 $10.36 $5.00 $5.36 0.00%

1901087 RITE-AID 1 0.0% $224.12 $1.75 $8.00 $233.87 $69.59 $164.28 0.02%

1901102 RITE-AID 1 0.0% $286.41 $2.00 $6.62 $295.03 $5.00 $290.03 0.03%

1901102 RITE-AID 4 0.0% $205.94 $7.50 $5.59 $219.03 $51.85 $167.18 0.02%

1903156 RITE-AID 20 0.1% $1,289.40 $32.75 $59.16 $1,381.31 $625.65 $755.66 0.07%

1903156 RITE-AID 410 2.5% $34,102.44 $744.25 $1,525.05 $36,371.74 $11,160.12 $25,211.62 2.42%

1912826 RITE-AID 5 0.0% $273.56 $9.50 $11.15 $294.21 $135.01 $159.21 0.02%

1915125 RITE-AID 9 0.1% $260.28 $16.75 $12.16 $289.19 $188.13 $101.06 0.01%

1916785 RITE-AID 2 0.0% $358.95 $3.50 $11.00 $373.45 $120.00 $253.45 0.02%

1917016 RITE-AID 1 0.0% $185.61 $2.00 $5.03 $192.64 $5.00 $187.64 0.02%

1917383 RITE-AID 1 0.0% $166.28 $1.75 $6.80 $174.83 $120.00 $54.83 0.01%

1917383 RITE-AID 73 0.4% $4,818.71 $130.75 $190.97 $5,140.43 $2,056.26 $3,084.17 0.30%

1917573 RITE-AID 9 0.1% $314.41 $17.50 $14.18 $346.09 $130.80 $215.29 0.02%

1918955 RITE-AID 64 0.4% $2,917.49 $119.50 $130.61 $3,167.60 $1,776.43 $1,391.17 0.13% 1918955 RITE-AID 708 4.3% $59,341.22 $1,271.75 $2,632.18 $63,245.15 $19,000.80 $44,244.35 4.25%

1923348 RITE-AID 7 0.0% $437.68 $12.25 $20.46 $470.39 $220.00 $250.39 0.02%

1925227 RITE-AID 3 0.0% $36.29 $5.50 $1.94 $43.73 $34.27 $9.46 0.00%

1927194 RITE-AID 1 0.0% $71.64 $1.75 $2.97 $76.36 $76.35 $0.01 0.00%

2519784 RITE-AID 1 0.0% $269.86 $1.75 $0.00 $271.61 $120.00 $151.61 0.01%

4424191 RITE-AID 1 0.0% $391.73 $1.75 $0.00 $393.48 $120.00 $273.48 0.03%

181 Total 1,713 10.4% $145,638.16 $3,080.50 $6,377.52 $155,096.18 $47,050.57 $108,045.62 10.37%

4429709 SUPER D DRUGS 2 0.0% $154.62 $3.50 $0.00 $158.12 $152.11 $6.01 0.00%

205 Total 2 0.0% $154.62 $3.50 $0.00 $158.12 $152.11 $6.01 0.00%

0618198 TARGET 2 0.0% $1,218.87 $1.75 $0.00 $1,220.62 $124.00 $1,096.62 0.11%

1930684 TARGET 28 0.2% $2,986.70 $36.50 $135.63 $3,158.83 $1,002.19 $2,156.64 0.21% 1930684 TARGET 282 1.7% $16,143.01 $348.88 $728.27 $17,220.16 $6,083.19 $11,136.97 1.07%

A006B_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

CHN NABP Pharm Name # Rx % Rx Cost Fee Tax Rx Price Copay Amt Paid % 207 Total 312 1.9% $20,348.58 $387.13 $863.90 $21,599.61 $7,209.38 $14,390.23 1.38%

0133037 WALGREENS 2 0.0% $72.92 $3.50 $0.00 $76.42 $76.41 $0.01 0.00%

0421280 WALGREENS 4 0.0% $405.18 $5.50 $0.00 $410.68 $130.00 $280.68 0.03%

0560018 WALGREENS 3 0.0% $184.82 $5.25 $0.00 $190.07 $140.00 $50.07 0.00%

0619950 WALGREENS 1 0.0% $6.50 $2.00 $0.00 $8.50 $5.00 $3.50 0.00%

1074323 WALGREENS 12 0.1% $905.58 $22.00 $0.00 $927.58 $240.52 $687.06 0.07%

1471414 WALGREENS 1 0.0% $17.97 $2.00 $0.24 $20.21 $5.00 $15.21 0.00%

1900302 WALGREENS 5 0.0% $79.83 $5.75 $3.48 $89.06 $110.01 ($20.95) 0.00%

1922815 WALGREENS 5 0.0% $219.12 $9.50 $8.04 $236.66 $141.11 $95.55 0.01%

1924908 WALGREENS 1 0.0% $4.96 $2.00 $0.34 $7.30 $5.00 $2.30 0.00%

1925328 WALGREENS 3 0.0% $65.51 $5.75 $1.74 $73.00 $13.38 $59.62 0.01%

1925506 WALGREENS 4 0.0% $47.41 $7.50 $1.61 $56.52 $39.72 $16.80 0.00%

1925518 WALGREENS 4 0.0% $495.23 $7.25 $23.38 $525.86 $154.33 $371.53 0.04%

1925861 WALGREENS 1 0.0% $46.70 $1.75 $2.45 $50.90 $50.90 $0.00 0.00%

1926433 WALGREENS 14 0.1% $1,101.78 $26.00 $31.94 $1,159.72 $386.72 $773.00 0.07%

1926623 WALGREENS 1 0.0% $47.18 $1.75 $2.47 $51.40 $51.40 $0.00 0.00%

1926837 WALGREENS 64 0.4% $7,035.44 $110.00 $316.82 $7,462.26 $1,986.07 $5,476.19 0.53% 1926837 WALGREENS 849 5.2% $73,612.79 $1,501.75 $3,267.24 $78,381.78 $19,218.25 $59,163.52 5.68% 1927447 WALGREENS 64 0.4% $4,184.07 $109.50 $161.05 $4,454.62 $1,523.46 $2,931.16 0.28% 1927447 WALGREENS 560 3.4% $37,803.01 $973.75 $1,466.77 $40,243.53 $12,859.88 $27,383.67 2.63%

1927877 WALGREENS 5 0.0% $240.05 $9.75 $10.18 $259.98 $109.47 $150.51 0.01%

1928122 WALGREENS 1 0.0% $71.55 $1.75 $2.97 $76.27 $76.27 $0.00 0.00%

1929388 WALGREENS 6 0.0% $427.56 $11.00 $17.31 $455.87 $189.99 $265.88 0.03%

1930204 WALGREENS 4 0.0% $1,428.26 $7.25 $50.73 $1,486.24 $148.75 $1,337.49 0.13%

1930228 WALGREENS 2 0.0% $92.66 $3.50 $4.86 $101.02 $80.06 $20.96 0.00%

1930901 WALGREENS 143 0.9% $10,473.51 $255.89 $471.04 $11,200.44 $3,613.70 $7,586.74 0.73% 1930901 WALGREENS 1,216 7.4% $88,973.12 $2,154.00 $3,924.21 $95,051.33 $28,326.06 $66,725.26 6.41%

1931080 WALGREENS 5 0.0% $249.78 $9.50 $8.51 $267.79 $135.00 $132.79 0.01%

1931129 WALGREENS 1 0.0% $77.77 $1.75 $2.41 $81.93 $20.00 $61.93 0.01%

1931129 WALGREENS 5 0.0% $301.58 $9.50 $8.62 $319.70 $131.72 $187.98 0.02%

1931244 WALGREENS 2 0.0% $674.40 $3.50 $32.57 $710.47 $140.00 $570.47 0.05%

1931890 WALGREENS 6 0.0% $1,337.78 $10.50 $61.37 $1,409.65 $240.00 $1,169.65 0.11% 1931953 WALGREENS 7 0.0% $2,051.43 $12.75 $72.66 $2,136.84 $210.00 $1,926.84 0.18%

1932424 WALGREENS 2 0.0% $88.10 $3.50 $4.40 $96.00 $96.00 $0.00 0.00%

1932626 WALGREENS 4 0.0% $227.61 $7.25 $0.00 $234.86 $145.01 $89.85 0.01%

2519924 WALGREENS 1 0.0% $9.45 $2.00 $0.00 $11.45 $5.00 $6.45 0.00%

2521741 WALGREENS 1 0.0% $154.91 $1.75 $0.00 $156.66 $120.00 $36.66 0.00%

4528937 WALGREENS 4 0.0% $572.32 $7.50 $0.00 $579.82 $150.00 $429.82 0.04%

4530918 WALGREENS 4 0.0% $211.77 $7.00 $0.00 $218.77 $217.99 $0.78 0.00%

4535273 WALGREENS 11 0.1% $503.78 $20.50 $0.00 $524.28 $211.60 $312.68 0.03%

4557382 WALGREENS 6 0.0% $603.99 $10.75 $0.00 $614.74 $205.82 $408.92 0.04%

4568068 WALGREENS 2 0.0% $499.00 $3.50 $0.00 $502.50 $40.00 $462.50 0.04%

A006B_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

CHN NABP Pharm Name # Rx % Rx Cost Fee Tax Rx Price Copay Amt Paid %

4589961 WALGREENS 1 0.0% $23.38 $1.75 $0.00 $25.13 $25.14 ($0.01) 0.00%

4594683 WALGREENS 2 0.0% $173.63 $3.50 $0.00 $177.13 $80.00 $97.13 0.01%

4598287 WALGREENS 1 0.0% $27.40 $2.00 $0.00 $29.40 $5.00 $24.40 0.00%

226 Total 3,040 18.5% $235,830.79 $5,364.14 $9,959.41 $251,154.34 $71,859.74 $179,294.60 17.21%

0411962 WALMART 1 0.0% $4.00 $0.00 $0.00 $4.00 $4.00 $0.00 0.00%

0611308 WAL MART 1 0.0% $110.14 $1.75 $0.00 $111.89 $20.00 $91.89 0.01%

0611889 WALMART 9 0.1% $2,892.03 $14.00 $0.00 $2,906.03 $388.44 $2,517.59 0.24%

0612855 WAL-MART 7 0.0% $551.47 $3.50 $0.00 $554.97 $154.00 $400.97 0.04%

1097484 WALMART 2 0.0% $4,460.38 $3.50 $0.00 $4,463.88 $140.00 $4,323.88 0.42%

1921370 WALMART 1 0.0% $202.23 $1.75 $6.19 $210.17 $120.00 $90.17 0.01%

1921712 WALMART 3 0.0% $12.00 $0.00 $0.58 $12.58 $5.00 $7.58 0.00%

1921813 WALMART 11 0.1% $694.77 $14.50 $24.46 $733.73 $272.26 $461.47 0.04%

1922411 WALMART 27 0.2% $1,648.02 $36.50 $66.22 $1,750.74 $602.63 $1,148.11 0.11% 1922411 WALMART 187 1.1% $11,918.19 $240.50 $478.68 $12,637.37 $4,409.08 $8,228.29 0.79%

1922613 WALMART 6 0.0% $1,703.67 $8.75 $81.41 $1,793.83 $240.00 $1,553.83 0.15%

1922613 WALMART 48 0.3% $2,278.26 $62.00 $107.37 $2,447.63 $1,235.94 $1,211.69 0.12%

1922714 WALMART 1 0.0% $4.00 $0.00 $0.12 $4.12 $4.12 $0.00 0.00%

1923069 WALMART 1 0.0% $36.34 $2.00 $0.89 $39.23 $5.00 $34.23 0.00%

1924073 WALMART 60 0.4% $3,041.44 $76.00 $134.95 $3,252.39 $1,392.65 $1,859.74 0.18% 1924073 WALMART 922 5.6% $64,457.63 $1,240.75 $2,897.63 $68,596.01 $23,442.75 $45,153.26 4.33%

1926039 WALMART 1 0.0% $202.23 $1.75 $6.19 $210.17 $20.00 $190.17 0.02%

1926596 WALMART 2 0.0% $12.84 $4.00 $0.54 $17.38 $10.00 $7.38 0.00%

1929679 WALMART 1 0.0% $136.46 $0.00 $5.46 $141.92 $5.00 $136.92 0.01%

1930723 WALMART 66 0.4% $7,287.38 $74.75 $326.32 $7,688.45 $1,481.70 $6,206.75 0.60% 1930723 WALMART 428 2.6% $34,426.57 $524.25 $1,557.73 $36,508.55 $10,523.83 $25,984.71 2.49%

1932688 SAM'S PHA 4 0.0% $438.31 $3.50 $17.85 $459.66 $262.62 $197.04 0.02%

1932688 SAM'S PHA 39 0.2% $4,003.23 $41.25 $157.06 $4,201.54 $1,304.98 $2,896.56 0.28%

2127175 WALMART 3 0.0% $77.68 $6.00 $0.00 $83.68 $15.00 $68.68 0.01%

2514239 WAL-MART 5 0.0% $34.78 $2.00 $0.00 $36.78 $23.00 $13.78 0.00%

2514784 WALMART 21 0.1% $1,045.78 $28.00 $0.00 $1,073.78 $361.57 $712.21 0.07%

4514267 SAM'S CLUB 6 0.0% $186.44 $7.25 $0.00 $193.69 $160.96 $32.73 0.00%

4565240 WALMART 1 0.0% $104.11 $1.75 $0.00 $105.86 $105.86 $0.00 0.00%

4576609 WALMART 3 0.0% $96.92 $3.75 $0.00 $100.67 $41.30 $59.37 0.01%

4594328 WAL MART 1 0.0% $62.37 $2.00 $0.00 $64.37 $5.00 $59.37 0.01%

4926347 WAL MART 1 0.0% $4.00 $0.00 $0.00 $4.00 $4.00 $0.00 0.00%

229 Total 1,869 11.4% $142,133.67 $2,405.75 $5,869.65 $150,409.07 $46,760.69 $103,648.37 9.95%

1926065 WINN DIXIE 1 0.0% $4.92 $1.75 $0.24 $6.91 $6.91 $0.00 0.00%

1927423 WINN DIXIE 25 0.2% $1,205.89 $46.00 $36.71 $1,288.60 $373.67 $914.93 0.09% 1928982 WINN DIXIE 21 0.1% $1,724.05 $39.50 $66.04 $1,829.59 $395.00 $1,434.59 0.14%

A006B_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

CHN NABP Pharm Name # Rx % Rx Cost Fee Tax Rx Price Copay Amt Paid %

2518504 WINN DIXIE 5 0.0% $1,042.47 $9.00 $0.00 $1,051.47 $179.64 $871.83 0.08%

292 Total 52 0.3% $3,977.33 $96.25 $102.99 $4,176.57 $955.22 $3,221.35 0.31%

1008108 PUBLIX 17 0.1% $822.54 $25.00 $0.00 $847.54 $142.10 $705.44 0.07%

302 Total 17 0.1% $822.54 $25.00 $0.00 $847.54 $142.10 $705.44 0.07%

1916305 MEDICINE 6 0.0% $238.46 $12.00 $7.80 $258.26 $30.00 $228.26 0.02%

1920582 MEDICINE 1 0.0% $118.46 $1.75 $3.65 $123.86 $120.00 $3.86 0.00%

1924631 MEDICINE 48 0.3% $3,465.26 $89.50 $140.58 $3,695.34 $866.82 $2,828.52 0.27%

1924643 MEDICINE 6 0.0% $426.81 $11.00 $17.69 $455.50 $210.00 $245.50 0.02%

307 Total 61 0.4% $4,248.99 $114.25 $169.72 $4,532.96 $1,226.82 $3,306.14 0.32%

1926217 FRED'S 7 0.0% $722.26 $13.25 $40.46 $775.97 $220.00 $555.97 0.05%

1928196 FRED'S XPR 6 0.0% $556.35 $11.50 $27.24 $595.09 $160.00 $435.09 0.04%

2521765 FRED'S 31 0.2% $1,512.75 $53.75 $0.00 $1,566.50 $482.76 $1,083.74 0.10%

4434750 FRED'S 11 0.1% $1,564.83 $20.50 $0.00 $1,585.33 $344.99 $1,240.34 0.12%

345 Total 55 0.3% $4,356.19 $99.00 $67.70 $4,522.89 $1,207.75 $3,315.14 0.32%

1466033 CAREMARK 3 0.0% $11,533.44 $5.25 $233.48 $11,772.17 $220.00 $11,552.17 1.11% 380 Total 3 0.0% $11,533.44 $5.25 $233.48 $11,772.17 $220.00 $11,552.17 1.11%

2126060 SHOPPERS 5 0.0% $193.37 $9.25 $0.00 $202.62 $54.92 $147.70 0.01%

410 Total 5 0.0% $193.37 $9.25 $0.00 $202.62 $54.92 $147.70 0.01%

4521147 BROOKSHIRE 6 0.0% $490.85 $11.00 $0.00 $501.85 $222.75 $279.10 0.03%

453 Total 6 0.0% $490.85 $11.00 $0.00 $501.85 $222.75 $279.10 0.03%

1927358 BONVILLAIN 154 0.9% $18,213.10 $284.75 $814.42 $19,312.27 $3,825.42 $15,486.85 1.49% 540 Total 154 0.9% $18,213.10 $284.75 $814.42 $19,312.27 $3,825.42 $15,486.85 1.49%

4531314 CVS PROCARE 1 0.0% $679.11 $1.75 $0.00 $680.86 $120.00 $560.86 0.05%

A006B_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

CHN NABP Pharm Name # Rx % Rx Cost Fee Tax Rx Price Copay Amt Paid % 608 Total 1 0.0% $679.11 $1.75 $0.00 $680.86 $120.00 $560.86 0.05%

1925734 ROUSES 3 0.0% $44.44 $3.75 $1.79 $49.98 $12.96 $37.02 0.00%

1925734 ROUSES 109 0.7% $7,055.79 $190.50 $315.27 $7,561.56 $2,590.99 $4,970.57 0.48%

1926560 ROUSES 4 0.0% $166.48 $7.00 $7.01 $180.49 $139.74 $40.75 0.00%

1926560 ROUSES 57 0.3% $2,833.94 $84.50 $110.45 $3,028.89 $1,157.76 $1,871.13 0.18% 1927271 ROUSES 11 0.1% $3,337.43 $19.50 $135.76 $3,492.69 $634.45 $2,858.24 0.27%

1930052 ROUSES 25 0.2% $659.67 $37.00 $30.14 $726.81 $369.06 $357.75 0.03%

1930052 ROUSES 264 1.6% $19,507.57 $424.78 $878.75 $20,811.10 $6,811.64 $13,999.46 1.34% 627 Total 473 2.9% $33,605.32 $767.03 $1,479.17 $35,851.52 $11,716.60 $24,134.92 2.32%

4531807 AMBULATORY 1 0.0% $4,918.69 $1.75 $0.00 $4,920.44 $120.00 $4,800.44 0.46% 758 Total 1 0.0% $4,918.69 $1.75 $0.00 $4,920.44 $120.00 $4,800.44 0.46%

1085667 CURASCRIPT 1 0.0% $4,011.66 $1.75 $0.00 $4,013.41 $120.00 $3,893.41 0.37% 779 Total 1 0.0% $4,011.66 $1.75 $0.00 $4,013.41 $120.00 $3,893.41 0.37%

0100052 SMITHERMAN'S 23 0.1% $495.07 $31.75 $0.00 $526.82 $236.02 $290.80 0.03%

0127488 LILLIAN 7 0.0% $412.66 $13.50 $0.00 $426.16 $147.63 $278.53 0.03%

841 Total 30 0.2% $907.73 $45.25 $0.00 $952.98 $383.65 $569.33 0.05%

1909716 FRANKLIN AVE 7 0.0% $222.03 $12.25 $7.12 $241.40 $169.84 $71.57 0.01%

1924491 DAVE'S 1 0.0% ($28.15) ($2.00) ($0.81) ($30.96) ($5.00) ($25.96) 0.00%

1930406 AL DAVIS 11 0.1% $515.49 $17.25 $23.21 $555.95 $192.95 $363.00 0.03%

4540577 COLLEGE PARK 14 0.1% $845.99 $26.00 $0.00 $871.99 $239.57 $632.42 0.06%

854 Total 33 0.2% $1,555.36 $53.50 $29.52 $1,638.38 $597.36 $1,041.03 0.10%

1903663 LEE'S CITY DRUG 14 0.1% $591.18 $26.25 $32.91 $650.34 $263.12 $387.22 0.04%

1906354 STEWART'S DRUG 2 0.0% $65.41 $4.00 $2.41 $71.82 $10.00 $61.82 0.01%

1908182 M C STANDARD 18 0.1% $1,552.98 $33.50 $61.80 $1,648.28 $340.00 $1,308.28 0.13%

1912167 WOLFES 6 0.0% $165.43 $11.25 $7.92 $184.60 $139.68 $44.92 0.00%

1912167 WOLFES 332 2.0% $30,253.59 $586.50 $1,357.85 $32,197.94 $8,890.31 $23,307.63 2.24%

1915353 WEST ST JAMES 4 0.0% $171.26 $7.50 $5.59 $184.35 $99.39 $84.96 0.01%

1915353 WEST ST JAMES 21 0.1% $1,616.12 $38.75 $55.70 $1,710.57 $508.43 $1,202.14 0.12%

A006B_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

CHN NABP Pharm Name # Rx % Rx Cost Fee Tax Rx Price Copay Amt Paid %

1916824 PAUL'S 16 0.1% $978.82 $25.50 $55.64 $1,059.96 $312.79 $747.17 0.07%

1917319 CHANNELL 2 0.0% $7.73 $3.75 $0.55 $12.03 $9.11 $2.92 0.00%

1925962 J AND K DRUG 5 0.0% $210.72 $9.75 $10.81 $231.28 $40.00 $191.28 0.02%

2508298 MR DISCOUNT 5 0.0% $146.27 $9.75 $0.00 $156.02 $32.29 $123.73 0.01%

866 Total 425 2.6% $35,759.51 $756.50 $1,591.18 $38,107.19 $10,645.12 $27,462.07 2.64%

2126060 SHOPPERS 4 0.0% $282.42 $7.25 $0.00 $289.67 $165.00 $124.67 0.01%

880 Total 4 0.0% $282.42 $7.25 $0.00 $289.67 $165.00 $124.67 0.01%

ABC

2636883 CVS PHARMACY 2 0.0% $76.22 $4.00 $0.00 $80.22 $10.00 $70.22 0.01%

ABC Total 2 0.0% $76.22 $4.00 $0.00 $80.22 $10.00 $70.22 0.01%

CVS

1052644 CVS PHARMACY 5 0.0% $199.50 $5.75 $0.00 $205.25 $122.11 $83.14 0.01%

1901380 CVS PHARMACY 17 0.1% $1,055.00 $25.75 $45.75 $1,126.50 $278.40 $848.10 0.08%

1901417 CVS PHARMACY 2 0.0% $166.73 $3.50 $8.61 $178.84 $103.53 $75.31 0.01%

1901429 CVS PHARMACY 72 0.4% $6,207.92 $128.00 $279.79 $6,615.71 $1,707.82 $4,907.89 0.47% 1901429 CVS PHARMACY 635 3.9% $57,621.14 $1,100.00 $2,564.76 $61,285.90 $15,450.98 $45,834.92 4.40% 1901455 CVS PHARMACY 7 0.0% $5,797.52 $13.00 $234.65 $6,045.17 $215.00 $5,830.17 0.56%

1901506 CVS PHARMACY 27 0.2% $886.30 $39.50 $41.89 $967.69 $365.82 $601.87 0.06%

1901532 CVS PHARMACY 7 0.0% $617.32 $13.00 $27.27 $657.59 $266.50 $391.09 0.04%

1901582 CVS PHARMACY 7 0.0% $442.23 $12.75 $18.31 $473.29 $130.00 $343.29 0.03%

1901633 CVS PHARMACY 17 0.1% $695.35 $30.25 $26.99 $752.59 $363.34 $389.25 0.04%

1901633 CVS PHARMACY 163 1.0% $12,172.65 $288.91 $487.80 $12,949.36 $3,668.33 $9,281.04 0.89% 1901669 CVS PHARMACY 35 0.2% $1,845.73 $62.50 $86.44 $1,994.67 $1,006.55 $988.12 0.09%

1901758 CVS PHARMACY 3 0.0% $171.02 $5.50 $5.31 $181.83 $124.99 $56.84 0.01%

1912307 CVS PHARMACY 1 0.0% $95.20 $1.75 $4.51 $101.46 $101.46 $0.00 0.00%

1915151 CVS PHARMACY 34 0.2% $3,352.51 $55.25 $117.72 $3,525.48 $614.49 $2,910.99 0.28%

1915442 CVS PHARMACY 1 0.0% $835.03 $1.75 $29.63 $866.41 $20.00 $846.41 0.08%

1916278 CVS PHARMACY 150 0.9% $8,663.65 $257.25 $386.74 $9,307.64 $4,056.55 $5,251.09 0.50% 1916278 CVS PHARMACY 1,546 9.4% $113,679.52 $2,667.57 $5,073.07 $121,420.16 $36,514.99 $84,905.17 8.15%

1916519 CVS PHARMACY 1 0.0% $24.39 $2.00 $0.79 $27.18 $5.00 $22.18 0.00%

1917004 CVS PHARMACY 7 0.0% $1,245.63 $11.50 $55.03 $1,312.16 $165.00 $1,147.16 0.11%

1919731 CVS PHARMACY 8 0.0% $282.86 $15.50 $14.39 $312.75 $149.99 $162.76 0.02%

1919767 CVS PHARMACY 4 0.0% $265.14 $5.25 $10.93 $281.32 $133.95 $147.37 0.01%

1920811 CVS PHARMACY 15 0.1% $571.53 $21.75 $17.62 $610.90 $336.80 $274.10 0.03%

1921015 CVS PHARMACY 5 0.0% $156.55 $9.50 $7.29 $173.34 $82.66 $90.68 0.01%

1923742 CVS PHARMACY 4 0.0% $838.81 $5.50 $38.52 $882.83 $170.00 $712.83 0.07%

1924047 CVS PHARMACY 167 1.0% $8,172.44 $266.57 $361.34 $8,800.35 $3,261.89 $5,538.46 0.53% 1924047 CVS PHARMACY 1,558 9.5% $107,346.37 $2,631.86 $4,798.21 $114,776.44 $34,783.06 $79,993.39 7.68%

A006B_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

CHN NABP Pharm Name # Rx % Rx Cost Fee Tax Rx Price Copay Amt Paid %

2500216 CVS PHARMACY 7 0.0% $589.23 $10.75 $0.00 $599.98 $171.69 $428.29 0.04%

2510914 CVS PHARMACY 2 0.0% $30.58 $4.00 $0.00 $34.58 $10.00 $24.58 0.00%

2512374 CVS PHARMACY 1 0.0% $23.09 $2.00 $0.00 $25.09 $5.00 $20.09 0.00%

4506981 CVS PHARMACY 5 0.0% $733.31 $9.50 $0.00 $742.81 $155.00 $587.81 0.06%

4516499 CVS PHARMACY 1 0.0% $79.56 $1.75 $0.00 $81.31 $21.85 $59.46 0.01%

CVS Total 4,514 27.4% $334,863.81 $7,709.41 $14,743.36 $357,316.58 $104,562.75 $252,753.85 24.26%

GMG

1922548 DRUG EMPORIUM 6 0.0% $116.39 $7.50 $4.92 $128.81 $30.00 $98.81 0.01%

GMG Total 6 0.0% $116.39 $7.50 $4.92 $128.81 $30.00 $98.81 0.01%

Grand Total 16,460 100.0% $1,361,707.34 $27,713.46 $55,712.23 $1,445,133.03 $403,380.80 $1,041,752.27 100.00%

A017 - Therapeutic Class Totals

A017_Rpt Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007 Report Criteria

Code Therapeutic Class # Scripts Billed Used Fee Copay Tax Amt Paid

39 Antihyperlipidemic 942 $167,422.68 $137,661.18 $1,531.50 $37,395.75 $5,775.19 $107,572.12 27 Antidiabetic 723 $107,707.07 $85,731.08 $1,185.75 $17,829.64 $3,677.15 $72,764.34 49 Ulcer Drugs 565 $114,215.13 $91,980.90 $923.25 $25,924.09 $3,938.78 $70,918.84 58 Antidepressants 903 $111,093.17 $89,118.17 $1,521.75 $23,576.48 $3,702.79 $70,766.23 66 Analgesics-Anti-Inflammatory 423 $96,619.74 $72,347.41 $701.94 $9,113.20 $2,669.31 $66,605.46 36 Antihypertensive 1,312 $132,809.72 $102,560.80 $2,081.50 $44,603.05 $4,435.67 $64,474.96 72 Anticonvulsant 347 $62,711.05 $50,519.50 $606.50 $9,558.07 $2,141.59 $43,709.52 44 Antiasthmatic 400 $59,583.22 $49,224.82 $666.50 $15,525.38 $2,215.57 $36,581.51 85 Misc. Hematological 173 $39,741.31 $33,655.78 $304.50 $4,982.04 $1,347.23 $30,325.47 90 Dermatological 415 $44,475.99 $35,341.21 $708.50 $9,461.85 $1,451.75 $28,039.61 30 Misc. Endocrine 168 $41,926.92 $34,885.62 $291.00 $10,161.01 $1,362.91 $26,378.52 62 Misc. Psychotherapeutic and Neurological 101 $44,008.71 $29,761.37 $162.25 $4,692.49 $948.37 $26,179.50 33 Beta Blockers 729 $52,553.56 $36,532.77 $1,206.00 $13,987.52 $1,571.24 $25,322.49 34 Calcium Blockers 389 $42,415.80 $34,828.03 $690.25 $11,823.66 $1,413.36 $25,107.98 59 Antipsychotics 104 $30,639.59 $25,060.79 $174.25 $3,933.77 $1,099.99 $22,401.26 65 Analgesics-Narcotic 690 $38,075.99 $24,650.24 $1,270.25 $6,110.23 $967.61 $20,777.87 21 Antineoplastics 79 $25,394.88 $21,891.22 $130.75 $2,296.26 $952.24 $20,677.95 03 Macrolide Antibiotics 464 $23,508.47 $18,650.51 $882.25 $2,631.96 $677.40 $17,578.20 60 Hypnotics 247 $31,265.07 $24,874.34 $414.75 $8,795.57 $1,032.53 $17,526.05 40 Misc. Cardiovascular 25 $29,273.54 $17,635.51 $42.25 $1,477.88 $372.12 $16,572.00 41 Antihistamines 378 $31,530.92 $24,524.50 $656.25 $10,332.97 $1,016.23 $15,864.01 12 Antiviral 76 $21,950.11 $18,169.18 $126.75 $2,808.29 $329.13 $15,816.77 56 Miscellaneous Genitourinary Products 151 $22,463.56 $18,201.62 $253.25 $5,267.83 $771.86 $13,958.90 25 Contraceptives 556 $25,083.41 $21,822.17 $931.03 $12,295.41 $892.76 $11,350.55 43 Cough/Cold/Allergy 836 $27,683.69 $18,949.18 $1,531.13 $11,069.89 $828.33 $10,238.75 52 Misc. GI 102 $15,032.60 $12,075.44 $170.25 $3,270.68 $458.94 $9,433.95 24 Estrogens 394 $27,461.45 $21,456.68 $622.37 $13,819.56 $934.86 $9,194.35 02 Cephalosporins 298 $20,807.26 $15,960.74 $483.25 $8,046.52 $704.54 $9,102.01 42 Systemic And Topical Nasal Products 165 $15,022.49 $12,171.16 $288.50 $4,464.69 $497.34 $8,492.31 82 Hematopoitic Agents 108 $12,015.30 $9,435.39 $192.75 $1,795.91 $340.33 $8,172.56 54 Urinary Antispasmodics 75 $13,159.29 $10,668.23 $120.50 $3,076.84 $419.78 $8,131.67 73 Antiparkinsonian 72 $11,254.45 $9,454.27 $106.25 $1,923.51 $381.05 $8,018.06 67 Migraine Products 66 $12,391.67 $9,999.18 $95.75 $2,835.07 $451.53 $7,711.39 86 Ophthalmic 255 $21,016.15 $16,143.33 $426.25 $10,188.21 $710.31 $7,091.66 11 Antifunguals 99 $9,751.95 $7,641.83 $161.75 $1,272.93 $338.46 $6,869.11 94 Diagnostic Products 100 $11,454.33 $9,723.53 $153.25 $3,965.32 $426.45 $6,337.93 61 Stimulants/Anti-Obesity Anorexiants 88 $14,042.55 $11,152.67 $149.00 $5,515.63 $468.50 $6,254.54 83 Anticoagulants 149 $8,750.64 $6,972.63 $232.75 $1,819.97 $298.84 $5,684.25 75 Musculoskeletal Therapy Agents 209 $11,503.60 $6,815.70 $364.00 $1,856.62 $282.98 $5,606.06 57 Antianxiety Agents 333 $13,180.81 $6,624.16 $550.70 $2,315.97 $268.70 $5,127.59 01 Penicillins 301 $8,880.06 $6,128.85 $523.75 $1,862.86 $240.84 $5,030.58 99 Assorted Classes 10 $6,106.13 $5,130.55 $18.50 $360.00 $166.38 $4,955.43 05 Fluoroquinolones 203 $15,559.80 $9,184.11 $344.25 $5,088.75 $413.90 $4,853.51 37 Diuretics 485 $9,906.74 $5,921.58 $832.00 $2,416.69 $253.38 $4,590.27

A017 - Therapeutic Class Totals

A017_Rpt Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007 Report Criteria

Code Therapeutic Class # Scripts Billed Used Fee Copay Tax Amt Paid

32 Antianginal Agents 114 $7,483.08 $5,427.25 $154.50 $1,267.11 $238.32 $4,552.96 35 Antiarrhythmic 31 $4,542.17 $3,487.45 $38.25 $220.00 $149.98 $3,455.68 28 Thyroid 384 $10,506.14 $7,258.71 $635.00 $4,941.76 $313.30 $3,265.25 50 Antiemetics 45 $3,261.31 $2,597.00 $79.00 $332.39 $96.51 $2,440.12 04 Tetracyclines 90 $4,791.95 $3,019.69 $141.00 $894.25 $136.34 $2,402.78 79 Minerals and Electrolytes 82 $2,863.66 $2,250.73 $159.50 $407.79 $80.81 $2,083.25 53 Urinary Anti-Infectives 61 $3,046.12 $2,476.05 $117.75 $686.36 $89.75 $1,997.19 23 Androgen-Anabolic 12 $3,298.34 $2,747.23 $20.75 $900.64 $78.31 $1,945.65 55 Vaginal Products 53 $4,745.14 $3,574.98 $92.50 $2,307.31 $154.97 $1,515.14 89 Anorectal 27 $2,554.98 $2,083.17 $42.75 $776.99 $87.54 $1,436.47 46 Laxatives 59 $2,986.53 $2,107.59 $109.75 $879.18 $86.78 $1,424.94 13 Antimalarial 26 $1,280.09 $1,136.37 $33.50 $153.31 $38.66 $1,055.22 16 Misc. Anti-Infectives 147 $2,587.85 $1,465.57 $231.50 $906.76 $60.91 $851.22 64 Analgesics-Non Narcotic 42 $1,220.17 $955.58 $65.00 $258.96 $38.86 $800.48 22 Corticosteroids 187 $2,869.02 $1,262.47 $325.50 $940.42 $63.08 $710.63 09 Antimycobacterial Agents 10 $1,188.59 $674.60 $13.75 $49.62 $20.26 $658.99 88 Mouth and Throat (Local) 44 $1,185.71 $816.74 $69.75 $277.75 $29.50 $638.24 87 Otic 51 $2,753.98 $2,028.46 $93.25 $1,652.83 $89.47 $558.35 97 Medical Devices 78 $2,234.38 $1,628.04 $119.00 $1,393.41 $68.78 $422.41 26 Progestins 26 $1,364.89 $1,051.01 $40.75 $707.30 $36.13 $420.59 68 Gout 61 $1,625.52 $448.43 $114.29 $303.44 $22.91 $282.19 38 Pressors 3 $286.97 $231.81 $5.75 $30.00 $8.75 $216.31 31 Cardiotonics 62 $875.12 $505.46 $94.00 $462.66 $23.94 $160.74 47 Antidiarrheals 28 $424.54 $168.72 $42.00 $122.14 $8.85 $97.43 78 Multivitamins 25 $1,206.55 $851.86 $37.25 $834.60 $32.51 $87.02 93 Antidotes 1 $87.46 $85.46 $2.00 $5.00 $3.40 $85.86 92 Antiseptics and Disinfectants 1 $91.39 $86.36 $1.75 $73.80 $3.57 $17.88 15 Anthelmintic 1 $11.99 $4.52 $2.00 $5.00 $0.21 $1.73 80 Nutrients 1 $52.46 $38.10 $1.75 $40.00 $1.61 $1.46 Grand Total 16,460 $1,752,876.67 $1,361,707.34 $27,713.46 $403,380.80 $55,712.23 $1,041,752.27

A004A - Top 100 Utilized Drugs by Dollars

A004A_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

Amt Paid/ Ingred. Cost/ Desc NDC # Scripts Quantity Quant/RX Amt Paid RX Ingred. Cost 30 days Ind.* Main Form NEXIUM CAP 40MG 001865040 204 9389 46.0 $33,941.73 $166.38 $43,201.30 $149.68 N N I HUMIRA KIT 40MG/0.8 000743799 8 32 4.0 $21,824.26 $2,728.03 $21,395.52 $2,005.83 N N I ENBREL INJ 50MG/ML 584060435 9 52 5.8 $16,856.30 $1,872.92 $17,147.88 $1,382.89 N N I PLAVIX TAB 75MG 636531171 87 4245 48.8 $14,876.09 $170.99 $17,545.88 $123.56 N Y I LIPITOR TAB 20MG 000710156 94 5145 54.7 $14,465.34 $153.89 $18,751.69 $107.77 N Y I TRACLEER TAB 125MG 662150102 3 180 60.0 $11,552.17 $3,850.72 $11,533.44 $3,844.48 N Y N LIPITOR TAB 10MG 000710155 123 6508 52.9 $10,857.67 $88.27 $16,706.31 $77.01 N Y I PREVACID CAP 30MG DR 003003046 75 3390 45.2 $10,814.60 $144.19 $14,811.20 $146.65 N N I CELEBREX CAP 200MG 000251525 88 4435 50.4 $9,638.59 $109.53 $13,745.28 $123.61 N Y I CLOPIDOGREL TAB 75MG 605050253 51 2475 48.5 $9,343.28 $183.20 $9,197.65 $106.95 Y Y I AVANDIA TAB 4MG 000293159 43 3390 78.8 $9,099.62 $211.62 $10,923.46 $131.61 N Y I SINGULAIR TAB 10MG 000060117 101 4270 42.3 $8,989.67 $89.01 $13,412.44 $95.89 N Y I

CRESTOR TAB 10MG 003100751 98 4725 48.2 $8,685.09 $88.62 $13,710.30 $89.03 N Y I

REBIF INJ 44/0.5 440870044 3 30 10.0 $8,034.72 $2,678.24 $8,328.97 $1,735.20 N N I TRICOR TAB 145MG 000746123 58 3060 52.8 $7,524.85 $129.74 $10,222.21 $100.22 N Y I PROTONIX TAB 40MG 000080841 59 2714 46.0 $7,124.57 $120.76 $10,092.82 $116.72 N N N AZITHROMYCIN TAB 250MG 597623060 192 1149 6.0 $7,088.58 $36.92 $7,415.03 $231.00 Y N I LIPITOR TAB 40MG 000710157 35 2250 64.3 $6,730.45 $192.30 $8,115.44 $108.21 N Y I CYMBALTA CAP 60MG 000023237 63 2580 41.0 $6,627.98 $105.21 $9,221.78 $115.27 N N I

ACTOS TAB 30MG 647640301 26 1380 53.1 $6,606.96 $254.11 $7,637.87 $166.04 N Y I

IPRATROPIUM POW 515520393 4 1440 360.0 $6,428.64 $1,607.16 $6,393.60 $1,598.40 N N N

ZYRTEC TAB 10MG 000690731 146 5499 37.7 $6,329.53 $43.35 $11,802.26 $64.39 N N I

LEXAPRO TAB 10MG 004562010 110 4665 42.4 $6,254.38 $56.86 $11,083.98 $71.51 N N I

AMBIEN TAB 10MG 000245421 57 2120 37.2 $6,124.32 $107.44 $8,493.08 $120.19 N N I

SANDOSTATIN KIT LAR 000780342 2 2 1.0 $5,998.88 $2,999.44 $5,906.32 $2,953.16 N N N EFFEXOR XR CAP 75MG 000080833 40 2475 61.9 $5,914.18 $147.85 $7,878.35 $116.72 N N I SIMVASTATIN TAB 40MG 000937155 31 1530 49.4 $5,822.49 $187.82 $5,703.52 $107.61 Y Y I FORTEO SOL 750/3ML 000028971 5 27 5.4 $5,755.05 $1,151.01 $5,959.78 $667.14 N N I LAMISIL TAB 250MG 000780179 14 513 36.6 $5,740.91 $410.07 $6,292.58 $353.52 N N I

ARIMIDEX TAB 1MG 003100201 18 780 43.3 $5,684.62 $315.81 $6,334.88 $243.65 N Y I

ZYPREXA TAB 20MG 000024420 7 270 38.6 $5,588.90 $798.41 $5,658.46 $628.72 N N I

WELLBUTRIN TAB XL 001730730 27 1860 68.9 $5,433.76 $201.25 $6,822.12 $151.60 N N I LOTREL CAP 10-20MG 000780364 43 2460 57.2 $5,431.21 $126.31 $7,681.91 $97.24 N Y I HUMIRA PEN KIT 40MG/0.8 000744339 2 8 4.0 $5,428.99 $2,714.49 $5,348.88 $1,432.74 N N I SIMVASTATIN TAB 20MG 000937154 30 1380 46.0 $5,265.30 $175.51 $5,152.61 $112.01 Y Y I AMBIEN CR TAB 12.5MG 000245521 63 2133 33.9 $5,117.91 $81.24 $6,982.52 $101.05 N N I

FLOMAX CAP 0.4MG 005970058 65 3320 51.1 $5,044.00 $77.60 $7,562.55 $75.12 N Y I

ACTOS TAB 45MG 647640451 25 1020 40.8 $4,989.09 $199.56 $6,059.85 $178.23 N Y I

LANTUS INJ 100/ML 000882220 37 825 22.3 $4,879.68 $131.88 $6,059.34 $130.78 N Y I

ZETIA TAB 10MG 665820414 52 2400 46.2 $4,784.50 $92.01 $6,454.67 $80.68 N Y I

NORVASC TAB 5MG 000691530 86 4920 57.2 $4,520.61 $52.57 $7,940.34 $53.65 N Y I

SEROQUEL TAB 200MG 003100272 10 750 75.0 $4,393.26 $439.33 $4,571.50 $371.67 N N I

NORVASC TAB 10MG 000691540 66 3166 48.0 $4,380.71 $66.37 $7,063.86 $68.89 N Y I

INFERGEN INJ 9MCG 641160039 2 18 9.0 $4,323.88 $2,161.94 $4,460.38 $2,230.19 N N I

*Indicator: M,N = Brand no generic available; O = Brand with generic available; Y = generic

A004A_Rpt Report Criteria Group(s) = 111 Cycles between 1/1/2007 and 2/28/2007

Amt Paid/ Ingred. Cost/ Desc NDC # Scripts Quantity Quant/RX Amt Paid RX Ingred. Cost 30 days Ind.* Main Form ELMIRON CAP 100MG 173149300 12 1630 135.8 $4,237.75 $353.15 $4,573.72 $252.69 N N I CYMBALTA CAP 30MG 000023240 34 1595 46.9 $4,202.97 $123.62 $5,701.01 $150.03 N N I

EVISTA TAB 60MG 000024165 32 2040 63.8 $4,158.28 $129.95 $6,108.40 $89.83 N Y I

BUDEPRION XL TAB 300MG 000935351 26 1004 38.6 $4,118.61 $158.41 $4,058.67 $121.28 Y N I COPAXONE KIT 20MG/ML 000881153 2 60 30.0 $4,062.42 $2,031.21 $3,925.76 $1,962.88 N N I PRAVACHOL TAB 80MG 000035195 17 930 54.7 $4,017.19 $236.31 $4,467.11 $144.10 N Y I

LYRICA CAP 75MG 000711014 30 2756 91.9 $3,972.69 $132.42 $5,062.96 $130.26 N Y I

PROGRAF CAP 1MG 004690617 4 1050 262.5 $3,925.29 $981.32 $4,049.73 $809.95 N Y I

LOTREL CAP 5-20MG 000780406 36 2070 57.5 $3,912.69 $108.69 $5,574.18 $96.11 N Y I ASACOL TAB 400MG DR 001490752 14 4140 295.7 $3,809.91 $272.14 $4,657.00 $211.68 N Y I ACIPHEX TAB 20MG 628560243 25 1230 49.2 $3,802.03 $152.08 $5,525.51 $141.68 N N N

LOTREL CAP 5-10MG 000780405 41 2265 55.2 $3,785.12 $92.32 $5,721.81 $86.04 N Y I

FLUTICASONE SPR 50MCG 000543270 59 1006 17.1 $3,779.11 $64.05 $3,816.69 $65.77 Y N I

LIDODERM DIS 5% 634810687 15 780 52.0 $3,726.60 $248.44 $4,449.61 $306.87 N N N

TOPAMAX TAB 100MG 000450641 8 750 93.8 $3,600.07 $450.01 $3,677.86 $229.87 N Y I

AVANDIA TAB 8MG 000293160 9 675 75.0 $3,566.57 $396.29 $3,951.97 $188.19 N Y I

COREG TAB 6.25MG 000074140 23 2250 97.8 $3,453.95 $150.17 $4,187.46 $107.37 N Y I ADVAIR DISKU MIS 250/50 001730696 20 1440 72.0 $3,427.88 $171.39 $4,198.32 $174.93 N Y I EFFEXOR XR CAP 150MG 000080836 37 1470 39.7 $3,424.76 $92.56 $5,172.31 $105.56 N N I FEXOFENADINE TAB 180MG 000937253 48 1685 35.1 $3,415.02 $71.15 $3,439.18 $61.23 Y N I SERTRALINE TAB 50MG 000937176 31 1470 47.4 $3,399.15 $109.65 $3,375.47 $75.01 Y N I TOPROL XL TAB 100MG 001861092 76 4898 64.4 $3,366.88 $44.30 $6,200.93 $50.58 N Y I SORIATANE CAP 25MG 630320091 3 180 60.0 $3,324.19 $1,108.06 $3,480.24 $696.05 N N N

ZELNORM TAB 6MG 000780426 18 1500 83.3 $3,311.82 $183.99 $4,677.55 $179.91 N N N

XELODA TAB 500MG 000041101 2 224 112.0 $3,311.22 $1,655.61 $3,297.43 $3,532.96 N N I SERTRALINE TAB 100MG 597624910 30 1425 47.5 $3,304.07 $110.14 $3,280.73 $78.11 Y N I

FOSAMAX TAB 70MG 000060031 43 292 6.8 $3,293.44 $76.59 $5,362.65 $82.71 N Y I

AVANDARYL TAB 4-4MG 000073153 14 1074 76.7 $3,248.02 $232.00 $3,726.51 $170.16 N Y I PEG-INTRON KIT 120 RP 000851297 2 8 4.0 $3,228.16 $1,614.08 $3,264.66 $1,748.93 N N I

ALTACE CAP 10MG 615700120 38 2460 64.7 $3,214.30 $84.59 $4,524.97 $66.54 N Y I

AZITHROMYCIN TAB 250MG 000937146 81 489 6.0 $3,106.22 $38.35 $3,234.76 $236.69 Y N I

COREG TAB 25MG 000074142 22 2040 92.7 $3,003.50 $136.52 $3,796.66 $94.92 N Y I

CASODEX TAB 50MG 003100705 5 210 42.0 $2,990.40 $598.08 $3,092.55 $441.79 N N I

AVALIDE TAB 300-12.5 000872776 33 1950 59.1 $2,955.11 $89.55 $4,209.61 $64.76 N Y I VYTORIN TAB 10-20MG 665820312 37 1560 42.2 $2,936.06 $79.35 $4,528.45 $87.09 N Y I RIBAVIRIN CAP 200MG 004062260 2 348 174.0 $2,932.13 $1,466.07 $2,938.13 $1,519.72 Y N I

COREG TAB 12.5MG 000074141 23 1770 77.0 $2,780.58 $120.89 $3,294.15 $89.03 N Y I

DURAGESIC DIS 504580036 4 50 12.5 $2,768.11 $692.03 $2,889.25 $1,313.30 O N N

HYZAAR TAB 100-25 000060747 30 1860 62.0 $2,709.99 $90.33 $4,249.80 $72.03 N Y I

COREG TAB 3.125MG 000074139 16 1680 105.0 $2,701.64 $168.85 $3,126.63 $113.70 N Y I WELLBUTRIN TAB XL 001730731 21 674 32.1 $2,676.20 $127.44 $3,263.26 $145.25 O N I

ENBREL INJ 25MG 584060425 2 16 8.0…