Document:

SPECIMENS OF STOCK OPTION AGREEMENTS UNDER THE 1995 STOCK OPTION PLAN

 Exhibit 10.13 
  
 SPECIMENS OF STOCK OPTION AGREEMENTS 
  
 IDX SYSTEMS CORPORATION 
  
 STOCK OPTION AGREEMENT 
 (attached to Notice of Grant of Stock Options) 
  
 1. Grant of Option. IDX Systems Corporation, a Vermont corporation (the “Company”), hereby grants to the individual (the “Optionee”) specified on the Notice of Grant of Stock Option to which
this Agreement is attached (the “Notice”), an option (the “Option”) pursuant to the Company’s 1995 Stock Option Plan (the “Plan”) to purchase the number of shares specified in the Notice of Common Stock, $0.01 par
value per share (“Common Stock”) of the Company at the price per share specified in the Notice, purchasable as set forth in and subject to the terms and conditions of the Notice, this Agreement, and the Plan. Except where the context
otherwise requires, the term “Company” shall include the parent and all present and future subsidiaries of the Company as defined in Sections 424 (e) and 424 (f) of the Internal Revenue Code of 1986, as amended or replaced from time to
time (the “Code”) and all of the Company’s predecessors, successors and assigns. 
  
 2. Incentive Stock Option. This Option is not intended to qualify as an incentive stock option within the meaning of Section 422 of the Code.

  
 3. Exercise of Option and Provisions for Termination.

  
 (a) Expiration. The Option shall expire on the date
that is ten (10) years after the date of grant set forth in the Notice (the “Expiration Date”). The Option may not be exercised at any time after the Expiration Date. 
  
 (b) Vesting Schedule. Except as otherwise provided in this Agreement, the Option shall become exercisable prior to
the Expiration Date in four annual increments, each representing one-fourth of the total number of shares subject to the Option, as set forth in the Notice. The right of exercise shall be cumulative so that it shall be exercisable, in whole or in
part, with respect to all vested shares not purchased at any time prior to the Expiration Date or the earlier termination of this Option. 
  
 (c) Exercise Procedure. Subject to the conditions set forth in this Agreement, this Option shall be exercised by the Optionee’s delivery of
written notice of exercise to the Secretary of the Company, specifying the number of shares to be purchased and the purchase price to be paid therefor and accompanied by payment in full in accordance with Section 4. Such exercise shall be effective
upon receipt by the Secretary of the Company of such written notice together with the required payment. The Optionee may purchase less than the number of shares covered hereby, provided that no partial exercise of this Option may be for any
fractional share or for fewer than ten whole shares. 

 (d) Continuous Employment Required. Except as otherwise provided in this Section 3, this Option
may not be exercised unless the Optionee, at the time he or she attempts to exercise this Option, is, and has been at all times since the date of grant of this Option, an employee of the Company or as a consultant of the Company subsequent to the
termination of employment with the Company. 
  
 (e) Exercise
Period Upon Termination of Employment. If the Optionee ceases to be employed by the Company for any reason, or ceases to continue working for the Company as a consultant subsequent to the termination of employment with the Company, then, except
as provided in paragraphs (f) and (g) below, the right to exercise this Option shall terminate 30 days after such cessation (but in no event after the Expiration Date), provided that this Option shall be exercisable only to the extent that the
Optionee was entitled to exercise this Option on the date of such cessation. The Company’s obligation to deliver shares upon the exercise of this Option shall be subject to the satisfaction of all applicable federal, state and local income and
employment tax withholding requirements, arising by reason of this Option being treated as a non-statutory option or otherwise. Notwithstanding the foregoing, if the Optionee, prior to the Expiration Date, materially violates the non-competition or
confidentiality provisions of any employment contract, confidentiality and nondisclosure agreement or other agreement between the Optionee and the Company, the right to exercise this Option shall terminate immediately upon written notice to the
Optionee from the Company describing such violation. 
  
 (f)
Exercise Period Upon Death or Disability. If the Optionee dies or becomes disabled prior to the Expiration Date while he or she is an employee of the Company, or ceases to continue working for the Company as a consultant subsequent to the
termination of employment by the Company, or if the Optionee dies within three months after the Optionee ceases to be an employee or consultant of the Company, this Option shall be exercisable, within the period of one year following the date of
death or disability of the Optionee (but in no event after the Expiration Date), by the Optionee or by the person to whom this Option is transferred by will or the laws of descent and distribution, provided that this Option shall be exercisable by
the Optionee on the date of his or her death or disability. Except as otherwise indicated by the context, the term “Optionee”, as used in this Option, shall be deemed to include the estate of the Optionee or any person who acquires the
right to exercise this Option by bequest or inheritance or otherwise by reason of the death of the Optionee. 
  
 (g) Resignation of Employment. If the Optionee, prior to the Expiration Date, voluntarily resigns from employment with the Company, the right to
exercise this Option shall terminate immediately upon such resignation. 
  
 4. Payment of Purchase Price. 
  
 (a) Method
of Payment. Payment of the purchase price for shares purchased upon exercise of this Option shall be made (i) by delivery to the Company of cash or a check to 

 the order of the Company in an amount equal to the purchase price of such shares, (ii) subject to the consent of the
Company, by delivery to the Company of shares of Common Stock of the Company then owned by the Optionee having a fair market value equal in amount to the purchase price of such shares, (iii) by any other means which the Board of Directors determines
are consistent with the purpose of the Plan and with applicable laws and regulations (including, without limitation, the provisions of Rule 16b-3 under the Securities Exchange Act of 1934 and Regulations T promulgated by the Federal Reserve Board),
or (iv) by any combination of such methods of payment. 
  
 (b)
Valuation of Shares or Other Non-Cash Consideration Tendered in Payment of Purchase Price. For the purposes hereof, the fair market value of any share of the Company’s Common Stock or other non-cash consideration which may be delivered
to the Company in exercise of this Option shall be determined in good faith by the Board of Directors of the Company. 
  
 (c) Delivery of Shares Tendered in Payment of Purchase Price. If the Optionee exercises Options by delivery of shares of Common Stock of the
Company, the certificate or certificates representing the shares of Common Stock of the Company to be delivered shall be duly executed in blank by the Optionee or shall be accompanied by a stock power duly executed in blank suitable for purposes of
transferring such shares to the Company. Fractional shares of Common Stock of the Company will not be accepted in payment of the purchase price of shares acquired upon exercise of this Option. 
  
 (d) Restrictions on Use of Option Stock. Notwithstanding the
foregoing, no shares of Common Stock of the Company may be tendered in payment of the purchase price of shares to be so tendered were acquired within twelve (12) months before the date of such tender, through the exercise of an Option granted under
the Plan or any other stock option or restricted stock plan of the Company. 
  
 5. Delivery of Shares; Compliance with Securities Laws, Etc. 
  
 (a) General. The Company shall, upon payment of the Option price for the number of shares purchased and paid for, make prompt delivery of such
shares to the Optionee, provided that if any law or regulation requires the Company to take any action with respect to such shares before the issuance thereof, then the date of delivery of such shares shall be extended for the period necessary to
complete such action. 
  
 (b) Listing, Qualification, Etc.
This Option shall be subject to the requirement that if, at any time, counsel to the Company shall determine that the listing, registration or qualification of the shares subject hereto upon any securities exchange or under any state or federal law,
or the consent or approval of any governmental or regulatory body, or that the disclosure of non-public information or the satisfaction of any other condition is necessary as a condition of, or in connection with, the issuance or purchase of shares
hereunder, this Option may not be exercised, in whole or in part, unless such listing, registration, qualification, consent or approval, disclosure or satisfaction of such other condition shall have been effected or 

 obtained on terms acceptable to the Board of Directors. Nothing herein shall be deemed to require the Company to apply
for, effect or obtain such listing, registration, qualification, or disclosure, or to satisfy such other condition. 
  
 6. Nontransferability of Option. Except as provided in paragraph (f) of Section 3, this Option is personal and no rights granted hereunder may be
transferred, assigned, pledged or hypothecated in any way (whether by operation of law or otherwise) nor shall any such rights be subject to execution, attachment or similar process. Upon any unauthorized attempt to transfer, assign, pledge,
hypothecate or otherwise dispose of this Option or of such rights contrary to the provisions hereof, or upon the levy of any attachment or similar process upon this Option or such rights, this Option and such rights shall, at the election of the
Company, become null and void. Notwithstanding the foregoing, Optionee may transfer by gift all or any portion of the Option to any lineal descendent (including any legally adopted child), spouse or parent, or to any trust or similar entity of which
such a person is the beneficiary. 
  
 7. No Special Employment
Rights. Nothing contained in the Plan or this Option shall be construed or deemed by any person under any circumstances to bind the Company to continue the employment of the Optionee for the period within which this Option may be exercised.

  
 8. Termination of the Plan; No Right to Future Grants;
Extraordinary Item of Compensation. By entering into the Notice and Stock Option Agreement, the Optionee acknowledges: (i) that the Plan is discretionary in nature and may be suspended or terminated by the Company at any time; (ii) that the
grant of the Option is a one-time benefit which does not create any contractual or other right to receive future grants of options, or benefits in lieu of options; (iii) that all determinations with respect to any such future grants, including, but
not limited to, the times when options shall be granted, the number of shares subject to each option, the option price, and the time or times when each option shall be exercisable, will be at the sole discretion of the Company; (iv) that the
Optionee’s participation in the Plan is voluntary; (v) that the value of the option is an extraordinary item of compensation which is outside the scope of the Optionee’s employment contract, if any; and (vi) that the Option is not part of
normal or expected compensation for purposes of calculating any severance, resignation, redundancy, end of service payments, bonuses, long-service awards, pension or retirement benefits or similar payments. 
  
 9. Cancellation and Rescission of Option. 
  
 (a) General. The Company may cancel, rescind, suspend, withhold or
otherwise limit or restrict any options that have not been exercised at any time if the Optionee is not in compliance with all applicable provisions of this Agreement and the Plan, or if the Optionee engages in any “Detrimental Activity.”
For purposes of this Section 9, “Detrimental Activity” shall include: (i) the rendering of services for any organization or engaging directly or indirectly in any business which is or becomes competitive with the Company, or which
organization or business, or the rendering of services to such organization or business, is or becomes otherwise prejudicial to or in conflict with the interests of the Company; (ii) the 

 disclosure to anyone outside the Company, or the use in other than the Company’s business, without prior written
authorization from the Company, of any confidential information or material, as defined in any agreement between the Optionee and the Company, including without limitation the Company’s Employment, Non-competition and Non-disclosure Agreement,
relating to the business of the Company, acquired by the Optionee either during or after employment with the Company; (iii) the failure or refusal to disclose promptly and to assign to the Company, pursuant to any agreement between the Optionee and
the Company, including without limitation the Company’s Employment, Non-competition and Non-disclosure Agreement, all right, title and interest in any invention or idea, patentable or not, made or conceived by the Optionee during employment by
the Company, relating in any manner to the actual or anticipated business, research or development work of the Company or the failure or refusal to do anything reasonably necessary to enable the Company to secure a patent where appropriate in the
United States and in other countries; (iv) activity that results in termination of the Optionee’s employment for cause; (v) a violation of any rules, policies, procedures or guidelines of the Company; (vi) any attempt directly or indirectly to
induce any employee of the Company to be employed or perform services elsewhere or any attempt directly or indirectly to solicit the trade or business of any current or prospective customer, supplier or partner of the Company; or (vii) any other
conduct or act determined to be injurious, detrimental or prejudicial to any interest of the Company. 
  
 (b) Rescission. Upon exercise of an Option pursuant to this Stock Option Agreement, the Optionee shall certify in a manner acceptable to the
Company that he or she is in compliance with the terms and conditions of the Plan. In the event a Optionee fails to comply with the provisions of paragraphs (a)(i)-(vii) of this Section 9 prior to, or during the six months after, any exercise,
payment or delivery pursuant to an Option, such exercise, payment or delivery may be rescinded within two years thereafter. In the event of any such rescission, the Optionee shall pay to the Company the amount of any gain realized or payment
received as a result of the rescinded exercise, payment or delivery, in such manner and on such terms and conditions as may be required by the Company, and the Company shall be entitled to set-off against the amount of any such gain any amount owed
to the Optionee by the Company. 
  
 10. Rights as a
Shareholder. The Optionee shall have no rights as a shareholder with respect to any shares which may be purchased by exercise of this Option (including, without limitation, any rights to receive dividends or non-cash distributions with respect
to such shares) unless and until a certificate representing such shares is duly issued and delivered to the Optionee. No adjustment shall be made for dividends or other rights for which the record date is prior to the date such stock certificate is
issued. 
  
 11. Data Privacy. By entering into the Notice
and Stock Option Agreement, the Optionee: (i) authorizes the Company, and any agent of the Company administering the Plan or providing Plan recordkeeping or communication services, to disclose to the Company such information and data as the Company
shall request in order to facilitate the grant of past, present or future options and the administration of the Plan; (ii) waives any data privacy rights he or she may have with respect to such information; and (iii) authorizes the Company to store
and transmit such information in electronic form. 

 12. Adjustment Provisions. 
  
 (a) General. If, through, or as a result of, any merger, consolidation, sale of all or substantially all of the
assets of the Company, reorganization, recapitalization, reclassification, stock dividend, stock split, reverse stock split or other similar transaction, (i) the outstanding shares of Common Stock are increased or decreased or are exchanged for a
different number or kind of shares or other securities of the Company, or (ii) additional shares or new or different shares or other securities of the Company or other non-cash assets are distributed with respect to such shares of Common Stock or
other securities, the Optionee shall, with respect to this Option or any unexercised portion hereof, be entitled to the rights and benefits, and be subject to the limitations, set forth in Section 15(a) of the Plan. 
  
 (b) Board Authority to Make Adjustments. Any adjustments under this
Section 12 will be made by the Board of Directors, whose determination as to what adjustments, if any, will be made and the extent thereof will be final, binding and conclusive. No fractional shares will be issued pursuant to this Option on account
of any such adjustments. 
  
 (c) Limits on Adjustments. No
adjustment shall be made under this Section 12 which would, within the meaning of any applicable provision of the Code, constitute a modification, extension or renewal of this Option or a grant of additional benefits to the Optionee. 
  
 13. Mergers, Consolidation, Distributions, Liquidations Etc. In the
event of (i) a consolidation or merger, (ii) sale of all or substantially all of the assets of the Company in which outstanding shares of Common Stock are exchanged for securities, cash or other property of any other corporation or business entity,
or (iii) a liquidation of the Company, prior to the Expiration Date or termination of this Option, the Optionee shall, with respect to this Option or any unexercised portion hereof, be entitled to the rights and benefits, and be subject to the
limitations, set forth in Section 16(a) of the Plan. 
  
 14.
Withholding Taxes. The Company’s obligation to deliver shares upon the exercise of this Option shall be subject to the Optionee’s satisfaction of all applicable federal, state and local income and employment tax withholding
requirements. 
  
 15. Investment Representations; Legends.

  
 (a) Representations. The Optionee represents, warrants
and covenants that: 
  
 (i) Any shares purchased upon exercise
of this Option shall be acquired for the Optionee’s account for investment only and not with a view to, or for sale in connection with, any distribution of the share in violation of the Securities Act of 1933 (the “Securities Act”) or
any rule or regulation under the Securities Act. 

 (ii) The Optionee has had such opportunity as he or she has deemed adequate to obtain from
representatives of the Company such information as is necessary to permit the Optionee to evaluate the merits and risks of his or her investment in the Company. 
  

(iii) The Optionee is able to bear the economic risk of holding shares acquired pursuant to the exercise of this Option for an indefinite period.

  
 (iv) The Optionee understands that (A) the shares acquired
pursuant to the exercise of this Option may not be registered under the Securities Act and may be “restricted securities” within the meaning of Rule 144 under the Securities Act; (B) such shares cannot be sold, transferred or otherwise
disposed of unless they are subsequently registered under the Securities Act or an exemption from registration is then available; (C) in any event, an exemption from registration under Rule 144 or otherwise under the Securities Act may not be
available for at least two years and even then will not be available unless a public market then exists for the Common Stock, adequate information concerning the Company is then available to the public and other terms and conditions of Rule 144 are
complied with; and (D) there is currently a registration statement on file with the Securities and Exchange Commission with respect to certain shares of Common Stock of the Company, and a registration statement with respect to shares exercisable
under the Plan, but the Company has no obligation to register any shares acquired pursuant to the exercise of this Option under the Securities Act or to keep current any existing registration or prospectus. 
  
 By making payment upon exercise of this Option, the Optionee shall be deemed to have
reaffirmed, as of the date of such payment, the representations made in this Section 15. 
  
 (b) Legends on Stock Certificates. If required by the Company, all stock certificates representing shares of Common Stock issued to the Optionee or any other person upon exercise of this Option shall have
affixed thereto legends substantially in the following forms, in addition to any other legends required by applicable state law: 
  
 “The shares of stock represented by this certificate have not been registered under the Securities Act of 1933 and may not be transferred, sold or
otherwise disposed of in the absence of an effective registration statement with respect to the shares evidenced by this certificate, filed and made effective under the Securities Act of 1933, or an opinion of counsel satisfactory to the Company to
the effect that registration under such Act is not required. The shares of stock represented by this certificate are subject to certain restrictions on transfer contained in an Option Agreement, a copy of which will be furnished upon request by the
issuer.” 

 16. Miscellaneous. 
  
 (a) Except as provided herein, this Option may not be amended or otherwise modified unless evidenced in writing and signed
by the Company and the Optionee. 
  
 (b) All notices under this
Option shall be mailed or delivered by hand to the parties at their respective addresses set forth beneath their names below or at such other address as may be designated in writing by either of the parties to one another one year from the date of
grant. 
  
 (c) This Option shall be governed by and construed in
accordance with the laws of the State of Vermont. 

 Form of Director Stock Option Agreement 
 (to be used in connection with the grant of options with a transferability provision) 
  
 1. Grant of Option. IDX Systems Corporation, a Vermont corporation (the “Company”), hereby grants to
                     (the “Optionee”) an option, pursuant to the Company’s 1995 Director Stock Option Plan (the
“Plan”), to purchase an aggregate of              shares of Common Stock (“Common Stock”) of the Company at a price of
$             per share, purchasable as set forth in and subject to the terms and conditions of this option and the Plan. Except where the context otherwise requires, the term
“Company” shall include the parent and all present and future subsidiaries of the Company as defined in Sections 424(e) and 424(f) of the Internal Revenue Code of 1986, as amended or replaced from time to time (the “Code”).

  
 2. Non-Statutory Stock Option. This option is not
intended to qualify as an incentive stock option within the meaning of Section 422 of the Code. 
  
 3. Exercise of Option and Provisions for Termination. 
  
 (a) Vesting Schedule. Except as otherwise provided in this Agreement, this option shall become exercisable on or after
             and prior to the tenth anniversary of the date of grant (hereinafter the “Expiration Date”). The right of exercise shall be cumulative so that if the option is
not exercised to the maximum extent permissible during any exercise period, it shall be exercisable, in whole or in part, with respect to all shares not so purchased at any time prior to the Expiration Date or the earlier termination of this option.
This option may not be exercised at any time on or after the Expiration Date, except as otherwise provided in Section 3(e) below. 
  
 (b) Exercise Procedure. Subject to the conditions set forth in this Agreement, this option shall be exercised by the Optionee’s delivery of
written notice of exercise to the Treasurer of the Company, specifying the number of shares to be purchased and the purchase price to be paid therefor and accompanied by payment in full in accordance with Section 4. Such exercise shall be effective
upon receipt by the Secretary of the Company of such written notice together with the required payment. The Optionee may purchase less than the number of shares covered hereby, provided that no partial exercise of this option may be for any
fractional share or for fewer than ten whole shares. 
  
 (c)
Continuous Relationship with the Company Required. Except as otherwise provided in this Section 3, this option may not be exercised unless the Optionee, at the time he or she exercises this option, is, and has been at all times since the date
of grant of this option a director of the Company (an “Eligible Optionee”). 
  
 (d) Termination of Relationship with the Company. If the Optionee ceases to be an Eligible Optionee for any reason, then, except as provided in paragraphs (e) and (f) below, the right to exercise this option
shall terminate one year after such cessation (but in no event after the Expiration Date), provided that this option shall be exercisable only to the extent that the 

 Optionee was entitled to exercise this option on the date of such cessation. Notwithstanding the foregoing, if the
Optionee, prior to the Expiration Date, materially violates the confidentiality provisions of any nondisclosure agreement or other agreement between the Optionee and the Company, the right to exercise this option shall terminate immediately upon
such violation. 
  
 (e) Exercise Period Upon Death or
Disability. If the Optionee dies or becomes disabled (within the meaning of Section 22(e)(3) of the Code) prior to the Expiration Date while he or she is an Eligible Optionee, or if the Optionee dies within one year after the Optionee ceases to
be an Eligible Optionee (other than as the result of a termination of such relationship by the Company for “cause” as specified in paragraph (f) below), this option shall be exercisable, within the period of one year following the date of
death or disability of the Optionee (whether or not such exercise occurs before the Expiration Date), by the Optionee or by the person to whom this option is transferred by will or the laws of descent and distribution, provided that
this option shall be exercisable only to the extent that this option was exercisable by the Optionee on the date of his or her death or disability. Except as otherwise indicated by the context, the term “Optionee”, as used in this option,
shall be deemed to include the estate of the Optionee or any person who acquires the right to exercise this option by bequest or inheritance or otherwise by reason of the death of the Optionee. 
  
 (f) Discharge for Cause. If the Optionee, prior to the Expiration
Date, is removed as a director for “cause” (as defined below), the right to exercise this option shall terminate immediately upon such cessation of employment. “Cause” shall mean willful misconduct by the Optionee or willful
failure to perform his or her responsibilities in the best interests of the Company (including, without limitation, breach by the Optionee of any provision of any nondisclosure or other similar agreement between the Optionee and the Company), as
determined by the Company, which determination shall be conclusive. The Optionee shall be considered to have been removed “for cause” if the Company determines, within 30 days after the Optionee’s resignation, that discharge for cause
was warranted. 
  
 (g) Rights of Transferee. A transferee
who has received this option [, or a part thereof,] pursuant to Section 5(c) of the Plan may exercise such option only to the extent that the Optionee is an Eligible Optionee at the time of such exercise, or, after the Optionee has ceased to be an
Eligible Optionee, for the duration and to the extent that the Optionee is permitted to exercise such option pursuant to this Section 3. 
  
 4. Payment of Purchase Price. 
  
 (a) Method of Payment. Payment of the purchase price for shares purchased upon exercise of this option shall be made (i) by delivery to the Company
of cash or a check to the order of the Company in an amount equal to the purchase price of such shares, (ii) subject to the consent of the Company, by delivery to the Company of shares of Common Stock of the Company then owned by the Optionee having
a fair market value equal in amount to the purchase price of such shares, (iii) by any other means which the Board of Directors determines are consistent with the purpose of the Plan and with applicable laws and regulations (including, without
limitation, the provisions of Rule 16b-3 under the Securities Exchange Act of 1934 and Regulation T promulgated by the Federal Reserve Board), or (iv) by any combination of such methods of payment. 

 (b) Valuation of Shares or Other Non-Cash Consideration Tendered in Payment of Purchase Price. For
the purposes hereof, the fair market value of any share of the Company’s Common Stock or other non-cash consideration which may be delivered to the Company in exercise of this option shall be determined in good faith by the Board of Directors
of the Company. 
  
 (c) Delivery of Shares Tendered in Payment
of Purchase Price. If the Optionee exercises this option by delivery of shares of Common Stock of the Company, the certificate or certificates representing the shares of Common Stock of the Company to be delivered shall be duly executed in blank
by the Optionee or shall be accompanied by a stock power duly executed in blank suitable for purposes of transferring such shares to the Company. Fractional shares of Common Stock of the Company will not be accepted in payment of the purchase price
of shares acquired upon exercise of this option. 
  
 (d)
Restrictions on Use of Option Stock. Notwithstanding the foregoing, no shares of Common Stock of the Company may be tendered in payment of the purchase price of shares purchased upon exercise of this option if the shares to be so tendered
were acquired within twelve (12) months before the date of such tender, through the exercise of an option granted under the Plan or any other stock option or restricted stock plan of the Company. 
  
 5. Delivery of Shares; Compliance With Securities Laws, Etc.

  
 (a) General. The Company shall, upon payment of the
option price for the number of shares purchased and paid for, make prompt delivery of such shares to the Optionee, provided that if any law or regulation requires the Company to take any action with respect to such shares before the issuance
thereof, then the date of delivery of such shares shall be extended for the period necessary to complete such action. 
  
 (b) Listing, Qualification, Etc. This option shall be subject to the requirement that if, at any time, counsel to the Company shall determine that
the listing, registration or qualification of the shares subject hereto upon any securities exchange or under any state or federal law, or the consent or approval of any governmental or regulatory body, or that the disclosure of non-public
information or the satisfaction of any other condition is necessary as a condition of, or in connection with, the issuance or purchase of shares hereunder, this option may not be exercised, in whole or in part, unless such listing, registration,
qualification, consent or approval, disclosure or satisfaction of such other condition shall have been effected or obtained on terms acceptable to the Board of Directors. Nothing herein shall be deemed to require the Company to apply for, effect or
obtain such listing, registration, qualification or disclosure, or to satisfy such other condition. 
  
 6. Nontransferability of Option. This option is personal and no rights granted hereunder may be transferred, assigned, pledged or hypothecated in
any way (whether by 

 operation of law or otherwise) nor shall any such rights be subject to execution, attachment or similar process, except
that this option may be transferred (i) by will or the laws of descent and distribution, (ii) pursuant to a qualified domestic relations order as defined in Section 414(p) of the Code, or (iii) pursuant to Section 5(c) of the Plan. Upon any attempt
to transfer, assign, pledge, hypothecate or otherwise dispose of this option or of such rights contrary to the provisions hereof, or upon the levy of any attachment or similar process upon this option or such rights, this option and such rights
shall, at the election of the Company, become null and void. 
  
 7. No Special Employment or Similar Rights. Nothing contained in the Plan or this option shall be construed or deemed by any person under any circumstances to bind the Company to continue the relationship of the Optionee with the
Company for the period within which this option may be exercised. 
  
 8. Rights as a Shareholder. The Optionee shall have no rights as a shareholder with respect to any shares which may be purchased by exercise of this option (including, without limitation, any rights to receive dividends or non-cash
distributions with respect to such shares) unless and until a certificate representing such shares is duly issued and delivered to the Optionee. No adjustment shall be made for dividends or other rights for which the record date is prior to the date
such stock certificate is issued. 
  
 9. Adjustment
Provisions. 
  
 (a) General. If, through or as a
result of any merger, consolidation, sale of all or substantially all of the assets of the Company, reorganization, recapitalization, reclassification, stock dividend, stock split, reverse stock split or other similar transaction, (i) the
outstanding shares of Common Stock are increased or decreased or are exchanged for a different number or kind of shares or other securities of the Company, or (ii) additional shares or new or different shares or other securities of the Company or
other non-cash assets are distributed with respect to such shares of Common Stock or other securities, the Optionee shall, with respect to this option or any unexercised portion hereof, be entitled to the rights and benefits, and be subject to the
limitations, set forth in Section 15(a) of the Plan. 
  
 (b)
Board Authority to Make Adjustments. Any adjustments under this Section 9 will be made by the Board of Directors, whose determination as to what adjustments, if any, will be made and the extent thereof will be final, binding and conclusive.
No fractional shares will be issued pursuant to this option on account of any such adjustments. 
  
 10. Mergers, Consolidation, Distributions, Liquidations Etc. In the event of a merger or consolidation or sale of all or substantially all of the
assets of the Company in which outstanding shares of Common Stock are exchanged for securities, cash or other property of any other corporation or business entity, or in the event of a liquidation of the Company, prior to the Expiration Date or
termination of this option, the Optionee shall, with respect to this option or any unexercised portion hereof, be entitled to the rights and benefits, and be subject to the limitations, set forth in Section 16(a) of the Plan. 

 11. Withholding Taxes. The Company’s obligation to deliver shares upon the exercise of this
option shall be subject to the Optionee’s satisfaction of all applicable federal, state and local income and employment tax withholding requirements. 
  
 12. Investment Representations; Legends. 
  
 (a) Representations. The Optionee represents, warrants and covenants that: 
  
 (i) Any shares purchased upon exercise of this option shall be acquired for the Optionee’s account for
investment only, and not with a view to, or for sale in connection with, any distribution of the shares in violation of the Securities Act of 1933 (the “Securities Act”), or any rule or regulation under the Securities Act. 
  
 (ii) The Optionee has had such opportunity as he or she has
deemed adequate to obtain from representatives of the Company such information as is necessary to permit the Optionee to evaluate the merits and risks of his or her investment in the Company. 
  
 (iii) The Optionee is able to bear the economic risk of
holding such shares acquired pursuant to the exercise of this option for an indefinite period. 
  
 (iv) The Optionee understands that (A) the shares acquired pursuant to the exercise of this option will not be registered under the
Securities Act and are “restricted securities” within the meaning of Rule 144 under the Securities Act; (B) such shares cannot be sold, transferred or otherwise disposed of unless they are subsequently registered under the Securities Act
or an exemption from registration is then available; (C) in any event, an exemption from registration under Rule 144 or otherwise under the Securities Act not be available for at least two years and even then will not be available unless a public
market then exists for the Common Stock, adequate information concerning the Company is then available to the public, and other terms and conditions of Rule 144 are complied with; and (D) there is now no registration statement on file with the
Securities and Exchange Commission with respect to any stock of the Company and the Company has no obligation or current intention to register any shares acquired pursuant to the exercise of this option under the Securities Act. 
  
 (v) The Optionee agrees that, if the Company offers any of
its Common Stock for sale pursuant to a registration statement under the Securities Act, the Optionee will not, without the prior written consent of the Company, offer, sell, contract to sell or otherwise dispose of, directly or indirectly (a
“Disposition”), any shares purchased upon exercise of this option for a period of 90 days after the effective date of such registration statement. 

 By making payment upon exercise of this option, the Optionee shall be deemed to have reaffirmed, as of the date of such
payment, the representations made in this Section 12. 
  
 (b)
Legends on Stock Certificate. All stock certificates representing shares of Common Stock issued to the Optionee upon exercise of this option shall have affixed thereto legends substantially in the following forms, in addition to any other
legends required by applicable state law: 
  
 “The shares of
stock represented by this certificate have not been registered under the Securities Act of 1933 and may not be transferred, sold or otherwise disposed of in the absence of an effective registration statement with respect to the shares evidenced by
this certificate, filed and made effective under the Securities Act of 1933, or an opinion of counsel satisfactory to the Company to the effect that registration under such Act is not required.” 
  
 “The shares of stock represented by this certificate are subject to
certain restrictions on transfer contained in an Option Agreement, a copy of which will be furnished upon request by the issuer.” 
  
 13. Miscellaneous. 
  
 (a) Except as provided herein, this option may not be amended or otherwise modified unless evidenced in writing and signed by the Company and the
Optionee. 
  
 (b) All notices under this option shall be mailed or
delivered by hand to the parties at their respective addresses set forth beneath their names below or at such other address as may be designated in writing by either of the parties to one another. 

 (c) This option shall be governed by and construed in accordance with the laws of the State of Vermont.

  

					
	Date of Grant:	 	IDX Systems Corporation
			
	
	 	By:	 	  

	 	 	Name:	 	 
	 	 	Title:	 	 

  
 OPTIONEE’S
ACCEPTANCE 
  
 The undersigned hereby accepts the foregoing option
and agrees to the terms and conditions thereof. The undersigned hereby acknowledges receipt of a copy of the Company’s current Prospectus for the Plan. 
  

	
	OPTIONEE
	
	

	Name:
	
	 ADDRESS:

	
	

 Form of Addendum to Director Stock Option Agreement 
  
 THIS ADDENDUM is made as of this      day of
            ,             , by and between IDX Systems Corporation (“IDX” or “Company”) and
                             (the “Optionee”). 
  
 Background of Agreement 
  
 The Company has granted to Optionee the options listed below (the
“Options”), on the dates set forth below, under the Company’s 1995 Director Stock Option Plan, as amended (the “Plan”), to purchase the number of shares of Common Stock of the Company at the exercise price per share, each as
set forth below. Each such option is purchasable in accordance with the terms set forth in certain Director Stock Option Agreements (the “Existing Option Agreements”) and is subject to the terms and conditions of the respective Existing
Option Agreement and the Plan. 
  
 Options 
  

					
	 Grant Date

	 	 Number of Shares

	 	 Exercise Price per Share

  
 [Options] 

 
 In connection with an amendment to the Plan approved by the Board of
Directors of the Company on May     , 2003, IDX and Optionee desire to amend each Existing Option Agreement to permit certain transfers by the Optionee of his Options. 
  
 IN CONSIDERATION of the premises, the covenants set forth herein, and other
consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows: 
  

	 	1.	SCOPE AND EFFECT. This Addendum modifies, supplements and becomes a part of each Existing Option Agreement and in the event of any express conflict or inconsistency between the
express terms hereof and the terms of the Existing Option Agreements, the terms of this Addendum shall govern and control. In all other respects, each Existing Option Agreement shall be and remain in full force and effect. 

 

	 	2.	RIGHTS OF TRANSFEREE. Section 3 of each Existing Option Agreement is hereby amended by adding the following as a new Section 3(g): 

  
 “(g) Rights of Transferee. A transferee who has received this
option[, or a part thereof,] pursuant to Section 5(c) of the Plan may exercise such option only to the extent that the Optionee is an Eligible Optionee at the time of such exercise, or, after the Optionee has ceased to be an Eligible Optionee, for
the duration and to the extent that the Optionee is permitted to exercise such option pursuant to this Section 3.” 

	 	3.	NONTRANSFERABILITY OF OPTION. Section 6 of each Existing Option Agreement is hereby amended and restated as follows: 

  
 “6. Nontransferability of Option. This option is personal and no
rights granted hereunder may be transferred, assigned, pledged or hypothecated in any way (whether by operation of law or otherwise) nor shall any such rights be subject to execution, attachment or similar process, except that this option may be
transferred (i) by will or the laws of descent and distribution, (ii) pursuant to a qualified domestic relations order as defined in Section 414(p) of the Code, or (iii) pursuant to Section 5(c) of the Plan. Upon any attempt to transfer, assign,
pledge, hypothecate or otherwise dispose of this option or of such rights contrary to the provisions hereof, or upon the levy of any attachment or similar process upon this option or such rights, this option and such rights shall, at the election of
the Company, become null and void.” 
  
 IN WITNESS WHEREOF,
the parties hereto have caused this Addendum to be executed as of the date first set forth above. 
  

			
	IDX SYSTEMS CORPORATION
		
	By:	 	  

	 	 	James H. Crook, Jr.
	 	 	Chief Executive Officer

  
 OPTIONEE’S
ACCEPTANCE 
  
 The undersigned hereby accepts the foregoing
Addendum and agrees to the terms and conditions thereof. 
  

	
	OPTIONEE
	
	

	Name:AMENDMENT TO DISTRIBUTION AND DEVELOPEMENT AGREEMENT

 Exhibit 10.32 
  
 Confidential Materials omitted and filed separately with the 
 Securities and Exchange Commission. Asterisks denote omissions. 
  
 AMENDMENT TO DISTRIBUTION AND DEVELOPMENT AGREEMENT 
  
 This Amendment (“Amendment”) is made effective as of January 1, 2004 (the “Amendment Effective Date”) by and between,
STENTOR, INC., a Delaware corporation (“Stentor”), and IDX SYSTEMS CORPORATION, a Vermont corporation (“IDX”). 
  
 RECITALS 
  
 A. Stentor and IDX entered into a Distribution and Development Agreement dated November 15, 2000 (the “Original Agreement”),
pursuant to which they agreed (i) to engage in development to facilitate the integration of certain Stentor products for archiving and viewing medical images and certain IDX products for automating the management of work flow in radiology practices
and departments, and (ii) thereby to offer an integrated system for medical image management. 
  
 B. The parties have succeeded in offering such integrated system in North America, and now wish to amend certain provisions of the
Original Agreement (as amended, including as amended by this Amendment, the “Agreement”) for the remainder of the Initial Term, ending November 15, 2005. 
  
 C. Among other things, the parties wish to continue their relationship during the remainder of the Initial
Term (from January 1, 2004 to November 15, 2005) on a different basis such that, subject to the terms and conditions of the Agreement, (i) each party (each a “Licensee Party”) would have the worldwide right (but no obligation) to
distribute the designated products of the other party (each a “Licensor Party”) as part of the MIMS System on a nonexclusive basis using the Licensee Party’s own branding, (ii) each Licensor Party would use commercially reasonable
efforts to make available APIs to allow the Licensee Party to make calls to data elements of such Licensor Party products as part of the MIMS System, and (iii) each Licensor Party would continue to provide second-level support to the Licensee Party.

  
 NOW, THEREFORE, in consideration of the
mutual covenants and other terms and conditions set forth herein, the parties hereby agree as follows: 
  
 AGREEMENT 
  

	1.	Sections 4.1.1 through 4.1.5 will be deleted in their entirety and replaced with the following: 

  
 4.1.1 Additional API Request Process. 
  
 (a) As soon as reasonably practicable, but in no event later than January 9, 2004, IDX may provide to
Stentor a detailed list of Stored Data Elements of Stentor to which IDX would like to interface. As soon as reasonably practicable, but in no event later than January 30, 2004, Stentor shall respond to such list with an indication as to (a) whether
it believes it is commercially 

 practicable to permit IDX to interface to such Stored Data Elements and (b) if so, the estimated schedule
for any development that would reasonably be required in connection with making available access to such Stored Data Elements (e.g., developing the related APIs). If the parties cannot agree on the commercial practicability and development schedule
for the requested Stored Data Elements, the parties shall meet no later than February 9, 2004 and use commercially reasonable efforts to reach agreement by February 13, 2004. If the parties cannot agree by February 13, 2004, each party may escalate
the matter, and the parties will engage in mediation to resolve the dispute, in accordance with the process set forth in Section 10.19. Stentor shall undertake commercially reasonable efforts to implement the mutually agreed APIs by version 3.5 of
the Stentor Products, which Stentor anticipates being released in approximately the third calendar quarter of 2004, and to the extent commercially reasonable efforts would not allow inclusion in version 3.5 but would in the subsequent version, by
such subsequent version. The period between the Amendment Effective Date and the release of version 3.5 of the Stentor Product is referred to herein as the “Catch-Up Period”. Thereafter, during the remainder of the Initial Term, each party
(as Licensee Party) may (no more often than twice a year) make a request for additional Stored Data Elements of the Licensor Party to which the Licensee would like to interface, and the Licensor Party will respond with an indication as to (i)
whether it believes it is commercially practicable to permit the Licensee Party to interface to such Stored Data Elements, and (ii) if so, the estimated schedule for any development that would be reasonably required in connection with making
available such Stored Data Elements (e.g., developing related APIs). If the parties cannot agree on such issues, each party may escalate the matter, and the parties will engage in mediation to resolve the dispute, in accordance with the process set
forth in Section 10.19. The parties anticipate that the work described above will require approximately one engineer (full-time equivalent) after the Catch-Up Period, and that Stentor likely will need to devote additional resources during the
Catch-Up Period. For purposes of this Section 4.1.1, “Stored Data Elements” means (A) in the case of Stentor, data elements stored by Stentor that are received by Stentor either through interface messaging, such as HL7, or through DICOM
messages associated with an image, or the Stentor-stored output of functional events generated by routines provided or accessed by Stentor (e.g., measurements, 3D analysis outputs), and (B) in the case of IDX, data elements stored by IDX that are
received by IDX or the IDX-stored output of functional events generated by routines provided or accessed by IDX. 
  
 (b) Each party (as Licensee Party) shall, at the Licensor Party’s request, dedicate resources to be and remain knowledgeable about
and up to date on the products of the other party (i.e., the Stentor Products or IDX Products, as applicable), including their APIs. Such efforts shall include dedicating no less than one (1) person to working on APIs with the Licensor Party and
having such person(s) attend training sessions at the Licensor Party’s request regarding APIs. 
  

 2 

 (c) Each party (as Licensee Party) shall use commercially reasonable efforts to make use
of existing APIs of the Licensor Party before requesting access to additional data elements or the development of any new APIs of the Licensor Party. In any event, the Licensor Party will have no obligation to make available any data element,
provide any API or engage in any other activity that would or could reasonably affect the existing or future integrity, stability, compatibility, functionality or performance of any product (including any data used by a product). 
  
 (d) Each party (as Licensee Party) may use data elements and
APIs made available by the Licensor Party (including any related materials or information) solely as part of the MIMS System to allow the Licensee Party products included in the MIMS System to interface to data stored by the Licensor Party’s
products included in the MIMS System. The above limitation shall not apply to data elements and APIs supporting industry standards, e.g., DICOM Query Retrieve. 
  

(e) Should either party (as Licensee Party) enter into any agreement with a third party that involves access to or use of any data
element or APIs of the Licensor Party by a product or service of the third party, the Licensee Party shall not include any exclusivity or other similar provision affecting the right of the third party and the Licensor Party to work together or to
have the third-party product or service interface with products of the Licensor Party. 
  
 4.1.2 Early Test Participation. To the extent consistent with third-party contractual obligations, each Licensor Party shall provide to the Licensee Party the opportunity to participate in early testing
programs for new releases of the Stentor Products (in the case of Stentor) or IDX Products (in the case of IDX) to be available to the Licensee Party for use as part of the MIMS System. The parties acknowledge and agree that the purpose of such
participation is intended to permit the Licensee Party to provide feedback at the alpha or beta product stage no later than any other customer of the Licensor Party. The parties also acknowledge and agree that participation in such early testing is
subject to the reasonable requirements of the Licensor Party, including, but not limited to, testing only in a non-production environment on a separate server, appropriate disclaimers of liability and warranties, reasonable confidentiality and
security terms, the receipt of useful feedback from the Licensee Party, and the availability of a competent technical coordinator at the Licensee Party for such testing. 
  
 4.1.3 Web Compatibility. IDX acknowledges that Stentor is migrating to a Web services-based platform that will not
support existing APIs. The general release of the version of the Stentor Products that does not support existing APIs will in no event occur earlier than November 15, 2005. IDX acknowledges that for Stentor Products not on the above-mentioned Web
services-based platform, Stentor’s commercially reasonable efforts to provide support, as specified in Section 8.1 of the Agreement, shall thereafter be limited to bug fixes (i.e., 
  

 3 

 correction of errors and nonconformity with Stentor’s published documentation). Stentor acknowledges
and agrees that it will maintain backwards compatibility of existing APIs from the Amendment Effective Date until November 15, 2005, except for reasonable changes required for maintenance or support purposes (e.g., to resolve unintended API
conflicts). 
  

	2.	Sections 5.1 and 5.2 shall be replaced in their entirety with the following, which shall be deemed to be effective as of the Effective Date of the Original Agreement:

  
 5.1 Ownership; In General. Except for
the rights expressly granted herein to Stentor, IDX reserves and retains all right, title and interest (including without limitation patents, trade secrets and copyrights) in the IDX Products, and all customizations, additions, modifications,
changes, enhancements, improvements, and derivative works thereof made by IDX or by a third party on behalf of IDX, and all rights therein and copies thereof. Except for the rights expressly granted herein to IDX, Stentor reserves and retains all
right, title and interest (including without limitation patents, trade secrets and copyrights) in the Stentor Products, and all customizations, additions, modifications, changes, enhancements, improvements, and derivative works thereof made by
Stentor, or by a third party on behalf of Stentor, and all rights therein and copies thereof. 
  
 5.2 Ownership to Works Created Under the Development Plan. 
  
 (a) Any Intellectual Property developed by Stentor and any derivative works of Stentor Products developed by
Stentor or a third party contractor of Stentor pursuant to the Development Plan shall be owned by Stentor. Any Intellectual Property developed by IDX and any derivative works of IDX Products developed by IDX or a third party contractor of IDX
pursuant to the Development Plan shall be owned by IDX. Any Intellectual Property jointly developed by IDX and Stentor (i.e., patents or trade secrets as to which employees or contractors of both parties are joint inventors or copyrightable subject
matter as to which the parties or their employees or contractors are joint authors) pursuant to the Development Plan shall be jointly owned by IDX and Stentor and each of IDX and Stentor (or any successor to, or assignee of, or licensee of IDX or
Stentor) shall be free to use such Intellectual Property without interference from the other party and without any obligation to make any payment or account for any profits, except as otherwise provided for in this Agreement. Such joint ownership
shall apply only to the specific modules, elements or other subject matter that are the result of the joint development, and not to other modules, elements or other subject matter. Notwithstanding any previous assertions by the parties to the
contrary, the provisions in this Amendment set forth the parties’ understanding and intent with respect to the ownership of Intellectual Property. 
  
 (b) Each party believes that it has not made and that it will not make any patent application for a patent constituting a Conflicting
Patent that covers the core technology of the other party. “Conflicting Patent” means such a patent that 
  

 4 

 is applied for before or within one year after the Amendment Effective Date for an invention made before
the Amendment Effective Date resulting from joint development efforts under the Development Plan where the invention (i) is based on the technology of the other party and (ii) is directed toward and embodied in a PACS system (in the case of IDX as
patent holder) or a product for automating the management of work flow in radiology practices and departments (in the case of Stentor as patent holder). If a party believes that an issued patent of the other party is a Conflicting Patent, then the
parties shall discuss in good faith the facts and circumstances regarding such patent and whether such patent constitutes a Conflicting Patent and, if so, the possibility of a license of such patent. If the parties cannot reach agreement as to the
appropriate treatment of such patent, then either party may submit the matter to a mutually agreeable third party for nonbinding mediation in accordance Section 10.19. 
  

	3.	Section 5.3.1 shall be replaced in its entirety with the following: 

  
 5.3.1 IDX hereby grants to Stentor a non-exclusive, non-transferable (except as provided in Sections 2.4 and 10.14) term license to market and sublicense,
and in connection therewith to sell, offer for sale, copy, use, distribute, perform, display, modify, make derivative works of and Merge, the IDX Products, only as they may be Merged into the MIMS System, provided that (subject to Section 5.6)
Stentor may do so only to Persons that are not Stentor License Exclusion Customers. Notwithstanding the limited scope of this license, Stentor may communicate with, and demonstrate, perform and display the MIMS System to, Stentor License Exclusion
Customers to make them aware of the availability of the MIMS System from IDX and to provide information to Stentor License Exclusion Customers regarding the MIMS System. “Stentor License Exclusion Customers” shall mean those customers in
the Territory or [**] that meet the definition of “Stentor License Exclusion Customers” in the Agreement and have been included in the parties’ list of Stentor License Exclusion Customers as of the Amendment Effective Date (an initial
version of which shall be provided by the parties no later than fifteen (15) business days after execution of this Amendment), as such list may be modified by the parties from time to time in accordance with the Agreement. 
  

	4.	Section 5.4 and 5.5 shall be replaced in their entirety with the following: 

  

5.4 Stentor Products. Stentor hereby grants to IDX a non-exclusive, non-transferable (except as provided in Sections 2.4 and 10.14) term license
to market and sublicense (including through one or more Distribution Partners acceptable to Stentor), and in connection therewith to sell, offer for sale, copy, use, distribute, perform, display, modify, make derivative works of and Merge, the
Stentor Products, only as they may be Merged into the MIMS System. 
  
 5.5 Territory. This Agreement, including the licenses granted hereunder, shall apply to the parties worldwide, provided that the Parties will be subject to certain restrictions in the Territory (as well as in [**]) as set forth in
Section 6.1. The “Territory” is redefined to mean the [**]. 
  

 5 

	5.	The parties acknowledge and agree that nothing in the Agreement restricts the use of the MIMS System by either party (as Licensee Party) to, or changes the pricing for, any
particular field of use (i.e., there is no restriction on use in, or difference in pricing for use in, medical specialties other than radiology), provided that the foregoing will not imply any obligation to provide (a) additional support as a result
of use outside radiology, (b) any APIs to support use outside radiology, or (c) any products designed for use outside radiology (i.e., other than the Stentor Products and IDX Products included in the MIMS System). 

  

	6.	Section 5.6 shall be replaced in its entirety with the following: 

  
 5.6 Treatment of Stentor License Exclusion Customers. If a Stentor License Exclusion Customer (other than existing customers of Stentor as set
forth in Attachment A, which Attachment A will be completed within fifteen (15) business days after execution of this Amendment) seeks to acquire the MIMS System from Stentor, Stentor will inform the customer that it should contact IDX. If the
customer nonetheless expresses an interest in acquiring the MIMS System from Stentor, Stentor will notify IDX and will refrain for a period of forty-five (45) days (after such notice) from sales activities targeted at the customer. Forty-five (45)
days after Stentor has provided the above-referenced notice to IDX, Stentor may contact the customer and, if the customer remains interested in acquiring the MIMS System from Stentor, the customer shall be deemed not to be a Stentor License
Exclusion Customer. Should the customer (other than the customers set forth in Attachment A) then purchase the MIMS System from Stentor, Stentor shall (unless the parties otherwise agreed) pay IDX [**] percent ([**]%) above the normal royalty for
such MIMS System for the remainder of the Interim Term, and shall further pay IDX half of the commission that would normally be payable to Stentor’s sales force for making such sale if the customer were not a Stentor License Exclusion Customer.
This Section 5.6 shall apply to customers within the Territory and the [**] but not elsewhere. Stentor acknowledges that it will provide IDX with appropriate current and future product information required for IDX to effectively represent the MIMS
System to prospective customers, when Stentor provides such information generally to Stentor’s own sales force, and promptly respond to IDX inquiries regarding the MIMS System, with the objective that IDX sales representatives should be no less
informed about the MIMS System than their Stentor counterparts. IDX acknowledges that Stentor will provide the information and related training to IDX’s sales trainers and that IDX is responsible for disseminating the information to IDX’s
sales representatives. 
  

	7.	The following Section 5.7 will be added to the Agreement: 

  
 Each party (as Licensee Party) acknowledges that the other party (as Licensor Party) will have control over its own APIs, including the right to negotiate

  

 6 

 licenses for the APIs with third parties. Notwithstanding the above, this Section 5.7 shall not be
construed to prevent, or require additional payment for, any APIs licensed or otherwise provided by the Licensor Party to the Licensee Party from being used by the Licensee Party in connection with Providing a MIMS System under the Agreement, even
if such use includes providing the APIs to a third party, provided that such third party has entered into the Licensor Party’s form of license agreement with respect to such APIs (which form will not require third party-by-third party execution
by the Licensor Party) and provided that a copy of each such license agreement is delivered to the Licensor Party. The parties acknowledge that the foregoing does not apply to industry standard interfaces such as DICOM Query Retrieve. 
  

	8.	The parties agree that the IDX Drivers (including any updates and upgrades to IDX Drivers and any new IDX Drivers) will, effective as of the Amendment Effective Date, be included in
the licenses granted and the services provided by IDX to Stentor (to the same extent as the other IDX Products) and that no separate license or maintenance fees will be payable with respect thereto. 

  

	9.	The following sentences shall be added to Section 6.1.1 after the first sentence of Section 6.1.1 (i.e., the sentence beginning “Stentor shall not (i) Provide” and ending
“Stentor Products in the Territory”): 

  
 Stentor shall not authorize or license [**], or the successor of any of them, to Provide the MIMS System or the Stentor Products in the [**]. Nothing in this Section 6.1.1 shall be construed to prohibit or disturb any relationship between
Stentor and any third party (including a third party that may become a successor to [**]) to the extent such relationship was not and is not formed in breach of the Agreement (and, for purposes of this Section 6.1.1, “successor” of an
entity means the business operation of such entity, but does not include the other business operations of such third party). 
  

	10.	Section 6.2 is deleted in its entirety. 

  

	11.	The obligations set forth in Sections 6.3 and 6.4 regarding the use of the other party’s marks are no longer in effect. The rights set forth in Sections 6.3 and 6.4 regarding
the use of the other party’s marks will remain in effect only until December 31, 2004. After such time, the affected party shall not use any of the names, marks or branding of the other party in or with the affected party’s products or in
marketing, support or distribution activities (including press or public relations materials). Nothing in the foregoing shall be deemed to prohibit a party from making factual descriptions regarding the other party’s products in general
materials about such party and its products (provided that the materials are not designed for marketing, press or public relations purposes). 

  

 7 

	12.	Section 7.1 shall be replaced in its entirety with the following: 

  
 7.1 Compensation; Payment. IDX and Stentor shall be entitled to compensation for their respective licensing to the other of their respective rights
and technology incorporated into the MIMS System as set forth in the amended Exhibit E attached to the Amendment. The compensation schedule set forth in the amended Exhibit E will become effective as of December 31, 2003 (and the “true
ups” contemplated by such amended Exhibit E will constitute the final resolution of any royalties, reimbursements or other payments required for the period before December 31, 2003 and are due and payable as of December 31, 2003). 

 

	13.	The parties acknowledge that, while their rights under this Agreement with respect to the other’s products (i.e., the IDX Products and Stentor Products) are worldwide as of the
Amendment Effective Date, the parties’ support obligations as to countries outside the Territory will not be materially greater than such obligations as to countries in the Territory (e.g., IDX would not be obligated to fix a [**] bug, but
would be obligated to address a technical error that could also occur in a country in the Territory) unless the other party agrees to pay for the additional support work (the cost of which additional work the parties will negotiate in good faith,
and, if the parties are unable to agree on such cost, the party will carry out the work on a time and materials basis, at reasonable rates and on other terms and conditions which are, as a whole, no less favorable to the other party than those made
available to comparable customers of the party doing the work for comparable work). 

  

	14.	IDX and Stentor represent and warrant that their statements in Sections 9.1.3 and 9.2.3, respectively, with respect to patents are true, to such party’s knowledge, up to and as
of the Amendment Effective Date, and the parties make no further representations and warranties as to noninfringement of patents. 

  

	15.	Section 10.1 shall be replaced in its entirety with the following, which shall be deemed to be effective as of the Effective Date of the Original Agreement:

  
 10.1.1 Confidential Information. Each
Party (as “Receiving Party”) shall use the same care and measures to prevent the unauthorized disclosure and dissemination of the Confidential Information of the other Party (as “Disclosing Party”) as the Receiving Party uses for
its own confidential information or material of a similar nature. Such measures may include instructing and requiring recipients of Confidential Information to maintain the confidentiality of such Confidential Information and restricting disclosure
of such Confidential Information to those representatives of the Receiving Party and its affiliates, its and their contractors, suppliers and licensees, and other authorized third parties who have a “need to know” consistent with the
purposes for which such Confidential Information is disclosed, if and to the extent the Receiving Party uses such measures for its own confidential information or material of a similar nature. The Receiving Party further agrees not to remove or
destroy any proprietary rights or confidentiality legends or markings placed upon any documentation or other materials by the Disclosing Party. 
  

 8 

 “Confidential Information” means any technology, information and materials related to research,
products, services, hardware or software, inventions, processes, designs, drawings, engineering or other technology that is supplied or licensed by either party after the Effective Date (as the Disclosing Party) to the other party (as the Receiving
Party) and which is designated in writing as proprietary or confidential (or with a similar designation) or, if disclosed orally or by demonstration, is designated as confidential or proprietary at the time of disclosure and summarized in a writing
so designated within thirty (30) days of the initial disclosure. 
  
 10.1.2 Non-Confidential Information; Permitted Disclosures. Confidential Information shall not include, however, information or material which (i) is or becomes available to the relevant public other than as a result of a wrongful
act or omission by the Receiving Party, (ii) was available to the Receiving Party (without a duty of confidentiality owed to the Disclosing Party with respect to such information or material) prior to its receipt from the Disclosing Party, (iii)
becomes available to the Receiving Party from a Person not otherwise bound by a confidentiality agreement with the Disclosing Party with respect to such information or material, or (iv) was independently developed by the Receiving Party without use
of the Disclosing Party’s Confidential Information. Further, notwithstanding Section 10.1.1, the Receiving Party may disclose the Disclosing Party’s Confidential Information in the event that the Receiving Party is required (by the
disclosure requirements of any rule, regulation, or form of any governmental authority or securities exchange or by interrogatories, requests for information or request for documents by any governmental authority or other party in legal proceedings,
subpoenas, civil investigative demands, or other similar processes) to disclose such Confidential Information, provided that the Receiving Party so required shall provide the Disclosing Party with prompt written notice of any such requirement so
that the Disclosing Party may object to production and seek a protective order or other appropriate remedy, and/or waive compliance with the provisions of this Agreement. If the Disclosing Party objects to production and seeks a protective order or
other appropriate remedy, the Receiving Party shall exercise commercially reasonable efforts (at the sole expense of the Disclosing Party) to cooperate, including, without limitation, by cooperating with the Disclosing Party to obtain an appropriate
protective order or other reasonable assurance that confidential treatment will be accorded such Confidential Information. 
  
 10.1.3 Residuals. Notwithstanding anything in the Agreement to the contrary, either party may use or disclose residual information for any purpose,
including without limitation use in development, manufacture, promotion, sale and maintenance of its products and services, provided that this right to residual information does not constitute and shall not imply a license under any patents or
copyrights of the other party. “Residual information” means any information that is retained in the unaided memories of a party’s personnel without ongoing use of 
  

 9 

 the tangible embodiment of the other party’s Confidential Information. An individual’s memory
is unaided if the individual has not intentionally memorized the Confidential Information for the purpose of retaining and subsequently using or disclosing it. 
  

	16.	The following sentences shall be added to the end of Section 10.3: 

  
 Each party shall apply for and use commercially reasonable efforts to obtain by December 2004 the necessary regulatory and other approvals and clearances
(e.g., Food and Drug Administration 510(k) premarketing approvals or clearances or the equivalent) required for its activities hereunder (including the sale or license of the MIMS System) at each party’s own sole expense and responsibility.
Each party shall reasonably confer and cooperate with the other party to assist the other party in complying with any applicable export control regulations. Each party agrees that, if and for so long as it uses or operates under any regulatory or
other approvals or clearances of the other (a) it will comply strictly with the other party’s quality system requirements, including those for integration, installation, training and support, as required to maintain the MIMS System in
compliance with such regulatory or other approvals or clearances, and (b) it will not Provide the MIMS Systems unless it is in compliance with the regulatory or other approvals or clearances. 
  

	17.	Section 10.6 (but not Section 10.6.1 through 10.6.4) shall be replaced in its entirety with the following: 

  
 Each party (an “Indemnifying Party”) will defend the other party,
its officers, employees, and agents (each an “Indemnified Party”) against, and pay any damages (including costs and attorneys’ fees) awarded against an Indemnified Party by a court of competent jurisdiction (or pay any settlement of
such claim agreed to by the Indemnifying Party) (“Losses”) resulting from, any claim, suit, or demand by any third party (“Third Party Claim”) (i) for injuries to or deaths of persons or loss of or damage to property arising out
of the Indemnifying Party’s products or services as provided to the Indemnified Party, unless the Indemnified Parties shall have acted outside the scope of their rights under this Agreement or the injuries, death, loss or damage results from an
act or omission of the Indemnified Party; (ii) for injuries to or deaths of persons or loss of or damage to property arising out of the willful misconduct of the Indemnifying Party, its employees, officers, or agents in connection with the
Indemnifying Party’s performance of this Agreement, except to the extent caused by the negligence of any Indemnified Party; and (iii) that the Indemnifying Party’s products, or any component thereof, as provided to the Indemnified Party
infringes any patents, copyrights, trademarks, trade secrets or other proprietary rights of the third party. 
  

 10 

	18.	Section 10.6.2 shall be replaced in its entirety with the following: 

  
 An Indemnified Party shall notify the Indemnifying Party promptly of any claim for which the Indemnifying Party is responsible and shall cooperate with
the Indemnifying Party in every commercially reasonable way to facilitate the defense of any such claim, provided that the Indemnified Party’s failure to notify the Indemnifying Party shall not diminish the Indemnifying Party’s obligations
under this Section except to the extent that the Indemnifying Party is materially prejudiced as a result of such failure. The Indemnified Party shall authorize and allow Indemnifying Party to have sole control of the defense and settlement of the
claim, provided that that the Indemnifying Party shall not, without the consent of the Indemnified Party, enter into any settlement or agree to any disposition that imposes an obligation on the Indemnified Party that is not wholly discharged or
dischargeable by the Indemnifying Party, or imposes any conditions or obligations on the Indemnified Party other than the payment of monies that are readily measurable for purposes of determining the monetary indemnification or reimbursement
obligations of Indemnifying Party. An Indemnified Party shall at all times have the option to participate in any matter or litigation through counsel of its own selection and at its expense. 
  

	19.	The addresses for the parties in Section 10.9 shall be replaced with the following: 

  
 Stentor, Inc. 
 5000 Marina Boulevard 
 Brisbane, CA 94005-1811 
 Attention: Oran Muduroglu 
 Facsimile: 650-228-5566 
  
 With a copy to the Corporate Counsel of Stentor. 
  
 IDX Systems Corporation 
 40 IDX Drive 
 P.O. Box 1070 
 Burlington, VT 05402-1070 
 Attention: President 
 Facsimile: 802-865-3681 
  
 With a copy to the General Counsel of IDX. 
  

	20.	The following sentences shall be added to the end of Section 10.10: 

  
 Without limitation of the generality of the foregoing, the parties acknowledge that the requirements of this Section 10.10 apply to statements concerning
the relationship between IDX and Stentor—for example “end-of-life” plans for the MIMS System, limitations on further development of the MIMS System, and limitations on support for the MIMS System. The parties will work together to
agree on how such matters will be described and will instruct appropriate marketing and sales personnel to be consistent with such mutually agreed to descriptions in their marketing and sales activities. 
  

 11 

	21.	Section 10.14 shall be replaced in its entirety with the following: 

  
 10.14 Assignment. This Agreement shall be binding upon the parties and their respective successors and permitted assigns and their Affiliates
Controlled by them, respectively. Neither party may assign this Agreement without the prior written consent of the other party, except that either party hereto may assign this Agreement to any Person that acquires all or substantially all of the
assets of (i) in the case of IDX, IDX’s Radiology Information Systems Division, and IDX shall be relieved of any obligation or liability hereunder, or (ii) in the case of Stentor, Stentor’s PACS business, and Stentor shall be relieved of
any obligation or liability hereunder. If (i) IDX shall sell or transfer any of its assets, other than the assets of IDX’s Radiology Information Systems Division, to a Person that is not an Affiliate of IDX, or if (ii) Stentor shall sell or
transfer any of its assets, other than the assets of the PACS business, to a Person that is not an Affiliate of Stentor, then such Person shall not have any obligations or liabilities under this Agreement and the assets transferred shall not be
encumbered by or subject to this Agreement in any way. 
  

	22.	The following sentence shall be added to the end of Section 10.19: 

  
 Except as provided herein, no civil action with respect to any dispute, claim or controversy arising out of or relating to this Agreement may be commenced
until the matter has been submitted for mediation as described below. Either party may commence such mediation by providing to the other party a written request for mediation, setting forth the subject of the dispute, claim or controversy and the
relief requested. The parties will cooperate with one another in selecting a mediator and in scheduling the mediation proceedings. The parties covenant that they will participate in the mediation in good faith, and that they will share equally in
its costs. All offers, promises, conduct and statements, whether oral or written, made in the course of the mediation by any of the parties, their agents, employees, experts and attorneys, and by the mediator, are confidential, privileged and
inadmissible for any purpose, including impeachment, in any litigation or other proceeding involving the parties, provided that evidence that is otherwise admissible or discoverable shall not be rendered inadmissible or non-discoverable as a result
of its use in the mediation. Notwithstanding the foregoing, either party may seek equitable relief, whether or not prior to commencement of the mediation (e.g., to preserve the status quo pending the completion of the mediation process or to prevent
irreparable harm). Except for such an action to obtain equitable relief, neither party may commence a civil action with respect to the matters submitted to mediation until after the completion of the initial mediation session, or forty-five (45)
days after the filing of the written request for mediation, whichever occurs first. Mediation may continue after the commencement of a civil action, if the parties so desire. The provisions of this Section 10.19 may be 
  

 12 

 enforced by any court of competent jurisdiction, and the party prevailing in the enforcement action shall
be entitled to an award of fees, costs and expenses, including attorney’s fees, as the court ordering the enforcement may determine to be equitable. 
  

	23.	Continuation of Provisions. Except as expressly set forth herein, all other terms and conditions of the Original Agreement shall remain in full force and effect. In the event
of any inconsistency or conflict between this Amendment and the Original Agreement, the terms, conditions and provisions of this Amendment shall supersede the Original Agreement and shall govern and control. Except as expressly defined or otherwise
modified herein, all capitalized terms in this Amendment have the same meanings as set forth in the Original Agreement. If a defined term is defined both in this Amendment and in the Original Agreement, then the term shall have the meaning set forth
in this Amendment. 

  

	24.	Authorization. Each party represents and warrants that it possesses the right and capacity to enter into this Amendment. Each party represents and warrants to the other party
that this Amendment has been duly authorized, executed and delivered by it and constitutes its valid and legally binding agreement with respect to the subject matter contained herein. 

  

	25.	Entire Agreement. The Original Agreement, as amended by this Amendment, constitutes the complete and exclusive statement of the agreement between the parties and supersedes
all prior and contemporaneous proposals and understandings, oral and written, relating to the subject matter contained therein. 

  
 IN WITNESS THEREOF, the parties have executed this Amendment by their duly authorized representatives. 
  

			
	 STENTOR, INC.
	 	 IDX SYSTEMS CORPORATION

		
	 /s/ Oran Muduroglu

	 	 /s/ James H. Crook, Jr.

	 Oran Muduroglu
	 	 James H. Crook, Jr.

	 Printed Name
	 	 Printed Name

		
	 Title President
	 	 Title Chief Executive Officer

		
	 Date 12/31/03
	 	 Date 12/31/03

  
  

 13 

 Exhibit E to the Amendment to the Distribution and Development Agreement 
  
 I. Scope. 
  
 A. Payment Structure 
  
 Payments between the parties will consist of four components: (1) Initiation Royalties paid
upon execution of a new customer agreement, (2) Sustaining Royalties paid over the life of a customer agreement, (3) a fee for dormant archives and (4) one-time true-up payments for outstanding liabilities. 
  
 B. Transition to New Payment Structure 
  
 Contracts signed after June 30, 2003 will be covered solely by the provisions described in
this Exhibit and not by the payment provisions of the un-amended Agreement. Contracts signed prior to July 1, 2003 will be treated as follows: 
  

	 	1.	All royalties recorded and paid prior to July 1, 2003 will be retained. 

  

	 	2.	Royalties paid since July 1, 2003 shall be reversed as described in Section V.C.1 below. 

  

	 	3.	Contracts signed prior to July 1, 2003 will not be subject to an Initiation Royalty or any Sustaining Royalty for Managed Study Volume incurred prior to July 1, 2003.

  

	 	4.	Contracts signed prior to July 1, 2003 will be subject to Sustaining Royalties beginning July 1, 2003. Their studies will be included in Managed Study Volume for purposes of
determining the Sustaining Tier Rate. 

  
 II.
Calculating Initiation Royalties. 
  
 The party entering into a contract
subject to these terms (the “Contracting Party”) will pay to the other party an “Initiation Royalty” at the end of each calendar quarter. Such Initiation Royalty will be based on [**] and [**] for the [**] that the Contracting
Party enters into during the year. The Initiation Royalty will be calculated by multiplying the [**] times [**] 
  
 Initiation Royalty = [**] x [**] 
  

 1 

 A. Definition of Average Annual Studies 
  
 Average Annual Studies is the sum of [**] for all MIMS System contracts for Diagnostic
and/or Archive products signed during a quarter. 
  
 Contracts shall include both
(1) new contracts and (2) additional volume/duration contracts for an existing customer. For each contract included in the calculation, its contribution shall be the higher of [**], summed for all years of the contract term (not to exceed 7 years),
divided by the years of the contract term (not to exceed 7 years). Such projection will be based on the Contracting Party’s good faith estimate at the time of execution of the agreement. Each Party shall estimate in advance the Average Annual
Studies it expects to sign during the ensuing year (“Estimated Average Annual studies”). That estimate shall be the basis for determining the Initiation Tier Rate as defined below. 
  
 Average Annual Studies = Total of (Number of estimated studies under a
given contract (for up to seven years) / number of years in contract (for up to seven years)) 
  
 Example for 3 contracts signed in Q1’2004 (studies in thousands): 
  

													
							
	 	  	Avg.

	  	Yr1

	  	Yr2

	  	Yr3

	  	Yr4

	  	Yr5

	 Contract #1
	  	[**]	  	[**]	  	[**]	  	[**]	  	[**]	  	[**]
							
	 Contract #2
	  	[**]	  	[**]	  	[**]	  	[**]	  	[**]	  	 
							
	 Contract #3
	  	[**]	  	[**]	  	[**]	  	[**]	  	 	  	 
							
	 	  	[**]	  	 	  	 	  	 	  	 	  	 
	
	 Average Annual Studies – [**]

  
 B. Definition of
Initiation Tier Rate 
  
 For Diagnostic and/or Archive Contracts:

  
 The Initiation Tier Rate is the rate charged [**] to compute the
Initiation Royalty each quarter. The rate for Diagnostic and/or Archive contracts will be based on Estimated Average Annual Studies as follows: 
  

							
			
	 Average Annual Studies (thousands)

	  	IDX

	  	Stentor

			
	 0-1,000
	  	$	[**]	  	$	[**]
			
	 1,000-1,999
	  	$	[**]	  	$	[**]
			
	 2,000-2,999
	  	$	[**]	  	$	[**]
			
	 3,000-3,999
	  	$	[**]	  	$	[**]
			
	 4,000+
	  	$	[**]	  	$	[**]

  

 2 

 Assuming that IDX and Stentor each project an Estimated Average Annual Study of [**], then using the example above, IDX
would pay Stentor an Initiation Royalty of [**] x $[**] = $[**]. If Stentor had signed the same number of Average Annual Studies, it would pay IDX an Imitation Royalty of: [**] x $[**] = $[**]. 
  
 If a portion of Average Annual Studies were for contracts that are either
“Diagnostic-only Studies” or “Stored-only Studies”, the Initiation Royalty for that portion would be the applicable Initiation Tier Rate times [**]%. 
  
 C. Adjustment to actual signed Average Annual Studies 
  
 At the end of each calendar year the parties shall compare “Actual Average Annual Studies’ to Estimated Average Annual Studies. If
Actual Average Annual Studies places the party in a different Initiation Tier Rate than it used during the year to pay Initiation Royalties, the party shall make an adjustment payment to the other in the amount of Actual Average Annual Studies times
the difference in the Initiation Tier Rates. 
  
 For Enterprise Contracts:

  
 For Enterprise contracts, the calculations would be made as above, except
the Initiation Tier Rate would be based on Diagnostic and/or Archive Average Annual studies for that quarter, the Initiation Royalty per study would be [**]% of the Diagnostic and/or Archive amount, and the Enterprise studies used to compute the
royalty will be based on viewed studies rather than total DICOM studies (the Average Annual Viewed Enterprise Studies). For example, if two Enterprise contracts were signed in the same quarter as the Initiation Royalty for IDX would be: [**] x
($[**] x [**]%) = $[**]. A similar adjustment to actual studies would be made as described above. 
  

	III.	Calculating Sustaining Royalty. 

  
 A Contracting Party will pay to the other party an ongoing royalty each quarter based on total new managed studies for that quarter, whether from ASP or Capital contracts
for the MIMS System, (The “Sustaining Royalty”). The Sustaining Royalty will be calculated by multiplying the [**] times the [**]. 
  
 Sustaining Royalty = [**] x [**] 
  
  

 3 

 A. Definition of Managed Study Volume 
  
 Managed Study Volume means the quarterly sum, across all customers who are in live clinical
use of total MIMS System DICOM actual new stored Studies plus, for customers which are not archiving, [**]. Managed Study Volume excludes totals from customer contracts that have been terminated, under which the customer is not paying maintenance or
dormant archives that are subject to the dormant archive fee described below. Studies that the Contracting Party deems to be “Diagnostic-only Volume” or “Stored-only Volume” will be itemized separately. 
  
 B. Definition of Sustaining Tier Rate 
  
 The Sustaining Tier Rate is the per study royalty rate applied to Managed Study Volume to
compute the Sustaining Royalty each quarter. The Sustaining Tier Rate is based on Quarterly Managed Study Volume as follows: 
  

							
			
	 Managed Study Volume

	  	IDX

	  	Stentor

			
	 0-625,000
	  	$	[**]	  	$	[**]
			
	 626,000-1,249,000
	  	$	[**]	  	$	[**]
			
	 1,250,000-1,875,000
	  	$	[**]	  	$	[**]
			
	 1,876,000-2,499,000
	  	$	[**]	  	$	[**]
			
	 2,500,000+
	  	$	[**]	  	$	[**]

  
 For Diagnostic-only Volume and
Stored-only Volume: 
  
 For the portion(s) of Managed Study Volume that were
either “Diagnostic-only Volume” or “Stored-only Volume,” the Sustaining Royalty will be the applicable Sustaining Tier Rate times [**]%. 
  
 For Enterprise Contracts: 
  
 For Enterprise contracts, the calculations will be done as above, except the Sustaining Tier Rate will be based on Diagnostic and/or Archive Managed Study Volume for that
quarter, the Sustaining Royalty per study will be [**]% of the Diagnostic and/or Archive amount, and the Enterprise studies used to compute the royalty will be based on [**] rather than [**]. For example, if the Enterprise Viewed Studies Volume
totaled [**] for the quarter, then the Enterprise Sustaining Royalty for IDX would be: [**] x ($[**] x [**]%) = $[**]. 
  
  

 4 

 Example of Sustaining Royalty. 
  
 For the example outlined below, a Managed Study Volume of [**] studies for the quarter is assumed, broken down as follows: 
  

			
		
	 Managed Study Volume:
	 	 [**]

		
	 Stored Volume
	 	 [**]

		
	 Diagnostic-only Volume
	 	 [**]

		
	 Stored-only Volume
	 	 [**]

  
 The Managed Study Volume of [**] would
result in Sustaining Tier rate of $[**] for IDX and $[**] for Stentor, and the Sustaining Royalty payable by IDX and Stentor would be: 
  

					
	 	  	 IDX

	  	 Stentor

			
	 Stored Volume
	  	$[**]	  	$[**]
			
	 [**]
	  	 	  	 
			
	 Diagnostic-only Volume
	  	$[**]	  	$[**]
			
	 [**]
	  	 	  	 
			
	 Stored-only Volume
	  	$[**]	  	$[**]
			
	 [**]
	  	 	  	 
	 	  	
	  	

	 Total Sustaining Royalty
	  	$[**]	  	$[**]

  
 IV. Additional Fees.

  
 A. MIMS System Dormant Archive Fee 
  
 In the event that a customer’s MIMS System archive is a “Dormant Archive” as
defined by either (1) no longer storing new MIMS System studies or (2) storing new studies at a quarterly rate of 10 percent or less of their highest quarterly Managed Study Volume (the “Maximum Managed Study Volume”); an ongoing quarterly
payment will be owed to the supporting party until such time that the archive is no longer on-line. The Dormant Archive Fee shall be based on the customer’s highest annual [**] during its contract term, divided by [**] (the “Dormant
Archive Volume”) and then multiplied by the following fee per study: 
  

	 	1.	For Stentor Customers: $[**] per quarter per Dormant Archive Volume ($[**] per year). 

  

 5 

	 	2.	For IDX Customers: $[**] per quarter per Dormant Archive Volume ($[**] per year). 

  
 B. Prior Contract “True Up” 
  

	 	1.	IDX and Stentor have agreed to a one-time correction of outstanding royalty compensation and service fees for 2003. The following corrections represent both parties’ best
efforts to a) reconcile royalty calculations (including restatement of net revenue as required) that were exchanged prior to July 1, 2003 under the previous agreement, b) calculate royalty compensation under this new agreement for July 1, 2003
through September 30, 2003, including royalties paid from July 1, 2003 to September 30, 2003, c) finalize service fees associated with Stentor Disaster Recovery Service, and reconcile outstanding fees owed to Stentor by IDX for these services in
2003. The parties agree that all royalties through September 30, 2003 are therefore paid in full and not subject to future adjustments. 

  

	 	2.	Summary of one-time corrections. 

  

	 	a.	June 30, 2003 and Prior royalty compensation corrections: 

  
 i. IDX has a debit to Stentor in the amount of $[**] 
  
 ii. Stentor has a debit to IDX in the amount of $[**] 
  

	 	b.	July 1, 2003 through September 30, 2003, previous contract payment reversal: 

  

i. IDX has a credit to Stentor in the amount of $[**] 
  
 ii. Stentor has a credit to IDX in the amount of $ [**] 
  

	 	c.	July 1, 2003 through September 30, 2003 new royalty compensations: 

  
 i. IDX has a debit to Stentor in the amount of $ [**] 
  
 ii. Stentor has a debit to IDX in the amount of $ [**] 
  

	 	d.	Device Driver royalty compensation correction: 

  
 i. Stentor has a debit to IDX in the amount of $ [**] 
  

	 	e.	Service Fees for Stentor Disaster Recovery Service 

  
 i. IDX has a debit to Stentor in the amount of $ [**] 
  

	 	3.	Stentor agrees to pay the balance of $[**] in cash within 60 days of the Amendment Effective Date. 

  

 6

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