Document:

Exhibit 10.33

Exhibit 10.33

[THOSE PORTIONS OF THIS AGREEMENT THAT HAVE BEEN OMITTED AND FILED SEPARATELY WITH 

THE U.S. SECURITIES AND EXCHANGE COMMISSION PURSUANT TO HEALTHSPRING,
INC.’S APPLICATION
REQUESTING CONFIDENTIAL TREATMENT ARE MARKED “[***]” HEREIN.]

SECOND AMENDMENT TO AMENDED & RESTATED MANAGEMENT SERVICES AGREEMENT

This Second Amendment, effective as of November 1, 2009 (“Amendment Effective Date”), is to
the Amended & Restated Management Services Agreement dated January 1, 2009, as amended (the “MSA”),
between Argus Health Systems, Inc. (“Argus”) and HealthSpring of Tennessee, Inc., a Tennessee
corporation; HealthSpring of Tennessee, Inc., a Tennessee corporation d/b/a HealthSpring of
Illinois; Texas HealthSpring, LLC, a Texas limited liability company; HealthSpring Life & Health
Insurance Company, Inc., a Texas insurance company; HealthSpring of Florida, Inc., a Florida
corporation; and HealthSpring of Alabama, Inc., an Alabama corporation (individually and
collectively referred to herein as “Customer”).

NOW, THEREFORE, in consideration of the promises, covenants, representations and warranties
set forth herein and other consideration, the sufficiency of which is hereby acknowledged, Argus
and Customer hereby agree as follows:

1. Definitions: Capitalized terms used in this Second Amendment shall have the same meaning as in
the MSA unless otherwise specifically defined herein.

2. Section 2 of the MSA is hereby deleted in its entirety and replaced with the following:

“2. TERM. This MSA shall remain in full force and effect until December 31, 2010.
This MSA shall automatically renew for a two (2) year period unless either party
provides written notice of its intent not to renew at least one hundred-eighty (180)
days prior to the end of the initial term.”

3. Exhibit C to MSA (Fees and Expenses) is deleted in its entirety and replaced with Exhibit C to
MSA (First Revision) attached hereto and incorporated herein by reference with such pricing being
retroactively effective as of January 1, 2009.

4. Section (2) of the penalty calculation for Performance Standard No. 11 provided in Exhibit D to
the MSA is hereby amended to read as follows:

“(2) For files transmitted that contain incorrect information (to be reported by
Customer and verified by Argus), [***] received by Argus during the Quarterly
Reporting Period.”

Second Amendment to Amended & Restated MSA

Page 3

 

 

 

5. The penalty calculation for Performance Standard No.3 provided in Exhibit D to the MSA is hereby
amended to read as follows:

“[***] received by Argus during the Monthly Reporting Period for failure to meet
either or both Standard 3A or 3B for the Monthly Reporting Period.”

6. The following shall be added to the end of the Definitions provided in Exhibit D to the MSA:

“Monthly Reporting Period — A Monthly Reporting Period is a calendar month. Each
subsequent Monthly Reporting Period will begin immediately following the end of the
previous Monthly Reporting Period.”

7. Exhibit F, attached hereto and incorporated herein by reference, shall be added to the MSA.

8. As of the Effective Date, Schedule A to the Services Addendum to MSA for Pharmacy Network
Services (Customer Election of Argus Network) is deleted in its entirety and replaced with Schedule
A (First Revision) to the Services Addendum to MSA for Pharmacy Network Services attached hereto
and incorporated herein by reference.

9. Except as amended and modified by this Amendment, all of the terms and conditions of the MSA
shall remain in full force and effect. This Amendment may not be modified except in writing signed
by both parties hereto. This Amendment, the MSA and exhibits and schedules thereto constitute the
entire agreement of the parties with respect to the subject matter contained therein and supersede
any and all prior agreements between the parties, whether oral or written, concerning the subject
matter contained herein.

IN WITNESS WHEREOF, the parties hereto by their duly authorized representatives executed this
Amendment to be effective as of the Amendment Effective Date.

Second Amendment to Amended & Restated MSA

Page 4

 

 

 

SIGNATURE PAGE

	 	 	 	 	 	 	 
	ARGUS HEALTH SYSTEMS, INC.	 	HEALTHSPRING OF TENNESSEE, INC.
	 
	 	 	 	 	 	 
	By:

	 	/s/ Jonathan Boehm
	 	By:
	 	/s/ Michael G. Mirt
	 

	 	 
	 	 	 	 
	 

	 	Printed Name: Jonathan Boehm
	 	 	 	Printed Name: Michael G. Mirt
	 

	 	Title: President
	 	 	 	Title: CEO
	Date: October 29, 2009	 	Date: October 29, 2009
	 
	 	 	 	 	 	 
	 	 	 	 	HEALTHSPRING OF TENNESSEE, INC

d/b/a HEALTHSPRING OF ILLINOIS
	 
	 	 	 	 	 	 
	 

	 	 	 	By:
	 	/s/ Michael G. Mirt
	 

	 	 	 	 	 	 
	 

	 	 	 	 	 	Printed Name: Michael G. Mirt
	 

	 	 	 	 	 	Title: CEO
	 	 	 	 	Date: October 29, 2009
	 
	 	 	 	 	 	 
	 	 	 	 	TEXAS HEALTHSPRING, LLC
	 
	 	 	 	 	 	 
	 

	 	 	 	By:
	 	/s/ Michael G. Mirt
	 

	 	 	 	 	 	 
	 

	 	 	 	 	 	Printed Name: Michael G. Mirt
	 

	 	 	 	 	 	Title: CEO
	 	 	 	 	Date: October 29, 2009
	 
	 	 	 	 	 	 
	 	 	 	 	HEALTHSPRING OF ALABAMA, INC.
	 
	 	 	 	 	 	 
	 

	 	 	 	By:
	 	/s/ Michael G. Mirt
	 

	 	 	 	 	 	 
	 

	 	 	 	 	 	Printed Name: Michael G. Mirt
	 

	 	 	 	 	 	Title: CEO
	 	 	 	 	Date: October 29, 2009
	 
	 	 	 	 	 	 
	 	 	 	 	HEALTHSPRING OF FLORIDA, INC.
	 
	 	 	 	 	 	 
	 

	 	 	 	By:
	 	/s/ Michael G. Mirt
	 

	 	 	 	 	 	 
	 

	 	 	 	 	 	Printed Name: Michael G. Mirt
	 

	 	 	 	 	 	Title: CEO
	 	 	 	 	Date: October 29, 2009
	 
	 	 	 	 	 	 
	 	 	 	 	HEALTHSPRING LIFE & HEALTH INSURANCE
COMPANY, INC.
	 
	 	 	 	 	 	 
	 

	 	 	 	By:
	 	/s/ Michael G. Mirt
	 

	 	 	 	 	 	 
	 

	 	 	 	 	 	Printed Name: Michael G. Mirt
	 

	 	 	 	 	 	Title: CEO
	 	 	 	 	Date: October 29, 2009

Second Amendment to Amended & Restated MSA

Page 3

 

 

 

EXHIBIT C TO MSA (FIRST REVISION)****

	1. 	Claims Processing

Electronic Claims Processing (includes standard financial reports)

	 	 	 	 	 
	Claim Volume Threshhold	 	Per Paid Claim Fee	 
	[***]
	 	 	[***]	 
	[***]
	 	 	[***]	 
	[***]
	 	 	[***]	 
	[***]
	 	 	[***]	 
	[***]
	 	 	 	 
	 
	Universal Claim Form (UCF) entered by Argus
	 	 	[***]	 
	Direct Member Reimbursement (DMR) processing
entered by Argus
	 	 	[***]	 
	Adjustments to prior processed claims — customer
ordered and entered by Argus
	 	 	[***]	 
	Adjustments to prior processed claims — customer
entered or batch file provided by customer
	 	 	[***]	 
	IPNS on-line access fee
	 	 	[***]	 

	2. 	Disbursements

	 	 	 	 	 
	Pharmacy Checks
	 	 	[***]	 
	Pharmacy Reconciliation Reports
	 	 	[***]	 
	Member Checks, Explanation of checks (EOC’s)
	 	 	[***]	 
	(includes postage*)
	 	 	 	 

	3. 	Reporting

	 	 	 	 	 
	RxFocus II (Ad Hoc reporting)
	 	 	 	 
	Set up fee (one time)
	 	 	[***]	 
	Per claim
	 	 	[***]	 
	Access fee — License & Maintenance
	 	 	[***]	 
	Additional users
	 	 	[***]	 
	 
	Argus Standard Management Reports- Electronic media
	 	 	[***]	 
	Paid Claims Data/Transmissions (PCT) in existing
	 	 	[***]	 
	Argus format- 1 per financial cycle
	 	 	 	 
	Paid Claims Data/Transmissions (PCT) in existing
	 	 	[***]	 
	Argus format — each additional
	 	 	 	 
	 
	Custom Reporting
	 	 	 	 
	All custom Management & Financial Reports; all PCT’s outside of existing Argus format;
all custom RxFocusII and Rebate reports.
	 	 	 	 
	Development of report
	 	 	[***]	 
	Production of report- Electronic media
	 	 	[***]	 

	4. 	Rebates Administration

	 	 	 	 	 
	Rebate Processing tool and reporting
	 	 	[***]	 
	(quarterly reconciliation)
	 	 	 	 

Second Amendment to Amended & Restated MSA

Page 3

 

 

 

	5. 	Clinical Programs

	 	 	 	 	 
	DUR
	 	 	[***]	 
	Administrative Prior Authorizations
	 	 	[***]	 
	Clinical Authorizations
	 	 	[***]	 
	Step Therapy
	 	 	[***]	 
	Clinical services — quarterly benchmark reports
	 	 	[***]	 

	6. 	Pharmacy Networks

	 	 	 	 	 
	Use of Argus Pharmacy Networks
	 	 	[***]	 
	Desk Top Audits
	 	 	[***]	 
	On-site Pharmacy Audits
	 	 	[***]	 
	Argus MAC
	 	 	[***]	 

	7. 	Provider and Member Support

	 	 	 	 	 
	Pharmacy Call Center — non-dedicated line
	 	 	[***]	 
	Member Call Center support
	 	 	[***]	 
	 
	Tier I calls- 5 minute handling time
	 	 	[***]	 
	Tier II calls- 6 minute handling time
	 	 	[***]	 
	 
	Member Portal- Drug Pricing, Pharmacy Locator, and Claim Search
	 	 	 	 
	License and maintenance
	 	 	[***]	 
	Per pre-adjudication
	 	 	[***]	 
	All other Member Portal components priced on an ad hoc basis
	 	 	 	 

	8. 	ePrescribing

	 	 	 	 	 
	Monthly Maintenance Fee
	 	 	[***]	 
	Transaction fee
	 	 	[***]	 

	9. 	Training

	 	 	 	 	 
	As part of Implementation
	 	 	[***]	 
	Additional Training
	 	 	 	 
	Standard Classes
	 	 	[***]	 
	Special/Custom Training
	 	 	[***]	 

	10. 	Other Services

	 	 	 	 	 
	Professional Fees/Programming/Conversions
	 	 	[***]	 

	11. 	Part D Services (not specified elsewhere in this exhibit)

	 	 	 	 	 
	CMS Reporting
	 	 	[***]	 
	CMS Testing
	 	 	[***]	 
	PDE
	 	 	[***]	 
	LICS claim adjustment
	 	 	[***]	 
	LICS Additional Financial
	 	 	[***]	 
	DMR Letters
	 	 	[***]	 
	EOB’s
	 	 	 	 
	EOB Data File
	 	 	[***]	 
	(available if Argus is not providing EOB print
services)
	 	 	 	 
	Transition Letters
	 	 	 	 
	Print/mail- up to 2 pages/4 images (daily as required)
	 	 	[***]	 
	Additional pages
	 	 	[***]	 
	Transition Claims Data File
	 	 	[***]	 

Second Amendment to Amended & Restated MSA

Page 4

 

 

 

	12. 	PA Vendor Services — Effective December 1, 2009

	 	 	 	 	 
	Implementation Fee
	 	 	 	 
	Authorizations
	 	 	[***]	 
	Eligibility
	 	 	[***]	 
	 
	 	 	 	 
	Maintenance Fee
	 	 	[***]	 
	 
	 	 	 	 
	Transaction Fee
	 	 	 	 
	Eligibility
	 	 	[***]	 
	Authorization
	 	 	[***]	 

				
	 	 	 	 
	13. Out of Pocket Expenses
	 	[***]	 

Including but not limited to:

	 	•	 	Postage for mailing Management and Financial Reports, Paid Claims Tapes, Inserts, etc.

	 	•	 	Airfreight/overnight letters

	 	•	 	Mailings, inserts

	 	•	 	Stop payment or other fees/bank charges

	 	•	 	Archival retrieval of Claim information

	 	•	 	Maintenance fees for direct access communication lines, VPN support and maintenance

	 	•	 	Travel and expenses related to training beyond implementation days

	 	•	 	Non- electronic media creation

	 	•	 	Mailing to Providers, Clients of Customer

				
	 	 	 	 
	14. MONTHLY MINIMUM CLAIMS PROCESSING FEE
	 	[***]	 

	 	 	 
	*	 	Effective January 1 of the year following the first calendar year in which Argus EOB’s/Transition
Letters/DMR Letters/Pharmacy Checks/Member Checks are produced and each January 1 thereafter, the
fee will increase by an amount equal to any increase in the applicable postage rate during the
prior calendar year.

	 
	**	 	Subject to change as described in
Section 5 of E-Prescribing Services Addendum.

	 
	***	 	HealthSpring may terminate use of the Rebates Administration service upon 60 days prior written
notice. Both parties shall mutually agree upon any transition services and fees to be provided
after the date of termination.

	 
	****	 	The parties hereby agree that any interest owed by Customer to Argus that accrues prior to
November 30, 2009, relating to late payments as provided in Section 7 of the MSA or otherwise shall
not be settled upon a cash basis but shall be available to offset any current or future fees or
penalties owed by Argus to Customer under the MSA. Any interest owed by Customer to Argus that
accrues on or after December 1, 2009, relating to late payments as provided in Section 7 of the MSA
or otherwise shall be payable in accordance with the MSA.

Second Amendment to Amended & Restated MSA

Page 5

 

 

 

EXHIBIT F

PA Vendor Services

Argus will provide web service connectivity with Customer’s contracted prior authorization vendor
(“PA Vendor”) allowing for eligibility searches and the entry of multiple Argus authorization types
currently offered in Argus IPNS. Argus will perform implementation activities necessary to allow
Customer to utilize the PA Vendor application including: (a) send and receive data to and from PA
Vendor by using third party internet browsers, and (b) web service feeds to the PA Vendor system.
Argus will also provide web service integration with Argus’ IPNS for eligibility and
authorizations.

Customer shall provide reasonable written notice to Argus of the date its agreement with the PA
Vendor is to expire, terminate or will otherwise be altered in a manner that will prohibit Argus
from providing the services as provided herein (“PA Termination Date”). On the PA Termination Date,
except as otherwise agreed to by the parties, this Exhibit F will be null and void and neither
party will have any additional obligations under this Exhibit F except that this termination shall
not relieve Customer of paying Argus fees for any services provided prior to receipt of such
notification. The parties hereby agree that Customer may, upon 90 days advance written notice,
terminate this Exhibit F for any reason.

Second Amendment to Amended & Restated MSA

Page 3

 

 

 

SCHEDULE A (FIRST REVISION) TO SERVICES ADDENDUM TO MSA FOR

PHARMACY NETWORK SERVICES

CUSTOMER ELECTION OF ARGUS NETWORK

The capitalized terms used in this Schedule are defined in Exhibit A to the MSA. For the selected
network schedule to apply, Argus must receive Claims in Argus Format at point of sale from
Contracted Pharmacy. Customer understands that Argus Pharmacies may terminate their participation
in an Argus Network upon six months notice, or as otherwise negotiated, and thus that the
composition of the Network selected by Customer may change during the term of this agreement. The
Argus Network pricing established herein represents the rates targeted for contract negotiations
with Argus Pharmacies. Argus warrants that Customer will receive the benefit of any and all rates
negotiated for Customer even to the extent that contracted rates result in lower reimbursements
than indicated in the rates set forth below. The parties agree that Participating Pharmacies that
elect to participate in the pharmacy network developed by Argus and utilized by Customer shall be
reimbursed in accordance with the contracted rates. Adherence with the contracted rates shall be
measured by Customer through an audit right, including the use of a third party auditor, to verify
Argus’ adherence to the transparency and pass through pricing objectives.

Network Reimbursement Rates for Argus Pharmacies*

Retail Network paid on a per-claim, pass through, and lesser of the AWP discount, Usual and
Customary (U&C) or MAC.

	 	•	 	Brand [***]

	 	•	 	Brand Dispensing Fee — [***]

	 	•	 	Generic [***]

	 	•	 	Generic Dispensing Fee — [***]

Retail — Extended Supply Claims for 31 — 34 Days Supply paid on a per-claim, pass through, and
lesser of the AWP discount, Usual and Customary (U&C) or MAC.

	 	•	 	Brand [***]

	 	•	 	Dispensing Fee — [***]

	 	•	 	Generic [***]

	 	•	 	Dispense Fee — [***]

Retail — Extended Supply Claims for 35 — 60 Days Supply paid on a per-claim, pass through, and
lesser of the AWP discount, Usual and Customary (U&C) or MAC.

	 	•	 	Brand [***]

	 	•	 	Dispensing Fee — [***]

	 	•	 	Generic [***]

	 	•	 	Dispense Fee — [***]

Second Amendment to Amended & Restated MSA

Page 4

 

 

 

Retail — Extended Supply Claims for 61 — 84 Days Supply paid on a per-claim, pass through, and
lesser of the AWP discount, Usual and Customary (U&C) or MAC.

	 	•	 	Brand [***]

	 	•	 	Dispensing Fee — [***]

	 	•	 	Generic [***]

	 	•	 	Dispense Fee — [***]

Retail — Extended Supply Claims for 85 and more Days Supply paid on a per-claim, pass through,
and lesser of the AWP discount, Usual and Customary (U&C) or MAC.

	 	•	 	Brand [***]

	 	•	 	Dispensing Fee — [***]

	 	•	 	Generic [***]

	 	•	 	Dispense Fee — [***]

Mail Order Network paid on a per-claim, pass through, and lesser of the AWP discount or MAC

	 	•	 	Brand [***]

	 	•	 	Generic [***]

	 	•	 	Dispensing Fee — [***]

Specialty Pharmacy paid on a per-claim, pass through basis

	 	•	 	Brand [***]
	 
	 	•	 	Generic [***]
	 
	 	•	 	Dispensing Fee — [***]

Long Term Pharmacies paid on a per-claim, pass through, and lesser of the AWP discount or MAC if
applicable

	 	•	 	Brand @ [***]

	 	•	 	Generic Effective Rate @ [***]

	 	•	 	Dispensing Fee — @ [***]

	 	 	 
	*	 	Notes

Second Amendment to Amended & Restated MSA

Page 5

 

 

 

[***]

[Three pages have been omitted and filed separately with the U.S. Securities and Exchange
Commission pursuant to HealthSpring, Inc.’s application requesting confidential treatment.]

Second Amendment to Amended & Restated MSA

Page 6

 

 

 

Summary

[***]

[This page has been omitted and filed separately with the U.S. Securities and Exchange Commission
pursuant to HealthSpring, Inc.’s application requesting confidential treatment.]

 

 

 

Brand HS

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Wtd	 	 	Wtd	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Dispense Fees	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Avg	 	 	Avg	 	 	AWP	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Act	 	 	Target	 	 	 	 
	Cust	 	Clm	 	Date	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Ingred	 	 	Disp	 	 	AWP	 	 	 	 	 	 	Disc	 	 	Disp	 	 	Prices	 	 	Actual	 	 	Target	 	 	 	 	 	 	Disp	 	 	Disp	 	 	 	 
	Id	 	#	 	Filled	 	NDC	 	Label Name	 	GPI	 	 	Qty	 	 	D.S.	 	 	Count	 	 	Ext. AWP	 	 	Cost	 	 	Fee	 	 	Disc	 	 	Count	 	 	Rate	 	 	Fee	 	 	Total AWP	 	 	IC	 	 	IC	 	 	Variance	 	 	Fees	 	 	Fees	 	 	Variance	 
	359
	 	27	 	1/23/2009	 	00486111101	 	K-PHOS ORIGINAL TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	45	 	1/23/2009	 	52268040001	 	NULYTELY WITH FLAVOR PACKS SOL	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	26	 	1/23/2009	 	08290320119	 	BD UF MINI PEN NEEDLE 31GX3/16	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	97	 	1/23/2009	 	08290320109	 	BD UF SHORT PEN NEEDL 31GX5/16	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	13	 	1/23/2009	 	00173068220	 	VENTOLIN HFA 90 MCG INHALER	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	91	 	1/23/2009	 	08290328468	 	BD UF INS SYR 0.5 ML 31GX5/16"	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	63	 	1/23/2009	 	00046110281	 	PREMARIN 0.625 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	74	 	1/23/2009	 	00046087506	 	PREMPRO 0.625-2.5 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	15	 	1/23/2009	 	65597010330	 	BENICAR 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	70	 	1/23/2009	 	00186108805	 	TOPROL XL 25 MG TABLET SA	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	94	 	1/23/2009	 	00006095254	 	COZAAR 50 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	46	 	1/23/2009	 	65726025110	 	INNOPRAN XL 120 MG CAP SA	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	34	 	1/23/2009	 	65597010430	 	BENICAR 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	41	 	1/23/2009	 	00078035834	 	DIOVAN 80 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	75	 	1/23/2009	 	65597010530	 	BENICAR HCT 20-12.5 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	95	 	1/23/2009	 	00071101568	 	LYRICA 100 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 

 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Wtd	 	 	Wtd	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Dispense Fees	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Avg	 	 	Avg	 	 	AWP	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Act	 	 	Target	 	 	 	 
	Cust	 	Clm	 	Date	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Ingred	 	 	Disp	 	 	AWP	 	 	 	 	 	 	Disc	 	 	Disp	 	 	Prices	 	 	Actual	 	 	Target	 	 	 	 	 	 	Disp	 	 	Disp	 	 	 	 
	Id	 	#	 	Filled	 	NDC	 	Label Name	 	GPI	 	 	Qty	 	 	D.S.	 	 	Count	 	 	Ext. AWP	 	 	Cost	 	 	Fee	 	 	Disc	 	 	Count	 	 	Rate	 	 	Fee	 	 	Total AWP	 	 	IC	 	 	IC	 	 	Variance	 	 	Fees	 	 	Fees	 	 	Variance	 
	358
	 	99	 	1/23/2009	 	00023918703	 	LUMIGAN 0.03% EYE DROPS	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	17	 	1/23/2009	 	00078048515	 	TEKTURNA 150 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	76	 	1/23/2009	 	00013830304	 	XALATAN 0.005% EYE DROPS	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	72	 	1/23/2009	 	00013830301	 	XALATAN 0.005% EYE DROPS	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	55	 	1/23/2009	 	00078031534	 	DIOVAN HCT 160-12.5 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	44	 	1/23/2009	 	00002831501	 	HUMULIN N 100 UNITS/ML VIAL	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	51	 	1/23/2009	 	00456202001	 	LEXAPRO 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	84	 	1/23/2009	 	00071015523	 	LIPITOR 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	89	 	1/23/2009	 	00071015523	 	LIPITOR 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	47	 	1/23/2009	 	65597010730	 	BENICAR HCT 40-25 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	61	 	1/23/2009	 	00149047201	 	ACTONEL 35 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	87	 	1/23/2009	 	00149047201	 	ACTONEL 35 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	24	 	1/23/2009	 	00149047201	 	ACTONEL 35 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	98	 	1/23/2009	 	00078036034	 	DIOVAN 320 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	60	 	1/23/2009	 	00173071215	 	AVODART 0.5 MG SOFTGEL	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	71	 	1/23/2009	 	00173071215	 	AVODART 0.5 MG SOFTGEL	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	66	 	1/23/2009	 	00597005801	 	FLOMAX 0.4 MG CAPSULE SA	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	62	 	1/23/2009	 	66582031331	 	VYTORIN 10-40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 

 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Wtd	 	 	Wtd	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Dispense Fees	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Avg	 	 	Avg	 	 	AWP	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Act	 	 	Target	 	 	 	 
	Cust	 	Clm	 	Date	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Ingred	 	 	Disp	 	 	AWP	 	 	 	 	 	 	Disc	 	 	Disp	 	 	Prices	 	 	Actual	 	 	Target	 	 	 	 	 	 	Disp	 	 	Disp	 	 	 	 
	Id	 	#	 	Filled	 	NDC	 	Label Name	 	GPI	 	 	Qty	 	 	D.S.	 	 	Count	 	 	Ext. AWP	 	 	Cost	 	 	Fee	 	 	Disc	 	 	Count	 	 	Rate	 	 	Fee	 	 	Total AWP	 	 	IC	 	 	IC	 	 	Variance	 	 	Fees	 	 	Fees	 	 	Variance	 
	359
	 	16	 	1/23/2009	 	00078047134	 	DIOVAN HCT 320-12.5 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	39	 	1/23/2009	 	00078047134	 	DIOVAN HCT 320-12.5 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	93	 	1/23/2009	 	00002416502	 	EVISTA 60 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	64	 	1/23/2009	 	00002416502	 	EVISTA 60 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	12	 	1/23/2009	 	00002323560	 	CYMBALTA 20 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	68	 	1/23/2009	 	00006011754	 	SINGULAIR 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	14	 	1/23/2009	 	00006011731	 	SINGULAIR 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	31	 	1/23/2009	 	00006011731	 	SINGULAIR 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	58	 	1/23/2009	 	00006011731	 	SINGULAIR 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	35	 	1/23/2009	 	00310075190	 	CRESTOR 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	37	 	1/23/2009	 	00007337113	 	COREG CR 20 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	82	 	1/23/2009	 	00074612390	 	TRICOR 145 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	18	 	1/23/2009	 	00074612390	 	TRICOR 145 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	92	 	1/23/2009	 	00008083321	 	EFFEXOR XR 75 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	10	 	1/23/2009	 	00002323730	 	CYMBALTA 60 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	50	 	1/23/2009	 	00002323730	 	CYMBALTA 60 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	73	 	1/23/2009	 	00002324030	 	CYMBALTA 30 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	5	 	1/23/2009	 	00071015723	 	LIPITOR 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	21	 	1/23/2009	 	00071015723	 	LIPITOR 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	29	 	1/23/2009	 	00071015623	 	LIPITOR 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 

 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Wtd	 	 	Wtd	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Dispense Fees	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Avg	 	 	Avg	 	 	AWP	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Act	 	 	Target	 	 	 	 
	Cust	 	Clm	 	Date	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Ingred	 	 	Disp	 	 	AWP	 	 	 	 	 	 	Disc	 	 	Disp	 	 	Prices	 	 	Actual	 	 	Target	 	 	 	 	 	 	Disp	 	 	Disp	 	 	 	 
	Id	 	#	 	Filled	 	NDC	 	Label Name	 	GPI	 	 	Qty	 	 	D.S.	 	 	Count	 	 	Ext. AWP	 	 	Cost	 	 	Fee	 	 	Disc	 	 	Count	 	 	Rate	 	 	Fee	 	 	Total AWP	 	 	IC	 	 	IC	 	 	Variance	 	 	Fees	 	 	Fees	 	 	Variance	 
	358
	 	56	 	1/23/2009	 	00071015823	 	LIPITOR 80 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	90	 	1/23/2009	 	00009519101	 	DETROL LA 4 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	88	 	1/23/2009	 	00310027110	 	SEROQUEL 100 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	100	 	1/23/2009	 	00310027110	 	SEROQUEL 100 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	11	 	1/23/2009	 	00009454402	 	DETROL 2 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	33	 	1/23/2009	 	63653117106	 	PLAVIX 75 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	9	 	1/23/2009	 	63653117106	 	PLAVIX 75 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	19	 	1/23/2009	 	63653117106	 	PLAVIX 75 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	20	 	1/23/2009	 	63653117106	 	PLAVIX 75 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	32	 	1/23/2009	 	63653117106	 	PLAVIX 75 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	52	 	1/23/2009	 	63653117106	 	PLAVIX 75 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	86	 	1/23/2009	 	63653117101	 	PLAVIX 75 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	28	 	1/23/2009	 	00597000160	 	AGGRENOX CAPSULE SA	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	48	 	1/23/2009	 	00456321060	 	NAMENDA 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	59	 	1/23/2009	 	00186504031	 	NEXIUM 40 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	69	 	1/23/2009	 	00597007541	 	SPIRIVA 18 MCG CP-HANDIHALER	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	40	 	1/23/2009	 	00597007541	 	SPIRIVA 18 MCG CP-HANDIHALER	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	77	 	1/23/2009	 	00186037220	 	SYMBICORT 80-4.5 MCG INHALER	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	78	 	1/23/2009	 	00074712613	 	DEPAKOTE ER 500 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 

 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Wtd	 	 	Wtd	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Dispense Fees	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Avg	 	 	Avg	 	 	AWP	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Act	 	 	Target	 	 	 	 
	Cust	 	Clm	 	Date	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Ingred	 	 	Disp	 	 	AWP	 	 	 	 	 	 	Disc	 	 	Disp	 	 	Prices	 	 	Actual	 	 	Target	 	 	 	 	 	 	Disp	 	 	Disp	 	 	 	 
	Id	 	#	 	Filled	 	NDC	 	Label Name	 	GPI	 	 	Qty	 	 	D.S.	 	 	Count	 	 	Ext. AWP	 	 	Cost	 	 	Fee	 	 	Disc	 	 	Count	 	 	Rate	 	 	Fee	 	 	Total AWP	 	 	IC	 	 	IC	 	 	Variance	 	 	Fees	 	 	Fees	 	 	Variance	 
	359
	 	25	 	1/23/2009	 	00006022131	 	JANUVIA 25 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	81	 	1/23/2009	 	00169368712	 	LEVEMIR 100 UNITS/ML VIAL	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	38	 	1/23/2009	 	00074712653	 	DEPAKOTE ER 500 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	67	 	1/23/2009	 	00088222060	 	LANTUS SOLOSTAR 100 UNITS/ML	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	53	 	1/23/2009	 	00049397060	 	GEODON 40 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	8	 	1/23/2009	 	00029316013	 	AVANDIA 8 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	4	 	1/23/2009	 	00173069600	 	ADVAIR 250-50 DISKUS	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	85	 	1/23/2009	 	59011010310	 	OXYCONTIN 20 MG TABLET SA	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	22	 	1/23/2009	 	00310027810	 	SEROQUEL 50 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	80	 	1/23/2009	 	00456202001	 	LEXAPRO 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	2	 	1/23/2009	 	50458030250	 	RISPERDAL 0.5 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	49	 	1/23/2009	 	58914079010	 	URSO FORTE 500 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	83	 	1/23/2009	 	00088222033	 	LANTUS 100 UNITS/ML VIAL	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	42	 	1/23/2009	 	00310027460	 	SEROQUEL 300 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	36	 	1/23/2009	 	50458055101	 	INVEGA 6 MG ER TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	3	 	1/23/2009	 	00173064460	 	LAMICTAL 200 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	7	 	1/23/2009	 	00088222052	 	LANTUS 100 UNITS/ML CARTRIDGE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	54	 	1/23/2009	 	00049397060	 	GEODON 40 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	6	 	1/23/2009	 	00310027534	 	SEROQUEL 25 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	65	 	1/23/2009	 	62856024630	 	ARICEPT 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 

 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Wtd	 	 	Wtd	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Dispense Fees	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Avg	 	 	Avg	 	 	AWP	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Act	 	 	Target	 	 	 	 
	Cust	 	Clm	 	Date	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Ingred	 	 	Disp	 	 	AWP	 	 	 	 	 	 	Disc	 	 	Disp	 	 	Prices	 	 	Actual	 	 	Target	 	 	 	 	 	 	Disp	 	 	Disp	 	 	 	 
	Id	 	#	 	Filled	 	NDC	 	Label Name	 	GPI	 	 	Qty	 	 	D.S.	 	 	Count	 	 	Ext. AWP	 	 	Cost	 	 	Fee	 	 	Disc	 	 	Count	 	 	Rate	 	 	Fee	 	 	Total AWP	 	 	IC	 	 	IC	 	 	Variance	 	 	Fees	 	 	Fees	 	 	Variance	 
	359
	 	57	 	1/23/2009	 	59148000813	 	ABILIFY 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	1	 	1/23/2009	 	00074621553	 	DEPAKOTE 500 MG TABLET EC	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	30	 	1/23/2009	 	63459020101	 	PROVIGIL 200 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	79	 	1/23/2009	 	00310027910	 	SEROQUEL 400 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	43	 	1/23/2009	 	59148000913	 	ABILIFY 15 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	96	 	1/23/2009	 	00173074200	 	EPZICOM TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	23	 	1/23/2009	 	00049318030	 	VFEND 200 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Rx Count	 	 	AWP	 	 	Ing Cost	 	 	Disp Fee	 	 	Total Cost	 	 	 	 	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	 
	 	 	 	 	 	 	 	Totals	 	 	 	 	 	 	 	 	 	 	 	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 
	 	 	 	 	 	 	 	Net Effective AWP Discount Rate	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	[***]	%	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Target AWP Discount Rate	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	[***]	%	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Net Effective Disp Fee	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Target Dispense Fee	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 
	 	 	 	 	 	 	 	Monetary Value of Discount Rate Difference	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Monetary Value of Dispense Fee Difference *	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Total	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 
	 	 	 	 	 	 	 	* Monetary Value of Dispense Fee Difference Calculation:	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 
	 	 	 	 	 	 	 	Target Dispense Fee	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Weighted Average Dispense Fees	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Dispense Fee Difference	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Actual Claims	 	 	 	 	 	 	 	 	 	 	 	 	 	 	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Monetary Value of Dispense Fee Difference	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 

 

 

 

Generic HS

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Based on	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Claim	 	 	 	 	 	 	Real HS Approach	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Counts	 	 	 	 	 	 	AWP Prices	 	 	Dispense Fees	 
	Cust	 	Clm	 	Date	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Ext.	 	 	Ingred	 	 	 	 	 	 	IngredDis	 	 	 	 	 	 	Wtd Avg	 	 	Wtd Avg	 	 	Total	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Act Disp	 	 	Target	 	 	 	 
	Id	 	#	 	Filled	 	NDC	 	Label Name	 	GPI	 	 	Qty	 	 	D.S.	 	 	Count	 	 	AWP	 	 	Cost	 	 	Disp Fee	 	 	count	 	 	Count	 	 	Disc Rate	 	 	Disp Fee	 	 	AWP	 	 	Actual IC	 	 	Target IC	 	 	Variance	 	 	Fees	 	 	Disp Fees	 	 	Variance	 
	359
	 	1	 	1/23/2009	 	00378020810	 	FUROSEMIDE 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	2	 	1/23/2009	 	00172208380	 	HYDROCHLOROTHIAZIDE 25 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	3	 	1/23/2009	 	00172208380	 	HYDROCHLOROTHIAZIDE 25 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	4	 	1/23/2009	 	00172208380	 	HYDROCHLOROTHIAZIDE 25 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	5	 	1/23/2009	 	00172208380	 	HYDROCHLOROTHIAZIDE 25 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	6	 	1/23/2009	 	00143147710	 	PREDNISONE 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	7	 	1/23/2009	 	00527132401	 	DIGOXIN 125 MCG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	8	 	1/23/2009	 	62584098901	 	DIGOXIN 125 MCG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	9	 	1/23/2009	 	00172290880	 	FUROSEMIDE 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	10	 	1/23/2009	 	00378020810	 	FUROSEMIDE 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	11	 	1/23/2009	 	00781196610	 	FUROSEMIDE 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	12	 	1/23/2009	 	00781196610	 	FUROSEMIDE 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	13	 	1/23/2009	 	00378021610	 	FUROSEMIDE 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	14	 	1/23/2009	 	00378021610	 	FUROSEMIDE 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	15	 	1/23/2009	 	00472030180	 	TRIAMCINOLONE 0.1% CREAM	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	16	 	1/23/2009	 	00168005430	 	NYSTATIN 100,000 UNIT/GM CREAM	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	17	 	1/23/2009	 	00527134510	 	LEVOTHYROXINE 100 MCG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	18	 	1/23/2009	 	00781155601	 	ISOSORBIDE DN 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	19	 	1/23/2009	 	00781112305	 	TRIAMTERENE-HCTZ 37.5-25 MG TB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	20	 	1/23/2009	 	00832108000	 	BENZTROPINE MES 0.5 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	21	 	1/23/2009	 	00378180901	 	LEVOTHYROXINE 100 MCG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	22	 	1/23/2009	 	00093063710	 	TRAZODONE 50 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	23	 	1/23/2009	 	00378214605	 	SPIRONOLACTONE 25 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	24	 	1/23/2009	 	50111043302	 	TRAZODONE 50 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	25	 	1/23/2009	 	00093834301	 	GLYBURIDE 2.5 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	26	 	1/23/2009	 	00245005810	 	KLOR-CON M20 TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	27	 	1/23/2009	 	00378018105	 	ALLOPURINOL 300 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	28	 	1/23/2009	 	00378018105	 	ALLOPURINOL 300 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 

 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Based on	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Claim	 	 	 	 	 	 	Real HS Approach	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Counts	 	 	 	 	 	 	AWP Prices	 	 	Dispense Fees	 
	Cust	 	Clm	 	Date	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Ext.	 	 	Ingred	 	 	 	 	 	 	IngredDis	 	 	 	 	 	 	Wtd Avg	 	 	Wtd Avg	 	 	Total	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Act Disp	 	 	Target	 	 	 	 
	Id	 	#	 	Filled	 	NDC	 	Label Name	 	GPI	 	 	Qty	 	 	D.S.	 	 	Count	 	 	AWP	 	 	Cost	 	 	Disp Fee	 	 	count	 	 	Count	 	 	Disc Rate	 	 	Disp Fee	 	 	AWP	 	 	Actual IC	 	 	Target IC	 	 	Variance	 	 	Fees	 	 	Disp Fees	 	 	Variance	 
	358
	 	29	 	1/23/2009	 	58177000104	 	POTASSIUM CL 10 MEQ CAP SA	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	30	 	1/23/2009	 	00603373934	 	FUROSEMIDE 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	31	 	1/23/2009	 	62175011937	 	ISOSORBIDE MN 60 MG TAB SA	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	32	 	1/23/2009	 	68462018801	 	NAPROXEN 250 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	33	 	1/23/2009	 	00781144605	 	FUROSEMIDE 80 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	34	 	1/23/2009	 	00378021810	 	ATENOLOL 25 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	35	 	1/23/2009	 	00093712901	 	TORSEMIDE 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	36	 	1/23/2009	 	00781100805	 	TRIAMTERENE-HCTZ 75-50 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	37	 	1/23/2009	 	68180051303	 	LISINOPRIL 5 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	38	 	1/23/2009	 	00008060601	 	PANTOPRAZOLE SOD 20 MG TAB EC	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	39	 	1/23/2009	 	68180051403	 	LISINOPRIL 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	40	 	1/23/2009	 	00591533710	 	TRIHEXYPHENIDYL 5 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	41	 	1/23/2009	 	53489011010	 	CARISOPRODOL 350 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	42	 	1/23/2009	 	59762374301	 	CLINDAMYCIN PH 1% GEL	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	43	 	1/23/2009	 	64679092503	 	ENALAPRIL MALEATE 10 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	44	 	1/23/2009	 	00378003210	 	METOPROLOL TARTRATE 50 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	45	 	1/23/2009	 	00378003210	 	METOPROLOL TARTRATE 50 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	46	 	1/23/2009	 	00378003210	 	METOPROLOL TARTRATE 50 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	47	 	1/23/2009	 	00603497528	 	OXYBUTYNIN 5 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	48	 	1/23/2009	 	00591086001	 	LISINOPRIL-HCTZ 10-12.5 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	49	 	1/23/2009	 	00172503260	 	LISINOPRIL-HCTZ 20-25 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	50	 	1/23/2009	 	00172409660	 	BACLOFEN 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	51	 	1/23/2009	 	59762502201	 	QUINAPRIL 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	52	 	1/23/2009	 	58177022208	 	ISOSORBIDE MN 30 MG TAB SA	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	53	 	1/23/2009	 	00591320301	 	HYDROCODONE-APAP 7.5-325 TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	54	 	1/23/2009	 	00093834410	 	GLYBURIDE 5 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	55	 	1/23/2009	 	00338004902	 	SODIUM CHLORIDE 0.9% SOLN	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	56	 	1/23/2009	 	00172433180	 	METFORMIN HCL 500 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	57	 	1/23/2009	 	00093104598	 	QUINAPRIL 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	58	 	1/23/2009	 	00228277911	 	PROPRANOLOL 80 MG CAPSULE SA	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	59	 	1/23/2009	 	00378644001	 	VERAPAMIL ER 240 MG CAP	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 

 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Based on	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Claim	 	 	 	 	 	 	Real HS Approach	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Counts	 	 	 	 	 	 	AWP Prices	 	 	Dispense Fees	 
	Cust	 	Clm	 	Date	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Ext.	 	 	Ingred	 	 	 	 	 	 	IngredDis	 	 	 	 	 	 	Wtd Avg	 	 	Wtd Avg	 	 	Total	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Act Disp	 	 	Target	 	 	 	 
	Id	 	#	 	Filled	 	NDC	 	Label Name	 	GPI	 	 	Qty	 	 	D.S.	 	 	Count	 	 	AWP	 	 	Cost	 	 	Disp Fee	 	 	count	 	 	Count	 	 	Disc Rate	 	 	Disp Fee	 	 	AWP	 	 	Actual IC	 	 	Target IC	 	 	Variance	 	 	Fees	 	 	Disp Fees	 	 	Variance	 
	358
	 	60	 	1/23/2009	 	00591038705	 	HYDROCODONE-APAP 7.5-750 TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	61	 	1/23/2009	 	00472037945	 	CLOTRIMAZOLE-BETAMETHASONE CRM	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	62	 	1/23/2009	 	68382012205	 	AMLODIPINE BESYLATE 5 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	63	 	1/23/2009	 	00172572860	 	FAMOTIDINE 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	64	 	1/23/2009	 	00781212801	 	RAMIPRIL 5 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	65	 	1/23/2009	 	00591050205	 	HYDROCODONE-APAP 7.5-650 TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	66	 	1/23/2009	 	53489046710	 	METFORMIN HCL 500 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	67	 	1/23/2009	 	60505019001	 	METFORMIN HCL 500 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	68	 	1/23/2009	 	00591565801	 	CYCLOBENZAPRINE 10 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	69	 	1/23/2009	 	00378521077	 	AMLODIPINE BESYLATE 10 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	70	 	1/23/2009	 	00378521005	 	AMLODIPINE BESYLATE 10 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	71	 	1/23/2009	 	00093722398	 	FOSINOPRIL SODIUM 20 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	72	 	1/23/2009	 	68462019005	 	NAPROXEN 500 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	73	 	1/23/2009	 	00591317801	 	CITALOPRAM HBR 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	74	 	1/23/2009	 	59762490004	 	SERTRALINE HCL 50 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	75	 	1/23/2009	 	00093517244	 	ALENDRONATE SODIUM 35 MG TAB	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	76	 	1/23/2009	 	00172433180	 	METFORMIN HCL 500 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	77	 	1/23/2009	 	00172443280	 	METFORMIN HCL 1,000 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	78	 	1/23/2009	 	00172435770	 	RANITIDINE 150 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	79	 	1/23/2009	 	00172435770	 	RANITIDINE 150 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	80	 	1/23/2009	 	68180050103	 	MELOXICAM 7.5 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	81	 	1/23/2009	 	00093737301	 	AMLODIPINE-BENAZEPRIL 10-20 MG	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	82	 	1/23/2009	 	65162062711	 	TRAMADOL HCL 50 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	83	 	1/23/2009	 	00185014460	 	AMIODARONE HCL 200 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	84	 	1/23/2009	 	00781104801	 	PERPHENAZINE 8 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	85	 	1/23/2009	 	00054004421	 	CILOSTAZOL 100 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	86	 	1/23/2009	 	00093031101	 	LOPERAMIDE 2 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	87	 	1/23/2009	 	00172572960	 	FAMOTIDINE 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	88	 	1/23/2009	 	00591083960	 	BUPROPION SR 150 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	89	 	1/23/2009	 	00093001298	 	PANTOPRAZOLE SOD 40 MG TAB DR	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 

 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Based on	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Claim	 	 	 	 	 	 	Real HS Approach	 	 	 	 	 	 	 	 	 	 	 	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Counts	 	 	 	 	 	 	AWP Prices	 	 	Dispense Fees	 
	Cust	 	Clm	 	Date	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Ext.	 	 	Ingred	 	 	 	 	 	 	IngredDis	 	 	 	 	 	 	Wtd Avg	 	 	Wtd Avg	 	 	Total	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Act Disp	 	 	Target	 	 	 	 
	Id	 	#	 	Filled	 	NDC	 	Label Name	 	GPI	 	 	Qty	 	 	D.S.	 	 	Count	 	 	AWP	 	 	Cost	 	 	Disp Fee	 	 	count	 	 	Count	 	 	Disc Rate	 	 	Disp Fee	 	 	AWP	 	 	Actual IC	 	 	Target IC	 	 	Variance	 	 	Fees	 	 	Disp Fees	 	 	Variance	 
	358
	 	90	 	1/23/2009	 	68180046903	 	LOVASTATIN 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	91	 	1/23/2009	 	68180046903	 	LOVASTATIN 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	92	 	1/23/2009	 	00781223310	 	OMEPRAZOLE 20 MG CAPSULE DR	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	93	 	1/23/2009	 	00781223310	 	OMEPRAZOLE 20 MG CAPSULE DR	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	94	 	1/23/2009	 	00781223310	 	OMEPRAZOLE 20 MG CAPSULE DR	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	95	 	1/23/2009	 	68180048003	 	SIMVASTATIN 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	96	 	1/23/2009	 	68180047903	 	SIMVASTATIN 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	 	 	 	 	[***]	%	 	 	 	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	97	 	1/23/2009	 	00093715598	 	SIMVASTATIN 40 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	98	 	1/23/2009	 	68180047903	 	SIMVASTATIN 20 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	359
	 	99	 	1/23/2009	 	68462013001	 	ZONISAMIDE 100 MG CAPSULE	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	358
	 	100	 	1/23/2009	 	00093724306	 	RISPERIDONE 4 MG TABLET	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	%	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	Rx Count	 	AWP	 	 	Ing Cost	 	 	Disp Fee	 	 	Total Cost	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Totals	 	 	 	 	 	 	 	 	 	 	 	 	 	 	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	 	[***]	 	 	 	[***]	%	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 	 	$	[***]	 
	 
	 
	 	 	 	 	 	 	 	Net Effective AWP Discount Rate	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Target AWP Discount Rate	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 
	 	 	 	 	 	 	 	Net Effective Disp Fee	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 
	 	 	 	 	 	 	 	Target Dispense Fee	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 
	 	 	 	 	 	 	 	Monetary Value of Discount Rate Difference	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Monetary Value of Dispense Fee Difference	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Total	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 
	 	 	 	 	 	 	 	* Monetary Value of Dispense Fee Difference Calculation:	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 
	 	 	 	 	 	 	 	Target Dispense Fee	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Weighted Average Dispense Fees	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 
	 	 	 	 	 	 	 	Dispense Fee Difference	 	 	 	 	 	 	 	 	 	 	 	 	 	$	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Actual Claims	 	 	 	 	 	 	 	 	 	 	 	 	 	 	[***]	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 
	 	 	 	 	 	 	 	Monetary Value of Dispense Fee  Difference	 	 	 	 	 	 	 	 	 	 	 	 	 	 	[***]Exhibit 10.1

Exhibit 10.1

EMPLOYMENT AGREEMENT

THIS AGREEMENT is made on the 9th day of February, 2010 by and between Zachary Parker (the
“Employee”) and TEAMSTAFF, INC., a New Jersey corporation (the “Company”).

W I T N E S S E T H:

WHEREAS, the Company and its subsidiaries are engaged in the business of providing business
outsourcing services; and

WHEREAS, the Company desires to employ the Employee and secure for the Company the experience,
ability and services of the Employee; and

WHEREAS, the Employee desires to accept employment with the Company, pursuant to the terms and
conditions herein set forth, superseding all prior oral and written agreements, term sheets and
letters between the Company, its subsidiaries and/or predecessors and Employee;

NOW, THEREFORE, it is mutually agreed by and between the parties hereto as follows:

ARTICLE I

DEFINITIONS

1.1 Accrued Compensation. Accrued Compensation shall mean an amount which
shall include all amounts earned or accrued through the “Termination Date” (as defined below) but
not paid as of the Termination Date, including (i) Base Salary, (ii) reimbursement for business
expenses incurred by the Employee on behalf of the Company, pursuant to the Company’s expense
reimbursement policy in effect at such time, (iii) vacation pay, and (iv) unpaid bonuses and
incentive compensation earned and awarded prior to the Termination Date.

 

 

 

1.2 Cause. Cause shall mean: (i) willful disobedience by the Employee of a material and lawful
instruction of the Board of Directors of the Company; (ii) formal charge, indictment or conviction
of the Employee of any misdemeanor involving fraud or embezzlement or similar crime, or any felony;
(iii) conduct amounting to fraud, dishonesty, gross negligence, willful misconduct or
recurring insubordination; or (iv) excessive absences from work, other than for illness or
Disability; provided that the Company shall not have the right to terminate the employment of
Employee pursuant to the foregoing clauses (i), (iii), and (iv) above unless written notice
specifying such breach shall have been given to the Employee and, in the case of breach which is
capable of being cured, the Employee shall have failed to cure such breach within thirty (30) days
after his receipt of such notice.

1.3 Change in Control. “Change in Control” shall mean any of the following events:

a. (i) An acquisition (other than directly from the Company) of any voting securities of the
Company (the “Voting Securities”) by any “Person” (as the term person is used for purposes of
Section 13(d) or 14(d) of the Securities Exchange Act of 1934, as amended (the “1934 Act”))
immediately after which such Person has “Beneficial Ownership” (within the meaning of Rule 13d-3
promulgated under the 1934 Act) of twenty percent (20%) or more of the combined voting power of the
Company’s then outstanding Voting Securities (27% if such Person is Wynnnefield Capital Inc. and
its affiliates); provided, however, that in determining whether a Change in Control has occurred,
Voting Securities which are acquired in a “Non-Control Acquisition” (as defined below) shall not
constitute an acquisition which would cause a Change in Control. A “Non-Control Acquisition” shall
mean an acquisition by (1) an employee benefit plan (or a trust forming a part thereof) maintained
by (x) the Company or (y) any corporation or other Person of which a majority of its voting power
or its equity securities or equity interest is owned directly or indirectly by the Company (a
“Subsidiary”), or (2) the Company or any Subsidiary.

 

2

 

(ii) Notwithstanding the foregoing, a Change in Control shall not be deemed to occur solely
because a Person (the “Subject Person”) gained Beneficial Ownership of more than
the permitted amount of the outstanding Voting Securities as a result of the acquisition of
Voting Securities by the Company which, by reducing the number of Voting Securities outstanding,
increases the proportional number of shares Beneficially Owned by the Subject Person, provided that
if a Change in Control would occur (but for the operation of this sentence) as a result of the
acquisition of Voting Securities by the Company, and after such share acquisition by the Company,
the Subject Person becomes the Beneficial Owner of any additional Voting Securities which increases
the percentage of the then outstanding Voting Securities Beneficially Owned by the Subject Person,
then a Change in Control shall occur.

b. The individuals who, as of the date this Agreement is approved by the Board, are members of
the Board (the “Incumbent Board”), cease for any reason to constitute at least two-thirds of the
Board; provided, however, that if the election, or nomination for election by the Company’s
stockholders, of any new director was approved by a vote of at least two-thirds of the Incumbent
Board, such new director shall, for purposes of this Agreement, be considered and defined as a
member of the Incumbent Board; and provided, further, that no individual shall be considered a
member of the Incumbent Board if such individual initially assumed office as a result of either an
actual “Election Contest” (as described in Rule 14a-11 promulgated under the 1934 Act) or other
solicitation of proxies or consents by or on behalf of a Person other than the Board (a “Proxy
Contest”); or

 

3

 

c. Approval by stockholders of the Company of:

(i) A merger, consolidation or reorganization involving the Company, unless: (1) the
stockholders of the Company, immediately before such merger, consolidation or reorganization, own,
directly or indirectly immediately following such merger, consolidation or
reorganization, at least sixty percent (60%) of the combined voting power of the outstanding
voting securities of the corporation resulting from such merger or consolidation or reorganization
(the “Surviving Corporation”) in substantially the same proportion as their ownership of the Voting
Securities immediately before such merger, consolidation or reorganization, (2) the individuals who
were members of the Incumbent Board immediately prior to the execution of the agreement providing
for such merger, consolidation or reorganization constitute at least two-thirds of the members of
the board of directors of the Surviving Corporation, and (3) no Person (other than the Company, any
Subsidiary, any employee benefit plan (or any trust forming a part thereof) maintained by the
Company, the Surviving Corporation or any Subsidiary) becomes Beneficial Owner of twenty percent
(20%) or more of the combined voting power of the Surviving Corporation’s then outstanding voting
securities as a result of such merger (27% if such Person is Wynnnefield Capital Inc. and its
affiliates), consolidation or reorganization, a transaction described in clauses (1) through (3)
shall herein be referred to as a “Non-Control Transaction”; or

(ii) An agreement for the sale or other disposition of all or substantially all of the assets
of the Company, to any Person, other than a transfer to a Subsidiary, in one transaction or a
series of related transactions;

(iii) The stockholders of the Company approve any plan or proposal for the liquidation or
dissolution of the Company.

 

4

 

d. Notwithstanding anything contained in this Agreement to the contrary, if the Employee’s
employment is terminated prior to a Change in Control and the Employee reasonably demonstrates that
such termination (i) was at the request of a third party who has indicated an intention or taken
steps reasonably calculated to effect a Change in Control (a “Third Party”) or
(ii) otherwise occurred in connection with, or in anticipation of, a Change in Control, then
for all purposes of this Agreement, the date of a Change in Control with respect to the Employee
shall mean the date immediately prior to the date of such termination of the Employee’s employment.

1.4 Continuation Benefits. Continuation Benefits shall be the continuation of the Benefits,
as defined in Section 5.1, for the period commencing on the Termination Date and terminating 12
months thereafter, or such other period as specifically stated by this agreement (the “Continuation
Period”) at the Company’s expense on behalf of the Employee and his dependents; provided, however,
that (i) in no event shall the Continuation Period exceed 18 months from the Termination Date; and
(ii) the level and availability of benefits provided during the Continuation Period shall at all
times be subject to the post-employment conversion or portability provisions of the benefit plans.
The Company’s obligation hereunder with respect to the foregoing benefits shall also be limited to
the extent that if the Employee obtains any such benefits pursuant to a subsequent employer’s
benefit plans, the Company may reduce the coverage of any benefits it is required to provide the
Employee hereunder as long as the aggregate coverage and benefits of the combined benefit plans is
no less favorable to the Employee than the coverage and benefits required to be provided hereunder.
This definition of Continuation Benefits shall not be interpreted so as to limit any benefits to
which the Employee, his dependents or beneficiaries may be entitled under any of the Company’s
employee benefit plans, programs or practices following the Employee’s termination of employment,
including, without limitation, retiree medical and life insurance benefits.

 

5

 

1.5 Disability. Disability shall mean a physical or mental infirmity which impairs the
Employee’s ability to substantially perform his duties with the Company for a period of sixty (60)
consecutive days and the Employee has not returned to his full time employment prior to the
Termination Date as stated in the “Notice of Termination” (as defined below).

1.6 Good Reason. “Good Reason” shall mean without the written consent of the Employee: (A) a
material breach of any provision of this Agreement by the Company; (B) failure by the Company to
pay when due any compensation to the Employee; (C) a reduction in the Employee’s Base Salary; (D)
failure by the Company to maintain the Employee in the positions referred to in Section 2.1 of this
Agreement; (E) assignment to the Employee of any duties materially and adversely inconsistent with
the Employee’s positions, authority, duties, responsibilities, powers, functions, reporting
relationship or title or any other action by the Company that results in a material diminution of
such positions, authority, duties, responsibilities, powers, functions, reporting relationship or
title; or (F) a Change in Control, provided the event on which the Change of Control is predicated
occurs within 90 days of the service of the Notice of Termination by the Employee, it being
understood that Employee shall have the right to terminate his employment under this Section 1.6
(F) for any reason or no reason within such 90 day period; and provided further, however, that the
Employee agrees not to terminate his employment for Good Reason pursuant to clauses (A) through (E)
unless (a) the Employee has given the Company at least 30 days’ prior written notice of his intent
to terminate his employment for Good Reason, which notice shall specify the facts and circumstances
constituting Good Reason; and (b) the Company has not remedied such facts and circumstances
constituting Good Reason to the reasonable and good faith satisfaction of the Employee within a
30-day period after receipt of such notice.

 

6

 

1.7 Notice of Termination. Notice of Termination shall mean a written notice from the
Company, or the Employee, of termination of the Employee’s employment which indicates the provision
in this Agreement relied upon, if any and which sets forth in reasonable detail the facts and
circumstances claimed to provide a basis for termination of the Employee’s employment under
the provision so indicated. A Notice of Termination served by the Company shall specify the
effective date of termination.

1.8 Pro Rata Bonus. “Pro Rata Bonus” shall mean an amount equal to the maximum bonus Employee
had an opportunity to earn pursuant to section 4.2 multiplied by a fraction, the numerator of which
shall be the number of days from the commencement of the fiscal year to the Termination Date, and
the denominator of which shall be the number of days in the fiscal year in which Employee was
terminated.

1.1 Severance Payment. “Severance Payment” shall mean an amount equal to the sum of 12 months
of Employee’s Base Salary in effect on the Termination Date. The Severance Payment shall be
payable in equal installments on each of the Company’s regular pay dates for executives during the
twelve months commencing on the first regular executive pay date following the Termination Date.
The Severance Payment is conditioned on the Employee executing a termination agreement and release
in a form reasonably acceptable to the Employee and the Company.

 

7

 

1.2 Termination Date. Termination Date shall mean (i) in the case of the Employee’s death, his
date of death; (ii) in the case of Good Reason, 30 days from the date the Notice of Termination is
given to the Company, provided the Company has not remedied such facts and circumstances
constituting Good Reason to the reasonable and good faith satisfaction of the Employee; (iii) in
the case of termination of employment on or after the Expiration Date, the last day of employment;
and (iv) in all other cases, the date specified in the Notice of Termination; provided, however, if
the Employee’s employment is terminated by the Company for any reason except Cause, the date
specified in the Notice of Termination shall be at least 30 days from the date the Notice of
Termination is given
to the Employee, and provided further that in the case of Disability, the Employee shall not
have returned to the full-time performance of his duties during such period of at least 30 days.

ARTICLE II

EMPLOYMENT

2.1 Subject to and upon the terms and conditions of this Agreement, the Company hereby agrees
to employ the Employee, and the Employee hereby accepts such employment, as President and Chief
Executive Officer of the Company, which positions he shall assume on February 22, 2010. The
Employee’s position includes acting as an officer and/or director of any of the Company’s
subsidiaries as determined by the Board of Directors. The Company shall nominate Employee, and use
its best efforts to have Employee elected to the Board of Directors of the Company (the “Board”)
commencing on February 22, 2010 and continuing throughout the term of this Agreement. The Employee
agrees to resign from the Board upon the termination of employment for any reason.

 

8

 

ARTICLE III

DUTIES

3.1 The Employee shall, during the term of his employment with the Company, and subject to the
direction and control of the Company’s Board of Directors, perform such duties and functions as he
may be called upon to perform by the Company’s Board of Directors during the term of this
Agreement, consistent with his position as President and Chief Executive Officer.

3.2 The Employee shall perform, in conjunction with the Company’s Executive Management, to the
best of his ability the following services and duties for the Company and its subsidiary
corporations (by way of example, and not by way of limitation):

(i) Those duties attendant to the position of Chief Executive Officer;

(ii) Establish and implement current and long range objectives, plans, and policies, subject
to the approval of the Board of Directors;

(iii) Financial planning including the development of, liaison with, financing sources and
investment bankers;

(iv) Managerial oversight of the Company’s business;

(v) Shareholder relations;

(vi) Compliance with local, state and federal regulations and laws governing business
operations;

(vii) Business expansion of the Company including acquisitions, joint ventures, and other
opportunities; and

(viii) Promotion of the relationships of the Company and its subsidiaries with their
respective employees, customers, suppliers and others in the business community.

 

9

 

3.3 The Employee agrees to devote full business time and his best efforts in the performance
of his duties for the Company and any subsidiary corporation of the Company.

3.4 Employee shall undertake regular travel to the Company’s executive and operational
offices, and such other occasional travel within or outside the United States as is or may be
reasonably necessary in the interests of the Company. All such travel shall be at the sole cost
and expense of the Company and shall include reasonable lodging and food costs incurred by Employee
while traveling.

ARTICLE IV

COMPENSATION

4.1 During the term of this Agreement, Employee shall be compensated initially at the rate of
$288,000 per annum, subject to such increases, if any, as determined by the Board of Directors, or
if the Board so designates, the Management Resources and Compensation Committee (the “Committee”),
in its discretion, at the commencement of each of the Company’s fiscal years during the term of
this Agreement (the “Base Salary”). The Base Salary shall be paid to the Employee in accordance
with the Company’s regular executive payroll periods.

4.2 Employee may receive a bonus (the “Bonus”) in the sole discretion of the Committee.

(i) Employee will have an opportunity to earn a cash Bonus of up to 70% of Employee’s Base
Salary for each fiscal year of employment. The Bonus will be based on performance targets and
other key objectives established by the Committee at the commencement of each fiscal year, and the
determination of whether the performance criteria shall have been attained shall be solely in the
discretion of the Committee.

(ii) Targeted bonus will be reduced or increased by 2% of Base Salary for every 1% of variance
between the actual results and the targets.

 

10

 

(iii) No bonus will be awarded if results are less than 90% of target and no bonus will exceed
90% of salary.

(iv) For the period commencing on the effective date of this Agreement and September 30,
2010, Employee shall be guaranteed a bonus of $45,000 payable $25,000 on June 30, 2010 and $20,000
on September 30, 2010, provided Employee has not voluntarily resigned, or been terminated for
cause prior to such dates. The Committee will establish performance targets for the
balance of Fiscal 2010 in consultation with Employee within thirty (30) days of the
Commencement Date to enable Employee to earn additional cash bonus for Fiscal 2010, not to exceed
in the aggregate 70% of the portion of the Base Salary actually paid in Fiscal 2010.

4.3 The Company shall deduct from Employee’s compensation all federal, state, and local taxes
which it may now or hereafter be required to deduct.

4.4 Employee may receive such other additional compensation as may be determined from time to
time by the Board of Directors including bonuses and other long term compensation plans. Nothing
herein shall be deemed or construed to require the Board to award any bonus or additional
compensation.

ARTICLE V

BENEFITS

5.1 During the term hereof, the Company shall provide Employee with the following benefits
(the “Benefits”): (i) group health care and insurance benefits as generally made available to the
Company’s senior management; and (ii) such other insurance benefits obtained by the Company and
made generally available to the Company’s senior management. The Company shall reimburse Employee,
upon presentation of appropriate vouchers, for all reasonable business expenses incurred by
Employee on behalf of the Company upon presentation of suitable documentation.

 

11

 

5.2 In the event the Company wishes to obtain Key Man life insurance on the life of Employee,
Employee agrees to cooperate with the Company in completing any applications necessary to obtain
such insurance and promptly submit to such physical examinations and furnish such information as
any proposed insurance carrier may request.

5.3 Employee shall be entitled to paid vacation at the rate of four (4) weeks per annum; three
(3) weeks for the balance of Fiscal 2010.

ARTICLE VI

NON-DISCLOSURE

6.1 The Employee shall not, at any time during or after the termination of her employment
hereunder, except when acting on behalf of and with the authorization of the Company, make use of
or disclose to any person, corporation, or other entity, for any purpose whatsoever, any trade
secret or other confidential information concerning the Company’s business, finances, marketing,
accounting, personnel and/or staffing business of the Company and its subsidiaries, including
information relating to any customer of the Company or pool of temporary or permanent employees,
governmental customer or any other nonpublic business information of the Company and/or its
subsidiaries learned as a consequence of Employee’s employment with the Company (collectively
referred to as the “Proprietary Information”). For the purposes of this Agreement, trade secrets
and confidential information shall mean information disclosed to the Employee or known by him as a
consequence of her employment by the Company, whether or not pursuant to this Agreement, and not
generally known in the industry. The Employee acknowledges that trade secrets and other items of
confidential information, as they may exist from time to time, are valuable and unique assets of
the Company, and that disclosure of any such information would cause substantial injury to the
Company. Trade secrets and confidential information shall cease to be trade secrets or
confidential information, as applicable, at such time as such information becomes public other than
through disclosure, directly or indirectly, by Employee in violation of this Agreement.

 

12

 

6.2 If Employee is requested or required (by oral questions, interrogatories, requests for
information or document subpoenas, civil investigative demands, or similar process) to
disclose any Proprietary Information, Employee shall, unless prohibited by law, promptly notify
the Company of such request(s) so that the Company may seek an appropriate protective order.

ARTICLE VII

RESTRICTIVE COVENANT

7.1 During the term of Employment with the Company, and for a period of one (1) year following
termination of employment for any reason, Employee agrees that he will not, directly or indirectly,
enter into or become associated with or engage in any other business (whether as a partner,
officer, director, shareholder, employee, consultant, or otherwise), which is involved in the
business of providing (i) temporary and/or permanent staffing of governmental employees, and (ii)
medical and office administration/technical professionals through Federal Supply Schedule (“FSS”)
contracts with both the United States General Services Administration (“GSA”), United States
Department of Veterans Affairs (“DVA”), United States Department of Defense (“DOD”) or other
federal, state and local entities, or (iii) is otherwise engaged in the same or similar business as
the Company in direct competition with the Company, or which the Company was in the process of
developing, during the tenure of Employee’s employment by the Company. Notwithstanding the
foregoing, the ownership by Employee of less than five percent of the shares of any publicly held
corporation shall not violate the provisions of this Article VII. In furtherance of, and in
addition to, the foregoing, Employee shall not during the aforesaid period of non-competition,
directly or indirectly, in connection with any temporary or permanent employee placement,
governmental staffing or any other business of the Company and its subsidiaries, or any business
similar to the business in which the Company was engaged, or in the process of developing during
Employee’s tenure with the Company, solicit any
customer of the Company who was a customer of the Company during the tenure of his employment.

 

13

 

7.2 In addition, Employee will not for a period of one year after the termination of
employment for any reason, either directly or indirectly, (a) solicit any person who is employed by
the Company (or who was employed by the Company within 90 days of the Termination Date to: (i)
terminate his employment with the Company; (ii) accept employment with anyone other than the
Company, or (iii) in any manner interfere with the business of the Company.

7.3 If any court shall hold that the duration of non-competition or any other restriction
contained in this Article VII is unenforceable, it is our intention that same shall not thereby be
terminated but shall be deemed amended to delete therefrom such provision or portion adjudicated to
be invalid or unenforceable or, in the alternative, such judicially substituted term may be
substituted therefor.

ARTICLE VIII

TERM

8.1 This Agreement shall be for a term (the “Initial Term”) commencing on the effective date
as set forth above (the “Commencement Date”) and terminating on September 30, 2013 (the “Expiration
Date”), unless sooner terminated upon the death of the Employee, or as otherwise provided herein.

 

14

 

8.2 Unless this Agreement is earlier terminated pursuant to the terms hereof, the Company
agrees to use its best efforts to notify Employee in writing whether it intends to negotiate a
renewal of this Agreement by notice ninety (90) days prior to the Expiration Date. In the event
(i) the Company shall have failed to notify the Employee of its intention to renew as provided by
this Section 8.2, or (ii) the Company fails to reach agreement with Employee as to the terms of a
new employment agreement
after providing such notice, in addition to any other payments due hereunder, upon termination
of the Employee’s employment on or after the Expiration Date for any reason except Cause, the
Company shall pay Employee the Severance Payment.

ARTICLE IX

TERMINATION

9.1 The Company may terminate this Agreement by giving a Notice of Termination to the Employee
in accordance with this Agreement:

(i) for Cause;

(ii) without Cause;

(iii) for Disability.

9.2 Employee may terminate this Agreement by giving a Notice of Termination to the Company in
accordance with this Agreement, at any time, with or without good reason.

 

15

 

9.3 If the Employee’s employment with the Company shall be terminated, the Company shall pay
and/or provide to the Employee the following compensation and benefits in lieu of any other
compensation or benefits arising under this Agreement or otherwise:

(i) if the Employee was terminated by the Company for Cause, or the Employee terminates
without Good Reason, the Accrued Compensation;

(ii) if the Employee was terminated by the Company for Disability, the Continuation Benefits;
the Accrued Compensation; and the Severance Payment; or

(iii) if termination was due to the Employee’s death, the Accrued Compensation; the
Continuation Benefits; and the Pro Rata Bonus; or

(iv) if the Employee was terminated by the Company without cause, or the
Employee terminates this Agreement for Good Reason, the Accrued Compensation; the Severance
Payment; and the Continuation Benefits.

9.4 The amounts payable under this Section 9, shall be paid as follows:

(i) Accrued Compensation shall be paid within five (5) business days after the Employee’s
Termination Date (or earlier, if required by applicable law).

(ii) If the Continuation Benefits are paid in cash, the payments shall be made on the first
day of each month during the Continuation Period (or earlier, if required by applicable law).

(iii) The Base Salary through the Expiration Date shall be paid in accordance with the
Company’s regular pay periods (or earlier, if required by applicable law).

 

16

 

9.5 Notwithstanding the foregoing, in the event Employee is a member of the Board of Directors
on the Termination Date, the payment of any and all compensation due hereunder, except Accrued
Compensation, and Employee’s right to exercise any Employee Stock Option after the Termination
Date, is expressly conditioned on Employee’s resignation from the Board of Directors within five
(5) business days of notice by the Company requesting such resignation.

9.6 The Employee shall not be required to mitigate the amount of any payment provided for in
this Agreement by seeking other employment or otherwise and no such payment shall be offset or
reduced by the amount of any compensation or benefits provided to the Employee in any subsequent
employment except as provided in Sections 1.4.

ARTICLE X

TERMINATION OF PRIOR AGREEMENTS

10.1 This Agreement sets forth the entire agreement between the parties and supersedes all
prior agreements, letters and understandings between the parties, whether oral or written
prior to the effective date of this Agreement except for the terms of employee stock option plans,
restricted stock grants and option certificates.

ARTICLE XI

STOCK OPTIONS

11.1 As an inducement to Employee to enter into this Agreement, the Company hereby grants to
Employee options to purchase 500,000 shares of the Company’s Common Stock, $.001 par value (the
“Options”), subject to the terms and conditions of the Company’s 2006 Long Term Incentive Plan (the
“Plan”), and the terms and conditions set forth in the Stock Option Agreement which are
incorporated herein by reference. Provided Employee is an employee of the Company on the vesting
date, and unless otherwise provided by this Agreement, the options shall vest as follows:

(i) 50,000 options on the Commencement Date;

(ii) 150,000 options if the closing price of the Company’s Common Stock equals or exceeds
$3.00 per share for ten consecutive trading days;

(iii) 50,000 options if the closing price of the Company’s Common Stock equals or exceeds
$4.00 per share for ten consecutive trading days;

 

17

 

(iv) 50,000 options if the closing price of the Company’s Common Stock equals or exceeds $5.00
per share for ten consecutive trading days;

(v) 50,000 options if the closing price of the Company’s Common Stock equals or exceeds $6.00
per share for ten consecutive trading days;

(vi) 50,000 options if the closing price of the Company’s Common Stock equals or exceeds $7.00
per share for ten consecutive trading days; and

(vii) 100,000 options if the closing price of the Company’s Common Stock equals or exceeds
$9.00 per share for ten consecutive trading days.

11.2 The Options, to the extent vested, shall be exercisable for a period of ten years from
the date of this Agreement (the “Exercise Period”).

11.3 The Closing Price of a share of Common Stock shall mean (i) if the Common Stock is traded
on a national securities exchange or on the Nasdaq Stock Market (“Nasdaq”), the per share closing
price of the Common Stock shall be the reported closing price the principal securities exchange on
which they are listed or on Nasdaq, as the case may be, on the date of determination (or if there
is no closing price for such date of determination, then the last preceding business day on which
there was a closing price); or (ii) if the Common Stock is traded in the over-the-counter market
but bid quotations are not published on Nasdaq, the closing bid price per share for the Common
Stock as furnished by a broker-dealer which regularly furnishes price quotations for the Common
Stock; provided, however, that in the event of a Change in Control, the closing price shall be the
“Change in Control Price” as defined in the Plan.

 

18

 

11.4 The exercise price of the Options shall be equal to Fair Market Value of the Company’s
Common Stock on the date this Agreement is fully executed as determined under the Plan, and shall
contain such other terms and conditions as set forth in the stock option agreement.

11.5 The Options provided for herein are not transferable by Employee and shall be exercised
only by Employee, or by his legal representative or executor, as provided in the Plan. Such
Options shall terminate as provided in the Plan, except as otherwise modified by this Agreement or
the stock option agreement.

11.6 In the event of a termination of Employee’s employment with the Company pursuant to
Section 9.1(i), options granted and not exercised as of the Termination Date shall terminate
immediately and be null and void. In the event of a termination of Employee’s employment with the
Company due to the Employee’s death, or Disability, the Employee’s (or his estate’s or legal
representative’s) right to purchase shares of Common Stock of the Company pursuant to any stock
option or stock option plan to the extent vested as of the Termination Date shall remain
exercisable in accordance with the Plan. In the event of a termination of Employee’s employment
with the Company by the Employee other than for Good Reason, the Employee’s right to purchase
shares of Common Stock of the Company pursuant to any stock option or stock option plan to the
extent vested as of the Termination Date shall remain exercisable for a period of three months
following the Termination Date, but in no event after the expiration of the exercise period.

11.7 In the event of Employee’s termination by the Company without cause or by Employee for
Good Reason, vested options shall remain exercisable in accordance with the Plan.

11.8 In the event of a Change of Control, as defined in Section 1.3, vested options shall
remain exercisable in accordance with the Plan.

 

19

 

ARTICLE XII

EXTRAORDINARY TRANSACTIONS

12.1 The Company’s Board of Directors has determined that it is appropriate to reinforce and
encourage the continued attention and dedication of members of the Company’s management, including
the Employee, to their assigned duties without distraction in potentially disturbing circumstances
arising from the possibility of a change in control of the Company.

12.2 In the event that within ninety days (90) days of a Change of Control as described in
Section 12.2, (i) Employee is terminated, or (ii) Employee’s status, title, position or
responsibilities are
materially reduced and Employee terminates his Employment, the Company shall pay and/or
provide to the Employee, the following compensation and benefits:

	 	a.	 	The Company shall pay the Employee, in lieu of any other
payments due hereunder, (i) the Accrued Compensation; (ii) the Continuation
Benefits; and (iii) a lump sum payment equal to 150% of the Employee’s Base
Salary in effect on the effective date of the Change of Control.

12.3 Notwithstanding the foregoing, if the payment under this Article XII, either alone or
together with other payments which the Employee has the right to receive from the Company, would
constitute an “excess parachute payment” as defined in Section 280G of the Internal Revenue Code of
1986, as amended (the “Code”), the aggregate of such credits or payments under this Agreement and
other agreements shall be reduced to the largest amount as will result in no portion of such
aggregate payments being subject to the excise tax imposed by Section 4999 of the Code. The
priority of the reduction of excess parachute payments shall be in the discretion of the Employee.
The Company shall give notice to the Employee as soon as practicable after its determination that
Change of Control payments and benefits are subject to the excise tax, but no later than ten (10)
days in advance of the due date of such Change of Control payments and benefits, specifying the
proposed date of payment and the Change of Control benefits and payments subject to the excise tax.
Employee shall exercise his option under this paragraph 12.2 by written notice to the Company within
five (5) days in advance of the due date of the Change of Control payments and benefits specifying
the priority of reduction of the excess parachute payments.

 

20

 

ARTICLE XIII

ARBITRATION AND INDEMNIFICATION

13.1 Any controversy, dispute or claim arising out of or relating to this Agreement or breach
thereof, with the sole exception of any claim, breach, or violation arising under Articles VI or
VII hereof, shall be shall first be settled through good faith negotiation. If the dispute cannot
be settled through negotiation, the parties agree to attempt in good faith to settle the dispute by
mediation administered by JAMS. If the parties are unsuccessful at resolving the dispute through
mediation, the parties agree to final and binding arbitration before a single arbitrator in the
State of Georgia in accordance with the Rules of the American Arbitration Association. The
arbitrator shall be selected by the Association and shall be an attorney-at-law experienced in the
field of corporate law. Any judgment upon any arbitration award may be entered in any court,
federal or state, having competent jurisdiction of the parties.

13.2 The Company hereby agrees to indemnify, defend, and hold harmless the Employee for any
and all claims arising from or related to his employment by the Company at any time asserted, at
any place asserted, to the fullest extent permitted by law, except for claims based on Employee’s
fraud, deceit or willfulness. The Company shall maintain such insurance as is necessary and
reasonable to protect the Employee from any and all claims arising from or in connection with his
employment by the Company during the term of Employee’s employment with the Company and for a
period of six (6) years after the date of termination of employment for any reason. The provisions
of this Section 13.2 are in addition to and not in lieu of any indemnification, defense or other
benefit to which Employee may be entitled by statute, regulation, common law or otherwise.

 

21

 

ARTICLE XIV

SEVERABILITY

If any provision of this Agreement shall be held invalid and unenforceable, the remainder of
this Agreement shall remain in full force and effect. If any provision is held invalid or
unenforceable with respect to particular circumstances, it shall remain in full force and effect in
all other circumstances.

ARTICLE XV

NOTICE

For the purposes of this Agreement, notices and all other communications provided for in the
Agreement shall be in writing and shall be deemed to have been duly given when (a) personally
delivered or (b) sent by (i) a nationally recognized overnight courier service or (ii) certified
mail, return receipt requested, postage prepaid and in each case addressed to the respective
addresses as set forth below or to any such other address as the party to receive the notice shall
advise by due notice given in accordance with this paragraph. All notices and communications shall
be deemed to have been received on (A) if delivered by personal service, the date of delivery
thereof; (B) if delivered by a nationally recognized overnight courier service, on the first
business day following deposit with such courier service; or (C) on the third business day after
the mailing thereof via certified mail. Notwithstanding the foregoing, any notice of change of
address shall be effective only upon receipt.

 

22

 

The current addresses of the parties are as follows:

	 	 	 
	IF TO THE COMPANY:

	 	TeamStaff, Inc.
	 

	 	1 Executive Drive
	 

	 	Somerset, NJ 08873
	 
	 	 
	WITH A COPY TO:

	 	Victor J. DiGioia
	 

	 	Becker & Poliakoff, LLP
	 

	 	45 Broadway
	 

	 	New York, NY 10006
	 
	 	 
	IF TO THE EMPLOYEE:
	 	 

ARTICLE XVI

BENEFIT

This Agreement shall inure to, and shall be binding upon, the parties hereto, the successors
and assigns of the Company, and the heirs and personal representatives of the Employee.

ARTICLE XVII

WAIVER

The waiver by either party of any breach or violation of any provision of this Agreement shall
not operate or be construed as a waiver of any subsequent breach of construction and validity.

 

23

 

ARTICLE XVIII

GOVERNING LAW

This Agreement has been negotiated and executed in the State of Georgia which shall govern its
construction and validity.

ARTICLE XIX

JURISDICTION

Any or all actions or proceedings which may be brought by the Company or Employee under this
Agreement shall be brought in courts having a situs within the State of Georgia, and Employee and
the Company each hereby consent to the jurisdiction of any local, state, or federal court located
within the State of Georgia.

ARTICLE XX

ENTIRE AGREEMENT

This Agreement contains the entire agreement between the parties hereto. No change, addition,
or amendment shall be made hereto, except by written agreement signed by the parties hereto.

IN WITNESS WHEREOF, the parties hereto have executed this Agreement and affixed their hands
and seals the day and year first above written.

	 	 	 	 	 
	 	TEAMSTAFF, INC.

 	 
	 	By:  	/s/ Frederick G. Wasserman
 	 
	 	 	Frederick G. Wasserman 	 
	 	 	Chairman of the Board 	 
	 
	 

	 	/s/ Zachary Parker
 

	 
	 
	 	Zachary Parker	 
	 
	 	Employee	 

 

24

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