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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
Dept Svc Code Description Charge UBC CPT/HCPC Mod
PHAR 000001720219 SKIN TEST-COCCI 0.1ML SQ 000012.00 300 86490 24
PHAR 000001720020 SKIN TEST-HISTOPLAS 0.1ML INJ 000009.60 300 86510 24
PHAR 000001720576 RABIES IMMU GLOB 10ML 150U INJ 002001.00 636 90375
PHAR 000001720620 VARICELLA-ZOSTER IMMU SOL 100 000840.00 636 90396
PHAR 000001720937 VARICELLA-ZOSTER U SOL 100 000946.24 636 90396
PHAR 000001726016 HEPATITIS A VAC ADLT INJ 1ML 000237.60 636 90632
PHAR 000001726015 HEPATITIS A VACC PED INJ 0.5 000157.20 636 90633
PHAR 000001756588 INFLUENZA VAC PEDS I INJ 000038.40 636 90657
PHAR 000001756519 INFLUENZA VAC > 3 YRS INJ 000038.40 636 90658
PHAR 000001721038 INFLUENZA VACC 0.5ML 000038.40 636 90659
PHAR 000001720343 RABIES VACCINE HUMAN INJ 1ML 000548.52 636 90675
PHAR 000001721046 DIPTHER/PERTUS/TETA N INJ 000041.75 636 90701
PHAR 000001790016 DIPTHER/PERTUS/TETA N 1DOSE VI 000041.75 636 90701
PHAR 000001716038 DIPTHERIA/TETAN.PEDS 0.5ML 000022.80 636 90702
PHAR 000001790017 DIPTHER/TETANUS PED S 1DOSE IN 000024.00 636 90702
PHAR 000001720373 TETANUS TOXOID ADSORB SYR 0.5 000031.80 636 90703
PHAR 000001756543 TETANUS TOXOID 0.5ML INJ 000031.80 636 90703
PHAR 000001790007 TETANUS TOXOID ADSORB 000024.00 250 90703
PHAR 000001720059 MUMPS VIRUS VACCINE L 1 DOSE I 000098.40 636 90704
PHAR 000001720257 MEASLES VIRUS VACCINE 0.5ML IN 000086.40 636 90705
PHAR 000001720412 RUBELLA VIR VAC/LIVE 1DOSE INJ 000075.60 636 90706
PHAR 000001720158 MMR II INJ 000042.00 636 90707
PHAR 000001716001 POLIOVIRUS LIVE TRIVA 1 DOSE S 000030.78 636 90712
PHAR 000001780042 POLIOVIRUS VACC INACT SYR 1ML 000141.60 636 90713
PHAR 000001780065 POLIOVIRUS VACC INACT INJ 0.5 000141.60 636 90713
PHAR 000001721059 VARICELLA VACC 1DOSE INJ 0.5 000192.00 636 90716
PHAR 000001720371 TETANUS/DIPHTHER INJ 000024.00 636 90718
PHAR 000001721039 TETANUS/DIPH ADLT 0.5ML 000031.80 636 90718
PHAR 000001755425 TETRAMUNE UD INJ 000042.00 636 90720
PHAR 000001721080 DIPTH/PERT/TET(ACELLL INJ 1ML 000141.60 636 90721
PHAR 000001720337 PNEUMOVOCCAL 23 SDV C INJ 0.5 000075.60 636 90732
PHAR 000001721100 PNEUMOCOCCAL 7 INJ 0.5 000261.00 636 90732
PHAR 000001726014 MENINGOCOCCAL VACC INJ 1DO 000192.00 636 90733
PHAR 000001720519 HEPATITIS B VAC PEDS INJ 20M 000141.60 636 90744
PHAR 000001720633 HEPATITIS B VAC ADLTT INJ 20M 000141.60 636 90746
PHAR 000001780076 HEP B VAC ADLT-INDMED 10MCG IN 000028.14 636 90746
PHAR 000001755682 BUSULFAN 6MG INJ 000921.18 636 C1178
PHAR 000001780081 APLIGRAFT 002691.00 636 C1305
PHAR 000001795313 APLIGRAFT 001989.00 636 C1305
PHAR 000001759919 SYNAGIS/H2O INJ 100 003375.31 636 C9003
PHAR 000001759981 SYNAGIS 50MG INJ 001787.51 636 C9003
PHAR 000001795321 SYNAGIS 100MG INJ 003375.31 636 C9003
PHAR 000001795331 SYNAGIS 50MG INJ 001787.51 636 C9003
PHAR 000001757066 BACLOFEN IT 1AMP(SCREEN KIT) 000234.00 636 C9007
PHAR 000001726010 BACLOFEN IT 500MCG KIT 000632.10 636 C9008
PHAR 000001726018 BACLOFEN IT 2000MCG KIT 002381.40 636 C9009
9/7/2010 11:52 AM Page 1 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001720099 HEPATITIS B IMMUNE GL INJ 1ML 002059.64 636 C9105
PHAR 000001720802 HEPATITIS B IMMUNE GL INJ 1ML 000588.00 636 C9105
PHAR 000001757252 HEP B IMM GLOB 5ML 002056.80 636 C9105
PHAR 000001759995 HEP B IMM GLOB 1ML 000504.00 636 C9105
PHAR 000001759991 PANTOPRAZOLE INJ 4MG 000146.40 636 C9113
PHAR 000001759990 ARGATROBAN 250MG INJ 002152.80 636 C9121
PHAR 000001755706 OXALIPLATIN VIAL INJ 5MG 002485.65 636 C9205
PHAR 000001720684 ADENOSINE 6MG INJ 3MG 000141.60 636 C9233
PHAR 000001755541 IDAMYCIN INJ 000641.55 636 C9429
PHAR 000001720109 MITOMYCIN 5MG INJ 000445.64 636 C9432
PHAR 000001711475 SANDIMMUNE 100MG CAP 000016.69 636 C9438
PHAR 000001712179 NEORAL 100MG CAP 000015.48 636 C9438
PHAR 000001710713 AMANTADINE 100MG CAP 000004.16 636 G9033
PHAR 000001710936 OSELTAMIVIR PHOS CAP 75M 000017.35 636 G9035
PHAR 000001721096 ABCIXIMAB 10MG INJ 001490.40 636 J0130
PHAR 000001759797 ABCIXIMAB 10MG INJ 001490.46 636 J0130
PHAR 000001720081 ADRENALIN AMP 1:1000 000014.50 636 J0170
PHAR 000001720163 EPINEPHRINE HCL 0.1MG/ML SYR 000075.60 636 J0170
PHAR 000001720457 EPINEPHRINE 1MG INJ 000017.40 636 J0170
PHAR 000001757047 EPINEPHRINE 1MG INJ 000028.80 636 J0170
PHAR 000001757048 EPINEPHRINE LVP 1 MG 000028.80 636 J0170
PHAR 000001790010 ADRENALIN AMP 1:1000 000008.00 636 J0170
PHAR 000001795083 EPINEPHRINE 1MG INJ 000017.40 636 J0170
PHAR 000001757757 AMIFOSTINE INJ 50M 001139.25 636 J0207
PHAR 000001720151 METHYLDOPATE HCL 50MG INJ 000034.80 636 J0210
PHAR 000001754589 METHYLDOPATE PB 250 000042.00 636 J0210
PHAR 000001757691 METHYLDOPATE 250MG INJ 000048.00 636 J0210
PHAR 000001720653 PROTEINASE INHIBITOR 1GM INJ 000746.82 636 J0256
PHAR 000001717071 AMINOPHYLLINE SOL 21M 000020.29 636 J0280
PHAR 000001720024 AMINOPHYLLINE 250MG INJ 000022.80 636 J0280
PHAR 000001720032 AMINOPHYLLINE 500MG INJ 000028.80 636 J0280
PHAR 000001754023 AMINOPHYLLINE 250MG INJ 000028.80 636 J0280
PHAR 000001754024 AMINOPHYL PB 100MG INJ 000028.80 636 J0280
PHAR 000001754025 AMINOPHYL PB 250MG INJ 000031.80 636 J0280
PHAR 000001754026 AMINOPHYL PB 500MG INJ 000042.00 636 J0280
PHAR 000001754027 AMINOPHYL PB 1 GM INJ 000062.40 636 J0280
PHAR 000001754900 AMINOPHYLLINE 250MG INJ 000042.00 636 J0280
PHAR 000001754946 AMINOPHYLLIN/PB 5 MG INJ 000028.80 636 J0280
PHAR 000001754947 AMINOPHYLLIN/PB 10 M INJ 000028.80 636 J0280
PHAR 000001754948 AMINOPHYLLIN/PB 20 M INJ 000028.80 636 J0280
PHAR 000001754949 AMINOPHYLLIN/PB 100 INJ 000031.80 636 J0280
PHAR 000001757205 AMINOPHYLLINE 250MG INJ 000028.80 636 J0280
PHAR 000001757206 AMINOPHYL LVP 125MG INJ 000028.80 636 J0280
PHAR 000001757207 AMINOPHYL LVP 250MG INJ 000032.40 636 J0280
PHAR 000001757208 AMINOPHYL LVP 500MG INJ 000042.00 636 J0280
PHAR 000001757209 AMINOPHYL LVP 1GM INJ 000058.80 636 J0280
PHAR 000001795139 AMINOPHYLLINE 250MG INJ 000022.80 636 J0280
9/7/2010 11:52 AM Page 2 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001721063 AMIODARONE HCL 50MG INJ 000258.00 636 J0282
PHAR 000001759831 AMIODARONE 150MG INJ 000253.20 636 J0282
PHAR 000001759832 AMIODARONE HCL 150MG INJ 000253.20 636 J0282
PHAR 000001759833 AMIODARONE HCL 300 MG INJ 000494.58 636 J0282
PHAR 000001759834 AMIODARONE HCL 450 MG INJ 000693.00 636 J0282
PHAR 000001759835 AMIODARONE HCL 600 MG INJ 000858.00 636 J0282
PHAR 000001759837 AMIODARONE HCL 900 MG INJ 001138.50 636 J0282
PHAR 000001759838 AMIODARONE HCL 1050 MG INJ 001328.24 636 J0282
PHAR 000001720273 AMPHOTERICIN B INJ 5MG 000141.60 636 J0285
PHAR 000001757256 AMPHOTERICIN B REGUL INJ 5MG 000141.60 636 J0285
PHAR 000001759014 AMPHOTERICIN B REGUL INJ 5MG 000141.60 636 J0285
PHAR 000001759792 ABELCET-AMPHOTER-LPD INJ 5MG 000484.78 636 J0285
PHAR 000001757065 AMBISOME (LIPOSOMAL) INJ 4 M 000659.40 636 J0289
PHAR 000001720396 AMPICILLIN VIAL INJ 500 000017.40 636 J0290
PHAR 000001720397 AMPICILLIN VIAL INJ 1GM 000020.40 636 J0290
PHAR 000001720398 AMPICILLIN VIAL INJ 2GM 000038.40 636 J0290
PHAR 000001752200 AMPICILLIN /NS INJ 50M 000045.07 636 J0290
PHAR 000001752203 AMPICILLIN/PB 0.5GM 000035.47 636 J0290
PHAR 000001752204 AMPICILLIN/PB 1GM 000045.07 636 J0290
PHAR 000001752210 AMPICILLIN/PB 4GM 000100.27 636 J0290
PHAR 000001752214 AMPICILLIN/PB 6GM 000119.47 636 J0290
PHAR 000001795002 AMPICILLIN 1GM INJ 000020.40 636 J0290
PHAR 000001752190 UNASYN 3GM INJ 000100.27 636 J0295
PHAR 000001752191 UNASYN/PB 3GM 000100.27 636 J0295
PHAR 000001752192 UNASYN/PB 6GM 000157.87 636 J0295
PHAR 000001752205 AMPICILLIN/PB 1.5GM 000051.67 636 J0295
PHAR 000001752206 AMPICILLIN/PB 2GM 000064.27 636 J0295
PHAR 000001752207 AMPICILLIN/PB 2.5GM 000069.07 636 J0295
PHAR 000001752208 AMPICILLIN/PB 3GM 000076.27 636 J0295
PHAR 000001752209 AMPICILLIN/PB 3.5GM 000081.07 636 J0295
PHAR 000001752299 UNASYN/PB 1.5GM 000064.27 636 J0295
PHAR 000001720071 SUCCINYLCHOLINE INJ 20MG/ML 000034.80 636 J0330
PHAR 000001795200 SUCCINYLCHOLINE VIAL 20MG 000012.66 636 J0330
PHAR 000001720072 HYDRALAZINE INJ 20M 000020.40 636 J0360
PHAR 000001754317 HYDRALAZINE 20MG INJ 000057.60 636 J0360
PHAR 000001754318 HYDRALAZINE/PB 10 MG 000038.40 636 J0360
PHAR 000001755419 HYDRALAZINE 1MG/ML INJ 000057.60 636 J0360
PHAR 000001755420 HYDRALAZINE 0.5MG/ML INJ 000057.60 636 J0360
PHAR 000001795251 HYDRALAZINE 20MG INJ 000060.00 636 J0360
PHAR 000001753436 AZITHROMYCIN 500MG INJ 000151.20 636 J0456
PHAR 000001720251 ATROPINE 0.3MG INJ 000017.40 636 J0460
PHAR 000001795115 ATROPINE SULFATE 000003.60 636 J0460
PHAR 000001720306 DIMERCAPROL 100MG INJ 000172.80 636 J0470
PHAR 000001720318 DICYCLOMINE HCL AMP 10MG INJ 000086.40 636 J0500
PHAR 000001720910 BENTYL INJ 10MG/ML 10ML 000217.20 636 J0500
PHAR 000001720290 BENZTROPINE 1MG 000048.00 636 J0515
PHAR 000001721003 BETHANECHOL INJ INJ 5MG 000038.40 636 J0520
9/7/2010 11:52 AM Page 3 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001720008 BICILLIN C-R 2.4MMU 600000UN 000126.00 636 J0530
PHAR 000001720015 PENICILLIN G BENZATH SYR 600 000048.00 636 J0530
PHAR 000001720025 PENICILLIN G BENZATH SYR 600 000141.60 636 J0530
PHAR 000001720328 BICILLIN C-R 1.2MMU 600000UN 000060.00 636 J0530
PHAR 000001720333 BICILLIN CR 600MU SYR 600 000038.40 636 J0530
PHAR 000001720499 PENICILLIN G BENZATH SYR 600 000075.60 636 J0530
PHAR 000001721073 BOTULISM 100 U INJ 001276.50 636 J0587
PHAR 000001795334 BOTULISM 100 U INJ 001276.50 636 J0587
PHAR 000001720351 BUTORPHANOL 2MG VIAL 2MG INJ 000054.00 636 J0595
PHAR 000001720353 BUTORPHANOL 1MG VIAL 1MG INJ 000048.00 636 J0595
PHAR 000001720575 BUTORPHANOL 4MG VIAL 2MG 000086.40 636 J0595
PHAR 000001720186 EDETATE CALCIUM DISOD 200MG IN 000172.80 636 J0600
PHAR 000001759727 EDETATE CALCIUM DISOD 200MG IN 000229.20 636 J0600
PHAR 000001720196 CALCIUM GLUC 100MG/ML 10ML 000017.40 636 J0610
PHAR 000001754014 CALCIUM GLUC 1GM INJ 000028.80 636 J0610
PHAR 000001763012 CALC GLUC 10%(MG) 100MG/ML 000001.20 636 J0610
PHAR 000001720101 CALCITONIN 200IU INJ 000192.00 636 J0630
PHAR 000001720636 CALCITRIOL 1MCG INJ 000086.40 636 J0636
PHAR 000001759988 CASPOFUNGIN ACETATE INJ 5MG 001123.20 636 J0637
PHAR 000001720078 LEUCOVORIN 50MG INJ 000031.80 636 J0640
PHAR 000001720108 LEUCOVORIN 100MG INJ 000038.40 636 J0640
PHAR 000001720720 LEUCOVORIN CALCIUM 350MG INJ 000496.58 636 J0640
PHAR 000001720729 LEUCOVORIN 50MG INJ 000051.60 636 J0640
PHAR 000001754502 LEUCOVORIN 50MG INJ 000045.00 636 J0640
PHAR 000001758586 LEUCOVORIN CA INJ 5MG 000044.40 636 J0640
PHAR 000001720267 MEPIVACAINE HCL 1.50% INJ 000086.40 636 J0670
PHAR 000001720276 MEPIVACAINE HCL 2% INJ 000075.60 636 J0670
PHAR 000001720430 CEFAZOLIN 1GM INJ 000025.80 636 J0690
PHAR 000001720629 CEFAZOLIN 500MG INJ 000022.80 636 J0690
PHAR 000001750033 CEFAZOLIN PB 2 GM 000048.00 636 J0690
PHAR 000001750035 CEFAZOLIN PB 3 GM 000062.00 636 J0690
PHAR 000001750038 CEFAZOLIN PB 4.5 GM 000086.00 636 J0690
PHAR 000001750334 CEFAZOLIN 1GM INJ 000045.07 636 J0690
PHAR 000001750336 CEFAZOLIN/PB 0.5GM 000035.47 636 J0690
PHAR 000001750337 CEFAZOLIN/PB 0.75GM 000041.47 636 J0690
PHAR 000001750338 CEFAZOLIN/PB 1GM 000045.07 636 J0690
PHAR 000001750339 CEFAZOLIN/PB 1.5GM 000055.87 636 J0690
PHAR 000001750340 CEFAZOLIN/PB 2GM 000064.27 636 J0690
PHAR 000001750342 CEFAZOLIN/PB 3GM 000081.07 636 J0690
PHAR 000001795003 CEFAZOLIN 1GM INJ 000025.80 636 J0690
PHAR 000001750497 CEFEPIME/PB 1GM 000119.47 636 J0692
PHAR 000001750498 CEFEPIME/PB 2GM 000187.87 636 J0692
PHAR 000001750499 CEFEPIME/PB 3GM 000221.47 636 J0692
PHAR 000001720567 CEFOXITIN INJ 2 GM 000093.00 636 J0694
PHAR 000001750434 CEFOXITIN PB 1 GM 000062.00 636 J0694
PHAR 000001720449 ROCEPHIN INJ 1GM 000206.40 636 J0696
PHAR 000001720469 CEFTRIAXONE SODIUM 2GM INJ 000324.64 636 J0696
9/7/2010 11:52 AM Page 4 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001720792 CEFTRIAXONE 500MG INJ 000157.20 636 J0696
PHAR 000001750473 CEFTRIAXONE 1GM INJ 000221.47 636 J0696
PHAR 000001750474 CEFTRIAXONE/PB 0.5GM 000157.87 636 J0696
PHAR 000001750475 CEFTRIAXONE/PB 1GM 000221.47 636 J0696
PHAR 000001750476 CEFTRIAXONE/PB 1.5GM 000257.47 636 J0696
PHAR 000001750477 CEFTRIAXONE/PB 2GM 000273.47 636 J0696
PHAR 000001750479 CEFTRIAXONE/PB 3GM 000400.20 636 J0696
PHAR 000001780028 CEFTRIAXONE SODIUM INJ 250 000086.40 636 J0696
PHAR 000001795007 CEFTRIAXONE 1GM INJ 000206.40 636 J0696
PHAR 000001720583 CEFUROXIME 750MG INJ 000060.00 636 J0697
PHAR 000001750480 CEFUROXIME/ST H20 INJ 100 000085.87 636 J0697
PHAR 000001750483 CEFUROXIME/PB 0.75GM 000069.07 636 J0697
PHAR 000001750484 CEFUROXIME/PB 1.5GM 000109.87 636 J0697
PHAR 000001750486 CEFUROXIME/PB 3GM 000172.27 636 J0697
PHAR 000001750489 CEFUROXIME/PB 1GM 000085.87 636 J0697
PHAR 000001750490 CEFUROXIME/PB 2GM 000144.67 636 J0697
PHAR 000001750491 CEFUROXIME/PB 2.5GM 000157.87 636 J0697
PHAR 000001795327 CEFUROXIME 1.5GM INJ 000086.40 636 J0697
PHAR 000001720498 CEFOTAXIME 1GM VIAL 000075.60 636 J0698
PHAR 000001750214 CEFOTAXIME/ST H20 INJ 100 000085.87 636 J0698
PHAR 000001720213 BETAMETHASONE SODIUM 3MG INJ 000086.40 636 J0702
PHAR 000001756536 CAFFEINE CIT 60MG/3ML INJ 000199.20 636 J0706
PHAR 000001722013 CEFTAZIDIME 1GM INJ 000098.40 636 J0713
PHAR 000001750248 CEFTAZIDIME 1GM INJ 000109.87 636 J0713
PHAR 000001750250 CEFTAZIDIME/PB 0.5GM 000069.07 636 J0713
PHAR 000001750251 CEFTAZIDIME/PB 1GM 000109.87 636 J0713
PHAR 000001750252 CEFTAZIDIME/PB 1.5GM 000157.87 636 J0713
PHAR 000001750253 CEFTAZIDIME/PB 2GM 000172.27 636 J0713
PHAR 000001750254 CEFTAZIDIME/PB 2.5GM 000187.87 636 J0713
PHAR 000001750255 CEFTAZIDIME/PB 3GM 000221.47 636 J0713
PHAR 000001750257 CEFTAZIDIME/PB 4GM 000249.07 636 J0713
PHAR 000001753006 CHLORAMPHENICOL INJ 1GM 000064.27 636 J0720
PHAR 000001720021 CHORIONIC GONADOTROPI 5000 U I 000874.54 636 J0725
PHAR 000001753116 IMIPENEM/CILASTATIN INJ 50M 000172.27 636 J0743
PHAR 000001753118 PRIMAXIN/PB 250MG 000119.47 636 J0743
PHAR 000001753119 PRIMAXIN/PB 500MG 000172.27 636 J0743
PHAR 000001753120 PRIMAXIN/PB 750MG 000221.47 636 J0743
PHAR 000001753121 PRIMAXIN/PB 1000MG 000249.07 636 J0743
PHAR 000001753138 PRIMAXIN/PB 1500MG 000327.97 636 J0743
PHAR 000001753347 CIPROFLOXACIN INJ 10M 000165.60 636 J0744
PHAR 000001753414 CIPROFLOXACIN/D5W INJ 2MG 000112.80 636 J0744
PHAR 000001737002 CODEINE 30MG INJ 000019.20 636 J0745
PHAR 000001737006 CODEINE 30MG INJ 000019.20 636 J0745
PHAR 000001720293 COLCHICINE 1MG/2ML 0.5MG INJ 000028.80 636 J0760
PHAR 000001721090 COLISTIMETHATE SOD 150MG INJ 000192.00 636 J0770
PHAR 000001720295 COMPAZINE 10MG/2ML 000021.50 636 J0780
PHAR 000001720454 COMPAZINE INJ 5MG/ML 2ML 000025.80 636 J0780
9/7/2010 11:52 AM Page 5 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001720005 CORTICOTROPIN 40U GEL IM 000141.60 636 J0800
PHAR 000001720013 CORTICOTROPIN 40U IM 000157.20 636 J0800
PHAR 000001756586 CORTICOTROPIN 80U/1ML INJ 000628.45 636 J0800
PHAR 000001720304 COSYNTROPIN INJ 0.1 000075.60 636 J0835
PHAR 000001754264 COSYNTROPIN INJ 0.1 000093.60 636 J0835
PHAR 000001754265 CORTROSYN/PB 0.25 MG IV 000093.60 636 J0835
PHAR 000001757605 COSYNTROPIN INJ 0.2 000093.60 636 J0835
PHAR 000001757606 CORTROSYN/LVP 0.25MG IV 000093.60 636 J0835
PHAR 000001758636 CMV IMM GL 2.5GM 001906.64 636 J0850
PHAR 000001720046 DEFEROXAMINE MES VIAL 500MG IV 000066.00 636 J0895
PHAR 000001757525 DESFERAL LVP 500 MG IV 000084.00 636 J0895
PHAR 000001720197 ESTRADIOL VAL 50MG 10MG INJ 000172.80 636 J0970
PHAR 000001720206 ESTRADIOL VAL 20MG 20MG INJ 000098.40 636 J0970
PHAR 000001720214 ESTRADIOL CYPIONATE 5MG INJ 000098.40 636 J1000
PHAR 000001720218 METHYLPREDNISOLONE AC 40MG INJ 000038.40 636 J1030
PHAR 000001720226 METHYLPREDNISOLONE AC 40MG INJ 000126.00 636 J1030
PHAR 000001795285 METHYLPREDNISOLONE AC 40MG INJ 000012.31 636 J1030
PHAR 000001720010 METHYLPREDNISOLONE AC 80MG INJ 000060.00 636 J1040
PHAR 000001720017 METHYLPREDNISOLONE AC 80MG INJ 000172.80 636 J1040
PHAR 000001720028 MEDROXYPROGESTERONE 400MG INJ 000922.98 636 J1051
PHAR 000001720045 MEDROXYPROGESTERONE 400MG INJ 000297.68 636 J1051
PHAR 000001720053 MEDROXYPROGESTERONE 100MG INJ 000217.20 636 J1051
PHAR 000001720368 TESTOSTERONE 100MG INJ 000048.00 636 J1070
PHAR 000001720103 DEXAMETHASONE 5ML INJ 24M 000386.75 636 J1094
PHAR 000001720453 DEXAMETHASONE VIAL INJ 10M 000098.40 636 J1094
PHAR 000001720748 DEXAMETHASONE 100MG INJ 000111.60 636 J1094
PHAR 000001720914 DEXAMETHASONE INJ 10M 000022.80 636 J1094
PHAR 000001753506 DEXAMETHASONE 40 MG IV 000079.20 636 J1094
PHAR 000001754120 DEXAMETHASONE 4MG INJ 000028.80 636 J1094
PHAR 000001754121 DEXAMETH PB 2 MG IV 000028.80 636 J1094
PHAR 000001754122 DEXAMETH PB 4 MG IV 000028.80 636 J1094
PHAR 000001754123 DEXAMETH PB 6 MG IV 000031.80 636 J1094
PHAR 000001754124 DEXAMETH PB 8 MG IV 000034.80 636 J1094
PHAR 000001754125 DEXAMETH PB 10 MG IV 000038.40 636 J1094
PHAR 000001754126 DEXAMETH PB 12 MG IV 000042.00 636 J1094
PHAR 000001754127 DEXAMETH PB 14 MG IV 000045.00 636 J1094
PHAR 000001754130 DEXAMETH PB 20 MG IV 000057.60 636 J1094
PHAR 000001754751 DEXAMETHASONE 4MG INJ 000028.80 636 J1094
PHAR 000001754752 DEXAMETH PB 2 MG IV 000028.80 636 J1094
PHAR 000001754883 DEXAMETHASONE 4MG INJ 000028.80 636 J1094
PHAR 000001757596 DEXAMETHASONE 20MG INJ 000051.60 636 J1094
PHAR 000001757597 DEXAMETH/LVP 5 MG IV 000028.80 636 J1094
PHAR 000001757598 DEXAMETH/LVP 10 MG IV 000035.40 636 J1094
PHAR 000001757599 DEXAMETH/LVP 15 MG IV 000044.40 636 J1094
PHAR 000001757600 DEXAMETH/LVP 20 MG IV 000051.60 636 J1094
PHAR 000001757603 DEXAMETH/LVP 50 MG IV 000093.60 636 J1094
PHAR 000001782003 DEXAMETH 4 MG DOSE 000014.50 636 J1094
9/7/2010 11:52 AM Page 6 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001795317 DEXAMETHASONE 5ML 24MG INJ 000313.20 636 J1094
PHAR 000001720065 DIHYDROERGOTAMINE MES 1MG INJ 000066.00 636 J1110
PHAR 000001720067 ACETAZOLAMIDE 500MG INJ 000157.20 636 J1120
PHAR 000001754030 ACETAZOLAMIDE 500MG INJ 000165.60 636 J1120
PHAR 000001754031 ACETAZOLAM PB 250 MG IV 000103.20 636 J1120
PHAR 000001795069 ACETAZOLAMIDE 500MG INJ 000157.20 636 J1120
PHAR 000001720137 DIGOXIN INJ .25MG/ML 2ML 000017.40 636 J1160
PHAR 000001720393 LANOXIN PED INJ 0.1MG/ML 000048.00 636 J1160
PHAR 000001795094 DIGOXIN 0.5MG INJ 000017.40 636 J1160
PHAR 000001720098 PHENYTOIN INJ 50MG/ML 000020.40 636 J1165
PHAR 000001754105 PHENYTOIN 100MG INJ 000031.80 636 J1165
PHAR 000001754108 PHENYTOIN PB 50 MG 000034.80 636 J1165
PHAR 000001754109 PHENYTOIN PB 100 MG 000049.20 636 J1165
PHAR 000001754110 PHENYTOIN PB 150 MG 000062.40 636 J1165
PHAR 000001754115 PHENYTOIN PB 400 MG 000124.80 636 J1165
PHAR 000001754116 PHENYTOIN PB 450 MG 000138.00 636 J1165
PHAR 000001754117 PHENYTOIN PB 500 MG 000151.20 636 J1165
PHAR 000001754119 PHENYTOIN PB 600 MG 000165.60 636 J1165
PHAR 000001754553 PHENYTOIN PB 900 MG 000199.20 636 J1165
PHAR 000001754554 PHENYTOIN PB 1000 MG 000214.80 636 J1165
PHAR 000001754557 PHENYTOIN PB 1300 MG 000242.40 636 J1165
PHAR 000001757285 PHENYTOIN 250MG INJ 000035.40 636 J1165
PHAR 000001757286 PHENYTOIN 500 MG INJ 000048.00 636 J1165
PHAR 000001757287 PHENYTOIN 750 MG INJ 000058.80 636 J1165
PHAR 000001757288 PHENYTOIN 1000 MG INJ 000074.40 636 J1165
PHAR 000001757289 PHENYTOIN 1250 MG INJ 000093.60 636 J1165
PHAR 000001757290 PHENYTOIN 1500 MG INJ 000102.00 636 J1165
PHAR 000001795146 PHENYTOIN 250MG INJ 000022.80 636 J1165
PHAR 000001737012 HYDROMORPHONE HCL AMP INJ 1MG 000019.20 636 J1170
PHAR 000001737014 HYDROMORPHONE HCL AMP INJ 2MG 000019.20 636 J1170
PHAR 000001737017 HYDROMORPHONE HCL AMP INJ 4MG 000021.60 636 J1170
PHAR 000001758154 HYDROMORPHONE HCL INJ 2MG 000122.40 636 J1170
PHAR 000001758155 HYDROMORPHON/LVP 4MG 000032.40 636 J1170
PHAR 000001758157 HYDROMORPH/LVP 12MG 000055.20 636 J1170
PHAR 000001758158 HYDROMORPH/LVP 16MG 000058.80 636 J1170
PHAR 000001758161 HYDROMORPH/LVP 28MG 000102.00 636 J1170
PHAR 000001758167 HYDROMORPH/LVP 52MG 000146.40 636 J1170
PHAR 000001758174 HYDROMORPH/LVP 80MG 000184.80 636 J1170
PHAR 000001758257 HYDROMORPH/LVP 100MG 000217.20 636 J1170
PHAR 000001758912 HYDROMORPHONE HCL-HP INJ 10M 000100.80 636 J1170
PHAR 000001759887 HYDROMORPHONE PWDR 1MG PWD IV000055.20 636 J1170
PHAR 000001795310 HYDROMORPHONE *OP P INJ 2MG 000019.20 636 J1170
PHAR 000001755614 DEXRAZOXANE 500MG INJ 000880.44 636 J1190
PHAR 000001755615 DEXRAZOXANE INJ 10M 000507.94 636 J1190
PHAR 000001720312 DIPHENHYDRAMINE VIAL 50MG INJ 000017.40 636 J1200
PHAR 000001754519 DIPHENHYDRAMINE 50MG INJ 000028.80 636 J1200
PHAR 000001754520 DIPHENHYDRAMINE 20 MG IVPB 000028.80 636 J1200
9/7/2010 11:52 AM Page 7 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001754521 DIPHENHYDRAMINE 30 MG IVPB 000028.80 636 J1200
PHAR 000001754523 DIPHENHYDRAMINE 50 MG IVPB 000028.80 636 J1200
PHAR 000001759570 DIPHENHYDRAMINE 50MG INJ 000028.80 636 J1200
PHAR 000001795085 DIPHENHYDRAMINE 50MG INJ 000017.40 636 J1200
PHAR 000001720125 CHLOROTHIAZIDE VIAL INJ 25M 000060.00 636 J1205
PHAR 000001754161 CHLOROTHIAZIDE INJ 25M 000074.40 636 J1205
PHAR 000001730057 METHADONE HCL INJ 10M 000019.20 636 J1230
PHAR 000001734002 METHADONE HCL SOL 1MG 000015.35 636 J1230
PHAR 000001737019 METHADONE 10MG INJ 000021.60 636 J1230
PHAR 000001737076 METHADONE PYX UD SYR INJ 10M 000019.20 636 J1230
PHAR 000001739003 DOLOPHINE (PCA) INJ 1MG 000016.00 636 J1230
PHAR 000001758818 METHADONE 200MG INJ 000102.00 636 J1230
PHAR 000001758856 METHADONE LVP 10 MG 000028.80 636 J1230
PHAR 000001720145 DIMENHYDRINATE 50MG INJ 000020.40 636 J1240
PHAR 000001720695 DIPYRIDAMOLE 10MG INJ 000141.60 636 J1245
PHAR 000001754971 DIPYRIDAMOLE 10MG INJ 000151.20 636 J1245
PHAR 000001757187 DOBUTAMINE 250MG INJ 000237.60 636 J1250
PHAR 000001757189 DOBUTAMINE LVP 250MG 000237.60 636 J1250
PHAR 000001759122 DOBUTAMINE 250MG BAG BAG 2MG 000051.03 636 J1250
PHAR 000001720207 AMITRIPTYLINE INJ 10MG 000060.00 636 J1320
PHAR 000001759843 EPOPROSTENOL INJ 0.5 000132.00 636 J1325
PHAR 000001711131 ERYTHROMYCIN 500 MG 000002.38 636 J1364
PHAR 000001721097 ERYTHROMYCIN INJ 500MG VIAL 000086.40 636 J1364
PHAR 000001753018 ERYTHROMYCIN INJ 50M 000157.87 636 J1364
PHAR 000001753022 ERYTHROMYCIN/PB 500MG 000100.27 636 J1364
PHAR 000001720178 ESTRADIOL VAL 100MG 20MG INJ 000206.40 636 J1390
PHAR 000001720160 ESTROGENS, CONJ 25MG INJ 5MG 000141.60 636 J1410
PHAR 000001754246 ESTROGENS 25MG INJ 000151.20 636 J1410
PHAR 000001795213 "ESTROGENS, CONJUGATED" 25 MG 000109.66 636 J1410
PHAR 000001758363 ETIDRONATE 300MG INJ 000253.20 636 J1436
PHAR 000001720891 ETANERCEPT INJ 25M 000495.00 636 J1438
PHAR 000001720708 NEUPOGEN 300MCG INJ 000516.00 636 J1440
PHAR 000001756548 FILGRASTIM=NEUPOGEN INJ 300 000516.90 636 J1440
PHAR 000001759032 FILGRASTIM=NEUPOGEN INJ 300 000516.90 636 J1440
PHAR 000001720709 NEUPOGEN 480MCG INJ 000768.32 636 J1441
PHAR 000001753169 FLUCONAZOLE/PB 200MG 000257.47 636 J1450
PHAR 000001753170 FLUCONAZOLE/PB 250MG 000296.92 636 J1450
PHAR 000001753171 FLUCONAZOLE/PB 300MG 000354.97 636 J1450
PHAR 000001753172 FLUCONAZOLE/PB 350MG 000413.02 636 J1450
PHAR 000001753173 FLUCONAZOLE/PB 400MG 000471.07 636 J1450
PHAR 000001753390 FLUCONAZOLE/PB 500MG 000548.47 636 J1450
PHAR 000001753391 FLUCONAZOLE/PB 550MG 000602.65 636 J1450
PHAR 000001753392 FLUCONAZOLE/PB 600MG 000656.83 636 J1450
PHAR 000001753444 FLUCONAZOLE/PB 800MG 000811.63 636 J1450
PHAR 000001753445 FLUCONAZOLE/PB 900MG 000912.25 636 J1450
PHAR 000001753446 FLUCONAZOLE/PB 1000MG 000954.82 636 J1450
PHAR 000001754909 FOSCARNET INJ 6000MG/250ML 002427.04 636 J1455
9/7/2010 11:52 AM Page 8 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001753151 GANCICLOVIR INJ 50M 000192.00 636 J1570
PHAR 000001753156 GANCICLOVIR/PB 500MG 000187.87 636 J1570
PHAR 000001753157 GANCICLOVIR/PB 600MG 000221.47 636 J1570
PHAR 000001753158 GANCICLOVIR/PB 700MG 000231.07 636 J1570
PHAR 000001753159 GANCICLOVIR/PB 800MG 000249.07 636 J1570
PHAR 000001753458 GANCICLOVIR/PB 1000MG 000264.67 636 J1570
PHAR 000001720048 GENTAMICIN 20MG INJ 000017.40 636 J1580
PHAR 000001720055 GENTAMICIN 80MG INJ 000017.40 636 J1580
PHAR 000001720068 GENTAMICIN 800MG/20ML INJ 000075.60 636 J1580
PHAR 000001720189 GENTAMICIN INTRATHEC INJ 2MG 000025.80 636 J1580
PHAR 000001726008 GENTAMICIN 80MG INJ 000017.40 636 J1580
PHAR 000001752042 GENTAMICIN(PEDS)3700 INJ 10M 000028.80 636 J1580
PHAR 000001752043 GENT PEDS PB 5 MG 000028.80 636 J1580
PHAR 000001752044 GENT PEDS PB 10 MG 000028.80 636 J1580
PHAR 000001752045 GENT PEDS PB 15 MG 000028.80 636 J1580
PHAR 000001752046 GENT PEDS PB 20 MG 000028.80 636 J1580
PHAR 000001752088 GENTAMICIN 80MG INJ 000038.47 636 J1580
PHAR 000001752089 GENTAMICIN/PB 10MG 000035.47 636 J1580
PHAR 000001752090 GENTAMICIN/PB 20MG 000035.47 636 J1580
PHAR 000001752091 GENTAMICIN/PB 30MG 000035.47 636 J1580
PHAR 000001752092 GENTAMICIN/PB 40MG 000035.47 636 J1580
PHAR 000001752093 GENTAMICIN/PB 60MG 000035.47 636 J1580
PHAR 000001752094 GENTAMICIN/PB 80MG 000038.47 636 J1580
PHAR 000001752095 GENTAMICIN/PB 100MG 000038.47 636 J1580
PHAR 000001752096 GENTAMICIN/PB 120MG 000038.47 636 J1580
PHAR 000001752097 GENTAMICIN/PB 140MG 000045.07 636 J1580
PHAR 000001752098 GENTAMICIN/PB 160MG 000048.67 636 J1580
PHAR 000001752099 GENTAMICIN/PB 180MG 000048.67 636 J1580
PHAR 000001752100 GENTAMICIN/PB 200MG 000051.67 636 J1580
PHAR 000001752101 GENTAMICIN/PB 220MG 000055.87 636 J1580
PHAR 000001752102 GENTAMICIN/PB 240MG 000060.07 636 J1580
PHAR 000001752103 GENTAMICIN/PB 260MG 000064.27 636 J1580
PHAR 000001752104 GENTAMICIN/PB 280MG 000064.27 636 J1580
PHAR 000001752105 GENTAMICIN/PB 300MG 000064.27 636 J1580
PHAR 000001752134 GENT PEDS PB 25 MG 000031.80 636 J1580
PHAR 000001752135 GENT PEDS PB 30 MG 000031.80 636 J1580
PHAR 000001752221 GENTAMICIN 80MG INJ 000038.47 636 J1580
PHAR 000001752222 GENTAMIC PB 10 MG 000028.80 636 J1580
PHAR 000001752223 GENTAMIC PB 20 MG 000028.80 636 J1580
PHAR 000001752224 GENTAMIC PB 30 MG 000028.80 636 J1580
PHAR 000001752225 GENTAMIC PB 40 MG 000028.80 636 J1580
PHAR 000001752226 GENTAMIC PB 60 MG 000028.80 636 J1580
PHAR 000001752227 GENTAMIC PB 80 MG 000031.80 636 J1580
PHAR 000001752228 GENTAMIC PB 100 MG 000031.80 636 J1580
PHAR 000001752229 GENTAMIC PB 120 MG 000034.80 636 J1580
PHAR 000001752231 GENTAMIC PB 160 MG 000042.00 636 J1580
PHAR 000001752233 GENTAMIC PB 200 MG 000045.00 636 J1580
9/7/2010 11:52 AM Page 9 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001752236 GENTAMIC PB 260 MG 000057.60 636 J1580
PHAR 000001752237 GENTAMIC PB 280 MG 000057.60 636 J1580
PHAR 000001752238 GENTAMIC PB 300 MG 000057.60 636 J1580
PHAR 000001752285 GENTAMICIN/PB 320MG 000069.07 636 J1580
PHAR 000001752286 GENTAMICIN/PB 340MG 000069.07 636 J1580
PHAR 000001752287 GENTAMICIN/PB 360MG 000069.07 636 J1580
PHAR 000001752288 GENTAMICIN/PB 380MG 000076.27 636 J1580
PHAR 000001752289 GENTAMICIN/PB 400MG 000076.27 636 J1580
PHAR 000001752308 GENTAMICIN/PB 450MG 000076.27 636 J1580
PHAR 000001752309 GENTAMICIN/PB 500MG 000081.07 636 J1580
PHAR 000001752310 GENTAMICIN/PB 600MG 000081.07 636 J1580
PHAR 000001752311 GENTAMICIN/PB 700MG 000085.87 636 J1580
PHAR 000001752312 GENTAMICIN/PB 800MG 000085.87 636 J1580
PHAR 000001752313 GENTAMICIN/PB 1000MG 000100.27 636 J1580
PHAR 000001752320 GENTAMICIN (PEDS) 000038.40 636 J1580
PHAR 000001795006 GENTAMICIN 80MG INJ 000017.40 636 J1580
PHAR 000001720086 GLUCAGON EMER KIT 1MG INJ 000192.00 636 J1610
PHAR 000001720502 GLUCAGON 1 MG INJ 000192.00 636 J1610
PHAR 000001795091 GLUCAGON 1MG INJ 000192.00 636 J1610
PHAR 000001755407 GRANISETRON INJ 1MG 000557.76 250 J1626
PHAR 000001720105 HALOPERIDOL 5MG INJ 000054.00 636 J1630
PHAR 000001721048 HALOPERIDOL VIAL 5MG INJ 000258.00 636 J1630
PHAR 000001795328 HALOPERIDOL 5MG INJ 000054.00 636 J1630
PHAR 000001720525 HALOPERIDOL DECANOATE 50MG INJ 000157.20 636 J1631
PHAR 000001720135 HEPARIN SODIUM INJ 10U 000017.40 636 J1642
PHAR 000001720564 HEPARIN SODIUM 10U IV 000012.00 636 J1642
PHAR 000001721098 HEPARIN FLUSH-NICU INJ 5U 000012.00 636 J1642
PHAR 000001757408 HEPARIN LVP 10 U 000014.50 636 J1642
PHAR 000001720056 HEPARIN 1000 U/ML 10 000021.50 636 J1644
PHAR 000001720069 HEPARIN SODIUM VIAL 1000U IV 000025.80 636 J1644
PHAR 000001720087 HEPARIN SODIUM INJ 100 000048.00 636 J1644
PHAR 000001720391 HEPARIN INJ 10,000U/ML 000017.40 250 J1644
PHAR 000001720392 HEPARIN SOD INJ 1000U/ML 000017.40 636 J1644
PHAR 000001759637 HEPARIN LVP 1000 U 000017.40 636 J1644
PHAR 000001764066 HEPARIN SODIUM TPN 1000 U IV 000017.40 636 J1644
PHAR 000001795153 HEPARIN 1,000U/1ML INJ 000017.40 636 J1644
PHAR 000001756532 LOVENOX INJ 100MG/ML PB 000098.40 636 J1650
PHAR 000001720166 TETANUS IMMUNE GLOBUL INJ 000075.60 636 J1670
PHAR 000001720797 TETANUS IMM GLOB SYR 250U INJ 000247.20 636 J1670
PHAR 000001720332 HYDROCORT NA (.1) INJ 50M 000020.40 636 J1720
PHAR 000001720335 HYDROCORT NA (.25) INJ 125 000054.00 636 J1720
PHAR 000001720336 HYDROCORT NA (.5) INJ 125 000098.40 636 J1720
PHAR 000001720338 HYDROCORT NA (1) INJ 125 000141.60 636 J1720
PHAR 000001753416 HYDROCRT 5MG/ML INJ 000034.80 636 J1720
PHAR 000001753417 HYDROCRT 0.5MG/ML INJ 000034.80 636 J1720
PHAR 000001754312 HYDROCORT NA (.1) INJ 50M 000034.80 636 J1720
PHAR 000001754313 HYDROCORT/PB 50 MG 000028.80 636 J1720
9/7/2010 11:52 AM Page 10 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001754314 HYDROCORT/PB 100 MG 000034.80 636 J1720
PHAR 000001754315 HYDROCORT/PB 150 MG 000045.00 636 J1720
PHAR 000001754316 HYDROCORT/PB 200 MG 000053.40 636 J1720
PHAR 000001757720 HYDROCORT NA (.1) INJ 50M 000035.40 636 J1720
PHAR 000001757721 HYDROCORT/LVP 50 MG 000028.80 636 J1720
PHAR 000001757722 HYDROCORT/LVP 100MG 000035.40 636 J1720
PHAR 000001757863 HYDROCORT/LVP 250MG 000058.80 636 J1720
PHAR 000001759553 HYDROCORT/LV 1200 MG 000168.00 636 J1720
PHAR 000001795170 HYDROCORT NA *OP INJ 125 000054.00 636 J1720
PHAR 000001719052 DIAZOXIDE 50MG/ML 30ML 000154.90 636 J1730
PHAR 000001720180 DIAZOXIDE 300MG INJ 000237.60 636 J1730
PHAR 000001722011 IBUTILIDE FUM INJ 0.1 000645.40 636 J1742
PHAR 000001756533 IBUTILIDE FUMARATE INJ 0.1 000645.40 636 J1742
PHAR 000001757347 INFLIXIMAB INJ 5MG 001614.60 636 J1745
PHAR 000001720340 IRON DEXTRAN 100MG INJ 000192.00 250 J1750
PHAR 000001757026 IRON DEXTRAN 100MG INJ 000192.00 250 J1750
PHAR 000001757010 CEREZYME INJ 40U/ML 001850.00 636 J1785
PHAR 000001720345 DROPERIDOL INJ 2.5 000042.00 636 J1790
PHAR 000001757019 DROPERIDOL INJ 2.5 000055.20 636 J1790
PHAR 000001757020 DROPERIDOL LVP 2.5MG 000039.00 636 J1790
PHAR 000001795149 DROPERIDOL *OP INJ 2.5 000042.00 636 J1790
PHAR 000001720057 PROPRANOLOL HCL INJ 1MG 000038.40 636 J1800
PHAR 000001754213 PROPRANOLOL HCL INJ 1MG 000049.20 636 J1800
PHAR 000001754214 PROPRANOLOL/PB 1 MG 000062.40 636 J1800
PHAR 000001755426 PROPRANOLOL/NS SPECDL INJ 0.1 000034.80 636 J1800
PHAR 000001756587 PROPRANOLOL/NS S/DIL INJ 0.0 000028.80 636 J1800
PHAR 000001795092 PROPRANOLOL *OP O INJ 1MG 000038.40 636 J1800
PHAR 000001720808 INSULIN HUM(REG) UD SOL 1DO 000012.00 636 J1815
PHAR 000001720817 INSULIN, (NPH) SUS 100 000012.00 636 J1815
PHAR 000001720819 INSULIN NOVO REGULAR SOL 100 000012.00 636 J1815
PHAR 000001723002 INSULIN BR (HUMAN) 100 U INJ 000086.40 636 J1815
PHAR 000001757076 INS REG HUM LVP 10 U 000028.80 636 J1815
PHAR 000001757077 INS REG HUM LVP 20 U 000028.80 636 J1815
PHAR 000001757078 INS REG HUM LVP 30 U 000028.80 636 J1815
PHAR 000001757079 INS REG HUM LVP 40 U 000028.80 636 J1815
PHAR 000001757080 INS REG HUM LVP 50 U 000028.80 636 J1815
PHAR 000001757081 INS REG HUM LVP 60 U 000028.80 636 J1815
PHAR 000001757082 INS REG HUM LVP 70 U 000028.80 636 J1815
PHAR 000001757084 INS REG HUM LVP 90 U 000032.40 636 J1815
PHAR 000001757085 INS REG HUM LVP 100U 000032.40 636 J1815
PHAR 000001757087 INS REG HUM LVP 200U 000042.00 636 J1815
PHAR 000001720461 KANAMYCIN SULFATE 250MG 000028.80 636 J1840
PHAR 000001720672 KETOROLAC 60MG INJ 000060.00 636 J1885
PHAR 000001720673 KETOROLAC 30MG INJ 000060.00 636 J1885
PHAR 000001720710 KETOROLAC 15MG INJ 000054.00 636 J1885
PHAR 000001795038 KETOROLAC 60MG INJ 000027.89 636 J1885
PHAR 000001795278 KETOROLAC 30MG INJ 000060.00 636 J1885
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001720037 FUROSEMIDE 40MG INJ 000017.40 636 J1940
PHAR 000001720047 FUROSEMIDE 100MG INJ 000022.80 636 J1940
PHAR 000001754036 FUROSEMIDE 100MG INJ 000079.20 636 J1940
PHAR 000001754037 FUROSEMIDE PB 5 MG 000028.80 636 J1940
PHAR 000001754038 FUROSEMIDE PB 10 MG 000028.80 636 J1940
PHAR 000001754039 FUROSEMIDE PB 20 MG 000031.80 636 J1940
PHAR 000001754040 FUROSEMIDE PB 40 MG 000045.00 636 J1940
PHAR 000001754041 FUROSEMIDE PB 60 MG 000057.60 636 J1940
PHAR 000001754042 FUROSEMIDE PB 80 MG 000069.60 636 J1940
PHAR 000001754043 FUROSEMIDE PB 100 MG 000079.20 636 J1940
PHAR 000001754044 FUROSEMIDE PB 120 MG 000093.60 636 J1940
PHAR 000001754989 FUROSEMIDE PB 400 MG 000199.20 636 J1940
PHAR 000001758917 FUROSEMIDE 100MG INJ 000084.00 636 J1940
PHAR 000001758918 FUROSEMIDE 10 MG 000028.80 636 J1940
PHAR 000001758919 FUROSEMIDE 20 MG 000032.40 636 J1940
PHAR 000001758920 FUROSEMIDE 30 MG 000039.00 636 J1940
PHAR 000001758921 FUROSEMIDE 40 MG 000044.40 636 J1940
PHAR 000001758922 FUROSEMIDE 50 MG 000051.60 636 J1940
PHAR 000001758923 FUROSEMIDE 75 MG 000067.20 636 J1940
PHAR 000001758924 FUROSEMIDE 100 MG 000084.00 636 J1940
PHAR 000001758925 FUROSEMIDE 125 MG 000093.60 636 J1940
PHAR 000001758926 FUROSEMIDE 150 MG 000112.80 636 J1940
PHAR 000001758927 FUROSEMIDE 175 MG 000122.40 636 J1940
PHAR 000001758928 FUROSEMIDE 200 MG 000132.00 636 J1940
PHAR 000001758929 FUROSEMIDE LVP 300 M 000168.00 636 J1940
PHAR 000001758930 FUROSEMIDE/LVP 400 MG IV 000201.60 636 J1940
PHAR 000001758931 FUROSEMIDE/LVP 500 MG IV 000229.20 636 J1940
PHAR 000001758936 FUROSEMIDE/LVP 1000 MG IV 000337.82 636 J1940
PHAR 000001795150 FUROSEMIDE 20MG INJ 000017.40 636 J1940
PHAR 000001720692 LUPRON DEPOT 22.5MG KIT 005164.98 636 J1950
PHAR 000001720911 LUPRON DEPOT 30MG KIT 006886.64 636 J1950
PHAR 000001721031 LUPRON DEPOT 3.75MG KIT 001431.45 636 J1950
PHAR 000001721086 LEVOFLOXACIN INJ 25M 000192.00 636 J1956
PHAR 000001753529 LEVOFLOXACIN/D5W INJ 5MG 000199.20 636 J1956
PHAR 000001720837 HYOSCYAMINE SULF AMP 0.5MG INJ 000048.00 636 J1980
PHAR 000001720524 CHLORDIAZEPOXIDE AMP INJ 50M 000054.00 636 J1990
PHAR 000001757201 LIDOCAINE LVP 1 GM 000039.00 636 J2001
PHAR 000001757202 LIDOCAINE LVP 2 GM 000055.20 636 J2001
PHAR 000001757204 LIDOCAINE LVP 4 GM 000093.60 636 J2001
PHAR 000001758001 LIDOCAINE 1% 50ML INJ 000042.00 636 J2001
PHAR 000001758004 LIDOCAINE 2% 50ML INJ 000048.00 636 J2001
PHAR 000001758006 LIDOCAINE/LVP 50 ML 000048.00 636 J2001
PHAR 000001759664 LIDOCAINE 1% 50ML INJ 000028.80 636 J2001
PHAR 000001795253 LIDOCAINE 100MG INJ 000034.80 636 J2001
PHAR 000001795308 LIDOCAINE 0.5% 50ML INJ 000031.80 636 J2001
PHAR 000001795319 LIDOCAINE 2GM/D5 INJ 250ML 000088.24 636 J2001
PHAR 000001753528 LINEZOLID/D5W INJ 2MG 000272.07 636 J2020
9/7/2010 11:52 AM Page 12 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001720212 LORAZEPAM INJ 4MG 000481.46 636 J2060
PHAR 000001720436 LORAZEPAM INJ 2MG 000385.20 636 J2060
PHAR 000001720439 LORAZEPAM INJ 2MG 000060.00 636 J2060
PHAR 000001720440 LORAZEPAM INJ 4MG 000098.40 636 J2060
PHAR 000001759746 LORAZEPAM LVP INJ 2MG 000078.00 636 J2060
PHAR 000001720208 MANNITOL 25% INJ 50ML 000042.00 636 J2150
PHAR 000001757232 MANNITOL 12.5GM INJ 000042.00 636 J2150
PHAR 000001795103 MANNITOL 12.5GM INJ 000042.00 636 J2150
PHAR 000001737007 MEPERIDINE HCL 100MG INJ 000019.20 636 J2175
PHAR 000001757168 MEPERIDINE LVP 100MG 000019.20 636 J2175
PHAR 000001720284 METHYLERGONOVINE 0.2MG INJ 000025.80 636 J2210
PHAR 000001737042 MIDAZOLAM HCL INJ 5MG 000100.80 636 J2250
PHAR 000001737045 MIDAZOLAM HCL INJ 5MG 000062.40 636 J2250
PHAR 000001737047 MIDAZOLAM HCL INJ 1MG 000086.40 636 J2250
PHAR 000001737056 MIDAZOLAM HCL . INJ 1MG 000036.00 636 J2250
PHAR 000001737058 MIDAZOLAM HCL INJ 5MG 000261.62 636 J2250
PHAR 000001758498 MIDAZOLAM HCL INJ 5MG 000287.71 636 J2250
PHAR 000001758499 VERSED/LVP 25 MG 000229.20 636 J2250
PHAR 000001758500 VERSED/LVP 50 MG 000331.20 636 J2250
PHAR 000001758501 VERSED/LVP 75 MG 000496.80 636 J2250
PHAR 000001758513 VERSED/LVP 100 MG 000575.40 636 J2250
PHAR 000001758514 VERSED/LVP 125 MG 000828.00 636 J2250
PHAR 000001758515 VERSED/LVP 150 MG 000993.60 636 J2250
PHAR 000001758845 VERSED/LVP 175 MG 001159.20 636 J2250
PHAR 000001758846 VERSED/LVP 200 MG 001324.80 636 J2250
PHAR 000001758848 VERSED/LVP 250 MG 001656.00 636 J2250
PHAR 000001759483 VERSED/LVP 400 MG 002649.60 636 J2250
PHAR 000001759569 VERSED/LVP 500 MG 003312.00 636 J2250
PHAR 000001795260 MIDAZOLAM 2MG INJ 000036.00 636 J2250
PHAR 000001795263 MIDAZOLAM 5MG INJ 000062.40 636 J2250
PHAR 000001759526 MILRINONE 10MG INJ 000260.40 636 J2260
PHAR 000001759897 MILRINONE LACTATE 60 MG IV 000966.00 636 J2260
PHAR 000001759898 MILRINONE LACTATE 70 MG IV 001117.20 636 J2260
PHAR 000001759899 MILRINONE LACTATE 80 MG IV 001276.80 636 J2260
PHAR 000001759900 MILRINONE LACTATE 90 MG IV 001436.40 636 J2260
PHAR 000001759901 MILRINONE LACTATE 100 MG IV 001596.00 636 J2260
PHAR 000001759902 MILRINONE LACTATE 110 MG IV 001754.40 636 J2260
PHAR 000001771234 MILRINONE LAC/D5W 100ML 000502.93 636 J2260
PHAR 000001734015 MORPHINE SULFATE SOL 2MG 000005.40 259 J2270
PHAR 000001734031 MORPHINE SOL 4MG 000000.71 636 J2270
PHAR 000001734038 MORPHINE SOLUTION SOL 2MG 000000.66 636 J2270
PHAR 000001737011 MORPHINE SULFATE INJ 15M 000019.20 636 J2270
PHAR 000001737013 MORPHINE SULFATE INJ 10M 000019.20 636 J2270
PHAR 000001737015 MORPHINE SULFATE INJ 8MG 000019.20 636 J2270
PHAR 000001737040 MORPHINE SULFATE INJ 1MG 000068.40 636 J2270
PHAR 000001737060 MORPHINE SULFATE 200 10 MG INJ 000561.60 636 J2270
PHAR 000001737069 MORPHINE SULFATE 500 25 MG INJ 001011.60 636 J2270
9/7/2010 11:52 AM Page 13 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001737078 MORPHINE SULFATE INJ 2MG 000019.20 636 J2270
PHAR 000001737082 MORPHINE SULFATE INJ 2MG 000019.40 636 J2270
PHAR 000001737083 MORPHINE SULFATE INJ 4MG 000019.40 636 J2270
PHAR 000001757237 MORPHINE 15MG/ML 20ML INJ 000088.80 636 J2270
PHAR 000001759330 MORPH SULF 50 MG LVP 000027.60 636 J2270
PHAR 000001759888 MORPHINE .PWDR 1MG PWD IV 000043.20 636 J2270
PHAR 000001795040 MORPHINE SULFATE *OP INJ 10M 000019.20 636 J2270
PHAR 000001759331 MORPH SULF 100 MG LVP 000043.20 636 J2271
PHAR 000001759332 MORPH SULF 150 MG LVP 000055.20 636 J2271
PHAR 000001759334 MORPH SULF 250 MG LVP 000088.80 636 J2271
PHAR 000001759335 MORPH SULF 300 MG LVP 000100.80 636 J2271
PHAR 000001759340 MORPH SULF 550 MG LVP 000160.80 636 J2271
PHAR 000001759680 MORPHINE 100MG INJ 000078.00 636 J2271
PHAR 000001759681 MS/HLVP 100 MG 000078.00 636 J2271
PHAR 000001759992 MORPHINE SULF 500MG INJ 000036.00 636 J2271
PHAR 000001737039 MORPHINE SULFATE PF INJ 0.5 000088.80 636 J2275
PHAR 000001737061 MORPHINE 30MG PCA SYR INJ 000086.40 636 J2275
PHAR 000001737072 MORPHINE PCA SYR 1MG/ML 000068.40 636 J2275
PHAR 000001758396 MORPHINE PF 200MG INJ 000561.60 636 J2275
PHAR 000001758801 MORPHINE PF 10MG INJ 000068.40 636 J2275
PHAR 000001759620 MORPHINE PF 10MG INJ 000129.60 636 J2275
PHAR 000001759940 MORPHINE SULF PF INJ 25M 000242.40 636 J2275
PHAR 000001759974 MORPHINE PF 10MG INJ 000068.40 636 J2275
PHAR 000001720255 NALBUPHINE 10MG INJ 000048.00 636 J2300
PHAR 000001720411 NALBUPHINE 20MG INJ 000022.80 636 J2300
PHAR 000001759515 NALBUPHINE 20MG INJ 000028.80 636 J2300
PHAR 000001795163 NALBUPHINE HCL AMP 10MG 000013.91 636 J2300
PHAR 000001720483 NALOXONE HCL 0.4MG INJ 000192.00 636 J2310
PHAR 000001720711 NALOXONE HCL 1MG INJ 000111.60 636 J2310
PHAR 000001757644 NARCAN/LVP 12 MG 000511.56 636 J2310
PHAR 000001757985 NARCAN/LVP 40 MG 001400.70 636 J2310
PHAR 000001758903 NARCAN/LVP 2 MG 000168.00 636 J2310
PHAR 000001720096 NANDROLONE DECANOATE 50MG INJ 000042.00 636 J2320
PHAR 000001720085 NANDROLONE DECANOATE 100MG INJ 000141.60 636 J2321
PHAR 000001757974 NESIRITIDE INJ 0.3 001311.00 250 J2324
PHAR 000001758942 OCTREOTIDE 1 MG INJ 000259.20 636 J2353
PHAR 000001720913 SANDOSTATIN 30MG KIT 005887.60 636 J2354
PHAR 000001720927 SANDOSTATIN 20MG KIT 004195.92 636 J2354
PHAR 000001756540 SANDOSTATIN PB 50MCG/ML 000062.60 636 J2354
PHAR 000001720887 OPRELVEKIN 5MG INJ 000703.87 636 J2355
PHAR 000001795189 CHLOROPROCAINE HYDROC 3% 000064.08 636 J2400
PHAR 000001720697 ONDANSETRON 20ML MDV INJ 2MG 000717.92 636 J2405
PHAR 000001721066 ONDANSETRON SDV INJ 2MG 000141.60 636 J2405
PHAR 000001754413 ONDANSETRON 20MG INJ 000416.91 636 J2405
PHAR 000001754414 ONDANSETRON/PB 10MG 000259.87 636 J2405
PHAR 000001754415 ONDANSETRON/PB 20MG 000416.91 636 J2405
PHAR 000001754416 ONDANSETRON/PB 30MG 000583.59 636 J2405
9/7/2010 11:52 AM Page 14 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001754417 ONDANSETRON/PB 40MG 000724.59 636 J2405
PHAR 000001754421 ONDANSETRON/PB 80MG 001288.67 636 J2405
PHAR 000001754628 ONDANSETRON INJ 2MG 000724.59 636 J2405
PHAR 000001754629 ONDANSETRON/PB 10MG 000259.87 636 J2405
PHAR 000001754630 ONDANSETRON/PB 20MG 000416.91 636 J2405
PHAR 000001758490 ONDANSETRON INJ 2MG 000717.92 636 J2405
PHAR 000001758533 ONDANSETRON 10 MG/LV 000237.60 636 J2405
PHAR 000001758534 ONDANSETRON 20 MG/LV 000386.57 636 J2405
PHAR 000001758618 ONDANSETRON 30 MG/LV 000541.20 636 J2405
PHAR 000001795266 ONDANSETRON 4MG INJ 000141.60 636 J2405
PHAR 000001737023 OXYMORPHONE HCL 1.5MG INJ 000038.40 636 J2410
PHAR 000001759467 PAMIDRONATE 30MG INJ 000909.57 636 J2430
PHAR 000001759469 AREDIA/LVP 20 MG IV 000409.00 636 J2430
PHAR 000001759470 AREDIA/LVP 30 MG IV 000572.62 636 J2430
PHAR 000001759471 AREDIA/LVP 60 MG IV 001002.07 636 J2430
PHAR 000001759472 AREDIA/LVP 90 MG IV 001411.08 636 J2430
PHAR 000001780056 PAPAVERINE HCL 30MG INJ 000028.80 636 J2440
PHAR 000001720909 ZEMPLAR INJ 5 MCG/ML 000157.20 636 J2501
PHAR 000001721013 PENICILLIN G PROCAINE 600000U 000075.60 636 J2510
PHAR 000001721014 PENICILLIN G PROCAINE 600000U 000038.40 636 J2510
PHAR 000001721015 PENICILLIN G PROCAINE 600000U 000025.80 636 J2510
PHAR 000001737071 PENTOBARBITAL UD INJ 50MG INJ 000018.00 636 J2515
PHAR 000001757272 PENTOBARB INJ 50MG 000019.20 636 J2515
PHAR 000001720420 PENICILLIN G POTASS INJ 500 000017.40 636 J2540
PHAR 000001751417 PENICILLIN G K INJ 600 000035.47 636 J2540
PHAR 000001751414 PIPERCIL/TAZOBACTAM INJ 0.6 000119.47 636 J2543
PHAR 000001751415 ZOSYN/PB 3.375GM 000119.47 636 J2543
PHAR 000001751416 ZOSYN/PB 6.75GM 000172.27 636 J2543
PHAR 000001720455 PHENERGAN INJ 25MG/ML 1ML 000017.40 636 J2550
PHAR 000001720456 PROMETHAZINE INJ 50MG/ML 1ML 000020.40 636 J2550
PHAR 000001720211 PHENOBARBITAL 65MG INJ 000019.20 636 J2560
PHAR 000001737075 PHENOBARBITAL 30MG INJ 000022.80 636 J2560
PHAR 000001754187 PHENOBARBITAL 65MG INJ 000028.80 636 J2560
PHAR 000001754188 PHENOBARB PB 10 MG 000028.80 636 J2560
PHAR 000001754189 PHENOBARB PB 30 MG 000028.80 636 J2560
PHAR 000001754190 PHENOBARB PB 65 MG 000028.80 636 J2560
PHAR 000001754192 PHENOBARB PB 200 MG 000038.40 636 J2560
PHAR 000001754193 PHENOBARB PB 240 MG 000042.00 636 J2560
PHAR 000001754194 PHENOBARB PB 300 MG 000049.20 636 J2560
PHAR 000001754427 PHENOBARBITAL 65 MG INJ 000028.80 636 J2560
PHAR 000001754772 PHENOBARBITAL 65MG INJ 000028.80 636 J2560
PHAR 000001754950 PHENOBARB/PB 1 MG 000028.80 636 J2560
PHAR 000001754951 PHENOBARB PB 2 MG 000028.80 636 J2560
PHAR 000001754952 PHENOBARB PB 3 MG 000028.80 636 J2560
PHAR 000001754953 PHENOBARB PB 4 MG 000028.80 636 J2560
PHAR 000001754954 PHENOBARB PB 5 MG 000028.80 636 J2560
PHAR 000001754955 PHENOBARB 6 MG 000028.80 636 J2560
9/7/2010 11:52 AM Page 15 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001754956 PHENOBARB 7 MG 000028.80 636 J2560
PHAR 000001754957 PHENOBARB 8 MG 000028.80 636 J2560
PHAR 000001754958 PHENOBARB 9 MG 000028.80 636 J2560
PHAR 000001754959 PHENOBARB 10 MG 000028.80 636 J2560
PHAR 000001754960 PHENOBARB 20 MG 000028.80 636 J2560
PHAR 000001754961 PHENOBARB/PB 30 MG 000028.80 636 J2560
PHAR 000001754962 PHENOBARB/PB 40 MG 000028.80 636 J2560
PHAR 000001754963 PHENOBARB PB 50 MG 000028.80 636 J2560
PHAR 000001756544 PHENOBARBITAL 60MG INJ 000034.80 636 J2560
PHAR 000001720915 OXYTOCIN 10U/ML 10ML 000038.40 636 J2590
PHAR 000001757732 OXYTOCIN 10U INJ 000028.80 636 J2590
PHAR 000001720413 DESMOPRESSIN INJ 4MCG/ML 000141.60 636 J2597
PHAR 000001720511 DESMOPRESSIN ACET 10M 4MCG INJ 000610.49 636 J2597
PHAR 000001757507 DESMOPRESSIN 4MCG INJ 000112.80 636 J2597
PHAR 000001758103 TOLAZOLINE 100MG INJ 000112.80 636 J2670
PHAR 000001758104 TOLAZOLINE/LVP 100MG 000093.60 636 J2670
PHAR 000001758105 TOLAZOLINE/LVP 200MG 000146.40 636 J2670
PHAR 000001758106 TOLAZOLINE/LVP 300MG 000184.80 636 J2670
PHAR 000001758153 TOLAZOLINE/LVP 400MG 000229.20 636 J2670
PHAR 000001758311 TOLAZOLINE/LVP 500MG 000244.80 636 J2670
PHAR 000001759599 TOLAZOLINE/LVP 600MG 000260.40 636 J2670
PHAR 000001759669 TOLAZOLINE/LVP 700 M 000290.09 636 J2670
PHAR 000001759670 TOLAZOLINE/LVP 800MG 000331.56 636 J2670
PHAR 000001759714 TOLAZOLINE/LVP 1GM 000414.43 636 J2670
PHAR 000001721037 PROGESTERONE 500MG INJ 000192.00 636 J2675
PHAR 000001720182 FLUPHENAZINE 2.5MG INJ 000237.60 636 J2680
PHAR 000001720193 FLUPHENAZINE DECANOAT 25MG INJ 000217.20 636 J2680
PHAR 000001720209 PROCAINAMIDE 1GM INJ 000075.60 636 J2690
PHAR 000001720217 PROCAINAMIDE 1GM INJ 000075.60 636 J2690
PHAR 000001754217 PROCAINAMIDE 1GM INJ 000093.60 636 J2690
PHAR 000001754218 PRONESTYL PB 100 MG 000028.80 636 J2690
PHAR 000001754226 PRONESTYL PB 900 MG 000093.60 636 J2690
PHAR 000001754227 PRONESTYL PB 1000 MG 000093.60 636 J2690
PHAR 000001757312 PROCAINAMIDE 1GM INJ 000093.60 636 J2690
PHAR 000001757313 PROCAINAMIDE LVP 0.5 000055.20 636 J2690
PHAR 000001757314 PROCAINAMIDE LVP 1 G 000093.60 636 J2690
PHAR 000001757315 PROCAINAMIDE LVP 1.5 000122.40 636 J2690
PHAR 000001757316 PROCAINAMIDE LVP 2 G 000146.40 636 J2690
PHAR 000001757318 PROCAINAMIDE LVP 3 G 000184.80 636 J2690
PHAR 000001795099 PROCAINAMIDE 1GM INJ 000075.60 636 J2690
PHAR 000001751134 OXACILLIN 1GM INJ 000100.27 636 J2700
PHAR 000001751272 OXACILLIN/PB 0.25GM 000045.07 636 J2700
PHAR 000001751273 OXACILLIN/PB 0.5GM 000064.27 636 J2700
PHAR 000001751274 OXACILLIN/PB 1GM 000100.27 636 J2700
PHAR 000001751275 OXACILLIN/PB 2GM 000157.87 636 J2700
PHAR 000001751276 OXACILLIN/PB 3GM 000187.87 636 J2700
PHAR 000001720222 NEOSTIGMINE METHYLSUL 0.25MG 000017.40 636 J2710
9/7/2010 11:52 AM Page 16 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001720231 NEOSTIGMINE METHYLSUL 0.5MG IN 000020.40 636 J2710
PHAR 000001720237 NEOSTIGMINE METHY 10M 0.5MG IN 000075.60 636 J2710
PHAR 000001720493 NEOSTIGMINE METHYLSUL 1MG INJ 000111.60 636 J2710
PHAR 000001720140 PROTAMINE SULF 50MG 10MG INJ 000048.00 636 J2720
PHAR 000001720150 PROTAMINE SULF 250MG 10MG INJ 000126.00 636 J2720
PHAR 000001758007 PROTAMINE 50MG INJ 000051.60 636 J2720
PHAR 000001758008 PROTAMINE/LVP 25 MG 000035.40 636 J2720
PHAR 000001758009 PROTAMINE/LVP 50 MG 000051.60 636 J2720
PHAR 000001758010 PROTAMINE/LVP 75 MG 000067.20 636 J2720
PHAR 000001795214 PROTAMINE 250MG INJ 000048.00 636 J2720
PHAR 000001720379 PROTIRELIN 500MCG INJ 000141.60 636 J2725
PHAR 000001720666 PRALIDOXIME CL 1 GM 50MG INJ 000157.20 636 J2730
PHAR 000001758607 PRALIDOXIME 1GM INJ 000168.00 636 J2730
PHAR 000001720203 PHENTOLAMINE MESYLATE INJ 2.5 000157.20 636 J2760
PHAR 000001795100 PHENTOLAMINE 5MG INJ 000157.20 636 J2760
PHAR 000001720223 METOCLOPRAMIDE HCL INJ 5MG 000022.80 636 J2765
PHAR 000001754061 METOCLOPRAMIDE HCL INJ 5MG 000124.80 636 J2765
PHAR 000001754404 METOCLOPRAM PB 10 MG 000028.80 636 J2765
PHAR 000001754406 METOCLOPRAM PB 30 MG 000042.00 636 J2765
PHAR 000001756542 METOCLOPRAMIDE 0.5MG/ML INJ 000031.80 636 J2765
PHAR 000001757319 METOCLOPRAMIDE HCL INJ 5MG 000122.40 636 J2765
PHAR 000001758524 METOCLOPRAM/LVP 100 MG 000093.60 636 J2765
PHAR 000001759600 METOCLOPRAMIDE HCL INJ 5MG 000122.40 636 J2765
PHAR 000001795158 METOCLOPRAMIDE 10MG INJ 000022.80 636 J2765
PHAR 000001753511 SYNERCID 500MG INJ 000386.73 636 J2770
PHAR 000001720783 RASBURICASE 1.5MG INJ 1.5 000938.75 636 J2783
PHAR 000001721083 RHO IMM GLOB 1500U INJ 000676.80 636 J2790
PHAR 000001759839 RHO IMM GLOB 1500U INJ 000789.60 636 J2790
PHAR 000001759984 RHO(D)IMM GLOB 5000U 003068.95 636 J2790
PHAR 000001712178 RISPERIDONE 1MG TAB 000009.36 636 J2794
PHAR 000001712188 RISPERIDONE 2MG TAB 000012.39 636 J2794
PHAR 000001712189 RISPERIDONE 3MG TAB 000013.76 636 J2794
PHAR 000001712190 RISPERIDONE 4MG TAB 000016.61 636 J2794
PHAR 000001712232 RISPERIDONE 0.5MG TAB 000010.27 636 J2794
PHAR 000001712235 RISPERIDONE 0.25MG TAB 000010.27 636 J2794
PHAR 000001720238 METHOCARBAMOL INJ 100MG/ML 000111.60 250 J2800
PHAR 000001759022 SARGRAMOSTIM-LEUKINE INJ 250 000435.60 636 J2820
PHAR 000001759027 SARGRAMOSTIM INJ 500 000645.12 636 J2820
PHAR 000001720934 FERRIC GLUC 62.5MG INJ 000192.00 636 J2916
PHAR 000001759931 FERRIC GLUC 62.5MG INJ 000201.60 636 J2916
PHAR 000001720346 METHYLPRED NA INJ 40M 000020.40 636 J2920
PHAR 000001754228 METHYLPRED NA INJ 40M 000031.80 636 J2920
PHAR 000001755574 METHYLPRED NA INJ 40M 000032.40 636 J2920
PHAR 000001755575 SOLU-MEDROL 10 MG LVP 000028.80 636 J2920
PHAR 000001755576 SOLU-MEDROL 20 MG LVP 000028.80 636 J2920
PHAR 000001755577 SOLU-MEDROL 30 MG LVP 000028.80 636 J2920
PHAR 000001755578 SOLU-MEDROL 40 MG LVP 000032.40 636 J2920
9/7/2010 11:52 AM Page 17 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001757516 METHYLPRED NA INJ 40M 000032.40 636 J2920
PHAR 000001757517 SOLU-MEDROL 10 MG LVP 000028.80 636 J2920
PHAR 000001757519 SOLU-MEDROL 30 MG LVP 000028.80 636 J2920
PHAR 000001757520 SOLU-MEDROL 40 MG LVP 000032.40 636 J2920
PHAR 000001720342 METHYLPRED NA. INJ 62. 000141.60 636 J2930
PHAR 000001720344 METHYLPRED NA. INJ 125 000098.40 636 J2930
PHAR 000001720347 METHYLPRED NA INJ 62. 000025.80 636 J2930
PHAR 000001754467 METHYLPRED NA INJ 62. 000057.60 636 J2930
PHAR 000001754468 SOLU-MEDROL 125 MG LVP 000057.60 636 J2930
PHAR 000001754469 SOLU-MEDROL 250 MG LVP 000093.60 636 J2930
PHAR 000001754470 SOLU-MEDROL 375 MG LVP 000112.80 636 J2930
PHAR 000001755579 SOLU-MEDROL 60 MG LVP 000039.00 636 J2930
PHAR 000001757511 METHYLPRED NA INJ 62. 000055.20 636 J2930
PHAR 000001757512 SOLU-MEDROL 125 MG LVP 000055.20 636 J2930
PHAR 000001757513 SOLU-MEDROL 250 MG LVP 000093.60 636 J2930
PHAR 000001757514 SOLU-MEDROL 375 MG LVP 000112.80 636 J2930
PHAR 000001758998 METHYLPRED NA INJ 125 000168.00 636 J2930
PHAR 000001795171 METHYLPRED 250MG INJ 000025.80 636 J2930
PHAR 000001720548 SOMATROPIN VIAL 5MG 000655.20 636 J2941
PHAR 000001753500 HUMATROPE INJ 5MG/ML 000655.20 636 J2941
PHAR 000001753502 SOMATROPIN 1 MG INJ 000214.80 636 J2941
PHAR 000001753534 SOMATROPIN *SPEC DIL INJ 1 M 000131.04 636 J2941
PHAR 000001757011 NUTROPIN AQ 10MG INJ 001323.67 636 J2941
PHAR 000001720445 PROMAZINE HCL INJ 50M 000157.20 636 J2950
PHAR 000001720919 RETEPLASE 18.1MG INJ 003643.20 636 J2993
PHAR 000001759985 RETEPLASE 18.1MG LVP 003643.20 636 J2993
PHAR 000001720356 STREPTOKINASE 250K VI 250000U 000386.42 636 J2995
PHAR 000001720357 STREPTOKINASE 750K U 0.75MU IV 000739.16 636 J2995
PHAR 000001720788 STREPTOKINASE 1.5MU V 1.5MU 001307.80 636 J2995
PHAR 000001757580 STREPTOKINASE 250,000U INJ 000386.42 636 J2995
PHAR 000001757581 STREPTAS/LVP 250000U 000386.42 636 J2995
PHAR 000001757583 STREPTOKINASE 750,000U INJ 001961.62 636 J2995
PHAR 000001757584 STREPTAS/LVP 750000U 000739.16 636 J2995
PHAR 000001720527 ALTEPLASE (TPA) 50MG 003795.00 636 J2997
PHAR 000001720787 ALTEPLASE (TPA) 100MG 007590.00 636 J2997
PHAR 000001720932 ALTEPLASE (CATHETER) INJ 2MG 000270.00 636 J2997
PHAR 000001756537 ACTIVASE 2 MG/LVP 000237.60 636 J2997
PHAR 000001756538 ACTIVASE 5 MG/LVP 000495.00 636 J2997
PHAR 000001756539 ACTIVASE 10 MG/LVP 000858.00 636 J2997
PHAR 000001758367 ALTEPLASE (TPA-IV) INJ 1MG 003795.00 636 J2997
PHAR 000001758368 ACTIVASE 50 MG/LVP IV 003795.00 636 J2997
PHAR 000001758369 ACTIVASE 100 MG/LVP IV 007590.00 636 J2997
PHAR 000001720358 STREPTOMYCIN 1 GM VIA 1GM 000022.80 636 J3000
PHAR 000001737024 FENTANYL INJ 50M 000024.60 636 J3010
PHAR 000001737025 FENTANYL INJ 50M 000033.60 636 J3010
PHAR 000001737026 FENTANYL INJ 50M 000100.80 636 J3010
PHAR 000001737027 FENTANYL INJ 50M 000088.80 636 J3010
9/7/2010 11:52 AM Page 18 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001758203 FENTANYL INJ 50M 000024.60 636 J3010
PHAR 000001758225 FENTANYL/LVP 2 MG 000184.80 636 J3010
PHAR 000001759361 FENTANYL/LVP 5 MG 000272.23 636 J3010
PHAR 000001795043 FENTANYL 100MCG INJ 000024.60 636 J3010
PHAR 000001721041 SUMATRIPTAN INJ 6MG 000217.20 636 J3030
PHAR 000001737005 PENTAZOCINE LACTATE 30MG INJ 000033.60 636 J3070
PHAR 000001720036 TESTOSTERONE CYPIONAT 100MG IN 000172.80 636 J3120
PHAR 000001720097 TESTOSTERONE CYPIONAT 200MG IN 000237.60 636 J3130
PHAR 000001720369 TESTOSTERONE 50MG INJ 000034.80 636 J3140
PHAR 000001720370 TESTOSTERONE 25MG INJ 000025.80 636 J3140
PHAR 000001720378 THORAZINE 50MG/2ML 000019.00 636 J3230
PHAR 000001720458 CHLORPROMAZINE 50MG 25MG INJ 000017.40 636 J3230
PHAR 000001720459 CHLORPROMAZINE HCL INJ 50 000017.40 636 J3230
PHAR 000001795080 CHLORPROMAZINE 50MG INJ 000017.40 636 J3230
PHAR 000001722022 TIROFIBAN 12.5MG INJ 001206.12 636 J3246
PHAR 000001720380 TRIMETHOBENZAMIDE 100MG INJ 000031.92 636 J3250
PHAR 000001795174 TRIMETHOBENZAMIDE 200MG INJ 000031.92 636 J3250
PHAR 000001720432 TOBRAMYCIN 80MG INJ 000054.00 636 J3260
PHAR 000001720535 TOBRAMYCIN (PED-INJ) INJ 10M 000031.80 636 J3260
PHAR 000001752037 TOBRAMYCIN(PEDS)3700 INJ 10M 000038.40 636 J3260
PHAR 000001752038 TOBRAM PB PEDS 5MG 000028.80 636 J3260
PHAR 000001752039 TOBRAM PB PEDS 10MG 000028.80 636 J3260
PHAR 000001752040 TOBRAM PB PEDS 15MG 000034.80 636 J3260
PHAR 000001752041 TOBRAM PB PEDS 20MG 000038.40 636 J3260
PHAR 000001752137 TOBRAM PB PEDS 25 MG 000045.00 636 J3260
PHAR 000001752138 TOBRAM PB PEDS 30 MG 000049.20 636 J3260
PHAR 000001752139 TOBRAM PB PEDS 35 MG 000053.40 636 J3260
PHAR 000001752140 TOBRAM PB PEDS 40 MG 000057.60 636 J3260
PHAR 000001752244 TOBRAMYCIN 80MG INJ 000076.27 636 J3260
PHAR 000001752245 TOBRAMYCIN/PB 10MG 000035.47 636 J3260
PHAR 000001752246 TOBRAMYCIN/PB 20MG 000038.47 636 J3260
PHAR 000001752247 TOBRAMYCIN/PB 30MG 000045.07 636 J3260
PHAR 000001752248 TOBRAMYCIN/PB 40MG 000051.67 636 J3260
PHAR 000001752249 TOBRAMYCIN/PB 60MG 000064.27 636 J3260
PHAR 000001752250 TOBRAMYCIN/PB 80MG 000076.27 636 J3260
PHAR 000001752251 TOBRAMYCIN/PB 100MG 000085.87 636 J3260
PHAR 000001752252 TOBRAMYCIN/PB 120MG 000100.27 636 J3260
PHAR 000001752253 TOBRAMYCIN/PB 140MG 000109.87 636 J3260
PHAR 000001752254 TOBRAMYCIN/PB 160MG 000119.47 636 J3260
PHAR 000001752255 TOBRAMYCIN/PB 180MG 000131.47 636 J3260
PHAR 000001752256 TOBRAMYCIN/PB 200MG 000144.67 636 J3260
PHAR 000001752257 TOBRAMYCIN/PB 220MG 000157.87 636 J3260
PHAR 000001752258 TOBRAMYCIN/PB 240MG 000157.87 636 J3260
PHAR 000001752259 TOBRAMYCIN/PB 280MG 000172.27 636 J3260
PHAR 000001752260 TOBRAMYCIN/PB 300MG 000172.27 636 J3260
PHAR 000001752261 TOBRAMYCIN 80MG INJ 000069.60 636 J3260
PHAR 000001752262 TOBRAMYC PB 10 MG 000028.80 636 J3260
9/7/2010 11:52 AM Page 19 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001752263 TOBRAMYC PB 20 MG 000031.80 636 J3260
PHAR 000001752264 TOBRAMYC PB 30 MG 000038.40 636 J3260
PHAR 000001752265 TOBRAMYC PB 40 MG 000045.00 636 J3260
PHAR 000001752266 TOBRAMYC PB 60 MG 000057.60 636 J3260
PHAR 000001752267 TOBRAMYC PB 80 MG 000069.60 636 J3260
PHAR 000001752269 TOBRAMYC PB 120 MG 000093.60 636 J3260
PHAR 000001752270 TOBRAMYC PB 140 MG 000103.20 636 J3260
PHAR 000001752302 TOBRAMYCIN/PB 325MG 000172.27 636 J3260
PHAR 000001752303 TOBRAMYCIN/PB 350MG 000187.87 636 J3260
PHAR 000001752304 TOBRAMYCIN/PB 375MG 000241.87 636 J3260
PHAR 000001752305 TOBRAMYCIN/PB 400MG 000241.87 636 J3260
PHAR 000001752306 TOBRAMYCIN/PB 450MG 000257.47 636 J3260
PHAR 000001752307 TOBRAMYCIN/PB 500MG 000264.67 636 J3260
PHAR 000001757631 TOBRAMYCIN 80MG INJ 000067.20 636 J3260
PHAR 000001757632 TOBRAMYC/LVP 20 MG 000032.40 636 J3260
PHAR 000001757633 TOBRAMYC/LVP 40 MG 000044.40 636 J3260
PHAR 000001757634 TOBRAMYC/LVP 60 MG 000055.20 636 J3260
PHAR 000001757635 TOBRAMYC/LVP 80 MG 000067.20 636 J3260
PHAR 000001757640 TOBRAMYC/LVP 180 MG 000122.40 636 J3260
PHAR 000001795008 TOBRAMYCIN 80MG INJ 000054.00 636 J3260
PHAR 000001720839 TORSEMIDE 10MG INJ 000031.80 636 J3265
PHAR 000001720840 TORSEMIDE 10MG INJ 000042.00 636 J3265
PHAR 000001720077 TRIAMCINOLONE ACETONI 40MG INJ 000042.00 636 J3301
PHAR 000001720181 TRIAMCINOLONE ACETONI 10MG INJ 000048.00 636 J3301
PHAR 000001720190 TRIAMCINOLONE ACETONI 40MG INJ 000141.60 636 J3301
PHAR 000001744036 TRIAMCINOLONE ACETONI 20 GM IN 000061.61 636 J3301
PHAR 000001720177 TRIAMCINOLONE DIACETA 40MG INJ 000048.00 636 J3302
PHAR 000001721042 PERPHENAZINE 5MG INJ 000038.40 636 J3310
PHAR 000001721001 SPECTINOMYCIN HCL VIA 4GM INJ 000157.20 636 J3320
PHAR 000001737041 DIAZEPAM INJ 5MG 000024.60 636 J3360
PHAR 000001737080 DIAZEPAM INJ 5MG 000019.20 636 J3360
PHAR 000001795044 DIAZEPAM 10MG INJ 000024.60 636 J3360
PHAR 000001720041 UROKINASE OPEN-CATH INJ 500 000237.60 636 J3364
PHAR 000001757577 UROKINASE/LVP 5000 U 000237.60 636 J3364
PHAR 000001720031 "UROKINASE 250,000U " 500000U 001242.61 636 J3365
PHAR 000001757573 UROKINASE (250 KU)IV INJ 500 001242.61 636 J3365
PHAR 000001757574 UROKINAS/LVP 250000U 001242.61 636 J3365
PHAR 000001757862 UROKINAS/LVP 1 MU 004970.42 636 J3365
PHAR 000001720475 VANCOMYCIN 500MG INJ 000054.00 636 J3370
PHAR 000001720688 VANCOMYCIN 1GM INJ 000098.40 636 J3370
PHAR 000001753042 VANCOMYCIN 1GM INJ 000118.27 636 J3370
PHAR 000001753176 VANCOMYCIN 1GM INJ 000118.27 636 J3370
PHAR 000001753230 VANCOMYCIN/PB 500MG 000069.07 636 J3370
PHAR 000001753231 VANCOMYCIN/PB 750MG 000100.27 636 J3370
PHAR 000001753232 VANCOMYCIN/PB 1000MG 000109.87 636 J3370
PHAR 000001753233 VANCOMYCIN/PB 1250MG 000131.47 636 J3370
PHAR 000001753234 VANCOMYCIN/PB 1500MG 000157.87 636 J3370
9/7/2010 11:52 AM Page 20 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001753235 VANCOMYCIN/PB 2000MG 000172.27 636 J3370
PHAR 000001753236 VANCOMYCIN/PB 2500MG 000187.87 636 J3370
PHAR 000001753432 VANCOMYCIN 500 MG IVPB 000069.07 636 J3370
PHAR 000001753433 VANCOMYCIN 1000 MG IVPB 000118.27 636 J3370
PHAR 000001753434 VANCOMYCIN 2000 MG IVPB 000172.27 636 J3370
PHAR 000001753435 VANCOMYCIN 3000 MG IVPB 000221.47 636 J3370
PHAR 000001795009 VANCOMYCIN 1GM INJ 000111.60 636 J3370
PHAR 000001720637 TRIFLUOPERAZINE HCL 2MG INJ 000025.80 636 J3400
PHAR 000001720092 THIAMINE HCL 100MG INJ 000017.40 636 J3411
PHAR 000001757658 THIAMINE 100MG INJ 000028.80 636 J3411
PHAR 000001757661 THIAMINE/LVP 100 MG 000028.80 636 J3411
PHAR 000001757662 THIAMINE/LVP 200 MG 000028.80 636 J3411
PHAR 000001765007 THIAMINE HCL 100MG INJ 000001.20 636 J3411
PHAR 000001715101 PYRIDOXINE (IV FORM) 100MG INJ 000008.40 636 J3415
PHAR 000001720460 PYRIDOXINE HCL 100MG INJ 000017.40 636 J3415
PHAR 000001720634 PYRIDOXINE HCL INJ 100 000022.80 636 J3415
PHAR 000001720082 PHYTONADIONE INJ 2MG 000022.80 636 J3420
PHAR 000001720402 CYANOCOBALAMIN 1000MCG INJ 000020.40 636 J3420
PHAR 000001720933 PHYTONADIONE 1MG INJ 000022.80 636 J3420
PHAR 000001765005 CYANOCOBALAMIN 1000MCG IV 000001.20 636 J3420
PHAR 000001753462 VORICONAZOLE INJ 10M 000265.63 636 J3465
PHAR 000001720707 HYALURONIDASE INJ 150 000062.50 636 J3470
PHAR 000001721016 HYALURONIDASE INJ 150 000126.00 636 J3470
PHAR 000001795067 HYALURONIDASE 150UU INJ 000023.00 636 J3470
PHAR 000001715016 MAG SULF (IV FRM) OS 0.5GM 000006.60 636 J3475
PHAR 000001720064 MAGNESIUM SULFATE SYR 50 000060.00 636 J3475
PHAR 000001720200 MAGNESIUM SULFATE INJ 500 000017.40 636 J3475
PHAR 000001720117 POTASSIUM CHLORIDE INJ 2ME 000031.80 636 J3480
PHAR 000001757096 POTASSIUM CHLORIDE INJ 2ME 000055.20 636 J3480
PHAR 000001757809 POTASSIUM CHL 3700 INJ 2ME 000055.20 636 J3480
PHAR 000001763009 POTASSIUM CHLORIDE INJ 2ME 000001.20 636 J3480
PHAR 000001768034 POTASSIUM CHLORIDE INJ 2ME 000000.00 636 J3480
PHAR 000001720846 ZIDOVUDINE 200MG INJ 000111.60 636 J3485
PHAR 000001795301 NACL 0.9% 1000ML 000052.27 636 J7030
PHAR 000001771017 D5.9% NACL 500ML 000052.27 636 J7042
PHAR 000001795292 NACL 0.9% 250ML INJ 000052.27 636 J7050
PHAR 000001771068 NACL 0.9% -PRES FREE INJ 1ML 000052.27 250 J7051
PHAR 000001771007 D5W 500ML 000052.27 636 J7060
PHAR 000001795318 D5W INJ 500ML 000012.00 636 J7060
PHAR 000001771006 D5W 1000ML 000052.27 636 J7070
PHAR 000001771091 DEXTRAN 40/NS 500ML 000122.27 636 J7100
PHAR 000001771092 DEXTRAN 40/D5W 500ML 000122.27 636 J7100
PHAR 000001771045 LACTATED RINGERS 1000ML 000052.27 636 J7120
PHAR 000001771047 LACTATED RINGERS 500ML 000052.27 636 J7120
PHAR 000001771049 LACTATED RINGERS 250ML 000052.27 636 J7120
PHAR 000001780072 LACTATED RINGERS 000069.85 636 J7120
PHAR 000001795295 LACTATED RINGERS 500ML 000052.27 636 J7120
9/7/2010 11:52 AM Page 21 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001795296 LACTATED RINGERS 1000ML 000052.27 636 J7120
PHAR 000001720464 HT FACTORATE VIA 325 000292.50 250 J7190
PHAR 000001720596 MONOCLATE-P 100 IU (HUMAN) 000177.60 636 J7190
PHAR 000001720616 FACTOR 8 (KOATE-HT) 490U 000298.90 636 J7190
PHAR 000001720668 HUMATE-P 100 RCU (HUMAN) 000175.20 636 J7190
PHAR 000001720659 HYATE:C 100 IU (PORCINE) 000439.20 636 J7191
PHAR 000001720597 MONOCLATE P 1000U 001776.00 636 J7192
PHAR 000001720681 MONOCLATE 1040 UNIT 001160.64 636 J7192
PHAR 000001720686 MONOCLATE 225 UNITS 000475.20 636 J7192
PHAR 000001720727 MONOCLATE 515 UNIT 000574.74 636 J7192
PHAR 000001720773 MONOCLATE - P 1130 U 001261.08 636 J7192
PHAR 000001720789 MONOCLATE -P 240 U 000267.84 636 J7192
PHAR 000001720848 BIOCLATE 100 IU (RECOMB) 000276.00 636 J7192
PHAR 000001720878 HELIXATE 100 IU (RECOMB) 000187.20 636 J7192
PHAR 000001720879 HELIXATE 550 UNITS 001029.60 636 J7192
PHAR 000001720880 HELIXATE 1032 UNITS 001931.90 636 J7192
PHAR 000001720881 HELIXATE 1207 UNITS 002259.50 636 J7192
PHAR 000001720882 HELIXATE 1174 UNITS 002197.73 636 J7192
PHAR 000001720883 HELIXATE 272 UNITS 000509.18 636 J7192
PHAR 000001720908 HELIXATE 366 UNITS 000685.15 636 J7192
PHAR 000001720923 HELIXATE-FS 100 IU (RECOMB) 000252.00 636 J7192
PHAR 000001721102 RECOMBINATE 100 IU (RECOMB) 000300.00 636 J7192
PHAR 000001721103 RECOMBINATE 273U 000819.00 636 J7192
PHAR 000001720588 ANTIHEMOPHILIC FACTOR 1UNIT 000001.01 636 J7193
PHAR 000001720884 BENEFIX 100 IU (RECOMBINANT) 000199.20 636 J7195
PHAR 000001720885 BENEFIX 470 U IV 000810.00 636 J7195
PHAR 000001720886 BENEFIX 250 U IV 000424.80 636 J7195
PHAR 000001720745 ANTITHROMBIN III 100 IU 000420.00 636 J7197
PHAR 000001720930 HYALURONATE 16MG/2ML INJ 000702.41 636 J7320
PHAR 000001795316 HYALURONATE 16MG/2ML INJ 000702.41 636 J7320
PHAR 000001710262 AZATHIOPRINE 50MG TAB 000007.11 636 J7500
PHAR 000001715912 AZATHIOPRINE OS SUS 50M 000008.40 636 J7500
PHAR 000001720431 AZATHIOPRINE 100MG INJ 000247.20 636 J7501
PHAR 000001754300 AZATHIOPRINE 100MG INJ 000253.20 636 J7501
PHAR 000001754303 AZATHIOPRINE 100 MG LVP 000253.20 636 J7501
PHAR 000001754304 AZATHIOPRINE 150 MG LVP 000349.92 636 J7501
PHAR 000001755349 AZATHIOPRINE 100MG INJ 000253.20 636 J7501
PHAR 000001757867 AZATHIOPRINE 100MG INJ 000253.20 636 J7501
PHAR 000001759002 ATGAM ANTITHYMCT GLBL INJ 50M 000818.19 636 J7504
PHAR 000001759004 ATGAM/LVP 500 MG INJ 001447.54 636 J7504
PHAR 000001759005 ATGAM/LVP 750 MG INJ 002171.32 636 J7504
PHAR 000001759006 ATGAM/LVP 1000 MG INJ 002895.11 636 J7504
PHAR 000001759007 ATGAM/LVP 1250 MG INJ 003618.85 636 J7504
PHAR 000001754373 MUROMONAB CD3/OKT3 INJ 1MG 002070.66 636 J7505
PHAR 000001710062 PREDNISONE 5MG TAB 000002.60 636 J7506
PHAR 000001710095 PREDNISONE 2.5MG TAB 000002.46 636 J7506
PHAR 000001710450 PREDNISONE 1MG TAB 000002.53 636 J7506
9/7/2010 11:52 AM Page 22 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001715712 PREDNISONE OS 1MG/ML 000006.60 636 J7506
PHAR 000001715989 PREDNISONE INTENSOL SOL 5MG 000006.60 636 J7506
PHAR 000001712166 TACROLIMUS 1MG CAP 000009.74 636 J7507
PHAR 000001759922 THYMOGLOBULIN INJ 5MG 001006.07 636 J7511
PHAR 000001720877 DACLIZUMAB INJ 5MG 001154.23 636 J7513
PHAR 000001757060 DACLIZUMAB INJ 5MG 001154.23 636 J7513
PHAR 000001711480 SANDIMMUNE 25MG CAP 000007.78 636 J7515
PHAR 000001712164 SANDIMMUNE 50MG CAP 000009.30 636 J7515
PHAR 000001712180 NEORAL 25MG CAP 000007.47 636 J7515
PHAR 000001720256 CYCLOSPORINE 250MG INJ 000157.20 636 J7516
PHAR 000001759035 CYCLOSPORINE 250MG INJ 000168.00 636 J7516
PHAR 000001711643 MYCOPHENOLATE 250MG CAP 000009.81 636 J7517
PHAR 000001712219 MYCOPHENOLATE 500MG CAP 000014.52 636 J7517
PHAR 000001715961 MYCOPHENOLATE OS 200MG/ML 000030.24 636 J7518
PHAR 000001711808 SIROLIMUS 1MG TAB 000017.13 636 J7520
PHAR 000001715997 SIROLIMUS OS 1MG/ML SOL 1MG 000387.65 636 J7520
PHAR 000001719196 SIROLIMUS 1MG/ML 60ML 000790.32 636 J7520
PHAR 000001722004 TACROLIMUS AMP INJ 5MG 000416.26 636 J7525
PHAR 000001759721 TACROLIMUS 5MG INJ 000416.26 636 J7525
PHAR 000001711160 BUSULFAN 2MG TAB 000007.51 636 J8510
PHAR 000001710810 CYCLOPHOSPHAMIDE 50MG TAB 000010.46 636 J8530
PHAR 000001710811 CYCLOPHOSPHAMIDE 25MG TAB 000009.68 636 J8530
PHAR 000001711528 ETOPOSIDE 50MG CAP 000063.10 636 J8560
PHAR 000001710221 MELPHALAN TAB 2MG 000008.02 636 J8600
PHAR 000001710517 METHOTREXATE 2.5MG TAB 000011.39 636 J8610
PHAR 000001712260 TEMOZOLOMIDE 20MG CAP 000062.60 636 J8700
PHAR 000001712261 TEMOZOLOMIDE 100MG CAP 000293.78 636 J8700
PHAR 000001712262 TEMOZOLOMIDE 250MG CAP 000727.26 636 J8700
PHAR 000001720111 DOXORUBICIN 10MG INJ 000217.20 636 J9000
PHAR 000001720121 DOXORUBICIN 50MG INJ 000717.60 636 J9000
PHAR 000001755130 DOXORUBICIN 10MG INJ 000115.20 636 J9000
PHAR 000001755636 DOXIL (LIPOSOME) INJ INJ 2MG 001038.19 636 J9001
PHAR 000001755704 ALEMTUZUMAB 3ML DS INJ 10M 004233.70 636 J9010
PHAR 000001755554 ALDESLEUKIN INJ 18. 001851.27 636 J9015
PHAR 000001755683 ARSENIC TRIOXIDE SSJ 1MG 000780.00 636 J9017
PHAR 000001720215 ASPARAGINASE INJ 100 000228.00 636 J9020
PHAR 000001755204 ASPARAGINASE /NS INJ 500 000240.00 636 J9020
PHAR 000001755512 ERWINIA/NS INJ 100 000115.80 636 J9020
PHAR 000001759920 BCG VACCINE INJ 50M 000517.91 636 J9031
PHAR 000001720042 BLEOMYCIN 15U INJ 000827.54 636 J9040
PHAR 000001755066 BLEOMYCIN INJ 3U 000912.48 636 J9040
PHAR 000001755528 BLEOMYCIN 15U IM INJ 000912.48 636 J9040
PHAR 000001755707 BORTEZOMIB INJ 1MG 002850.00 636 J9041
PHAR 000001755491 CARBOPLATIN INJ 10M 000377.86 636 J9045
PHAR 000001755109 CARMUSTINE INJ 3.3 000396.43 636 J9050
PHAR 000001755006 CISPLATIN 10MG INJ 000220.80 636 J9060
PHAR 000001755613 CLADRIBINE 1MG INJ 000250.80 636 J9065
9/7/2010 11:52 AM Page 23 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001755027 CYCLOPHOSPHAMIDE INJ 200MG 000067.20 636 J9080
PHAR 000001720009 CYTARABINE INJ 50M 000049.20 636 J9100
PHAR 000001755071 CYTARABINE INJ 50M 000067.20 636 J9100
PHAR 000001755656 CYTARABINE (IM) INJ 100 000067.20 636 J9100
PHAR 000001720307 DACTINOMYCIN 0.5MG INJ 000075.60 636 J9120
PHAR 000001755120 DACTINOMYCIN 0.5MG INJ 000115.20 636 J9120
PHAR 000001720153 DACARBAZINE 100MG INJ 000086.40 636 J9130
PHAR 000001720258 DAUNORUBICIN 20MG INJ 000520.93 636 J9150
PHAR 000001755125 DAUNORUBICIN 10MG INJ 000318.38 636 J9150
PHAR 000001755679 DENILEUKIN DIF 300MCG 002737.92 636 J9160
PHAR 000001755705 EPIRUBICIN HCL INJ 2MG 001892.50 636 J9178
PHAR 000001715985 ETOPOSIDE OS 10MG/ML 5ML 000037.13 636 J9181
PHAR 000001755146 ETOPOSIDE INJ 20M 000032.40 636 J9181
PHAR 000001755589 FLUDARABINE 50MG INJ 000809.64 636 J9185
PHAR 000001720252 FLUOROURACIL 500MG INJ 000020.40 636 J9190
PHAR 000001755053 FLUOROURACIL 500MG INJ 000044.40 636 J9190
PHAR 000001795018 FLUOROURACIL 500MG INJ 000013.50 636 J9190
PHAR 000001755042 FLOXURIDINE LVP 000354.48 636 J9200
PHAR 000001755609 GEMCITABINE HCL INJ 20M 000358.35 636 J9201
PHAR 000001755603 IRINOTECAN INJ 20M 000446.45 636 J9206
PHAR 000001755460 IFOSFAMIDE 1GM INJ 001026.65 636 J9208
PHAR 000001755702 IFOSFAMIDE 1GM/20ML INJ 50M 001182.24 636 J9208
PHAR 000001755703 IFOSFAMIDE 3GM/60ML INJ 50M 001715.04 636 J9208
PHAR 000001758372 MESNA 200MG INJ 000201.60 636 J9209
PHAR 000001721106 INTERFERN ALPHA-2A 3MU INJ 000192.00 636 J9213
PHAR 000001755387 INTERFERON 3MU/LVP 000172.80 636 J9213
PHAR 000001720496 INTERFERN ALFA-2B-3 INJ 6MU 000157.20 636 J9214
PHAR 000001720497 INTERFERN ALFA-2B-10 INJ 10M 000424.05 636 J9214
PHAR 000001720613 INTERFERN ALFA-2B-25 5MU INJ 000776.51 636 J9214
PHAR 000001720842 INTERFERN ALPHA-2B 5 10MU INJ 000217.20 636 J9214
PHAR 000001755384 INTERFERN ALFA-2B INJ 10M 000172.80 636 J9214
PHAR 000001756541 INTERFERN ALFA-2B-3 INJ 10M 000199.20 636 J9214
PHAR 000001795282 INTERFERN ALFA-2B*OP INJ 6MU 000113.44 636 J9214
PHAR 000001720912 INTERFERON ALFA-N3 5MU/1ML 000555.78 636 J9215
PHAR 000001721075 INTERFERN GAMMA-1B INJ 4MU 000687.96 636 J9216
PHAR 000001720544 LEUPROLIDE ACETATE 7.5MG KIT 001380.00 636 J9217
PHAR 000001722009 LEUPROLIDE ACETATE 11.25MG KIT 002571.98 636 J9218
PHAR 000001755082 MECHLORETHAMINE 10MG INJ 000100.80 636 J9230
PHAR 000001755553 MELPHALAN HCL INJ 5MG 001079.89 636 J9245
PHAR 000001720305 METHOTREXATE INJ 50MG VIAL 000086.40 636 J9250
PHAR 000001720546 METHOTREXATE INJ 100MG VIAL 000060.00 636 J9250
PHAR 000001755186 METHOTREXATE 100MG INJ 000172.80 636 J9250
PHAR 000001755187 METHOTREX LVP 50 MG 000117.60 636 J9250
PHAR 000001755371 METHOTREXATE INJ 25 000256.80 636 J9250
PHAR 000001755565 METHOTREX LV 2000 MG 001559.40 636 J9250
PHAR 000001755685 PACLITAXEL INJ 6MG 000578.32 636 J9265
PHAR 000001759501 PACLITAXEL INJ 6MG 000589.18 636 J9265
9/7/2010 11:52 AM Page 24 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001755594 PEGASPARGASE INJ 750 003780.00 636 J9266
PHAR 000001755684 PENTOSTATIN 10MG INJ 005083.20 636 J9268
PHAR 000001720309 PLICAMYCIN 2.5MG INJ 000282.07 636 J9270
PHAR 000001755155 PLICAMYCIN 2.5MG INJ 000282.06 636 J9270
PHAR 000001755048 MITOMYCIN LVP 5 MG 000376.24 636 J9280
PHAR 000001755049 MITOMYCIN LVP 10 MG 000652.18 636 J9280
PHAR 000001720116 MITOMYCIN 20MG INJ 001153.87 636 J9290
PHAR 000001755047 MITOMYCIN 20MG INJ 001153.87 636 J9290
PHAR 000001755567 MITOMYCIN LVP 60 MG 003461.62 636 J9291
PHAR 000001720549 MITOXANTRONE 20MG INJ 001553.47 636 J9293
PHAR 000001755456 MITOXANTRONE 20MG INJ 001553.47 636 J9293
PHAR 000001755457 MITOXANTRONE/LVP 20 001553.47 636 J9293
PHAR 000001755481 MITOXANTRONE/LVP 40 003106.93 636 J9293
PHAR 000001755680 GEMTUZUMAB 5MG INJ 005606.25 636 J9300
PHAR 000001755659 RITUXIMAB INJ 10M 001221.05 636 J9310
PHAR 000001755160 STREPTOZOCIN 1GM INJ 000250.80 636 J9320
PHAR 000001755162 ZANOSAR LVP 1 GM 000250.80 636 J9320
PHAR 000001720376 THIOTEPA 15MG INJ 000322.25 636 J9340
PHAR 000001755061 THIOTEPA 15MG INJ 000256.80 636 J9340
PHAR 000001755065 THIOTEPA LVP 30 MG 000452.74 636 J9340
PHAR 000001755598 TOPOTECAN HCL INJ 1MG 001929.65 636 J9350
PHAR 000001755701 TRASTUZUMAB INJ 21M 006753.44 636 J9355
PHAR 000001721006 VINBLASTINE 10MG VIAL INJ 1MG 000192.00 636 J9360
PHAR 000001755089 VINBLASTINE,SULFATE INJ 1MG 000204.00 636 J9360
PHAR 000001755090 VINBLASTINE LVP 5 MG 000142.80 636 J9360
PHAR 000001755091 VINBLASTINE LVP 10MG 000204.00 636 J9360
PHAR 000001755092 VINBLASTINE LVP 15MG 000250.80 636 J9360
PHAR 000001720262 VINCRISTINE SULFATE INJ 1MG 000172.80 636 J9370
PHAR 000001755094 VINCRISTINE SULFATE INJ 1MG 000189.60 636 J9370
PHAR 000001755098 VINCRISTINE 2MG INJ 000264.00 636 J9375
PHAR 000001755671 VINORELBINE 10MG INJ 000274.68 636 J9390
PHAR 000001770002 ALBUMIN INJ 5% 50ML 000278.00 386 P9041
PHAR 000001757630 ALBUMIN HUMAN 5% MLS IV 000347.88 389 P9045
PHAR 000001770005 ALBUMIN INJ 5% 250ML 000716.00 386 P9045
PHAR 000001770006 ALBUMIN INJ 5% 500ML 000918.00 386 P9045
PHAR 000001754001 ALBUMIN 25% 5GM/20ML 000183.60 386 P9046
PHAR 000001757611 ALBUMIN 25% 5GM/20ML INJ 000183.60 386 P9046
PHAR 000001757646 ALBUMIN HUMAN 25% GM IV 000726.00 389 P9046
PHAR 000001770004 ALBUMIN 25% 20ML INJ 000239.00 386 P9046
PHAR 000001757651 ALBUMIN HUMAN 25% GM IV 001518.00 389 P9047
PHAR 000001770003 ALBUMIN 25% 100ML INJ 000918.00 386 P9047
PHAR 000001770007 ALBUMIN INJ 25% 50ML 000541.00 386 P9047
PHAR 000001720614 EPOGEN INJ 2000U/1ML 000141.60 636 Q0136
PHAR 000001720618 EPOGEN 10,000U/ML 1ML 000432.00 636 Q0136
PHAR 000001720619 EPOGEN INJ 4000U/ML 000217.20 636 Q0136
PHAR 000001720677 EPOETIN ALFA 3000U 000192.00 636 Q0136
PHAR 000001720918 EPOETIN 40,000U INJ 001452.17 636 Q0136
9/7/2010 11:52 AM Page 25 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001754422 EPOETIN ALFA 1250 U INJ 000112.80 636 Q0136
PHAR 000001754423 EPOETIN ALFA 1500 U INJ 000124.80 636 Q0136
PHAR 000001754424 EPOETIN ALFA 1750 U INJ 000151.20 636 Q0136
PHAR 000001754425 EPOETIN ALFA 2000 U INJ 000151.20 636 Q0136
PHAR 000001754992 EPOETIN ALFA L INJ 200 000151.20 636 Q0136
PHAR 000001754998 EPOGEN PB 700 U 000074.40 636 Q0136
PHAR 000001754999 EPOGEN PB 800 U 000079.20 636 Q0136
PHAR 000001755000 EPOGEN PB 900 U 000093.60 636 Q0136
PHAR 000001755197 EPOGEN PB 1000 U 000103.20 636 Q0136
PHAR 000001756500 EPOETIN ALFA 3000 U INJ 000199.20 636 Q0136
PHAR 000001756501 EPOETIN ALFA 4000 U INJ 000224.40 636 Q0136
PHAR 000001756502 EPOETIN ALFA 6000 U INJ 000259.20 636 Q0136
PHAR 000001756547 EPOETIN 40,000 U/ML INJ 001508.81 636 Q0136
PHAR 000001711313 DIPHENHYDRAMINE 50MG CAP 000002.64 636 Q0163
PHAR 000001716071 DIPHENHYDRAMINE 50MG UD ELIX 000003.50 636 Q0163
PHAR 000001710782 PROCHLORPERAZINE 5MG TAB 000003.58 636 Q0164
PHAR 000001710786 PROCHLORPERAZINE 15MG CAP 000007.84 636 Q0164
PHAR 000001719004 PROCHLORPERAZINE 1MG SYR 000030.06 636 Q0164
PHAR 000001712186 GRANISETRON 1MG TAB 000079.07 636 Q0166
PHAR 000001730003 DRONABINOL CAP 2.5 000012.24 636 Q0167
PHAR 000001710621 PROMETHAZINE HCL TAB 12. 000002.58 636 Q0169
PHAR 000001748042 PROMETHAZINE HCL SUP 12. 000008.27 636 Q0169
PHAR 000001711161 CHLORPROMAZINE 10MG TAB 000002.51 636 Q0171
PHAR 000001711172 TRIMETHOBENZAMIDE HCL CAP 300 000003.38 636 Q0173
PHAR 000001711077 PERPHENAZINE 2MG TAB 000003.62 636 Q0175
PHAR 000001711081 PERPHENAZINE 4MG TAB 000004.08 636 Q0175
PHAR 000001711071 HYDROXYZINE PAMOATE 25MG CAP 000002.81 636 Q0177
PHAR 000001711178 HYDROXYZINE 25MG TAB 000002.59 636 Q0177
PHAR 000001711594 ONDANSETRON TAB 8MG 000050.50 636 Q0179
PHAR 000001711783 ONDANSETRON ODT TAB 8MG 000050.49 636 Q0179
PHAR 000001715969 ONDANSETRON LIQ LIQ 0.8 000045.79 636 Q0179
PHAR 000001719181 ONDANSETRON LIQ LIQ 0.8 000260.02 636 Q0179
PHAR 000001796110 ONDANSETRON ODT 8MG TAB 000050.49 636 Q0179
PHAR 000001721107 FACTOR 7A RECOMBINAN INJ 1.2 002678.40 636 Q0187
PHAR 000001721108 FACTOR 7A RECOMBINAN INJ 4.8 010713.00 636 Q0187
PHAR 000001759117 ELLIOT'S B SOLUTION 10ML 000112.80 636 Q2002
PHAR 000001720854 APROTININ VIAL 10000KIU INJ 000604.80 636 Q2003
PHAR 000001720855 APROTININ VIAL 10000KIU INJ 001058.40 636 Q2003
PHAR 000001759847 APROTININ 1MU INJ 000604.80 636 Q2003
PHAR 000001720892 ACTHREL 100MCG INJ 001095.15 636 Q2005
PHAR 000001720298 DIGOXIN IMMUNE 38MG INJ 001843.13 636 Q2006
PHAR 000001721070 ETHANOLAMINE 100MG INJ 000157.20 636 Q2007
PHAR 000001759993 FOMEPIZOLE 1500MG INJ 003174.00 636 Q2008
PHAR 000001722019 FOSPHENYTOIN 500MG INJ 000228.00 636 Q2009
PHAR 000001756585 FOSPHENYTOIN 50MG INJ 000058.80 636 Q2009
PHAR 000001759921 HEMIN INJ 7MG 000884.27 636 Q2011
PHAR 000001757346 BASILIXIMAB INJ 4MG 003378.24 636 Q2019
9/7/2010 11:52 AM Page 26 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001758127 LEPIRUDIN INJ 50M 000453.60 636 Q2021
PHAR 000001753001 ACYCLOVIR INJ 50 000144.67 636 Q4075
PHAR 000001753003 ACYCLOVIR/PB 375MG 000076.27 636 Q4075
PHAR 000001753004 ACYCLOVIR/PB 500MG 000085.87 636 Q4075
PHAR 000001753005 ACYCLOVIR/PB 1000MG 000144.67 636 Q4075
PHAR 000001753387 ACYCLOVIR/PB 750MG 000119.47 636 Q4075
PHAR 000001753388 ACYCLOVIR/PB 1250MG 000157.87 636 Q4075
PHAR 000001756584 ACYCLOVIR INJ 25 000144.00 636 Q4075
PHAR 000001720095 DOPAMINE HCL 400 SYRI 40MG IV 000054.00 636 Q4076
PHAR 000001720115 DOPAMINE HCL 800 SYRI 80MG IV 000192.00 636 Q4076
PHAR 000001720516 DOPAMINE HCL 200 VIAL 40MG IV 000028.80 636 Q4076
PHAR 000001720517 DOPAMINE HCL 400 VIAL 80MG IV 000042.00 636 Q4076
PHAR 000001720635 DOPAMINE HCL 800 VIAL 160MG IV 000086.40 636 Q4076
PHAR 000001757212 DOPAMINE HCL INJ 80M 000055.20 636 Q4076
PHAR 000001757213 DOPAMINE LVP 50 MG 000028.80 636 Q4076
PHAR 000001757214 DOPAMINE LVP 100 MG 000028.80 636 Q4076
PHAR 000001757215 DOPAMINE LVP 200 MG 000039.00 636 Q4076
PHAR 000001757216 DOPAMINE LVP 400 MG 000055.20 636 Q4076
PHAR 000001757217 DOPAMINE LVP 600 MG 000074.40 636 Q4076
PHAR 000001757218 DOPAMINE LVP 800 MG 000093.60 636 Q4076
PHAR 000001757219 DOPAMINE LVP 1000 MG 000112.80 636 Q4076
PHAR 000001757220 DOPAMINE LVP 1200 MG 000122.40 636 Q4076
PHAR 000001757221 DOPAMINE LVP 1600 MG 000146.40 636 Q4076
PHAR 000001757222 DOPAMINE LVP 1800 MG 000168.00 636 Q4076
PHAR 000001759494 DOPAMINE 3500MG INJ 000237.60 636 Q4076
PHAR 000001771187 DOPAMINE 400/D5W 250ML 000121.11 636 Q4076
PHAR 000001795145 DOPAMINE 200MG INJ 000028.80 636 Q4076
PHAR 000001700000 PHARMACY 000000.00
PHAR 000001700002 IP MEDS PHARM 000000.00 250
PHAR 000001710001 ISOTRETINOIN 10MG CAP 000010.98 259
PHAR 000001710002 DANAZOL 200MG CAP 000010.70 259
PHAR 000001710003 DEMECLOCYCLINE HCL 150MG CAP 000010.97 259
PHAR 000001710008 HALOPERIDOL 0.5MG TAB 000002.72 259
PHAR 000001710009 ISOTRETINOIN 40MG CAP 000013.31 259
PHAR 000001710010 DEMECLOCYCLINE HCL 300MG TAB 000017.29 259
PHAR 000001710011 PHENOXYBENZAMINE 10MG CAP 000003.64 259
PHAR 000001710012 DICLOXACILLIN SODIUM 125MG CAP 000003.53 259
PHAR 000001710015 NICOTINE GUM#96 2MG GUM 000057.26 259
PHAR 000001710016 DANTRIUM 25MG CAP 000004.04 259
PHAR 000001710019 LIOTRIX 120MG TAB 000002.88 259
PHAR 000001710021 HALOPERIDOL 1MG TAB 000002.74 259
PHAR 000001710022 HALOPERIDOL 2MG TAB 000002.86 259
PHAR 000001710024 DEMULEN 1/50 28 DAY JAN-50 TAB 000042.29 250
PHAR 000001710025 DANTRIUM 50MG CAP 000007.48 259
PHAR 000001710027 ETIDRONATE DISODIUM 200MG TAB 000008.44 259
PHAR 000001710032 NICOTINE GUM -UD 2MG GUM 000003.08 259
PHAR 000001710033 ERGOCALCIFEROL 50000U CAP 000002.65 259
9/7/2010 11:52 AM Page 27 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001710034 VALPROIC ACID 250MG CAP 000002.91 259
PHAR 000001710037 EXCEDRIN TAB 000002.75 259
PHAR 000001710044 HALOPERIDOL 5 MG TAB 000003.37 259
PHAR 000001710047 DANTROLENE SODIUM 100MG CAP 000007.16 259
PHAR 000001710048 PREDNISONE 50MG TAB 000002.93 259
PHAR 000001710055 TRIAMTERENE 50MG CAP 000003.31 259
PHAR 000001710056 HALOPERIDOL 10 MG TAB 000003.64 259
PHAR 000001710058 ERGOLOID MESYLATES 1MG SUBL 000002.62 259
PHAR 000001710061 PYRIMETHAMINE 25MG TAB 000003.18 259
PHAR 000001710063 FERROUS SULFATE 1TAB TAB 000002.54 250
PHAR 000001710064 POTASSIUM BICARBONATE 25MEQ TA 000004.00 259
PHAR 000001710068 TRAZODONE HCL 50MG TAB 000003.16 259
PHAR 000001710069 HALOPERIDOL 20 MG TAB 000007.14 259
PHAR 000001710072 MAGNESIUM GLUCONATE TAB 500 000002.63 259
PHAR 000001710075 PREDNISONE 10MG TAB 000002.56 259
PHAR 000001710077 TRIAMTERENE 100MG CAP 000003.55 259
PHAR 000001710079 HYDROXYUREA 500MG CAP 000007.75 259
PHAR 000001710080 TRAZODONE 100MG TAB 000003.72 259
PHAR 000001710088 SPIRONOLACTONE 25MG TAB 000002.84 259
PHAR 000001710090 PREDNISONE 20MG TAB 000002.64 259
PHAR 000001710096 DEXAMETHASONE 0.5MG TAB 000002.68 259
PHAR 000001710097 DIHYDROTACHYSTEROL 0.125MG TAB 000003.95 259
PHAR 000001710098 ERYTHROMYCIN ETHYLSUC 200MG CH 000003.20 250
PHAR 000001710100 ORTHO-NOVUM 1/50 21D TAB 000037.27 259
PHAR 000001710101 METHENAMINE MANDELATE 500MG TA 000002.77 259
PHAR 000001710102 NEUTRA-PHOS 250MG CAP 000002.64 259
PHAR 000001710103 SPIRONOLACTONE 50MG TAB 000003.92 259
PHAR 000001710106 HYDROCORTISONE 20MG TAB 000003.18 259
PHAR 000001710108 NICOTINIC ACID 500MG TAB 000002.47 259
PHAR 000001710109 TAMOXIFEN 10MG TAB 000008.44 259
PHAR 000001710111 DEXAMETHASONE 0.75MG TAB 000002.71 259
PHAR 000001710112 DIHYDROTACHYSTEROL 0.2MG TAB 000004.09 259
PHAR 000001710113 ETHACRYNIC ACID TAB 25M 000003.01 259
PHAR 000001710114 FERROUS SULFATE 1CAP CAP 000002.81 259
PHAR 000001710116 ORTHO-NOVUM 1/35 21D TAB 000037.27 259
PHAR 000001710117 ORTHO-NOVUM 1/35 28D JAN-35 TA 000037.42 259
PHAR 000001710119 VITAMIN B COMP /C TAB 000002.52 259
PHAR 000001710121 VITAMIN E 200U CAP 000002.47 259
PHAR 000001710122 METHENAMINE MANDELATE 1GM TAB 000003.04 259
PHAR 000001710123 NICOTINIC ACID 50MG TAB 000002.50 259
PHAR 000001710125 DILANTIN CHE 50MG TAB 000002.99 259
PHAR 000001710126 ETHACRYNIC ACID TAB 50M 000003.28 259
PHAR 000001710130 NICOTINIC ACID 100MG TAB 000002.44 259
PHAR 000001710132 DIPHENOXYLATE/ATROP TAB 000002.15 259
PHAR 000001710134 AMOXICILLIN 250MG 250MG CHE 000002.95 259
PHAR 000001710136 CEPHALEXIN 250MG CAP 000003.41 259
PHAR 000001710137 SPIRONOLACTONE 100MG TAB 000007.36 259
9/7/2010 11:52 AM Page 28 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001710140 METHYLDOPA 250MG TAB 000002.78 259
PHAR 000001710141 ISOSORBIDE DINITRATE 10MG SUBL 000002.98 259
PHAR 000001710142 FERROUS GLUCONATE 325MG TAB 000002.53 259
PHAR 000001710144 NIACINAMIDE 500MG TAB 000002.43 259
PHAR 000001710146 DEXAMETHASONE 1.5MG TAB 000002.93 259
PHAR 000001710147 DILANTIN 100MG CAP 000002.92 259
PHAR 000001710148 CEPHALEXIN 500MG CAP 000006.78 259
PHAR 000001710149 CEPHALEXIN T CAP 250 000007.58 250
PHAR 000001710151 NORTRIPTYLINE HCL 10MG CAP 000003.25 259
PHAR 000001710152 PROMETHAZINE HCL TAB 50M 000003.30 259
PHAR 000001710155 CHLORTHALIDONE TAB 50M 000002.66 259
PHAR 000001710157 NIACINAMIDE 100MG TAB 000002.44 259
PHAR 000001710158 METHYLDOPA 500MG TAB 000003.23 259
PHAR 000001710159 DEXAMETHASONE 2MG TAB 000003.36 259
PHAR 000001710163 DILANTIN-PB 30MG 30MG CAP 000002.70 259
PHAR 000001710165 FERRO-SEQUEL CAP 000002.88 259
PHAR 000001710166 CHLORTHALIDONE TAB 100 000007.04 259
PHAR 000001710168 PROCARBAZINE HCL CAP 50M 000139.20 259
PHAR 000001710169 NIACIN 125MG CAP 000003.76 259
PHAR 000001710170 DEXAMETHASONE 4MG TAB 000003.42 259
PHAR 000001710171 NORTRIPTYLINE 25MG CAP 000003.73 259
PHAR 000001710172 FERROUS SULF 325MG TAB 000002.50 259
PHAR 000001710174 NIACIN TAB 250 000004.19 259
PHAR 000001710176 POLY-VI-FLOR 0.5MG CHE 000002.72 259
PHAR 000001710179 CHLORTHALIDONE TAB 25M 000002.62 259
PHAR 000001710182 PAPAVERINE 150MG ER CAP 000002.53 259
PHAR 000001710183 CIMETIDINE TAB 200 000003.99 259
PHAR 000001710185 DEXAMETHASONE 6MG TAB 000004.00 259
PHAR 000001710186 BROMPHENIRAMINE 4MG TAB 000002.59 259
PHAR 000001710193 DEXAMETHASONE 0.25MG TAB 000002.50 259
PHAR 000001710196 FLAGYL 500MG TAB 000003.89 259
PHAR 000001710200 NORETHINDRONE 5MG TAB 000007.51 259
PHAR 000001710203 COMBINATION TAB 000000.57 250
PHAR 000001710204 KEFLEX SUS 25MG/ML 000015.93 259
PHAR 000001710208 BROMPHENIRAMINE 12MG TAB 000002.82 259
PHAR 000001710210 METRONIDAZOLE 250MG TAB 000003.40 259
PHAR 000001710215 DISOPYRAMIDE 100MG CAP 000003.38 259
PHAR 000001710216 DIABETA TAB 1.25 MG 000001.30 259
PHAR 000001710217 BROMPHENIRAMINE 8MG TAB 000002.77 250
PHAR 000001710218 FLEXERIL 10MG TAB 000004.06 259
PHAR 000001710228 NITROGLYCERIN 0.15MG SUBL 000009.06 259
PHAR 000001710229 DISOPYRAMIDE 150MG CAP 000003.56 259
PHAR 000001710237 CHLORPROPAMIDE 100MG TAB 000002.70 259
PHAR 000001710238 BROMPHEN/PHENYLPROP TAB 1 000002.99 259
PHAR 000001710242 NITROGLYCERIN 0.3MG SUBL 000009.54 259
PHAR 000001710243 DISOPYRAMIDE CR 100MG CAP 000003.77 259
PHAR 000001710246 POLY-VI-FLOR C IRON 1MG CHE 000002.63 259
9/7/2010 11:52 AM Page 29 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001710247 DOCUSATE SODIUM CAP 100 000002.50 259
PHAR 000001710248 FOLIC ACID 1MG TAB 000002.68 259
PHAR 000001710249 DIGOXIN 0.05MG CAP 000002.69 259
PHAR 000001710250 METHYLPREDNISOLONE 2MG TAB 000003.04 259
PHAR 000001710251 DESIPRAMINE 10MG TAB 000003.43 259
PHAR 000001710254 CHLORPROPAMIDE 250MG TAB 000002.81 259
PHAR 000001710256 FLORINEF 0.1MG TAB 000003.77 259
PHAR 000001710258 NITROGLYCERIN 0.6MG SUBL 000009.54 259
PHAR 000001710260 DOCUSATE SOD 250MG CAP 000002.51 259
PHAR 000001710263 DIGOXIN 0.1MG CAP 000002.65 250
PHAR 000001710264 KETOCONAZOLE 200MG TAB 000009.91 259
PHAR 000001710265 DESIPRAMINE 25MG TAB 000003.50 259
PHAR 000001710267 ALUMINUM HYDROXID 475MG CAP 000002.71 259
PHAR 000001710268 DOCUSATE/SENNA L TAB 1TA 000002.52 259
PHAR 000001710270 GRISEOFULVIN ULTRAMIC 250 MG T 000004.06 259
PHAR 000001710271 METHYLPREDNISOLONE 4MG TAB 000003.41 259
PHAR 000001710275 GRISEOFULVIN 500 MG TAB 000007.09 259
PHAR 000001710276 DIGOXIN 0.2MG CAP 000002.65 259
PHAR 000001710277 METHYLPREDNISOLONE 16MG TAB 000007.42 259
PHAR 000001710279 DESIPRAMINE 50MG TAB 000006.89 259
PHAR 000001710280 METAPROTERENOL SULFAT 20MG TAB 000003.41 259
PHAR 000001710283 PROPRANOLOL 10MG TAB 000002.72 259
PHAR 000001710285 DESIPRAMINE 75MG TAB 000007.75 259
PHAR 000001710286 POLY-VI-SOL CHE 000002.60 259
PHAR 000001710288 ACETAZOLAMIDE TAB 125 000002.94 259
PHAR 000001710290 DIGOXIN 0.125MG TAB 000002.98 259
PHAR 000001710293 BROMOCRIPTINE 5MG CAP 000009.54 259
PHAR 000001710297 NITROFURANTOIN 50MG TAB 000003.54 259
PHAR 000001710298 PROPRANOLOL 20MG TAB 000002.87 259
PHAR 000001710302 ACETAZOLAMIDE 250MG TAB 000003.33 259
PHAR 000001710304 DIGOXIN 0.25MG TAB 000002.98 259
PHAR 000001710307 MEDROXYPROGESTERONE 10MG TAB 000002.98 259
PHAR 000001710308 ACETAZOLAMIDE SR CAP 500 000004.04 259
PHAR 000001710310 PROPRANOLOL 40MG TAB 000003.16 259
PHAR 000001710312 THIORIDAZINE HCL 10MG TAB 000002.72 259
PHAR 000001710315 AMINOCAPROIC ACID 500MG TAB 000008.18 259
PHAR 000001710316 DITROPAN 5MG TAB 000003.20 259
PHAR 000001710325 NITROFURANTOIN 100MG TAB 000007.01 259
PHAR 000001710326 THIORIDAZINE HCL 15MG TAB 000002.71 259
PHAR 000001710330 POLY-VI-SOL C IRON CHE 000002.62 259
PHAR 000001710333 LOPERAMIDE 2MG CAP 000003.51 259
PHAR 000001710335 LEVODOPA 100MG TAB 000002.87 259
PHAR 000001710340 LIBRIUM CAP 5 MG 000002.53 259
PHAR 000001710342 PROPRANOLOL HCL 80MG TAB 000004.27 259
PHAR 000001710343 LEVODOPA 500MG TAB 000003.29 259
PHAR 000001710344 THIORIDAZINE HCL 25MG TAB 000002.86 259
PHAR 000001710348 AMINOPHYLLINE 100MG TAB 000002.51 259
9/7/2010 11:52 AM Page 30 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001710349 GUAIFENESIN/PPA CAP 1 000003.28 259
PHAR 000001710351 PROPRANOLOL LA 80MG CAP 000004.22 259
PHAR 000001710352 LEVODOPA 250MG TAB 000003.14 259
PHAR 000001710358 INDOMETHACIN 25MG CAP 000002.97 259
PHAR 000001710359 THIORIDAZINE HCL 50MG TAB 000002.94 259
PHAR 000001710362 PLAQUENIL 200MG TAB 000007.14 259
PHAR 000001710364 AMITRIPTYLINE TAB 10M 000002.63 259
PHAR 000001710368 FUROSEMIDE 40MG TAB 000002.55 259
PHAR 000001710373 ELAVIL 25MG TAB 000002.67 259
PHAR 000001710374 GUAIFENESIN/PPA TAB 1 000003.89 259
PHAR 000001710378 AMITRIPTYLINE 50MG TAB 000002.74 259
PHAR 000001710380 EPHEDRINE 25MG CAP 000002.62 259
PHAR 000001710382 INDOMETHACIN 50MG CAP 000003.12 259
PHAR 000001710383 FUROSEMIDE 80MG TAB 000002.72 259
PHAR 000001710384 THIORIDAZINE HCL 100MG TAB 000002.89 259
PHAR 000001710388 AMMONIUM CHLORIDE 500MG TAB 000002.50 259
PHAR 000001710392 THIORIDAZINE HCL 150MG TAB 000003.29 259
PHAR 000001710394 LIBRIUM CAP 10 MG 000002.75 259
PHAR 000001710395 AMMONIUM CHLORIDE 1GM TAB 000002.57 250
PHAR 000001710396 INDOMETHACIN SR 75MG CAP 000004.43 259
PHAR 000001710397 FUROSEMIDE 20MG TAB 000002.54 259
PHAR 000001710404 ERGOTAMINE TARTRATE 2MG 000003.73 259
PHAR 000001710408 THIORIDAZINE HCL 200MG TAB 000003.25 250
PHAR 000001710411 ALUMINUM HYDROXIDE 300MG TAB 000002.50 259
PHAR 000001710424 CHLORAMBUCIL 2MG TAB 000007.14 259
PHAR 000001710428 AMOXICILLIN 250MG CAP 000002.68 259
PHAR 000001710430 DONNATAL TAB 000002.68 259
PHAR 000001710431 ERYTHROMYCIN BASE 250MG TAB 000002.70 259
PHAR 000001710433 MEPHYTON 5MG TAB 000003.65 259
PHAR 000001710436 PREDNISOLONE 5MG TAB 000002.47 259
PHAR 000001710438 LIBRIUM CAP 25 MG 000003.27 259
PHAR 000001710439 CLIDINIUM/CHLORDIAZ 2.5/5 CAP 000003.59 259
PHAR 000001710442 AMOXICILLIN 500MG CAP 000002.87 259
PHAR 000001710444 DONNATAL CAP 000002.63 259
PHAR 000001710445 GAVISCON CHE TAB 000002.54 259
PHAR 000001710447 MESTINON 60MG TAB 000003.44 259
PHAR 000001710453 BACLOFEN 10MG TAB 000003.15 259
PHAR 000001710454 PYRIDOSTIGMINE BR 180MG TAB 000003.73 259
PHAR 000001710455 BISMUTH SUBSALICYLATE 262MG TA 000005.83 259
PHAR 000001710458 FLUCYTOSINE 250 MG CAP 000006.97 259
PHAR 000001710460 HYDROCHLOROTHIAZIDE 25MG TAB 000002.58 259
PHAR 000001710461 ISONIAZID 100MG TAB 000002.46 259
PHAR 000001710466 FLUCYTOSINE 500 MG CAP 000008.98 259
PHAR 000001710467 ISONIAZID 300MG TAB 000002.47 259
PHAR 000001710473 DISULFIRAM 250MG TAB 000003.76 259
PHAR 000001710475 HYDROCHLOROTHIAZIDE 50MG TAB 000002.62 259
PHAR 000001710483 VERAPAMIL 80MG TAB 000003.16 259
9/7/2010 11:52 AM Page 31 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001710484 METHYLTESTOSTERONE 10MG CAP 000008.21 259
PHAR 000001710485 CYPROHEPTADINE HCL 4MG TAB 000002.52 259
PHAR 000001710487 ESTROGENS CONJ 2.5MG TAB 000004.30 259
PHAR 000001710488 AMPICILLIN 250MG CAP 000002.62 259
PHAR 000001710489 DIMENHYDRINATE 50MG TAB 000002.87 259
PHAR 000001710490 LITHIUM CARB.EXT REL 300MG TAB 000002.72 259
PHAR 000001710491 METHYLTESTOSTERONE 25MG TAB 000010.30 259
PHAR 000001710493 AMPICILLIN 500MG CAP 000002.99 259
PHAR 000001710498 VERAPAMIL 120MG TAB 000003.41 259
PHAR 000001710500 METHYLTESTOSTERONE 5MG 000002.86 259
PHAR 000001710502 PREMARIN 1.25MG TAB 000003.68 259
PHAR 000001710503 PRO-BANTHINE 15MG TAB 000002.77 259
PHAR 000001710507 LITHIUM CARB 300MG CAP 000042.00 259
PHAR 000001710508 PROPANTHELINE BR 7.5MG TAB 000003.13 259
PHAR 000001710509 MECLIZINE 12.5MG TAB 000003.02 259
PHAR 000001710511 ETHINYL ESTRADIOL 0.05MG TAB 000003.38 259
PHAR 000001710512 ISOSORBIDE DINITRATE 5MG SUBL 000002.84 259
PHAR 000001710513 METHYLERGONOVINE 0.2MG TAB 000003.29 259
PHAR 000001710516 ETHINYL EST 0.5MG TAB 000004.38 259
PHAR 000001710519 PREMARIN 0.625MG TAB 000003.32 259
PHAR 000001710521 MECLIZINE 25MG TAB 000002.72 259
PHAR 000001710522 BISACODYL 5MG TAB 000002.46 259
PHAR 000001710523 ETHINYL ESTRADIOL 0.02MG TAB 000002.99 259
PHAR 000001710524 ISOSORBIDE DINITRATE 2.5MG SUB 000002.82 259
PHAR 000001710525 METOPIRONE 250MG TAB 000010.96 259
PHAR 000001710526 ESTROGENS CONJ 0.3MG TAB 000002.98 259
PHAR 000001710529 METOCLOPRAMIDE HCL TAB 10M 000002.91 259
PHAR 000001710531 AMILORIDE 5MG TAB 000003.51 259
PHAR 000001710534 ROCALTROL 0.25MCG CAP 000007.39 259
PHAR 000001710535 TRIFLUOPERAZINE HCL 5MG TAB 000004.09 259
PHAR 000001710537 ESTRADIOL 1MG TAB 000003.08 259
PHAR 000001710538 ISOSORBIDE DINITRATE 5MG TAB 000002.84 259
PHAR 000001710539 MIDRIN CAP 000003.13 259
PHAR 000001710541 PREMARIN C METHYLTEST 0.625/5 000004.01 259
PHAR 000001710542 QUINIDINE GLUC 324MG TAB 000003.38 259
PHAR 000001710544 SULFINPYRAZONE 200MG CAP 000003.54 259
PHAR 000001710546 ESTRADIOL 2MG TAB 000003.41 259
PHAR 000001710547 MOM CONC 10 ML 000000.87 259
PHAR 000001710549 PREMARIN C METHYLTEST 1.25/10 000007.51 259
PHAR 000001710550 QUININE SULFATE 260MG TAB 000003.71 259
PHAR 000001710552 ISORDIL 10MG TAB 000002.67 259
PHAR 000001710553 MINOXIDIL 2.5MG TAB 000003.02 259
PHAR 000001710558 AMITRIPTY/PERPHE 2/10 1TAB TAB 000003.53 259
PHAR 000001710559 MINOXIDIL 10MG TAB 000003.47 259
PHAR 000001710561 DIPYRIDAMOLE 25MG TAB 000003.00 259
PHAR 000001710563 QUINIDINE SULF CR 300MG TAB 000003.71 259
PHAR 000001710565 TRIAMTER/HCTZ 37.5/25 TAB 000003.29 259
9/7/2010 11:52 AM Page 32 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001710566 ISORDIL 20MG TAB 000002.80 259
PHAR 000001710571 ROCALTROL 0.5MG CAP 000008.93 259
PHAR 000001710572 HYDRALAZINE 25MG TAB 000002.66 259
PHAR 000001710573 AMITRIPTY/PERPHE 2/25 1TAB TAB 000003.82 259
PHAR 000001710575 QUININE SULFATE 200MG CAP 000002.98 259
PHAR 000001710578 DICLOXACILLIN SODIUM 250MG CAP 000003.32 259
PHAR 000001710579 METOPROLOL 50MG TAB 000003.29 259
PHAR 000001710580 PRAZOSIN 1MG CAP 000003.27 259
PHAR 000001710581 DIPYRIDAMOLE 50MG TAB 000002.94 259
PHAR 000001710582 PROCAINAMIDE ER 750MG TAB 000002.71 259
PHAR 000001710584 HYDRALAZINE 50MG TAB 000002.73 259
PHAR 000001710585 DICLOXACILLIN 500MG CAP 000003.74 259
PHAR 000001710588 NIFEDIPINE 10MG CAP 000003.33 259
PHAR 000001710592 METOPROLOL 100MG TAB 000003.74 259
PHAR 000001710593 PRAZOSIN 2MG CAP 000003.47 259
PHAR 000001710594 DIPYRIDAMOLE 75MG TAB 000003.54 259
PHAR 000001710596 TRIFLUOPERAZINE HCL 10MG TAB 000007.33 259
PHAR 000001710597 VITAMIN A 25000U CAP 000002.48 259
PHAR 000001710598 AMITRIPTY/PERPHE 4/25 1TAB TAB 000003.94 259
PHAR 000001710605 LEVOTHYROXINE 0.1MG TAB 000002.95 259
PHAR 000001710606 VITAMIN A (SYNTHETIC) 50000U C 000003.88 259
PHAR 000001710610 FLUPHENAZINE 1 MG TAB 000004.19 259
PHAR 000001710615 PRAZOSIN 5MG CAP 000003.95 259
PHAR 000001710617 METHYSERGIDE MALEATE 2MG TAB 000008.15 259
PHAR 000001710622 FLUPHENAZINE HCL 2.5MG TAB 000007.13 250
PHAR 000001710623 RIMACTANE 300MG CAP 000008.91 259
PHAR 000001710625 PSEUDOEPHEDRINE HCL 30MG TAB 000002.47 259
PHAR 000001710626 LEVOTHYROXINE 0.15MG TAB 000003.06 259
PHAR 000001710627 CHLOROQUINE PHOSPHATE 500MG TA 000011.68 259
PHAR 000001710631 SENNA TAB 1TA 000002.51 259
PHAR 000001710632 PSEUDOEPHEDRINE 60MG TAB 000002.49 259
PHAR 000001710633 CARBAMAZEPINE TAB 200 000003.04 259
PHAR 000001710635 FLUPHENAZINE 5 MG TAB 000007.81 259
PHAR 000001710637 PSEUDOEPHEDRINE HCL 120MG CAP 000002.88 259
PHAR 000001710638 LEVOTHYROXINE 0.125MG TAB 000003.04 259
PHAR 000001710640 ATENOLOL 50MG TAB 000003.53 259
PHAR 000001710643 PROMETHAZINE HCL TAB 25M 000002.47 259
PHAR 000001710644 FLUPHENAZINE 10 MG TAB 000009.07 259
PHAR 000001710645 METHOCARBAMOL 500MG TAB 000002.55 259
PHAR 000001710649 MINOCYCLINE HCL 50MG CAP 000007.39 259
PHAR 000001710651 TMP/SULFAM 80/400 TAB 1TA 000003.49 259
PHAR 000001710652 SULFADIAZINE 500MG TAB 000007.15 259
PHAR 000001710657 ROBAXIN 750MG TAB 000002.70 259
PHAR 000001710658 LEVOTHYROXINE 0.2MG TAB 000002.98 259
PHAR 000001710659 BENZONATATE 100MG CAP 000003.62 259
PHAR 000001710661 MINOCYCLINE HCL 100MG CAP 000009.11 259
PHAR 000001710662 TMP/SULFAM 160/800 1TAB TAB 000006.79 259
9/7/2010 11:52 AM Page 33 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001710663 TETRACYCLINE HCL 250MG CAP 000002.50 259
PHAR 000001710664 CHLORPROMAZINE HCL 50MG TAB 000002.52 259
PHAR 000001710669 LEVOTHYROXINE 0.3MG TAB 000003.18 259
PHAR 000001710671 THEO-DUR 300MG TAB 000003.31 259
PHAR 000001710672 INDAPAMIDE 2.5MG TAB 000007.16 259
PHAR 000001710673 THIABENDAZOLE 500MG CHE 000004.46 259
PHAR 000001710675 GLYCOPYRROLATE TAB 1 M 000002.87 259
PHAR 000001710677 TETRACYCLINE HCL 500MG CAP 000002.59 259
PHAR 000001710681 GLYCOPYRROLATE TAB 2 M 000002.94 259
PHAR 000001710685 THEOPHYLLINE 100MG TAB 000002.86 259
PHAR 000001710686 CHLORPROMAZINE HCL 100MG TAB 000002.56 259
PHAR 000001710689 MOLINDONE HCL 5MG TAB 000003.35 250
PHAR 000001710697 MOLINDONE HCL 10MG TAB 000003.76 259
PHAR 000001710700 DOCUSATE CALCIUM 240MG CAP 000002.80 259
PHAR 000001710702 THEO-DUR 200MG TAB 000003.16 259
PHAR 000001710703 MOLINDONE HCL 25MG TAB 000004.40 250
PHAR 000001710706 ATENOLOL 100MG TAB 000007.06 259
PHAR 000001710707 THEOPHYLLINE SPRINKLE 125MG CA 000002.84 259
PHAR 000001710708 TRIHEXYPHENIDYL HCL 2MG TAB 000002.63 259
PHAR 000001710712 SINEMET 10/100 TAB 000003.51 259
PHAR 000001710714 CIMETIDINE TAB 300 000003.88 259
PHAR 000001710715 THEOPHYLLINE SPRINKLE 200MG CA 000002.90 250
PHAR 000001710717 PROCAINAMIDE 375MG CAP 000002.63 259
PHAR 000001710720 CIMETIDINE TAB 400 000007.30 259
PHAR 000001710722 CHLORPROMAZINE HCL 200MG TAB 000002.66 259
PHAR 000001710723 TRIHEXYPHENIDYL HCL 5MG TAB 000002.87 259
PHAR 000001710726 SINEMET 25/100 TAB 000003.61 259
PHAR 000001710735 NORETHINDRONE 0.35MG TAB 000053.98 259
PHAR 000001710748 PARLODEL 2.5MG TAB 000009.02 259
PHAR 000001710749 OVRAL 21DAY TAB 000056.75 259
PHAR 000001710750 OVRAL 28DAY TAB 000057.23 259
PHAR 000001710751 NORGESTREL 0.075MG TAB 000018.72 259
PHAR 000001710754 LO/OVRAL 21DAY TAB 000039.07 259
PHAR 000001710755 LO/OVRAL 28DAY TAB 000039.41 259
PHAR 000001710756 LOESTRIN FE 20-JAN TAB 000039.78 250
PHAR 000001710757 LOESTRIN 21DAY 20-JAN TAB 000000.88 259
PHAR 000001710758 LOESTRIN 21DAY 1.5/30 TAB 000000.76 259
PHAR 000001710759 LOESTRIN C IRON 1.5/30 TAB 000021.52 259
PHAR 000001710761 QUINIDINE SULF 200MG TAB 000002.62 259
PHAR 000001710762 QUINIDINE SULF 300MG TAB 000002.96 259
PHAR 000001710765 CLINDAMYCIN 75MG CAP 000003.70 259
PHAR 000001710766 CLINDAMYCIN CAP 150 000007.74 259
PHAR 000001710767 SULINDAC 150MG TAB 000004.15 259
PHAR 000001710768 SULINDAC 200MG TAB 000007.28 259
PHAR 000001710770 KLONOPIN TAB 0.5 MG 000003.04 259
PHAR 000001710775 BENZTROPINE 2MG TAB 000002.62 259
PHAR 000001710776 BENZTROPINE 1MG TAB 000002.58 259
9/7/2010 11:52 AM Page 34 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001710783 PROCHLORPERAZINE TAB 10M 000003.23 259
PHAR 000001710784 PROCHLORPERAZINE 25MG TAB 000003.60 259
PHAR 000001710785 PROCHLORPERAZINE 10MG CAP 000004.45 259
PHAR 000001710788 NADOLOL 40MG TAB 000006.82 259
PHAR 000001710789 NADOLOL 80MG TAB 000007.51 259
PHAR 000001710790 NADOLOL 120MG TAB 000008.14 259
PHAR 000001710791 NADOLOL 160MG TAB 000008.52 259
PHAR 000001710792 CORTEF 10MG TAB 000003.00 259
PHAR 000001710793 CORTISONE ACETATE 10MG TAB 000002.89 259
PHAR 000001710794 CORTISONE ACETATE 25MG TAB 000003.60 259
PHAR 000001710795 COUMADIN 2MG TAB 000003.51 259
PHAR 000001710796 COUMADIN 2.5MG TAB 000003.55 259
PHAR 000001710797 COUMADIN 5MG TAB 000003.56 259
PHAR 000001710798 COUMADIN 7.5MG TAB 000004.11 259
PHAR 000001710799 COUMADIN 10MG TAB 000004.17 259
PHAR 000001710800 PENICILLAMINE 250MG CAP 000004.30 259
PHAR 000001710801 PENICILLAMINE 125MG CAP 000003.73 250
PHAR 000001710807 LIOTHYRONINE 50MCG TAB 000002.93 259
PHAR 000001710808 LIOTHYRONINE 25MCG TAB 000002.75 259
PHAR 000001710809 LIOTHYRONINE 5MCG TAB 000002.69 259
PHAR 000001710813 CALCIUM 250MG (ELE) TAB 000002.51 259
PHAR 000001710814 NORDETTE TAB 000038.96 259
PHAR 000001710815 NORDETTE 28 DAY TAB 000039.31 259
PHAR 000001710823 TOCAINIDE 600MG TAB 000007.04 259
PHAR 000001710827 ISOTRETINOIN 20MG CAP 000012.13 250
PHAR 000001710831 DOCUSATE SOD 50MG CAP 000002.53 259
PHAR 000001710834 PYRIDOXINE 50MG TAB 000002.46 259
PHAR 000001710835 COLCHICINE 0.6MG TAB 000002.48 259
PHAR 000001710836 DISOPYRAMIDE CR 150MG CAP 000004.02 259
PHAR 000001710837 COTAZYM 1CAP CAP 000002.80 259
PHAR 000001710838 QUINIDINE SULF 100MG TAB 000002.63 259
PHAR 000001710846 CORTEF 5MG TAB 000002.57 259
PHAR 000001710849 PANCREASE CAP 000003.23 259
PHAR 000001710853 SALSALATE 750MG TAB 000002.71 259
PHAR 000001710858 PRIMROSE OIL 500MG CAP 000002.77 259
PHAR 000001710859 VIT B COMPLEX 100MG TAB 000002.72 259
PHAR 000001710860 CITALOPRAM TAB 20 000008.98 259
PHAR 000001710861 CITALOPRAM TAB 40M 000009.16 259
PHAR 000001710862 LIPOIC ACID 100MG CAP 000002.78 259
PHAR 000001710863 N-ACETYL-CYSTEINE 600MG CAP 000003.05 259
PHAR 000001710864 VITAMIN B COMPLEX 50 50MG TAB 000002.64 259
PHAR 000001710865 COENZYME Q10 10MG CAP 000002.68 259
PHAR 000001710866 COENZYME Q10 30MG CAP 000002.80 259
PHAR 000001710867 COENZYME Q10 60MG CAP 000003.44 259
PHAR 000001710868 COENZYME Q10 100MG CAP 000003.26 250
PHAR 000001710869 BICALUTAMIDE 50MG TAB 000028.74 259
PHAR 000001710870 CELEBREX 100MG CAP 000007.88 259
9/7/2010 11:52 AM Page 35 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001710871 CELEBREX 200MG CAP 000010.03 259
PHAR 000001710872 AVANDIA 4MG TAB 000010.20 259
PHAR 000001710873 AVANDIA 8MG TAB 000014.66 259
PHAR 000001710875 DOSTINEX 0.5MG TAB 000069.81 259
PHAR 000001710876 ZIAGEN 300MG TAB 000017.37 259
PHAR 000001710877 TEGRETOL-XR 100MG TAB 000002.89 259
PHAR 000001710878 ACTOS 15MG TAB 000010.96 259
PHAR 000001710879 TRICOR 200MG CAP 000009.66 259
PHAR 000001710880 DITROPAN XL 5MG TAB 000009.39 259
PHAR 000001710881 ARAVA 20MG TAB 000022.43 259
PHAR 000001710882 TIAZAC 360MG CAP 000009.32 259
PHAR 000001710883 HYZAAR 50/12.5MG TAB 000007.50 259
PHAR 000001710884 TOPIRAMATE 15MG CAP 000007.37 259
PHAR 000001710885 DEMSER 250MG CAP 000008.33 259
PHAR 000001710887 SELENIUM 100MCG TAB 000002.47 259
PHAR 000001710888 IVERMECTIN 6MG TAB 000026.34 259
PHAR 000001710889 MIRAPEX 0.25MG TAB 000006.97 259
PHAR 000001710890 SINEMET CR 25/100 TAB 000004.30 259
PHAR 000001710891 VALTREX 500MG CAP 000011.95 259
PHAR 000001710892 NORVIR 100MG CAP 000008.81 259
PHAR 000001710893 TENEX 2MG TAB 000007.94 259
PHAR 000001710894 GLUCOTROL XL 10MG TAB 000003.87 259
PHAR 000001710896 ZYPREXA 2.5MG TAB 000014.91 259
PHAR 000001710898 TAMIFLU 75MG KIT 000102.96 259
PHAR 000001710899 ARTHROTEC 50/200MG TAB 000007.97 259
PHAR 000001710900 ZANAFLEX 4MG TAB 000007.00 259
PHAR 000001710901 SINGULAIR 10MG TAB 000009.92 259
PHAR 000001710902 VIVARIN 200MG CAPL 000002.70 259
PHAR 000001710903 CARBAMAZEPINE SR CAP 300 000003.96 259
PHAR 000001710904 NORTRIPTYLINE 50MG CAP 000008.13 259
PHAR 000001710905 TRILEPTAL 150MG TAB 000004.32 259
PHAR 000001710906 AMERGE 2.5MG TAB 000040.97 259
PHAR 000001710907 COMBIVIR 150/300MG TAB 000026.08 259
PHAR 000001710908 RENAGEL 403MG CAP 000003.59 259
PHAR 000001710909 ACEBUTOLOL 200MG CAP 000007.58 259
PHAR 000001710910 AMOXICILLIN 875MG TAB 000004.49 259
PHAR 000001710911 ZIAC 2.5/6.25MG TAB 000007.37 259
PHAR 000001710912 LARIAM 250MG TAB 000020.78 259
PHAR 000001710914 DOFETILIDE 0.125MG CAP 000007.37 259
PHAR 000001710915 DOFETILIDE 0.25MG CAP 000007.37 259
PHAR 000001710916 DOFETILIDE 0.5MG CAP 000007.37 259
PHAR 000001710917 SILDENAFIL 25MG TAB 000024.29 259
PHAR 000001710918 RALOXIFENE 60MG TAB 000009.36 259
PHAR 000001710919 CLARITIN 10MG REDITAB 000010.56 259
PHAR 000001710920 MOEXIPRIL 15MG TAB 000003.91 259
PHAR 000001710921 GLYBURIDE/METFORMIN TAB 1.2 000003.81 259
PHAR 000001710922 GLYBURIDE/METFORMIN TAB 2.5 000004.08 259
9/7/2010 11:52 AM Page 36 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001710923 GLYBURIDE/METFORMIN TAB 5/5 000004.08 259
PHAR 000001710924 ZONISAMIDE 100MG CAP 000008.45 259
PHAR 000001710925 CARBAMAZEPINE SR CAP 200 000003.68 259
PHAR 000001710926 RISEDRONATE 5MG TAB 000008.75 259
PHAR 000001710927 RISEDRONATE 30MG TAB 000032.62 259
PHAR 000001710928 MONTELUKAST 4MG CHEW TAB 000010.47 259
PHAR 000001710929 ZIAC 5/6.25 TAB 000007.63 259
PHAR 000001710930 MG PLUS TAB 000002.54 259
PHAR 000001710931 ALENDRONATE SOD TAB 70M 000038.14 259
PHAR 000001710932 PENTOSAN 100MG CAP 000009.02 259
PHAR 000001710933 ZIPRASIDONE 20MG CAP 000013.58 259
PHAR 000001710934 ZIPRASIDONE 40MG CAP 000013.58 259
PHAR 000001710935 OXANDROLONE TAB 2.5 000007.40 259
PHAR 000001710937 RIFAXIMIN TAB 200 000009.38 250
PHAR 000001710938 CITALOPRAM TAB 10 000006.82 250
PHAR 000001710939 BUPROPION SR TAB 200 000009.10 250
PHAR 000001710940 ASPIRIN-EC 81MG TAB 81M 000001.46 250
PHAR 000001711003 PROCAINAMIDE 500MG CAP 000002.83 259
PHAR 000001711007 TRIHEXYPHENIDYL HCL 5MG CAP 000003.28 259
PHAR 000001711008 PHENOBARBITAL 15 MG 000002.07 259
PHAR 000001711011 SINEMET 25/250 TAB 000003.94 259
PHAR 000001711012 LEVOTHYROXINE 0.025MG TAB 000002.87 259
PHAR 000001711015 ORTHO-NOVUM 28DAY 777 TAB 000018.70 259
PHAR 000001711018 IBUPROFEN 300MG TAB 000002.83 259
PHAR 000001711019 METHIMAZOLE 10MG TAB 000002.86 259
PHAR 000001711021 OVCON 28DAY 0.4/35 TAB 000039.49 259
PHAR 000001711022 ASCORBIC ACID 250MG TAB 000002.47 259
PHAR 000001711023 SODIUM FLUORIDE 0.5MG CHE 000002.51 259
PHAR 000001711024 PROCAINAMIDE 250MG CAP 000003.97 259
PHAR 000001711025 DOXEPIN 10MG CAP 000002.70 259
PHAR 000001711026 LEVOTHYROXINE 0.05MG TAB 000002.88 259
PHAR 000001711029 PHENOBARB TAB 30 MG 000002.07 259
PHAR 000001711030 ASCORBIC ACID 500MG TAB 000002.48 259
PHAR 000001711031 SODIUM FLUORIDE 0.25MG CHE 000002.51 250
PHAR 000001711032 IBUPROFEN 400MG TAB 000002.80 259
PHAR 000001711033 THEOPHYLLINE 125MG TAB 000002.92 259
PHAR 000001711034 OVCON 28DAY JAN-50 TAB 000042.46 250
PHAR 000001711037 MITOTANE 500MG TAB 000009.05 259
PHAR 000001711038 IBUPROFEN 600MG TAB 000002.93 259
PHAR 000001711039 DOXEPIN 25MG CAP 000002.95 259
PHAR 000001711040 LEVOTHYROXINE 0.075MG TAB 000002.93 259
PHAR 000001711042 CHLORPROMAZINE HCL 75MG CAP 000004.08 259
PHAR 000001711045 OVCON 21DAY 0.4/35 TAB 000039.49 259
PHAR 000001711046 PROPYLTHIOURACIL 50MG TAB 000002.52 259
PHAR 000001711048 THEOPHYLLINE 250MG TAB 000003.37 259
PHAR 000001711051 ETHAMBUTOL HCL 100MG TAB 000003.28 259
PHAR 000001711052 NEOSTIGMINE BROMIDE 15MG TAB 000003.19 259
9/7/2010 11:52 AM Page 37 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001711053 DOXEPIN 50MG CAP 000003.17 259
PHAR 000001711054 ORTHO-NOVUM 21DAY 7/7/7 TAB 000037.44 259
PHAR 000001711055 THEOPHYLLINE 250MG TAB 000003.04 259
PHAR 000001711060 MYAMBUTOL 400MG TAB 000008.20 259
PHAR 000001711061 PROVERA 2.5MG TAB 000003.02 259
PHAR 000001711063 THEOPHYLLINE 500MG TAB 000003.35 259
PHAR 000001711064 AMOXAPINE 50MG TAB 000004.56 259
PHAR 000001711065 NITROFURANTOIN MACRO 25MG CAP 000003.53 259
PHAR 000001711068 OXACILLIN SODIUM CAP 500 000007.60 259
PHAR 000001711069 CHLORPROMAZINE HCL 200MG CAP 000007.33 259
PHAR 000001711072 AMOXAPINE 25MG TAB 000003.96 259
PHAR 000001711073 NITROSTAT 0.4 MG UD 000002.20 259
PHAR 000001711074 PURINETHOL 50MG TAB 000011.29 259
PHAR 000001711075 CARBAMAZEPINE CHEW CHE 100 000002.93 259
PHAR 000001711076 MULTI-VITAMIN TAB 000002.53 259
PHAR 000001711079 DOXEPIN 100MG CAP 000003.35 259
PHAR 000001711080 HYDRALAZINE 10MG TAB 000002.61 259
PHAR 000001711083 HYDROXYZINE PAMOATE 50MG CAP 000003.00 259
PHAR 000001711084 PHENOBARB TAB 60 MG 000002.08 259
PHAR 000001711085 AMOXAPINE 100MG TAB 000008.56 259
PHAR 000001711086 NITROFURANTOIN MACROC 50MG CAP 000003.74 259
PHAR 000001711088 MULTI-VIT W/MIN TAB 000002.52 259
PHAR 000001711089 THYROID 15MG TAB 000002.54 259
PHAR 000001711090 PERPHENAZINE 8MG TAB 000004.43 259
PHAR 000001711092 PHENOBARB TAB 100 MG 000002.05 259
PHAR 000001711093 AMOXAPINE 150MG TAB 000011.48 259
PHAR 000001711095 DOXEPIN 75MG CAP 000003.18 259
PHAR 000001711096 THYROID 30MG TAB 000002.63 259
PHAR 000001711097 PERPHENAZINE 16MG TAB 000007.54 250
PHAR 000001711098 HYDROXYZINE PAMOATE 100MG CAP 000002.94 259
PHAR 000001711099 HYDRALAZINE 100MG TAB 000002.64 259
PHAR 000001711100 BENZTROPINE 0.5MG TAB 000002.59 259
PHAR 000001711101 MACRODANTIN 100MG CAP 000007.93 259
PHAR 000001711105 PHENAZOPYRIDINE HCL 100MG TAB 000002.81 259
PHAR 000001711106 IMIPRAMINE 10MG TAB 000003.01 259
PHAR 000001711107 THERAGRAN HEMATINIC TAB 000003.17 259
PHAR 000001711108 THYROID 60MG TAB 000002.65 259
PHAR 000001711110 VIOKASE 1TAB TAB 000002.86 259
PHAR 000001711116 NYSTATIN 1TAB TAB 000003.30 259
PHAR 000001711118 CHOLINE MAG TRISALIC 500MG TAB 000003.70 259
PHAR 000001711119 NITROGLYCERIN 2.5MG CAP 000002.70 259
PHAR 000001711121 VITAMIN A 10000U CAP 000002.45 259
PHAR 000001711123 NITROGLYCERIN 6.5MG CAP 000002.71 259
PHAR 000001711125 PHENAZOPYRIDINE HCL 200MG TAB 000003.24 259
PHAR 000001711126 THIAMINE HCL 50MG TAB 000002.42 259
PHAR 000001711127 THYROID 120MG TAB 000002.71 259
PHAR 000001711129 CALCIUM 500MG (ELE) TAB 000002.45 259
9/7/2010 11:52 AM Page 38 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001711130 DIDRONEL 400MG TAB 000014.69 259
PHAR 000001711133 AMITRIPTYLINE 100MG TAB 000003.08 259
PHAR 000001711135 THIAMINE 100MG TAB 000002.46 259
PHAR 000001711139 SODIUM CHL 1GM TAB 000002.53 259
PHAR 000001711141 DIAZOXIDE 50MG CAP 000007.97 259
PHAR 000001711142 SODIUM BICARBONATE 325MG TAB 000002.48 259
PHAR 000001711143 THYROID 180MG TAB 000002.96 259
PHAR 000001711144 CYANOCOBALAMIN 100MCG TAB 000002.46 259
PHAR 000001711145 CIPROFLOXACIN TAB 250 000011.16 259
PHAR 000001711147 MYLANTA CHEW TABS CHE 000002.53 259
PHAR 000001711148 SODIUM BICARB 650MG TAB 000002.53 259
PHAR 000001711149 THIOGUANINE TAB 40M 000013.11 259
PHAR 000001711150 THYROID 240MG TAB 000003.24 259
PHAR 000001711155 THYROID 300MG TAB 000003.44 259
PHAR 000001711157 PROTRIPTYLINE HCL 5MG TAB 000003.35 259
PHAR 000001711158 NITRO SL 0.4MG TAB #25 000011.75 259
PHAR 000001711159 CIPROFLOXACIN 500MG TAB 000010.14 259
PHAR 000001711164 VIVACTIL 10MG TAB 000003.75 259
PHAR 000001711165 HYDROXYZINE HCL 10MG TAB 000002.84 259
PHAR 000001711167 TRIMETHOBENZAMIDE 100MG CAP 000003.22 259
PHAR 000001711168 TUMS 500MG CHEW TABS 000003.30 259
PHAR 000001711171 CHLORPROMAZINE HCL 25MG TAB 000002.51 259
PHAR 000001711174 LEUCOVORIN 5MG TAB 000010.65 259
PHAR 000001711176 CIPROFLOXACIN TAB 750 000012.23 259
PHAR 000001711177 LEUCOVORIN CALCIUM 25MG TAB 000048.07 259
PHAR 000001711179 SOMA 350MG TAB 000007.84 259
PHAR 000001711182 COMBINATION TAB 000003.61 259
PHAR 000001711183 SIMETHICONE 80MG TAB 000002.65 259
PHAR 000001711184 UNIPHYL 400MG TAB 000004.36 259
PHAR 000001711185 PROZAC 20MG CAP 000009.55 259
PHAR 000001711186 ACETAMINOPHEN CPL 500 000000.60 259
PHAR 000001711188 HYDROXYZINE HCL TAB 50M 000003.04 259
PHAR 000001711189 THEOPHYLLINE 100MG CAP 000002.86 250
PHAR 000001711191 ACETAMINOPHEN CHE 80M 000000.60 259
PHAR 000001711193 PRIMIDONE 250MG TAB 000003.41 259
PHAR 000001711194 THEOPHYLLINE 200MG CAP 000003.01 259
PHAR 000001711195 ESTROGENS CONJ 0.9MG TAB 000003.35 259
PHAR 000001711196 HYDROXYZINE HCL TAB 100 000007.01 259
PHAR 000001711197 IMIPRAMINE 25MG TAB 000002.58 259
PHAR 000001711198 PRIMIDONE 50MG TAB 000002.71 259
PHAR 000001711201 ASPIRIN 81MG CHEW TAB 000002.42 259
PHAR 000001711202 IMIPRAMINE 50MG TAB 000002.68 259
PHAR 000001711203 NAFCILLIN SODIUM 250MG CAP 000004.42 259
PHAR 000001711204 ATROPINE 0.4MG TAB 000002.48 259
PHAR 000001711206 ACETAMINOPHEN CPL 325 000000.60 259
PHAR 000001711207 ASPIRIN-EC 325MG TAB 000002.46 259
PHAR 000001711211 IMIPRAMINE PAMOATE 75MG CAP 000004.12 259
9/7/2010 11:52 AM Page 39 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001711212 BETHANECHOL CHLORIDE 5MG TAB 000002.62 259
PHAR 000001711215 XANAX TAB 1 MG 000003.42 259
PHAR 000001711217 IMIPRAMINE PAMOATE 150MG CAP 000007.78 259
PHAR 000001711218 BETHANECHOL CHLORIDE 10MG TAB 000002.64 259
PHAR 000001711220 IMIPRAMINE PAMOATE 100MG CAP 000007.66 259
PHAR 000001711222 IMIPRAMINE PAMOATE 125MG CAP 000008.36 259
PHAR 000001711226 TOLMETIN 200MG TAB 000003.72 259
PHAR 000001711230 BETHANECHOL CHLORIDE 25MG TAB 000002.84 259
PHAR 000001711233 RANITIDINE HCL 150MG TAB 000007.72 259
PHAR 000001711234 SULFASALAZINE 500MG TAB 000002.72 259
PHAR 000001711235 NAPROXEN 250MG TAB 000003.79 259
PHAR 000001711236 PANCRELIPASE MT4 4000U CAP 000002.96 259
PHAR 000001711237 BETHANECHOL CHLORIDE 50MG TAB 000003.10 259
PHAR 000001711238 ETHOSUXIMIDE 250MG CAP 000003.89 259
PHAR 000001711239 PANCRELIPASE MT 10 10000U CAP 000003.79 259
PHAR 000001711240 PANCREASE MT16 CAP 000007.55 259
PHAR 000001711241 LACTOBACILLUS ACIDOPH 1TAB TAB 000002.92 259
PHAR 000001711242 NAPROXEN 375MG TAB 000004.18 259
PHAR 000001711246 NAPROXEN TAB 500 000007.33 259
PHAR 000001711248 METOLAZONE 2.5MG TAB 000003.29 259
PHAR 000001711249 AMITRIPTYLINE 150MG TAB 000002.92 259
PHAR 000001711253 FLAVOXATE HCL 100 MG TAB 000003.68 259
PHAR 000001711255 ZAROXOLYN 5MG TAB 000003.76 259
PHAR 000001711256 ACTIGALL 300MG CAP 000010.47 259
PHAR 000001711257 PHENELZINE SULFATE TAB 15M 000003.19 259
PHAR 000001711258 PROMAZINE HCL 25MG TAB 000003.16 259
PHAR 000001711259 PENICILLIN V K 250MG TAB 000002.54 259
PHAR 000001711260 AMITRIPTYLINE 75MG TAB 000002.81 259
PHAR 000001711263 METOLAZONE 10MG TAB 000003.54 259
PHAR 000001711266 PENICILLIN V K 500MG TAB 000002.65 259
PHAR 000001711267 ZINC SULFATE CAP 220 000002.46 259
PHAR 000001711269 THIOTHIXENE 2MG CAP 000003.38 259
PHAR 000001711270 GUANABENZ 8MG TAB 000004.43 259
PHAR 000001711272 DILTIAZEM HCL ER CPC 90M 000004.18 259
PHAR 000001711273 DILTIAZEM HCL ER CAP 120 000007.12 259
PHAR 000001711274 THIOTHIXENE 5MG CAP 000003.98 259
PHAR 000001711276 ALLOPURINOL 100MG TAB 000002.66 259
PHAR 000001711277 TRIFLUOPERAZINE HCL 1MG TAB 000003.32 250
PHAR 000001711278 NIMODIPINE 30MG CAP 000016.06 259
PHAR 000001711280 ALLOPURINOL 300MG TAB 000003.00 259
PHAR 000001711281 TRIFLUOPERAZINE HCL 2MG TAB 000003.76 259
PHAR 000001711284 THIOTHIXENE 10MG CAP 000006.83 259
PHAR 000001711285 FLUTAMIDE 125MG CAP 000007.92 250
PHAR 000001711286 BECOTIN CAP 000002.23 259
PHAR 000001711288 THIOTHIXENE 20MG CAP 000007.75 259
PHAR 000001711291 MEGESTROL 20MG TAB 000003.58 259
PHAR 000001711292 MEGESTROL 40MG TAB 000006.72 259
9/7/2010 11:52 AM Page 40 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001711295 ALBUTEROL 2MG TAB 000003.11 259
PHAR 000001711298 ALBUTEROL 4MG TAB 000003.44 259
PHAR 000001711300 MEBENDAZOLE 100MG CHE 000014.80 259
PHAR 000001711303 ERGOT/BELLAD/PHENOB TAB 000007.33 259
PHAR 000001711305 CHLORZOXAZONE 500MG TAB 000003.37 259
PHAR 000001711307 MISOPROSTOL 200MCG TAB 000004.10 259
PHAR 000001711308 DOXYCYCLINE 50MG CAP 000003.92 259
PHAR 000001711310 NEOMYCIN SULF 500MG TAB 000003.43 259
PHAR 000001711311 DIPHENHYDRAMINE 25MG CAP 000002.60 259
PHAR 000001711312 DOXYCYCLINE HYCLATE 100MG CAP 000007.21 259
PHAR 000001711314 SODIUM FLUORIDE 2.2MG TAB 000002.23 250
PHAR 000001711315 PROBENECID 500MG TAB 000003.02 259
PHAR 000001711316 DICYCLOMINE 10MG CAP 000002.90 259
PHAR 000001711317 DICYCLOMINE HCL 20MG TAB 000002.51 259
PHAR 000001711318 GEMFIBROZIL 600MG TAB 000006.67 259
PHAR 000001711322 VITAMIN B(+ C) TAB 000003.18 250
PHAR 000001711328 TERBUTALINE SULFATE 2.5MG TAB 000002.88 259
PHAR 000001711331 TRIPHASIL 21DAY TAB 000036.43 259
PHAR 000001711335 QUININE SULFATE 300MG CAP 000002.60 259
PHAR 000001711337 VITAMIN E CAP 400 000002.48 259
PHAR 000001711338 VITAMIN E 1000U CAP 000002.66 259
PHAR 000001711339 PYRIDOXINE HCL 100MG TAB 000002.46 259
PHAR 000001711343 TRANYLCYPROMINE SULF TAB 10M 000003.34 259
PHAR 000001711344 GLYBURIDE 2.5MG TAB 000002.95 259
PHAR 000001711345 GLYBURIDE 5MG TAB 000003.35 259
PHAR 000001711347 DEPAKOTE 250MG TAB 000003.96 259
PHAR 000001711348 DEPAKOTE 500MG TAB 000007.65 259
PHAR 000001711349 GUANABENZ 4MG TAB 000003.76 259
PHAR 000001711354 TRI-NORINYL 28DAY 777 TAB 000035.50 259
PHAR 000001711355 ENALAPRIL TAB 2.5 000003.97 259
PHAR 000001711357 DICLOFENAC SODIUM TAB 25M 000003.22 259
PHAR 000001711358 DICLOFENAC SODIUM TAB 50M 000004.26 259
PHAR 000001711359 ORTHO-NOVUM 28DAY 10/11 TAB 000040.00 259
PHAR 000001711360 DICLOFENAC SODIUM TAB 75M 000007.05 259
PHAR 000001711363 MYCELEX 10MG TAB 000007.20 259
PHAR 000001711366 DEXAMETHASONE 1MG TAB 000002.92 259
PHAR 000001711367 VICODIN TAB 000003.68 259
PHAR 000001711368 CLONIDINE 0.2MG TAB 000002.96 259
PHAR 000001711370 DESIPRAMINE 150MG TAB 000010.43 259
PHAR 000001711371 TRIAMTER/HCTZ 75/50 TAB 000007.04 259
PHAR 000001711374 NORTRIPTYLINE HCL 75MG CAP 000009.24 259
PHAR 000001711375 ERYTHROMYCIN 250MG CAP 000003.23 259
PHAR 000001711376 GLIPIZIDE TAB 5 M 000003.13 259
PHAR 000001711377 GLIPIZIDE TAB 10 000003.82 259
PHAR 000001711380 ACYCLOVIR 200MG CAP 000004.18 259
PHAR 000001711381 CAPOTEN 12.5MG TAB 000003.49 259
PHAR 000001711382 TOCAINIDE 400MG TAB 000004.26 259
9/7/2010 11:52 AM Page 41 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001711384 LABETALOL 100MG TAB 000003.46 259
PHAR 000001711385 LABETALOL 200MG TAB 000003.87 259
PHAR 000001711386 LABETALOL 300MG TAB 000003.83 259
PHAR 000001711387 AMOXICILLIN/CLAVULANI 250MG TA 000008.77 259
PHAR 000001711388 AUGMENTIN 500MG TAB 000011.07 259
PHAR 000001711390 TRI-PHASIL 7/7/7 TAB 000037.88 259
PHAR 000001711391 WELLBUTRIN 100MG TAB 000007.09 259
PHAR 000001711395 DESIPRAMINE 100MG TAB 000008.68 259
PHAR 000001711397 PSEUDOEPH/TRIPROLIDIN 1TAB TAB 000002.66 259
PHAR 000001711399 ISOSORBIDE E.R. 40MG TAB 000003.29 259
PHAR 000001711405 IBUPROFEN 800MG TAB 000002.97 259
PHAR 000001711409 GLYBURIDE 1.25MG TAB 000002.84 259
PHAR 000001711410 PENTOXIFYLLINE E.R. TAB 400 000003.69 259
PHAR 000001711411 ESTROPIPATE 1.25MG TAB 000006.66 259
PHAR 000001711412 ESTROPIPATE 0.625MG TAB 000006.13 259
PHAR 000001711418 IBUPROFEN 200MG TAB 000000.60 259
PHAR 000001711420 PROPRANOLOL LA 120MG CAP 000007.20 259
PHAR 000001711421 PROPRANOLOL LA 160MG CAP 000007.94 259
PHAR 000001711426 METHYLPREDNISOLONE 16MG KIT 000028.78 259
PHAR 000001711427 METHYLPREDNISOLONE 4MG KIT 000019.09 259
PHAR 000001711433 THEOPHYLLINE 100MG CPC 000002.88 259
PHAR 000001711434 THEOPHYLLINE 50MG CAP 000002.80 259
PHAR 000001711435 THEOPHYLLINE 200MG CPC 000003.11 259
PHAR 000001711436 THEOPHYLLINE 300MG CPC 000003.24 259
PHAR 000001711438 ASCORBIC ACID 100MG TAB 000002.42 259
PHAR 000001711439 PENICILLIN G K 250MG TAB 000002.65 259
PHAR 000001711440 FLECAINIDE 100MG TAB 000007.16 259
PHAR 000001711443 GRISEOFULVIN 500 MG TAB 000007.16 250
PHAR 000001711446 GRISEOFULVIN ULTRAMIC 330 MG T 000007.01 259
PHAR 000001711449 VERAPAMIL HCL 120MG TAB 000003.74 259
PHAR 000001711450 ERYTHROMYCIN 250MG TAB 000002.70 259
PHAR 000001711451 ERY-TAB 333MG TAB 000003.09 259
PHAR 000001711452 ERY-TAB 500MG TAB 000003.19 259
PHAR 000001711453 DEMECLOCYCLINE HCL 150MG TAB 000011.66 259
PHAR 000001711454 COMBINATION TBC 000004.20 259
PHAR 000001711457 VASOTEC 5MG TAB 000006.77 259
PHAR 000001711458 ENALAPRIL TAB 10M 000004.13 259
PHAR 000001711459 VASOTEC 20MG TAB 000007.71 259
PHAR 000001711462 DOXYCYCLINE 100MG TAB 000006.81 259
PHAR 000001711466 CLONIDINE 0.3MG TAB 000003.03 259
PHAR 000001711467 THEOPHYLLINE 75MG CAP 000002.76 259
PHAR 000001711468 THEOPHYLLINE 125MG CPC 000002.89 259
PHAR 000001711469 DILTIAZEM HCL ER CPC 60M 000003.78 259
PHAR 000001711471 SKELAXIN 400MG TAB 000003.87 259
PHAR 000001711473 NADOLOL 20MG TAB 000004.31 259
PHAR 000001711474 BUPROPION HCL 75 MG TAB 000003.56 259
PHAR 000001711476 TOLMETIN 600MG TAB 000007.34 259
9/7/2010 11:52 AM Page 42 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001711477 VERAPAMIL HCL SR 180MG TAB 000007.15 259
PHAR 000001711478 OMEPRAZOLE 20MG CAP 000011.77 259
PHAR 000001711479 THEOPHYLLINE 450MG TAB 000003.25 259
PHAR 000001711481 DIFLUCAN TAB 100 MG 000016.38 259
PHAR 000001711483 COUMADIN 1MG TAB 000003.47 259
PHAR 000001711484 QUININE SULF 325MG CAP 000002.75 259
PHAR 000001711487 DIFLUCAN 50MG TAB 000014.76 259
PHAR 000001711488 DIFLUCAN 100MG TAB 000017.84 259
PHAR 000001711489 DIFLUCAN 200MG TAB 000026.14 259
PHAR 000001711490 TERAZOSIN 1MG TAB 000008.51 259
PHAR 000001711491 TERAZOSIN 2MG TAB 000008.51 259
PHAR 000001711492 VERAPAMIL HCL 40MG TAB 000003.08 259
PHAR 000001711498 LEVOTHYROXINE 0.112MG TAB 000002.92 259
PHAR 000001711499 MORCIZINE HCL 200MG TAB 000004.08 259
PHAR 000001711502 MISOPROSTIL 100MCG TAB 000003.41 259
PHAR 000001711506 PHOSLO 667MG TAB 000002.59 259
PHAR 000001711508 CREON-10 CAP 000003.88 259
PHAR 000001711509 PHOSPHOLIPID SUS 25M 002001.22 259
PHAR 000001711513 AMOXICILLIN 125MG CHE 000002.72 259
PHAR 000001711514 DIVALPROEX SODIUM TAB 125 000003.02 259
PHAR 000001711515 ACYCLOVIR 800MG TAB 000011.19 259
PHAR 000001711518 SELEGILINE HCL 5MG TAB 000010.33 259
PHAR 000001711519 BENAZEPRIL 5MG TAB 000003.82 259
PHAR 000001711520 BENAZEPRIL 10MG TAB 000003.82 259
PHAR 000001711521 BENAZEPRIL 20MG TAB 000003.82 259
PHAR 000001711522 BENAZEPRIL 40MG TAB 000004.11 259
PHAR 000001711525 FLECAINIDE 50MG TAB 000003.54 259
PHAR 000001711526 VIOKASE POW 120 000000.00 250
PHAR 000001711527 KETOROLAC 10MG TAB 000006.78 259
PHAR 000001711529 PRENATAL S TAB 1EA 000002.71 259
PHAR 000001711531 CLARITHROMYCIN 500MG TAB 000010.70 259
PHAR 000001711533 CARDIZEM CD 180MG CAP 000007.41 259
PHAR 000001711534 CARDIZEM CD 240MG CAP 000008.51 259
PHAR 000001711535 DILTIAZEM HCL CD 300MG CPC 000008.56 259
PHAR 000001711536 PROPAFENONE 150MG TAB 000007.01 259
PHAR 000001711538 PRAVACHOL 10MG TAB 000009.36 259
PHAR 000001711539 PRAVACHOL 20MG TAB 000009.71 259
PHAR 000001711540 DEPAKOTE SPRINK 125MG CAP 000003.21 259
PHAR 000001711541 CHLOROPHYLL DERIVATIV 20 MG TA 000002.45 259
PHAR 000001711542 DIDANOSINE 25MG TAB 000003.18 259
PHAR 000001711543 ISOSORBIDE MONONITRAT 20MG TAB 000003.71 259
PHAR 000001711544 DOXAZOSIN 1MG TAB 000004.24 259
PHAR 000001711545 ZITHROMAX 250MG TAB 000018.95 259
PHAR 000001711546 DAPSONE 100MG TAB 000002.72 259
PHAR 000001711547 ATENOLOL 25MG TAB 000003.51 259
PHAR 000001711548 K-PHOS NEUTRAL TAB 000002.64 259
PHAR 000001711550 MAG-OX 400MG TAB 000002.62 259
9/7/2010 11:52 AM Page 43 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001711551 NITROGLYCERIN 0.4MG TAB 000002.64 259
PHAR 000001711552 NICARDIPINE 20MG CAP 000003.13 259
PHAR 000001711553 NICARDIPINE 30MG CAP 000003.55 259
PHAR 000001711554 ZOLOFT 50MG TAB 000008.89 259
PHAR 000001711555 ZOLOFT 100MG TAB 000009.05 259
PHAR 000001711556 HYOSCYAMINE SULFATE 0.125MG TA 000002.96 259
PHAR 000001711559 CARDIZEM CD 120MG CAP 000006.97 259
PHAR 000001711560 BETAPACE 80MG TAB 000008.83 259
PHAR 000001711561 BETAPACE 160MG TAB 000010.33 259
PHAR 000001711562 BETAPACE 240MG TAB 000011.99 259
PHAR 000001711568 PROZAC 10MG CAP 000010.25 259
PHAR 000001711569 FIORICET 1TAB TAB 000003.37 259
PHAR 000001711570 ONDANSETRON TAB 4MG 000024.07 259
PHAR 000001711577 AMLODIPINE 2.5MG TAB 000007.66 259
PHAR 000001711578 AMLODIPINE 5MG TAB 000007.18 259
PHAR 000001711579 AMLODIPINE 10MG TAB 000008.71 259
PHAR 000001711580 DIPENTUM 250MG CAP 000004.52 259
PHAR 000001711581 PROPAFENONE 300MG TAB 000008.72 259
PHAR 000001711583 PAXIL 20MG TAB 000008.89 259
PHAR 000001711585 POTASSIUM CHL 8MEQ CAP 000002.76 259
PHAR 000001711587 FINASTERIDE 5 MG TAB 000008.59 259
PHAR 000001711588 FOSINOPRIL 10MG TAB 000003.67 259
PHAR 000001711589 METOPROLOL SUCCINATE TAB 50M 000003.32 259
PHAR 000001711593 FELBAMATE 600MG TAB 000003.59 259
PHAR 000001711596 DIDANOSINE 50MG TAB 000003.95 259
PHAR 000001711598 PERGOLIDE MESYLATE 0.25MG TAB 000004.00 259
PHAR 000001711599 CEFUROXIME AXETIL 250 MG TAB 000012.60 259
PHAR 000001711601 ADEKS TAB 1EA 000003.05 259
PHAR 000001711602 CARBIDOPA/LEV 50/200 TAB 000007.39 259
PHAR 000001711604 FELBAMATE 400MG TAB 000003.43 259
PHAR 000001711606 DAPSONE 25MG TAB 000002.77 259
PHAR 000001711607 SIMVASTATIN 20MG TAB 000011.65 259
PHAR 000001711608 ISRADIPINE 2.5MG CAP 000003.77 259
PHAR 000001711609 OFLOXACIN 400 MG TAB 000011.14 259
PHAR 000001711611 CHEMSTRIP-10 UD 1 STRIP (PROD) 000000.00 250
PHAR 000001711612 LORATADINE 10 MG TAB 000009.41 259
PHAR 000001711614 TICLID 250MG TAB 000009.03 259
PHAR 000001711616 LEVOCARNITINE 330MG TAB 000004.10 259
PHAR 000001711618 NABUMETONE 500MG TAB 000007.42 259
PHAR 000001711621 VERAPAMIL HCL SR 120MG TAB 000004.02 259
PHAR 000001711622 ISOSORBIDE MONONITRAT TAB 60M 000007.76 259
PHAR 000001711624 OXAPROZIN 600MG CAP 000007.95 259
PHAR 000001711627 GABAPENTIN 100MG CAP 000003.33 259
PHAR 000001711628 LEVOTHYROXINE 0.088MG TAB 000002.84 259
PHAR 000001711629 LORAZEPAM TAB 2 MG 000003.39 259
PHAR 000001711631 CLARITHROMYCIN 250MG TAB 000011.84 259
PHAR 000001711632 GLIPIZIDE XL TAB 5MG 000003.14 259
9/7/2010 11:52 AM Page 44 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001711635 BIOTIN 300MCG TAB 000002.47 259
PHAR 000001711638 LAMOTRIGINE 25MG TAB 000008.86 259
PHAR 000001711639 LAMOTRIGINE 100MG TAB 000007.78 259
PHAR 000001711640 LAMOTRIGINE 150MG TAB 000007.92 259
PHAR 000001711641 LAMOTRIGINE 200MG TAB 000008.09 259
PHAR 000001711642 FAMCICLOVIR 500MG TAB 000017.04 259
PHAR 000001711644 LOSARTAN 25MG TAB 000007.50 259
PHAR 000001711645 LOSARTAN 50MG TAB 000007.50 259
PHAR 000001711646 TRETINOIN 10MG CAP 000029.96 259
PHAR 000001711647 GLYBURIDEPRESTAB 3 MG TAB 000003.29 259
PHAR 000001711648 GLYBURIDEPRESTAB 6 MG TAB 000003.98 259
PHAR 000001711649 GLYBURIDEPRESTAB 1.5 MG TAB 000002.93 259
PHAR 000001711650 NEPHRO-VITE RX TAB 000002.62 259
PHAR 000001711651 TRAMADOL HCL TAB 50 000004.01 259
PHAR 000001711652 ADALAT CC 30MG TAB 000006.78 259
PHAR 000001711653 ADALAT CC 60MG TAB 000008.20 259
PHAR 000001711654 ADALAT CC 90MG TAB 000008.92 259
PHAR 000001711655 PINDOLOL TAB 5 M 000004.53 259
PHAR 000001711656 PINDOLOL TAB 10 000013.07 259
PHAR 000001711657 GABAPENTIN 400MG CAP 000007.33 259
PHAR 000001711658 VIOKASE POW 1TS 000000.00 250
PHAR 000001711661 TOLAZAMIDE 250MG TAB 000003.62 259
PHAR 000001711662 TERBINAFINE HCL 250MG TAB 000016.98 259
PHAR 000001711663 CHLORPROPAMIDE 250MG TAB 000003.89 250
PHAR 000001711664 QUINAPRIL 10MG TAB 000004.51 259
PHAR 000001711665 QUINAPRIL 20MG TAB 000004.51 259
PHAR 000001711666 QUINAPRIL 5MG TAB 000004.51 259
PHAR 000001711669 ATOVAQUONE TAB 250 000010.79 259
PHAR 000001711670 PIMOZIDE 2MG TAB 000004.00 259
PHAR 000001711671 HYOSCYAMINE TIMECAP 0.375MG CA 000003.83 259
PHAR 000001711672 COUMADIN 3MG TAB 000003.55 259
PHAR 000001711673 COUMADIN 6MG TAB 000003.86 259
PHAR 000001711674 AMOXICILLIN/CLAVULANI 875MG TA 000013.16 259
PHAR 000001711675 ACYCLOVIR 400MG TAB 000005.90 259
PHAR 000001711676 CHARCOAL ACTIVATED CAP 000002.64 259
PHAR 000001711677 ULTRASE MT 12 CAP 000003.93 259
PHAR 000001711678 CARVEDILOL 25MG TAB 000007.97 259
PHAR 000001711679 COREG 12.5MG TAB 000008.14 259
PHAR 000001711680 COREG 6.25MG TAB 000008.14 259
PHAR 000001711681 CARVEDILOL TAB 3.1 000003.86 259
PHAR 000001711682 NELFINAVIR 250MG TAB 000009.26 259
PHAR 000001711683 ISRADIPINE 5MG CAP 000004.39 259
PHAR 000001711684 ISRADIPINE CR 5MG CAP 000004.76 259
PHAR 000001711685 ISRADIPINE CR 10MG CAP 000008.56 259
PHAR 000001711686 IRBESARTAN 300MG TAB 000009.34 259
PHAR 000001711687 IRBESARTAN 75MG TAB 000007.26 259
PHAR 000001711688 IRBESARTAN 150MG TAB 000007.39 259
9/7/2010 11:52 AM Page 45 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001711689 ATORVASTATIN 10MG TAB 000008.86 259
PHAR 000001711690 ATORVASTATIN 20MG TAB 000011.08 259
PHAR 000001711691 ATORVASTATIN 40MG TAB 000013.56 258
PHAR 000001711692 PILOCARPINE HCL TAB 5MG 000007.38 259
PHAR 000001711693 ACARBOSE 25MG TAB 000003.22 259
PHAR 000001711694 ACARBOSE 50MG TAB 000003.22 259
PHAR 000001711695 ACARBOSE 100MG TAB 000003.50 259
PHAR 000001711697 ULTRASE MT 18 1CAP CAP 000004.69 259
PHAR 000001711698 ULTRASE MT 20 1CAP CAP 000004.93 259
PHAR 000001711699 DIDANOSINE 100MG TAB 000008.46 259
PHAR 000001711702 CLOFAZIMINE 50MG CAP 000002.74 259
PHAR 000001711705 BUPROPION HCL SR 150MG TAB 000007.68 259
PHAR 000001711706 NISOLDIPINE 10MG TAB 000002.80 259
PHAR 000001711707 NISOLDIPINE 20MG TAB 000004.40 259
PHAR 000001711708 NISOLDIPINE 30MG TAB 000002.80 259
PHAR 000001711709 VALSARTAN 160MG CAP 000007.41 259
PHAR 000001711710 VALSARTAN 80MG CAP 000006.98 259
PHAR 000001711711 TROGLITAZONE 200MG TAB 000011.23 259
PHAR 000001711712 TROGLITAZONE 300MG TAB 000011.23 259
PHAR 000001711713 TROGLITAZONE 400MG TAB 000015.04 259
PHAR 000001711714 LANSOPRAZOLE 15MG CAP 000010.93 259
PHAR 000001711715 LANSOPRAZOLE 30MG CAP 000011.27 259
PHAR 000001711716 DONEPEZIL HCL 10MG TAB 000012.38 259
PHAR 000001711717 DONEPEZIL HCL 5MG TAB 000012.38 259
PHAR 000001711718 ZAFIRLUKAST 20MG TAB 000004.08 259
PHAR 000001711719 BUPROPION SR 100MG TAB 000007.48 259
PHAR 000001711720 BUPROPION SR 150MG TAB 000007.68 259
PHAR 000001711721 VENLAFAXINE XR CAP 150 000009.91 259
PHAR 000001711722 VENLAFAXINE XR CAP 75M 000009.48 259
PHAR 000001711723 SAQUINAVIR 200MG CAP 000007.15 259
PHAR 000001711724 OMEPRAZOLE 10MG CAP 000012.29 259
PHAR 000001711725 CLOPIDOGREL BISULF 75MG TAB 000010.21 259
PHAR 000001711726 IBUPROFEN 100MG TAB 000002.86 259
PHAR 000001711727 LEVOFLOXACIN 250MG TAB 000019.70 259
PHAR 000001711728 LEVOFLOXACIN 500MG TAB 000022.21 259
PHAR 000001711729 ARIMIDEX 1MG TAB 000018.79 259
PHAR 000001711730 ZYRTEC 5MG TAB 000008.82 259
PHAR 000001711731 CETIRIZINE HCL 10MG TAB 000008.70 259
PHAR 000001711732 NEVIRAPINE 200MG TAB 000013.97 259
PHAR 000001711733 FERROUS SULF SR 160MG TAB 000002.89 259
PHAR 000001711734 DDAVP 0.1MG TAB 000008.56 259
PHAR 000001711735 DDAVP 0.2MG TAB 000010.66 259
PHAR 000001711736 ZINC LOZENGE 1TAB LOZ 000002.54 259
PHAR 000001711738 PROCAINAMIDE ER 500MG TAB 000003.76 259
PHAR 000001711739 ALBUTEROL SULF. TAB 4MG 000004.03 259
PHAR 000001711740 LITHIUM CARBONATE 150MG CAP 000002.58 259
PHAR 000001711741 CLINDAMYCIN 300MG CAP 000011.45 259
9/7/2010 11:52 AM Page 46 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001711742 FEXOFENADINE 60MG CAP 000004.06 259
PHAR 000001711743 ANAGRELIDE HCL 0.5MG CAP 000013.87 259
PHAR 000001711744 TOLTERODINE TARTRATE 1MG TAB 000007.39 259
PHAR 000001711745 DETROL 2MG TAB 000007.59 259
PHAR 000001711746 NEFAZODONE HCL 100MG TAB 000006.97 259
PHAR 000001711747 NEFAZODONE HCL 150MG TAB 000006.74 259
PHAR 000001711748 NEFAZODONE HCL 200MG TAB 000006.74 259
PHAR 000001711749 NEFAZODONE HCL 50MG TAB 000004.74 259
PHAR 000001711750 ESTROGEN/PROGEST 2.5MG TAB 000043.76 259
PHAR 000001711752 FOSINOPRIL 10MG TAB 000004.26 259
PHAR 000001711753 FOSINOPRIL 20MG TAB 000004.26 259
PHAR 000001711754 FOSINOPRIL 40MG TAB 000004.26 259
PHAR 000001711755 FLOMAX 0.4MG CAP 000007.90 259
PHAR 000001711756 SINGULAIR 5MG CHEW TAB 000010.01 259
PHAR 000001711758 ISOSORBIDE MONONITRAT TAB 30M 000004.86 259
PHAR 000001711759 ALENDRONATE SOD TAB 10M 000008.22 259
PHAR 000001711760 ALENDRONATE SOD TAB 5MG 000008.22 259
PHAR 000001711761 VITAMIN B COMPLEX 1TAB TAB 000002.50 259
PHAR 000001711762 ALBUTEROL 4MG ER TAB 4MG TAB 000004.02 259
PHAR 000001711763 CEFPROZIL 250MG TAB 000011.11 250
PHAR 000001711766 GLIMEPIRIDE 1MG TAB 000002.90 259
PHAR 000001711767 GLIMEPIRIDE 2MG TAB 000003.23 259
PHAR 000001711768 HYDROCHLOROTZ/SPRINO TAB 25/ 000003.47 250
PHAR 000001711769 PRAMIPEXOLE 1MG TAB 000008.90 259
PHAR 000001711770 BIPERIDEN 2MG TAB 000003.05 250
PHAR 000001711771 TOLAZAMIDE 500MG TAB 000003.52 259
PHAR 000001711772 VENLAFAXINE XR CAP 37. 000008.41 259
PHAR 000001711773 ONE-A-DAY 50 PLUS TAB 000002.60 259
PHAR 000001711774 SIMVASTATIN 10MG TAB 000008.73 259
PHAR 000001711775 TACROLIMUS 0.5MG CAP 000008.43 259
PHAR 000001711776 PRANDIN 2MG TAB 000004.19 259
PHAR 000001711777 TIAGABINE 4MG TAB 000007.18 259
PHAR 000001711778 TEGRETOL XR 200MG TAB 000003.38 259
PHAR 000001711779 TEGRETOL XR 400MG TAB 000004.35 259
PHAR 000001711780 SUSTIVA 200MG CAP 000014.26 259
PHAR 000001711782 ONDANSETRON ODT TAB 4MG 000032.23 259
PHAR 000001711784 METOCLOPRAMIDE TAB 5MG 000002.95 259
PHAR 000001711786 CALFACTANT SUS 35M 002020.65 259
PHAR 000001711787 LOTREL 2.5MG CAP 000008.40 259
PHAR 000001711788 AMARYL 4MG TAB 000004.08 259
PHAR 000001711789 ONDANSETRON TAB 24M 000147.76 259
PHAR 000001711790 PERMAX 0.05MG TAB 000004.44 259
PHAR 000001711791 PRANDIN 1MG TAB 000004.01 259
PHAR 000001711792 LAMOTRIGINE 5MG TAB 000009.00 259
PHAR 000001711793 AVANDIA 2MG TAB 000008.72 259
PHAR 000001711794 BAYCOL 0.3MG TAB 000008.14 259
PHAR 000001711795 DIFLUCAN 150MG TAB 000030.48 259
9/7/2010 11:52 AM Page 47 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001711796 MIGLITOL 100MG TAB 000003.91 259
PHAR 000001711797 ENTACAPONE 200MG TAB 000008.43 259
PHAR 000001711798 MESALAMINE CR 250MG CAP 000003.18 259
PHAR 000001711799 NIACIN 50MG TAB 000002.43 259
PHAR 000001711800 MIGLITOL 25MG TAB 000003.52 259
PHAR 000001711801 OMEPRAZOLE 40MG CAP 000017.63 259
PHAR 000001711802 CALCIUM/VIT D 500MG TAB 000002.52 259
PHAR 000001711803 DIDANOSINE 200MG TAB 000013.36 259
PHAR 000001711804 IMATINIB MESYLATE CAP 100 000047.32 259
PHAR 000001711805 NATEGLINIDE 60MG TAB 000004.40 259
PHAR 000001711806 NATEGLINIDE 120MG TAB 000004.47 259
PHAR 000001711807 PHOSPHOLIPID SUS 25M 001255.28 259
PHAR 000001711810 ZALEPLON 5MG CAP 000008.93 259
PHAR 000001711811 GLIPIZIDE XL 2.5MG TAB 000003.19 259
PHAR 000001711812 SIMVASTATIN 40MG TAB 000013.79 259
PHAR 000001711813 ROPINIROLE 0.25MG TAB 000007.29 259
PHAR 000001711814 DIDANOSINE EC 400MG CAP 000025.43 259
PHAR 000001711815 FOLIC ACID 0.4MG TAB 000002.45 259
PHAR 000001711816 ROPINIROLE 0.5MG TAB 000007.29 259
PHAR 000001711817 ESCITALOPRAM OXALATE TAB 10 000005.27 259
PHAR 000001711818 ESCITALOPRAM OXALATE TAB 20 000005.47 259
PHAR 000001711819 VORICONAZOLE TAB 50 000019.53 259
PHAR 000001711820 VORICONAZOLE TAB 200 000078.12 259
PHAR 000001711821 ATOMOXETINE HCL 10MG CAP 10M 000007.81 250
PHAR 000001711822 ATOMOXETINE HCL 18MG CAP 18M 000007.81 250
PHAR 000001711823 ATOMOXETINE HCL 25MG CAP 25M 000007.81 250
PHAR 000001711824 ATOMOXETINE HCL 40MG CAP 40M 000007.81 250
PHAR 000001711825 ATOMOXETINE HCL 60MG CAP 60M 000007.81 250
PHAR 000001711826 FEXOFENADINE HCL TAB 30M 000001.76 250
PHAR 000001711827 ARIPIPAZOLE 10MG TAB 10 000026.40 250
PHAR 000001711828 ARIPIPAZOLE 15MG TAB 15 000026.40 250
PHAR 000001711829 ARIPIPAZOLE 20MG TAB 20 000037.34 250
PHAR 000001711830 ARIPIPAZOLE 30MG TAB 30 000037.34 250
PHAR 000001711831 OXCARBAZEPINE 300MG TAB 300 000004.85 250
PHAR 000001711832 LITHIUM CARBONATE CAP 600 000002.71 250
PHAR 000001711833 MESORIDAZINE BESYLATE TAB 10M 000003.38 250
PHAR 000001711834 NALTREXONE HCL TAB 50M 000012.98 250
PHAR 000001711835 B COMPLEX WITH C TAB 1TA 000002.54 250
PHAR 000001711836 CLOMIPRAMINE HCL CAP 25M 000003.86 250
PHAR 000001711837 CLOMIPRAMINE HCL CAP 50M 000006.77 250
PHAR 000001711838 CLOMIPRAMINE HCL CAP 75M 000007.39 250
PHAR 000001711839 DULOXETINE HCL CAP 20M 000007.95 250
PHAR 000001711840 DULOXETINE HCL CAP 30M 000008.90 250
PHAR 000001711841 DULOXETINE HCL CAP 60M 000008.90 250
PHAR 000001711842 IMATINIB MESYLATE TAB 400 000236.38 250
PHAR 000001711843 IMATINIB MESYLATE TAB 100 000059.09 250
PHAR 000001711844 WARFARIN SODIUM TAB 4MG 000003.51 250
9/7/2010 11:52 AM Page 48 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001711845 METOPROLOL SUCCINATE TAB 25M 000002.35 250
PHAR 000001712001 TERBUTALINE SULFATE 5MG TAB 000003.07 259
PHAR 000001712005 BUMETANIDE 0.5MG TAB 000002.93 259
PHAR 000001712006 BUMETANIDE 1MG TAB 000003.12 259
PHAR 000001712008 ERGOTAMINE/CAFF 1TAB TAB 000006.62 259
PHAR 000001712011 CALCIUM GLUCONATE 1 GM TAB 000002.71 259
PHAR 000001712012 CALCIUM GLUCONATE 500MG TAB 000002.58 259
PHAR 000001712014 CALCIUM LACTATE 650MG TAB 000002.53 259
PHAR 000001712016 CAPTOPRIL 25MG TAB 000003.35 259
PHAR 000001712017 CAPTOPRIL 50MG TAB 000006.83 259
PHAR 000001712018 CAPTOPRIL 100MG TAB 000007.76 259
PHAR 000001712020 VERAPAMIL SR 240MG TAB 000006.99 259
PHAR 000001712021 BUSPAR 5MG TAB 000003.81 259
PHAR 000001712022 LACTINEX TAB 000012.77 259
PHAR 000001712025 HIPREX 1GM TAB 000007.52 259
PHAR 000001712026 NORFLOXACIN 400MG TAB 000012.14 259
PHAR 000001712027 SUCRALFATE 1GM TAB 000003.79 259
PHAR 000001712032 DILTIAZEM 30MG TAB 000003.21 259
PHAR 000001712033 DILTIAZEM 60MG TAB 000003.67 259
PHAR 000001712035 CALCIUM CITRATE 950 MG TAB 000002.54 259
PHAR 000001712037 CLONIDINE 0.1MG TAB 000002.83 259
PHAR 000001712039 CEFACLOR 250MG CAP 000008.60 259
PHAR 000001712040 CEFACLOR 500MG CAP 000012.22 259
PHAR 000001712042 DILTIAZEM 90MG TAB 000003.94 259
PHAR 000001712043 SALSALATE 500MG CAP 000002.86 259
PHAR 000001712045 LOMUSTINE 10MG CAP 000013.56 259
PHAR 000001712046 LOMUSTINE 40MG CAP 000031.20 259
PHAR 000001712047 LOMUSTINE 100MG CAP 000054.97 259
PHAR 000001712048 BETAMETHASONE 0.6MG TAB 000007.49 259
PHAR 000001712049 METHSUXIMIDE 300MG CAP 000003.85 259
PHAR 000001712051 LOVASTATIN 20MG TAB 000009.07 259
PHAR 000001712052 FAMOTIDINE TAB 20 000007.99 259
PHAR 000001712055 FAMOTIDINE TAB 40 000010.96 259
PHAR 000001712056 NYSTATIN LOZ 200,000 U 000004.49 259
PHAR 000001712059 GUANFACINE HCL TAB 1 M 000007.09 259
PHAR 000001712061 LISINOPRIL 5MG TAB 000004.31 259
PHAR 000001712062 LISINOPRIL 10MG TAB 000004.37 259
PHAR 000001712063 LISINOPRIL 20MG TAB 000004.51 259
PHAR 000001712064 ZIDOVUDINE 100MG CAP 000008.02 259
PHAR 000001712075 CHLORPHENIRAMINE 4MG TAB 000002.66 259
PHAR 000001712082 RIFAMPIN 150MG CAP 000008.02 259
PHAR 000001712085 SULFASALAZINE 500MG TAB 000002.66 259
PHAR 000001712086 PYRAZINAMIDE 500MG TAB 000007.23 259
PHAR 000001712089 AMIODARONE 200MG TAB 000008.10 259
PHAR 000001712090 MEXILETINE HCL 150MG CAP 000004.00 259
PHAR 000001712091 MEXILETINE HCL 200MG CAP 000004.30 259
PHAR 000001712092 MEXILETINE HCL 250MG CAP 000007.01 259
9/7/2010 11:52 AM Page 49 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001712097 BUMETANIDE 2MG TAB 000003.79 259
PHAR 000001712099 CHOLINE MAG TRISALICI 750 MG T 000004.16 259
PHAR 000001712100 LITHIUM CARBONATE 450MG TAB 000003.13 259
PHAR 000001712101 AMINOPHYLLINE 200MG TAB 000002.52 259
PHAR 000001712104 VANCOMYCIN HCL 125MG CAP 000011.20 259
PHAR 000001712105 VANCOMYCIN HCL 250MG CAP 000025.21 259
PHAR 000001712107 BACLOFEN 20MG TAB 000003.72 259
PHAR 000001712109 ESTRADIOL PATCH 0.05MG PAT 000029.18 259
PHAR 000001712110 ESTRADIOL PATCH 0.1MG PAT 000029.98 259
PHAR 000001712112 K-DUR TAB 20 MEQ 000002.43 259
PHAR 000001712116 PROPRANOLOL LA 60MG CAP 000004.38 259
PHAR 000001712119 CALCIUM 600MG (ELE) TAB 000002.48 259
PHAR 000001712122 VOLTAREN TAB 50 MG 000003.41 259
PHAR 000001712134 BUSPIRONE TAB 10M 000007.26 259
PHAR 000001712135 PCE TAB 333 MG 000003.25 259
PHAR 000001712137 POTASSIUM CHLORIDE 20MEQ TAB 000003.14 259
PHAR 000001712138 K-DUR 10MEQ TAB 000002.97 259
PHAR 000001712140 NITROFURANTION 100MG CAP 000007.97 259
PHAR 000001712142 PAROMOMYCIN 250MG CAP 000010.87 259
PHAR 000001712144 ASACOL 400MG TAB 000003.87 259
PHAR 000001712151 TERAZOSIN 5MG CAP 000008.51 259
PHAR 000001712152 TERAZOSIN 10MG CAP 000008.51 259
PHAR 000001712156 FELODIPINE 5MG TAB 000004.04 259
PHAR 000001712157 FELODIPINE 10MG TAB 000007.75 259
PHAR 000001712158 GABAPENTIN 300MG CAP 000006.98 259
PHAR 000001712159 MAGNESIUM (ELE) TAB 64M 000002.69 259
PHAR 000001712160 METHYLTESTOST/ESTROG 1TAB TAB 000003.68 259
PHAR 000001712161 METHYLTESTOST/ESTROG 1TAB TAB 000004.00 259
PHAR 000001712162 L-CITRULLINE 600MG CAP 000003.17 259
PHAR 000001712165 TACROLIMUS 5MG CAP 000035.09 259
PHAR 000001712171 ITRACONAZOLE CAP 100 000014.88 259
PHAR 000001712172 FLUVASTATIN 20MG CAP 000007.51 259
PHAR 000001712173 FLUVASTATIN 40MG CAP 000007.51 259
PHAR 000001712174 TORSEMIDE 5MG TAB 000003.22 259
PHAR 000001712175 TORSEMIDE 10MG TAB 000003.28 259
PHAR 000001712176 TORSEMIDE 20MG TAB 000003.35 259
PHAR 000001712177 TORSEMIDE 100MG TAB 000008.81 259
PHAR 000001712181 GLUCOPHAGE 500MG TAB 000003.49 259
PHAR 000001712182 GLUCOPHAGE 850MG TAB 000007.02 259
PHAR 000001712183 LAMIVUDINE 150MG TAB 000012.85 259
PHAR 000001712184 PERGOLIDE MESLYATE 1MG TAB 000068.24 259
PHAR 000001712185 VENLAFAXINE HCL TAB 100 000025.97 259
PHAR 000001712187 VENLAFAXINE HCL TAB 75M 000024.77 259
PHAR 000001712193 RIFABUTIN 150MG CAP 000011.66 259
PHAR 000001712194 GUAIFENESIN ER TAB 600 000002.87 259
PHAR 000001712195 FELODIPINE 2.5MG TAB 000003.74 259
PHAR 000001712196 CYANOCOBALAMIN 1000MCG TAB 000002.54 259
9/7/2010 11:52 AM Page 50 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001712197 CLARITIN-D 1TAB TAB 000006.91 259
PHAR 000001712198 CLARITIN-D 24HR TAB 000010.13 259
PHAR 000001712199 NIZATIDINE 150MG CAP 000007.75 250
PHAR 000001712200 SUMATRIPTAN SUCC 25MG TAB 000031.85 259
PHAR 000001712201 SUMATRIPTAN SUCC 50MG TAB 000035.33 259
PHAR 000001712202 METOPROLOL SUCC TAB 100 000004.04 259
PHAR 000001712203 METOPROLOL SUCC TAB 200 000008.08 259
PHAR 000001712204 SIMVASTATIN 5MG TAB 000008.00 259
PHAR 000001712205 LISINOPRIL 5MG TAB 000004.28 259
PHAR 000001712206 LISINOPRIL 10MG TAB 000004.34 259
PHAR 000001712207 LISINOPRIL 20MG TAB 000004.48 259
PHAR 000001712208 MAG-TAB SR 84MG CPL 000002.26 259
PHAR 000001712209 ERYTHROMYCIN ETHYLSUC 400MG CH 000002.83 259
PHAR 000001712210 DOXAZOSIN 2MG TAB 000004.55 259
PHAR 000001712211 DOXAZOSIN 8MG TAB 000004.26 259
PHAR 000001712213 CYTOVENE 250MG CAP 000013.43 259
PHAR 000001712214 MIDODRINE HCL TAB 5MG 000007.32 259
PHAR 000001712215 MIDODRINE HCL TAB 2.5 000004.39 259
PHAR 000001712217 CLOZAPINE 25MG TAB 000004.20 259
PHAR 000001712218 CLOZARIL 100MG TAB 000012.41 259
PHAR 000001712220 ACARBOSE TAB 50M 000003.11 259
PHAR 000001712222 CYTOVENE 500MG CAP 000022.07 259
PHAR 000001712223 VENLAFAXINE TAB 37. 000007.22 259
PHAR 000001712224 LAMIVUDINE HBV 100MG TAB 000014.16 259
PHAR 000001712225 ZIDOVUDINE 300MG TAB 000015.73 259
PHAR 000001712226 CLIMARA 0.1MG PATCH 000014.43 259
PHAR 000001712227 ALBENZA 200MG TAB 000007.41 259
PHAR 000001712228 MAXALT 10MG TAB 000035.73 259
PHAR 000001712229 GENGRAF 25MG CAP 000007.28 259
PHAR 000001712230 GENGRAF 100MG CAP 000014.69 259
PHAR 000001712231 RAMIPRIL 5MG CAP 000004.56 259
PHAR 000001712233 THALIDOMIDE CAP 50M 000110.35 259
PHAR 000001712234 AGGRENOX 200/25MG CAP 000007.99 259
PHAR 000001712236 LEVETIRACETAM 250MG TAB 000007.83 259
PHAR 000001712237 LEVETIRACETAM 500MG TAB 000008.50 259
PHAR 000001712238 NELFINAVIR 250MG TAB 000009.67 259
PHAR 000001712239 VENLAFAXINE HCL TAB 25M 000007.24 259
PHAR 000001712240 URSODIOL 250MG TAB 000009.00 259
PHAR 000001712241 GLUCOSAMINE CAP 500 000002.58 259
PHAR 000001712242 LINEZOLID TAB 600 000100.43 259
PHAR 000001712243 POTASSIUM GLUC 550MG TAB 000002.46 259
PHAR 000001712244 ALOSETRON 1MG TAB 000010.19 259
PHAR 000001712245 ZOLMITRIPTAN 2.5MG TAB 000030.26 259
PHAR 000001712246 METFORMIN XR 500MG TAB 000003.89 259
PHAR 000001712247 CAPECITABINE 500MG TAB 000023.25 259
PHAR 000001712248 VALGANCICLOVIR TAB 450 000066.96 259
PHAR 000001712249 OLANZAPINE DT 5MG TAB 000017.46 259
9/7/2010 11:52 AM Page 51 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001712250 OLANZAPINE DT 10MG TAB 000022.94 259
PHAR 000001712251 ZIPRASIDONE 60MG CAP 000013.58 259
PHAR 000001712252 ZIPRASIDONE 80MG CAP 000013.58 259
PHAR 000001712253 SEVELAMER 800MG TAB 000007.45 259
PHAR 000001712254 RAMIPRIL 1.25MG CAP 000004.33 259
PHAR 000001712255 RAMIPRIL 2.5MG CAP 000007.14 259
PHAR 000001712256 RAMIPRIL 10MG CAP 000007.87 259
PHAR 000001712257 CHARCOAL 250MG TAB 000002.57 259
PHAR 000001712258 ZIAC 10/6.25MG TAB 000007.63 259
PHAR 000001712259 BISOPROLOL 10MG TAB 000007.63 259
PHAR 000001712263 MEDROXYPROGESTERONE 5MG TAB 000004.39 259
PHAR 000001712264 TRANDOLAPRIL TAB 1MG 000003.98 259
PHAR 000001712265 TRANDOLAPRIL TAB 2MG 000003.98 259
PHAR 000001712266 TRANDOLAPRIL TAB 4MG 000003.98 259
PHAR 000001712267 PANTOPRAZOLE TAB 40M 000011.85 259
PHAR 000001712268 ESTRADIOL 0.05MG PATCH 000015.31 259
PHAR 000001712269 RILUZOLE 50MG TAB 000037.19 259
PHAR 000001712271 LEVOFLOXACIN TAB 750 000052.86 250
PHAR 000001712273 VALDECOXIB 20MG TAB 20M 000008.25 250
PHAR 000001712274 TEGASEROD TAB 2MG 000007.35 250
PHAR 000001712275 TEGASEROD TAB 6MG 000007.35 250
PHAR 000001712276 TEMOZOLOMIDE CAP 5MG 000021.78 250
PHAR 000001712277 THALIDOMIDE CAP 100 000176.20 250
PHAR 000001712278 THALIDOMIDE CAP 200 000236.13 250
PHAR 000001712279 BUPROPION XL TAB 150 000008.02 250
PHAR 000001712280 BUPROPION XL TAB 300 000010.59 250
PHAR 000001712281 METOPROLOL TARTRATE TAB 25M 000001.06 250
PHAR 000001713001 COLYTE 2000 ML 000037.00 250
PHAR 000001713002 SODIUM POLYSTYRENE POW 1GM 000000.60 259
PHAR 000001713003 CHYMORAL-100 000008.51 250
PHAR 000001713013 ELECTROLYTE SOL/PEG SOL 1EA 000000.00 250
PHAR 000001713014 SODIUM POLY-NICU UD 1 1GM POW 000003.16 259
PHAR 000001713064 POTASSIUM CL (KLOR) 20MEQ 000004.13 259
PHAR 000001713080 LACTINEX 1GM PKT 000003.40 259
PHAR 000001713081 CHOLESTYRAMINE 4GM PKT 000007.20 259
PHAR 000001713086 COLYTE 2000 ML 000035.00 250
PHAR 000001713105 NEUTRA-PHOS 250MG/PKT 000002.98 259
PHAR 000001713106 VIOKASE POW 5GM 000000.00 250
PHAR 000001713107 NELFINAVIR POWDER 50MG PWD 000009.26 259
PHAR 000001713108 SALT & SODA 1TSP PWD PO 000001.20 259
PHAR 000001713109 CRIXIVAN 400MG CAP 000010.36 259
PHAR 000001713110 SODIUM PHENYLBUTYRTE 1GM POW 000019.64 259
PHAR 000001713111 PAXIL 30MG TAB 000009.76 259
PHAR 000001713112 PRO-PHREE PWD 1GM 000000.00 250
PHAR 000001713113 PROVIMIN PWD 1GM 000000.00 250
PHAR 000001713115 MODUCAL PWD 1GM 000000.00 259
PHAR 000001713117 NEUTRA-PHOS*K***PKT PKT 250 000001.55 250
9/7/2010 11:52 AM Page 52 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001713120 PAXIL 40MG TAB 000010.04 259
PHAR 000001713121 PAXIL 10MG TAB 000009.41 259
PHAR 000001713130 STAVUDINE 15MG CAP 000012.56 259
PHAR 000001713131 STAVUDINE 20MG CAP 000012.88 259
PHAR 000001713132 STAVUDINE 30MG CAP 000013.48 259
PHAR 000001713133 STAVUDINE 40MG CAP 000013.54 259
PHAR 000001713135 MIRTAZAPINE 15MG TAB 000008.36 259
PHAR 000001713136 MIRTAZAPINE 30MG TAB 000008.47 259
PHAR 000001713138 TOPIRAMATE 25MG TAB 000003.97 259
PHAR 000001713139 TOPIRAMATE 100MG TAB 000010.10 259
PHAR 000001713140 TOPIRAMATE 200MG TAB 000011.02 259
PHAR 000001713141 OLANZAPINE 5MG TAB 000014.23 259
PHAR 000001713142 OLANZAPINE 7.5MG TAB 000014.23 259
PHAR 000001713143 OLANZAPINE 10MG TAB 000018.73 259
PHAR 000001713145 QUETIAPINE FUMARATE 25MG TAB 000006.96 259
PHAR 000001713146 QUETIAPINE FUMARATE 100MG TAB 000008.72 259
PHAR 000001713147 QUETIAPINE FUMARATE 200MG TAB 000012.66 259
PHAR 000001713148 AGAR POWDER 250MG 000001.27 259
PHAR 000001713149 LACTULOSE 20GM PKT 000007.62 259
PHAR 000001713150 MIRALAX PWD 255GM 000035.10 259
PHAR 000001713151 RISPERIDONE M-TAB TAB 0.5 000009.43 250
PHAR 000001713152 RISPERIDONE M-TAB TAB 1MG 000011.00 250
PHAR 000001713153 RISPERIDONE M-TAB TAB 2MG 000017.73 250
PHAR 000001713163 INSULIN (NOVOLOG)UD SOL 1DO 000012.60 250
PHAR 000001713167 INSULIN NOVO (NPH) INJ 100 000012.00 250
PHAR 000001714002 ZINC OXIDE 454G JAR 20% OIN TO 000019.15 259
PHAR 000001714008 FLUVOXAMINE MALEATE 50MG TAB 000007.55 259
PHAR 000001714009 FLUVOXAMINE MALEATE 100MG TAB 000007.63 259
PHAR 000001715002 OSMOGLYN OS 0.6GM 000006.60 259
PHAR 000001715003 ATROPINE SULFATE OS SOL 0.3 000008.40 259
PHAR 000001715004 ATROPINE SULFATE OS SOL 0.4 000007.00 259
PHAR 000001715005 ZINC (ELEMENTAL) OS SUS 10M 000006.60 259
PHAR 000001715006 DIAZOXIDE OS 50MG/ML 000008.40 259
PHAR 000001715008 CLINDAMYCIN OS 15MG SUS 000006.60 259
PHAR 000001715012 PROPRANOLOL HCL OS 4MG 000006.60 259
PHAR 000001715017 MAG SULFATE ORAL SYR 000005.50 259
PHAR 000001715021 ISONIAZID OS 10MG SYR 000008.40 259
PHAR 000001715023 FUROSEMIDE OS IVFORM 10MG/ML 000008.40 259
PHAR 000001715024 DIGOXIN OS IV FORM 0.1MG/ML 000008.40 250
PHAR 000001715027 CAL GLUC 10%(MG) OS 100MG PO 000008.40 259
PHAR 000001715029 PHENOBARB IV-FORM OS 130MG/ML 000008.40 259
PHAR 000001715031 POTASSIUM CL IVFM 37 INJ 2ME 000008.40 259
PHAR 000001715033 NAPROXEN OS 25MG SUS 000006.60 259
PHAR 000001715036 SODIUM POLYSTY OS 0.25GM SUS 000006.60 259
PHAR 000001715038 CALCIUM CARB SUSP 250MG SUS 000006.60 259
PHAR 000001715042 NEUTRA-PHOS K ***** 25MG SUS 000008.40 259
PHAR 000001715043 PROMETHAZINE OS 1.25MG/ML 000006.60 259
9/7/2010 11:52 AM Page 53 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001715046 MG CL ORAL SYR 000007.00 259
PHAR 000001715049 THIORIDAZINE HCL OS 5MG SUS 000008.40 259
PHAR 000001715052 THIORIDAZINE HCL OS 100MG PO 000008.40 259
PHAR 000001715054 FER-IN-SOL DROP ML DRP 1ML 000006.60 259
PHAR 000001715056 FER-IN-SOL DROP 3700 DRP 25M 000006.60 259
PHAR 000001715057 ACYCLOVIR OS 40MG SUS 000008.40 259
PHAR 000001715059 AMINOPHYLLINE-IV OS 25 MG 000006.60 259
PHAR 000001715061 VERAPAMIL HCL OS 25MG SUS 000008.40 259
PHAR 000001715063 IBUPROFEN OS 20MG/ML 000006.60 259
PHAR 000001715066 LABETALOL HCL OS 10 MG 000008.40 259
PHAR 000001715067 HYDROCHLOROTHIAZI OS SOL 10M 000006.60 259
PHAR 000001715069 ZIDOVUDINE OS 10MG SYR 000008.40 259
PHAR 000001715071 MAG SULF (IV FRM) OS 4.06MEQ 000006.60 259
PHAR 000001715073 FAMOTIDINE OS SUS 8MG 000008.40 259
PHAR 000001715083 CARNITOR OS 100MG/ML 000008.40 250
PHAR 000001715085 FLECAINIDE OS LIQ 20M 000008.40 259
PHAR 000001715089 MAGNESIUM CL OS 2MEQ 000008.40 259
PHAR 000001715090 ALDACTAZIDE SUSP. SUS 5MG 000008.14 250
PHAR 000001715091 SANDIMMUNE OS 50MG/ML(IV FORM) 000038.16 259
PHAR 000001715093 PYRAZINAMIDE OS SOL 100 000008.40 259
PHAR 000001715095 CALCIUM CL 10%(MG) OS 100MG PO 000006.60 259
PHAR 000001715099 HYDROCODE/ACETAM OS PO 000006.60 259
PHAR 000001715103 DEXAMETHASNE IVFM OS 4MG 000008.40 259
PHAR 000001715105 POLYCITRA OS 000006.60 259
PHAR 000001715111 FELBAMATE OS 120MG/ML 000008.40 259
PHAR 000001715115 GRISEOFULVIN OS 25MG SUS 000008.40 259
PHAR 000001715117 FLUOXETINE OS 4MG PO 000008.40 259
PHAR 000001715119 SUCRALFATE OS 100MG/ML 000006.60 259
PHAR 000001715121 ACETYLCYSTEINE 20%OS SOL 200 000007.15 250
PHAR 000001715123 SODIUM BENZOATE OS 200 MG 000008.40 259
PHAR 000001715125 MEGESTROL OS 40MG/ML 000006.60 259
PHAR 000001715128 ETHAMBUTOL HCL OS 50 MG 000008.40 259
PHAR 000001715134 LORAZEPAM ORAL SUSP SOL 0.5 000008.40 259
PHAR 000001715136 METHOTREXATE OS 2MG SYR 000008.40 259
PHAR 000001715138 SAFFLOWER OIL OS 000006.60 259
PHAR 000001715142 HALOPERIDOL CONC OS 2MG PO 000008.40 259
PHAR 000001715147 HYDROXYZINE 37IVFORM 50MG 000006.60 250
PHAR 000001715148 PREDNISOLONE OS 1MG SYR 000006.60 259
PHAR 000001715149 PREDNISOLONE OS 3MG/ML 5ML 000006.60 259
PHAR 000001715272 VANCOMYCIN OS 50MG/ML 000029.27 259
PHAR 000001715300 FLUCONAZOLE OS 40MG SUS 000036.00 259
PHAR 000001715333 DECONAMINE ORAL SYR 000002.50 259
PHAR 000001715451 SPIRONOLACTONE OS 2MG/ML 000008.40 259
PHAR 000001715454 NEUTRA-PHOS OS 25MG 000008.40 259
PHAR 000001715456 NEUTRA-PHOS OS 0.8MM 000008.40 259
PHAR 000001715458 SODIUM CHLORIDE OS37 SOL 2.5 000006.60 259
PHAR 000001715460 ACETAMINOPHEN OS DRP 100 000006.60 259
9/7/2010 11:52 AM Page 54 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001715462 ACETAMINOPHEN OS SOL 32M 000006.60 259
PHAR 000001715466 ACETAMINOPHEN/COD OS 2.4MG ELI 000006.60 259
PHAR 000001715468 PHENOBARB OS 4MG/ML 000006.60 259
PHAR 000001715470 CHLORAL HYDRATE OS 100MG SYR 000006.60 259
PHAR 000001715472 THIOGUANINE SUSP OS SUS 40M 000006.60 259
PHAR 000001715474 HYDROXYZINE HCL OS 2MG SYR 000006.60 259
PHAR 000001715476 OPIUM 0.4MG/ML-SPEC DIL 1ML 000006.60 259
PHAR 000001715478 OXYBUTYNIN CL OS 1MG SYR 000006.60 259
PHAR 000001715480 TMP/SULFAMETH OS 8 MG SUS 000008.40 259
PHAR 000001715482 METOCLOPRAMIDE OS SYR 1MG 000006.60 259
PHAR 000001715484 PHENYLPRO/BROMPH OS ELI 000006.60 259
PHAR 000001715486 DIPHENHYDRAMINE OS 2.5MG ELI 000006.60 259
PHAR 000001715488 DICLOXACILLIN OS 12.5MG SUS 000008.40 259
PHAR 000001715490 FUROSEMIDE OS 10MG/ML 000006.60 259
PHAR 000001715493 POTASSIUM CL OS 1.334MEQ PO 000006.60 259
PHAR 000001715497 NEO-CALGLUCON SYRUP SYR 1ML 000006.60 259
PHAR 000001715499 PHENYTOIN OS 25MG/ML 000006.60 259
PHAR 000001715503 SOD. BICARBONATE OS 1MEQ 000006.60 259
PHAR 000001715507 AMINOPHYLLINE OS SOL 21M 000006.60 259
PHAR 000001715511 RIFAMPIN OS SUS 10M 000008.40 259
PHAR 000001715513 VALPROIC ACID OS 50MG SYR 000006.60 259
PHAR 000001715519 BETHANECHOL OS 1MG SUS 000008.40 259
PHAR 000001715521 DIAZEPAM OS SOL 1MG 000006.60 259
PHAR 000001715523 METAPROTERENOL OS 2MG SYR 000006.60 259
PHAR 000001715525 AMPICILLIN 125MG OS 25MG SUS 000008.40 259
PHAR 000001715527 AMPICILLIN 250MG OS 50MG SUS 000008.40 259
PHAR 000001715531 CHLOROTHIAZIDE OS 50MG/ML 000006.60 259
PHAR 000001715535 VITAMIN E OS 50U 000006.60 259
PHAR 000001715547 FURAZOLIDONE OS 3.3333MG PO 000008.40 259
PHAR 000001715551 DONNAGEL OS 1 ML SUS 000006.60 259
PHAR 000001715553 ENTEX OS 1 ML 000006.60 259
PHAR 000001715557 PENICILL G K 250/5 50MG 000008.40 259
PHAR 000001715559 CYPROHEPTADINE OS 0.4MG SYR 000006.60 259
PHAR 000001715562 MULTI-VIT LIQ OS 20ML 000006.60 259
PHAR 000001715564 ERYTHRO ETHY 200 OS 40MG SUS 000008.40 259
PHAR 000001715574 QUINIDINE GLUC OS 80MG/ML 000008.40 259
PHAR 000001715580 ALLOPURINOL OS 10MG SUS 000008.40 259
PHAR 000001715582 ERYTHRO ETHY 400 OS 80MG SUS 000008.40 259
PHAR 000001715584 GLYCOPYRROLATE OS 37 SOL 0.2 000008.40 259
PHAR 000001715592 AMMONIUM CHLORIDE OS 5MEQ 000006.60 259
PHAR 000001715594 CEFACLOR 125MG OS 25MG SUS 000008.40 259
PHAR 000001715596 CEPHALEXIN 125MG OS 25MG SUS 000008.40 259
PHAR 000001715598 AMOXICILLIN 125MG OS 25MG SUS 000008.40 259
PHAR 000001715600 CEFACLOR 250MG OS 50MG SUS 000008.40 259
PHAR 000001715604 CEPHALEXIN 250MG OS 50MG SUS 000008.40 259
PHAR 000001715606 AMOXICILLIN 250MG OS 50MG SUS 000008.40 259
PHAR 000001715610 FERROUS SULFATE OS ELI 44M 000006.60 259
9/7/2010 11:52 AM Page 55 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001715612 LACTULOSE OS 0.67GM SYR 000006.60 259
PHAR 000001715614 CLONAZEPAM OS 16MCG/ML 000008.40 259
PHAR 000001715620 MED CHAIN TRIGLY OS OIL PO 000006.60 259
PHAR 000001715622 DOCUSATE LIQUID OS LIQ 10M 000006.60 259
PHAR 000001715624 METRONIDAZOLE SUSP 50MG SUS 000008.40 259
PHAR 000001715626 MINERAL OIL OS OIL PO 000006.60 259
PHAR 000001715628 FLUCYTOSINE OS 10 MG 000008.40 259
PHAR 000001715630 DOCUSATE OS 4MG/ML 000006.60 259
PHAR 000001715632 PRIMIDONE OS 50MG/ML 000006.60 259
PHAR 000001715634 HYDRALAZINE HCL OS 2MG 000008.40 259
PHAR 000001715638 FOLIC ACID OS 5MG 000006.60 259
PHAR 000001715642 PROCHLORPERAZINE OS 1MG SYR 000006.60 259
PHAR 000001715644 NITROFURANTOIN OS 5MG SUS 000006.60 259
PHAR 000001715646 NEOMYCIN OS 25MG/ML 000008.40 259
PHAR 000001715648 GANTRISIN OS 000005.50 259
PHAR 000001715650 AUGMENTIN 125/5 OS 25MG SUS 000008.40 259
PHAR 000001715652 HYDROCORTISONE OS 2MG SUS 000008.40 259
PHAR 000001715654 GLYCERIN OS 1.25GM 000006.60 259
PHAR 000001715658 AUGMENTIN 250/5 OS 50MG SUS 000008.40 259
PHAR 000001715659 AUGMENTIN 400/5 OS 80MG SUS 000008.40 259
PHAR 000001715664 DEXAMETHASONEOS 0.1MG 000008.40 259
PHAR 000001715670 SULFASALAZINE OS SUS 100 000008.40 259
PHAR 000001715672 ACETAZOLAMIDE OS 30MG SUS 000008.40 259
PHAR 000001715674 INDOMETHACIN OS SUS 5MG 000006.60 259
PHAR 000001715676 NYSTATIN OS 1 ML SUS 000006.60 259
PHAR 000001715678 DIGOXIN OS 1MG/20ML 000006.60 259
PHAR 000001715680 PEDIAZOLE SUSPENSION SUS 000008.40 259
PHAR 000001715682 BACLOFEN OS 2MG SUS 000008.40 259
PHAR 000001715684 PENICILL V K 125/5 25MG 000008.40 259
PHAR 000001715686 PENICILL V K 250/5 50MG 000008.40 259
PHAR 000001715688 BISMUTH SUB OS SUS 000006.60 259
PHAR 000001715690 DICYCLOMINE HCL OS 2MG SYR 000006.60 250
PHAR 000001715692 DIPHENHYDRAMINE OS 2.5MG SYR 000006.60 259
PHAR 000001715694 DONNATAL OS 1 ML ELI 000006.60 259
PHAR 000001715696 DIMENHYDRINATE OS 3.125MG/ML 000006.60 259
PHAR 000001715700 ERGOCALCIFEROL OS 8000U 000006.60 259
PHAR 000001715704 PROMETHAZINE FORTE 5MG SYR 000006.60 250
PHAR 000001715706 PROMETHAZ/CODEINE ELI SYR 1ML 000006.60 259
PHAR 000001715714 GUAIFENESIN W/DM OS SYR 000006.60 259
PHAR 000001715718 GUAIFENESIN OS 20MG SYR 000006.60 259
PHAR 000001715720 GUAIFENSEN/COD SYR 1ML 000006.60 259
PHAR 000001715722 SENNA SYR/OS 000006.60 259
PHAR 000001715724 PSEUDOEPHEDRINE OS 6MG SYR 000006.60 259
PHAR 000001715726 CIMETIDINE OS SYR 60M 000006.60 259
PHAR 000001715728 CARBAMAZEPINE OS SUS 20M 000006.60 259
PHAR 000001715730 NAFCILLIN SODIUM OS SUS 50M 000008.40 259
PHAR 000001715732 HYDROXYZINE PAMOA OS 5MG SUS 000006.60 259
9/7/2010 11:52 AM Page 56 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001715734 ETHOSUXIMIDE OS 50MG SYR 000006.60 259
PHAR 000001715736 ZINC SULFATE OS 10MG SUS 000006.60 259
PHAR 000001715742 FUROSEMIDE ORAL SYR 000005.50 259
PHAR 000001715747 CHLORAL HYD ORALSYR 000005.50 259
PHAR 000001715766 LEVETIRACETAM OS SOL 100 000006.80 250
PHAR 000001715873 TYLENOL EL ORALSYR 000005.50 259
PHAR 000001715885 VITAMIN A OS 50000U 000006.60 259
PHAR 000001715891 LOPERAMIDE OS 0.2MG/ML 20ML 000006.60 259
PHAR 000001715895 RYNATAN PED SUSP OS SUS 000006.60 259
PHAR 000001715897 PROCAINAMIDE OS 50MG/ML 000006.60 259
PHAR 000001715898 DANTROLENE OS 1MG SUS 000008.40 259
PHAR 000001715902 THIORIDAZINE HCL OS 30MG PO 000008.40 259
PHAR 000001715904 CHLORPROMAZINE OS 2MG SYR 000006.60 259
PHAR 000001715906 PROMETHAZINE DM OS 10ML 000006.60 259
PHAR 000001715910 KETOCONAZOLEOS 20MG SUS 000008.40 259
PHAR 000001715914 LOMOTIL OS 0.5MG/ML 000006.60 259
PHAR 000001715916 AMANTADINE OS 10MG/ML 000008.40 259
PHAR 000001715924 TRIHEXYPHENIDYL OS 0.4MG ELI 000008.40 259
PHAR 000001715928 BICITRA OS 1 MEQ 000006.60 259
PHAR 000001715930 RANITIDINE HCL OS 15MG SYR 000008.40 259
PHAR 000001715932 METOLAZONE OS SUS 1MG 000008.40 259
PHAR 000001715934 AMINOCAPROIC ACID OS 250MG PO 000006.60 259
PHAR 000001715937 ALBUTEROL OS 0.4MG SYR 000006.60 259
PHAR 000001715939 PYRIDOSTIGMINE BR OS 12MG SYR 000008.40 259
PHAR 000001715941 CAPTOPRIL OS 1MG/ML 000006.60 259
PHAR 000001715942 URSODEOXYCHOLIC ACD OS 60MG/ML 000008.40 259
PHAR 000001715943 ADEK VITAMIN DROPS DRP 1ML 000006.60 259
PHAR 000001715945 ATOVAQUONE OS 150MG/ML 000038.50 259
PHAR 000001715946 SODIUM ACETATE OS 2MEQ 000008.40 259
PHAR 000001715947 AZITHROMYCIN 200/5 40MG SUS 000012.00 259
PHAR 000001715948 TACROLIMUS OS 0.5MG/ML 000025.94 259
PHAR 000001715950 MIDAZOLAM SYRUP 2MG SYR 000043.68 259
PHAR 000001715952 AMIODARONE OS 5MG SYR 000006.60 259
PHAR 000001715953 CEFPROZIL OS 25MG SUS 000008.40 259
PHAR 000001715954 CEFPROZIL OS 50MG SUS 000008.40 259
PHAR 000001715955 CLARITHROMYCIN OS 50MG SUS 000008.40 259
PHAR 000001715956 CA GLUC 37 IVFORM 100MG 000006.60 250
PHAR 000001715957 AZITHROMYCIN 100/5 20MG SUS 000012.00 259
PHAR 000001715958 CAFFEINE CIT OS 10MG/ML 000006.60 259
PHAR 000001715959 FLUCONAZOLE OS 10MG SUS 000008.40 259
PHAR 000001715960 RITONAVIR OS 80MG 000038.86 259
PHAR 000001715962 CLARITIN OS 1MG/ML 000008.40 259
PHAR 000001715963 LAMIVUDINE OS 10MG/ML 000008.40 259
PHAR 000001715964 VIDEX OS 10MG/ML 000006.60 259
PHAR 000001715965 VIRAMUNE OS 10MG/ML 000008.40 259
PHAR 000001715966 ZERIT OS 1MG/ML 000008.40 259
PHAR 000001715968 ZYRTEC SYRUP OS 1MG/ML 000008.40 259
9/7/2010 11:52 AM Page 57 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001715970 POTASSIUM ACET IV-FM OS 000006.60 259
PHAR 000001715971 TETRACYCLINE OS 25MG/ML 5ML 000006.60 259
PHAR 000001715973 CAFFEINE IV-FM OS 37 INJ 20M 000039.74 259
PHAR 000001715974 CIPRO OS 250MG/5ML 000008.40 259
PHAR 000001715975 CIPRO OS 500MG/5ML 000008.40 259
PHAR 000001715976 OMEPRAZOLE OS 2MG/ML 000018.81 259
PHAR 000001715977 CHILD'S BENADRYL OS 5ML 000006.60 259
PHAR 000001715978 CALCITRIOL OS 1MCG 000008.40 259
PHAR 000001715979 LINEZOLID OS LIQ 20M 000023.92 259
PHAR 000001715980 LANSOPRAZOLE OS 3MG/ML 000006.60 259
PHAR 000001715981 GENTAMICIN OS 20MG/2ML 000006.60 259
PHAR 000001715982 CLARITHROMYCIN OS 25MG/ML 000008.40 259
PHAR 000001715983 CAFFEINE CIT OS 20MG/ML 000039.74 259
PHAR 000001715984 GANCICLOVIR OS 100MG/ML 000047.80 259
PHAR 000001715986 ENALAPRIL OS 1MG/ML 5ML 000008.40 259
PHAR 000001715987 DILTIAZEM 4MG/ML OS SUS 4MG 000003.21 259
PHAR 000001715988 DEXAMETHAS. INTENSOL SOL 1MG 000008.40 259
PHAR 000001715990 OXCARBAZEPINE SUS 60 000008.00 259
PHAR 000001715991 ITRACONAZOLE OS SUS 10M 000014.88 259
PHAR 000001715992 MERCAPTOPURINE OS SUS 25M 000011.29 259
PHAR 000001715994 SULFADIAZINE OS SUS 100 000007.15 259
PHAR 000001715995 ARGININE HCL 10% OS SOL 0.4 000003.47 259
PHAR 000001715996 ACETYLCYSTEINE 10%OS SOL 100 000007.15 259
PHAR 000001715998 SILDENAFIL CIT. OS SUS 2.5 000225.53 250
PHAR 000001715999 SOTALOL HCL OS SYR 5 M 000008.83 250
PHAR 000001716002 LOMOTIL 0.5ML/ML LIQ 60ML 000020.65 259
PHAR 000001716003 ACETAMINOPHEN BTL SOL 32M 000011.40 259
PHAR 000001716005 CEPHALEXIN 250MG/5ML 50MG SUS 000003.79 250
PHAR 000001716009 AMOXICILLIN 125MG UD 25MG SUS 000008.50 259
PHAR 000001716010 AMOXICILLIN SUS 250MG UD 000008.86 259
PHAR 000001716011 METAMUCIL 1 PKT 000002.86 259
PHAR 000001716014 POTASSIUM CL 10% 40 1.334MEQ P 000003.10 259
PHAR 000001716015 GUAIFENESIN SYR 000003.14 259
PHAR 000001716016 GUAIFENESIN SYR 000003.14 259
PHAR 000001716018 GUAIFENESIN/DEXTROMET LIQ 1ML 000003.10 259
PHAR 000001716019 GUAIFENESIN/DEXTROMET SYR 1ML 000003.12 259
PHAR 000001716020 MAGNESIUM HYDROXIDE 10 ML PO 000003.02 259
PHAR 000001716021 MAGNESIUM HYDOX/CASCA SUS 000003.23 259
PHAR 000001716022 POTASSIUM CL 10% 20 1.334MEQ P 000003.10 259
PHAR 000001716023 POTASSIUM IODIDE 1GM 000016.33 259
PHAR 000001716024 VANCOMYCIN 1GM SOL 000111.60 250
PHAR 000001716025 LIDOCAINE VISCOUS 2% 000008.03 259
PHAR 000001716028 ACETAMINOPHEN CUP 325 000003.18 259
PHAR 000001716030 POTASSIUM CL BTL 20% PO 000010.58 259
PHAR 000001716031 GUAIFENESIN/DEXTROMET PO 000008.93 259
PHAR 000001716034 IBUPROFEN SUSP 120ML 000014.26 259
PHAR 000001716035 ACETAMINOPHEN SOL 32M 000002.88 259
9/7/2010 11:52 AM Page 58 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001716037 PHENYTOIN 100MG SUSP 000007.30 259
PHAR 000001716039 DIPHENHYDRAMINE 5 UD 2.5MG ELI 000002.93 259
PHAR 000001716040 DONNATAL ELI 000003.95 259
PHAR 000001716042 MAGNES/ALUMIN HYDROX SUS 000003.20 259
PHAR 000001716043 THEOPHYLLINE UD 5.33MG 000003.06 259
PHAR 000001716044 PHENOBARBITAL ELI 4MG 000003.00 259
PHAR 000001716045 ALUM HYDR/MAGN/SIMETH SUS 000002.08 259
PHAR 000001716046 CHLORAL HYDRATE 100MG SYR 000002.90 259
PHAR 000001716047 AMINOPHYLLINE 375MGUD 25MG 000003.41 259
PHAR 000001716048 IBUPROFEN UD 100MG SUSP 000008.25 259
PHAR 000001716049 POTASSIUM CL 10% 30 1.334MEQ P 000003.10 259
PHAR 000001716050 FERROUS SULFATE UD LIQ 60M 000002.95 259
PHAR 000001716053 SODIUM CIT/CITRAC 000003.00 259
PHAR 000001716054 ACETAMINOPHEN CUP 650 000003.18 259
PHAR 000001716056 CARBAMAZEPINE UD SUS 20M 000008.85 259
PHAR 000001716057 CIMETIDINE UD 300MG LIQ 000009.91 259
PHAR 000001716058 DIGOXIN UD ELX 0.0 000006.87 250
PHAR 000001716060 DOCUSATE SOD UD 10ML 000003.05 259
PHAR 000001716062 FUROSEMIDE 40MG UD SOL 000007.50 259
PHAR 000001716063 HALOPERIDOL UD SOL 2MG 000010.18 259
PHAR 000001716064 LACTULOSE UD 30ML 000010.09 259
PHAR 000001716066 NYSTATIN UD SUSP 5ML 000006.82 259
PHAR 000001716068 SORBITOL 70% 30ML UD 000003.30 259
PHAR 000001716069 VALPROIC ACID 250MG UD SYRUP 000008.29 259
PHAR 000001716072 METOCLOPRAMIDE UDCUP LIQ 1MG 000001.40 250
PHAR 000001716073 DOCUSATE LIQ 100MG LIQ 10M 000001.03 250
PHAR 000001716074 CARBAMAZEPINE 200MG SUS 20 000004.17 250
PHAR 000001716075 GUAIFENESIN/CODEINE T UD 1ML 000002.62 250
PHAR 000001716076 DIPHENOX+ATROP UD T LIQ CUP 000020.80 250
PHAR 000001717002 PHENOBARB ELIX 180ML 4MG/ML 000012.71 259
PHAR 000001717004 TRIPROLIDINE/PSEUDO SYR 000001.20 259
PHAR 000001717006 DEPAKENE SYRUP 50MG/ML 90ML 000035.47 259
PHAR 000001717007 FERROUS SULFATE ELI 44M 000011.25 259
PHAR 000001717009 DEXAMETHASONE BTL 0.1MG 000001.20 259
PHAR 000001717012 METHENAMINE MANDELATE 50MG SUS000001.80 259
PHAR 000001717013 METHENAMINE MANDELATE 100MG SU 000002.40 259
PHAR 000001717014 FERROUS SULFATE 3.6MG ELX 000001.20 259
PHAR 000001717016 PHENYTOIN BTL 25MG SUS 000025.36 259
PHAR 000001717018 MEDIUM CHAIN TRIGLY OIL PO 000001.20 259
PHAR 000001717020 METHYLDOPA BTL 50MG SUS 000001.20 259
PHAR 000001717023 DIMETAPP 120ML ELX 000011.13 259
PHAR 000001717026 PROMETHAZINE HCL BTL 1.25MG SY 000001.20 259
PHAR 000001717027 PROMETHAZ/CODEINE ELI SYR 1ML 000013.55 259
PHAR 000001717029 THEOPHYLLINE 90ML 5.33MG/ML 000013.09 259
PHAR 000001717030 METAPROTERENOL SULFAT 2MG SYR 000001.20 259
PHAR 000001717034 AMINOCAPROIC ACID 250MG SYR 000006.00 259
PHAR 000001717035 OXYBUTYNIN CHLORIDE 1MG SYR 000001.20 259
9/7/2010 11:52 AM Page 59 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001717036 NITROFURANTOIN BTL 5MG SUS 000001.80 259
PHAR 000001717039 ENTEX SOL 1ML 000050.09 259
PHAR 000001717040 ERYTHROMYCIN ETH 200 SUS 40M 000013.98 259
PHAR 000001717041 ERYTHROMYCIN ETH 400 80MG SUS 000001.20 259
PHAR 000001717042 SODIUM CITRATE/POTASS SYR 000001.20 259
PHAR 000001717043 CHLOROTHIAZIDE SUSP 90ML 000001.20 259
PHAR 000001717046 DONNAGEL SUS 000001.20 259
PHAR 000001717047 DONNAGEL-PG SUS 000001.20 259
PHAR 000001717048 SAFFLOWER OIL 90ML 000000.60 259
PHAR 000001717049 PYRIDOSTIGMINE BR 12MG SYR 000001.80 259
PHAR 000001717050 PREDNISONE 90ML LIQ 000020.02 259
PHAR 000001717051 DOCUSATE/CASANTHRANOL SYR 000001.20 259
PHAR 000001717052 CYPROHEPTADINE 2MG/5M 0.4MG SY 000001.20 259
PHAR 000001717053 DIMENHYDRINATE 120ML LIQ 000002.40 259
PHAR 000001717055 METOCLOPRAMIDE HCL SYR 1MG 000013.33 259
PHAR 000001717056 PSEUDOEPHEDRINE HCL 6MG SYR 000001.20 259
PHAR 000001717059 DEXTROSE SRYP BTL SYR 000001.20 259
PHAR 000001717060 AMANTADINE 10MG/ML 90ML 000003.00 259
PHAR 000001717062 TRIHEXYPHENIDYL HCL 0.4MG ELI 000001.20 259
PHAR 000001717066 NEOMYCIN SOL 25MG/ML 90ML 000010.22 259
PHAR 000001717067 HYDROXYZINE PAM BTL 5MG SUS 000037.61 259
PHAR 000001717068 DONNATAL ELI 000001.20 259
PHAR 000001717069 HYDROXYZINE HCL BTL 2MG SYR 000013.12 259
PHAR 000001717072 PRIMIDONE 50MG/ML 90ML 000025.09 259
PHAR 000001717073 SORBITOL BTL 70% 000009.79 259
PHAR 000001717074 SULFASALAZINE BTL 50MG SUS 000014.62 250
PHAR 000001717075 ETHOSUXIMIDE BTL 50MG SYR 000026.45 259
PHAR 000001717079 NEO-CALGLUCON SYRUP SYR 000015.04 259
PHAR 000001717080 DIPHENHYDRAMINE BTL 2.5MG ELI 000014.93 259
PHAR 000001717081 DICYCLOMINE HCL BTL 2MG SYR 000016.07 259
PHAR 000001717082 DIPHENHYDRAMINE BTL 2.5MG SYR 000012.17 259
PHAR 000001717085 LACTULOSE 240ML 000017.52 259
PHAR 000001717089 LITHIUM CITRATE 60MG SYR 000014.16 259
PHAR 000001717091 DOCUSATE SOD 90ML LIQ 000014.02 259
PHAR 000001717092 DOCUSATE SOD 90ML LIQ 000014.58 259
PHAR 000001717093 GREEN GODESS SUS 000014.40 259
PHAR 000001717094 TMP/SULF 20ML SUSP 000007.85 259
PHAR 000001717096 SOD CITRATE/CITRIC AC 000011.84 259
PHAR 000001717097 FLUPHENAZINE 0.5MG/ML 90ML 000042.62 259
PHAR 000001717100 BROMPHEN/PSEUDOEPHED ELX 2.5 000006.60 259
PHAR 000001717106 NYSTATIN UD SUS 1ML 000008.40 259
PHAR 000001717108 ACETAMINOPHEN/COD ELI UD 1ML 000002.48 259
PHAR 000001717124 ACETAMINOPHEN 256MG SOL 32M 000002.83 259
PHAR 000001717130 LOPERAMIDE 0.2MG/ML 120ML 000011.77 259
PHAR 000001717131 CHLORAL HYDRATE 100MG SYR 000011.72 259
PHAR 000001717134 CHLORPROMAZINE HCL 2MG SYR 000035.82 259
PHAR 000001717137 FERROUS GLUCONATE 60MG ELI 000012.78 259
9/7/2010 11:52 AM Page 60 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001717141 ROBITUSSIN-PE SYR 000012.98 259
PHAR 000001717151 SORBITOL 20% BTL 000011.00 259
PHAR 000001717156 ANTACID - UNIT DOSE 000002.50 259
PHAR 000001717158 PROPRANOLOL HCL 3OZ 4MG 000016.50 259
PHAR 000001717159 INDOMETHACIN SUSP 90ML 000018.96 259
PHAR 000001717161 SORBITOL 70% BTL 000011.00 259
PHAR 000001717162 PROMETHAZINE HCL BTL 5MG SYR 000018.90 259
PHAR 000001717164 BROMPHENIRAMINE 0.4MG ELI 000012.42 259
PHAR 000001717165 DOXYCYCLINE CA BTL 10MG SYR 000045.56 259
PHAR 000001717166 DOXYCYCLINE MONO BTL 5MG SUS 000017.94 259
PHAR 000001717167 NAPROXEN BTL 25MG SUS 000018.71 259
PHAR 000001717168 ALBUTEROL SYRUP SYR 0.4 000017.18 259
PHAR 000001717169 NORTRIPTYLINE BTL 2MG 000020.10 259
PHAR 000001717170 RANITIDINE HCL BTL 15MG SYR 000050.72 259
PHAR 000001717174 ACYCLOVIR 200MG/5ML 40MG SUS 000028.67 259
PHAR 000001717177 DIPHENHYDRAMNE 10 UD 2.5MG ELI 000001.91 259
PHAR 000001717181 FLUOXETINE HCL 4MG PO 000093.53 259
PHAR 000001717182 ZIDOVUDINE SYR BTL 10MG SYR 000026.27 259
PHAR 000001717187 ISONIAZID BTL 10MG SYR 000014.00 259
PHAR 000001717189 SUCRALFATE SUSP 90ML 000015.83 259
PHAR 000001717194 ACETAMINOPHEN 80MG SOL 32M 000006.60 259
PHAR 000001717196 MCT OIL UD SYR OIL PO 000004.20 259
PHAR 000001717198 FLUCONAZOLE SUSP 40MG SUS 000185.94 259
PHAR 000001717199 VANCOMYCIN HCL (ORAL) 50MG 000078.00 259
PHAR 000001717200 FLUCONAZOLE SUSP 10MG SUS 000058.09 259
PHAR 000001717201 NORVIR SOL 80MG/ML 90ML 000151.42 259
PHAR 000001717202 ACETAMIN U/D CUP SOL 32. 000001.64 259
PHAR 000001717203 POLYCITRA-K 30ML SOL 000004.23 259
PHAR 000001717204 LEECH SALINE SOL 5% 000020.00 259
PHAR 000001718002 PENICILLIN V K 125/5 25MG SUS 000007.61 259
PHAR 000001718003 PENICILL V K 125/5 25MG SUS 000009.11 259
PHAR 000001718004 PENICILLIN V K 250/5 50MG SUS 000008.22 259
PHAR 000001718005 PENICILLIN V K 250/5 50MG SUS 000010.07 259
PHAR 000001718007 CEFACLOR 125MG/5ML 25MG SUS 000022.76 259
PHAR 000001718009 CEFACLOR 250MG/5ML 50MG SUS 000042.79 259
PHAR 000001718011 CLINDAMYCIN 75MG/5ML 15MG SUS 000020.33 259
PHAR 000001718013 DICLOXACILLIN 12.5MG SUS 000016.04 259
PHAR 000001718015 DICLOXACILLIN 12.5MG SUS 000027.04 259
PHAR 000001718017 AMOXICILLIN/CLAVULANI 25MG SUS 000041.10 259
PHAR 000001718019 AMOXICILLIN/CLAVULANI 50MG SUS 000073.31 259
PHAR 000001718023 CLARITHROMYCIN 25MG SUS 000047.26 259
PHAR 000001718024 CLARITHROMYCIN 50MG SUS 000090.08 259
PHAR 000001718025 AMOXICIL/CLAVULANATE 80MG SUS 000051.66 259
PHAR 000001718026 AMOXICIL/CLAVULANATE 80MG SUS 000064.08 259
PHAR 000001718027 AMOXICIL/CLAVULANATE 80MG SUS 000094.26 259
PHAR 000001718029 MYCOPHENOLATE SUSP 175ML 000480.02 259
PHAR 000001718030 CEFUROXIME 50MG/ML SUSP 100ML 000154.97 259
9/7/2010 11:52 AM Page 61 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001719003 ATTAPULGITE PO 000009.91 259
PHAR 000001719008 CEPHALEXIN 250MG/5ML 50MG SUS 000011.45 259
PHAR 000001719011 NYSTATIN BTL SUS 000012.35 259
PHAR 000001719014 POLY-VI-FLOR 0.5MG 000018.66 259
PHAR 000001719016 EMETROLLIQ 120ML 000013.66 259
PHAR 000001719018 POLY-VI-SOL 000014.83 259
PHAR 000001719019 DIGOXIN ELIX 0.05MG/ML 60ML 000017.08 259
PHAR 000001719020 POLY-VI-SOL WITH IRON 000014.83 259
PHAR 000001719023 PHOSPHO-SODA 45ML 000004.23 259
PHAR 000001719025 AMPICILLIN 100ML BOT 25MG SUS 000008.28 259
PHAR 000001719026 AMPICILLIN 200ML BOT 25MG SUS 000010.31 259
PHAR 000001719027 AMPICILLIN 100ML BOT 50MG SUS 000009.64 259
PHAR 000001719028 AMPICILLIN 200ML BOT 50MG SUS 000012.88 259
PHAR 000001719030 ERYTHROMYCIN/SULFISOX 40MG SUS 000019.88 259
PHAR 000001719032 ERYTHROMYCIN/SULFISOX 40MG SUS 000038.78 259
PHAR 000001719036 THIORIDAZINE HCL 30MG PO 000045.65 259
PHAR 000001719037 THIORIDAZINE HCL 100MG PO 000115.67 259
PHAR 000001719041 GLYCERIN 000039.96 259
PHAR 000001719042 GAVISCON SUS 1ML 000012.79 259
PHAR 000001719043 BISMUTH SUBSALICYLATE SUS 000008.71 259
PHAR 000001719048 CHOLESTYRAMINE 210GM PWD 000055.37 259
PHAR 000001719049 ERGOCALCIFEROL 8000U 000094.31 250
PHAR 000001719050 GUAIFENESIN SYR 000008.42 259
PHAR 000001719051 MINERAL OIL OIL PO 000005.06 259
PHAR 000001719053 TRIFLUOPERAZINE 10MG/ML 60ML 000156.74 259
PHAR 000001719055 PEDIALYTE PLAIN SOL 1ML 000000.00 259
PHAR 000001719056 VITAMIN A 50000U 000061.24 259
PHAR 000001719057 VITAMIN E 50U 000063.65 259
PHAR 000001719058 SENNA GRANULES 60GM 326MG GRA 000013.90 259
PHAR 000001719059 SENNA SYR 60ML BOTTLE 000016.73 259
PHAR 000001719060 SENNA 240ML BOTTLE 000027.53 259
PHAR 000001719061 CHLORHEXIDINE GLUCONA 000019.70 250
PHAR 000001719063 MINOCYCLINE HCL 10MG SUS 000042.98 259
PHAR 000001719066 CHLORPROMAZINE CONC 30MG SYR 000050.82 259
PHAR 000001719068 LUGOL'S 60ML SOL 000007.90 250
PHAR 000001719069 TRI-VI-FLOR 0.25MG 0.25MG 000017.36 259
PHAR 000001719071 TRI-VI-SOL 000013.96 259
PHAR 000001719072 TRI-VI-SOL W IRON 000013.96 259
PHAR 000001719073 ISOSORBIDE 000039.07 250
PHAR 000001719076 MULTI-VIT LIQ 120ML 000009.86 259
PHAR 000001719079 PAIN COCKTAIL 1 DOSE SUS 000015.60 250
PHAR 000001719080 SIMETHICONE DROPS 30ML 000017.95 259
PHAR 000001719081 FAMOTIDINE SUS 8MG 000116.21 259
PHAR 000001719082 ACETAMINOPHEN DRP 100 000010.25 259
PHAR 000001719084 ALUMINUM CARB SUSP 80MG SUS 000012.01 259
PHAR 000001719085 THIOTHIXENE HCL 5MG PO 000040.19 259
PHAR 000001719087 ASCORBIC ACID OS 500MG/5ML 000006.60 259
9/7/2010 11:52 AM Page 62 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001719089 HYDROCORTISONE BTL 2MG SUS 000027.23 259
PHAR 000001719092 HALOPERIDOL 2MG PO 000201.60 259
PHAR 000001719093 MUCOSITIS COCKTAIL SUS 000021.60 259
PHAR 000001719094 POLY-VI-FLOR WITH IRO 0.5MG 000018.66 259
PHAR 000001719096 BISMUTH SUBSALICYLATE SUS 000004.92 259
PHAR 000001719097 MUCOSITIS COCKTAIL SUS 000036.00 259
PHAR 000001719098 ATTAPULGITE PO 000007.27 259
PHAR 000001719102 AMOXICILLIN 250MG/5ML 80ML 000011.94 259
PHAR 000001719105 SODIUM FLUOR DRPS SOL 0.1 000015.97 250
PHAR 000001719106 MAGALDRATE SUS 000008.88 259
PHAR 000001719108 POLY-VI-FLOR WITH IRO 0.25MG 000018.62 259
PHAR 000001719110 LIDOCAINE VISCOUS 2% 000010.62 250
PHAR 000001719113 ALUM HYDR/MAGN/SIMETH SUS 000002.59 259
PHAR 000001719125 PEDIASURE RTU LIQ 1CA 000000.00 259
PHAR 000001719126 FUROSEMIDE 10MG/ML SOL 60ML 000015.64 259
PHAR 000001719127 FUROSEMIDE 10MG/ML SOL 120ML 000028.04 259
PHAR 000001719128 MAGNESIUM CITRATE 000003.12 259
PHAR 000001719131 THIORIDAZINE HCL 5MG SUS 000069.67 259
PHAR 000001719134 ALUM HYDROX/MAGN EXTR SUS 000006.55 259
PHAR 000001719136 SANDIMMUNE 50ML SOL 100MG/ML 000502.98 259
PHAR 000001719137 HYDROGEN PEROXIDE 3% 000001.67 250
PHAR 000001719138 TRI-VI-FLOR 0.5MG/ML 50ML 000017.51 259
PHAR 000001719139 TRI-VI-FLOR 0.25MG IR 0.25MG 000017.46 259
PHAR 000001719140 THEOPHYLLINE BTL 5.33MG 000014.82 259
PHAR 000001719141 DOXEPIN 10MG/ML LIQ 120ML 000040.96 259
PHAR 000001719146 ALUMINUM HYDROX GEN. SUS 000005.20 259
PHAR 000001719149 MAGALDRATE 108MG SUS 000008.88 259
PHAR 000001719150 ALUM HYDROX/MAGNESIUM SUS 000009.58 259
PHAR 000001719152 POLY-VI-FLOR 0.25MG 000018.66 259
PHAR 000001719156 HCTZ SOL 10MG/ML 90ML 000013.27 259
PHAR 000001719158 HYOSCYAMINE SULF 15ML 0.125MG 000027.48 250
PHAR 000001719161 CHARCOAL 50GM LIQ 000014.26 259
PHAR 000001719162 CHARCOAL 25GM LIQ 000012.34 259
PHAR 000001719164 SODIUM POLYST 2OZ UD 000031.14 259
PHAR 000001719171 ADEK VITAMIN DROPS DRP 000015.02 259
PHAR 000001719172 MEGESTROL 40MG/ML SUS 000299.32 259
PHAR 000001719176 NEORAL 50ML SOL 100MG/ML 000638.99 259
PHAR 000001719177 CHARCOAL/SORB 25GM 208.3MG PO 000014.45 259
PHAR 000001719178 CHARCOAL/SORB 50GM 208.3MG PO 000017.52 259
PHAR 000001719179 MESORIDAZINE CONC 25MG PO 000096.37 259
PHAR 000001719182 PSYLLIUM PKT PKT 000003.01 259
PHAR 000001719183 LAMIVUDINE 240ML 10MG/ML 000140.76 259
PHAR 000001719184 ALUMINUM HYDROX SUSP SUS 000013.33 259
PHAR 000001719186 PREDNISOLONE BTL 1MG SYR 000030.86 259
PHAR 000001719188 PREDNISOLONE BTL 3MG SYR 000130.58 259
PHAR 000001719190 RISPERIDONE SOL 30ML 000181.26 259
PHAR 000001719191 CLARITIN SYRP 1MG/ML 90ML 000046.39 259
9/7/2010 11:52 AM Page 63 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001719192 CARNITOR SOL 100MG/ML 118ML 000058.22 259
PHAR 000001719193 PROLIXIN SOL 5MG/ML 120ML 000289.37 259
PHAR 000001719194 ITRACONAZOLE SOL 10M 000214.57 259
PHAR 000001719195 ZYRTEC SYRUP 1MG/ML 4OZ 000055.00 259
PHAR 000001719198 CIPRO SUS 50MG/ML 100ML 000145.66 259
PHAR 000001719199 CIPRO SUS 100MG/ML 100ML 000170.33 259
PHAR 000001719200 CHILD'S BENADRYL 118ML 000009.01 259
PHAR 000001719201 CALCIUM CARB SUSP 500ML 000019.44 259
PHAR 000001719202 ATOVAQUONE 150MG/ML 210ML 001035.48 250
PHAR 000001719203 PROMETH+COD SY 5ML SYR 5ML 000003.20 250
PHAR 000001719204 NYSTATIN SOL 5ML SUS 1ML 000004.18 250
PHAR 000001719205 ACETYLCYSTEINE 20% LIQ 200 000099.26 250
PHAR 000001720006 AMIKACIN 500MG INJ 000264.24 250
PHAR 000001720007 PHYSOSTIGMINE SALICYL 1MG INJ 000066.00 250
PHAR 000001720016 CYTARABINE INJ 50 000157.20 250
PHAR 000001720019 HEPARIN SODIUM INJ 100 000014.50 250
PHAR 000001720026 SODIUM BICARB SYR 50MEQ 000141.60 259
PHAR 000001720029 FUROSEMIDE INJ 10 000017.40 250
PHAR 000001720038 HEPARIN 10,000/ML 4M 000045.00 250
PHAR 000001720039 SKIN TEST-TRICHOPHYT INJ 000009.60 300
PHAR 000001720043 SODIUM BICARB SYR PED 1MEQ SYR 000086.40 259
PHAR 000001720049 HEPARIN SODIUM SYR 100 000020.40 250
PHAR 000001720054 DEXTROSE INJ 50% VL 50ML 000038.40 258
PHAR 000001720061 SUCCINYLCHOLINE VIAL 500MG IV 000060.00 250
PHAR 000001720062 ANTIVENIN INJ 10ML 001738.80 250
PHAR 000001720063 BRETHINE INJ 1MG/ML 000017.40 250
PHAR 000001720070 INDIGOTINDISULFONATE 8MG INJ 000075.60 250
PHAR 000001720074 DANTROLENE 20MG VIAL 0.286MG I 000237.60 250
PHAR 000001720079 MECHLORETHAMINE HCL 1MG 000075.60 250
PHAR 000001720080 TETRACAINE HCL INJ 1% 000042.00 250
PHAR 000001720083 BRETYLIUM 500 MG VIAL 50MG INJ 000038.40 250
PHAR 000001720084 CALCIUM CHL INJ SYR 1GM 000098.40 250
PHAR 000001720090 KETAJECT 10MG/ML 50M 000082.00 250
PHAR 000001720091 EPINEPHRINE HCL VIAL 1MG INJ 000066.00 250
PHAR 000001720094 BUMETANIDE 0.5MG VIAL 0.25MG I 000020.40 250
PHAR 000001720102 EPINEPHRINE SYR 0.1MG/ML 000098.40 250
PHAR 000001720104 DILANTIN 250MG INJ 000022.80 250
PHAR 000001720107 KETAMINE HCL 10ML VIA 50MG INJ 000129.60 250
PHAR 000001720110 POTASSIUM ACETATE INJ 2ME 000028.80 250
PHAR 000001720118 POTASSIUM PHOSPHATE INJ 3MM 000111.60 250
PHAR 000001720119 ALPROSTADIL 500 MCG INJ 000673.92 250
PHAR 000001720122 CALCIUM CHL INJ 100MG/ML 000017.40 250
PHAR 000001720126 HEPARIN SODIUM INJ 100 000017.40 250
PHAR 000001720127 DEXAMETHASONE 1ML INJ 4MG 000017.40 250
PHAR 000001720128 PREDNISOLONE TEBUTATE 20MG SUS 000126.00 259
PHAR 000001720130 NOREPINEPHRINE 4MG INJ 000111.60 250
PHAR 000001720131 PHYTONADIONE INJ 10M 000042.00 250
9/7/2010 11:52 AM Page 64 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001720132 LIDOCAINE 50MG 1% SYR 000075.60 250
PHAR 000001720133 DELALUTIN INJ 250MG 000063.00 250
PHAR 000001720134 DOBUTAMINE HCL 12.5MG IV 000228.00 250
PHAR 000001720136 DECADRON INJ 4MG/ML 000020.40 250
PHAR 000001720138 METOPROLOL INJ 5MG/5ML 000075.60 250
PHAR 000001720139 BENZYLPENICILLOYL 0.25ML INJ 000098.40 250
PHAR 000001720141 ALCOHOL ABSOLUTE,USP INJ 99% 000075.60 250
PHAR 000001720143 DEXTROSE 50% SYR 50ML 000111.60 250
PHAR 000001720155 VISTARIL INJ 50MG/ML 000017.40 250
PHAR 000001720156 VERAPAMIL HCL VIAL 2.5MG INJ 000025.80 250
PHAR 000001720161 AMINOCAPROIC ACID 250MG IV 000048.00 250
PHAR 000001720167 ISOPROTERENOL 200MCG INJ 000028.80 250
PHAR 000001720169 MVI-12 VIALS IV 000025.80 250
PHAR 000001720171 TRIMETHAPHAN CAMSYLAT 50MG INJ 000157.20 250
PHAR 000001720174 ISOPROTERENOL HCL 200MCG INJ 000111.60 250
PHAR 000001720175 NALOXONE INJ 0.4MG/ML 1ML 000086.40 250
PHAR 000001720183 QUINIDINE GLUC 800MG/10ML INJ 000086.40 250
PHAR 000001720184 PHENOBARBITAL SODIUM INJ 130 000019.20 250
PHAR 000001720188 DACARBAZINE 200MG INJ 000141.60 250
PHAR 000001720191 MVI PEDS VIAL IV 000054.00 250
PHAR 000001720194 QUINIDINE SULF 200MG INJ 000025.80 250
PHAR 000001720198 ETHACRYNATE SOD 50MG INJ 000141.60 250
PHAR 000001720199 SKIN TEST-CANDIDA 0.1ML INJ 000009.60 300
PHAR 000001720201 PHENYLEPHRINE HCL 1% 10MG INJ 000054.00 250
PHAR 000001720202 FLUPHENAZINE ENANTHAT 25MG INJ 000377.14 250
PHAR 000001720205 INDOCYANINE GREEN 25MG 000258.00 250
PHAR 000001720216 NITROGLYCERIN 50MG 5MG INJ 000075.60 250
PHAR 000001720220 BUPIVACAINE 0.25% MDV 2.5MG 000060.00 250
PHAR 000001720224 ATROPINE 0.5 MG 0.1MG SYR 000075.60 250
PHAR 000001720225 CELESTONE SOLUSPAN 6MG INJ 000126.00 250
PHAR 000001720228 SKIN TEST-TUBERCULIN INJ 25U 000009.60 300
PHAR 000001720229 BUPIVACAINE HYDROCHLO INJ 000054.00 250
PHAR 000001720230 VECURONIUM INJ 10MG VIAL 000157.20 250
PHAR 000001720232 REGONOL 2ML AMP 000014.50 250
PHAR 000001720233 ATROPINE 1MG 0.1MG SYR 000075.60 250
PHAR 000001720234 EPHEDRINE AMPS 50MG INJ 000017.40 250
PHAR 000001720235 SKIN TEST-TUBERCULIN INJ 5U 000009.60 300
PHAR 000001720239 POLYESTRADIOL PHOS 20MG PO 000192.00 259
PHAR 000001720241 BUPIVACAINE 0.5% SDV 5MG INJ 000048.00 250
PHAR 000001720243 SKIN TEST-TUBERCULIN INJ 1U 000009.60 300
PHAR 000001720244 GLYCOPYRROLATE INJ 0.2 000038.40 250
PHAR 000001720245 ATROPINE INJ 0.4MG 1ML 000017.40 250
PHAR 000001720246 FLUORESCEIN 10% 000075.60 250
PHAR 000001720247 SKIN TEST-ASPERGILLUS 000012.00 300
PHAR 000001720248 PROCAINE HCL 1% INJ 000086.40 250
PHAR 000001720249 SKIN TEST-MUMPS ANTIG INJ 0.1 000009.60 300
PHAR 000001720254 BUPIVACAINE 0.5% MDV 5MG INJ 000060.00 250
9/7/2010 11:52 AM Page 65 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001720259 FOLIC ACID 5MG INJ 000086.40 250
PHAR 000001720261 BUPIVACAINE 0.75% AMP 7.5MG 000054.00 250
PHAR 000001720264 BACITRACIN 50000U INJ 000066.00 250
PHAR 000001720270 SECRETIN VIAL 75U INJ 000667.27 250
PHAR 000001720279 PYRIDOSTIGMINE BROMID 5MG INJ 000017.40 250
PHAR 000001720281 SODIUM ACETATE VIAL 2MEQ INJ 000034.80 250
PHAR 000001720286 SODIUM BICARB 50MEQ/50ML 000054.00 250
PHAR 000001720288 PANCURONIUM BR 1MG INJ 000086.40 250
PHAR 000001720289 SODIUM CL VIAL 2.5MEQ IV 000025.80 250
PHAR 000001720292 SODIUM CL INJ 0.9% 10ML 000017.40 250
PHAR 000001720294 METHYLENE BLUE 1% INJ 000048.00 250
PHAR 000001720296 METHYLENE BLUE 1% INJ 000075.60 250
PHAR 000001720300 METOCURINE IODIDE 2MG INJ 000141.60 250
PHAR 000001720315 MICONAZOLE 200MG INJ 10M 000192.00 250
PHAR 000001720317 SODIUM PHOS VIAL INJ 3MM 000025.80 250
PHAR 000001720322 VASOPRESSIN TANNATE INJ 5 U 000028.80 250
PHAR 000001720325 VASOPRESSIN 20U 000054.00 250
PHAR 000001720334 RANITIDINE HCL INJ 25M 000031.80 250
PHAR 000001720349 SODIUM TETRADECYL AMP 3% INJ 000086.40 250
PHAR 000001720359 EPINEPHRINE 5MG INJ 000157.20 250
PHAR 000001720360 EPINEPHRINE 5MG INJ 000025.80 250
PHAR 000001720361 LEVOTHYROXINE VIAL 500MCG INJ 000172.80 250
PHAR 000001720362 LEVOTHYROXINE INJ 200MCG 000172.80 250
PHAR 000001720364 CIMETIDINE 300MG INJ 150 000034.80 250
PHAR 000001720365 EDROPHONIUM 10MG INJ 000034.80 250
PHAR 000001720366 EDROPHONIUM 10MG INJ 000075.60 250
PHAR 000001720374 ESTRONE 20MG 2MG INJ 000126.00 250
PHAR 000001720375 THIAMINE HYDROCHLORID SOL 000025.80 250
PHAR 000001720381 IMIPRAMINE 25MG INJ 000022.80 250
PHAR 000001720383 ATRACURIUM BESYALTE 10MG INJ 000141.60 250
PHAR 000001720386 CARBOPROST TROMETHAM 250MCG IN000157.20 250
PHAR 000001720388 SODIUM CHLORIDE 0.9% ML INJ 000017.40 250
PHAR 000001720389 PITOCIN INJ 10U 000017.40 250
PHAR 000001720395 AMPICILLIN VIAL INJ 250 000017.40 250
PHAR 000001720399 METHICILLIN SODIUM 1GM PO 000042.00 259
PHAR 000001720400 SCOPOLAMINE SDV 0.4MG INJ 000017.40 250
PHAR 000001720403 SODIUM CHL 0.9% 50ML INJ 000025.80 250
PHAR 000001720410 ISOPROTERENOL HCL 200MCG SYR 000086.40 259
PHAR 000001720415 INSULIN - UNIT DOSE 000010.00 250
PHAR 000001720416 LABETALOL 100MG INJ 000192.00 250
PHAR 000001720417 INAMRINONE INJ 100MG/20ML 000247.20 250
PHAR 000001720421 PENICILLIN G POTASS INJ 5MU 000028.80 250
PHAR 000001720422 NEBCIN 1.2GM PWD 000949.56 250
PHAR 000001720423 BUMETANIDE 2.5MG VIAL 0.25MG I 000054.00 250
PHAR 000001720424 BUMETANIDE 1MG VIAL 0.25MG INJ 000025.80 250
PHAR 000001720425 "WATER, STERILE BACTER" ML INJ 000017.40 250
PHAR 000001720426 LIDOCAINE/EPINEPHRINE 000034.80 250
9/7/2010 11:52 AM Page 66 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001720428 SANDOGLOBULIN INJ 3GM 000603.59 250
PHAR 000001720434 FLAGYL VIAL 500 MG 000072.00 250
PHAR 000001720437 KETAMINE HCL5ML VIA 100MG INJ 000129.60 250
PHAR 000001720438 VECURONIUM 20MG VIAL 1MG INJ 000206.40 250
PHAR 000001720441 FACTREL INJ 50MCG/ML 000631.77 250
PHAR 000001720442 RIBAVIRINVIAL 6GM INH 002011.44 259
PHAR 000001720444 FLUOGEN 0.5 ML VIAL 000010.00 250
PHAR 000001720446 DOXAPRAM HCL 20ML VIA 20MG IV 000206.40 250
PHAR 000001720451 KETAMINE HCL 20ML VIA 10MG INJ 000068.40 250
PHAR 000001720472 CLINDAMYCIN 600MG/4M 000105.00 250
PHAR 000001720473 CLINDAMYCIN 300MG 150MG INJ 000054.00 250
PHAR 000001720474 CLINDAMYCIN 900MG INJ 000126.00 250
PHAR 000001720478 PRISCOLINE INJ 25MG/ML 000098.40 250
PHAR 000001720479 NITROPRUSSIDE 50MG INJ 000054.00 250
PHAR 000001720487 PENTAGASTRIN 0.25MG INJ 000172.80 250
PHAR 000001720488 MAGNESIUM SULFATE INJ 4.0 000017.40 250
PHAR 000001720491 GLYCOPYRROLATE INJ 0.2 000017.40 250
PHAR 000001720492 GLYCOPYRROLATE INJ 0.2 000017.40 250
PHAR 000001720494 ATROPINE 20ML MDV 0.4MG INJ 000017.40 250
PHAR 000001720500 HEPARIN SODIUM INJ 100 000054.00 250
PHAR 000001720501 HEPARIN SOD INJ 100U 000017.40 250
PHAR 000001720515 ETIDRONATE DISODIUM 50MG 000247.20 250
PHAR 000001720521 SPIDER ANTIVENIN 2.5ML 000141.60 250
PHAR 000001720528 CAFFEINE SOD BENZ 500MG INJ 000126.00 250
PHAR 000001720532 NEOMYCIN SULFATE INJ 500 000054.00 250
PHAR 000001720533 BUPIVACAINE 0.75% SDV 7.5MG 000031.80 250
PHAR 000001720545 NAFCILLIN 1GM VIAL 000038.40 250
PHAR 000001720550 PENTAMIDINE 20MG INJ 000355.50 250
PHAR 000001720553 ESMOLOL HCL 2.5GM SOL 250 000274.52 250
PHAR 000001720554 LOXAPINE HYDROCHLORID SOL 50 000066.00 259
PHAR 000001720555 CEFUROXIME 1.5GM VIAL 150MG IN 000086.40 250
PHAR 000001720556 CEFAMANDOLE 1 GM VIA 000055.00 250
PHAR 000001720557 BUPIVACAINE/EPI 0.5% 30ML 000048.00 250
PHAR 000001720558 CEFOXITIN/ST H20 INJ 100 000093.60 250
PHAR 000001720559 DOXYCYCLINE HYCLATE 10MG IV 000111.60 250
PHAR 000001720560 BUPIVACAINE 0.25% SDV 2.5MG 000034.80 250
PHAR 000001720561 ETOMIDATE 40MG VIAL 2MG 000141.60 250
PHAR 000001720562 LIDOCAINE AMP 1.5 000066.00 250
PHAR 000001720563 LIDOCAINE 1.5%/EPINEP 1.50% IN 000075.60 250
PHAR 000001720566 COMBINATION SOL 000048.00 259
PHAR 000001720568 BUPIVACAINE HYDROCHLO SOL 000048.00 250
PHAR 000001720569 XYLOCAINE 1%/EPINEP INJ 000075.60 250
PHAR 000001720570 LIDOCAINE 1.50% AMP 000042.00 250
PHAR 000001720572 LIDOCAINE/GLUC 7.5% 5% INJ 000038.40 250
PHAR 000001720573 LIDOCAINE PF 1% AMP 000066.00 250
PHAR 000001720574 LIDOCAINE 100MG CARD AMP 2% 000034.80 250
PHAR 000001720578 TRACE ELEMENTS-ADULT IV 000008.40 250
9/7/2010 11:52 AM Page 67 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001720579 THROMBIN 5,000 U 000076.00 250
PHAR 000001720582 ENALAPRIL INJ 2.5MG 000157.20 250
PHAR 000001720584 BRETYLIUM 500MG 50MG SYR 000048.00 250
PHAR 000001720585 OCTREOTIDE ACETATE 0.5MG AMP 000237.60 250
PHAR 000001720586 OCTREOTIDE ACETATE AMP 0.0 000042.00 250
PHAR 000001720587 OCTREOTIDE ACET 100MCG/NL 1ML 000075.60 250
PHAR 000001720589 OCTREOTIDE ACET 100MCG/ML 1ML 000102.00 250
PHAR 000001720609 LABETALOL 200MG INJ 000237.60 250
PHAR 000001720612 ESMOLOL HCL 100 MG SOL 10M 000111.60 250
PHAR 000001720627 PIPERACILLIN SODIUM 2GM INJ 000075.60 250
PHAR 000001720628 ATROPINE 1MG INJ 000017.40 250
PHAR 000001720630 SKIN TEST-TETANUS INJ 1EA 000012.00 300
PHAR 000001720631 LIDOCAINE 2%/EPI INJ 1ML 000075.60 250
PHAR 000001720649 SODIUM CL 0.9% 10ML INJ 000017.40 250
PHAR 000001720663 LIDOCAINE UD 0.3ML 1% 000007.20 250
PHAR 000001720676 ERYTHROMYCIN 1GM VIAL 50MG 000075.60 250
PHAR 000001720678 LIDOCAINE 2GM IV 200MG 000126.00 250
PHAR 000001720680 ISONIAZID INJ 100MG/ML 000098.40 250
PHAR 000001720683 SUCCINYLCHOLINE 1DOSE IV 000014.40 250
PHAR 000001720689 XYLOCAINE 1.5%EPINEPH INJ 000025.80 250
PHAR 000001720703 LIDOCAINE 100MG 2% SYR 000022.80 250
PHAR 000001720704 ATROPINE 0.5MG INJ 000017.40 250
PHAR 000001720723 HEPARIN SODIUM 100U IV 000028.80 250
PHAR 000001720731 IMMUNE GLOB 16.5% 2ML 000098.40 250
PHAR 000001720732 KETAMINE HCL U.D.INJ 000030.00 250
PHAR 000001720734 ETOMIDATE 20MG VIAL 2MG 000141.60 250
PHAR 000001720737 BUPIVACAINE SOL 000028.80 250
PHAR 000001720738 DEXTRAN VIAL 150MG IV 000060.00 250
PHAR 000001720739 DIPRIVAN 200MG INJ 000098.40 250
PHAR 000001720741 BUPIVACAINE 0.5% AMP 5MG 000066.00 250
PHAR 000001720743 HEPATITIS B VACC-PEDS INJ 20M 000141.60 250
PHAR 000001720744 THROMBATE III 584U 001121.28 250
PHAR 000001720747 INSULIN NPH HUMAN UD 000010.00 250
PHAR 000001720750 KETAMINE PYXIS UD 10MG 000017.40 250
PHAR 000001720751 KETAMINE PYXIS 100UD 100MG 000031.80 250
PHAR 000001720753 BUPIVACAINE 0.25% 10ML 000025.80 250
PHAR 000001720754 BUPIVACAINE 0.5% 10ML 000028.80 250
PHAR 000001720782 ALCOHOL 98% INJ 5ML 000126.00 250
PHAR 000001720793 DILTIAZEM HCL VIAL 5MG INJ 000141.60 250
PHAR 000001720796 MEDROXYPROGESTERONE 150MG SUS 000192.00 259
PHAR 000001720806 DIPRIVAN 500MG INJ 000192.00 250
PHAR 000001720809 INSULIN NOVOLIN70/30 SUS 1DO 000012.00 250
PHAR 000001720811 INSULIN HUMAN LENTE SOL 100 000016.44 250
PHAR 000001720818 INSULIN REG BEEF UD 000010.00 250
PHAR 000001720824 INSULIN ULTRALENTE SUS 100 000012.00 250
PHAR 000001720828 KETAMINE INJ U.D. 50MG/ML 000021.60 250
PHAR 000001720838 LIDOCAINE 100 MG SYR 000050.00 250
9/7/2010 11:52 AM Page 68 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001720841 INSULIN HUM 50/50 1DOSE SUS SQ 000012.00 250
PHAR 000001720847 MONOCLATE-P 1000U 001776.00 250
PHAR 000001720849 ANTIHEMOPHILIC FACTO 508 INJ 000719.33 250
PHAR 000001720850 ANTIHEMOPHILIC FACTO 1000 INJ 001416.00 250
PHAR 000001720851 ANTIHEMOPHILIC FACTO 1030 INJ 001458.48 250
PHAR 000001720862 ANTIHEMOPHILIC FACTO 963 INJ 001363.61 250
PHAR 000001720866 ANTIHEMOPHILIC FACTO 1080 INJ 001529.28 250
PHAR 000001720867 FEIBA VH 734 UNITS 001497.36 250
PHAR 000001720868 FEIBA VH 512 UNITS 001044.48 250
PHAR 000001720869 MORRHUATE 50MG/ML 30ML INJ 000172.80 250
PHAR 000001720874 ANTIHEMOPHILIC FACTO 286 INJ 000404.98 250
PHAR 000001720875 FEIBA VH 584 UNITS 001191.36 250
PHAR 000001720876 ANTIHEMOPHILIC FACTO 588 INJ 000832.80 250
PHAR 000001720888 DIPRIVAN 1000MG INJ 000270.00 250
PHAR 000001720890 PENICILLIN G SODIUM INJ 5MU 000054.00 250
PHAR 000001720893 PROPOFOL EML 10MG/ML 000086.40 250
PHAR 000001720894 PROPOFOL EML 10MG/ML 000184.80 250
PHAR 000001720895 PROPOFOL EML 10MG/ML 000260.40 250
PHAR 000001720896 DALTEPARIN SYR 500 000141.60 259
PHAR 000001720897 AVONEX INJ 30MCG/10ML 000664.56 636
PHAR 000001720899 EPI-PEN INJ 0.3MG SYR 000073.08 250
PHAR 000001720900 BUPIV/DEXTR SPINAL INJ 7.5 000031.80 250
PHAR 000001720902 RETEPLASE INJ 10U 007590.00 250
PHAR 000001720903 REBETRON ANTIVIRAL KIT 002026.94 250
PHAR 000001720904 ADENOSCAN 3MG/ML 20ML INJ 000522.92 250
PHAR 000001720905 ADENOSINE VIAL INJ 3MG 000698.10 250
PHAR 000001720916 AMIKACIN 100MG INJ 000060.00 250
PHAR 000001720917 EPI-PEN JR INJ 0.15MG 000082.76 250
PHAR 000001720920 DALTEPARIN SYR 250 000098.40 259
PHAR 000001720922 PHENYLEPHRINE INJ 50MG 000098.40 250
PHAR 000001720926 SOD BICARB 4.2% 5ML 000025.80 250
PHAR 000001720928 PORACTANT ALFA SUS 80M 001214.40 259
PHAR 000001720929 PORACTANT ALFA SUS 80M 002103.12 259
PHAR 000001720931 ASCORBIC ACID 500MG/2ML 000017.40 250
PHAR 000001720936 LEVOBUPIVACAINE INJ 5MG 000060.00 250
PHAR 000001720938 CEFEPIME HCL2GM/20ML INJ 2GM 000089.65 250
PHAR 000001720940 NEO WASH 100ML INJ 0.1 000098.41 250
PHAR 000001720941 BOTULISM IMM GLOB INJ 50M 045700.00 250
PHAR 000001720942 LABETALOL HCL 5MG/ML INJ 5MG 000011.98 250
PHAR 000001720943 DAPTOMYCIN 500MG INJ 50M 000445.50 250
PHAR 000001720944 PALONOSETRON HCL SDV INJ 0.0 000850.20 250
PHAR 000001720945 OLANZAPINE 10MG VIAL INJ 1MG 000138.70 250
PHAR 000001721002 TUBOCURARINE CHLORIDE 3MG INJ 000075.60 250
PHAR 000001721004 LIDOCAINE 10ML SPK TP 20% 000075.60 250
PHAR 000001721005 VASOXYL 20MG/ML 1ML 000118.00 250
PHAR 000001721010 WATER STER 10ML INJ 000017.40 250
PHAR 000001721018 LIDOCAINE 1GM VIAL 40MG INJ 000020.40 250
9/7/2010 11:52 AM Page 69 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001721019 LIDOCAINE 2GM VIAL 40MG INJ 000022.80 250
PHAR 000001721020 LIDOCAINE 0.50% MDV 000031.80 250
PHAR 000001721021 LIDOCAINE 1% 20ML VIAL 000022.80 250
PHAR 000001721022 LIDOCAINE PF 1% AMP 000020.40 250
PHAR 000001721024 LIDOCAINE 2% MDV 000028.80 250
PHAR 000001721025 LIDOCAINE 2% MDV 000017.40 250
PHAR 000001721026 LIDOCAINE PF 2% AMP 000042.00 250
PHAR 000001721027 LIDOCAINE PF 2% AMP 000020.40 250
PHAR 000001721028 LIDOCAINE 1% MDV 000025.80 250
PHAR 000001721029 LIDOCAINE PF 1% AMP 000017.40 250
PHAR 000001721030 LIDOCAINE/EPI 1% 30ML 000017.40 250
PHAR 000001721033 FLUMAZENIL 0.1MG INJ 000157.20 250
PHAR 000001721034 FLUMAZENIL 0.1MG INJ 000206.40 250
PHAR 000001721035 EDROPHONIUM 10MG IV 000038.40 250
PHAR 000001721036 ATENOLOL 0.5MG INJ 000025.80 250
PHAR 000001721040 MIVACURIUM CHLORIDE 2MG INJ 000098.40 250
PHAR 000001721045 BUPIVACAINE/EPI 0.50% 000066.00 250
PHAR 000001721047 FLUMAZENIL 0.1MG INJ 000111.60 250
PHAR 000001721049 SODIUM THIOSULFATE INJ 10% 000060.00 250
PHAR 000001721050 LOVENOX 30MG SYR 000098.40 259
PHAR 000001721053 MINOCIN INJ 100MG/VIAL 000210.00 250
PHAR 000001721054 INTERFERN ALPHA-2A 36MU INJ 001013.12 250
PHAR 000001721057 XYLOCA 1.5% 20ML VIA 000063.00 250
PHAR 000001721058 XYLOCA 1% 30ML VIAL 000045.00 250
PHAR 000001721060 LIDOCAINE 1%/EPI VIAL 10MG SDV 000022.80 250
PHAR 000001721061 LIDOCAINE 2%/EPI VIAL 20MG SDV 000022.80 250
PHAR 000001721062 LIDOCAINE MDV 1% VIA 000020.40 250
PHAR 000001721067 SODIUM THIOSULFATE INJ 25% 000141.60 250
PHAR 000001721068 ISOSULFAN BLUE INJ 10MG/ML 000228.00 250
PHAR 000001721072 CISATRACURIUM BESYLAT 2MG INJ 000111.60 250
PHAR 000001721074 NICARDIPINE HCL INJ 2.5 000145.20 250
PHAR 000001721076 PYRIDOSTIGMINE BROM 5MG INJ 000038.40 250
PHAR 000001721077 WARFARIN SOD 5MG INJ 000111.60 250
PHAR 000001721078 INSULIN (HUMALOG)UD SOL 1DO 000012.00 259
PHAR 000001721081 BUPIVICAINE/EPI 0.25% INJ 000031.92 250
PHAR 000001721085 BOTULISM IMM GLOB 500MG INJ 004140.00 250
PHAR 000001721087 DOLASETRON 12.5MG INJ 000126.00 250
PHAR 000001721088 NALMEFENE HCL 100 MCG INJ 000028.80 250
PHAR 000001721089 VALPROATE SOD 500MG INJ 000066.00 250
PHAR 000001721091 LOVENOX 40MG SYR 000154.22 259
PHAR 000001721092 LOVENOX 60MG SYR 000215.20 259
PHAR 000001721093 LOVENOX 80MG SYR 000262.92 259
PHAR 000001721094 LOVENOX 100MG SYR 000298.66 259
PHAR 000001721095 BUPIVACAINE/EPI SDV 0.25% INJ 000054.00 250
PHAR 000001721099 COMVAX 0.5ML VACCINE 000228.00 250
PHAR 000001721101 CROTALIDAE ANTIVENIN INJ 10M 002967.00 250
PHAR 000001721104 INSULIN (GLARGINE) SOL 100 000012.00 250
9/7/2010 11:52 AM Page 70 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001721105 BOTULISM IMM GLOB 100MG INJ 001435.20 250
PHAR 000001721109 ALCOHOL DEHYDRATED 1ML AMP. 000034.80 250
PHAR 000001721110 INSULIN HUMALOG75/25 SOL 1DO 000013.53 250
PHAR 000001721111 INSULIN NOVO REGULAR SOL 1DO 000012.00 250
PHAR 000001721112 INSULIN NOVO(REG)UD SOL 1DO 000012.00 250
PHAR 000001721113 INSULIN HUMAN (NPH) SUS 100 000016.44 250
PHAR 000001721114 INSULIN NOVOLIN70/30 SUS 1DO 000016.44 250
PHAR 000001721116 INSULIN (NOVOLOG)UD SOL 1DO 000015.35 250
PHAR 000001721118 INSULIN,NOVOLOG70/30 SOL 1DO 000012.00 250
PHAR 000001721119 HEP B/DP(A)T POLIO I INJ 0.5 000218.65 250
PHAR 000001721120 AMIODARONE HCL BEDF INJ 50M 000187.50 250
PHAR 000001721121 LIDOCAINE AMP 2% 000028.80 250
PHAR 000001721122 HYALURONIDASE SDV INJ 150 000062.50 250
PHAR 000001722001 DILTIAZEM 25MG INJ 000086.40 250
PHAR 000001722003 DIPHENHYDRAMINE SYR 50MG INJ 000020.40 250
PHAR 000001722005 ROCURONIUMVIAL 10MG INJ 000126.00 250
PHAR 000001722006 CEFOTETAN DISODIUM INJ 100 000141.60 250
PHAR 000001722008 LEUPROLIDE ACETATE 15MG KIT 002984.26 250
PHAR 000001722010 CLONIDINE HCL 100MCG INJ 000217.20 250
PHAR 000001722014 ROPIVACAINE INJ 2 M 000042.00 250
PHAR 000001722015 ROCURONIUMVIAL 10MG INJ 000192.00 250
PHAR 000001722016 BUPIVICANE 0.25% AMP INJ 000060.00 250
PHAR 000001722017 ROPIVACAINE INJ 10M 000086.40 250
PHAR 000001722018 FOSPHENYTOIN 100MG INJ 000141.60 250
PHAR 000001722020 INTEGRILIN INJ 2MG/ML BOLUS 000217.20 250
PHAR 000001722021 INTEGRILIN INJ 0.75MG/ML 000529.20 250
PHAR 000001722024 HEPARIN SODIUM NICU INJ 100 000017.40 250
PHAR 000001722025 HEPARIN SODIUM INJ 100 000017.40 250
PHAR 000001723003 LIDOCAINE 1% MDV 000017.40 250
PHAR 000001724002 PRIMACOR INJ 1MG/ML 20ML 000485.24 250
PHAR 000001724003 DEXTROSE 25% SYR 25% SYR 000075.60 250
PHAR 000001724004 MICROFIBRILLER COLLAG SYR 1GM 000258.00 250
PHAR 000001724005 PRIMACOR INJ 1MG/ML 10ML 000258.00 250
PHAR 000001725219 BICITRA 30ML 1 OZ 000018.00 259
PHAR 000001726011 VISCOAT 0.5 ML SYR 000371.25 250
PHAR 000001726013 LIDOCAINE PF INJ 4% 000025.80 250
PHAR 000001726017 GLIADEL WAFER IMPLANT 018432.00 278
PHAR 000001726019 CYANIDE ANTIDOTE KIT 000856.63 250
PHAR 000001726020 SODIUM MORRHUATE 5% INJ 5% 000156.25 250
PHAR 000001728011 SOYBEAN OIL SOL 1ML 000012.00 250
PHAR 000001730001 CODEINE SULFATE 15MG TAB 000004.22 259
PHAR 000001730002 MEPERIDINE 100MG TAB 000008.56 259
PHAR 000001730004 PENTOBARBITAL SODIUM 100MG CAP 000004.55 259
PHAR 000001730005 DRONABINOL CAP 5MG 000018.48 259
PHAR 000001730006 DRONABINOL CAP 10M 000030.96 250
PHAR 000001730007 MORPHINE SUST.REL. TAB 60M 000011.70 259
PHAR 000001730009 LORAZEPAM TAB 2MG 000008.63 259
9/7/2010 11:52 AM Page 71 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001730011 ALPRAZOLAM TAB 0.2 000004.90 259
PHAR 000001730012 ALPRAZOLAM TAB 0.5 000004.92 259
PHAR 000001730013 OXYCODONE/ASPIRIN TAB 000004.76 259
PHAR 000001730014 LORAZEPAM TAB 1MG 000005.41 259
PHAR 000001730016 LORAZEPAM TAB 0.5 000004.98 259
PHAR 000001730018 CODEINE SULFATE 60MG TAB 000004.93 259
PHAR 000001730019 MORPHINE SUST.REL. TAB 15M 000005.17 259
PHAR 000001730022 ALPRAZOLAM 2MG TAB 000009.46 259
PHAR 000001730025 CODEINE SULFATE 30MG TAB 000004.33 259
PHAR 000001730026 DEXTROAMPHETAMINE SRA CAP 15M 000004.94 259
PHAR 000001730027 HYDROMORPHONE HCL TAB 4MG 000004.89 259
PHAR 000001730029 SECOBARBITAL SODIUM 100MG CAP 000004.04 259
PHAR 000001730031 METHADONE HCL 5MG TAB 000004.18 259
PHAR 000001730034 METHADONE HCL 10MG TAB 000004.24 259
PHAR 000001730035 PRELUDIN ENDURETS 50 000003.71 259
PHAR 000001730036 CHLORAL HYDRATE 500MG CAP 000003.89 259
PHAR 000001730037 MEPERIDINE 50MG TAB 000004.73 259
PHAR 000001730039 FLURAZEPAM 15MG CAP 000004.45 259
PHAR 000001730041 FLURAZEPAM 30MG CAP 000004.52 259
PHAR 000001730042 DARVOCET-N-50 1TAB TAB 000004.14 250
PHAR 000001730043 DARVOCET-N-100 TAB 1TA 000004.62 259
PHAR 000001730045 PROPOXYPHENE HCL 65MG CAP 000004.27 259
PHAR 000001730047 DARVON COMPOUND 65MG 65MG CAP 000004.27 259
PHAR 000001730049 PROPOXYPHENE NAPSYLAT 100MG TA 000004.73 259
PHAR 000001730054 FIORINAL CAP 000004.78 259
PHAR 000001730055 FIORINAL TAB 000004.49 259
PHAR 000001730058 FIORINAL WITH COD CAP 000008.14 259
PHAR 000001730069 HYDROC/ACET 10/650 TAB 000003.35 259
PHAR 000001730071 MORPHINE SUST.REL. 100MG TAB 000013.87 259
PHAR 000001730073 MORPHINE SUST.REL. 60MG TAB 000010.69 259
PHAR 000001730076 MORPHINE SUST.REL. 30MG TAB 000008.34 259
PHAR 000001730077 ACETAMINOPHEN/COD #2 15MG TAB 000004.08 259
PHAR 000001730078 ACETAMINOPHEN/COD #3 TAB 1TA 000003.91 259
PHAR 000001730079 ACETAMINOPHEN/COD #4 60MG TAB 000004.48 259
PHAR 000001730080 DIAZEPAM TAB 2MG 000003.91 259
PHAR 000001730081 DIAZEPAM TAB 5MG 000004.06 259
PHAR 000001730082 DIAZEPAM TAB 10M 000004.33 259
PHAR 000001730083 TRANXENE 7.5MG TAB 000007.58 259
PHAR 000001730084 TRANXENE 15MG TAB 000008.72 259
PHAR 000001730085 MORPHINE SUST.REL. 15MG TAB 000004.70 259
PHAR 000001730086 TRANXENE 3.75MG TAB 000007.04 259
PHAR 000001730090 METHYLPHENIDATE SR 20MG TAB 000008.29 259
PHAR 000001730091 DEXTROAMPHETAMINE SRL CAP 10M 000004.66 259
PHAR 000001730092 DEXTROAMPHETAMINE SRL CAP 5MG 000004.44 259
PHAR 000001730094 DEXTROAMPHETAMINE SRL 5MG TAB 000003.98 259
PHAR 000001730095 HYDROMORPHONE HCL TAB 1MG 000004.01 250
PHAR 000001730096 HYDROMORPHONE HCL TAB 2MG 000004.45 259
9/7/2010 11:52 AM Page 72 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001730101 MORPHINE SULF SR TAB 30M 000009.14 259
PHAR 000001730102 OXYCODONE/ACETAMINOPH TAB 000004.66 259
PHAR 000001730103 METHYLPHENIDATE HCL 10MG TAB 000004.37 259
PHAR 000001730104 METHYLPHENIDATE HCL 20MG TAB 000005.08 259
PHAR 000001730105 METHYLPHENIDATE HCL 5MG TAB 000004.14 259
PHAR 000001730108 PENTAZOCINE/NALOXONE 1TAB TAB 000005.04 259
PHAR 000001730110 ACETAMINOPHEN/COD #1 7.5MG TAB 000004.00 259
PHAR 000001730111 METHYLTESTOSTERONE TAB 10M 000004.08 259
PHAR 000001730112 AMPHETAMINE 10MG TAB 000004.54 259
PHAR 000001730113 AMPHETAMINE 20MG TAB 000005.17 259
PHAR 000001730114 OXYCODONE SR 10MG TAB 000007.99 259
PHAR 000001730115 OXYCODONE SR 20MG TAB 000009.80 259
PHAR 000001730116 OXYCODONE SUST. REL. TAB 30M 000011.54 259
PHAR 000001730117 ALPRAZOLAM 1MG TAB 000004.10 259
PHAR 000001730118 CHLORDIAZEPOXIDE HYDR CAP 5MG 000003.04 259
PHAR 000001730119 CHLORDIAZEPOXIDE HYDR CAP 10M 000003.30 259
PHAR 000001730120 CHLORDIAZEPOXIDE HYDR CAP 25M 000003.92 259
PHAR 000001730121 CLONAZEPAM TAB 2MG 000003.46 259
PHAR 000001730122 CLONAZEPAM TAB 0.5 000003.65 259
PHAR 000001730123 CLONAZEPAM TAB 1MG 000003.82 259
PHAR 000001730124 LOMOTIL 2.5MG TAB 000002.58 259
PHAR 000001730125 FLUOXYMESTERONE 2 MG TAB 000003.29 259
PHAR 000001730126 FLUOXYMESTERONE 5 MG TAB 000006.98 259
PHAR 000001730127 FLUOXYMESTERONE 10 MG TAB 000008.05 250
PHAR 000001730128 HYDROCODONE BIT/APAP TAB 1TA 000004.42 259
PHAR 000001730129 MEPROBAMATE 200MG TAB 000002.45 259
PHAR 000001730130 MEPROBAMATE 400MG TAB 000002.46 259
PHAR 000001730131 OXYMETHOLONE 50MG TAB 000004.18 259
PHAR 000001730132 PEMOLINE 18.75MG TAB 000003.66 250
PHAR 000001730133 PEMOLINE 37.5MG TAB 000006.77 259
PHAR 000001730134 PEMOLINE 75MG TAB 000008.21 259
PHAR 000001730135 PHENOBARBITAL TAB 15M 000002.48 259
PHAR 000001730136 PHENOBARBITAL TAB 30M 000002.48 259
PHAR 000001730137 PHENOBARBITAL TAB 60M 000002.50 259
PHAR 000001730138 PHENOBARBITAL TAB 100 000002.46 259
PHAR 000001730140 TEMAZEPAM 15MG CAP 000004.70 259
PHAR 000001730141 TEMAZEPAM 30MG CAP 000004.84 259
PHAR 000001730142 OXYCODONE IMMED REL. TAB 5MG 000004.80 259
PHAR 000001730143 OXYCODONE I.R. 10MG TAB 000005.82 259
PHAR 000001730144 OXYCODONE I.R. 20MG TAB 000010.25 259
PHAR 000001730145 OXYCODONE I.R. 40MG TAB 000013.56 259
PHAR 000001730146 HYDROCODONE/ACET TAB 1TA 000004.90 259
PHAR 000001730147 FENTANYL 400MCG SUCKER 000022.11 250
PHAR 000001730148 FENTANYL 200MCG SUCKER 000019.36 250
PHAR 000001730149 FENTANYL 800MCG SUCKER 000030.94 250
PHAR 000001730150 FENTANYL ACTIQ MUC 600 000029.11 250
PHAR 000001730151 FENTANYL ACTIQ MUC 160 000032.00 250
9/7/2010 11:52 AM Page 73 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001730152 FENTANYL ACTIQ MUC 120 000032.00 250
PHAR 000001731004 MORPHINE IMMED.REL. 15MG TAB 000004.08 259
PHAR 000001731005 PENTOBARBITAL 50MG CAP 000004.27 259
PHAR 000001731006 MORPHINE IMMED.REL. 30MG TAB 000004.42 259
PHAR 000001731007 ZOLPIDEM TARTRATE TAB 10M 000007.99 259
PHAR 000001731008 ZOLPIDEM TARTRATE TAB 5MG 000008.27 259
PHAR 000001731009 DEXTROAMPHETAMINE TAB 5MG 000004.00 259
PHAR 000001731010 DEXTROAMPHETAMINE TAB 10M 000004.36 259
PHAR 000001731011 TESTOLACTONE 50MG TAB 000009.66 259
PHAR 000001731012 OXYCODONE SR 80MG TAB 000022.64 259
PHAR 000001731013 AMPHETAMINE 5MG TAB 000004.68 259
PHAR 000001731014 AMPHETAMINE 30MG TAB 000009.74 250
PHAR 000001731015 OXYCODONE SUST. REL. TAB 40M 000015.11 259
PHAR 000001731016 METHYLPHENIDATE 18MG TAB 000011.00 259
PHAR 000001731017 MODAFINIL TAB 100 000014.61 259
PHAR 000001731018 METHYLPHENIDATE 36MG TAB 000011.27 259
PHAR 000001731019 METHYLPHENIDATE ER TAB 27M 000011.27 250
PHAR 000001731020 AMPHETAMINE CAP 20M 000009.75 250
PHAR 000001731021 ESTAZOLAM TAB 1MG 000003.54 250
PHAR 000001731022 ESTAZOLAM TAB 2MG 000003.94 250
PHAR 000001731023 TEMAZEPAM CAP 15M 000004.84 250
PHAR 000001733001 FENTANYL ORALET MUC 400 000000.00 250
PHAR 000001733002 FENTANYL ORALET MUC 200 000054.44 250
PHAR 000001733003 FENTANYL ORALET MUC 300 000000.00 250
PHAR 000001733004 COCAINE 10% SOL 4ML 000068.64 250
PHAR 000001734001 COCAINE 4% SOL 4ML 000036.00 250
PHAR 000001734003 METHADONE ORAL SOLN SOL 2MG 000005.40 259
PHAR 000001734007 OXYCODONE/ACETAMINOPH 000017.64 259
PHAR 000001734008 PAREGORIC TIN 0.4 000013.10 250
PHAR 000001734011 MEPERIDINE 10MG/ML 90ML 000027.66 259
PHAR 000001734017 TUSSIONEX SUSP BTL SUS 000026.58 259
PHAR 000001734020 ACETAMINOPHEN/COD ELI 1ML 000014.33 259
PHAR 000001734022 DIAZEPAM LIQ UD SOL 1DO 000008.40 259
PHAR 000001734024 HYDROMORPHONE/GUAIFEN SYR 000017.50 259
PHAR 000001734028 METHADONE 1 DOSEI 1DOSE 000005.40 259
PHAR 000001734029 HYDROMORPHONE ORAL SOL 1MG 000008.40 259
PHAR 000001734035 MEPERIDINE 10MG/1ML LIQ 000000.79 259
PHAR 000001734036 METHADONE 1MG/1ML SOL 000000.66 259
PHAR 000001734037 MORPHINE SOL 20M 000001.25 636
PHAR 000001734041 ROXICET SOL 5ML DOSE 000005.40 259
PHAR 000001734042 PAREGORIC LIQ 0.4 000006.60 259
PHAR 000001734045 LORTAB ELIX 15ML 000008.40 259
PHAR 000001734046 OXYCODONE SOL SOL 1MG 000001.32 259
PHAR 000001734047 DIAZEPAM(PER ML) SOL 1MG 000000.69 259
PHAR 000001734049 HYDROCODONE/PPA OS PO 000006.60 259
PHAR 000001734050 OXYCODONE INTENSOL LIQ 20M 000025.40 259
PHAR 000001734051 LORTAB LIQ UD 1ML 000000.70 259
9/7/2010 11:52 AM Page 74 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001734052 OXYCODONE SOL UD SOL 1MG 000000.68 259
PHAR 000001734053 MORPHINE SPEC DIL OS SOL 0.4 000006.60 259
PHAR 000001734054 CODEINE PHOS 3MG/ML SOL 3MG 000000.65 250
PHAR 000001734055 MORPHINE LIPSOMAL/PF INJ 10M 000599.75 250
PHAR 000001736001 BELLADONNA/OPIUM 16A SUP PR 000010.87 259
PHAR 000001736002 HYDROMORPHONE SUP SUP 3MG 000011.39 259
PHAR 000001737001 AMOBARBITAL NA 500MG INJ 000062.40 250
PHAR 000001737003 MEPERIDINE HCL INJ 25M 000019.20 250
PHAR 000001737004 MEPERIDINE HCL 50MG INJ 000019.20 250
PHAR 000001737008 LEVO DROMORA INJ 2MG/ML 000027.60 250
PHAR 000001737009 MEPERIDINE 75MG INJ 000019.20 250
PHAR 000001737010 ALFENTANIL 2ML 500MCG IV 000055.20 250
PHAR 000001737016 MORPHINE SULFATE SYR 1MG 000066.00 259
PHAR 000001737028 SUFENTANIL CITR. AMP 50MCG 000088.80 250
PHAR 000001737029 SUFENTANIL CIT. AMP 50MCG 000145.20 250
PHAR 000001737030 SUFENTANIL CIT AMP 50MCG 000222.00 250
PHAR 000001737031 METHOHEXITAL INJ 500MG 000055.20 250
PHAR 000001737032 METHOHEXITAL SODIUM 5 GM PO 000210.00 259
PHAR 000001737033 THIOPENTAL 500MG INJ 000100.80 250
PHAR 000001737035 ALFENTANIL 5ML 500MCG IV 000088.80 250
PHAR 000001737036 ALFENTANIL 10ML 500MCG IV 000145.20 250
PHAR 000001737043 DILAUDID-HP INJ 10MG/ML 000100.80 250
PHAR 000001737051 THIOPENTAL SODIUM 250MG SYR 000062.40 250
PHAR 000001737052 FENTANYL PAT 25M 000036.05 250
PHAR 000001737053 FENTANYL PAT 50M 000065.90 250
PHAR 000001737054 FENTANYL PAT 75M 000100.53 250
PHAR 000001737055 FENTANYL PAT 100 000133.40 250
PHAR 000001737057 MEPERIDINE 300MG PCA SYRINGE 000088.80 250
PHAR 000001737063 MEPERIDINE 25MG INJ 000019.20 250
PHAR 000001737065 FENTANYL SYR INJ 2MCG/ML 55ML 000019.20 250
PHAR 000001737066 REMIFENTANYL 0.3334MG INJ 000078.00 250
PHAR 000001737067 REMIFENTANYL 0.4MG INJ 000145.20 250
PHAR 000001737070 FENTANYL SYR INJ 2MCG/ML 55ML 000019.20 250
PHAR 000001737073 MEPERIDINE PCA SYR INJ 10M 000049.20 250
PHAR 000001737074 PHENOBARBITAL 130MG INJ 000027.60 250
PHAR 000001737077 HYDROMORPHONE (PCA) INJ 0.5 000068.40 250
PHAR 000001737079 FENT/ROPIV 135ML BAG 000100.80 250
PHAR 000001737081 FENT/BUPIV 250ML BAG 000100.80 250
PHAR 000001740004 TRIETHANOLAMINE OLEAT 10% TOP 000026.51 259
PHAR 000001740011 OXYMETAZOLINE HCL 0.05% SPR NA 000010.75 259
PHAR 000001740012 SULFACETAMIDE/PREDNIS 0.2%/GM 000004.73 250
PHAR 000001740013 TRIETHANOLAMINE OLEAT 10% TOP 000039.82 259
PHAR 000001740016 HOMATROPINE HBR 5% OPH OPHT 000027.30 250
PHAR 000001740021 OXYMETAZOLINE HCL 0.05% DRP NA 000011.00 259
PHAR 000001740022 SULFACETAMIDE/PREDNIS 0.2%/ML 000022.79 250
PHAR 000001740025 HOMATROPINE HBR 2% OPH OPHT 000022.92 250
PHAR 000001740031 CARBACHOL 3%/ML OPHT 000030.76 259
9/7/2010 11:52 AM Page 75 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001740032 HOMATROPINE HBR 2% OPH OPHT 000018.12 250
PHAR 000001740034 GENTAMICIN OPHT AUG 15MG OPH O 000023.51 250
PHAR 000001740037 CHLORAMPHENICOL 0.50% OPHT 000020.59 250
PHAR 000001740039 HOMATROPINE HBR 5% OPH OPHT 000019.62 250
PHAR 000001740040 OXYMETAZOLINE HCL 0.05% SPR NA 000014.21 259
PHAR 000001740041 BALANCED SALT SOLUTIO OPTH 000012.49 250
PHAR 000001740044 SCOPOLAMINE OPTH 5ML 0.25% OPH 000018.12 259
PHAR 000001740046 COLY-MYCIN-S SUS OTIC 000020.80 259
PHAR 000001740047 SCOPOLAMINE OPTH 15ML 0.25% OP 000022.92 259
PHAR 000001740048 COLY-MYCIN-S SUS OTIC 000035.29 259
PHAR 000001740051 CORTISPORIN OPTHALMIC OIN OPHT 000027.26 250
PHAR 000001740052 PILOCARPINE HCL 6% OPHT 000022.55 250
PHAR 000001740053 LACRI-LUBE OIN OPHT 000015.49 250
PHAR 000001740054 OXYMETAZOLINE PEDS 0.03% DRP N 000009.54 259
PHAR 000001740060 CORTISPORIN OTIC SUS OTIC 000030.78 259
PHAR 000001740061 PILOCARPINE HCL 4% OPHT 000020.98 250
PHAR 000001740063 ATROPINE OPHTH OINT 1% OIN OPH 000011.27 250
PHAR 000001740064 CORTISPORIN OTIC OTIC 000030.78 259
PHAR 000001740068 CYCLOGYL 1% OPHTH SOL 000012.12 250
PHAR 000001740069 PILOCARPINE HCL 0.50% OPHT 000019.55 250
PHAR 000001740071 BACITRACIN OPHTH OINT 500U OIN 000008.47 250
PHAR 000001740072 CYCLOPENTOLATE HCL 1%/ML OPTH 000018.12 250
PHAR 000001740073 PILOCARPINE HCL 1% OPHT 000019.55 250
PHAR 000001740075 CYCLOPENTOLATE HCL 1%/ML OPTH 000034.80 250
PHAR 000001740078 CYCLOPENTOLATE HCL SOL 1 % 000013.32 250
PHAR 000001740079 PILOCARPINE HCL 0.25% OPHT 000019.55 250
PHAR 000001740080 MAXITROL ML SUS OPHT 000030.60 250
PHAR 000001740082 PILOCARPINE HCL 8% OPHT 000027.30 250
PHAR 000001740083 MAXITROL OIN OPHT 000030.60 250
PHAR 000001740085 PILOCARPINE HCL 3% OPHT 000020.98 250
PHAR 000001740086 ACETYLCHOLINE OPHTH 10MG DRP O 000030.36 250
PHAR 000001740087 CYCLOPENTOLATE 2% 2ML SOL 000016.32 250
PHAR 000001740089 CYCLOPENTOLATE HCL 2%/ML OPTH 000023.22 250
PHAR 000001740090 PILOCARPINE HCL 2% OPHT 000019.78 250
PHAR 000001740091 MUROCOLL-2 OPHT 000019.02 250
PHAR 000001740094 TROPICAMIDE 0.50% OPHT 000034.80 250
PHAR 000001740095 DACRIOSE OPHT 000009.70 250
PHAR 000001740096 TROPICAMIDE 1% OPHT 000036.30 250
PHAR 000001740097 DACRIOSE OPHT 000013.66 250
PHAR 000001740098 DACRIOSE OPHT 000010.56 250
PHAR 000001740100 CARBAMIDE PEROXIDE 6.50% OTIC 000014.24 259
PHAR 000001740101 FLUNISOLIDE 0.03% INH 000041.42 259
PHAR 000001740102 CARBAMIDE PEROXIDE 6.50% OTIC 000011.02 259
PHAR 000001740103 NATAMYCIN 5% SUS OPHT 000142.87 250
PHAR 000001740106 DEXAMETHASONE OPHT SOL 0.1% 000029.40 250
PHAR 000001740107 PHENYLEPHRINE HCL 2.50% DRP OP 000031.70 250
PHAR 000001740111 PHENYLEPHRINE HCL 10% DRP OPHT 000030.70 250
9/7/2010 11:52 AM Page 76 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001740115 PHENYLEPHRINE HCL 0.50% SPR NA 000010.07 250
PHAR 000001740119 PHENYLEPHRINE HCL 0.50% DRP NA 000009.04 250
PHAR 000001740124 NEOSPORIN OPTH SOL OPHT 000027.00 250
PHAR 000001740126 NEOSPORIN OPTH OINT OIN OPHT 000027.00 250
PHAR 000001740128 SODIUM CL NASAL SPRY NASL 000008.28 259
PHAR 000001740131 GENTAMICIN OPHT OINT 0.30% OPH 000022.30 250
PHAR 000001740132 GLYCERIN OPH OPHT 000031.14 250
PHAR 000001740133 GENTAMICIN OPHT SOL 0.30% OPH 000022.30 250
PHAR 000001740135 HYDROXYPROPYL METHYLC 2.50% OP 000019.20 250
PHAR 000001740142 DEMECARIUM BROMIDE 0.13% OPHT 000022.20 250
PHAR 000001740150 PREDNISOLONE SODIUM P 1% OPHT 000020.14 250
PHAR 000001740152 ATROPINE OPHTH 0.50% OPHT 000016.32 250
PHAR 000001740154 ATROPINE OPHTH 3% OPHT 000017.52 250
PHAR 000001740156 ATROPINE OPHTH 1% OPHT 000017.22 250
PHAR 000001740157 ECHOTHIOPHATE 0.25% 12.5MG/M O 000042.65 259
PHAR 000001740160 OCUMYCIN OIN OPHT 000009.64 250
PHAR 000001740161 TETRACAINE OPHTHDROP SOL 0.5 000027.94 250
PHAR 000001740162 PREDNISOLONE ACETATE 1% SUS OP 000021.30 259
PHAR 000001740163 PREDNISOLONE ACETATE 1% SUS OP 000037.81 250
PHAR 000001740164 PREDNISOLONE ACETATE 0.13% SUS 000021.42 259
PHAR 000001740167 DIPIVEFRIN 0.1% 0.10% OPHT 000027.83 250
PHAR 000001740171 SULFACETAMIDE NS 3.5G 10% OIN 000022.30 250
PHAR 000001740172 SULFACETAMIDE NA 15ML 30% OPHT 000030.14 250
PHAR 000001740173 SULFACETAMIDE NA 15ML 10% OPHT 000028.90 250
PHAR 000001740176 TEARISOL OPHT 000014.02 250
PHAR 000001740179 TEARS PLUS 15ML OPTH 000014.52 250
PHAR 000001740180 TETRACAINE 0.5% OPHT DRP 000006.60 250
PHAR 000001740181 TIMOLOL 0.5%5 ML 0.50% OPHT 000028.79 250
PHAR 000001740182 TIMOLOL 0.25% 5ML 0.25% OPHT 000022.75 250
PHAR 000001740183 TIMOLOL 0.25% 10ML 0.25% OPHT 000044.09 250
PHAR 000001740184 TIMOLOL 0.5% 10ML SOL 0.5 000042.16 250
PHAR 000001740185 TOBRAMYCIN SULFATE 0.30% OPHT 000029.10 259
PHAR 000001740189 VASOCON OPHT 000021.50 250
PHAR 000001740190 NAPHAZOLINE HCL 0.10% DRP OPHT 000021.50 250
PHAR 000001740192 TRIFLURIDINE 1% OPHT 000070.76 250
PHAR 000001740193 TETRAHYDROZOLINE HCL 0.05% OPH 000009.20 250
PHAR 000001740195 ACETIC ACID 2% OTIC 000044.47 250
PHAR 000001740196 ACETIC ACIDHC 2% OTIC 000054.70 250
PHAR 000001740197 DESMOPRESSIN RHINAL T 0.01% NA 000095.86 259
PHAR 000001740198 SULFACETAMIDE NA 5ML 10% OPHT 000021.50 259
PHAR 000001740200 DIPIVEFRIN OPTH 5ML 0.10% OPHT 000016.62 250
PHAR 000001740201 DIPIVEFRIN 0.1% 0.10% OPHT 000039.04 250
PHAR 000001740203 SODIUM CL NASAL DRPS 0.90% NAS 000003.12 250
PHAR 000001740204 CORTISPORIN OPTHALMIC SUS OPTH 000027.26 259
PHAR 000001740206 CETYLPYRIDINIUM CHLOR LOZ 000002.48 259
PHAR 000001740208 ERYTHROMYCIN 0.5% 3.5GM OPHT 000009.36 250
PHAR 000001740210 BETAXOLOL HCL 0.50% DRP OPHT 000029.70 250
9/7/2010 11:52 AM Page 77 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001740211 BETAXOLOL HCL 0.50% OPHT 000054.30 250
PHAR 000001740212 DEXAMETHASONE/NEOMYCI OIN OPHT000012.73 250
PHAR 000001740213 NAPHAZOLINE/PHENIR 1DOSE OPTH 000028.08 250
PHAR 000001740219 TEARFAIR OPHT 000008.58 250
PHAR 000001740220 LEVOBUNOLOL HCL 0.50% OPHT 000019.25 250
PHAR 000001740221 LEVOBUNOLOL HCL 0.50% OPHT 000031.96 250
PHAR 000001740222 TOBRAMYCIN SULFATE 0.30% OIN O 000029.10 259
PHAR 000001740224 ANTIPYRINE/BENZOCAINE OTIC 000019.14 259
PHAR 000001740227 TEARFAIR OIN OPHT 000009.90 250
PHAR 000001740228 COMBINATION SOL 5 M 000017.89 259
PHAR 000001740229 PHENYLEPHRINE 0.25% 0.25% SPR 000009.74 250
PHAR 000001740232 PHENYLEPHRINE HCL UD SOL 2.5 000003.00 250
PHAR 000001740233 TROPICAMIDE 1% 3ML 000018.29 250
PHAR 000001740237 PILOCARPINE HCL 1% OPHT 000005.20 250
PHAR 000001740238 PILOCARPINE HCL 2% OPHT 000005.20 250
PHAR 000001740239 ERYTHROMYCIN 0.5% 1GM OPHT 000004.92 250
PHAR 000001740241 CEFAZOLIN OPTH50MG/ML 50MG OPH 000030.24 250
PHAR 000001740242 CARBACHOL0.01% 0.01%/ML 000042.79 259
PHAR 000001740243 COMBINATION SOL 000038.10 259
PHAR 000001740244 FLUOROMETHOLONE 0.10% OPH OPHT000020.99 250
PHAR 000001740245 FLUOROMETHOLONE 0.10% OPH OPHT000046.33 250
PHAR 000001740246 FLURBIPROFENOPTH 0.30% OPTH 000040.69 250
PHAR 000001740251 PHENYLEPHRINE HCL 1% 1% SPR NA 000010.48 250
PHAR 000001740256 SULFACETAMIDE NA 5ML 10% OPHT 000019.74 250
PHAR 000001740258 PROPARACAINE HCL 0.50% DRP OPT 000031.92 250
PHAR 000001740261 LEVOBUNOLOL HCL 0.25% OPHT 000022.21 250
PHAR 000001740262 PHENYLEPHRINE HCL DRP 0.2 000009.46 250
PHAR 000001740263 DESMOPRESSIN SPRAY 0.01% NASL 000157.57 259
PHAR 000001740264 GENTAMICIN OPHT SOL 0.30% OPH 000012.16 250
PHAR 000001740265 CIPROFLOXACIN 0.3% OPHT 2.5ML 000025.18 259
PHAR 000001740266 CIPROFLOXACIN 0.3% OPHT 5ML 000047.52 259
PHAR 000001740267 BACITRACIN/NEOMYCIN OIN OPTH 000008.98 250
PHAR 000001740268 GENTAMICIN OPHT OINT 0.30% OPH 000021.73 250
PHAR 000001740269 DEXACIDIN OPHT 5ML SUSP 000016.63 250
PHAR 000001740270 LUBRIFAIR OIN OPHT 000008.11 250
PHAR 000001740271 SULFACETAMIDE NA 3.5G 10% OIN 000021.12 250
PHAR 000001740272 POLYTRIM OPTH SOL 10ML 000027.35 250
PHAR 000001740276 BUTORPHANOL SPRAY 10MG/ML NASL 000084.98 250
PHAR 000001740279 PILOCARPINE HCL 4% GEL OPHT 000036.30 250
PHAR 000001740280 CROMOLYN SODIUM INHL 000059.09 259
PHAR 000001740283 BETAXOLOL HCL 0.25% SUS OPHT 000029.70 250
PHAR 000001740284 APRACLONIDINE HCL 1% OPTH 000019.78 250
PHAR 000001740287 DICLOFENAC SOD OPTH 0.10% OPHT 000042.47 250
PHAR 000001740288 CELLUVISC 1% OPHT SOL 000001.81 250
PHAR 000001740289 TOBRADEX OPHT OINT 3.5GM 000074.28 250
PHAR 000001740291 OPHTHETIC 0.5% 15 ML 000016.49 250
PHAR 000001740293 ATROPINE OPTH 1% OPTH 000005.20 250
9/7/2010 11:52 AM Page 78 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001740294 CARTEOLOL HCL 1% 1DROP OPTH 000035.18 259
PHAR 000001740295 POLYSPORIN OPHTH GEN 3.5GM OIN 000019.92 250
PHAR 000001740296 0
HYDROXYPROPLMETHYCELL OPH OPTH00068.40 250
PHAR 000001740298 TRUSOPT 2% OPHTH DRP 000043.01 250
PHAR 000001740300 APRACLONIDINE HCL 0.50% OPTH 000139.20 250
PHAR 000001740301 CYCLOPENTOLATE HCL 0.5%/ML OPT 000013.20 250
PHAR 000001740302 LATANPROSTOPTH 0.01% OPT OPTH 000073.79 250
PHAR 000001740303 OFLOXACIN 0.3% OPHT SOL 000050.27 250
PHAR 000001740304 IMITREX 20MG SPRAY 000037.71 259
PHAR 000001740305 REFRESH OPTH SOL OPT OPTH 000017.33 250
PHAR 000001740306 TOBRADEX OPHTH SOL. OPHT 000057.36 250
PHAR 000001740307 BRIMONIDINE TARTRATE SOL 0.1 000041.04 259
PHAR 000001740308 CIPRO/HYDROCORT OTIC SUS OTIC 000092.90 259
PHAR 000001740309 KETOROLAC TROMETH 0.50% DRP OP 000075.98 250
PHAR 000001740310 OLOPATADINE 0.10% DRP OPHT 000097.20 250
PHAR 000001740311 OFLOXACIN OTIC 0.30% OTIC 000057.65 259
PHAR 000001740312 BRINZOLAMIDE 1% SUS OPHT 000042.84 250
PHAR 000001740313 IPRATROPIUM NASAL SPY 0.0 000078.92 259
PHAR 000001740314 COSOPT OPHT SOL 5ML 000080.21 250
PHAR 000001740315 NASAREL SOL 0.025% 25ML 000079.29 250
PHAR 000001740316 RHINOCORT NASL INH 7GM 000074.12 259
PHAR 000001740317 IMITREX NASAL SPR 5MG 000037.71 259
PHAR 000001740318 MURO-128 OPH OINT 5% 3.5GM 000025.08 250
PHAR 000001740319 N'ICE LOZENGES 16/BOX 000004.60 259
PHAR 000001740320 OPCON-A OPHTH SOL 15ML 000009.36 250
PHAR 000001740321 IPRATROPIUM NASAL SPR 0.0 000070.78 259
PHAR 000001740322 AFRIN CHILDREN'S 15ML 000010.19 259
PHAR 000001740324 CILOXAN 0.3% OPHT OIN 3.5GM 000076.31 250
PHAR 000001740325 GENTEAL OPHT SOL 15ML 000016.44 250
PHAR 000001740326 GENTEAL OPHT GEL 10ML 000016.79 250
PHAR 000001740327 SOD CHL NASAL SPR 45ML 000003.29 259
PHAR 000001740328 BIMATOPROST SOL 0.0 000193.68 250
PHAR 000001740329 BETADINE OPTH SOL 5% SOL 5% 000027.35 250
PHAR 000001740330 GATIFLOXACIN SOL 0.3 000141.07 250
PHAR 000001743001 VITAMIN A&D OINT OIN TOP 000005.26 259
PHAR 000001743004 OATMEAL COLLOIDAL 000011.38 250
PHAR 000001743005 COLLOIDAL OATMEAL 50% BAR TOP 000008.08 259
PHAR 000001743006 BACITRACIN 30GM OIN TOP 000007.68 250
PHAR 000001743011 ERYTHROMYCIN 2% TOP 000027.12 250
PHAR 000001743012 BENZOCAINE 20% OIN TOP 000007.96 250
PHAR 000001743013 COAL TAR EMU 000021.38 250
PHAR 000001743015 BENZOIN TINC 170ML SPRAY 000009.22 250
PHAR 000001743016 CAMPHOR/MENTHOL OIN TOP 000002.42 259
PHAR 000001743017 COMPOUND W TOP 000010.68 250
PHAR 000001743018 CROTAMITON CRE TOP 000017.41 259
PHAR 000001743019 FLUOCINONIDE OINT 0.05% OIN TO 000028.94 259
PHAR 000001743023 METHYL SALICYL/MENTHO OIN TOP 000010.20 259
9/7/2010 11:52 AM Page 79 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001743025 BENZOYL PEROXIDE 10% LOT TOP 000009.30 250
PHAR 000001743028 DIFLORASONE 0.05% CRE TOP 000035.04 250
PHAR 000001743029 FLUOCINONIDE OINT 0.05% OIN TO 000061.58 259
PHAR 000001743032 DIPHENHYDRAMINE 30GM 1% CRE TO 000010.43 259
PHAR 000001743034 BENZOYL PEROXIDE 5% LOT TOP 000008.84 250
PHAR 000001743038 FLUOCINONIDE CREAM 0.05% CRE T 000035.82 259
PHAR 000001743039 FLUOCINONIDE CREAM 0.05% CRE T 000039.30 259
PHAR 000001743042 BENZOYL PEROXIDE 10% GEL 000020.52 250
PHAR 000001743047 FLUOCINONIDE OINT 0.05% OIN TO 000039.30 259
PHAR 000001743049 MICONAZOLE NITRATE 2% CRE TOP 000034.85 259
PHAR 000001743050 VICOPROFEN TAB 000005.60 259
PHAR 000001743057 MICONAZOLE NITRATE 2% CRE TOP 000019.78 259
PHAR 000001743059 EPINEPHRINE HCL TOPIC 0.10% TO 000016.79 259
PHAR 000001743061 BENZOYL PEROXIDE 5% GEL 000021.23 250
PHAR 000001743064 DIFLORASONE 0.05% OIN TOP 000045.41 250
PHAR 000001743066 MICONAZOLE NITRATE 2% CRE TOP 000060.38 250
PHAR 000001743070 TRIAMCINOLNE ACE 0.5% 0.50% OI 000037.25 259
PHAR 000001743076 MICONAZOLE NITRATE 2% LOT TOP 000028.13 250
PHAR 000001743078 MODUCAL POW 390 000000.00 259
PHAR 000001743079 NYSTATIN TOPICAL 15GM POW 000035.41 259
PHAR 000001743080 TRIAMCINOLNE ACE 0.5% 0.50% CR 000010.38 259
PHAR 000001743085 NEOMYCIN SULFATE 0.50% OIN TOP 000008.40 259
PHAR 000001743086 MICROFIBRILLER COLLAG 70 X 35 000154.61 250
PHAR 000001743090 TRIAMCINOLNE ACE 0.1% 0.10% OI 000035.62 259
PHAR 000001743093 CALADRYL LOT TOP 000006.35 250
PHAR 000001743097 NEOMYCIN SULFATE 0.50% OIN TOP 000009.82 259
PHAR 000001743100 TRIAMCINOLNE ACE 0.1% 0.10% OI 000014.93 259
PHAR 000001743102 FLURANDRENOLIDE 0.03% CRE TOP 000020.41 250
PHAR 000001743107 NEOSPORIN OINT 30 G 000010.86 250
PHAR 000001743108 TRIPLE ANTIBIOTIC OIN TOP 000006.95 250
PHAR 000001743110 AUREOMYCIN OIN 3% 30 000013.16 259
PHAR 000001743112 CALADRYL CRE TOP 000006.65 250
PHAR 000001743113 FLURANDRENOLIDE 4MCG TOP 000020.28 259
PHAR 000001743114 FLUOCINOLONE 0.01% 0.01% TOP 000053.44 259
PHAR 000001743115 CLOTRIMAZOLE 1% CRE TOP 000018.02 259
PHAR 000001743122 CALAMINE 120ML LOT TOP 000002.96 250
PHAR 000001743125 CLOTRIMAZOLE 1% CRE TOP 000029.62 259
PHAR 000001743128 NEOSPORIN OINT 0.9GM OIN TOP 000002.74 250
PHAR 000001743136 NEOSPORIN GU 000015.59 250
PHAR 000001743137 VICK'S VAPOR RUB OIN 000006.08 259
PHAR 000001743140 CAMPHO-PHENIQUE TOP 000006.04 259
PHAR 000001743143 CLOTRIMAZOLE 1% TOP 000031.30 259
PHAR 000001743144 COMBINATION SOL 000014.66 259
PHAR 000001743146 ORABASE PASTE PST TOP 000008.39 259
PHAR 000001743152 AMPHO B 3% OINT 20GM 000045.90 259
PHAR 000001743156 BENZOYL PEROXIDE 2.50% GEL 000018.60 250
PHAR 000001743159 SILVER SULFADIAZINE 1% CRE TOP 000042.76 259
9/7/2010 11:52 AM Page 80 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001743162 AMPHO B 3% CRM 20GM 000050.32 259
PHAR 000001743167 TRETINOIN 0.05% CRE TOP 000041.76 259
PHAR 000001743168 SILVER SULFADIAZINE 1% CRE TOP 000006.78 259
PHAR 000001743169 FLUOCINOLON CR 0.01% 0.01% CRE 000030.29 259
PHAR 000001743179 SILVER SULFADIAZINE 1% CRE TOP 000013.02 259
PHAR 000001743180 UREA 20% CRE TOP 000012.02 259
PHAR 000001743182 NITROFURAZONE 0.20% OIN TOP 000017.51 259
PHAR 000001743189 FLUOCINOLONE 0.03% CRE TOP 000051.04 250
PHAR 000001743192 NITROFURAZONE 0.20% CRE TOP 000022.27 259
PHAR 000001743195 ORABASE/BENZOCAINE PST TOP 000012.67 259
PHAR 000001743199 CHLORHEXIDINE GLUCONA 127GM GE 000003.97 259
PHAR 000001743200 CETACAINE TOP 000097.54 250
PHAR 000001743205 BENZOCAINE 10% GEL 000009.29 250
PHAR 000001743207 TRETINOIN 0.03% GEL 000035.14 250
PHAR 000001743208 FLUOCINOLONE 0.025% 0.03% OIN 000051.04 259
PHAR 000001743209 DESONIDE 0.05% CRE TOP 000046.15 250
PHAR 000001743210 HYDROCORTISONE 0.5% 0.50% LOT 000022.85 259
PHAR 000001743212 GENTAMICIN CREAM 0.10% CRE TOP 000026.93 259
PHAR 000001743220 HYDROCORTISONE 1% 1% LOT TOP 000028.06 259
PHAR 000001743222 GENTAMICIN OINTMENT 0.10% OIN 000026.93 259
PHAR 000001743225 HEXACHLOROPHENE 3% TOP 000176.84 250
PHAR 000001743227 FLUOCINOLONE 0.025% 0.03% CRE 000021.36 259
PHAR 000001743229 DESONIDE 0.05% CRE TOP 000017.87 250
PHAR 000001743231 CARBAMIDE PEROXIDE 6.5%/ML OTI 000017.10 259
PHAR 000001743235 FLUOCINOLONE 0.025% 0.03% OIN 000021.36 250
PHAR 000001743236 THROMBIN 1000U TOP 000053.10 259
PHAR 000001743237 DESONIDE 0.05% OIN TOP 000017.87 250
PHAR 000001743241 CARBAMIDEPEROXIDE 10%/ML 000010.00 250
PHAR 000001743247 DESONIDE 0.05% OIN TOP 000046.15 250
PHAR 000001743250 CETAPHIL 1BOTTLE LOT 000018.00 259
PHAR 000001743253 MICONAZOLE NITR 30GM 2% CRE TO 000015.44 259
PHAR 000001743255 SALIVA SUBSTITUTE 000008.98 259
PHAR 000001743259 BETAMETHASONE VALERAT 0.10% CR 000013.76 259
PHAR 000001743262 HEXACHLOROPHENE 3% TOP 000020.09 250
PHAR 000001743263 COLLAGENASE 250UNITS OIN TOP 000044.27 259
PHAR 000001743264 FLUOCINOLONE 0.01% 0.01% TOP 000028.25 259
PHAR 000001743265 THROMBIN W/DIL 10000U TOP 000061.92 259
PHAR 000001743268 HYDROCORTISONE 0.2% 0.20% CRE 000019.32 259
PHAR 000001743269 CHLORASEPTIC LOZ 000004.85 259
PHAR 000001743270 CORTISPORIN CRE TOP 000026.62 259
PHAR 000001743273 COLLAGENASE 250UNITS OIN TOP 000080.82 259
PHAR 000001743274 FLUOCINOLON CR.0.01% 0.01% CRE 000016.39 259
PHAR 000001743275 THROMBIN W/DIL 20000U TOP 000111.46 259
PHAR 000001743280 CORTISPORIN OIN TOP 000037.63 259
PHAR 000001743283 TOLNAFTATE 1% POW 000009.84 259
PHAR 000001743288 CLINDAMYCIN 1% TOP 1% TOP 000019.69 259
PHAR 000001743289 ECONAZOLE 1% CRM 30GM 000056.30 259
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001743293 TOLNAFTATE 1% TOP 000011.16 259
PHAR 000001743299 TOLNAFTATE 1% CRE TOP 000011.86 259
PHAR 000001743303 CHLORHEXIDNE GLUC 4% 120ML TOP 000008.02 259
PHAR 000001743307 CHLORHEXIDNE GLUC 4% 240ML TOP 000010.84 259
PHAR 000001743315 SELENIUM SULF SHAMPOO 2.50% SH 000019.91 259
PHAR 000001743316 DESOXIMETASONE 0.25% CRE TOP 000027.00 250
PHAR 000001743320 SELENIUM SULF SHAMPOO 1% SHA T 000009.53 259
PHAR 000001743321 DESOXIMETASONE 0.25% CRE TOP 000058.44 250
PHAR 000001743323 LIDOCAINE 5% OIN TOP 000019.00 250
PHAR 000001743325 SELENIUM SULF SHAMPOO SHA 1% 000012.30 250
PHAR 000001743327 LIDOCAINE JELLY 2% GEL 000030.00 250
PHAR 000001743329 CHLORHEXIDNE GLUC 4% 960ML TOP 000020.11 259
PHAR 000001743331 LIDOCAINE OINT 35G 5% OIN TOP 000019.48 250
PHAR 000001743334 DESOXIMETASONE 0.05% CRE TOP 000044.64 250
PHAR 000001743336 LIDOCAINE TOPICAL 4% TOP 000022.72 250
PHAR 000001743341 BENZOCAINE TOP 000007.84 250
PHAR 000001743342 HYDROCORTISONE 1% 1% CRE TOP 000027.49 259
PHAR 000001743346 HYDROCORTISONE 0.5% 0.50% CRE 000010.15 259
PHAR 000001743348 ZINC OXIDE OINT 30GM 20% OIN T 000008.27 250
PHAR 000001743349 ZINC UNDECYLENATE OIN TOP 000014.71 250
PHAR 000001743351 ACYCLOVIR 5% OIN TOP 000055.03 259
PHAR 000001743356 DESITIN 40% OIN TOP 000005.02 250
PHAR 000001743360 TRIAMCINOLONE 0.025% 0.03% CRE 000013.92 259
PHAR 000001743362 TRIAMCINOLNE ACE 0.1% 0.10% CR 000041.22 259
PHAR 000001743370 TRIAMCINOLONE 0.025% 0.03% OIN 000030.46 259
PHAR 000001743372 TRIAMCINOLONE 0.025% 0.03% OIN 000012.76 259
PHAR 000001743376 TRIAMCIN/ORABASE0.1%% 0.10% PS 000019.55 259
PHAR 000001743377 BETAMETHASONE DIPROPI 0.05% OI 000031.03 259
PHAR 000001743378 TRIAMCINOLONE ACETONI 0.10% LO 000053.08 259
PHAR 000001743379 BETAMETHASONE DIPROPI 0.05% OI 000055.33 250
PHAR 000001743381 BETAMETHASONE DIPROPI 0.05% LO 000038.66 259
PHAR 000001743384 TRIAMCINOLONE ACETONI 0.2MG TO 000038.41 259
PHAR 000001743386 KERI CREME CRE 1GM 000010.30 250
PHAR 000001743391 DOMEBORO PAC 1EA 000002.46 250
PHAR 000001743393 NITROGLYCERIN 2% OINT 30GM 000003.60 259
PHAR 000001743395 DOMEBORO TBE 1EA 000003.58 250
PHAR 000001743403 FLUOROURACIL 5% CRE TOP 000052.67 259
PHAR 000001743404 LANOLIN 30GM OIN TOP 000004.27 259
PHAR 000001743410 FLUOCINONIDE CREAM 0.05% CRE T 000016.14 250
PHAR 000001743418 HYDROQUINONE CRE 15GM 4% CRE T 000017.70 259
PHAR 000001743423 MICONAZOLE NITRATE 2% CRE TOP 000027.86 259
PHAR 000001743424 NYSTATIN 15GM OIN TOP 000013.25 259
PHAR 000001743425 NYSTATIN 15GM CRE TOP 000013.40 259
PHAR 000001743426 NYSTATIN 30GM CRE TOP 000035.83 259
PHAR 000001743427 NYSTATIN 30GM OIN TOP 000035.83 259
PHAR 000001743430 FLUOCINONIDE SOLUTION 0.05% TO 000060.11 259
PHAR 000001743431 METHYL SALICYL/MENTHO OIN TOP 000005.96 259
9/7/2010 11:52 AM Page 82 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001743432 NITROGLYCERIN 2% OIN 30GM 000013.07 259
PHAR 000001743434 DESOXIMETASONE 0.05% GEL 000053.70 250
PHAR 000001743435 TRIAMCINOLONE 0.025% 0.03% CRE 000035.80 259
PHAR 000001743437 TRIAMCINOLNE ACE 0.1% 0.10% CR 000011.59 259
PHAR 000001743439 NYSTATIN CREME 30GM 1GM CRE TO 000009.91 259
PHAR 000001743442 HYDROCORTISONE 1% 1% OIN TOP 000016.75 259
PHAR 000001743443 POLYSPORIN OIN TOP 000011.77 250
PHAR 000001743444 POLYSPORIN OIN TOP 000009.50 250
PHAR 000001743445 SCOPOLAMINE DISC #1 1.5MG DIS 000011.28 259
PHAR 000001743446 BENZOCAINE 20% TOP 000021.00 250
PHAR 000001743450 EAR PLUGS-SLEEPWELL 1EA 000000.00 270
PHAR 000001743452 TETRACYCLINE HCL 3% OIN TOP 000018.46 250
PHAR 000001743453 TRIAMCINOLNE ACE 0.1% 0.10% CR 000015.70 259
PHAR 000001743455 BETADINE OINT 30 GM 000010.88 250
PHAR 000001743456 CLONIDINE PATCH 0.1MG PAT 000017.94 259
PHAR 000001743457 CLONIDINE PATCH 0.2MG PAT 000026.92 259
PHAR 000001743458 CLONIDINE PATCH 0.3MG PAT 000035.45 259
PHAR 000001743463 EUCERIN CRE TOP 000005.81 259
PHAR 000001743469 BETAMETHASONE VALERAT 0.10% CR 000009.95 259
PHAR 000001743470 LOTRISONE CRE TOP 000027.76 259
PHAR 000001743471 LOTRISONE CRE TOP 000054.36 259
PHAR 000001743472 CETYLPYRIDINIUM CHLOR PO 000004.20 259
PHAR 000001743480 MAFENIDE ACETATE 120GM CRE TOP 000066.48 259
PHAR 000001743481 NYSTATIN/TRIAMCINONOL 1GM OIN 000022.00 250
PHAR 000001743482 NYSTATIN/TRIAMCINOLON 1GM OIN 000038.63 259
PHAR 000001743487 POLYSPORIN POW 000016.27 250
PHAR 000001743491 SALICYLIC ACID BTL 2% SHA TOP 000010.98 250
PHAR 000001743492 KETOCONAZOLE CRE 15GM 2% CRE T 000020.99 259
PHAR 000001743493 KETOCONAZOLE CRE 30GM 2% CRE T 000036.79 259
PHAR 000001743495 DIPROLENE OIN 0.05% 45GM 000067.22 259
PHAR 000001743496 BETAMETHASONE DIPROP 0.05% CRE 000037.10 259
PHAR 000001743497 BETAMETHASONE DIPROP 0.05% CRE 000067.22 259
PHAR 000001743505 NITROGLYCERIN 0.1MG/HR PAT 000007.06 259
PHAR 000001743506 NITROGLYCERIN 0.2MG/HR PAT 000007.09 259
PHAR 000001743507 NITROGLYCERIN 0.3MG/HR PAT 000007.37 259
PHAR 000001743508 NITROGLYCERIN 0.4MG/HR PAT 000007.37 259
PHAR 000001743509 NITROGLYCERIN 0.6MG/HR PAT 000007.58 259
PHAR 000001743510 FLUOCINONIDE GEL 0.05% GEL 000061.58 259
PHAR 000001743511 FLUOCINONIDE GEL 0.05% GEL 000028.94 259
PHAR 000001743517 CHLORASEPTIC 000009.47 259
PHAR 000001743518 CLOTRIMAZOLE 1% LOT TOP 000032.36 259
PHAR 000001743519 MICONAZOLE NITRATE 200MG SUP V 000038.66 259
PHAR 000001743521 MICONAZOLE NITRATE 100MG SUP V 000027.86 259
PHAR 000001743523 LACTIC ACID 12% LOT TOP 000050.20 250
PHAR 000001743526 NYSTATIN CRM 15GM 000008.27 259
PHAR 000001743528 NITROGLYCERIN 2% OIN TOP 000016.01 259
PHAR 000001743536 CAPSAICIN 0.25% CRM 45GM 000040.18 259
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001743537 CLINDAMYCIN 1% GEL 000031.38 259
PHAR 000001743540 NYSTATIN/TRIAMCINOLON CRE TOP 000008.98 259
PHAR 000001743541 THROMBIN W/DIL 5000U TOP 000036.23 259
PHAR 000001743543 NYSTATIN/TRIAMCINOLON CRE TOP 000011.66 259
PHAR 000001743544 MUPIROCIN 2% OIN TOP 000034.51 259
PHAR 000001743545 BETAMETHASONE VALERAT 0.10% OI 000010.08 259
PHAR 000001743546 BETAMETHASONE DIPROPI 0.05% CR 000013.04 250
PHAR 000001743548 BETAMETHASONE DIPROPI 0.05% CR 000019.49 259
PHAR 000001743551 THICK-IT #2 8OZ. POW 1EA 000000.00 250
PHAR 000001743555 NYSTATIN/TRIAMCINOLON OIN TOP 000012.30 250
PHAR 000001743557 NYSTATIN/TRIAMCINOLON OIN TOP 000009.18 259
PHAR 000001743558 NYSTATIN OINT 15GM 000008.44 259
PHAR 000001743559 METHYL SALICYLATE OIL OIL TOP 000005.94 259
PHAR 000001743560 TRIPLE ANTIBIOTIC OIN 000007.94 250
PHAR 000001743564 GELATIN 50 TOP 000034.37 250
PHAR 000001743565 GELATIN 100 TOP 000041.80 250
PHAR 000001743566 STOMAHESIVE POWDER POW 000014.00 271
PHAR 000001743569 TRETINOIN 0.03% CRE TOP 000072.06 259
PHAR 000001743570 TRETINOIN 0.03% CRE TOP 000040.68 259
PHAR 000001743571 BENZOCAINE TOP 000013.72 250
PHAR 000001743572 HYDROCORTISONE 0.5% 0.50% OIN 000007.44 259
PHAR 000001743575 TRIAMCINOLNE ACE 0.1% 0.10% OI 000011.64 259
PHAR 000001743576 HYDROCORTISONE 2.5% 2.50% OIN 000030.36 259
PHAR 000001743578 BACITRACIN/POLYMYXIN OIN TOP 000007.92 250
PHAR 000001743579 BACITRACIN/POLYMYXIN OIN TOP 000009.24 250
PHAR 000001743581 TAC SOL UD 5ML SOL 000031.92 259
PHAR 000001743582 CALMOSEPTINE OIN 113 000012.28 259
PHAR 000001743583 GELATIN POWDER 1GM POW 000053.17 250
PHAR 000001743584 BAG BALM 1OZ OIN TOP 000004.50 259
PHAR 000001743585 PEPPERMINT OIL NF 000009.89 259
PHAR 000001743588 SILVER SULFADIA TUBE 1% CRE TO 000007.66 259
PHAR 000001743589 GENTIAN VIOLET 1% SOL 30ML 000003.29 250
PHAR 000001743590 NIX LIQ 1% 60ML 000018.86 259
PHAR 000001743594 ACYCLOVIR 3GM 5% OIN TOP 000023.35 259
PHAR 000001743595 TERAZOL 7 CRM 45GM 000059.63 259
PHAR 000001743596 VITAMIN E 3000U CRE TOP 000006.96 259
PHAR 000001743597 BENZOCAINE 7.50% GEL 000007.57 250
PHAR 000001743598 TRIAMCINOLNE ACE 0.1% 0.10% CR 000027.98 259
PHAR 000001743600 AQUAPHOR OIN TOP 000024.12 259
PHAR 000001743604 CARMEXJAR OIN TOP 000002.71 259
PHAR 000001743605 NITROGLYCERIN 2% 1GM OINT 000002.82 259
PHAR 000001743606 MOMETASONE FUROATE 0.10% OIN T 000028.18 259
PHAR 000001743610 MOMETASONE FUROATE 0.10% OIN T 000050.62 259
PHAR 000001743612 PERMETHRIN 5% CRE 000028.03 259
PHAR 000001743613 MOMETASONE FUROATE 0.10% CRE T 000041.69 259
PHAR 000001743614 MOMETASONE FUROATE 0.10% CRE T 000022.38 259
PHAR 000001743615 ALCLOMETASONE DIPROPI 0.05% CR 000029.83 259
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001743616 ALCLOMETASONE DIPROPI 0.05% CR 000057.67 259
PHAR 000001743617 ALCLOVATE 0.05% OINT 45GM 000061.64 259
PHAR 000001743622 CUTIVATE 0.05% CRM 30GM 000058.34 259
PHAR 000001743624 MICONAZOLE NITRATE 2% TOP 000010.39 250
PHAR 000001743626 STOMAHESIVE PASTE PST TOP 000017.30 271
PHAR 000001743629 ALLANTOIN GEL GEL 000019.61 259
PHAR 000001743631 CALCIPOTRIENE 0.01% OIN TOP 000144.65 259
PHAR 000001743633 CAPSAICIN HP 0.08% CRM TOP 000042.94 259
PHAR 000001743634 LIDOCAINE HCL GEL UD 2% GEL 000014.40 250
PHAR 000001743637 SARNA LOTION 225 ML 000010.79 259
PHAR 000001743641 DIFLORASONE DIACETAT 0.05% CRM 000062.14 250
PHAR 000001743643 "COLLEGEN, MIRCOFIBR" 1GM POW 000172.56 250
PHAR 000001743646 ACCUZYME OINT 30 GM 000105.94 259
PHAR 000001743647 BACTROBAN 2% CRM 30GM 000094.13 259
PHAR 000001743648 CETAPHIL SOAP 1BOTTLE PO 000007.20 250
PHAR 000001743649 BACTROBAN 2% OINT 30GM 000076.94 259
PHAR 000001743650 MICONAZOLE 2% PWDR 1GM PWD TOP000010.80 259
PHAR 000001743651 LIDOCA/PRILOCAINE DSC 1GM 000009.37 250
PHAR 000001743652 TRIPLE ANTIBIOTIC OIN TOP 000039.35 250
PHAR 000001743654 NICOTINE 7MG PAT 000011.66 259
PHAR 000001743655 NICOTINE 14MG PAT 000011.66 259
PHAR 000001743656 NICOTINE 21MG PAT 000011.66 259
PHAR 000001743657 HYDROCORTISONE 2.5% 2.50% CRM 000018.17 259
PHAR 000001743658 TESTOSTERONE PAT 5MG 000012.35 259
PHAR 000001743659 LANOLIN ANHYDROUS CR 60GM CR 000012.49 259
PHAR 000001743661 ORAJEL BABY LIQUID 0.45OZ 000008.15 259
PHAR 000001743662 NAFTIN 1% CRM 15GM 000045.15 259
PHAR 000001743664 AQUAPHOR OINT 1.75OZ 000009.59 259
PHAR 000001743665 METROGEL 0.75% 30GM 000062.52 259
PHAR 000001743666 AVEENO LOTION 8OZ 000010.28 259
PHAR 000001743667 ERYTHROMYCIN TOP GEL 2% 000039.08 259
PHAR 000001743668 BALMEX OINT 2 OZ 000005.90 259
PHAR 000001743669 ABSORBASE OINT 4 OZ 000008.69 259
PHAR 000001743670 OXISTAT 1% CRM 30GM 000056.36 259
PHAR 000001743671 ULTRAVATE 0.05% OINT 50GM 000127.09 259
PHAR 000001743672 ULTRAVATE 0.05% CRM 50GM 000127.09 259
PHAR 000001743673 BACTROBAN 2% OINT 22GM 000071.95 259
PHAR 000001743674 IODOSORB GEL 1.4 OZ 000078.96 259
PHAR 000001743675 PANAFIL OINT 30 GM 000179.20 259
PHAR 000001743676 PENCICLOVIR 1% CRM 1.5GM 000045.53 259
PHAR 000001743677 LET TOPICAL SOL. 5ML 000010.20 259
PHAR 000001743678 TESTOSTERONE 2.5MG PAT 000010.05 259
PHAR 000001743679 TACROLIMUS 0.1% OINT 30GM 000112.81 259
PHAR 000001743680 LOPROX 0.77% CRM 30GM 000062.29 259
PHAR 000001743681 LAC-HYDRIN 12% CRM 280GM 000077.60 259
PHAR 000001743682 IMIQUIMOD 5% CRM 0.25GM 000022.37 259
PHAR 000001743683 ULTRAFOAM 100 CM 000077.28 272
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001743684 ULTRAFOAM 50 CM 000052.18 272
PHAR 000001743685 DOXEPIN 5% CRM 30GM 000067.52 259
PHAR 000001743686 MALATHION 0.5% LOT 59ML 000076.92 259
PHAR 000001743687 NASACORT AQ SPRAY 16.5GM 000111.20 259
PHAR 000001743688 INZ0 CREAM CRE 2% 000015.43 250
PHAR 000001743689 HYDROCORTISONE 1% CRE 1% 000002.25 250
PHAR 000001743690 GELATIN ASB. SZ 100 MIS 100 000000.00 250
PHAR 000001743691 GELATIN ASB. SZ 50 MIS 50 000045.10 250
PHAR 000001743692 GELATIN ASB. SZ 12 MIS 12 000045.10 250
PHAR 000001743693 MICROFIBER COLLAGEN MIS EA 000270.83 250
PHAR 000001743694 SILVASORB GEL GEL 1.5 000039.47 250
PHAR 000001743695 BIAFINE RE CREAM CRM 3.3 000019.06 250
PHAR 000001744001 METAPROTERENOL SULFAT 5% INH 000022.45 259
PHAR 000001744002 METAPROTERENOL SULFAT 5% INH 000031.15 259
PHAR 000001744005 CROMOLYN SODIUM INH 000017.40 259
PHAR 000001744012 EPINEPHRINE BITARTRAT 7MG INH 000035.42 259
PHAR 000001744013 ACETYLCYSTEINE 20% INH 200 000099.26 259
PHAR 000001744014 ALBUTEROL INH 17GM 000043.42 259
PHAR 000001744016 BECONASE AQ NAS 25GM 000079.98 259
PHAR 000001744033 TERBUTALINE SULFATE 7.5ML INH 000032.34 259
PHAR 000001744037 FLUNISOLIDE 0.03% INH 000069.07 259
PHAR 000001744039 CROMOLYN SODIUM 14 GM INHL 000088.55 259
PHAR 000001744040 CROMOLYN SODIUM INHL 000057.62 259
PHAR 000001744041 ISOETHARINE HCL 1% INH 000028.79 259
PHAR 000001744043 NITROGLYCERIN 12GM SPRAY 000064.16 259
PHAR 000001744046 BECLOMETHASONE INH INH 16. 000072.00 250
PHAR 000001744047 IPRATROPIUM BROMIDE 14GM INH 000043.20 259
PHAR 000001744049 ALBUTEROL NEB SOLN SOL 0.0 000027.04 259
PHAR 000001744050 VANCENASE AQ NAS 19GM 000112.34 259
PHAR 000001744051 BECONASE 16.8GM NASAL INH 000097.76 259
PHAR 000001744053 ACETYLCYSTEINE 20% SOL 200 000014.22 259
PHAR 000001744054 ALBUTEROL NEB SOL INH 0.5 000000.00 259
PHAR 000001744057 PENTAMIDINE 300MG INH 000355.50 259
PHAR 000001744058 AEROCHAMBER 000036.98 250
PHAR 000001744062 TRIAMCINOLONE ACETONI METERED 000057.19 259
PHAR 000001744063 NEDOCROMIL SODIUM 16.2GM INH 000066.02 259
PHAR 000001744064 ALBUTEROLUD PUFF 1DOSE INH 000000.12 259
PHAR 000001744070 DORNASE ALFA 2.5M AMP SOL 1MG 000052.68 259
PHAR 000001744072 SALMETEROL DISKUS INH 50M 000181.55 250
PHAR 000001744073 IPRATROPIUM SOL UD SOL 0.0 000008.60 259
PHAR 000001744075 SALMETEROL XINAFOATE 1DOSE INH 000097.80 259
PHAR 000001744076 CROMOLYN 4% OPHT SOL 10ML 000071.22 250
PHAR 000001744077 CALCITONIN NASAL SOL 000055.66 259
PHAR 000001744078 TOBRAMYCIN (TOBI UD) INH 60M 000074.06 259
PHAR 000001744079 BITOLTEROLINH 1 DOSE INH 000086.26 259
PHAR 000001744080 FLONASE NASAL SPRAY 000103.65 259
PHAR 000001744081 FLUTICASONE PROP. 44MCG INH 000084.53 259
9/7/2010 11:52 AM Page 86 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001744082 FLUTICASONE PROP. 110MCG INH 000103.51 259
PHAR 000001744083 FLUTICASONE PROP. 220MCG INH 000161.56 259
PHAR 000001744085 AZELASTINE NASAL SP. 34ML NASL 000087.14 259
PHAR 000001744086 PONARIS NASAL EMMLNT 1 OZ NASL 000014.89 259
PHAR 000001744087 COMBIVENT INH 14.7GM 000075.72 259
PHAR 000001744088 TORNALATE INH SOL 0.2% 60ML 000061.37 259
PHAR 000001744090 RELENZA 5MG INH KIT 000086.45 259
PHAR 000001744091 NASONEX NASL SPRAY 17GM 000099.45 259
PHAR 000001744092 PULMICORT INH 200MCG 000229.87 259
PHAR 000001744094 BUDESONIDE NEB SOL SOL 0.5 000009.26 259
PHAR 000001744095 BUDESONIDE NEB SOL SOL 0.2 000009.26 259
PHAR 000001744096 LEVALBUTEROL 1.25MG INH 000005.19 259
PHAR 000001744099 ADVAIR 100/50MCG INH 000206.76 259
PHAR 000001744100 ADVAIR 250/50MCG INH 000261.40 259
PHAR 000001744101 ADVAIR 500/50MCG INH 000358.86 259
PHAR 000001744103 BECLOMETHASONE 40MCG INH 7.3 000131.76 259
PHAR 000001744104 BECLOMETHASONE 80MCG INH 7.3 000165.98 259
PHAR 000001744105 ALBUTEROL 2.5MG/3ML INH 1 D 000000.00 250
PHAR 000001748002 ACETAMINOPHEN SUP 120 000002.44 259
PHAR 000001748003 ERGOTAMINE/CAFFEINE 1SUPP SUP 000011.50 250
PHAR 000001748004 FLEET PEDIATRIC ENEMA ENE 000000.00 250
PHAR 000001748005 PROCTOFOAM-HC RECT 000031.99 259
PHAR 000001748006 CHLORAL HYDRATE 500MG SUP PR 000007.16 259
PHAR 000001748007 NEMBUTAL 120 MG SUPP 000005.01 259
PHAR 000001748008 TRIMETHOBENZAMIDE 100MG SUP 000003.44 259
PHAR 000001748010 MINERAL OIL ENEMA ENE RECT 000007.00 259
PHAR 000001748012 ACETAMINOPHEN SUP 650 000002.95 259
PHAR 000001748013 PROCHLORPERAZINE 2.5MG SUP PR 000008.36 259
PHAR 000001748014 FLEET ENEMA ENE 1BO 000000.00 250
PHAR 000001748016 PENTOBARBITAL SODIUM 60MG SUP 000012.76 259
PHAR 000001748017 ACETAMINOPHEN SUP 325 000002.92 259
PHAR 000001748018 PROCHLORPERAZINE 5MG SUP PR 000008.76 259
PHAR 000001748019 GLYCERIN ADULT SUPP 000002.70 259
PHAR 000001748022 PROCHLORPERAZINE 25MG SUP PR 000009.71 259
PHAR 000001748028 CORTENEMA 60ML ENE PR 000015.80 250
PHAR 000001748030 CHLORPROMAZINE 25MG SUP PR 000009.88 259
PHAR 000001748033 DIBUCAINE 0.50% CRE TOP 000009.13 250
PHAR 000001748034 CHLORPROMAZINE HCL 100MG SUP P 000011.23 259
PHAR 000001748035 ANUSOL OIN TOP 000009.86 259
PHAR 000001748036 HYDROCORTISONE 10% 10% TOP 000060.96 259
PHAR 000001748039 ANUSOL SUP PR 000003.10 259
PHAR 000001748041 ANUSOL HC SUPP SUP PR 000006.78 259
PHAR 000001748044 ANUSOL HC 30GM 2.50% CRE PR 000032.11 259
PHAR 000001748045 BISACODYL 10MG SUP 000002.56 259
PHAR 000001748046 PROMETHAZINE HCL SUP 50M 000009.90 259
PHAR 000001748048 ASPIRIN 120MG SUPP 120MG SUP P 000002.84 259
PHAR 000001748049 PROMETHAZINE HCL SUP 25M 000008.78 259
9/7/2010 11:52 AM Page 87 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001748050 WITCH HAZEL CRE 40GM 50% CRE T 000010.19 259
PHAR 000001748051 PREPARATION H OIN RECT 000010.58 259
PHAR 000001748053 PREPARATION H SUP PR 000003.19 259
PHAR 000001748055 HYDROCORTISONE 1% 1% CRE PR 000029.89 259
PHAR 000001748057 ASPIRIN 300MG SUPP 300MG SUP P 000002.86 259
PHAR 000001748058 ASPIRIN 600MG SUPP 600MG SUP P 000002.88 259
PHAR 000001748059 TRIMETHOBENZAMIDE 200MG SUP 000003.11 259
PHAR 000001748063 DIBUCAINE 1% OIN 000009.85 250
PHAR 000001748065 INDOMETHACIN 50MG SUPP 000007.40 259
PHAR 000001748071 PROCTOCREAM-HC 1% CRE 000028.87 259
PHAR 000001748072 GLYCERIN SUPP PEDS SUP PR 000007.24 259
PHAR 000001748073 CHLORAL HYDRATE 650MG SUP PR 000003.38 259
PHAR 000001748074 CHLORAL HYDRATE 325 MG SUP PR 000009.30 259
PHAR 000001748075 HYDROCORTISONE 25MG SUP PR 000003.52 259
PHAR 000001748078 MESALAMINE 4GM ENE PR 000017.96 250
PHAR 000001748079 SODIUM POLYST ENEMA 0.25GM SUS 000036.17 259
PHAR 000001748081 ANALPRAM-HC 1%/1% 30GM CRM 000048.53 259
PHAR 000001748082 DIAZEPAM 5MG GEL 000299.81 259
PHAR 000001748083 DIAZEPAM 10MG GEL 000287.82 259
PHAR 000001748084 DIAZEPAM 15MG GEL 000287.82 259
PHAR 000001748085 DIAZEPAM 2.5MG GEL 000329.80 259
PHAR 000001748086 DIAZEPAM 20MG GEL 000287.82 259
PHAR 000001749005 PREMARIN CRM 42.5GM 000050.41 259
PHAR 000001749006 DINOPROSTONE 20MG SUP VAG 000152.14 259
PHAR 000001749007 SULFABENZAMIDE CRE VAG 000043.63 259
PHAR 000001749014 CLOTRIMAZOLE 1% CRE VAG 000022.31 259
PHAR 000001749018 NYSTATIN VAGINAL TAB VAG 000003.35 259
PHAR 000001749019 CLOTRIMAZOLE 500MG TAB VAG 000027.68 259
PHAR 000001749021 TRIPLE SULFA CRE VAG 000011.45 259
PHAR 000001749025 CLINDAMYCIN 2% CRE VAG 000044.44 259
PHAR 000001749026 METROGEL 0.75% 70GM 000056.95 259
PHAR 000001749027 DINOPROSTONE 10 MG SUP VAG 000323.76 259
PHAR 000001749028 EPINEPHRINE UD 0.5MLT INH 11. 000000.00 250
PHAR 000001750079 CEFUROXIME SODIUM SOL 000165.60 259
PHAR 000001750249 CEFTAZIDIME/PB 0.25GM 000048.67 250
PHAR 000001750335 CEFAZOLIN/PB 0.25GM 000035.47 250
PHAR 000001750344 CEFAZOLIN/PB 4GM 000100.27 250
PHAR 000001750388 CEFOPERAZ PB 0.5 GM 000058.00 250
PHAR 000001750417 CEFOTETAN/ST H20 INJ 100 000100.27 250
PHAR 000001750418 CEFOTETAN/PB 0.25GM 000045.07 250
PHAR 000001750419 CEFOTETAN/PB 0.5GM 000064.27 250
PHAR 000001750420 CEFOTETAN/PB 0.75GM 000081.07 250
PHAR 000001750421 CEFOTETAN/PB 1GM 000100.27 250
PHAR 000001750422 CEFOTETAN/PB 1.5GM 000131.47 250
PHAR 000001750423 CEFOTETAN/PB 2GM 000157.87 250
PHAR 000001750425 CEFOTETAN/PB 3GM 000205.87 250
PHAR 000001750446 CEFTAZIDIME/PB 1 GM PO 000112.80 259
9/7/2010 11:52 AM Page 88 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001750478 CEFTRIAXONE/PB 2.5GM 000340.17 250
PHAR 000001750481 CEFUROXIME/PB 0.175GM 000038.47 250
PHAR 000001750482 CEFUROXIME/PB 0.35GM 000048.67 250
PHAR 000001750492 CEFUROXIME/PB 3.5GM 000187.87 250
PHAR 000001750493 CEFUROXIME/PB 4GM 000205.87 250
PHAR 000001750496 CEFEPIME/H20 INJ 100 000119.47 250
PHAR 000001751096 MEZLOCILL PB 1 GM 000037.50 250
PHAR 000001751107 PENICILLIN G K INJ 0.5 000035.47 250
PHAR 000001751108 PEN G K/PB 10000U 000035.47 250
PHAR 000001751111 PEN G K/PB 100000U 000035.47 250
PHAR 000001751112 PEN G K/PB 250000U 000035.47 250
PHAR 000001751113 PEN G K/PB 500000U 000035.47 250
PHAR 000001751114 PEN G K/PB 1MU 000035.47 250
PHAR 000001751115 PEN G K/PB 2MU 000045.07 250
PHAR 000001751116 PEN G K/PB 3MU 000051.67 250
PHAR 000001751127 PEN G K/PB 4MU 000064.27 250
PHAR 000001751128 PEN G K/PB 5MU 000069.07 250
PHAR 000001751129 PENICILLIN G SOD INJ 500 000035.47 250
PHAR 000001751144 MEZLOCILL PB 8 GM 000151.00 250
PHAR 000001751145 TICARCILLIN/CLAVUL INJ 0.3 000109.87 250
PHAR 000001751146 TIMENTIN/PB 1.55GM 000069.07 250
PHAR 000001751147 TIMENTIN/PB 3.1GM 000109.87 250
PHAR 000001751232 PIPERACILLIN 2GM INJ 000100.27 250
PHAR 000001751233 PIPERACILLIN/PB 0.5GM 000045.07 250
PHAR 000001751234 PIPERACILLIN/PB 1GM 000064.27 250
PHAR 000001751235 PIPERACILLIN/PB 2GM 000100.27 250
PHAR 000001751236 PIPERACILLIN/PB 3GM 000131.47 250
PHAR 000001751237 PIPERACILLIN/PB 4GM 000157.87 250
PHAR 000001751239 PIPERACILLIN/PB 6GM 000187.87 250
PHAR 000001751326 NAFCILLIN 1GM INJ 000060.07 250
PHAR 000001751327 NAFCILLIN/PB 0.1GM 000035.47 250
PHAR 000001751328 NAFCILLIN/PB 0.25GM 000035.47 250
PHAR 000001751329 NAFCILLIN/PB 0.5GM 000041.47 250
PHAR 000001751330 NAFCILLIN/PB 1GM 000060.07 250
PHAR 000001751331 NAFCILLIN/PB 1.5GM 000069.07 250
PHAR 000001751332 NAFCILLIN/PB 2GM 000085.87 250
PHAR 000001751333 NAFCILLIN/PB 2.5GM 000100.27 250
PHAR 000001751334 NAFCILLIN/PB 3GM 000109.87 250
PHAR 000001751335 NAFCILLIN/PB 3.5GM 000119.47 250
PHAR 000001751336 NAFCILLIN/PB 4GM 000144.67 250
PHAR 000001751340 NAFCILLIN/PB 6GM 000172.27 250
PHAR 000001751396 PEN G K/PB 6MU 000076.27 250
PHAR 000001751397 PEN G K/PB 7MU 000085.87 250
PHAR 000001751398 PEN G K/PB 8MU 000100.27 250
PHAR 000001751399 PEN G K/PB 9MU 000100.27 250
PHAR 000001751400 PEN G K/PB 10MU 000109.87 250
PHAR 000001751402 PEN G K/PB 12MU 000119.47 250
9/7/2010 11:52 AM Page 89 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001751405 PEN G K/PB 15MU 000144.67 250
PHAR 000001751410 NAFCILLIN/PB 9GM 000221.47 250
PHAR 000001751413 NAFCILLIN/PB 12GM 000241.87 250
PHAR 000001752069 AMIKACIN 1GM INJ 000315.00 250
PHAR 000001752074 AMIKACIN 100MG INJ 000074.40 250
PHAR 000001752159 AMIKACIN PB 10 MG IVPB 000045.00 250
PHAR 000001752160 AMIKACIN PB 25 MG IVPB 000074.40 250
PHAR 000001752161 AMIKACIN PB 50 MG IVPB 000124.80 250
PHAR 000001752164 AMIKACIN PB 200 MG IVPB 000253.73 250
PHAR 000001752165 AMIKACIN PB 0.1 GM INJ 000093.60 250
PHAR 000001752166 AMIKACIN PB 0.25 GM INJ 000165.60 250
PHAR 000001752167 AMIKACIN PB 0.5 GM INJ 000242.40 250
PHAR 000001752169 AMIKACIN PB 1 GM INJ 000417.85 250
PHAR 000001752201 AMPICILLIN/PB 0.1GM 000035.47 250
PHAR 000001752202 AMPICILLIN/PB 0.25GM 000035.47 250
PHAR 000001752230 GENTAMIC PB 140 MG 000038.40 250
PHAR 000001752232 GENTAMIC PB 180 MG 000042.00 250
PHAR 000001752239 UNASYN 3GM INJ 000100.27 250
PHAR 000001752279 AMIKACIN 1GM INJ 000321.67 250
PHAR 000001752280 AMIKACIN/PB 0.1GM 000081.07 250
PHAR 000001752281 AMIKACIN/PB 0.25GM 000157.87 250
PHAR 000001752282 AMIKACIN/PB 0.5GM 000221.47 250
PHAR 000001752283 AMIKACIN/PB 0.75GM 000257.47 250
PHAR 000001752284 AMIKACIN/PB 1GM 000321.67 250
PHAR 000001752316 AMIKACIN/PB 1.5GM 000479.17 250
PHAR 000001752317 AMIKACIN/PB 2GM 000594.67 250
PHAR 000001753019 ERYTHROMYCIN/PB 50MG 000035.47 250
PHAR 000001753020 ERYTHROMYCIN/PB 100MG 000041.47 250
PHAR 000001753021 ERYTHROMYCIN/PB 250MG 000064.27 250
PHAR 000001753023 ERYTHROMYCIN/PB 1GM 000157.87 250
PHAR 000001753024 ERYTHROMYCIN/PB 1.5GM 000187.87 250
PHAR 000001753025 ERYTHROMYCIN/PB 2GM 000221.47 250
PHAR 000001753028 CLINDAMYCIN [C] INJ 150 000138.00 250
PHAR 000001753029 CLINDAMYC PB 75 MG IVPB 000031.80 250
PHAR 000001753030 CLINDAMYC PB 150 MG IVPB 000042.00 250
PHAR 000001753031 CLINDAMYC PB 300 MG IVPB 000062.40 250
PHAR 000001753032 CLINDAMYC PB 400 MG IVPB 000074.40 250
PHAR 000001753034 CLINDAMYC PB 900 MG IVPB 000138.00 250
PHAR 000001753035 METRONIDAZOLE/NS INJ 5MG 000035.47 250
PHAR 000001753036 METRONIDAZOLE/PB 50MG 000035.47 250
PHAR 000001753037 METRONIDAZOLE/PB 125MG 000035.47 250
PHAR 000001753038 METRONIDAZOLE/PB 250MG 000035.47 250
PHAR 000001753039 METRONIDAZOLE/PB 500MG 000035.47 250
PHAR 000001753040 METRONIDAZOLE/PB 750MG 000041.47 250
PHAR 000001753041 METRONIDAZOLE/PB 1000MG 000045.07 250
PHAR 000001753082 TMP/SULFAMETH INJ 16M 000205.87 250
PHAR 000001753083 SEPTRA/PB 40MG 000048.67 250
9/7/2010 11:52 AM Page 90 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001753084 SEPTRA/PB 80MG 000069.07 250
PHAR 000001753085 SEPTRA/PB 120MG 000085.87 250
PHAR 000001753086 SEPTRA/PB 160MG 000109.87 250
PHAR 000001753087 SEPTRA/PB 200MG 000119.47 250
PHAR 000001753088 SEPTRA/PB 240MG 000144.67 250
PHAR 000001753089 SEPTRA/PB 280MG 000157.87 250
PHAR 000001753090 SEPTRA/PB 320MG 000172.27 250
PHAR 000001753091 SEPTRA/PB 360MG 000172.27 250
PHAR 000001753092 SEPTRA/PB 400MG 000187.87 250
PHAR 000001753099 SEPTRA/PB 440MG 000187.87 250
PHAR 000001753100 SEPTRA/PB 480MG 000205.87 250
PHAR 000001753101 SEPTRA/PB 520MG 000221.47 250
PHAR 000001753102 SEPTRA/PB 560MG 000221.47 250
PHAR 000001753103 SEPTRA/PB 600MG 000231.07 250
PHAR 000001753105 SEPTRA/PB 680MG 000241.87 250
PHAR 000001753106 SEPTRA/PB 720MG 000249.07 250
PHAR 000001753109 PENTAMIDINE 300MG INJ 000496.80 250
PHAR 000001753110 PENTAMIDINE/PB 150MG 000264.67 250
PHAR 000001753111 PENTAMIDINE/PB 300MG 000503.47 250
PHAR 000001753112 PENTAMIDINE/PB 450MG 000652.51 250
PHAR 000001753115 PENTAMIDINE/PB 900MG 001149.31 250
PHAR 000001753117 PRIMAXIN/PB 125MG 000076.27 250
PHAR 000001753123 SEPTRA/PB 840MG 000264.67 250
PHAR 000001753135 METRONIDAZOLE/PB 1250MG 000051.67 250
PHAR 000001753139 METRONIDAZOLE/PB 1500MG 000055.87 250
PHAR 000001753152 GANCICLOVIR/PB 100MG 000069.07 250
PHAR 000001753153 GANCICLOVIR/PB 200MG 000109.87 250
PHAR 000001753154 GANCICLOVIR/PB 300MG 000157.87 250
PHAR 000001753155 GANCICLOVIR/PB 400MG 000172.27 250
PHAR 000001753160 FLUCONAZOLE/NS INJ 2MG 000471.07 250
PHAR 000001753161 FLUCONAZOLE/PB 10MG 000048.67 250
PHAR 000001753162 FLUCONAZOLE/PB 20MG 000069.07 250
PHAR 000001753163 FLUCONAZOLE/PB 30MG 000085.87 250
PHAR 000001753164 FLUCONAZOLE/PB 40MG 000109.87 250
PHAR 000001753165 FLUCONAZOLE/PB 50MG 000131.47 250
PHAR 000001753166 FLUCONAZOLE/PB 75MG 000157.87 250
PHAR 000001753167 FLUCONAZOLE/PB 100MG 000187.87 250
PHAR 000001753168 FLUCONAZOLE/PB 150MG 000231.07 250
PHAR 000001753177 VANCOMYCIN/PB 1MG 000035.47 250
PHAR 000001753178 VANCOMYCIN/PB 2MG 000035.47 250
PHAR 000001753179 VANCOMYCIN/PB 3MG 000035.47 250
PHAR 000001753180 VANCOMYCIN/PB 4MG 000035.47 250
PHAR 000001753181 VANCOMYCIN/PB 5MG 000035.47 250
PHAR 000001753182 VANCOMYCIN/PB 6MG 000035.47 250
PHAR 000001753183 VANCOMYCIN/PB 7MG 000035.47 250
PHAR 000001753184 VANCOMYCIN/PB 8MG 000035.47 250
PHAR 000001753185 VANCOMYCIN/PB 9MG 000035.47 250
9/7/2010 11:52 AM Page 91 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001753195 VANCOMYCIN/PB 10MG 000035.47 250
PHAR 000001753196 VANCOMYCIN/PB 20MG 000035.47 250
PHAR 000001753197 VANCOMYCIN/PB 30MG 000035.47 250
PHAR 000001753198 VANCOMYCIN/PB 40MG 000035.47 250
PHAR 000001753199 VANCOMYCIN/PB 50MG 000035.47 250
PHAR 000001753228 VANCOMYCIN/PB 200MG 000048.67 250
PHAR 000001753229 VANCOMYCIN/PB 250MG 000051.67 250
PHAR 000001753274 DOXYCYCLIN PB 50 MG 000031.80 250
PHAR 000001753314 AZTREONAM 2GM INJ 000112.80 250
PHAR 000001753315 AZTREONAM/PB 0.25 GM IVPB 000045.00 250
PHAR 000001753316 AZTREONAM/PB 0.5 GM IVPB 000069.60 250
PHAR 000001753317 AZTREONAM/PB 1 GM IVPB 000112.80 250
PHAR 000001753318 AZTREONAM/PB 1.5 GM IVPB 000151.20 250
PHAR 000001753319 AZTREONAM/PB 2 GM IVPB 000165.60 250
PHAR 000001753322 AZTREONAM/PB 3.5 GM IVPB 000235.20 250
PHAR 000001753334 RIFAMPIN INJ 60M 000292.44 250
PHAR 000001753376 VANCOMYCIN/PB 60MG 000035.47 250
PHAR 000001753377 VANCOMYCIN/PB 70MG 000035.47 250
PHAR 000001753378 VANCOMYCIN/PB 80MG 000035.47 250
PHAR 000001753379 VANCOMYCIN/PB 90MG 000035.47 250
PHAR 000001753380 VANCOMYCIN/PB 100MG 000035.47 250
PHAR 000001753389 FLUCONAZOLE/PB 450MG 000529.12 250
PHAR 000001753393 VANCOMYCIN/PB 125MG 000035.47 250
PHAR 000001753394 VANCOMYCIN/PB 150MG 000038.47 250
PHAR 000001753402 CLINDAMYCIN 900MG INJ 000144.67 250
PHAR 000001753403 CLINDAMYCIN/PB 150MG 000048.67 250
PHAR 000001753404 CLINDAMYCIN/PB 300MG 000069.07 250
PHAR 000001753405 CLINDAMYCIN/PB 60MG 000035.47 250
PHAR 000001753406 CLINDAMYCIN/PB 450MG 000085.87 250
PHAR 000001753407 CLINDAMYCIN/PB 600MG 000109.87 250
PHAR 000001753408 CLINDAMYCIN/PB 750MG 000119.47 250
PHAR 000001753409 CLINDAMYCIN/PB 900MG 000144.67 250
PHAR 000001753410 CLINDAMYCIN/PB 1200MG 000157.87 250
PHAR 000001753412 CLINDAMYCIN/PB 1750MG 000205.87 250
PHAR 000001753415 CIPROFLOXACIN/D5W INJ 2MG 000165.60 250
PHAR 000001753430 VANCOMYCIN/NS-PF INJ 5MG 000118.27 250
PHAR 000001753431 VANCOMYCIN 100 MG IVPB 000035.47 250
PHAR 000001753463 PALIFERMIN INJ 5MG 004296.87 250
PHAR 000001753505 DEXAMETHASONE 36 MG IV 000074.40 250
PHAR 000001753509 DEXAMETHASONE 52 MG IV 000093.60 250
PHAR 000001753510 MEROPENEM INJ 50M 000151.20 250
PHAR 000001753530 INDOMETHACIN/H2O IV INJ 0.5 000151.20 250
PHAR 000001753531 INDOMETHACIN PB 1MG 000151.20 250
PHAR 000001753532 INDOMETHACIN PB 2MG 000224.40 250
PHAR 000001753533 INDOMETHACIN PB 3MG 000261.90 250
PHAR 000001753535 MOXIFLOXACIN/0.8NACL INJ 1.6 000109.38 250
PHAR 000001753536 LEVOFLOXACIN/D5W INJ 5MG 000199.00 250
9/7/2010 11:52 AM Page 92 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001754032 ACETAZOLAM PB 500 MG IV 000165.60 250
PHAR 000001754099 FAMOTIDINE [C] INJ 10M 000034.80 250
PHAR 000001754100 FAMOTIDINE/PB 10 MG 000031.80 250
PHAR 000001754101 FAMOTIDINE/PB 20 MG 000042.00 250
PHAR 000001754102 FAMOTIDINE/PB 30 MG 000057.60 250
PHAR 000001754103 FAMOTIDINE/PB 40 MG 000062.40 250
PHAR 000001754106 PHENYTOIN PB 10 MG 000028.80 250
PHAR 000001754107 PHENYTOIN PB 25 MG 000028.80 250
PHAR 000001754113 PHENYTOIN PB 300 MG 000103.20 250
PHAR 000001754128 DEXAMETH PB 16 MG IV 000049.20 250
PHAR 000001754131 DEXAMETH PB 22 MG IV 000057.60 250
PHAR 000001754133 DEXAMETH PB 26 MG IV 000062.40 250
PHAR 000001754134 DEXAMETH PB 28 MG IV 000069.60 250
PHAR 000001754135 DEXAMETH PB 30 MG IV 000069.60 250
PHAR 000001754137 ETHACRYNATE SOD 50MG INJ 000138.00 250
PHAR 000001754138 EDECRIN PB 25 MG 000079.20 250
PHAR 000001754139 EDECRIN PB 50 MG 000138.00 250
PHAR 000001754143 EDECRIN PB 150 MG 000235.20 250
PHAR 000001754145 EDECRIN PB 200 MG 000262.80 250
PHAR 000001754146 CALCIUM CHL 1GM INJ 000028.80 250
PHAR 000001754147 CA CHL PB 0.1 GM IVPB 000028.80 250
PHAR 000001754149 CA CHL PB 0.5 GM IVPB 000028.80 250
PHAR 000001754150 CA CHL PB 1 GM IVPB 000028.80 250
PHAR 000001754158 CA CHL PB 5 GM IVPB 000045.00 250
PHAR 000001754162 DIURIL PB 25 MG 000028.80 250
PHAR 000001754163 DIURIL PB 50 MG 000028.80 250
PHAR 000001754165 DIURIL PB 100 MG 000031.80 250
PHAR 000001754191 PHENOBARB PB 130 MG 000031.80 250
PHAR 000001754203 FAMOTIDINE/PB 80 MG 000103.20 250
PHAR 000001754204 FAMOTIDINE/ST H20 INJ 2MG 000055.87 250
PHAR 000001754205 FAMOTIDINE/PB 10MG 000041.47 250
PHAR 000001754206 FAMOTIDINE/PB 20MG 000055.87 250
PHAR 000001754207 FAMOTIDINE/PB 30MG 000069.07 250
PHAR 000001754208 FAMOTIDINE/PB 40MG 000081.07 250
PHAR 000001754209 FAMOTIDINE/PB 50MG 000100.27 250
PHAR 000001754259 SODIUM BICARB 50MEQ INJ 000062.40 250
PHAR 000001754260 SODBICARB PB 5 MEQ 000028.80 250
PHAR 000001754261 SODBICARB PB 10 MEQ 000028.80 250
PHAR 000001754262 SODBICARB PB 25 MEQ 000042.00 250
PHAR 000001754284 ENALAPRIL 2.5MG INJ 000151.20 250
PHAR 000001754296 INDOMETHACIN PB 1MG 000151.20 250
PHAR 000001754301 AZATHIOPRINE 25 MG LVP 000122.40 250
PHAR 000001754302 AZATHIOPRINE 50 MG LVP 000184.80 250
PHAR 000001754355 VASOTEC/PB 0.625 MG 000062.40 250
PHAR 000001754366 TRAC-EL-TERM INJ 1ML 000001.20 250
PHAR 000001754376 METHOCARBAMOL 1GM INJ 000038.40 250
PHAR 000001754378 METHOCARBAMOL 1 G/PB 000038.40 250
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001754381 MAGNESIUM SULFATE INJ 4.0 000044.40 250
PHAR 000001754382 MAG SULF LVP 4 MEQ INJ 000028.80 250
PHAR 000001754383 MAG SULF LVP 8 MEQ INJ 000028.80 250
PHAR 000001754392 CALC GLUC PB 0.5 G IVPB 000028.80 250
PHAR 000001754393 CALC GLUC PB 1 G IVPB 000028.80 250
PHAR 000001754394 CALC GLUC PB 2 G IVPB 000028.80 250
PHAR 000001754395 CALC GLUC PB 3 G IVPB 000034.80 250
PHAR 000001754396 CALC GLUC PB 4 G IVPB 000038.40 250
PHAR 000001754397 CALC GLUC PB 5 G IVPB 000045.00 250
PHAR 000001754405 METOCLOPRAM PB 20 MG 000034.80 250
PHAR 000001754407 METOCLOPRAM PB 40 MG 000053.40 250
PHAR 000001754408 METOCLOPRAM PB 50 MG 000057.60 250
PHAR 000001754426 PHENOBARBITAL 130MG INJ 000038.40 250
PHAR 000001754428 PHENOBARBITAL 130 MG INJ 000038.40 250
PHAR 000001754429 PHENOBARBITAL 200 MG INJ 000057.60 250
PHAR 000001754430 PHENOBARBITAL 250 MG INJ 000057.60 250
PHAR 000001754432 PHENOBARBITAL 350 MG INJ 000074.40 250
PHAR 000001754433 PHENOBARBITAL 400 MG INJ 000093.60 250
PHAR 000001754460 BUMETANIDE 1MG INJ 000038.40 250
PHAR 000001754461 BUMEX IVPB 4 MG IVPB 000038.40 250
PHAR 000001754471 SOLU-MEDROL 500 MG LVP 000151.20 250
PHAR 000001754475 SOLU-MEDROL 1000 LVP 000214.80 250
PHAR 000001754491 VERAPAMIL 5MG INJ 000038.40 250
PHAR 000001754492 VERAPAMIL/PB 5 MG 000038.40 250
PHAR 000001754529 TERBUTALINE 1MG INJ 000028.80 259
PHAR 000001754530 TERBUTALINE 0.25 MG 000028.80 259
PHAR 000001754531 TERBUTALINE 0.5 MG 000028.80 259
PHAR 000001754555 PHENYTOIN PB 1100 MG 000224.40 250
PHAR 000001754558 CIMETIDINE [C] INJ 150 000042.00 250
PHAR 000001754561 CIMETIDINE PB 150 MG IVPB 000031.80 250
PHAR 000001754563 CIMETIDINE PB 300 MG IVPB 000042.00 250
PHAR 000001754564 CIMETIDINE PB 400 MG IVPB 000049.20 250
PHAR 000001754565 CIMETIDINE PB 450 MG IVPB 000053.40 250
PHAR 000001754570 CIMETIDINE PB 900 MG IVPB 000079.20 250
PHAR 000001754571 CIMETIDINE/ST H20 INJ 30M 000048.67 250
PHAR 000001754572 CIMETIDINE/PB 50MG 000035.47 250
PHAR 000001754573 CIMETIDINE/PB 100MG 000035.47 250
PHAR 000001754574 CIMETIDINE/PB 150MG 000038.47 250
PHAR 000001754575 CIMETIDINE/PB 200MG 000041.47 250
PHAR 000001754576 CIMETIDINE/PB 300MG 000048.67 250
PHAR 000001754577 CIMETIDINE/PB 400MG 000055.87 250
PHAR 000001754578 CIMETIDINE/PB 450MG 000060.07 250
PHAR 000001754579 CIMETIDINE/PB 500MG 000064.27 250
PHAR 000001754580 CIMETIDINE/PB 600MG 000069.07 250
PHAR 000001754583 CIMETIDINE/PB 900MG 000085.87 250
PHAR 000001754584 METHYLDOPATE 500MG INJ 000062.40 250
PHAR 000001754594 METHYLDOPATE PB 500 000062.40 250
9/7/2010 11:52 AM Page 94 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001754604 METHYLDOPATE PB 1000 000103.20 250
PHAR 000001754605 RANITIDINE HCL [C] INJ 25M 000042.00 250
PHAR 000001754606 RANITIDINE/PB 10 MG 000028.80 250
PHAR 000001754616 RANITIDINE/ST H20 INJ 5MG 000042.00 250
PHAR 000001754617 RANITIDINE/PB 10 MG 000028.80 250
PHAR 000001754618 RANITIDINE/PB 25 MG 000031.80 250
PHAR 000001754619 RANITIDINE/PB 50 MG 000042.00 250
PHAR 000001754631 ONDANSETRON/PB 30MG 000583.57 250
PHAR 000001754632 ONDANSETRON/PB 40MG 000724.59 250
PHAR 000001754907 ENALAPRILAT/NS SPEC INJ 0.0 000034.80 250
PHAR 000001754908 VASOTEC/PB 0.116 MG 000031.80 250
PHAR 000001754941 VASOTEC/PB 0.083 MG 000028.80 250
PHAR 000001754942 VASOTEC/PB 0.249 MG 000034.80 250
PHAR 000001754943 VASOTEC/PB 0.332 MG 000042.00 250
PHAR 000001754988 FUROSEMIDE PB 350 MG 000181.20 250
PHAR 000001754993 EPOGEN PB 200 U 000034.80 250
PHAR 000001754994 EPOGEN PB 300 U 000045.00 250
PHAR 000001754995 EPOGEN PB 400 U 000053.40 250
PHAR 000001754996 EPOGEN PB 500 U 000062.40 250
PHAR 000001754997 EPOGEN PB 600 U 000069.60 250
PHAR 000001755050 MITOMYCIN LVP 20 MG 001153.87 250
PHAR 000001755052 MITOMYCIN LVP 40 MG 002307.74 250
PHAR 000001755103 VINCRISTINE 5MG INJ 000581.62 250
PHAR 000001755114 DACARBAZINE 200MG INJ 000157.20 250
PHAR 000001755148 ETOPOSIDE INJ 20M 000142.80 250
PHAR 000001755157 MITHRACIN LVP 2.5 MG 000282.06 250
PHAR 000001755188 METHOTREX LVP 100 MG 000172.80 250
PHAR 000001755189 METHOTREX LVP 150 MG 000220.80 250
PHAR 000001755190 METHOTREX LVP 200 MG 000250.80 250
PHAR 000001755191 METHOTREX LVP 250 MG 000254.23 250
PHAR 000001755192 METHOTREX LVP 300 MG 000305.10 250
PHAR 000001755193 METHOTREX LVP 350 MG 000355.93 250
PHAR 000001755194 METHOTREX LVP 400 MG 000406.80 250
PHAR 000001755282 METHOTREX LVP 10 MG 000035.40 250
PHAR 000001755283 METHOTREX LVP 20 MG 000044.40 250
PHAR 000001755301 METHOTREX LVP 200 MG 000172.80 250
PHAR 000001755347 METHOTREX LVP 500 MG 000508.50 250
PHAR 000001755378 L-CARNITINE PB 5MG 000031.80 250
PHAR 000001755389 INTERFERON 9MU/LVP 000322.60 250
PHAR 000001755396 OFLOXACIN 400MG INJ 000038.40 250
PHAR 000001755401 SOTRADECOL 3% 2ML INJ 000103.20 250
PHAR 000001755427 PROPRANOLOL SPEC DIL 000034.80 259
PHAR 000001755461 METHOTREX/LVP 1 G 000256.80 250
PHAR 000001755462 METHOTREX/LVP 2 G 000442.37 250
PHAR 000001755463 METHOTREX/LVP 3 G 000619.32 250
PHAR 000001755464 METHOTREX/LVP 4 G 000766.78 250
PHAR 000001755465 METHOTREX/LVP 5 G 000903.17 250
9/7/2010 11:52 AM Page 95 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001755466 METHOTREX/LVP 6 G 001083.80 250
PHAR 000001755467 METHOTREX/LVP 7 G 001187.02 250
PHAR 000001755468 METHOTREX/LVP 8 G 001356.60 250
PHAR 000001755469 METHOTREX/LVP 9 G 001526.17 250
PHAR 000001755471 METHOTREX/LVP 11 G 001865.32 250
PHAR 000001755472 METHOTREX/LVP 12 G 002034.89 250
PHAR 000001755473 METHOTREX/LVP 13 G 002204.47 250
PHAR 000001755474 METHOTREX/LVP 14 G 002374.04 250
PHAR 000001755475 METHOTREX/LVP 15 G 002543.62 250
PHAR 000001755476 METHOTREX/LVP 16 G 002713.19 250
PHAR 000001755477 METHOTREX/LVP 17 G 002882.76 250
PHAR 000001755478 METHOTREX/LVP 18 G 003052.34 250
PHAR 000001755479 METHOTREX/LVP 19 G 003221.92 250
PHAR 000001755480 METHOTREX/LVP 20 G 003391.49 250
PHAR 000001755523 IDARUBICIN HCL 1MG INJ 000592.20 250
PHAR 000001755560 METHOTREX LVP 750 MG 000661.03 250
PHAR 000001755561 METHOTREX LV 1000 MG 000881.40 250
PHAR 000001755562 METHOTREX LV 1250 MG 001038.17 250
PHAR 000001755564 METHOTREX LV 1750 MG 001364.46 250
PHAR 000001755566 MITOMYCIN LVP 50 MG 002884.67 250
PHAR 000001755624 IOHEXOL-DILUENT 300MG IV 000042.00 250
PHAR 000001755637 ETOPOPHOS 100MG INJ 000381.41 250
PHAR 000001755638 ETOPOPHOS INJ/LVP 250MG 000834.33 250
PHAR 000001755681 DOCETAXEL INJ 10 000921.72 250
PHAR 000001755708 LANSOPRAZOLE INJ 6 M 000062.00 250
PHAR 000001755709 ERTAPENEM 1G/NS INJ 20M 000133.85 250
PHAR 000001756001 NEOSPORIN GU 1ML IRR 000074.40 250
PHAR 000001756002 NEOSPORIN GU/IR 1 ML 000055.20 250
PHAR 000001756003 NEOSPORIN GU/IR 2 ML 000093.60 250
PHAR 000001756004 NEOSPORIN GU/IR 3 ML 000122.40 250
PHAR 000001756005 NEOSPORIN GU/IR 4 ML 000146.40 250
PHAR 000001756008 POLYMYXIN B 500,000U IRR 000055.20 250
PHAR 000001756009 POLYMYXIN B/LVP 5000 000055.20 250
PHAR 000001756013 BACITRACIN 50,000U IRR 000102.00 250
PHAR 000001756014 BACITRAC IRR 25000 U IRR 000051.60 250
PHAR 000001756015 BACITRAC IRR 50000 U IRR 000084.00 250
PHAR 000001756017 BACITRAC IRR 100000 U IRR 000132.00 250
PHAR 000001756020 TALC(STERILE) 5GM POW 000036.00 250
PHAR 000001756503 EPOETIN ALFA 8000 U INJ 000345.60 250
PHAR 000001756504 EPOETIN 10,000 U INJ 000432.00 250
PHAR 000001756508 LEVOTHYROXINE 200MCG INJ 000057.60 250
PHAR 000001756511 LEVOTHYROXINE 100 MCG IV 000038.40 250
PHAR 000001756518 BUPIVACAINE POWDER 1MG PWD IV 000035.40 250
PHAR 000001756520 MYCOPHENOLATE MOFETIL INJ 33. 000165.60 250
PHAR 000001756522 CELLCEPT PB 250MG IV 000103.20 250
PHAR 000001756523 CELLCEPT INJ/PB 500MG 000165.60 250
PHAR 000001756524 CELLCEPT PB 750MG IV 000199.20 250
9/7/2010 11:52 AM Page 96 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001756525 CELLCEPT INJ/PB 1000MG 000235.20 250
PHAR 000001756526 CELLCEPT PB 1250MG IV 000258.00 250
PHAR 000001756527 CELLCEPT PB 1500MG IV 000288.58 250
PHAR 000001756530 KINEVAC/NS SPEC 0.1MCG/ML 000151.20 250
PHAR 000001756531 TETANUS TOX SKIN TEST SYR 0.1 000012.00 250
PHAR 000001756534 METHYLPRED/H2O INJ 6.25MG/ML 000028.80 250
PHAR 000001756535 METHYLPRED/H2O INJ 0.625MG/ML 000028.80 250
PHAR 000001756545 DEXAMETHASONE 0.04MG/ML INJ 000028.80 250
PHAR 000001756546 EPOETIN 10,000 U/1ML 000466.34 250
PHAR 000001756589 INFLUENZA VAC 0.5ML I INJ EA 000000.00 250
PHAR 000001757014 BRETYLIUM 500MG INJ 000051.60 250
PHAR 000001757015 BRETYLIUM LVP 500 MG IV 000055.20 250
PHAR 000001757018 BRETYLIUM LV 2000 MG IV 000142.80 250
PHAR 000001757030 ANTIVENIN/LVP 100ML 017388.00 250
PHAR 000001757049 EPINEPHRINE LVP 2 MG 000039.00 250
PHAR 000001757050 EPINEPHRINE LVP 3 MG 000048.00 250
PHAR 000001757051 EPINEPHRINE LVP 4 MG 000055.20 250
PHAR 000001757052 EPINEPHRINE LVP 5 MG 000067.20 250
PHAR 000001757053 EPINEPHRINE LVP 6 MG 000074.40 250
PHAR 000001757054 EPINEPHRINE LVP 7 MG 000093.60 250
PHAR 000001757055 EPINEPHRINE LVP 8 MG 000093.60 250
PHAR 000001757056 EPINEPHRINE LVP 9 MG 000102.00 250
PHAR 000001757057 EPINEPHRINE LVP 10MG 000112.80 250
PHAR 000001757059 CIDOFOVIR INJ 75M 002006.76 250
PHAR 000001757061 NICARDIPINE HCL INJ 2.5 000146.40 250
PHAR 000001757067 ROPIVACAINE 200MG INJ 000115.20 250
PHAR 000001757069 ROPIVACAINE 300MG IV 000142.80 250
PHAR 000001757070 ROPIVACAINE 400MG IV 000157.20 250
PHAR 000001757071 ROPIVACAINE 500MG IV 000189.60 250
PHAR 000001757075 INSULIN NOVOLIN REG SOL 100 000012.00 250
PHAR 000001757083 INS REG HUM LVP 80 U 000028.80 250
PHAR 000001757086 INS REG HUM LVP 150U 000039.00 250
PHAR 000001757088 INS REG HUM LVP 250U 000048.00 250
PHAR 000001757089 INS REG HUM LVP 300U 000055.20 250
PHAR 000001757091 INS REG HUM LVP 400U 000058.80 250
PHAR 000001757093 INS REG HUM LVP 500U 000074.40 250
PHAR 000001757097 KCL LVP 5 MEQ 000028.80 250
PHAR 000001757098 KCL LVP 10 MEQ 000028.80 250
PHAR 000001757099 KCL LVP 15 MEQ 000035.40 250
PHAR 000001757100 KCL LVP 20 MEQ 000039.00 250
PHAR 000001757101 KCL LVP 30 MEQ 000048.00 250
PHAR 000001757102 KCL LVP 40 MEQ 000055.20 250
PHAR 000001757103 KCL LVP 50 MEQ 000058.80 250
PHAR 000001757104 KCL LVP 60 MEQ 000074.40 250
PHAR 000001757105 KCL LVP 80 MEQ 000093.60 250
PHAR 000001757106 KCL LVP 100 MEQ 000102.00 250
PHAR 000001757107 KCL LVP 120 MEQ 000122.40 250
9/7/2010 11:52 AM Page 97 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001757110 CAL GLUC 10% (MG) INJ 100 000028.80 250
PHAR 000001757111 CA GLUC LVP 0.25 GM 000018.00 250
PHAR 000001757127 ISOPROTERENOL 1MG INJ 000122.40 250
PHAR 000001757128 ISUPREL LVP 0.5 MG 000074.40 250
PHAR 000001757129 ISUPREL LVP 1 MG 000122.40 250
PHAR 000001757130 ISUPREL LVP 1.5 MG 000168.00 250
PHAR 000001757131 ISUPREL LVP 2 MG 000201.60 250
PHAR 000001757132 ISUPREL LVP 2.5 MG 000217.20 250
PHAR 000001757133 ISUPREL LVP 3 MG 000237.60 250
PHAR 000001757134 ISUPREL LVP 3.5 MG 000253.20 250
PHAR 000001757135 ISUPREL LVP 4 MG 000257.90 250
PHAR 000001757136 ISUPREL LVP 4.5 MG 000290.16 250
PHAR 000001757139 ISUPREL LVP 6 MG 000386.89 250
PHAR 000001757141 ISUPREL LVP 7 MG 000451.37 250
PHAR 000001757143 ISUPREL LVP 8 MG 000515.84 250
PHAR 000001757144 ISUPREL LVP 8.5 MG 000511.56 250
PHAR 000001757145 ISUPREL LVP 9 MG 000541.63 250
PHAR 000001757146 ISUPREL LVP 10 MG 000601.85 250
PHAR 000001757147 AMINOCAPROIC ACID 5GM INJ 000058.80 250
PHAR 000001757148 AMICAR LVP 2.5 GM IV 000042.00 250
PHAR 000001757149 AMICAR LVP 5 GM IV 000058.80 250
PHAR 000001757150 AMICAR LVP 10 GM IV 000102.00 250
PHAR 000001757152 AMICAR LVP 20 GM IV 000168.00 250
PHAR 000001757153 AMICAR LVP 25 GM IV 000184.80 250
PHAR 000001757157 NOREPINEPHRINE BITART INJ 1MG 000093.60 250
PHAR 000001757158 LEVOPHED LVP 2 MG 000055.20 250
PHAR 000001757159 LEVOPHED LVP 4 MG 000093.60 250
PHAR 000001757160 LEVOPHED LVP 8 MG 000146.40 250
PHAR 000001757161 LEVOPHED LVP 12 MG 000184.80 250
PHAR 000001757162 LEVOPHED LVP 16 MG 000217.20 250
PHAR 000001757163 LEVOPHED LVP 20 MG 000237.60 250
PHAR 000001757164 MEPERIDINE 2000MG INJ 000160.80 250
PHAR 000001757165 MEPERIDINE LVP 10 MG 000019.20 250
PHAR 000001757166 MEPERIDINE LVP 25 MG 000019.20 250
PHAR 000001757171 MEPERIDINE LVP 250MG 000030.00 250
PHAR 000001757176 MEPERIDINE LVP 500MG 000049.20 250
PHAR 000001757188 DOBUTAMINE LVP 125MG 000168.00 250
PHAR 000001757190 DOBUTAMINE LVP 375MG 000274.14 250
PHAR 000001757191 DOBUTAMINE LVP 500MG 000365.54 250
PHAR 000001757192 DOBUTAMINE LVP 625MG 000456.91 250
PHAR 000001757193 DOBUTAMINE LVP 750MG 000511.76 250
PHAR 000001757194 DOBUTAMINE LVP 875MG 000597.04 250
PHAR 000001757195 DOBUTAMINE 1GM INJ 000633.61 250
PHAR 000001757196 DOBUTAMIN LVP 1.125G 000712.80 250
PHAR 000001757197 DOBUTAMINE 1.25GM INJ 000792.01 250
PHAR 000001757198 DOBUTAMIN LVP 1.375G 000871.20 250
PHAR 000001757199 DOBUTAMINE LVP 1.5GM 000895.58 250
9/7/2010 11:52 AM Page 98 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001757200 LIDOCAINE 2000MG INJ 000055.20 250
PHAR 000001757224 MAGNESIUM SULFATE INJ 0.5 000044.40 250
PHAR 000001757233 MANNITOL LVP 12.5 GM 000051.60 250
PHAR 000001757234 MANNITOL LVP 25 GM 000084.00 250
PHAR 000001757235 MANNITOL LVP 37.5 GM 000112.80 250
PHAR 000001757236 MANNITOL LVP 50 GM 000132.00 250
PHAR 000001757244 AMMONIUM CHL 100MEQ INJ 000051.60 250
PHAR 000001757246 AMM CHL LVP 100 MEQ IV 000051.60 250
PHAR 000001757251 ALBUMIN INJ 250MG/ML 000036.72 250
PHAR 000001757264 NITROGLYCERIN 50MG INJ 000032.40 250
PHAR 000001757265 NITROGLYC LVP 25 MG 000055.20 250
PHAR 000001757266 NITROGLYC LVP 50 MG 000093.60 250
PHAR 000001757267 NITROGLYC LVP 100 MG 000146.40 250
PHAR 000001757268 NITROGLYC LVP 150 MG 000184.80 250
PHAR 000001757269 NITROGLYC LVP 200 MG 000217.20 250
PHAR 000001757270 PENTOBARBITAL 1GM INJ 000100.80 250
PHAR 000001757271 NITROPRUSSIDE SODIUM INJ 25M 000000.00 250
PHAR 000001757273 PENTOBARB INJ 100MG 000021.60 250
PHAR 000001757274 PENTOBARB INJ 150MG 000024.60 250
PHAR 000001757275 PENTOBARB INJ 200MG 000027.60 250
PHAR 000001757276 PENTOBARB INJ 250MG 000033.60 250
PHAR 000001757277 PENTOBARB INJ 300MG 000036.00 250
PHAR 000001757278 PENTOBARB INJ 350MG 000043.20 250
PHAR 000001757279 PENTOBARB INJ 400MG 000043.20 250
PHAR 000001757280 PENTOBARB INJ 500MG 000055.20 250
PHAR 000001757281 PENTOBARB INJ 1GM 000100.80 250
PHAR 000001757282 PENTOBARB INJ 1.5GM 000145.20 250
PHAR 000001757283 PENTOBARB INJ 2GM 000177.60 250
PHAR 000001757284 PENTOBARB INJ 2.5GM 000194.40 250
PHAR 000001757294 VASOPRESSIN 20 U INJ 000067.20 250
PHAR 000001757295 VASOPRESSIN LVP 20 U 000067.20 250
PHAR 000001757296 VASOPRESSIN LVP 40 U 000112.80 250
PHAR 000001757297 VASOPRESSIN LVP 60 U 000146.40 250
PHAR 000001757298 VASOPRESSIN LVP 80 U 000168.00 250
PHAR 000001757299 VASOPRESSIN LVP 100U 000201.60 250
PHAR 000001757301 VASOPRESSIN LVP 140U 000237.60 250
PHAR 000001757302 VASOPRESSIN LVP 160U 000244.80 250
PHAR 000001757303 VASOPRESSIN LVP 180U 000260.40 250
PHAR 000001757304 VASOPRESSIN LVP 200U 000261.00 250
PHAR 000001757328 SODIUM BICARB 50MEQ INJ 000058.80 250
PHAR 000001757329 SODBICARB LVP 25 MEQ 000042.00 250
PHAR 000001757330 SODBICARB LVP 50MEQ 000058.80 250
PHAR 000001757331 SODBICARB LVP 100MEQ 000102.00 250
PHAR 000001757332 SODBICARB LVP 150MEQ 000132.00 250
PHAR 000001757333 SODBICARB LVP 200MEQ 000168.00 250
PHAR 000001757334 VIDARABINE 1000MG INJ 000244.80 250
PHAR 000001757350 TRACE ELEMENTS-PEDS IV 000008.40 250
9/7/2010 11:52 AM Page 99 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001757354 TRAC-EL-PREMIE IV 000008.40 250
PHAR 000001757365 SODIUM ACET 100MEQ INJ 000084.00 250
PHAR 000001757378 POTASSIUM PHOSPHATE INJ 3MM 000122.40 250
PHAR 000001757387 POTASSIUM PHOSPHATE INJ 4.4 000122.40 250
PHAR 000001757392 VASOPRESSIN LVP 1000 001065.76 250
PHAR 000001757396 ATGAM SKIN TEST 000090.00 250
PHAR 000001757409 HEPARIN LVP 50 U 000014.50 250
PHAR 000001757422 IMFERON LVP 50 MG 000122.40 250
PHAR 000001757423 IMFERON LVP 100 MG 000201.60 250
PHAR 000001757424 IMFERON LVP 150 MG 000237.60 250
PHAR 000001757425 IMFERON LVP 200 MG 000260.40 250
PHAR 000001757426 IMFERON LVP 250 MG 000339.74 250
PHAR 000001757427 IMFERON LVP 300 MG 000407.70 250
PHAR 000001757429 IMFERON LVP 400 MG 000507.36 250
PHAR 000001757431 IMFERON LVP 500 MG 000634.20 250
PHAR 000001757432 IMFERON LVP 750 MG 000877.50 250
PHAR 000001757433 IMFERON LVP 1000 MG 001090.01 250
PHAR 000001757435 K PHOS IN LVP 10 MM 000028.80 250
PHAR 000001757436 K PHOS IN LVP 16 MM 000032.40 250
PHAR 000001757437 K PHOS IN LVP 20 MM 000035.40 250
PHAR 000001757438 K PHOS IN LVP 30 MM 000042.00 250
PHAR 000001757439 K PHOS IN LVP 32 MM 000044.40 250
PHAR 000001757440 K PHOS IN LVP 40 MM 000048.00 250
PHAR 000001757441 K PHOS IN LVP 50 MM 000055.20 250
PHAR 000001757442 K PHOS IN LVP 60 MM 000058.80 250
PHAR 000001757447 K PHOS IN LVP 10 MEQ 000028.80 250
PHAR 000001757448 K PHOS IN LVP 20 MEQ 000032.40 250
PHAR 000001757449 K PHOS IN LVP 30 MEQ 000035.40 250
PHAR 000001757450 K PHOS IN LVP 40 MEQ 000042.00 250
PHAR 000001757451 K PHOS IN LVP 50 MEQ 000044.40 250
PHAR 000001757452 K PHOS IN LVP 60 MEQ 000051.60 250
PHAR 000001757459 CALCIUM CHL 1GM INJ 000028.80 250
PHAR 000001757460 CALCIUM CHL LVP 0.1G IV 000028.80 250
PHAR 000001757461 CALCIUM CHL LVP 0.2G IV 000028.80 250
PHAR 000001757462 CALCIUM CHL LVP 0.3G IV 000028.80 250
PHAR 000001757463 CALCIUM CHL LVP 0.4G IV 000028.80 250
PHAR 000001757464 CALCIUM CHL LVP 0.5G IV 000028.80 250
PHAR 000001757465 CALCIUM CH LVP 0.75G IV 000028.80 250
PHAR 000001757466 CALCIUM CHL LVP 1 G IV 000028.80 250
PHAR 000001757468 CALCIUM CHL LVP 2 G IV 000032.40 250
PHAR 000001757469 CALCIUM CHL LVP 2.5G IV 000032.40 250
PHAR 000001757470 CALCIUM CHL LVP 3 G IV 000035.40 250
PHAR 000001757471 PHENYLEPHRINE 10MG INJ 000067.20 250
PHAR 000001757473 PHENYLEPHRINE/LVP 10 000067.20 250
PHAR 000001757475 PHENYLEPHRINE/LVP 20 000112.80 250
PHAR 000001757477 PHENYLEPHRINE/LVP 30 000146.40 250
PHAR 000001757478 POTASSIUM ACETATE INJ 2ME 000074.40 250
9/7/2010 11:52 AM Page 100 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001757479 POT ACET LVP 10 MEQ 000028.80 250
PHAR 000001757480 POT ACET LVP 20 MEQ 000032.40 250
PHAR 000001757481 POT ACET LVP 30 MEQ 000035.40 250
PHAR 000001757482 POT ACET LVP 40 MEQ 000042.00 250
PHAR 000001757483 POT ACET LVP 60 MEQ 000051.60 250
PHAR 000001757484 POT ACET LVP 80 MEQ 000058.80 250
PHAR 000001757486 SODIUM CL-PRES FREE INJ 2.5 000039.00 250
PHAR 000001757487 SOD CHLOR LVP 5 MEQ 000028.80 250
PHAR 000001757488 SOD CHLOR LVP 10 MEQ 000028.80 250
PHAR 000001757489 SOD CHLOR LVP 20 MEQ 000028.80 250
PHAR 000001757490 SOD CHLOR LVP 30 MEQ 000032.40 250
PHAR 000001757491 SOD CHLOR LVP 40 MEQ 000035.40 250
PHAR 000001757492 SOD CHLOR LVP 50 MEQ 000039.00 250
PHAR 000001757493 SOD CHLOR LVP 60 MEQ 000042.00 250
PHAR 000001757494 SOD CHLOR LVP 70 MEQ 000044.40 250
PHAR 000001757495 SOD CHLOR LVP 80 MEQ 000048.00 250
PHAR 000001757496 SOD CHLOR LVP 90 MEQ 000051.60 250
PHAR 000001757497 SOD CHLOR LVP 100MEQ 000055.20 250
PHAR 000001757508 DDAVP/LVP 4 MCG IV 000112.80 250
PHAR 000001757509 DDAVP/LVP 8 MCG IV 000184.80 250
PHAR 000001757510 DDAVP/LVP 12 MCG IV 000237.60 250
PHAR 000001757515 SOLU-MEDROL 500 MG LVP 000146.40 250
PHAR 000001757523 DEFEROXAMINE 500MG INJ 000084.00 250
PHAR 000001757524 DESFERAL LVP 250 MG IV 000051.60 250
PHAR 000001757526 DESFERAL LVP 1 G IV 000132.00 250
PHAR 000001757527 DESFERAL LVP 1.5 G IV 000168.00 250
PHAR 000001757528 DESFERAL LVP 2 GM IV 000201.60 250
PHAR 000001757529 DESFERAL LVP 2.5 GM IV 000229.20 250
PHAR 000001757531 ALPROSTADIL IV SOL 500 000673.92 250
PHAR 000001757532 PROSTIN VR 250 MCG 000294.77 250
PHAR 000001757533 PROSTIN VR 500 MCG 000550.24 250
PHAR 000001757534 PROSTIN VR 750 MCG 000766.39 250
PHAR 000001757535 PROSTIN VR 1000 MCG 000962.90 250
PHAR 000001757536 PROSTIN VR 1250 MCG 001129.94 250
PHAR 000001757537 PROSTIN VR 1500 MCG 001355.93 250
PHAR 000001757538 CHROMIC CHL 40MCG INJ 000039.00 250
PHAR 000001757544 ZINC SULFATE 10MG INJ 000051.60 250
PHAR 000001757550 CUPRIC SULF 20MG INJ 000058.80 250
PHAR 000001757556 PHYTONADIONE 10MG INJ 000048.00 250
PHAR 000001757557 AQUA MEPH/LVP 2.5 MG IM 000028.80 250
PHAR 000001757558 AQUA MEPH/LVP 5 MG IM 000035.40 250
PHAR 000001757560 AQUA MEPH/LVP 10 MG IM 000048.00 250
PHAR 000001757563 EPINEPHRINE LVP 11MG 000112.80 250
PHAR 000001757565 EPINEPHRINE LVP 13MG 000132.00 250
PHAR 000001757566 EPINEPHRINE LVP 14MG 000146.40 250
PHAR 000001757567 EPINEPHRINE LVP 15MG 000146.40 250
PHAR 000001757568 EPINEPHRINE LVP 16MG 000146.40 250
9/7/2010 11:52 AM Page 101 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001757569 EPINEPHRINE LVP 17MG 000146.40 250
PHAR 000001757570 EPINEPHRINE LVP 18MG 000168.00 250
PHAR 000001757575 UROKINAS/LVP 500000U 002485.20 250
PHAR 000001757578 UROKINASE/LV 10000 U 000386.28 250
PHAR 000001757585 STREPTAS/LVP 1.5 MU 001307.75 250
PHAR 000001757588 VASOPRESSIN LVP 260U 000339.30 250
PHAR 000001757589 VASOPRESSIN LVP 280U 000365.40 250
PHAR 000001757590 VASOPRESSIN LVP 300U 000391.50 250
PHAR 000001757591 DESFERAL LVP 3 GM IV 000244.80 250
PHAR 000001757592 DESFERAL LVP 3.5 GM IV 000260.40 250
PHAR 000001757593 DESFERAL LVP 4 GM IV 000272.95 250
PHAR 000001757595 DESFERAL LVP 5 GM IV 000341.17 250
PHAR 000001757601 DEXAMETH/LVP 30 MG IV 000067.20 250
PHAR 000001757602 DEXAMETH/LVP 40 MG IV 000084.00 250
PHAR 000001757607 CORTROSYN/LVP 0.5MG IV 000146.40 250
PHAR 000001757610 DESFERAL LVP 6 GM IV 000409.43 250
PHAR 000001757612 ALBUMIN 25%/LVP 2.5G IV 000168.00 250
PHAR 000001757613 ALBUMIN 25%/LVP 5G IV 000228.00 250
PHAR 000001757614 ALBUMIN 25%/LVP 7.5G IV 000280.80 250
PHAR 000001757615 ALBUMIN 25%/LVP 10G IV 000374.40 250
PHAR 000001757616 ALBUMIN 25%/LVP 12.5 IV 000468.00 250
PHAR 000001757617 ALBUMIN 25%/LVP 15G IV 000524.16 250
PHAR 000001757624 DOBUTAMINE LVP 2 GM 001121.00 250
PHAR 000001757636 TOBRAMYC/LVP 100 MG 000084.00 250
PHAR 000001757637 TOBRAMYC/LVP 120 MG 000093.60 250
PHAR 000001757641 NALOXONE 0.4MG/ML 2ML INJ 000093.60 250
PHAR 000001757659 THIAMINE/LVP 25 MG 000028.80 250
PHAR 000001757660 THIAMINE/LVP 50 MG 000028.80 250
PHAR 000001757674 PHENYLEPHRINE/LVP 40 000168.00 250
PHAR 000001757676 PHENYLEPHRINE/LVP 50 000201.60 250
PHAR 000001757677 CIMETIDINE INJ 150 000042.00 250
PHAR 000001757678 CIMETIDINE/LVP 150MG INJ 000032.40 250
PHAR 000001757679 CIMETIDINE/LVP 300MG INJ 000042.00 250
PHAR 000001757680 CIMETIDINE/LVP 450MG INJ 000051.60 250
PHAR 000001757681 CIMETIDINE/LVP 600MG INJ 000058.80 250
PHAR 000001757682 SODIUM PHOSPHATES INJ 3MM 000039.00 250
PHAR 000001757683 SODIUM PHOSPHATES INJ 4 M 000039.00 250
PHAR 000001757684 SOD PHOS/LVP 20 MM 000028.80 250
PHAR 000001757685 SOD PHOS/LVP 30 MM 000032.40 250
PHAR 000001757686 SOD PHOS/LVP 40 MM 000035.40 250
PHAR 000001757687 SOD PHOS/LVP 50 MM 000039.00 250
PHAR 000001757688 SOD PHOS/LVP 60 MM 000044.40 250
PHAR 000001757689 SOD PHOS/LVP 70 MM 000048.00 250
PHAR 000001757695 METHYLDOPA LVP 500MG 000074.40 250
PHAR 000001757703 PHENYLEPHRINE/LVP 80 000244.80 250
PHAR 000001757707 PHENYLEPHRINE/LVP 10 000269.75 250
PHAR 000001757715 PHENYLEPHRINE/LVP 13 000377.64 250
9/7/2010 11:52 AM Page 102 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001757719 PHENYLEPHRINE/LVP 16 000431.60 250
PHAR 000001757726 VASOPRESSIN LVP 340U 000443.70 250
PHAR 000001757743 SODBICARB LVP 250MEQ 000184.80 250
PHAR 000001757744 FOLIC ACID 50MG INJ 000028.80 250
PHAR 000001757745 FOLIC ACID/LVP 1 MG 000028.80 250
PHAR 000001757746 FOLIC ACID/LVP 5 MG 000028.80 250
PHAR 000001757747 FOLIC ACID/LVP 10 MG 000028.80 250
PHAR 000001757766 DOXAPRAM 400MG INJ 000217.20 250
PHAR 000001757787 VERAPAMIL 5MG INJ 000039.00 250
PHAR 000001757789 VERAPAMIL/LVP 10 MG 000055.20 250
PHAR 000001757790 VERAPAMIL/LVP 15 MG 000067.20 250
PHAR 000001757791 VERAPAMIL/LVP 20 MG 000093.60 250
PHAR 000001757797 VERAPAMIL/LVP 50 MG 000168.00 250
PHAR 000001757799 VERAPAMIL/LVP 60 MG 000184.80 250
PHAR 000001757808 KCL 0.3 MEQ/ML D5W INJ 0.3 000055.20 250
PHAR 000001757810 SOD PHOS 2MG/ML D5W INJ 2MG 000039.00 250
PHAR 000001757811 POTASSIUM CHLORIDE INJ 2ME 000039.00 250
PHAR 000001757816 MAGNESIUM SULFATE INJ 4.0 000044.40 250
PHAR 000001757817 MAG SULF LVP 4 MEQ IV 000028.80 250
PHAR 000001757818 MAG SULF LVP 8 MEQ IV 000028.80 250
PHAR 000001757819 MAG SULF LVP 12 MEQ IV 000028.80 250
PHAR 000001757820 MAG SULF LVP 16 MEQ IV 000028.80 250
PHAR 000001757821 MAG SULF LVP 20 MEQ IV 000032.40 250
PHAR 000001757822 MAG SULF LVP 24 MEQ IV 000035.40 250
PHAR 000001757823 MAG SULF LVP 28 MEQ IV 000039.00 250
PHAR 000001757824 MAG SULF LVP 32 MEQ IV 000039.00 250
PHAR 000001757829 LABETALOL 100MG INJ 000184.80 250
PHAR 000001757830 LABETALOL LVP 100 MG 000184.80 250
PHAR 000001757831 LABETALOL LVP 200 MG 000253.20 250
PHAR 000001757832 LABETALOL LVP 300 MG 000333.50 250
PHAR 000001757833 INAMRINONE 100MG INJ 000258.20 250
PHAR 000001757834 AMRINONE LVP 100 MG IV 000244.80 250
PHAR 000001757835 AMRINONE LVP 200 MG IV 000417.20 250
PHAR 000001757836 AMRINONE LVP 300 MG IV 000584.06 250
PHAR 000001757837 AMRINONE LVP 400 MG IV 000723.16 250
PHAR 000001757838 AMRINONE LVP 500 MG IV 000903.96 250
PHAR 000001757847 SODBICARB LVP 300MEQ 000201.60 250
PHAR 000001757849 SODBICARB LVP 400MEQ 000237.60 250
PHAR 000001757851 SODBICARB LVP 500MEQ 000253.20 250
PHAR 000001757861 UROKINAS/LVP 750000U 003727.82 250
PHAR 000001757864 LEVOPHED LVP 24 MG 000260.40 250
PHAR 000001757865 LEVOPHED LVP 28 MG 000275.98 250
PHAR 000001757866 LEVOPHED LVP 32 MG 000315.40 250
PHAR 000001757876 MANNITOL LVP 62.5 GM 000146.40 250
PHAR 000001757879 MANNITOL LVP 100 GM 000201.60 250
PHAR 000001757881 SOLU-MEDROL 750 MG LVP 000184.80 250
PHAR 000001757885 SOLU-MEDROL 1250 MG LVP 000237.60 250
9/7/2010 11:52 AM Page 103 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001757890 SOLU-MEDROL 1875 MG LVP 000286.85 250
PHAR 000001757899 CALCIUM CHL 13.6MEQ INJ 000028.80 250
PHAR 000001757900 CA CHL/LVP 10MEQ IV 000028.80 250
PHAR 000001757902 CA CHL/LVP 30MEQ IV 000032.40 250
PHAR 000001757910 SOD CHLOR LVP 110MEQ 000055.20 250
PHAR 000001757914 SOD CHLOR LVP 130MEQ 000058.80 250
PHAR 000001757918 SOD CHLOR LVP 170MEQ 000074.40 250
PHAR 000001757919 SOD CHLOR LVP 180MEQ 000084.00 250
PHAR 000001757922 NITROPRUSSIDE 50MG INJ 000067.20 250
PHAR 000001757923 NITROPRUSS/LVP 50 MG 000067.20 250
PHAR 000001757924 NITROPRUSS/LVP 100MG 000112.80 250
PHAR 000001757925 NITROPRUSS/LVP 150MG 000146.40 250
PHAR 000001757926 NITROPRUSS/LVP 200MG 000184.80 250
PHAR 000001757927 NITROPRUSS/LVP 250MG 000201.60 250
PHAR 000001757931 HEPARIN SODIUM INJ INJ 100 000017.40 250
PHAR 000001757933 HEPARIN 25000 UNITS 000060.60 250
PHAR 000001757943 NITROPRUSS/LVP 500MG 000274.32 250
PHAR 000001757957 ASCORBIC ACID INJ 1GM 000039.00 250
PHAR 000001757958 ASCORBIC ACID 500MG LVP 000039.00 250
PHAR 000001757959 ASCORBIC ACID 1000MG LVP 000039.00 250
PHAR 000001757960 ASCORBIC ACID 2000MG LVP 000039.00 250
PHAR 000001757961 ASCORBIC ACID 3000MG LVP 000039.00 250
PHAR 000001757962 ASCORBIC ACID 4000MG LVP 000039.00 250
PHAR 000001757963 BRETYLIUM LV 2500 MG IV 000157.20 250
PHAR 000001757981 METHYLENE BLUE 10MG IV 000146.40 250
PHAR 000001757986 RANITIDINE HCL INJ 25M 000042.00 250
PHAR 000001757988 RANITIDINE/LVP 100MG 000058.80 250
PHAR 000001757997 CALCIUM GLUC 10%(MEQ) 0.46MEQ 000032.40 250
PHAR 000001757998 SELENIUM INJ/LVP 40MCG/ML 000039.00 250
PHAR 000001757999 TRICITRASOL INJ 200MG/ML 000058.80 250
PHAR 000001758002 LIDOCAINE/LVP 25 ML 000032.40 250
PHAR 000001758005 LIDOCAINE/LVP 25 ML 000035.40 250
PHAR 000001758023 MAG SULF LVP 40 MEQ IV 000044.40 250
PHAR 000001758034 LABETALOL LVP 400 MG 000444.67 250
PHAR 000001758035 LABETALOL LVP 500 MG 000518.78 250
PHAR 000001758038 LABETALOL LVP 800 MG 000770.76 250
PHAR 000001758039 PENTOBARB INJ 3GM 000222.00 250
PHAR 000001758040 PENTOBARB INJ 3.5GM 000231.60 250
PHAR 000001758041 PENTOBARB INJ 4GM 000252.00 250
PHAR 000001758045 IMFERON LVP 1500 MG 001562.86 250
PHAR 000001758062 VERAPAMIL/LVP 185 MG 000350.32 250
PHAR 000001758077 ANTIVENIN INJ 10ML 001738.80 250
PHAR 000001758092 DESFERAL LVP 8 GM IV 000509.51 250
PHAR 000001758098 DESFERAL LVP 11 GM IV 000650.52 250
PHAR 000001758100 DESFERAL LVP 12 GM IV 000709.68 250
PHAR 000001758107 RITODRINE 150MG INJ 000337.50 250
PHAR 000001758116 PANCURONIUM 10MG INJ 000112.80 250
9/7/2010 11:52 AM Page 104 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001758118 PAVULON/LVP 20 MG IV 000168.00 250
PHAR 000001758119 PAVULON/LVP 30 MG IV 000217.20 250
PHAR 000001758138 BUPIVACAINE 0.25% 30ML INJ 000067.20 250
PHAR 000001758156 HYDROMORPHON/LVP 8MG 000042.00 250
PHAR 000001758205 GAMMAGARD 10GM INJ 000536.98 250
PHAR 000001758206 GAMMAGARD/LVP 2.5 G 000536.98 250
PHAR 000001758207 GAMMAGARD/LVP 5 G 000930.76 250
PHAR 000001758208 GAMMAGARD/LVP 7.5 G 001235.04 250
PHAR 000001758209 GAMMAGARD/LVP 10 G 001646.72 250
PHAR 000001758211 GAMMAGARD/LVP 15 G 002470.09 250
PHAR 000001758213 GAMMAGARD/LVP 20 G 003293.45 250
PHAR 000001758230 DDAVP/LVP 16 MCG IV 000260.40 250
PHAR 000001758233 DDAVP/LVP 20 MCG IV 000306.00 250
PHAR 000001758234 DDAVP/LVP 24 MCG IV 000367.20 250
PHAR 000001758235 DDAVP/LVP 28 MCG IV 000428.40 250
PHAR 000001758249 UROKINASE/LV 25000 U 000836.94 250
PHAR 000001758250 UROKINASE/LV 30000 U 000946.39 250
PHAR 000001758290 ISUPREL LVP 12 MG 000670.61 250
PHAR 000001758294 ISUPREL LVP 16 MG 000894.16 250
PHAR 000001758316 LEVOPHED LVP 36 MG 000354.82 250
PHAR 000001758317 LEVOPHED LVP 40 MG 000394.27 250
PHAR 000001758357 METHOXAMINE/LVP 20 MG 000122.00 250
PHAR 000001758379 LABETALOL LVP 900 MG 000867.11 250
PHAR 000001758380 LABETALOL LVP 1 G 000907.87 250
PHAR 000001758385 LABETALOL LVP 1.5 G 001278.43 250
PHAR 000001758390 CALCIUM CHL LVP 4 GM IV 000042.00 250
PHAR 000001758434 SUFENTANIL 250MCG INJ 000222.00 250
PHAR 000001758439 EPINEPHRINE LVP 21MG 000184.80 250
PHAR 000001758443 EPINEPHRINE LVP 25MG 000201.60 250
PHAR 000001758445 EPINEPHRINE LVP 27MG 000201.60 250
PHAR 000001758448 EPINEPHRINE LVP 30MG 000217.20 250
PHAR 000001758449 CIMETIDINE/LVP 750MG INJ 000074.40 250
PHAR 000001758450 CIMETIDINE/LVP 900MG INJ 000084.00 250
PHAR 000001758451 CIMETIDINE/LVP 1050M INJ 000093.60 250
PHAR 000001758452 CIMETIDIE/LVP 1200MG INJ 000102.00 250
PHAR 000001758453 CIMETIDINE/LVP 1350M INJ 000112.80 250
PHAR 000001758455 MAG SULF/LVP 1 G 000028.80 250
PHAR 000001758456 MAG SULF/LVP 2 G 000028.80 250
PHAR 000001758457 MAG SULF/LVP 5 G 000032.40 250
PHAR 000001758458 MAG SULF/LVP 10 G 000044.40 250
PHAR 000001758459 MAG SULF/LVP 15 G 000055.20 250
PHAR 000001758460 MAG SULF/LVP 20 G 000067.20 250
PHAR 000001758461 MAG SULF/LVP 30 G 000093.60 250
PHAR 000001758462 MAG SULF/LVP 40 G 000112.80 250
PHAR 000001758463 MAG SULF/LVP 50 G 000132.00 250
PHAR 000001758466 MAG SULF/LVP 80 G 000184.80 250
PHAR 000001758468 MAG SULF/LVP 100 G 000201.60 250
9/7/2010 11:52 AM Page 105 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001758469 CA GLUC LVP 0.5 G IV 000028.80 250
PHAR 000001758470 CA GLUC LVP 1 G IV 000028.80 250
PHAR 000001758471 CA GLUC LVP 2 G IV 000028.80 250
PHAR 000001758472 CA GLUC LVP 3 G IV 000032.40 250
PHAR 000001758522 METOCLOPRAM/LVP 25 MG 000039.00 250
PHAR 000001758526 SOD ACET LVP 5 MEQ 000028.80 250
PHAR 000001758527 SOD ACET LVP 10 MEQ 000028.80 250
PHAR 000001758528 SOD ACET LVP 20 MEQ 000028.80 250
PHAR 000001758529 SOD ACET LVP 40 MEQ 000032.40 250
PHAR 000001758530 SOD ACET LVP 60 MEQ 000039.00 250
PHAR 000001758531 SOD ACET LVP 80 MEQ 000044.40 250
PHAR 000001758532 SOD ACET LVP 100 MEQ 000051.60 250
PHAR 000001758535 ESMOLOL HCL INJ 250 000237.60 250
PHAR 000001758546 VECURONIUM 10MG INJ 000146.40 250
PHAR 000001758547 NORCURON/LVP 10 MG 000146.40 250
PHAR 000001758548 NORCURON/LVP 20 MG 000217.20 250
PHAR 000001758549 NORCURON/LVP 30 MG 000260.40 250
PHAR 000001758550 NORCURON/LVP 40 MG 000321.41 250
PHAR 000001758551 NORCURON/LVP 50 MG 000401.76 250
PHAR 000001758552 NORCURON/LVP 60 MG 000482.11 250
PHAR 000001758553 NORCURON/LVP 70 MG 000524.96 250
PHAR 000001758583 NORCURON/LVP 80 MG 000599.96 250
PHAR 000001758585 NORCURON/LVP 100 MG 000696.38 250
PHAR 000001758611 HYDROCHLRIC ACD 0.1NN SOL 0.1 000012.00 250
PHAR 000001758619 THAM 3.6%(0.3 MOLAR) INJ 1ML 000481.51 250
PHAR 000001758620 THAM 3 MEQ/10 ML 000039.00 250
PHAR 000001758627 THAM 24 MEQ/80 ML 000146.40 250
PHAR 000001758669 CALCIUM CHL LVP 5 G IV 000044.40 250
PHAR 000001758684 ATRACURIUM 100MG INJ 000217.20 250
PHAR 000001758688 TRACRIUM/LVP 40 MG 000122.40 250
PHAR 000001758689 TRACRIUM/LVP 50 MG 000146.40 250
PHAR 000001758692 TRACRIUM/LVP 80 MG 000184.80 250
PHAR 000001758694 TRACRIUM/LVP 100 MG 000217.20 250
PHAR 000001758698 TRACRIUM/LVP 200 MG 000294.44 250
PHAR 000001758700 TRACRIUM/LVP 250 MG 000368.06 250
PHAR 000001758702 TRACRIUM/LVP 300 MG 000441.68 250
PHAR 000001758715 KETAMINE 200MG INJ 000084.00 250
PHAR 000001758716 KETAMINE LVP 10 MG 000028.80 250
PHAR 000001758717 KETAMINE LVP 20 MG 000028.80 250
PHAR 000001758718 KETAMINE LVP 30 MG 000028.80 250
PHAR 000001758719 KETAMINE LVP 40 MG 000032.40 250
PHAR 000001758720 KETAMINE LVP 50 MG 000035.40 250
PHAR 000001758724 KETAMINE LVP 90 MG 000048.00 250
PHAR 000001758725 KETAMINE LVP 100 MG 000051.60 250
PHAR 000001758727 KETAMINE LVP 150 MG 000067.20 250
PHAR 000001758729 KETAMINE LVP 200 MG 000084.00 250
PHAR 000001758731 KETAMINE LVP 250 MG 000102.00 250
9/7/2010 11:52 AM Page 106 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001758732 KETAMINE LVP 300 MG 000112.80 250
PHAR 000001758733 KETAMINE LVP 350 MG 000122.40 250
PHAR 000001758736 KETAMINE LVP 500 MG 000146.40 250
PHAR 000001758742 SOLU-MEDROL 3500 MG LVP 000535.46 250
PHAR 000001758752 DDAVP/LVP 32 MCG IV 000489.60 250
PHAR 000001758754 NORCURON/LVP 130 MG 000905.30 250
PHAR 000001758756 NORCURON/LVP 150 MG 000984.31 250
PHAR 000001758758 NORCURON/LVP 170 MG 001115.56 250
PHAR 000001758759 NORCURON/LVP 180 MG 001108.86 250
PHAR 000001758761 NORCURON/LVP 200 MG 001232.06 250
PHAR 000001758763 NORCURON/LVP 250 MG 001540.08 250
PHAR 000001758765 NORCURON/LVP 300 MG 001848.10 250
PHAR 000001758819 METHADONE LVP 50 MG 000042.00 250
PHAR 000001758820 METHADONE LVP 100 MG 000058.80 250
PHAR 000001758821 METHADONE LVP 150 MG 000084.00 250
PHAR 000001758823 METHADONE LVP 250 MG 000112.80 250
PHAR 000001758828 METHADONE LVP 500 MG 000184.80 250
PHAR 000001758842 BUPIVACN 0.125% FINL INJ 000067.20 250
PHAR 000001758849 BUPIVACN 0.25% FINAL INJ 000067.20 250
PHAR 000001758857 METHADONE LVP 20 MG 000028.80 250
PHAR 000001758858 METHADONE LVP 30 MG 000032.40 250
PHAR 000001758866 HEPARIN PF 5,000U INJ 000028.80 250
PHAR 000001758867 HEPARIN PF LVP 100 U 000028.80 250
PHAR 000001758868 HEPARIN PF LVP 250 U 000028.80 250
PHAR 000001758869 HEPARIN PF LVP 500 U 000028.80 250
PHAR 000001758871 HEPARIN PF LVP 5000 U 000028.80 250
PHAR 000001758872 HEPARIN PF LVP 10000 U 000035.40 250
PHAR 000001758899 NARCAN/LVP 0.4 MG 000055.20 250
PHAR 000001758900 NARCAN/LVP 0.8 MG 000093.60 250
PHAR 000001758902 NARCAN/LVP 1.6 MG 000146.40 250
PHAR 000001758909 BUPIVACAINE 0.5% 30ML INJ 000051.60 250
PHAR 000001758910 MARCAINE/LVP 15 ML 000035.40 250
PHAR 000001758911 MARCAINE/LVP 30 ML 000051.60 250
PHAR 000001758937 OCTREOTIDE 500MCG INJ 000201.60 250
PHAR 000001758938 OCTREOTIDE 0.1 MG INJ 000067.20 250
PHAR 000001758939 OCTREOTIDE 0.25 MG INJ 000122.40 250
PHAR 000001758940 OCTREOTIDE 0.5 MG INJ 000201.60 250
PHAR 000001758941 OCTREOTIDE 0.75 MG INJ 000237.60 250
PHAR 000001758943 OCTREOTIDE 1.25 MG INJ 000324.00 250
PHAR 000001758944 OCTREOTIDE 1.5 MG INJ 000388.80 250
PHAR 000001758947 DILAUDID HP 10 MG IV 000039.00 259
PHAR 000001758948 DILAUDID HP 20 MG IV 000055.20 250
PHAR 000001758949 DILAUDID HP 30 MG IV 000074.40 250
PHAR 000001758951 DILAUDID HP 50 MG IV 000112.80 250
PHAR 000001758952 DILAUDID HP 60 MG IV 000122.40 250
PHAR 000001758956 DILAUDID HP 100 MG IV 000168.00 250
PHAR 000001758959 DILAUDID HP 130 MG IV 000201.60 250
9/7/2010 11:52 AM Page 107 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001758961 DILAUDID HP 150 MG IV 000217.20 250
PHAR 000001758969 HYDROMORPH/LVP 200 M 000314.82 250
PHAR 000001758970 CALCIUM CHL LVP 7 GM IV 000055.20 250
PHAR 000001758971 CALCIUM CHL LVP 8 GM IV 000058.80 250
PHAR 000001758981 LABETALOL LVP 2 GM 001704.58 250
PHAR 000001758992 DILAUDID HP 200 MG IV 000244.80 250
PHAR 000001758997 DILAUDID HP 250 MG IV 000260.53 250
PHAR 000001758999 METHYLPRED 1000 MG IV 000168.00 250
PHAR 000001759013 TALC (STERILE) POW 5 G 000218.75 250
PHAR 000001759041 IVIG/NS/CARIMUNE 3% INJ 0.0 000244.80 250
PHAR 000001759066 IVIG/NS 6% INJ 0.0 000244.80 250
PHAR 000001759116 IMMUNE GLOB/PB 50 G 002610.00 250
PHAR 000001759118 IVIG/H2O/GAMMAR-P 5%M INJ 0.0 001562.50 250
PHAR 000001759119 IVIG/H2O/GAMMAR-P10%M INJ 0.1 001739.08 250
PHAR 000001759120 MAGNESIUM SULFATE 1G BAG 10M 000004.43 250
PHAR 000001759121 MAGNESIUM SULFATE 4G BAG 40M 000004.43 250
PHAR 000001759123 DOBUTAMINE 500MG BAG BAG 2MG 000076.53 250
PHAR 000001759212 IMMUNE GLOB/PB 44 G 004493.28 250
PHAR 000001759219 IVIG/NS/CARIMUNE 9% INJ 0.0 000244.80 250
PHAR 000001759223 IMMUNE GLOB/PB 4 G 000208.80 250
PHAR 000001759270 IVIG/H2O/CARIMUN 12% INJ 0.1 000244.80 250
PHAR 000001759321 METHYLPRED 2000 MG IV 000244.80 250
PHAR 000001759322 METHYLPRED 3000 MG IV 000324.00 250
PHAR 000001759323 METHYLPRED 4000 MG IV 000432.00 250
PHAR 000001759324 METHYLPRED 5000 MG IV 000540.00 250
PHAR 000001759325 METHYLPRED 6000 MG IV 000604.80 250
PHAR 000001759326 METHYLPRED 7000 MG IV 000655.20 250
PHAR 000001759327 METHYLPRED 8000 MG IV 000748.80 250
PHAR 000001759328 METHYLPRED 9000 MG IV 000842.40 250
PHAR 000001759329 METHYLPRED 10000 MG IV 000936.00 250
PHAR 000001759333 MORPH SULF 200 MG LVP 000078.00 250
PHAR 000001759337 MORPH SULF 400 MG LVP 000145.20 250
PHAR 000001759348 MORPH SULF 1000 MG LVP 000231.60 250
PHAR 000001759352 TRACRIUM/LVP 400 MG 000549.66 250
PHAR 000001759371 TERBUTALINE 1MG INJ 000028.80 259
PHAR 000001759372 TERBUTALINE 0.25 MG 000028.80 259
PHAR 000001759375 TERBUTALINE 1 MG 000028.80 259
PHAR 000001759376 TERBUTALINE 1.25 MG 000032.40 259
PHAR 000001759379 TERBUTALINE 2 MG 000039.00 250
PHAR 000001759383 TERBUTALINE 3 MG 000048.00 259
PHAR 000001759384 TERBUTALINE 3.25 MG 000051.60 250
PHAR 000001759385 TERBUTALINE 3.5 MG 000051.60 259
PHAR 000001759386 TERBUTALINE 3.75 MG 000055.20 259
PHAR 000001759387 TERBUTALINE 4 MG 000055.20 250
PHAR 000001759390 TERBUTALINE 4.75 MG 000058.80 259
PHAR 000001759391 TERBUTALINE 5 MG 000067.20 259
PHAR 000001759392 TERBUTALINE 6 MG 000074.40 259
9/7/2010 11:52 AM Page 108 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001759394 TERBUTALINE 8 MG 000093.60 259
PHAR 000001759395 TERBUTALINE 9 MG 000102.00 259
PHAR 000001759396 TERBUTALINE 10 MG 000112.80 259
PHAR 000001759397 TERBUTALINE 11 MG 000112.80 259
PHAR 000001759398 TERBUTALINE 12 MG 000122.40 259
PHAR 000001759399 TERBUTALINE 13 MG 000132.00 259
PHAR 000001759400 TERBUTALINE 14 MG 000132.00 259
PHAR 000001759401 TERBUTALINE 15 MG 000146.40 259
PHAR 000001759402 TERBUTALINE 16 MG 000146.40 250
PHAR 000001759404 TERBUTALINE 18 MG 000168.00 259
PHAR 000001759406 TERBUTALINE 20 MG 000168.00 259
PHAR 000001759407 DILTIAZEM 50MG INJ 000132.00 250
PHAR 000001759408 CARDIZEM INJ 5 MG 000035.40 250
PHAR 000001759409 CARDIZEM INJ 10 MG 000051.60 250
PHAR 000001759411 CARDIZEM INJ 20 MG 000084.00 250
PHAR 000001759412 CARDIZEM INJ 25 MG 000102.00 250
PHAR 000001759417 CARDIZEM INJ 50 MG 000146.40 250
PHAR 000001759427 CARDIZEM INJ 100 MG 000229.20 250
PHAR 000001759431 SOLU-MEDROL 10000 LVP 001172.98 250
PHAR 000001759442 CARDIZEM INJ 125 MG 000253.20 250
PHAR 000001759445 CARDIZEM INJ 200 MG 000359.42 250
PHAR 000001759447 CARDIZEM INJ 250 MG 000449.28 250
PHAR 000001759448 DOXYCYCLINE 100MG INJ 000132.00 250
PHAR 000001759449 DOXYCYCLINE 10 MG 000032.40 250
PHAR 000001759450 DOXYCYCLINE 20 MG 000044.40 250
PHAR 000001759451 DOXYCYCLINE 30 MG 000055.20 250
PHAR 000001759452 DOXYCYCLINE 40 MG 000067.20 250
PHAR 000001759453 DOXYCYCLINE 50 MG 000084.00 250
PHAR 000001759454 DOXYCYCLINE 60 MG 000093.60 250
PHAR 000001759456 DOXYCYCLINE 80 MG 000112.80 250
PHAR 000001759457 DOXYCYCLINE 90 MG 000122.40 250
PHAR 000001759458 DOXYCYCLINE 100 MG 000132.00 250
PHAR 000001759460 DOXYCYCLINE 150 MG 000168.00 250
PHAR 000001759462 DOXYCYCLINE 200 MG 000201.60 250
PHAR 000001759464 TRACRIUM/LVP 500 MG 000638.00 250
PHAR 000001759468 AREDIA/LVP 10 MG IV 000244.80 250
PHAR 000001759478 DOXYCYCLINE 300 MG 000244.80 250
PHAR 000001759479 DOXYCYCLINE 400 MG 000271.94 250
PHAR 000001759480 DOXYCYCLINE 500 MG 000339.95 250
PHAR 000001759481 VERSED/LVP 300 MG 001987.20 250
PHAR 000001759490 ALBUMIN 25%/LVP 20 G IV 000648.96 250
PHAR 000001759491 METHYLPRED 11000 MG IV 000970.20 250
PHAR 000001759496 KETAMINE LVP 1 GM 000229.20 250
PHAR 000001759497 KETAMINE LVP 1.5 GM 000261.90 250
PHAR 000001759502 EPINEPHRINE LVP 35 M 000237.60 250
PHAR 000001759504 EPINEPHRINE LVP 45MG 000260.40 250
PHAR 000001759505 EPINEPHRINE LVP 50MG 000260.28 250
9/7/2010 11:52 AM Page 109 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001759514 LEVOCARNITINE 1000MG INJ 000199.20 250
PHAR 000001759527 PRIMACOR LVP 1 MG 000055.20 250
PHAR 000001759528 PRIMACOR LVP 2 MG 000093.60 250
PHAR 000001759529 PRIMACOR LVP 3 MG 000122.40 250
PHAR 000001759530 PRIMACOR LVP 4 MG 000146.40 250
PHAR 000001759531 PRIMACOR LVP 5 MG 000168.00 250
PHAR 000001759532 PRIMACOR LVP 6 MG 000184.80 250
PHAR 000001759533 PRIMACOR LVP 7 MG 000217.20 250
PHAR 000001759539 PRIMACOR LVP 10 MG 000244.80 250
PHAR 000001759540 PRIMACOR LVP 12.5 MG 000260.14 250
PHAR 000001759541 PRIMACOR LVP 15 MG 000312.16 250
PHAR 000001759542 PRIMACOR LVP 17.5 MG 000364.21 250
PHAR 000001759543 PRIMACOR LVP 20 MG 000416.23 250
PHAR 000001759545 HYDROCORT/LVP 400 MG 000084.00 250
PHAR 000001759554 FENOLDOPAM MESYLATE INJ 10M 001275.12 250
PHAR 000001759555 FENOLDOPAM MESYLATE INJ 10M 000748.80 250
PHAR 000001759556 METHYLPRED 12000 MG IV 001058.40 250
PHAR 000001759557 METHYLPRED 13000 MG IV 001146.60 250
PHAR 000001759559 INS REG HUM 2500U 000217.20 250
PHAR 000001759561 INS REG HUM 1000 U 000122.40 250
PHAR 000001759562 INS REG HUM 1250 U 000146.40 250
PHAR 000001759585 LEVOCARNITINE 50 MG 000031.80 250
PHAR 000001759586 LEVOCARNITINE 100 MG 000045.00 250
PHAR 000001759587 LEVOCARNITINE 150 MG 000057.60 250
PHAR 000001759588 LEVOCARNITINE 200 MG 000069.60 250
PHAR 000001759607 BUPIVACN 0.0625% FNL INJ 000067.20 250
PHAR 000001759610 ISOLYTE S PH 7.4 000108.37 258
PHAR 000001759611 LEVOCARNITINE 300 MG 000093.60 250
PHAR 000001759612 LEVOCARNITINE 400 MG 000112.80 250
PHAR 000001759613 LEVOCARNITINE 500MG INJ 000124.80 250
PHAR 000001759614 LEVOCARNITIN 750 MG 000165.60 250
PHAR 000001759615 LEVOCARNITINE 1GM PB 000199.20 250
PHAR 000001759616 LEVOCARNITINE 1.5GM 000235.20 250
PHAR 000001759630 HEPARIN 1000U/ML 10ML INJ 000017.40 250
PHAR 000001759631 HEPARIN SODIUM INJ 100 000000.00 250
PHAR 000001759632 HEPARIN LVP 50 U 000017.40 250
PHAR 000001759635 HEPARIN LVP 250 U 000017.40 250
PHAR 000001759636 HEPARIN LVP 500 U 000017.40 250
PHAR 000001759638 HEPARIN LVP 5000 U 000028.80 250
PHAR 000001759639 HEPARIN LVP 10000 U 000028.80 250
PHAR 000001759640 HEPARIN LVP 15000 U 000060.60 250
PHAR 000001759641 HEPARIN LVP 20000 U 000060.60 250
PHAR 000001759642 HEPARIN LVP 25000 U 000060.60 250
PHAR 000001759643 HEPARIN LVP 50000 U 000075.00 250
PHAR 000001759674 PRIMACOR LVP 25 MG 000520.31 250
PHAR 000001759675 PRIMACOR LVP 30 MG 000582.72 250
PHAR 000001759676 PRIMACOR LVP 35 MG 000631.30 250
9/7/2010 11:52 AM Page 110 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001759677 PRIMACOR LVP 40 MG 000721.46 250
PHAR 000001759678 PRIMACOR LVP 45 MG 000811.67 250
PHAR 000001759679 PRIMACOR LVP 50 MG 000901.87 250
PHAR 000001759682 MS/HLVP 200 MG 000145.20 250
PHAR 000001759683 MS/HLVP 300 MG 000177.60 250
PHAR 000001759684 MS/HLVP 400 MG 000222.00 250
PHAR 000001759685 MS/HLVP 500 MG 000242.40 250
PHAR 000001759693 MS/HLVP 1300 MG 000529.99 250
PHAR 000001759694 TERBUTALINE 21 MG 000168.00 259
PHAR 000001759695 TERBUTALINE 22 MG 000184.80 250
PHAR 000001759697 TERBUTALINE 24 MG 000184.80 259
PHAR 000001759698 TERBUTALINE 25 MG 000201.60 259
PHAR 000001759699 CIMETIDINE/LVP 1800 INJ 000132.00 250
PHAR 000001759701 CIMETIDINE/LVP 2400M INJ 000168.00 250
PHAR 000001759736 SODIUM PHOSP 3700 INJ 93M 000039.00 250
PHAR 000001759741 POTASSIUM PHOSP 3700 INJ 93 000122.40 250
PHAR 000001759745 TRAC-EL-CHOLESTASIS INJ 1ML 000008.40 250
PHAR 000001759766 DEXTROSE 10% INJ 1ML 000045.60 250
PHAR 000001759767 DEXTROSE 12.5% INJ 1ML 000045.60 250
PHAR 000001759768 DEXTROSE 7.5% INJ 000045.60 250
PHAR 000001759769 DEXTROSE 15% INJ 1 M 000052.27 250
PHAR 000001759770 DEXTROSE 17.5% INJ 1 M 000045.60 250
PHAR 000001759771 DEXTROSE 20% INJ 1 M 000045.60 250
PHAR 000001759772 DEXTROSE 22.5% INJ 1 M 000045.60 250
PHAR 000001759773 DEXTROSE 25% INJ 1 M 000045.60 250
PHAR 000001759774 DEXTROSE 27.5% 1 ML INJ 000045.60 250
PHAR 000001759775 DEXTROSE 30% 1 ML INJ 000045.60 250
PHAR 000001759778 D10.2% NACL IV 000045.60 258
PHAR 000001759779 D10.3% NACL IV 000045.60 258
PHAR 000001759780 D10/0.45% NACL SOL 000038.00 258
PHAR 000001759781 D10/0.9% NACL SOL 000038.00 258
PHAR 000001759782 D10/0.11% NACL SOL 000038.00 258
PHAR 000001759783 GAMMAGARD 10GM INJ 000536.98 250
PHAR 000001759816 VENOGLOBULIN-S 10GM INJ 000522.00 250
PHAR 000001759845 METHYLPRED 40MG INJ 000028.80 250
PHAR 000001759846 METHYLPRED 40MG INJ 000028.80 250
PHAR 000001759851 DEXTROSE 2.5% INJ 1 M 000042.00 250
PHAR 000001759852 ISONIAZID 1000MG INJ 000103.20 250
PHAR 000001759861 ASCORBIC ACID 500MG LVP 000039.00 250
PHAR 000001759884 IVIG/H20/CARIMUNE 9% INJ 0.0 000244.80 250
PHAR 000001759885 IVIG/WATER 12% INJ 0.1 000244.80 250
PHAR 000001759903 DILTIAZEM HCL 300 MG IV 000449.28 250
PHAR 000001759907 DILTIAZEM HCL 500 MG IV 000648.00 250
PHAR 000001759932 DEXMEDETOMIDINE INJ 100 000137.50 250
PHAR 000001759954 EPOPROSTENOL INJ 1.5 000201.60 250
PHAR 000001759955 FLOLAN DILUENT 50ML 000146.40 250
PHAR 000001759971 IVIG/H20/CARIMUNE 6% INJ 0.0 000244.80 250
9/7/2010 11:52 AM Page 111 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001759972 BUPIVACN 0.01% FINAL CONC 000067.20 250
PHAR 000001759973 ROPIVACN 0.15% FINAL INJ 000067.20 250
PHAR 000001759975 INSULIN(R) SPE-NICU SOL 1U 000028.80 250
PHAR 000001759976 ITRACONAZOLE/NS INJ 3.3 000564.48 250
PHAR 000001759978 SOD THIOSULFATE 12.5GM/50ML 000146.40 250
PHAR 000001759979 NIMBEX INJ 200MG/20ML 000564.48 250
PHAR 000001759980 THIOPENTAL INJ 500MG 000100.80 250
PHAR 000001759983 CA CHLOR 10% 65ML 000028.80 250
PHAR 000001759986 CROTALIDAE ANTIVENIN INJ 1ML 002967.00 250
PHAR 000001759987 VASOPRESSIN SPEC DIL INJ 0.2 000028.80 250
PHAR 000001759989 ALLOPURINOL INJ 16. 001380.00 250
PHAR 000001759994 DROTRECOGIN ALFA INJ 2MG 000819.00 250
PHAR 000001760125 TROPHAMINE 10% 0.097GM/ML 000047.15 250
PHAR 000001760128 HEPATAMINE 8% IV 000048.38 258
PHAR 000001760168 CYSTEINE HCL 50MG IV 000017.40 250
PHAR 000001760186 NOVAMINE 15% INJ 0.1 000051.20 250
PHAR 000001760271 FREAMINE III 10% 50ML 000037.57 258
PHAR 000001760468 NEPHRAMINE 5.4% 50ML 000059.28 250
PHAR 000001760512 NEPHRAMINE 0.054GM/ML 50ML 000059.28 250
PHAR 000001760517 NEPHRAM/TPN 750 ML 000741.00 250
PHAR 000001760539 FREAMINE HBC 0.061GM/ML 000025.99 258
PHAR 000001760583 HEPATAMINE 8% 50ML 000048.38 258
PHAR 000001761079 INS(HUMALOG) TPN 100U/ML 000001.20 250
PHAR 000001763010 CALCIUM CHLOR10%(MEQ) 1.36MEQ 000001.20 250
PHAR 000001763011 CALC GLUC 10%(MEQ) 0.46MEQ/ML 000001.20 250
PHAR 000001763014 POTASSIUM PHOSPHATE 3MM IV 000001.20 250
PHAR 000001763015 MAGNESIUM SULFATE INJ 4.0 000001.20 250
PHAR 000001763016 SODIUM ACETATE SOL 2ME 000001.20 259
PHAR 000001763017 SODIUM CHLORIDE 2.5MEQ IV 000001.20 250
PHAR 000001763018 SODIUM PHOSPHATES INJ 3MM 000001.20 250
PHAR 000001763019 POTASSIUM ACETATE INJ 2ME 000001.20 250
PHAR 000001763020 A ELECTROLYTES IV 000006.00 250
PHAR 000001763025 POTASSIUM PHOSPHATE INJ 93 000001.20 250
PHAR 000001763026 SODIUM PHOSPHATE INJ 93M 000001.20 250
PHAR 000001763027 CALC CL 10%(MG) 100MG/ML 000001.20 250
PHAR 000001764001 CIMETIDINE 150MG INJ 000014.40 250
PHAR 000001764016 ALBUMIN INJ/TPN 0.25GM/ML 000036.72 250
PHAR 000001764017 RANITIDINE HCL INJ 25. 000015.00 250
PHAR 000001764049 FAMOTIDINE TPN INJ 10M 000018.00 250
PHAR 000001764074 INSULIN NOVO REGULAR SOL 100 000001.20 250
PHAR 000001764075 LEVOCARNITNE 200MG INJ 000039.84 250
PHAR 000001765001 MVI PEDS IV 000067.20 250
PHAR 000001765003 MVI-12 IV 000039.00 250
PHAR 000001765006 FOLIC ACID 5MG INJ 000001.20 250
PHAR 000001765008 ASCORBIC ACID TPN INGRED 000001.20 250
PHAR 000001765009 ZINC SULF 1MG/1ML TPN 000001.20 250
PHAR 000001765010 CHROMIC CHLORIDE INJ 4 M 000001.20 250
9/7/2010 11:52 AM Page 112 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001765011 ZINC CHL TPN 1ML 000001.20 250
PHAR 000001765012 IODIDE (SODIUM) 100 MCG IV 000001.20 250
PHAR 000001765013 SELENIUM 40MCG IV 000001.20 250
PHAR 000001765014 CUPRIC CL (COPPER) 400MCG/ML 000001.20 250
PHAR 000001765015 MANGANESE CL 0.1MG IV 000001.20 250
PHAR 000001765016 TRAC-EL-PED/NEONAT IV 000001.20 250
PHAR 000001765018 CERNEVIT 5ML INJ 000044.40 250
PHAR 000001765022 COPPER INJ/TPN 40MCG/ML 000001.20 250
PHAR 000001765023 TRAC-EL-TERM INJ 000001.20 250
PHAR 000001766044 LIPID 10%/TPN 000033.50 258
PHAR 000001766045 LIPID 10%/TPN 50 ML 000003.35 258
PHAR 000001766046 LIPID 10%/TPN 100 ML 000006.70 258
PHAR 000001766047 LIPID 10%/TPN 150 ML 000010.05 258
PHAR 000001766048 LIPID 10%/TPN 200 ML 000013.40 258
PHAR 000001766049 LIPID 10%/TPN 250 ML 000016.75 258
PHAR 000001766050 LIPID 10%/TPN 300 ML 000020.10 258
PHAR 000001766051 LIPID 10%/TPN 350 ML 000023.45 258
PHAR 000001766052 LIPID 10%/TPN 400 ML 000026.80 258
PHAR 000001766053 LIPID 10%/TPN 450 ML 000030.15 258
PHAR 000001766054 LIPID 10%/TPN 500 ML 000033.50 258
PHAR 000001766055 LIPID 10%/TPN 550 ML 000036.85 258
PHAR 000001766056 LIPID 10%/TPN 600 ML 000040.20 258
PHAR 000001766057 LIPID 10%/TPN 650 ML 000043.55 258
PHAR 000001766058 LIPID 10%/TPN 700 ML 000046.90 258
PHAR 000001766059 LIPID 10%/TPN 750 ML 000050.25 258
PHAR 000001766060 LIPID 10%/TPN 800 ML 000053.60 258
PHAR 000001766061 LIPID 10%/TPN 850 ML 000056.95 258
PHAR 000001766062 LIPID 10%/TPN 900 ML 000060.30 258
PHAR 000001766063 LIPID 10%/TPN 950 ML 000063.65 258
PHAR 000001766064 LIPID 10%/TPN 1L 000067.00 258
PHAR 000001766065 LIPID 10%/TPN 1.05L 000070.35 258
PHAR 000001766066 LIPID 10%/TPN 1.1L 000073.70 258
PHAR 000001766067 LIPID 10%/TPN 1.15L 000077.05 258
PHAR 000001766068 LIPID 10%/TPN 1.2L 000080.40 258
PHAR 000001766069 LIPID 10%/TPN 1.25L 000083.75 258
PHAR 000001766070 LIPID 10%/TPN 1.3L 000087.10 258
PHAR 000001766071 LIPID 10%/TPN 1.35L 000090.45 258
PHAR 000001766072 LIPID 10%/TPN 1.4L 000093.80 258
PHAR 000001766073 LIPID 10%/TPN 1.45L 000097.15 258
PHAR 000001766074 LIPID 10%/TPN 1.5L 000100.50 258
PHAR 000001766075 LIPID 10%/TPN 1.55L 000103.85 258
PHAR 000001766076 LIPID 10%/TPN 1.6L 000107.20 258
PHAR 000001766077 LIPID 10%/TPN 1.65L 000110.55 258
PHAR 000001766078 LIPID 10%/TPN 1.7L 000113.90 258
PHAR 000001766079 LIPID 10%/TPN 1.75L 000117.25 258
PHAR 000001766080 LIPID 10%/TPN 1.8L 000120.60 258
PHAR 000001766081 LIPID 10%/TPN 1.85L 000123.95 258
9/7/2010 11:52 AM Page 113 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001766082 LIPID 10%/TPN 1.9L 000127.30 258
PHAR 000001766083 LIPID 10%/TPN 1.95L 000130.65 258
PHAR 000001766084 LIPID 10%/TPN 2L 000134.00 258
PHAR 000001766085 INTRALIPID 20% EMU 000039.83 258
PHAR 000001766086 LIPID 20%/TPN 50 ML 000064.00 258
PHAR 000001766087 LIPID 20%/TPN 100 ML 000066.38 258
PHAR 000001766088 LIPID 20%/TPN 150 ML 000099.56 258
PHAR 000001766089 LIPID 20%/TPN 200 ML 000132.75 258
PHAR 000001766090 LIPID 20%/TPN 250 ML 000165.98 258
PHAR 000001766091 LIPID 20%/TPN 300 ML 000199.16 258
PHAR 000001766092 LIPID 20%/TPN 350 ML 000232.35 258
PHAR 000001766093 LIPID 20%/TPN 400 ML 000265.54 258
PHAR 000001766094 LIPID 20%/TPN 450 ML 000298.76 258
PHAR 000001766095 LIPID 20%/TPN 500 ML 000331.95 258
PHAR 000001766096 LIPID 20%/TPN 550 ML 000365.14 258
PHAR 000001766097 LIPID 20%/TPN 600 ML 000398.33 258
PHAR 000001766098 LIPID 20%/TPN 650 ML 000431.55 258
PHAR 000001766099 LIPID 20%/TPN 700 ML 000464.74 258
PHAR 000001766100 LIPID 20%/TPN 750 ML 000497.93 258
PHAR 000001766101 LIPID 20%/TPN 800 ML 000531.11 258
PHAR 000001766102 LIPID 20%/TPN 850 ML 000564.34 258
PHAR 000001766103 LIPID 20%/TPN 900 ML 000597.53 258
PHAR 000001766104 LIPID 20%/TPN 950 ML 000630.71 258
PHAR 000001766105 LIPID 20%/TPN 1L 000663.90 258
PHAR 000001766106 LIPID 20%/TPN 1.05L 000697.13 258
PHAR 000001766107 LIPID 20%/TPN 1.1L 000730.31 258
PHAR 000001766108 LIPID 20%/TPN 1.15L 000763.50 258
PHAR 000001766109 LIPID 20%/TPN 1.2L 000796.69 258
PHAR 000001766110 LIPID 20%/TPN 1.25L 000829.91 258
PHAR 000001766111 LIPID 20%/TPN 1.3L 000863.10 258
PHAR 000001766112 LIPID 20%/TPN 1.35L 000896.29 258
PHAR 000001766113 LIPID 20%/TPN 1.4L 000929.48 258
PHAR 000001766114 LIPID 20%/TPN 1.45L 000962.66 258
PHAR 000001766115 LIPID 20%/TPN 1.5L 000995.89 258
PHAR 000001766116 LIPID 20%/TPN 1.55L 001029.08 258
PHAR 000001766117 LIPID 20%/TPN 1.6L 001062.26 258
PHAR 000001766118 LIPID 20%/TPN 1.65L 001095.45 258
PHAR 000001766119 LIPID 20%/TPN 1.7L 001128.68 258
PHAR 000001766120 LIPID 20%/TPN 1.75L 001161.86 258
PHAR 000001766121 LIPID 20%/TPN 1.8L 001195.05 258
PHAR 000001766122 LIPID 20%/TPN 1.85L 001228.24 258
PHAR 000001766123 LIPID 20%/TPN 1.9L 001261.46 258
PHAR 000001766124 LIPID 20%/TPN 1.95L 001294.65 258
PHAR 000001766125 LIPID 20%/TPN 2L 001327.84 258
PHAR 000001766126 LIPOSYN 20%/TPN 000345.28 258
PHAR 000001766127 LIPOSYN 20/TPN 50ML 000064.00 258
PHAR 000001766128 LIPOSYN 20/TPN 100ML 000069.04 258
9/7/2010 11:52 AM Page 114 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001766129 LIPOSYN 20/TPN 150ML 000103.58 258
PHAR 000001766130 LIPOSYN 20/TPN 200ML 000138.11 258
PHAR 000001766131 LIPOSYN 20/TPN 250ML 000172.61 258
PHAR 000001766132 LIPOSYN 20/TPN 300ML 000207.15 258
PHAR 000001766133 LIPOSYN 20/TPN 350ML 000241.69 258
PHAR 000001766134 LIPOSYN 20/TPN 400ML 000276.23 258
PHAR 000001766135 LIPOSYN 20/TPN 450ML 000310.73 258
PHAR 000001766136 LIPOSYN 20/TPN 500ML 000345.26 258
PHAR 000001766137 LIPOSYN 20/TPN 550ML 000379.80 258
PHAR 000001766138 LIPOSYN 20/TPN 600ML 000414.34 258
PHAR 000001766139 LIPOSYN 20/TPN 650ML 000448.84 258
PHAR 000001766140 LIPOSYN 20/TPN 700ML 000483.38 258
PHAR 000001766141 LIPOSYN 20/TPN 750ML 000517.91 258
PHAR 000001766142 LIPOSYN 20/TPN 800ML 000552.45 258
PHAR 000001766143 LIPOSYN 20/TPN 850ML 000586.95 258
PHAR 000001766144 LIPOSYN 20/TPN 900ML 000621.49 258
PHAR 000001766145 LIPOSYN 20/TPN 950ML 000656.03 258
PHAR 000001766146 LIPOSYN 20/TPN 1L 000690.56 258
PHAR 000001766147 LIPOSYN 20/TPN 1.05L 000725.06 258
PHAR 000001766148 LIPOSYN 20/TPN 1.1L 000759.60 258
PHAR 000001766149 LIPOSYN 20/TPN 1.15L 000794.14 258
PHAR 000001766150 LIPOSYN 20/TPN 1.2L 000828.68 258
PHAR 000001766151 LIPOSYN 20/TPN 1.25L 000863.18 258
PHAR 000001766152 LIPOSYN 20/TPN 1.3L 000897.71 258
PHAR 000001766153 LIPOSYN 20/TPN 1.35L 000932.25 258
PHAR 000001766154 LIPOSYN 20/TPN 1.4L 000966.79 258
PHAR 000001766155 LIPOSYN 20/TPN 1.45L 001001.29 258
PHAR 000001766156 LIPOSYN 20/TPN 1.5L 001035.83 258
PHAR 000001766157 LIPOSYN 20/TPN 1.55L 001070.36 258
PHAR 000001766158 LIPOSYN 20/TPN 1.6L 001104.90 258
PHAR 000001766159 LIPOSYN 20/TPN 1.65L 001139.44 258
PHAR 000001766160 LIPOSYN 20/TPN 1.7L 001173.94 258
PHAR 000001766161 LIPOSYN 20/TPN 1.75L 001208.48 258
PHAR 000001766162 LIPOSYN 20/TPN 2L 001381.13 258
PHAR 000001766666 HICK/BROV REPAIR KIT 000160.00 272
PHAR 000001768002 DEXTROSE 70% SOL .7G 000000.00 250
PHAR 000001768005 CALCIUM GLUBIONATE SYR 1ML 000000.00 250
PHAR 000001768006 POLYCOSE POW 1TB 000000.00 259
PHAR 000001768007 PROMOD POW 1 G 000000.00 250
PHAR 000001768008 PROMOD POW 1TB 000000.00 250
PHAR 000001768009 SAFFLOWER OIL SOL 1ML 000000.00 250
PHAR 000001768010 SODIUM BICARBONATE(E) SOL 1ME 000000.00 250
PHAR 000001768012 LOPERAMIDE 0.2MG/ML 25ML 000006.00 250
PHAR 000001768014 MVI-12 INJ 1ML 000000.00 250
PHAR 000001768019 COTAZYM CAP 1CA 000000.00 250
PHAR 000001768020 SUCROSE (TABLE SUGAR) POW 1GM 000000.00 250
PHAR 000001768023 METAMUCIL POW 1GM 000000.00 259
9/7/2010 11:52 AM Page 115 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001768025 HUMAN MILK FORTIFIER POW 1PA 000000.00 250
PHAR 000001768026 MULTIVITAMINS LIQ 1ML 000000.00 259
PHAR 000001768027 KAOPECTATE SUS 1ML 000000.00 259
PHAR 000001768030 LOMOTIL 0.5MG/ML 5ML 000008.40 259
PHAR 000001768031 TRACE ELEMENTS-ADULT SOL 1ML 000000.00 250
PHAR 000001768032 MVI-PED INJ 1ML 000000.00 250
PHAR 000001768043 MCT OIL OIL 1ML 000000.00 250
PHAR 000001768050 BLUE FOOD COLOR 1ML LIQ 1ML 000000.00 250
PHAR 000001768051 FLAVOR PACK #1 PAC 1EA 000000.00 250
PHAR 000001768052 SOD CITRATE/CITRIC AC SOL 1ME 000000.00 250
PHAR 000001768053 FRUCTOSE PWD 1GM 000000.00 250
PHAR 000001768054 VIOKASE PWD 1GM 000000.00 250
PHAR 000001768056 PROSOBEE POW 000000.00 250
PHAR 000001768060 TOLEREX FEEDING PWD 1ML 000000.00 250
PHAR 000001768061 CITRIC ACID CRY 1GM 000000.00 259
PHAR 000001768062 PREGESTIMIL GRAMS POW 1GM 000000.00 250
PHAR 000001768063 FAMOTIDINE SUSP SUS 8MG 000012.00 259
PHAR 000001768064 FAMOTIDINE INJ INJ 10M 000012.00 250
PHAR 000001768065 BENEFIBER POW 56G 000000.00 259
PHAR 000001768066 BENEFIBER PACKET POW 4GM 000000.00 250
PHAR 000001769002 ISOMIL FE POW 1TB 000000.00 250
PHAR 000001769003 SIMILAC-24 W/IRON LIQ 1ML 000000.00 250
PHAR 000001769004 SIMILAC-24 W/IRON LIQ 1ML 000000.00 250
PHAR 000001769007 SIMILAC-20 W/IRON LIQ 1ML 000000.00 250
PHAR 000001769010 ENFAMIL LIQ 1ML 000000.00 250
PHAR 000001769011 SIMILAC LIQ 1CA 000000.00 250
PHAR 000001769013 SIMILAC PM 60/40 ENT LIQ 1CA 000000.00 250
PHAR 000001769014 PREGESTIMIL FEEDING POW 1ML 000000.00 250
PHAR 000001769015 PEDIALYTE SOL 1ML 000000.00 250
PHAR 000001769016 PRODUCT 3232A FEEDING POW 1TB 000000.00 250
PHAR 000001769018 PREGESTIMIL FEEDING POW 0.6 000000.00 250
PHAR 000001769028 DELIVER 2.0 LIQ 1ML 000000.00 250
PHAR 000001769034 ISOCAL LIQ 1ML 000000.00 250
PHAR 000001769038 PORTAGEN POW 1TB 000000.00 250
PHAR 000001769055 ENSURE LIQ 1ML 000000.00 250
PHAR 000001769057 ENSURE PLUS LIQ 1ML 000000.00 250
PHAR 000001769103 PROSOBEE LIQ 1ML 000000.00 250
PHAR 000001769109 METOCLOPRAMIDE HCL SYR 1MG 000008.40 259
PHAR 000001769113 NURSOY CON 1ML 000000.00 250
PHAR 000001769115 NURSOY CON 1CA 000000.00 250
PHAR 000001769116 RCF FORMULA LIQ 1ML 000000.00 250
PHAR 000001769118 PORTAGEN POW 1GM 000000.00 250
PHAR 000001769120 ENFAMIL W/IRON LIQ 1ML 000000.00 250
PHAR 000001769121 MODUCAL POW 1TB 000000.00 259
PHAR 000001769122 NUTRAMIGEN FEEDING POW 1TB 000000.00 250
PHAR 000001769126 SMA FORMULA CON 1CA 000000.00 250
PHAR 000001769134 PROSOBEE LIQ 1CA 000000.00 250
9/7/2010 11:52 AM Page 116 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001769149 ISOMIL FE POW 1CA 000000.00 250
PHAR 000001769151 SMA CON 1ML 000000.00 250
PHAR 000001769172 PEDIASURE LIQ 1ML 000000.00 250
PHAR 000001769174 ENFAMIL W/IRON LIQ 1CA 000000.00 250
PHAR 000001769180 SIMILAC-20 W/IRON LIQ 1CA 000000.00 250
PHAR 000001769182 SIMILAC-24 W/IRON LIQ 1CA 000000.00 250
PHAR 000001769184 ULTRACAL FEEDING LIQ 1ML 000000.00 250
PHAR 000001769188 SUPLENA LIQ 1ML 000000.00 250
PHAR 000001769189 SUPLENA LIQ 1ML 000000.00 250
PHAR 000001769198 ALIMENTUM LIQ 1ML 000000.00 259
PHAR 000001769200 IMMUN-AID PKT 1ML 000000.00 250
PHAR 000001769250 FERROUS SULFATE ELI 1ML 000000.00 259
PHAR 000001769251 INOSITOL POW 1ML 000000.00 250
PHAR 000001769252 INOSITOL POW 1GM 000000.00 250
PHAR 000001769253 PRODUCT 80056 POW 1TB 000000.00 250
PHAR 000001769261 COMPLY LIQ 1ML 000000.00 250
PHAR 000001769264 ENSURE/FIBER LIQ 1ML 000000.00 250
PHAR 000001769268 REPLETE LIQ 1ML 000000.00 250
PHAR 000001769270 LIPISORB LIQ 1ML 000000.00 258
PHAR 000001769271 ISOCAL HN LIQ 1ML 000000.00 250
PHAR 000001769272 NUTRIHEP LIQ 1ML 000000.00 250
PHAR 000001769274 CRUCIAL FEEDING LIQ 1ML 000000.00 250
PHAR 000001769275 GLYTROL /FEEDING LIQ 1ML 000000.00 250
PHAR 000001769277 KINDERCAL FEEDING LIQ 1ML 000000.00 250
PHAR 000001769278 VIVONEX PEDIATRIC POW 1ML 000000.00 250
PHAR 000001769280 SANDOSOURCE PEPTIDE LIQ 1ML 000000.00 250
PHAR 000001769281 MICROLIPID LIQ 1ML 000000.00 259
PHAR 000001769283 BOOST LIQ 1ML 000000.00 250
PHAR 000001769284 CHOICE DM LIQ 1ML 000000.00 250
PHAR 000001769285 BOOST PLUS LIQ 1ML 000000.00 250
PHAR 000001769286 TRAUMACAL LIQ 1ML 000000.00 250
PHAR 000001769287 NEOCATE FEEDING PWD 1ML 000000.00 250
PHAR 000001769289 ISOCAL HN PLUS LIQ 1ML 000000.00 250
PHAR 000001769290 ULTRACAL HN PLUS LIQ 1ML 000000.00 250
PHAR 000001770001 ACETIC ACID 0.25% IRR 000086.75 250
PHAR 000001771001 ROE'S SOLUTION 1000ML 000103.87 250
PHAR 000001771002 DEXTRAN 70/NS 500ML 000353.69 250
PHAR 000001771003 D5W 50ML 000052.27 258
PHAR 000001771004 D5W INJ 1ML 000052.27 258
PHAR 000001771005 D10W 1000ML 000057.30 258
PHAR 000001771009 D5W 250ML 000052.27 258
PHAR 000001771010 D10W 500ML 000052.27 258
PHAR 000001771011 D5W 100 ML 000052.80 258
PHAR 000001771012 D10W 250ML 000052.27 258
PHAR 000001771014 D10.9% NACL 1000ML 000067.92 258
PHAR 000001771015 D5.9% NACL 1000ML 000052.27 258
PHAR 000001771016 D10.45% NACL 1000ML 000078.99 258
9/7/2010 11:52 AM Page 117 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001771018 D30 500 ML 000093.29 258
PHAR 000001771019 D5.9% NACL 250ML 000052.27 258
PHAR 000001771020 D50 500 ML 000123.42 258
PHAR 000001771021 D5.45% NACL 1000ML 000052.27 258
PHAR 000001771022 DEXTROSE 50% INJ 50% 000123.78 250
PHAR 000001771023 D5.45% NACL 500ML 000052.27 258
PHAR 000001771024 D60 1000 ML 000098.43 258
PHAR 000001771025 D60 500 ML 000113.44 258
PHAR 000001771026 DEXTROSE 70% 1000 ML 000045.60 258
PHAR 000001771027 DEXTROSE % 1000ML 000052.27 258
PHAR 000001771028 EMPTY 1 LITER EVAC 000021.07 250
PHAR 000001771029 LIPID 10% 50 ML 000033.00 258
PHAR 000001771033 HEPATAMINE 8% 500 ML 000433.00 258
PHAR 000001771035 ISOLYTE S 1000ML 000052.27 258
PHAR 000001771036 ISOLYTE G/D5 1000 ML 000049.52 258
PHAR 000001771038 D5.45% NACL 250ML 000052.27 258
PHAR 000001771039 ISOLYTE M/D5 1000 ML 000041.00 258
PHAR 000001771040 D5.3% NACL 1000ML 000052.27 258
PHAR 000001771041 ISOLYTE P/D5 500 ML 000041.00 258
PHAR 000001771042 D5.3% NACL 250ML 000052.27 258
PHAR 000001771043 ISOLYTE P/D5 250 ML 000046.28 258
PHAR 000001771044 D5.2% NACL 1000ML 000052.27 258
PHAR 000001771046 PD 1.5% 1000ML 000047.47 250
PHAR 000001771048 D5.2% NACL 500ML 000052.27 258
PHAR 000001771050 D5.2% NACL 250ML 000052.27 258
PHAR 000001771051 MANNITOL 20% 500ML 000247.31 250
PHAR 000001771052 EMPTY 2 LITER EVAC 000021.07 250
PHAR 000001771053 MANNITOL 20% 250 ML 000183.94 258
PHAR 000001771054 D5/LR 1000ML 000061.56 258
PHAR 000001771055 D5/LR 500ML 000052.27 258
PHAR 000001771056 EMPTY 500ML EVAC 000021.07 250
PHAR 000001771057 D5.45 NACL 20MEQ KCL 1000ML 000074.51 250
PHAR 000001771058 COMBINATION SOL 000069.60 259
PHAR 000001771059 D5.45 NACL 30MEQ KCL 1000ML 000082.27 250
PHAR 000001771061 D5.45 NACL 40MEQ KCL 1000ML 000090.67 250
PHAR 000001771064 COMBINATION SOL 000045.60 259
PHAR 000001771066 NACL 0.45%-PRES FREE INJ 1ML 000052.27 258
PHAR 000001771067 NACL 0.45% 500ML 000052.27 258
PHAR 000001771069 NACL 0.9% INJ 1ML 000052.27 250
PHAR 000001771070 NACL 0.9% INJ 1ML 000052.27 250
PHAR 000001771071 SODIUM CL PRES FREE SOL 0.9 000045.60 250
PHAR 000001771072 NACL 0.9% INJ 1ML 000052.27 250
PHAR 000001771073 NACL 0.9% INJ 1ML 000052.27 250
PHAR 000001771075 NACL 0.9% IRRIG INJ 1ML 000000.00 250
PHAR 000001771076 PD 1.5% 1500ML 000047.47 250
PHAR 000001771078 NACL 3% INJ 1ML 000052.27 250
PHAR 000001771079 NACL 5% INJ 1ML 000052.27 250
9/7/2010 11:52 AM Page 118 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001771080 SORBITOL 3.3% IRR 4000 ML 000103.80 250
PHAR 000001771081 WATER,STERILE 1000ML 000052.27 250
PHAR 000001771082 WATER,STERILE INJ 1ML 000045.60 250
PHAR 000001771083 WATER,STERILE 250ML 000052.27 250
PHAR 000001771084 WATER, IRRIG INJ 1ML 000000.00 250
PHAR 000001771085 WATER, IRRIG INJ 1ML 000000.00 250
PHAR 000001771086 WATER, IRRIG INJ 1ML 000000.00 250
PHAR 000001771088 D5.3% NACL 500ML 000052.27 258
PHAR 000001771089 HETASTARCH 6% 500ML 000290.64 250
PHAR 000001771090 D5.11% NACL 500ML 000052.27 258
PHAR 000001771094 HYSKON 32% 100ML SOL 000118.84 250
PHAR 000001771095 ARGININE HCL 300ML 000440.17 250
PHAR 000001771098 LIPID 10% 50 ML 000033.00 258
PHAR 000001771099 LIPID 20% 50 ML 000040.00 258
PHAR 000001771100 DEXTRAN 70/D5W 500ML 000353.70 250
PHAR 000001771142 NACL 0.9% IRRIG INJ 1ML 000000.00 250
PHAR 000001771144 NACL 0.9% -PRES FREE INJ 1ML 000052.27 250
PHAR 000001771145 NACL 0.9% IRRIG INJ 1ML 000000.00 250
PHAR 000001771146 DEXTROSE 5% (BTL) 250ML 000052.27 258
PHAR 000001771147 PD 1.5% 2000ML 000049.87 250
PHAR 000001771148 PD 2.5% 500ML 000049.87 250
PHAR 000001771149 PD 2.5% 1000ML 000049.87 250
PHAR 000001771150 PD 1.5% 500ML 000049.87 250
PHAR 000001771151 PD 2.5% 1500ML 000049.87 250
PHAR 000001771153 PD 2.5% 2000ML 000049.87 250
PHAR 000001771155 PD 4.25% 500ML 000049.87 250
PHAR 000001771156 PD 4.25% 1000ML 000049.87 250
PHAR 000001771157 PD 4.25% 1500ML 000049.87 250
PHAR 000001771158 PD 4.25% 2000ML 000049.87 250
PHAR 000001771162 LIPOSYN 20% 100 ML 000047.00 258
PHAR 000001771163 LIPOSYN 20% 150 ML 000047.00 258
PHAR 000001771164 LIPOSYN 20% 200 ML 000051.84 258
PHAR 000001771165 LIPOSYN 20% 250 ML 000064.80 258
PHAR 000001771167 NACL 0.9% -PRES FREE INJ 1ML 000052.27 250
PHAR 000001771168 LIDOCAINE 2GM/D5 250ML 000102.05 250
PHAR 000001771169 HEPARIN 1000/0.9 NACL 500ML 000061.87 250
PHAR 000001771170 LIPOSYN 20% 500 ML 000313.06 258
PHAR 000001771171 DEXTROSE 5% 50ML 000070.03 258
PHAR 000001771172 DEXTROSE 5% 100ML 000052.27 258
PHAR 000001771175 LIPID 20% 50 ML 000049.00 258
PHAR 000001771176 LIPID 20% 25 ML 000037.00 258
PHAR 000001771177 FEEDING BAG #1 MIS 1 000000.00 271
PHAR 000001771178 LR LUER LOCK SYR 12 ML 000018.00 250
PHAR 000001771180 ANTICOAG CIT/DEXT 500ML 000102.59 250
PHAR 000001771181 HEPARIN 25,000 U/D5W 250ML 000097.87 250
PHAR 000001771183 TROMETHAMINE 3.6% 500ML 000552.38 250
PHAR 000001771185 NORMOSOL-R 1000ML 000052.27 258
9/7/2010 11:52 AM Page 119 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001771186 ALCOHOL 5%/ D5W 1000ML 000074.23 250
PHAR 000001771190 INTRALIPID 20% 100ML 000063.07 258
PHAR 000001771192 ROE'S SOLUTION 250 ML 000072.00 250
PHAR 000001771193 INTRALIPID 20% 500ML 000367.85 258
PHAR 000001771195 PD 2.5% LO-CALCIUM 2000ML 000049.87 250
PHAR 000001771196 PD 1.5% LO-CALCIUM 2000ML 000049.87 250
PHAR 000001771197 ANTICOAG SOD CIT 4% 250ML 000047.47 250
PHAR 000001771198 FREME'S SOLN 1000 ML 000496.00 258
PHAR 000001771199 LR 3000 ML 000058.26 258
PHAR 000001771200 LIPOSYN 20% 50 ML 000047.00 258
PHAR 000001771203 EMPTY 3 LITER BAG 000013.87 250
PHAR 000001771204 DEXTRAN HM 100 ML 000142.50 250
PHAR 000001771207 NACL 0.9% IRR-TRAVEN INJ 1ML 000000.00 250
PHAR 000001771208 ALUM, AMMONIUM POW 1GM 000012.00 259
PHAR 000001771209 INTRALIPID 20% 75ML 000065.17 258
PHAR 000001771210 ISOLYTE S PH 7.4 1000ML 000108.37 258
PHAR 000001771212 LACTATED RINGERS IRRG 2000 ML 000108.50 250
PHAR 000001771213 WATER, IRRIG INJ 1ML 000000.00 250
PHAR 000001771217 INTRALIPID 20% 250ML 000156.67 258
PHAR 000001771219 INTRALIPID 20% 30ML 000057.07 258
PHAR 000001771220 INTRALIPID 20% 55ML 000065.17 258
PHAR 000001771223 D5/.45 W/30K 1L 000054.61 250
PHAR 000001771224 NITROGLYCERIN 0.2MG/ML 250ML 000138.67 250
PHAR 000001771225 ANTI COAG CIT/DEX-A 750ML 000055.87 250
PHAR 000001771227 PD 1.5% 3000ML 000049.87 250
PHAR 000001771228 PD 2.5% 3000ML 000049.87 250
PHAR 000001771229 PD 4.25% 3000ML 000049.87 250
PHAR 000001771230 NACL 0.9% IRRIG INJ 1ML 000000.00 250
PHAR 000001771231 MAG SULF 40GM/H2O 1L 000052.27 250
PHAR 000001771232 KCL 10 MEQ/50ML H2O 000052.27 250
PHAR 000001771233 KCL 20 MEQ/100ML H2O 000052.27 250
PHAR 000001771235 KCL 20 MEQ/50ML H2O 000052.27 250
PHAR 000001771236 KCL 40 MEQ/100ML H2O 000052.27 250
PHAR 000001771237 NACL 0.9%/20MEQ KCL INJ 1ML 000052.27 250
PHAR 000001771238 D5.2% NACL 20MEQ KCL 1000ML 000052.27 250
PHAR 000001771239 D5.3% NACL 20MEQ KCL INJ 1ML 000052.27 250
PHAR 000001771240 ANTI COAG CIT/DEX-A 500ML 000055.87 250
PHAR 000001771241 ANTI COAG CIT BLD-PK INJ 1ML 000055.87 250
PHAR 000001771242 NACL 0.9% INJ 1ML 000000.00 258
PHAR 000001771243 PD 1.5% LO-CALCIUM 5000ML 000057.07 250
PHAR 000001771244 PD 2.5% LO-CALCIUM 5000ML 000057.07 250
PHAR 000001771245 ANTI COAG CIT/DEX-A 1000ML 000055.87 250
PHAR 000001771246 NACL 0.2% INJ 1ML 000052.27 250
PHAR 000001771247 NACL 0.2% INJ 1ML 000052.27 250
PHAR 000001771248 NACL 1.5% INJ 1ML 000052.27 250
PHAR 000001771249 SILVER NIT 0.5% SOL 960ML 000055.87 250
PHAR 000001771250 PD BAXTER PREMIXED SOL 1ML 000141.07 250
9/7/2010 11:52 AM Page 120 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001771251 PD 1.5% 2500ML 000052.27 250
PHAR 000001771252 PD 2.5% 2500ML 000052.27 250
PHAR 000001771253 PD 4.25% 2500ML 000052.27 250
PHAR 000001771254 MEDIUM 199 LIQUID IV ML 000100.00 250
PHAR 000001771255 DOPAMINE 800/D5W INJ 1ML 000121.11 250
PHAR 000001772005 PHENAPHTHAZINE 1 KIT 000040.15 259
PHAR 000001772009 AMYL NITRITE 0.3ML INH 000011.96 259
PHAR 000001772013 DEXTROSTIX 000003.08 250
PHAR 000001772021 ETHYL CL TOP SPR 120ML 000018.04 250
PHAR 000001772036 AMMONIA AMPULES 1AMP INH 000008.78 250
PHAR 000001772037 BENZOIN COMPOUND 60ML TIN 000007.25 250
PHAR 000001772038 BENZOIN TINCTURE 60ML TOP 000007.07 250
PHAR 000001772040 HYDROGEN PEROXIDE 3% 000001.67 250
PHAR 000001772047 CHEMSTRIP UGK #100 1STRP (PROD 000000.00 250
PHAR 000001772051 AMMONIA AMPULES 1'S 1AMP INH 000001.84 250
PHAR 000001772052 SILVER NITRATE STK TOP 000015.85 250
PHAR 000001772053 SILVER NITRATE STK TOP 000002.66 250
PHAR 000001772054 SILVER NITRATE STK 1EA 000001.34 250
PHAR 000001772055 SPACE SUIT #1 PO 000018.00 259
PHAR 000001772064 DAKIN'S SOL 1ML 000038.40 250
PHAR 000001772066 CLEFT LIP/PALATE NRSR 000004.62 250
PHAR 000001772067 CHEMSTRIP BG UD 1 STRIP (PROD) 000000.00 250
PHAR 000001772070 DEXTROSE GEL TUBE 40% ELI 000006.56 250
PHAR 000001772074 CHEMSTRIP 6 BOTTLE 1 BOT(PROD) 000000.00 250
PHAR 000001772076 CHEMSTRIP 9 BOTTLE 1 BOT(PROD) 000000.00 250
PHAR 000001772081 CHEMSTRIP-10 BOTTLE 1 BOT(PROD 000000.00 250
PHAR 000001772082 CHEMSTRIP 6 BOTTLE, 1 BOT(PROD 000000.00 250
PHAR 000001772086 HYDROGEN PEROX 16OZ 3% TOP 000002.35 250
PHAR 000001772088 ANTIBIOTIC TRANS IRR INJ 000459.00 250
PHAR 000001772089 VIASPAN SOLN WITHOUT INJ 000780.00 259
PHAR 000001772092 DUEO-DERM 4X4 EX-THIN TOP 000009.78 272
PHAR 000001772094 CHEMSTRIP-MICRA BOTTL (PROD) 000000.00 250
PHAR 000001772096 CHEMSTRIP K #100 (PROD) 1EA 000000.00 250
PHAR 000001772098 CHEMSTRIP #50 BOT. 1BOT (PROD) 000000.00 250
PHAR 000001772099 VIASPAN SOLN WITH AD INJ 000840.00 259
PHAR 000001773003 ENFAMIL W/IRON 180ML LIQ 1ML 000000.00 250
PHAR 000001773005 SMA CONC CON 1CA 000000.00 250
PHAR 000001773006 LOFENALAC POW 1CA 000000.00 250
PHAR 000001773010 POLYCOSE MIS 1CA 000000.00 250
PHAR 000001773012 ENFAMIL/IRON 454G POW 454 000000.00 250
PHAR 000001773015 POLYCOSE LIQ 1CA 000000.00 250
PHAR 000001773021 ENSURE LIQ 1CA 000000.00 250
PHAR 000001773022 PRODUCT 3232A 1LB POW 1CA 000000.00 250
PHAR 000001773029 ENSURE PLUS LIQ 1 C 000000.00 250
PHAR 000001773032 DELIVER 2.0 LIQ 1CA 000000.00 250
PHAR 000001773034 ISOCAL LIQ 1 C 000000.00 250
PHAR 000001773038 MERITENE PWDR 454 GM POW 1GM 000000.00 250
9/7/2010 11:52 AM Page 121 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001773039 HMF-ENFAMIL (MEAD-J) POW 1PA 000000.00 250
PHAR 000001773042 PHENYL-FREE 454G CAN POW 1CA 000000.00 250
PHAR 000001773044 ISOMIL FE CONC CON 1CA 000000.00 250
PHAR 000001773046 SIMILAC PM 60/40 POW 1CA 000000.00 259
PHAR 000001773047 SIMILAC WITH IRON POW 1CA 000000.00 259
PHAR 000001773049 MSUD DIET PWDR 1LB CA POW 1CA 000000.00 250
PHAR 000001773055 COMPLY LIQ 1 C 000000.00 250
PHAR 000001773056 ULTRACAL LIQ 1CA 000000.00 250
PHAR 000001773057 SUPLENA LIQ 1DO 000000.00 250
PHAR 000001773060 CALCIUM POLYCARBOPHIL TAB 1TA 000000.00 259
PHAR 000001773061 ISOMIL FE POW 1CA 000000.00 250
PHAR 000001773063 GOOD START SUPREME PWD 1CA 000000.00 250
PHAR 000001773065 NURSOY POW 000000.00 250
PHAR 000001773066 NURSOY CON 000000.00 250
PHAR 000001773068 TILACTASE TAB 300 000000.00 259
PHAR 000001773071 REPLETE LIQ 1CA 000000.00 250
PHAR 000001773073 KETONEX PWDR CAN PWD 350 000000.00 259
PHAR 000001773074 PULMOCARE LIQ 1CA 000000.00 250
PHAR 000001773075 LIPISORB LIQ 1CA 000000.00 258
PHAR 000001773076 TILACTASE LIQ 1ML 000000.00 259
PHAR 000001773077 ISOCAL HN LIQ 1 C 000000.00 250
PHAR 000001773079 ENSURE/FIBER LIQ 1DO 000000.00 250
PHAR 000001773080 NUTRIHEP LIQ 1CA 000000.00 250
PHAR 000001773081 GOOD START 2 POW 000000.00 250
PHAR 000001773085 BOOST LIQ 1CA 000000.00 250
PHAR 000001773086 LACTO-FREE PWDR CAN PWD 1CA 000000.00 259
PHAR 000001773088 SMA/FE POWDER 16OZ. PWD 1NA 000000.00 250
PHAR 000001773089 GLYTROL CAN LIQ 1DO 000000.00 250
PHAR 000001773091 CRUCIAL 1 CAN LIQ 1DO 000000.00 250
PHAR 000001773092 INOSITOL CAN POW 1GM 000000.00 250
PHAR 000001773093 TOLEREX PACKET PWD 1PA 000000.00 259
PHAR 000001773095 PREGESTIMIL 3OZ RTF LIQ 24C 000000.00 250
PHAR 000001773096 PROPINEX 454 GM CAN PWD 1CA 000000.00 250
PHAR 000001773098 JEVITY CAN LIQ 1ML 000000.00 250
PHAR 000001773100 SANDOSOURCE PEPTIDE LIQ 1 C 000000.00 250
PHAR 000001773102 GLUTAMINE PWD 10G 000000.00 250
PHAR 000001773103 RCF FORMULA CAN LIQ 1ML 000000.00 250
PHAR 000001773104 MICROLIPID CAN LIQ 1ML 000000.00 250
PHAR 000001773105 CYCLINEX PWDR PWD 1CA 000000.00 250
PHAR 000001773106 RESOURCE LIQ 1ML 000000.00 250
PHAR 000001773107 PROVIMIN CAN PWD 1CA 000000.00 250
PHAR 000001773108 CHOICE DM LIQ 1 C 000000.00 250
PHAR 000001773109 LACTASE LIQ 1ML 000000.00 259
PHAR 000001773110 UCD 1 CAN PWD 1DO 000000.00 250
PHAR 000001773111 PRO-PHREE CAN PWD 1 C 000000.00 250
PHAR 000001773113 CALCILO XD PWD 1 C 000000.00 250
PHAR 000001773115 BOOST PLUS LIQ 1 C 000000.00 250
9/7/2010 11:52 AM Page 122 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001773117 NEOCATE ONE + LIQ 1 C 000000.00 250
PHAR 000001773118 DUOCAL POW 400 000000.00 250
PHAR 000001773120 NEOCATE INFANT FORM PWD 400 000000.00 250
PHAR 000001773121 NEOCATE ONE + PWD 1 P 000000.00 250
PHAR 000001773122 NUTREN JR W/FIBER LIQ 1 C 000000.00 250
PHAR 000001773123 TRAUMACAL LIQ 1 C 000000.00 250
PHAR 000001773125 ENFAMIL AR POW 1 C 000000.00 250
PHAR 000001773126 ENFACARE PWD 1 C 000000.00 250
PHAR 000001773127 ISOSOURCE LIQ 1 C 000000.00 250
PHAR 000001773128 HMF-SIMILAC (ROSS) POW 1PA 000000.00 250
PHAR 000001773129 VIVONEX PEDIATRIC PWD 1PK 000000.00 250
PHAR 000001773130 ISOSOURCE HN LIQ 1CA 000000.00 250
PHAR 000001773131 ISOCAL HN PLUS LIQ 1CA 000000.00 250
PHAR 000001773132 ULTRACAL HN PLUS LIQ 1CA 000000.00 250
PHAR 000001773133 GLUTAREX-1 PWD 400GM 000064.56 250
PHAR 000001774007 KETOCONAZOLE SHAMPOO 2% SHA TO000031.76 259
PHAR 000001774008 FLUOCINOLONE ACETONID OIL PO 000033.84 259
PHAR 000001774013 EPSOM SALT 454GM 000002.77 250
PHAR 000001774014 TAXOL TUBING SET 000019.28 272
PHAR 000001774015 TAXOL FILTER 000007.92 272
PHAR 000001774022 SUCROSE SOL. SOL 000001.04 250
PHAR 000001779006 HICK/BROV REPAIR KIT 000160.00 272
PHAR 000001780003 LIDOCAINE/EP 2% PO 000017.40 250
PHAR 000001780004 GELATIN TOP 000760.46 250
PHAR 000001780005 GELATIN TOP 000076.07 250
PHAR 000001780009 PETROLATUM OIN 5G UD 5GM OIN T 000001.39 259
PHAR 000001780015 GELATIN 25MG POW 000064.20 250
PHAR 000001780019 MINERAL OIL 10ML INJ 000008.15 250
PHAR 000001780020 VIAL-O-JET 000025.13 259
PHAR 000001780021 BAG-A-JET NA 000019.15 250
PHAR 000001780022 PSEUDOCODE PO 000069.72 259
PHAR 000001780023 XYLOCAINE/EP 1% 000022.80 250
PHAR 000001780024 HYDROGEN PEROXIDE 3% 000038.40 250
PHAR 000001780025 GLYCINE 1.5% IRR 000038.26 250
PHAR 000001780027 TRIP ANTIBIOT 0.9G 000001.17 250
PHAR 000001780029 EPINEPHRINE SUS 000192.00 259
PHAR 000001780030 CELESTONE SOLUSPAN 6MG SUS IM 000036.00 259
PHAR 000001780033 OXIDIZED CELLUL 3X4 PAD TOP 000173.81 250
PHAR 000001780034 LIDOCAINE 2% UD 2% 000014.40 250
PHAR 000001780035 LIDOCAINE 1% UD 1% 000014.40 250
PHAR 000001780037 ARTIFICIAL SALIVA 240ML 000016.18 259
PHAR 000001780043 FLUORESCEIN 9 MG 000005.74 250
PHAR 000001780045 CHLORHEXIDINE GLUCONA 3GM JEL 000020.02 259
PHAR 000001780046 SODIUM HYALURONATE 10MG 000292.50 250
PHAR 000001780051 ACETIC ACID 5% 1000 M IRR 1ML 000030.00 250
PHAR 000001780053 FORMALIN 000001.20 250
PHAR 000001780064 LIDOCAINE/PRILOCAINE 1DOSE CRE 000015.74 250
9/7/2010 11:52 AM Page 123 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001780069 LIDOCAINE/PRILOCAINE CRE 1DO 000062.41 250
PHAR 000001780070 KIDNEY PRES ELECT 000228.00 250
PHAR 000001780073 LIDOCAINE/PRILOCA UD 1 DOSE CR 000008.47 250
PHAR 000001780074 TEST PACK PO 000007.44 259
PHAR 000001780075 TEST PACK PO 000008.78 259
PHAR 000001780077 PHENOL 500ML SOL 000090.67 259
PHAR 000001780078 OVRAL #1 1TAB TAB 000006.00 259
PHAR 000001780079 LO/OVRAL #1 1TAB TAB 000006.00 259
PHAR 000001780080 GELATIN SPONGE ABSRB 000012.30 250
PHAR 000001781001 PYXIS NO CHG ITEM 000000.00 250
PHAR 000001781006 PYXIS NO CHG ITEM 000000.00 250
PHAR 000001781010 BUPIVACAINE 0.25% SDV 2.5MG 000000.36 250
PHAR 000001781011 BUPIVACAINE HYDROCHLO 000000.00 250
PHAR 000001781015 GLYCOPYRROLATE INJ 0.2 000000.00 250
PHAR 000001781021 COMBINATION SOL 000015.36 259
PHAR 000001781027 PYXIS NO CHRG ITEM 000000.00 250
PHAR 000001781029 PYXIS NO CHRG ITEM 000000.00 250
PHAR 000001781031 PYXIS NO CHRG ITEM 000000.00 250
PHAR 000001781043 PYXIS NO CHRG ITEM 000000.00 250
PHAR 000001781044 BUTORPHANOL NAS STUDY 1DOSE IN 000000.00 250
PHAR 000001781048 PYXIS NO CHG ITEM 000000.00 250
PHAR 000001781050 PYXIS NO CHARGE ITEM 000000.00 250
PHAR 000001781058 KEYS-MED SERVER 000000.00 250
PHAR 000001781077 PXYIS NO CHG ITEM 000000.00 250
PHAR 000001781083 PXYIS NO CHG ITEM 000000.00 250
PHAR 000001781088 PYXIS NO CHG ITEM NA 1NA 000000.00 250
PHAR 000001781091 ACETYLCYSTEIN 10% MN INH 1 D 000000.00 259
PHAR 000001781092 ACETYLCYSTEIN 20% MN INH 1 D 000000.00 250
PHAR 000001781093 ALBUTEROL UNDILUTED INH 1 D 000000.00 250
PHAR 000001781094 ATROPINE 0.4MG MN INH 1 D 000000.00 250
PHAR 000001781097 CROMOLYN 20MG MN INH 1 D 000000.00 250
PHAR 000001781098 IPRATROPIUM 0.02% MN INH 1 D 000000.00 250
PHAR 000001781099 MICRONEPHRINE 2.25% INH 1 D 000000.00 250
PHAR 000001781102 METAPROTERENOL 5% MNT INH 1 D 000000.00 250
PHAR 000001781103 KENALOG 40MG MN I INH 1 D 000000.00 250
PHAR 000001781104 TERBUTALINE 5% MN INH 1 D 000000.00 250
PHAR 000001781105 LIDOCAINE 1.5% MN INH 1 D 000000.00 250
PHAR 000001781106 LIDOCAINE 4% MN INH 1 D 000000.00 250
PHAR 000001781107 LEVALBUTEROL SOL UD SOL 0.6 000000.00 259
PHAR 000001781108 LEVALBUTEROL SOL UD SOL 1.2 000000.00 259
PHAR 000001781120 SEDATION PACK (NOCH) 000000.00 250
PHAR 000001781124 SEDATION PACK (NOCH) 000000.00 250
PHAR 000001781132 PYXIS NO CHR ITEM 000000.00 250
PHAR 000001781133 PYXIS NO CHR ITEM 000000.00 250
PHAR 000001781141 INFANT 4-WAY ID BAND 000000.00 250
PHAR 000001781142 PYXIS NO CHG ITEM 000000.00 250
PHAR 000001781144 PYXIS NO CHRG ITEM 000000.00 250
9/7/2010 11:52 AM Page 124 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001781145 LIDOCAINE 4% TOP. CRE 1DO 000004.85 250
PHAR 000001781156 PYXIS NO CHG ITEM 000000.00 250
PHAR 000001781157 PYXIS NO CHG ITEM 000000.00 250
PHAR 000001782001 TRACRIUM 10 MG DOSE 000029.00 250
PHAR 000001782002 ATROPINE 0.4 MG DOSE 000014.50 250
PHAR 000001782004 DIPRIVAN 100MG DOSE 000054.00 250
PHAR 000001782006 ESMOLOL 10 MG DOSE 000014.50 250
PHAR 000001782007 KETAMINE 100 MG DOSE 000028.00 250
PHAR 000001782008 NEOSTIGMINE 1MG DOSE 000017.00 250
PHAR 000001782009 PANCRUONIUM 1MG DOSE 000014.50 250
PHAR 000001782010 ANECTINE 40 MG DOSE 000014.50 250
PHAR 000001782011 THIOPENTAL 100MG INJ 000035.64 250
PHAR 000001782012 ROCURONIUM DOSE-ANETH 10MG INJ 000031.80 250
PHAR 000001788007 BREVITAL INJ - UD 000012.00 250
PHAR 000001790013 ALUPENT PO 000012.00 259
PHAR 000001790018 HAEMOPHILUS B VACCINE INJ 0.5 000036.00 250
PHAR 000001790026 TESTOSTERONE CYPIONAT 200MG PO 000075.60 259
PHAR 000001795001 ZANTAC TAB 150MG 000006.30 259
PHAR 000001795004 CEFOTETAN *OP INJ 000075.60 250
PHAR 000001795005 CLINDAMYCIN 900MG INJ 000126.00 250
PHAR 000001795010 DOXYCYCLINE 100MG INJ 000111.60 250
PHAR 000001795011 CISATRACURIUM BESYLAT INJ 2MG 000052.59 250
PHAR 000001795012 GLYCOPYRROLATE INJ 0.2 000005.40 250
PHAR 000001795013 BETOPTIC-S 0.25% 5ML 000053.25 250
PHAR 000001795014 CELESTONE 0.5ML DOSE 000006.65 250
PHAR 000001795016 CYCLOGYL 1% OPTH 5ML 000036.00 250
PHAR 000001795017 FLUORESCEIN 9MG STRIP 000001.80 250
PHAR 000001795019 GENTAMICIN OPTH 1 ML 000008.88 250
PHAR 000001795020 GENTAMICIN OPH 3.5GM 000040.53 250
PHAR 000001795021 MAXITROL OP OINT 3.5 000055.50 250
PHAR 000001795022 MAXITROL OP SUSP 5ML 000055.50 259
PHAR 000001795023 MIOSTAT OP .01% 1.5M 000079.98 250
PHAR 000001795025 MYDRIACYL 0.5% 15ML 000060.00 250
PHAR 000001795026 MYDRIACYL OP 1% 3 ML 000018.75 250
PHAR 000001795027 NEOSPORIN OPTH 10ML 000012.75 250
PHAR 000001795028 NEO-SYN OP 2.5% 5ML 000031.50 250
PHAR 000001795029 NEO-SYNEPH 10% OP 1M 000006.24 250
PHAR 000001795030 OCUFEN OP .03% 2.5ML 000041.64 250
PHAR 000001795031 ALCAINE OP 0.5% 15ML 000036.00 259
PHAR 000001795032 DIPRIVAN 20ML INJ 000098.40 250
PHAR 000001795033 TETRACAINE OP .5%1ML 000006.24 250
PHAR 000001795034 GELFILM OPTH #1 000047.54 250
PHAR 000001795036 CORTISPORIN OTIC 10M 000055.95 259
PHAR 000001795037 PROPOFOL 50ML INJ 000184.80 250
PHAR 000001795039 ALFENTANIL 2500MCG INJ 000088.80 250
PHAR 000001795041 MEPERIDINE 50MG INJ 000019.20 250
PHAR 000001795042 COCAINE 4% SOL 4ML 000036.00 250
9/7/2010 11:52 AM Page 125 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001795046 KETAMINE 100MG/ML 5ML 000129.60 250
PHAR 000001795048 HYDROCODONE/ TAB 000001.80 259
PHAR 000001795050 DIAZEPAM TAB 5MG 000001.80 259
PHAR 000001795051 DARVOCET TAB 000003.60 259
PHAR 000001795052 ACETAMINOPHEN/COD 2.4MG ELI 000003.60 259
PHAR 000001795053 CHLORAMPHENICOL 1% OIN 000041.04 250
PHAR 000001795055 POLYSPORN OP OI 3.5G 000046.50 250
PHAR 000001795056 HOMATROPINE OP 5% 5M 000006.24 250
PHAR 000001795059 PILOCAR OPTH 1% 1 ML 000006.24 250
PHAR 000001795060 PILOCAR OPTH 2% 1 ML 000006.24 250
PHAR 000001795061 MUROCOLL-2 OPTH 5 ML 000031.65 250
PHAR 000001795063 POLY-PRED OPTH 5 ML 000048.54 250
PHAR 000001795064 TIMOPTIC OP 0.5% UD. 000005.03 250
PHAR 000001795068 DANTROLENE 20MG INJ 000237.60 250
PHAR 000001795071 MAALOX SUSP 30 ML UD 000001.50 259
PHAR 000001795072 CIMETIDINE 300MG INJ 000034.88 250
PHAR 000001795077 SODIUM BICAR OPSC SYR 1MEQ 000063.34 259
PHAR 000001795078 ESMOLOL 1000MG INJ 000111.60 250
PHAR 000001795079 CALCIUM CHL 1GM SYRINGE 000098.40 250
PHAR 000001795081 EPINEPHRINE HCL 000033.80 250
PHAR 000001795084 EPINEPHRINE HCL 000033.80 250
PHAR 000001795087 SOD BICARB 4.2% 5ML 000025.80 250
PHAR 000001795088 DEFEROXAMINE 500MG INJ 000066.00 250
PHAR 000001795090 EPHEDRINE 50MG INJ 000017.40 250
PHAR 000001795093 LABETALOL 100MG INJ 000184.80 250
PHAR 000001795095 PHENYLEPHRINE HYDROCH 000011.08 250
PHAR 000001795098 NITROPRUSSIDE 50MG INJ 000054.00 250
PHAR 000001795101 VERAPAMIL 5MG INJ 000025.80 250
PHAR 000001795102 MANNITOL 20% 000184.68 258
PHAR 000001795106 GELFOAM POWDER 1GM 000118.12 250
PHAR 000001795107 AMMONIA SOLUTION INH 000003.60 250
PHAR 000001795108 SILVER SULFADIAZINE 1% CRE TOP 000013.97 259
PHAR 000001795109 SILVER NITRA PO 000001.80 250
PHAR 000001795110 NEOSPORIN OINT 0.9 G 000001.50 250
PHAR 000001795111 POLYSPORIN OIN 0.9 G 000001.50 250
PHAR 000001795112 DEXTRAN HM 32% 100ML 000142.52 250
PHAR 000001795114 ETHYL CHLORIDE 000031.57 250
PHAR 000001795116 SODIUM CL 500ML BAG 0.90% 000033.97 250
PHAR 000001795117 ACETAMINOPHEN TAB 325 000001.80 259
PHAR 000001795118 TYLENOL TAB 500 MG 000001.50 259
PHAR 000001795122 TYLENOL 160 MG/5 ML 000001.50 259
PHAR 000001795124 ROBITUSSIN DM 10 ML 000001.50 259
PHAR 000001795126 CEPACOL LOZ #1 000001.50 259
PHAR 000001795127 INDIGOTINDISULFONATE 0.80% 000032.40 250
PHAR 000001795128 METHYLENE BLUE 1% 000025.20 250
PHAR 000001795130 GELATIN 50MG 000062.20 250
PHAR 000001795131 ACHROMYCIN OI 3% 30G 000032.34 259
9/7/2010 11:52 AM Page 126 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001795132 BACITRACIN OINT 0.9G 000001.50 250
PHAR 000001795138 LIDOCAINE OIN 5% 37G 000012.75 250
PHAR 000001795140 PHYSOSTIGMINE 2MG INJ 000066.00 250
PHAR 000001795142 DEXAMETHASONE 4MG 000005.40 250
PHAR 000001795143 DEXTROSE 50% INJ 50ML 000038.40 258
PHAR 000001795144 DEXTROSE 50% SYR 50ML 000111.60 250
PHAR 000001795147 DOXAPRAM 400MG INJ 000206.40 250
PHAR 000001795151 GLYCOPYRROLATE 4MG INJ 000038.40 250
PHAR 000001795152 HEPARIN 100U/1ML INJ 000017.40 250
PHAR 000001795154 ISOPROTERENOL 1MG INJ 000028.80 250
PHAR 000001795155 TRIAMCINOLONE 50MG INJ 000048.00 636
PHAR 000001795156 TRIAMCINOLONE 40MG INJ 000042.00 250
PHAR 000001795157 FLUMAZENIL 0.5MG INJ 000157.20 250
PHAR 000001795159 MIVACURIUM 20MG/ML 10ML 000054.00 250
PHAR 000001795160 NALOXONE 0.4MG INJ 000086.40 250
PHAR 000001795161 NEOSTIGMINE 10MG/10ML VIAL 000010.62 250
PHAR 000001795162 VECURONIUM BROMIDE 10MG 000080.35 250
PHAR 000001795166 PYRIDOSTIGMINE 10MG INJ 000038.40 250
PHAR 000001795167 SCOPOLAMINE 0.4MG INJ 000017.40 250
PHAR 000001795168 SODIUM CHL 0.9% 10ML INJ 000017.40 250
PHAR 000001795169 SODIUM CL BACT. 30ML 0.90% 000129.38 250
PHAR 000001795173 EDROPHONIUM 150MG INJ 000038.40 250
PHAR 000001795175 TIGAN 200 MG SUPP 000003.00 259
PHAR 000001795177 VASOPRESSIN 000019.44 250
PHAR 000001795178 HYDROXYZINE 100MG INJ 000017.40 250
PHAR 000001795179 WATER10ML VIAL PO 000003.60 250
PHAR 000001795180 "WATER, BACTERIOSTATIC" 30ML I 000006.40 250
PHAR 000001795181 THIOPENTAL 250MG INJ 000062.40 250
PHAR 000001795182 POLOCAINE 2% 20ML 000028.40 250
PHAR 000001795183 SENSORCAINE/ 000034.56 250
PHAR 000001795184 BUPIVACAINE HYDROCHLO 000012.38 250
PHAR 000001795185 BUPIVACAINE HYDROCHLO 000011.35 250
PHAR 000001795186 SENSORCAINE/ 000013.25 250
PHAR 000001795187 BUPIVACAINE HYDROCHLO 000012.91 250
PHAR 000001795188 BUPIVACAINE HYDROCHLO 000035.29 250
PHAR 000001795190 LIDOCAINE HCL 1% 30ML 1% 000031.18 250
PHAR 000001795191 LIDOCAINE 1.5% 20ML 1.50% 000032.68 250
PHAR 000001795193 XYLOCAINE/EP 000039.76 250
PHAR 000001795194 XYLOCAINE 000030.05 250
PHAR 000001795195 LIDOCAINE HCL 2% 10ML 2% 000019.42 250
PHAR 000001795196 XYLOCAINE/EP 000034.08 250
PHAR 000001795197 LIDOCAINE SPRY *OP AER 10% 000153.68 250
PHAR 000001795198 LIDOCAINE 4% VISC 20M 4% TOP 000033.26 250
PHAR 000001795199 LIDOCAINE 2% VISC 2% 000006.46 250
PHAR 000001795204 BACITRACIN 50000 U 000033.30 250
PHAR 000001795205 ETOMIDATE 200MG INJ 000141.60 250
PHAR 000001795206 ALCOHOL INJ 1ML AMP 000029.26 250
9/7/2010 11:52 AM Page 127 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001795215 THROMBIN 5K U VIAL 5000U 000076.28 250
PHAR 000001795216 THROMBIN 10000 U 000146.27 250
PHAR 000001795217 THROMBIN 20000 U 000232.55 250
PHAR 000001795218 ACETIC ACID 000076.55 250
PHAR 000001795222 BAG-A-JET PO 000014.36 250
PHAR 000001795224 COMBINATION (PROD) TES 000000.00 250
PHAR 000001795229 LIDOCAINE 100MG SYRIN 2% 000035.47 250
PHAR 000001795231 LACTATED RIN 000039.19 258
PHAR 000001795232 LACTATED RIN 000044.51 258
PHAR 000001795233 DEXTROSE5% 000036.41 258
PHAR 000001795234 DEXTROSE5% 000046.36 258
PHAR 000001795235 DEXTROSE 5%(PB) IV 000036.00 258
PHAR 000001795236 SODIUM CL 1L BAG 0.90% 000033.97 250
PHAR 000001795238 WATER, IRRIG *OP BOT 1ML 000000.00 250
PHAR 000001795239 WATER, IRRIG *OP BOT 1ML 000000.00 250
PHAR 000001795240 WATER, IRRIG *OP BOT 1ML 000000.00 250
PHAR 000001795243 SODIUM CL 2L IRRIG 000075.16 250
PHAR 000001795244 HESPAN INJ 6% 500ML 000229.68 250
PHAR 000001795245 SODIUM CHLR IRRIG 3L 0.90% 000059.35 250
PHAR 000001795246 SORBITOL 3% IRR 3L 3% 000073.22 250
PHAR 000001795247 ALFENTANIL 1000MCG INJ 000055.20 250
PHAR 000001795250 DIPHENHYDRAMINE 50MG SYRINGE 000020.40 259
PHAR 000001795252 LIDOCAINE HYDROCHLORI 1% 000003.60 250
PHAR 000001795254 LIDOCAINE HYDROCHLORI PO 000005.72 250
PHAR 000001795256 METHOHEXITAL 500MG INJ 000055.20 250
PHAR 000001795258 D5.2% NACL INJ 250ML 000012.00 258
PHAR 000001795259 D5.2% NACL INJ 500ML 000012.00 258
PHAR 000001795261 D5W INJ 250ML 000012.00 258
PHAR 000001795264 XYLOCAINE GEL 2% 5ML 000011.50 250
PHAR 000001795265 EMLA 5GM CRM OPSC 000017.19 259
PHAR 000001795268 ATROPINE 1 MG SYR 000075.60 250
PHAR 000001795269 ATROPINE 0.5 MG SYR 000075.60 250
PHAR 000001795270 BETADINE 8 OZ 000012.24 250
PHAR 000001795274 LIDOC W/EPI 0.5% 50M 000012.71 250
PHAR 000001795279 BISMUTH SUBGALLATE 120GM PWD P 000062.02 259
PHAR 000001795281 MITOMYCIN 0.4MG SYR 000033.60 259
PHAR 000001795283 LIDOCAINE MDV 1% VIA 000025.20 250
PHAR 000001795284 BUPIVACAINE/EPI 0.50% 000014.27 250
PHAR 000001795286 MORPHINE SULFATE *OP INJ 1MG 000068.40 250
PHAR 000001795287 METRONIDAZOLE 500MG INJ 000028.80 250
PHAR 000001795288 LOVENOX OPSC 30MG SYR 000051.84 259
PHAR 000001795289 IBUPROFEN 100MG UD SUSP*OP 000004.08 259
PHAR 000001795290 SORBITOL 3.3% IRR OP* 000042.00 250
PHAR 000001795291 SORBITOL 3.3% IRR *OP 000052.80 250
PHAR 000001795293 PD 1.5% 500 ML SOL 000026.40 250
PHAR 000001795297 D5/LR 500ML INJ 000052.27 258
PHAR 000001795298 D5/LR 1000ML INJ 000061.56 258
9/7/2010 11:52 AM Page 128 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001795299 D5W 100ML INJ 000052.27 258
PHAR 000001795300 NACL 0.9% 500ML 000052.27 258
PHAR 000001795302 CLONIDINE HCLOPSC 100MCG INJ 000174.42 250
PHAR 000001795303 REMIFENTANYL 1MG INJ 000078.00 250
PHAR 000001795304 REMIFENTANYL 2MG INJ 000145.20 250
PHAR 000001795306 MITOMYCIN 0.2MG SYR 000019.20 259
PHAR 000001795307 IOHEXOLVIAL OPSC 300MG IV 000173.66 250
PHAR 000001795309 SUFENTANIL 100MCG INJ 000145.20 250
PHAR 000001795311 DEXTRAN 150MG INJ 000060.00 250
PHAR 000001795312 DOLASETRON *OP INJ 20M 000000.00 250
PHAR 000001795314 MIDAZOLAM SYRUP 2MG SYR 000064.80 259
PHAR 000001795315 HYALURONATE SOD SYR 10MG INJ 000330.00 250
PHAR 000001795320 NACL 0.9% 100ML INJ 000052.27 250
PHAR 000001795322 ISOSULFAN BLUE INJ 10MG/ML 000181.22 250
PHAR 000001795323 PROPOFOL EML 10M 000118.80 250
PHAR 000001795324 LIDOCAINE 1%/EPI SDV 000010.55 250
PHAR 000001795325 NEBCIN 1.2GM PWD 000775.15 250
PHAR 000001795326 RAPLON INJ 20MG/ML 000059.83 250
PHAR 000001795329 HEPARIN 10,000U/1ML INJ 000017.40 250
PHAR 000001795330 INDOCYANINE INJ 25MG 000226.82 250
PHAR 000001795332 COCAINE 10% SOL 4ML 000067.68 250
PHAR 000001795333 PROPOFOL 20ML INJ 000086.40 250
PHAR 000001796003 BETOPTIC-S 0.25% OP 5ML 000063.90 250
PHAR 000001796004 CYCLOPENTOLATE 1% 5ML 000043.20 250
PHAR 000001796005 GENTAMICIN OPHT SOL 0.30% OPH 000010.66 250
PHAR 000001796006 GENTAMICIN OPHT OINT 0.30% OPH 000048.64 250
PHAR 000001796009 MIOSTAT 0.01% OPHT SOL 000099.00 250
PHAR 000001796012 TROPICAMIDE 1% 3ML 000018.29 250
PHAR 000001796014 PHENYLEPHRINE OPTH 5M 2.50% OP 000037.80 250
PHAR 000001796018 TETRACAINE HCL 1ML 0.50% OPTH 000007.49 250
PHAR 000001796024 HOMATROPINE 5% OPH OPHT 000007.49 250
PHAR 000001796026 PILOCARPINE HYDROCHLO 1% 000007.49 250
PHAR 000001796027 PILOCARPINE HYDROCHLO 2% 000007.49 250
PHAR 000001796032 VASOCIDIN 000047.09 259
PHAR 000001796034 ACETAZOLAMIDE 250MG TAB 000003.33 259
PHAR 000001796035 MAALOX UD 30ML 000003.20 259
PHAR 000001796037 METOCLOPRAMIDE *OP C TAB 10M 000003.60 259
PHAR 000001796038 OXYMETAZOLINE 15ML SPRAY 000010.75 259
PHAR 000001796039 DIPHENHYDRAMINE HCL 25MG CAP 000001.80 259
PHAR 000001796040 ALBUTEROL INH 17G 000079.16 259
PHAR 000001796041 NIFEDIPINE 10MG CAP 000003.33 259
PHAR 000001796042 NITROGLYCERIN #25 TABS 000011.75 259
PHAR 000001796043 MINERAL OIL, LIGHT 10ML 000007.90 259
PHAR 000001796045 NEOSPORIN OINT 1GM OIN 000001.80 250
PHAR 000001796047 ACETAMINOPHEN 500MG TAB 000000.60 259
PHAR 000001796048 ASPIRIN 325 MG TAB 000001.80 250
PHAR 000001796050 ACETAMINOPHEN 100MG DRP 000013.74 259
9/7/2010 11:52 AM Page 129 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000001796051 TYLENOL 160 MG/5 ML 000001.80 259
PHAR 000001796052 IBUPROFEN *OP TAB 600 000002.93 259
PHAR 000001796053 ROBITUSSIN DM UD 10ML 000003.12 259
PHAR 000001796054 PSEUDOEPHEDRINE HYDRO 30MG TAB000001.80 250
PHAR 000001796055 CEPACOL LOZ #1 000001.80 259
PHAR 000001796060 NITROGLYCERN OINT UD 2% OIN TO 000001.80 259
PHAR 000001796062 LIDOCAINE 2% GEL 30GM 000030.12 250
PHAR 000001796065 TRIMETHOBENZAMIDE 200MG SUP 000003.11 259
PHAR 000001796067 ACETAMINOPHEN 650 MG SUP PR 000003.60 259
PHAR 000001796069 PROMETHAZINE HYDROCHL 25MG SUP000007.97 259
PHAR 000001796070 PHENRGAN 50MG SUPP 000010.20 259
PHAR 000001796073 MINERAL OIL 55% OIL PO 000007.24 259
PHAR 000001796074 NIFEDIPINE *OP CAP 10 000003.60 259
PHAR 000001796075 OXYBUTYNIN 5MG TAB 000003.20 259
PHAR 000001796077 NITROGLYCERIN 2% OINT 30GM 000013.07 259
PHAR 000001796079 TOBRAMYCIN/DEXAMETH OPHT 000046.13 259
PHAR 000001796080 MIOCHOL-E 1% OPHT SOL 000109.98 250
PHAR 000001796081 PONARIS NASAL EMMLNT 1OZ 000024.12 259
PHAR 000001796082 AMMONIA INHALANT 1EA 000001.83 250
PHAR 000001796083 BELLADONNA/OPIUM SUPP 000010.87 259
PHAR 000001796084 DARVOCET-N 100 TAB 000004.62 259
PHAR 000001796085 EMLA CRM 5GM UD 000017.19 259
PHAR 000001796086 IBUPROFEN UD SUSP 5ML 000008.25 259
PHAR 000001796087 LIDOCAINE 2% JEL 5ML 000014.40 250
PHAR 000001796088 SILVADENE 1% CRM 20GM 000006.78 259
PHAR 000001796089 TYLENOL/COD UD 5ML ELIXER 000002.48 259
PHAR 000001796090 HYDROCODONE/APAP TAB 000004.42 259
PHAR 000001796091 MIDAZOLAM OS 10MG/5ML 000043.68 250
PHAR 000001796092 BRIMONIDINE TART *OP SOL 0.1 000041.04 250
PHAR 000001796093 CYCLOMYDRIL DT OPHT DRP 5ML 000064.58 250
PHAR 000001796101 CETACAINE SPRAY 000108.00 250
PHAR 000001796104 COLLODION FLEX 4OZ 000009.88 250
PHAR 000001796108 BACTROBAN 2% CRM 30GM 000094.13 259
PHAR 000008400000 PHARMACY 000000.00
PHAR 000008410267 ANAVAR TAB 2.5 MG 000004.37
PHAR 000008410268 AMPICILLIN CAP 500MG 000000.00
PHAR 000008410269 TAGAMET TAB 200 MG 000000.00
PHAR 000008410270 TAGAMET TAB 400 MG 000000.00
PHAR 000008410271 TROPAMINE PLUS CAP 000000.00
PHAR 000008410272 ACETAZOLAMIDE 250MG 000000.00
PHAR 000008410273 DIAMOX TAB 125 MG 000000.00
PHAR 000008410274 DYMELOR TAB 250 MG 000000.00
PHAR 000008410275 DYMELOR TAB 500 MG 000000.00
PHAR 000008410276 ALU-CAP 475 MG 000000.00
PHAR 000008410277 ALU-TAB 600 MG 000000.00
PHAR 000008410278 AMPHOJEL 0.3GM 000000.00
PHAR 000008410279 AMPHOJEL TAB 0.6 GM 000000.00
9/7/2010 11:52 AM Page 130 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008410280 DIALUME CAP 500 MG 000000.00
PHAR 000008410281 SYMMETREL CAP 100 MG 000000.00
PHAR 000008410282 MIDAMOR TAB 5 MG 000000.00
PHAR 000008410283 AMINOPHYLLIN 100MG 000000.00
PHAR 000008410284 AMITRIPTYLINE 10MG 000000.00
PHAR 000008410285 AMITRIPTYLINE 25 MG 000000.00
PHAR 000008410286 AMITRIPTYLINE 50MG 000000.00
PHAR 000008410287 AMMONIUM CHL 1GM 000000.00
PHAR 000008410288 AMMONIUM CHL 500MG 000000.00
PHAR 000008410289 AMOXICILLIN 250MG 000000.00
PHAR 000008410290 AMOXICILLIN 500MG 000000.00
PHAR 000008410291 AMOXIL CHEW 250 MG 000000.00
PHAR 000008410292 AMPICILLIN CAP 250MG 000000.00
PHAR 000008410293 MEASURIN TAB 000000.00
PHAR 000008410294 TENORMIN TAB 100 MG 000000.00
PHAR 000008410295 TENORMIN TAB 50 MG 000000.00
PHAR 000008410296 IMURAN TAB 50 MG 000000.00
PHAR 000008410297 LIORESAL TAB 10 MG 000000.00
PHAR 000008410298 TESSALON CAP 100 MG 000000.00
PHAR 000008410299 BENZTROPINE TAB 1 MG 000000.00
PHAR 000008410300 BENZTROPINE TAB 2 MG 000000.00
PHAR 000008410301 BISACODYL TAB 5 MG 000000.00
PHAR 000008410302 PEPTO-BISMOL TAB #24 000000.00
PHAR 000008410303 PARLODEL CAP 5 MG 000000.00
PHAR 000008410304 PARLODEL TAB 2.5 MG 000000.00
PHAR 000008410305 PARLODEL 2.5 MG #30 000000.00
PHAR 000008410306 DIMETANE EXTENTAB 12 000000.00
PHAR 000008410307 DIMETANE EXT 8 MG 000000.00
PHAR 000008410308 DIMETANE TAB 4 MG 000000.00
PHAR 000008410309 ROCALTROL 0.25MCG 000000.00
PHAR 000008410310 ROCALTROL CAP 0.5 MC 000000.00
PHAR 000008410311 TEGRETOL TAB 200 MG 000000.00
PHAR 000008410312 GEOCILLIN TAB 382 MG 000000.00
PHAR 000008410313 DURICEF CAP 500 MG 000000.00
PHAR 000008410314 DURICEF TAB 1 GM 000000.00
PHAR 000008410315 SUPRAX TAB 400MG 000000.00
PHAR 000008410316 CEFTIN TAB 250 MG 000000.00
PHAR 000008410317 CEFTIN TAB 500 MG 000000.00
PHAR 000008410318 KEFLEX CAP 250 MG 000000.00
PHAR 000008410319 KEFLEX CAP 500 MG 000000.00
PHAR 000008410320 KEFLEX TAB 1 GM 000000.00
PHAR 000008410321 LIBRIUM CAP 10 MG 000000.00
PHAR 000008410322 LIBRIUM CAP 25 MG 000000.00
PHAR 000008410323 LIBRIUM CAP 5 MG 000000.00
PHAR 000008410324 DIURIL TAB 250 MG 000000.00
PHAR 000008410325 DIURIL TAB 500 MG 000000.00
PHAR 000008410326 TELDRIN-TR CAP 12MG 000000.00
9/7/2010 11:52 AM Page 131 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008410327 CHLORPROMAZINE 200MG 000000.00
PHAR 000008410328 CHLORPROMAZINE 50 MG 000000.00
PHAR 000008410329 CHLORPROPAMIDE 100MG 000000.00
PHAR 000008410330 CHLORPROPAMIDE 250MG 000000.00
PHAR 000008410331 CHLORTHALIDONE 25MG 000000.00
PHAR 000008410332 CHLORTHALIDONE 50MG 000000.00
PHAR 000008410333 HYGROTON TAB 100 MG 000000.00
PHAR 000008410334 TAGAMET TAB 300 MG 000000.00
PHAR 000008410335 QUARZAN CAP 2.5 MG 000000.00
PHAR 000008410336 CLEOCIN CAP 150 MG 000000.00
PHAR 000008410337 CLEOCIN CAP 75 MG 000000.00
PHAR 000008410338 ANAFRANIL CAP 25 MG 000000.00
PHAR 000008410339 ANAFRANIL CAP 50 MG 000000.00
PHAR 000008410340 QUINIDINE 100 MG 000000.00
PHAR 000008410341 KLONOPIN TAB 0.5 MG 000000.00
PHAR 000008410342 KLONOPIN TAB 1 MG 000000.00
PHAR 000008410343 KLONOPIN TAB 2 MG 000000.00
PHAR 000008410344 FLINTSTONES CHW COMP 000000.00
PHAR 000008410345 CENTRUM JR TAB 000000.00
PHAR 000008410346 SEPTRA TAB 000000.00
PHAR 000008410347 SEPTRA-DS TAB 000000.00
PHAR 000008410348 COLCHICINE 0.5 MG 000000.00
PHAR 000008410349 COLCHICINE TAB 0.6MG 000000.00
PHAR 000008410350 ALDORIL-15 TAB 000000.00
PHAR 000008410351 ALDORIL-25 TAB 000000.00
PHAR 000008410352 ALLBEE-T TAB 000000.00
PHAR 000008410353 CAPOZIDE TAB 25/15 M 000000.00
PHAR 000008410354 COL-BENEMID TAB 000000.00
PHAR 000008410355 COMHIST TAB 000000.00
PHAR 000008410356 COMHIST-LA CAP 000000.00
PHAR 000008410357 CORICIDIN D TAB 000000.00
PHAR 000008410358 CORICIDIN TAB 000000.00
PHAR 000008410359 DECONAMINE TAB 000000.00
PHAR 000008410360 DECONAMINE-SR CAP 000000.00
PHAR 000008410361 DEMULEN 1/35 #21 000000.00
PHAR 000008410362 DEMULEN 1/35 #28 000000.00
PHAR 000008410363 DEMULEN 1/50 #21 000000.00
PHAR 000008410364 DEMULEN 1/50 #28 000000.00
PHAR 000008410365 DI-GEL TAB 000000.00
PHAR 000008410366 DIMETAPP EXTENTAB 000000.00
PHAR 000008410367 DIMETAPP TAB 000000.00
PHAR 000008410368 DIPHENOXYLATE W/ATR 000000.00
PHAR 000008410369 DOCUSATE/CAS CAP 000000.00
PHAR 000008410370 DONNATAL CAP 000000.00
PHAR 000008410371 DONNATAL EXTENTAB 000000.00
PHAR 000008410372 DONNATAL TAB 000000.00
PHAR 000008410373 DOXIDAN CAP 000000.00
9/7/2010 11:52 AM Page 132 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008410374 DRIXORAL-SA TAB 000000.00
PHAR 000008410375 ENTEX CAP 000000.00
PHAR 000008410376 ENTEX-LA TAB 000000.00
PHAR 000008410377 ESTRATEST TAB 000000.00
PHAR 000008410378 ETRAFON 2-10 TAB 000000.00
PHAR 000008410379 ETRAFON 2-25 TAB 000000.00
PHAR 000008410380 ETRAFON 4/25 000000.00
PHAR 000008410381 ETRAFON-A 4-10 TAB 000000.00
PHAR 000008410382 EXCEDRIN EXTRA STREN 000000.00
PHAR 000008410383 EXCEDRIN TAB 000000.00
PHAR 000008410384 FERRO-SEQUEL CAP 000000.00
PHAR 000008410385 FIORICET TAB 000000.00
PHAR 000008410386 GAVISCON TAB 000000.00
PHAR 000008410387 DARANIDE TAB 50 MG 000000.00
PHAR 000008410388 INDERIDE TAB 40/25 000000.00
PHAR 000008410389 INDERIDE TAB 80/25 000000.00
PHAR 000008410390 ISOCLOR TIMESULE 000000.00
PHAR 000008410391 KANULASE TAB 000000.00
PHAR 000008410392 LIBRAX CAP 000000.00
PHAR 000008410393 LO/OVRAL #21 000000.00
PHAR 000008410394 LO/OVRAL #28 000000.00
PHAR 000008410395 LOESTRIN 1.5/30 #21 000000.00
PHAR 000008410396 LOESTRIN 1/20 #21 000000.00
PHAR 000008410397 LOESTRIN-FE 1.5/30 000000.00
PHAR 000008410398 LOESTRIN-FE 1/2O #28 000000.00
PHAR 000008410399 MARAX TAB 000000.00
PHAR 000008410400 MATERNA TAB 000000.00
PHAR 000008410401 MIDRIN CAP 000000.00
PHAR 000008410402 MODICON #21 000000.00
PHAR 000008410403 NEUTRAPHOS 1.25G 000000.00
PHAR 000008410404 NORDETTE #21 PILPAK 000000.00
PHAR 000008410405 NORDETTE #28 PILPAK 000000.00
PHAR 000008410406 NORGESIC FORTE TAB 000000.00
PHAR 000008410407 NORGESIC TAB 000000.00
PHAR 000008410408 NORINYL 1+35 #21 000000.00
PHAR 000008410409 NORINYL 1+35 #28 000000.00
PHAR 000008410410 NORINYL 1+50 #21 000000.00
PHAR 000008410411 NORINYL 1+50 #28 000000.00
PHAR 000008410412 NORLESTRIN 1/50 #21 000000.00
PHAR 000008410413 NORLESTRIN 1/50 #28 000000.00
PHAR 000008410414 NORLESTRIN 2.5/50#21 000000.00
PHAR 000008410415 NORLESTRIN-FE 2.5/28 000000.00
PHAR 000008410416 ORNADE SPANSULES 000000.00
PHAR 000008410417 ORTHO-NOVUM 1/35 #21 000000.00
PHAR 000008410418 ORTHO-NOVUM 1/35#28 000000.00
PHAR 000008410419 ORTHO-NOVUM 1/50 #21 000000.00
PHAR 000008410420 ORTHO-NOVUM 1/50 #28 000000.00
9/7/2010 11:52 AM Page 133 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008410421 ORTHO-NOVUM 10/11 21 000000.00
PHAR 000008410422 OS-CAL TAB 000000.00
PHAR 000008410423 OVRAL #21 000000.00
PHAR 000008410424 OVRAL #28 000000.00
PHAR 000008410425 OVULEN #21 000000.00
PHAR 000008410426 PROBANTHINE W/PB 000000.00
PHAR 000008410427 QUIBRON CAP 000000.00
PHAR 000008410428 RONDEC TAB 000000.00
PHAR 000008410429 SER-AP-ES TAB 000000.00
PHAR 000008410430 SINEMET 10/100 TAB 000000.00
PHAR 000008410431 SINEMET 25/100 TAB 000000.00
PHAR 000008410432 SPIRONO/HCTZ 25/25 000000.00
PHAR 000008410433 STUARTNATAL TAB 1+1 000000.00
PHAR 000008410434 TRIAMT/HCTZ 50/25 000000.00
PHAR 000008410435 Z-BEC TAB 000000.00
PHAR 000008410436 FLEXERIL TAB 10 MG 000000.00
PHAR 000008410437 CYPROHEPTAD TAB 4MG 000000.00
PHAR 000008410438 DECLOMYCIN CAP 150 M 000000.00
PHAR 000008410439 DECLOMYCIN TAB 300 M 000000.00
PHAR 000008410440 NORPRAMIN TAB 10 MG 000000.00
PHAR 000008410441 NORPRAMIN TAB 25 MG 000000.00
PHAR 000008410442 NORPRAMIN TAB 50MG 000000.00
PHAR 000008410443 NORPRAMIN TAB 75 MG 000000.00
PHAR 000008410444 DEXAMETHASONE 0.25MG 000000.00
PHAR 000008410445 DEXAMETHASONE 0.5 MG 000000.00
PHAR 000008410446 DEXAMETHASONE 0.75MG 000000.00
PHAR 000008410447 DEXAMETHASONE 1.5MG 000000.00
PHAR 000008410448 DEXAMETHASONE 2MG 000000.00
PHAR 000008410449 DEXAMETHASONE 4MG 000000.00
PHAR 000008410450 DEXAMETHASONE 6MG 000000.00
PHAR 000008410451 POLARAMINE TAB 2 MG 000000.00
PHAR 000008410452 POLARAMINE TAB 4 MG 000000.00
PHAR 000008410453 POLARAMINE TAB 6 MG 000000.00
PHAR 000008410454 DICLOXACILLIN 125 MG 000000.00
PHAR 000008410455 DICLOXACILLIN 250 MG 000000.00
PHAR 000008410456 DICLOXACILLIN 500 MG 000000.00
PHAR 000008410457 DOLOBID TAB 250 MG 000000.00
PHAR 000008410458 DOLOBID TAB 500 MG 000000.00
PHAR 000008410459 LANOXICAP 0.05 MG 000000.00
PHAR 000008410460 LANOXICAP 0.1 MG 000000.00
PHAR 000008410461 LANOXICAP 0.2 MG 000000.00
PHAR 000008410462 LANOXIN TAB 0.125 MG 000000.00
PHAR 000008410463 LANOXIN TAB 0.25 MG 000000.00
PHAR 000008410464 DRAMAMINE TAB 50 MG 000000.00
PHAR 000008410465 PERSANTINE TAB 25 MG 000000.00
PHAR 000008410466 PERSANTINE TAB 50 MG 000000.00
PHAR 000008410467 PERSANTINE TAB 75 MG 000000.00
9/7/2010 11:52 AM Page 134 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008410468 NORPACE CAP 100 MG 000000.00
PHAR 000008410469 NORPACE CAP 150 MG 000000.00
PHAR 000008410470 NORPACE CR CAP 100MG 000000.00
PHAR 000008410471 NORPACE CR 150 MG 000000.00
PHAR 000008410472 ANTABUSE TAB 250 MG 000000.00
PHAR 000008410473 SURFAK CAP 240 MG 000000.00
PHAR 000008410474 SURFAK CAP 50 MG 000000.00
PHAR 000008410475 DOCUSATE CAP 100 MG 000000.00
PHAR 000008410476 DOCUSATE CAP 250 MG 000000.00
PHAR 000008410477 DOCUSATE SOD CAP 50 000000.00
PHAR 000008410478 ERGOTRATE TAB 0.2 MG 000000.00
PHAR 000008410479 ERGOLOID 1 MG TAB 000000.00
PHAR 000008410480 ERGOLOID 0.5 MG TAB 000000.00
PHAR 000008410481 ERGOLOID 1 MG TAB SL 000000.00
PHAR 000008410482 ERGOSTAT SL 2 MG #24 000000.00
PHAR 000008410483 ERYTHROMYCIN 250MG 000000.00
PHAR 000008410484 EES CHEWABLE 200MG 000000.00
PHAR 000008410485 E.E.S. TAB 400 MG 000000.00
PHAR 000008410486 ESTRACE TAB 1 MG 000000.00
PHAR 000008410487 ESTRACE TAB 2 MG 000000.00
PHAR 000008410488 PREMARIN TAB 0.3 MG 000000.00
PHAR 000008410489 PREMARIN TAB 0.625MG 000000.00
PHAR 000008410490 PREMARIN TAB 1.25 MG 000000.00
PHAR 000008410491 PREMARIN TAB 2.5 MG 000000.00
PHAR 000008410492 LODINE CAP 200 MG 000000.00
PHAR 000008410493 LODINE CAP 300 MG 000000.00
PHAR 000008410494 FERGON TAB 000000.00
PHAR 000008410495 FEOSOL SPANSULE 000000.00
PHAR 000008410496 FEOSOL TAB 000000.00
PHAR 000008410497 FERROUS SO4 300MG 000000.00
PHAR 000008410498 FLORINEF TAB 0.1 MG 000000.00
PHAR 000008410499 PROLIXIN TAB 1 MG 000000.00
PHAR 000008410500 PROLIXIN TAB 10 MG 000000.00
PHAR 000008410501 PROLIXIN TAB 2.5 MG 000000.00
PHAR 000008410502 PROLIXIN TAB 5 MG 000000.00
PHAR 000008410503 FOLVITE TAB 1 MG 000000.00
PHAR 000008410504 FUROSEMIDE TAB 20 MG 000000.00
PHAR 000008410505 FUROSEMIDE TAB 40 MG 000000.00
PHAR 000008410506 LOPID CAP 000000.00
PHAR 000008410507 ORGANIDIN TAB 000000.00
PHAR 000008410508 FULVICIN UF 250 MG 000000.00
PHAR 000008410509 FULVICIN UF 500MG 000000.00
PHAR 000008410510 FULVICIN PG 125MG 000000.00
PHAR 000008410511 FULVICIN-P/G 250 MG 000000.00
PHAR 000008410512 ISMELIN TAB 10 MG 000000.00
PHAR 000008410513 ISMELIN TAB 25 MG 000000.00
PHAR 000008410514 HALOPERIDOL TAB 0.5 000000.00
9/7/2010 11:52 AM Page 135 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008410515 HALOPERIDOL TAB 1 MG 000000.00
PHAR 000008410516 HALOPERIDOL TAB 1 MG 000000.00
PHAR 000008410517 HALOPERIDOL TAB 10MG 000000.00
PHAR 000008410518 HALOPERIDOL TAB 2 MG 000000.00
PHAR 000008410519 HALOPERIDOL TAB 20MG 000000.00
PHAR 000008410520 HALOPERIDOL TAB 5 MG 000000.00
PHAR 000008410521 HYDRALAZINE TAB 25MG 000000.00
PHAR 000008410522 HYDRALAZINE TAB 50MG 000000.00
PHAR 000008410523 HCTZ TAB 25 MG 000000.00
PHAR 000008410524 HCTZ TAB 50 MG 000000.00
PHAR 000008410525 CORTEF TAB 10 MG 000000.00
PHAR 000008410526 CORTEF TAB 20 MG 000000.00
PHAR 000008410527 CORTEF TAB 5 MG 000000.00
PHAR 000008410528 HYDROCORTISONE 20 MG 000000.00
PHAR 000008410529 MARPLAN TAB 10 MG 000000.00
PHAR 000008410530 ISONIAZID TAB 100 MG 000000.00
PHAR 000008410531 ISONIAZID TAB 300 MG 000000.00
PHAR 000008410532 ISORDIL SL TAB 10 MG 000000.00
PHAR 000008410533 ISORDIL SL TAB 2.5MG 000000.00
PHAR 000008410534 ISORDIL SL TAB 5 MG 000000.00
PHAR 000008410535 ISORDIL TAB 10 MG 000000.00
PHAR 000008410536 ISORDIL TAB 20 MG 000000.00
PHAR 000008410537 ISORDIL TAB 5 MG 000000.00
PHAR 000008410538 ACCUTANE CAP 10 MG 000000.00
PHAR 000008410539 ACCUTANE CAP 20 MG 000000.00
PHAR 000008410540 ACCUTANE CAP 40 MG 000000.00
PHAR 000008410541 NIZORAL TAB 200 MG 000000.00
PHAR 000008410542 LARODOPA TAB 100 MG 000000.00
PHAR 000008410543 LARODOPA TAB 250 MG 000000.00
PHAR 000008410544 SYNTHROID TAB 0.1 MG 000000.00
PHAR 000008410545 SYNTHROID 0.125MG 000000.00
PHAR 000008410546 SYNTHROID TAB 0.15MG 000000.00
PHAR 000008410547 SYNTHROID TAB 0.2 MG 000000.00
PHAR 000008410548 SYNTHROID TAB 0.3 MG 000000.00
PHAR 000008410549 LUDIOMIL TAB 25 MG 000000.00
PHAR 000008410550 LUDIOMIL TAB 50 MG 000000.00
PHAR 000008410551 LUDIOMIL TAB 75 MG 000000.00
PHAR 000008410552 ANTIVERT TAB 12.5 MG 000000.00
PHAR 000008410553 ANTIVERT TAB 25 MG 000000.00
PHAR 000008410554 MECLOMEN CAP 100 MG 000000.00
PHAR 000008410555 MECLOMEN CAP 50 MG 000000.00
PHAR 000008410556 AMEN TAB 10 MG 000000.00
PHAR 000008410557 PONSTEL CAP 000000.00
PHAR 000008410558 SERENTIL TAB 100MG 000000.00
PHAR 000008410559 SERENTIL TAB 10MG 000000.00
PHAR 000008410560 SERENTIL TAB 25MG 000000.00
PHAR 000008410561 SERENTIL TAB 50MG 000000.00
9/7/2010 11:52 AM Page 136 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008410562 CYTOMEL TAB 25 MCG 000000.00
PHAR 000008410563 CYTOMEL TAB 5 MCG 000000.00
PHAR 000008410564 CYTOMEL TAB 50 MCG 000000.00
PHAR 000008410565 LITHIUM CARB 300 MG 000000.00
PHAR 000008410566 LITHOBID TAB 300 MG 000000.00
PHAR 000008410567 IMODIUM CAP 2 MG 000000.00
PHAR 000008410568 MAGNESIUM GLUC 500MG 000000.00
PHAR 000008410569 ALUPENT TAB 10 MG 000000.00
PHAR 000008410570 ALUPENT TAB 20 MG 000000.00
PHAR 000008410571 METHOCARBAMOL 500 MG 000000.00
PHAR 000008410572 METHOCARBAMOL 750 MG 000000.00
PHAR 000008410573 METHYLDOPA TAB 250MG 000000.00
PHAR 000008410574 METHYLDOPA TAB 500MG 000000.00
PHAR 000008410575 METHERGINE TAB 0.2MG 000000.00
PHAR 000008410576 MEDROL TAB 16 MG 000000.00
PHAR 000008410577 MEDROL TAB 2 MG 000000.00
PHAR 000008410578 MEDROL TAB 4 MG 000000.00
PHAR 000008410579 SANSERT TAB 2 MG 000000.00
PHAR 000008410580 METOCLOPRAMIDE 10 MG 000000.00
PHAR 000008410581 LOPRESSOR TAB 100 MG 000000.00
PHAR 000008410582 LOPRESSOR TAB 50 MG 000000.00
PHAR 000008410583 FLAGYL TAB 250 MG 000000.00
PHAR 000008410584 FLAGYL TAB 500MG 000000.00
PHAR 000008410585 MINOCIN CAP 100 MG 000000.00
PHAR 000008410586 MINOCIN CAP 50 MG 000000.00
PHAR 000008410587 LONITEN TAB 2.5 MG 000000.00
PHAR 000008410588 LONITEN TAB 10 MG 000000.00
PHAR 000008410589 MOBAN TAB 10 MG 000000.00
PHAR 000008410590 MOBAN TAB 100 MG 000000.00
PHAR 000008410591 MOBAN TAB 25 MG 000000.00
PHAR 000008410592 MOBAN TAB 5 MG 000000.00
PHAR 000008410593 MOBAN TAB 50 MG 000000.00
PHAR 000008410594 CORGARD TAB 120 MG 000000.00
PHAR 000008410595 CORGARD TAB 160 MG 000000.00
PHAR 000008410596 CORGARD TAB 40 MG 000000.00
PHAR 000008410597 CORGARD TAB 80 MG 000000.00
PHAR 000008410598 TREXAN TAB 50 MG 000000.00
PHAR 000008410599 ARALEN TAB 500 MG 000000.00
PHAR 000008410600 ANAPROX TAB 275 MG 000000.00
PHAR 000008410601 NIACIN TAB 100 MG 000000.00
PHAR 000008410602 NIACIN TAB 25 MG 000000.00
PHAR 000008410603 NIACIN TAB 50 MG 000000.00
PHAR 000008410604 NIACIN TAB 500 MG 000000.00
PHAR 000008410605 NICOBID TEM 125MG 000000.00
PHAR 000008410606 NICOBID TEM 250MG 000000.00
PHAR 000008410607 NICOBID TEM 500MG 000000.00
PHAR 000008410608 NIACINAMIDE 100MG 000000.00
9/7/2010 11:52 AM Page 137 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008410609 NIACINAMIDE 500MG 000000.00
PHAR 000008410610 NIACINAMIDE 50MG 000000.00
PHAR 000008410611 NICORETTE 2 MG #96 000000.00
PHAR 000008410612 NIFEDIPINE CAP 10 MG 000000.00
PHAR 000008410613 FURADANTIN TAB 100MG 000000.00
PHAR 000008410614 FURADANTIN TAB 50 MG 000000.00
PHAR 000008410615 NITROSTAT 0.15MG #25 000000.00
PHAR 000008410616 NITROSTAT 0.3MG #25 000000.00
PHAR 000008410617 NITROSTAT 0.6MG #25 000000.00
PHAR 000008410618 AXID CAP 150MG 000000.00
PHAR 000008410619 OVRETTE #28 000000.00
PHAR 000008410620 NORTRIPTYLINE 10 MG 000000.00
PHAR 000008410621 PRILOSEC CAP 20 MG C 000000.00
PHAR 000008410622 NORFLEX TAB 000000.00
PHAR 000008410623 DITROPAN TAB 5 MG 000000.00
PHAR 000008410624 ILOZYME TAB 000000.00
PHAR 000008410625 PANCREASE CAP 000000.00
PHAR 000008410626 CYLERT TAB 18.75 MG 000000.00
PHAR 000008410627 CYLERT TAB 37.5 MG 000000.00
PHAR 000008410628 CYLERT TAB 75 MG 000000.00
PHAR 000008410629 DILANTIN CHEW 50 MG 000000.00
PHAR 000008410630 DILANTIN CAP 100 MG 000000.00
PHAR 000008410631 MEPHYTON TAB 5 MG 000000.00
PHAR 000008410632 ORAP TAB 2 MG 000000.00
PHAR 000008410633 FELDENE CAP 10 MG 000000.00
PHAR 000008410634 FELDENE CAP 20 MG 000000.00
PHAR 000008410635 K-LYTE TAB 000000.00
PHAR 000008410636 KLORVESS 20 MEQ TAB 000000.00
PHAR 000008410637 POTASS CHLOR 1 GM 000000.00
PHAR 000008410638 POTASS CHLOR 300MG 000000.00
PHAR 000008410639 KAON TAB 000000.00
PHAR 000008410640 MINIPRESS CAP 1 MG 000000.00
PHAR 000008410641 MINIPRESS CAP 2 MG 000000.00
PHAR 000008410642 MINIPRESS CAP 5 MG 000000.00
PHAR 000008410643 PREDNISOLONE 5 MG 000000.00
PHAR 000008410644 PREDNISONE TAB 1 MG 000000.00
PHAR 000008410645 PREDNISONE TAB 10 MG 000000.00
PHAR 000008410646 PREDNISONE 2.5 MG 000000.00
PHAR 000008410647 PREDNISONE TAB 20 MG 000000.00
PHAR 000008410648 PREDNISONE TAB 5 MG 000000.00
PHAR 000008410649 PREDNISONE TAB 50 MG 000000.00
PHAR 000008410650 PROCAINAMIDE CAP 375 000000.00
PHAR 000008410651 PROCAN SR TAB 250 MG 000000.00
PHAR 000008410652 PROCAN SR TAB 500 MG 000000.00
PHAR 000008410653 PROCAN SR TAB 750 MG 000000.00
PHAR 000008410654 COMPAZINE SPAN 10 MG 000000.00
PHAR 000008410655 COMPAZINE SPAN 15 MG 000000.00
9/7/2010 11:52 AM Page 138 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008410656 COMPAZINE SPAN 30 MG 000000.00
PHAR 000008410657 PROCHLORPERAZINE 10M 000000.00
PHAR 000008410658 PROCHLORPERAZINE 25M 000000.00
PHAR 000008410659 PROCHLORPERAZINE 5MG 000000.00
PHAR 000008410660 PHENERGAN TAB 12.5MG 000000.00
PHAR 000008410661 PHENERGAN TAB 25 MG 000000.00
PHAR 000008410662 PHENERGAN TAB 50 MG 000000.00
PHAR 000008410663 PRO-BANTHINE 7.5 MG 000000.00
PHAR 000008410664 PROPANTHELINE TAB 15 000000.00
PHAR 000008410665 INDERAL LA CAP 80 MG 000000.00
PHAR 000008410666 PROPRANOLOL TAB 10MG 000000.00
PHAR 000008410667 PROPRANOLOL TAB 20MG 000000.00
PHAR 000008410668 PROPRANOLOL TAB 40MG 000000.00
PHAR 000008410669 PROPRANOLOL TAB 80MG 000000.00
PHAR 000008410670 PSEUDOEPHED 30MG TAB 000000.00
PHAR 000008410671 PSEUDOEPHED TAB 60MG 000000.00
PHAR 000008410672 SUDAFED-SA CAP 120MG 000000.00
PHAR 000008410673 PYRIDOXINE TAB 50 MG 000000.00
PHAR 000008410674 QUINIDEX EXTENTAB 000000.00
PHAR 000008410675 QUINIDINE 200 MG 000000.00
PHAR 000008410676 QUINIDINE 300 MG 000000.00
PHAR 000008410677 QUINAMM TAB 000000.00
PHAR 000008410678 QUININE SULF 200 MG 000000.00
PHAR 000008410679 RIFAMPIN CAP 300 MG 000000.00
PHAR 000008410680 DISALCID TAB 500 MG 000000.00
PHAR 000008410681 DISALCID TAB 750 MG 000000.00
PHAR 000008410682 ELDEPRYL TAB 5MG 000000.00
PHAR 000008410683 SENOKOT TAB 000000.00
PHAR 000008410684 PHAZYME TAB 000000.00
PHAR 000008410685 ALDACTONE TAB 100 MG 000000.00
PHAR 000008410686 ALDACTONE TAB 50 MG 000000.00
PHAR 000008410687 SPIRONOLACTONE 25 MG 000000.00
PHAR 000008410688 SULFADIAZINE 500 MG 000000.00
PHAR 000008410689 GANTANOL TAB 500 MG 000000.00
PHAR 000008410690 GANTANOL-DS TAB 1GM 000000.00
PHAR 000008410691 GANTRISIN TAB 500 MG 000000.00
PHAR 000008410692 CLINORIL TAB 150 MG 000000.00
PHAR 000008410693 CLINORIL TAB 200 MG 000000.00
PHAR 000008410694 NOLVADEX TAB 10 MG 000000.00
PHAR 000008410695 TETRACYCLINE 250 MG 000000.00
PHAR 000008410696 TETRACYCLINE 500 MG 000000.00
PHAR 000008410697 ELIXOPHYLLIN 200MG 000000.00
PHAR 000008410698 QUIBRON-T,SR TAB 300 000000.00
PHAR 000008410699 THEO-DUR SPR 125 MG 000000.00
PHAR 000008410700 THEO-DUR SPR 200 MG 000000.00
PHAR 000008410701 THEO-DUR SPR 50 MG 000000.00
PHAR 000008410702 THEO-DUR SPR 75 MG 000000.00
9/7/2010 11:52 AM Page 139 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008410703 THEO-DUR TAB 100 MG 000000.00
PHAR 000008410704 THEO-DUR TAB 200 MG 000000.00
PHAR 000008410705 THEO-DUR TAB 300 MG 000000.00
PHAR 000008410706 THIORIDAZINE 10 MG 000000.00
PHAR 000008410707 THIORIDAZINE 100 MG 000000.00
PHAR 000008410708 THIORIDAZINE 15 MG 000000.00
PHAR 000008410709 THIORIDAZINE 150 MG 000000.00
PHAR 000008410710 THIORIDAZINE 200 MG 000000.00
PHAR 000008410711 THIORIDAZINE 25 MG 000000.00
PHAR 000008410712 THIORIDAZINE 50 MG 000000.00
PHAR 000008410713 PROLOID TAB 100 MG 000000.00
PHAR 000008410714 PROLOID TAB 130 MG 000000.00
PHAR 000008410715 PROLOID TAB 200 MG 000000.00
PHAR 000008410716 PROLOID TAB 32 MG 000000.00
PHAR 000008410717 PROLOID TAB 65 MG 000000.00
PHAR 000008410718 LACTAID TAB 3300 U 000000.00
PHAR 000008410719 ORINASE TAB 250 MG 000000.00
PHAR 000008410720 TOLBUTAMIDE 500 MG 000000.00
PHAR 000008410721 DESYREL TAB 100 MG 000000.00
PHAR 000008410722 DESYREL TAB 150 MG 000000.00
PHAR 000008410723 DESYREL TAB 50 MG 000000.00
PHAR 000008410724 ARISTO-PAK 4 MG #16 000000.00
PHAR 000008410725 ARISTOCORT TAB 2 MG 000000.00
PHAR 000008410726 ARISTOCORT TAB 4 MG 000000.00
PHAR 000008410727 DYRENIUM CAP 100 MG 000000.00
PHAR 000008410728 DYRENIUM CAP 50MG 000000.00
PHAR 000008410729 STELAZINE TAB 10 MG 000000.00
PHAR 000008410730 STELAZINE TAB 5 MG 000000.00
PHAR 000008410731 TRIHEXYPHENIDYL 2MG 000000.00
PHAR 000008410732 TRIHEXYPHENIDYL 5MG 000000.00
PHAR 000008410733 PROLOPRIM TAB 100 MG 000000.00
PHAR 000008410734 PBZ TAB 25 MG 000000.00
PHAR 000008410735 PBZ TAB 50 MG 000000.00
PHAR 000008410736 DEPAKENE CAP 250MG 000000.00
PHAR 000008410737 ISOPTIN TAB 120 MG 000000.00
PHAR 000008410738 ISOPTIN TAB 80 MG 000000.00
PHAR 000008410739 VITAMIN E CAP 200 IU 000000.00
PHAR 000008410740 COUMADIN TAB 10 MG 000000.00
PHAR 000008410741 COUMADIN TAB 2 MG 000000.00
PHAR 000008410742 COUMADIN TAB 2.5 MG 000000.00
PHAR 000008410743 COUMADIN TAB 5 MG 000000.00
PHAR 000008410744 COUMADIN TAB 7.5 MG 000000.00
PHAR 000008410745 TENORETIC 50/25 TAB 000000.00
PHAR 000008410746 LITHIUM CARB CAP 150 000000.00
PHAR 000008410747 IBUPROFEN TAB 200 MG 000000.00
PHAR 000008410748 IBUPROFEN TAB 400 MG 000000.00
PHAR 000008410749 IBUPROFEN TAB 600 MG 000000.00
9/7/2010 11:52 AM Page 140 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008410750 IBUPROFEN TAB 800 MG 000000.00
PHAR 000008410751 PERMITIL TAB 2.5 MG 000000.00
PHAR 000008410752 PERMITIL TAB 5 MG 000000.00
PHAR 000008410753 TUMS ANTACID 500 UD 000000.00
PHAR 000008410754 MICAPO-K 8 MEQ CAP 000000.00
PHAR 000008410755 B COMPLEX WITH C TAB 000000.00
PHAR 000008410756 LEVSIN SUB 0.125 MG 000000.00
PHAR 000008410757 LITHIUM CARB CAP 600 000000.00
PHAR 000008410758 FLOXIN TAB 400 MG 000000.00
PHAR 000008410759 FLOXIN TAB 200 MG 000000.00
PHAR 000008410760 FLOXIN TAB 300 MG 000000.00
PHAR 000008411001 TYLENOL CAPLETS 500 000000.00
PHAR 000008411002 TYLENOL CHEW 80 MG 000000.00
PHAR 000008411003 TYLENOL TAB 325 MG 000000.00
PHAR 000008411004 ZOVIRAX CAP 200 MG 000000.00
PHAR 000008411005 PROVENTIL RPTAB 4 MG 000000.00
PHAR 000008411006 VENTOLIN TAB 2 MG 000000.00
PHAR 000008411007 VENTOLIN TAB 4 MG 000000.00
PHAR 000008411008 ZYLOPRIM TAB 100 MG 000000.00
PHAR 000008411009 ZYLOPRIM TAB 300 MG 000000.00
PHAR 000008411010 XANAX TAB 0.25 MG 000000.00
PHAR 000008411011 XANAX TAB 0.5 MG 000000.00
PHAR 000008411012 XANAX TAB 1 MG 000000.00
PHAR 000008411013 BASALJEL CAP 000000.00
PHAR 000008411014 BASALJEL TAB 000000.00
PHAR 000008411015 AMITRIPTYLINE 100 MG 000000.00
PHAR 000008411016 AMITRIPTYLINE 150MG 000000.00
PHAR 000008411017 AMITRIPTYLINE TAB 75 000000.00
PHAR 000008411018 ASENDIN TAB 100 MG 000000.00
PHAR 000008411019 ASENDIN TAB 150 MG 000000.00
PHAR 000008411020 ASENDIN TAB 25 MG 000000.00
PHAR 000008411021 ASENDIN TAB 50 MG 000000.00
PHAR 000008411022 AMOXIL CHEW TAB 125 000000.00
PHAR 000008411023 ASCORBIC ACID 100 MG 000000.00
PHAR 000008411024 ASCORBIC ACID 250MG 000000.00
PHAR 000008411025 ASCORBIC ACID 500MG 000000.00
PHAR 000008411026 ASPERGUM #16 000000.00
PHAR 000008411027 ASPIRIN E.C. 325 MG 000000.00
PHAR 000008411028 BAYER ASA 81 MG 000000.00
PHAR 000008411029 RIDAURA CAP 3 MG 000000.00
PHAR 000008411030 BENZTROPINE TAB 0.5 000000.00
PHAR 000008411031 BETHANECHOL TAB 10 M 000000.00
PHAR 000008411032 BETHANECHOL TAB 25 M 000000.00
PHAR 000008411033 BETHANECHOL TAB 5 MG 000000.00
PHAR 000008411034 BETHANECHOL TAB 50 M 000000.00
PHAR 000008411035 WELLBUTRIN TAB 100MG 000000.00
PHAR 000008411036 WELLBUTRIN TAB 75 MG 000000.00
9/7/2010 11:52 AM Page 141 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008411037 MYLANTA CHEWABLE 000000.00
PHAR 000008411038 OS-CAL-500 TAB 000000.00
PHAR 000008411039 TUMS TABS #12 000000.00
PHAR 000008411040 TUMS EX # 8 000000.00
PHAR 000008411041 CAPOTEN TAB 12.5 MG 000000.00
PHAR 000008411042 TEGRETOL CHEW 100 MG 000000.00
PHAR 000008411043 SOMA TAB 350 MG 000000.00
PHAR 000008411044 CHLORPROMAZINE 10 MG 000000.00
PHAR 000008411045 CHLORPROMAZINE 25 MG 000000.00
PHAR 000008411046 THORAZINE SPAN 150MG 000000.00
PHAR 000008411047 THORAZINE SPAN 200MG 000000.00
PHAR 000008411048 THORAZINE SPANS 75MG 000000.00
PHAR 000008411049 CHLORZOXAZONE 500 MG 000000.00
PHAR 000008411050 TRILISATE TAB 500 MG 000000.00
PHAR 000008411051 CIPRO TAB 250 MG 000000.00
PHAR 000008411052 CIPRO TAB 500 MG 000000.00
PHAR 000008411053 CIPRO TAB 750 MG 000000.00
PHAR 000008411054 TAVIST TAB 2.68 MG 000000.00
PHAR 000008411055 TAVIST-1 TAB 1.34 MG 000000.00
PHAR 000008411056 ATROMID-S CAP 500 MG 000000.00
PHAR 000008411057 CLONIDINE TAB 0.2 MG 000000.00
PHAR 000008411058 CLONIDINE TAB 0.3 MG 000000.00
PHAR 000008411059 MYCELEX TROCHE 10 MG 000000.00
PHAR 000008411060 CLOXACILLIN CAP 250 000000.00
PHAR 000008411061 CLOXACILLIN CAP 500 000000.00
PHAR 000008411062 ACTIFED TAB 000000.00
PHAR 000008411063 ALDACTAZIDE 50/50 000000.00
PHAR 000008411064 PANCREATIN TAB 000000.00
PHAR 000008411065 AUGMENTIN TAB 500 000000.00
PHAR 000008411066 AZO-GANTANOL TAB 000000.00
PHAR 000008411067 AZO-GANTRISIN TAB 000000.00
PHAR 000008411068 BELLADENAL TAB 000000.00
PHAR 000008411069 BELLADENAL-S TAB 000000.00
PHAR 000008411070 BELLERGAL-S TAB 000000.00
PHAR 000008411071 BEROCCA TAB 000000.00
PHAR 000008411072 CHEMSTRIPS BG 000000.00
PHAR 000008411073 DRISTAN TAB 000000.00
PHAR 000008411074 ESGIC CAP 000000.00
PHAR 000008411075 ESGIC TAB 000000.00
PHAR 000008411076 MAXZIDE 37.5-25 MG 000000.00
PHAR 000008411077 MODICON #28 000000.00
PHAR 000008411078 MODURETIC TAB 5/50 000000.00
PHAR 000008411079 MYLANTA-II CHEWABLE 000000.00
PHAR 000008411080 ORTHO-NOVUM 10/11 28 000000.00
PHAR 000008411081 ORTHO NOVUM 21 7/7/7 000000.00
PHAR 000008411082 ORTHO-NOVUM 7/7/7 28 000000.00
PHAR 000008411083 OVCON-35 #21 000000.00
9/7/2010 11:52 AM Page 142 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008411084 OVCON-35 #28 000000.00
PHAR 000008411085 OVCON-50 #21 000000.00
PHAR 000008411086 OVCON-50 #28 000000.00
PHAR 000008411087 SINEMET 25/250 TAB 000000.00
PHAR 000008411088 SOMA CPD TAB 000000.00
PHAR 000008411089 TAVIST-D TAB 000000.00
PHAR 000008411090 THERAGRAN HEMATINIC 000000.00
PHAR 000008411091 THERAP MULTIVITE/MIN 000000.00
PHAR 000008411092 THERAGRAN TAB 000000.00
PHAR 000008411093 TITRALAC TAB 000000.00
PHAR 000008411094 TRI-NORINYL #21 000000.00
PHAR 000008411095 TRI-NORINYL #28 000000.00
PHAR 000008411096 TRI-PHASIL #21 000000.00
PHAR 000008411097 TRIPHASIL #28 000000.00
PHAR 000008411098 TRINALIN TAB 000000.00
PHAR 000008411099 URISED TAB 000000.00
PHAR 000008411100 VICON FORTE CAP 000000.00
PHAR 000008411101 VICON PLUS CAP 000000.00
PHAR 000008411102 VICON-C CAP 000000.00
PHAR 000008411103 VIOKASE TAB 325 MG 000000.00
PHAR 000008411104 VITRON-C TAB 000000.00
PHAR 000008411105 SANDIMMUNE CAP 100M 000000.00
PHAR 000008411106 DECLOMYCIN TAB 150MG 000000.00
PHAR 000008411107 NORPRAMIN TAB 100 MG 000000.00
PHAR 000008411108 NORPRAMIN TAB 150 MG 000000.00
PHAR 000008411109 DEXAMETHASONE 1 MG 000000.00
PHAR 000008411110 VOLTAREN TAB 25 MG 000000.00
PHAR 000008411111 VOLTAREN TAB 50 MG 000000.00
PHAR 000008411112 VOLTAREN TAB 75 MG 000000.00
PHAR 000008411113 DICYCLOMINE CAP 10MG 000000.00
PHAR 000008411114 CARDIZEM SR 120 MG 000000.00
PHAR 000008411115 CARDIZEM SR CAP 60 M 000000.00
PHAR 000008411116 CARDIZEM SR 90MG CAP 000000.00
PHAR 000008411117 DIPHENHYDRAMINE 25MG 000000.00
PHAR 000008411118 DIPHENHYDRAMINE 50MG 000000.00
PHAR 000008411119 DEPAKOTE TAB 250 MG 000000.00
PHAR 000008411120 DEPAKOTE TAB 500 MG 000000.00
PHAR 000008411121 SINEQUAN CAP 10 MG 000000.00
PHAR 000008411122 SINEQUAN CAP 100 MG 000000.00
PHAR 000008411123 SINEQUAN CAP 25 MG 000000.00
PHAR 000008411124 SINEQUAN CAP 50 MG 000000.00
PHAR 000008411125 SINEQUAN CAP 75 MG 000000.00
PHAR 000008411126 VASOTEC TAB 10 MG 000000.00
PHAR 000008411127 VASOTEC TAB 20 MG 000000.00
PHAR 000008411128 VASOTEC TAB 5 MG 000000.00
PHAR 000008411129 ERGOSTAT SL 2 MG 000000.00
PHAR 000008411130 E-MYCIN TAB 333 MG 000000.00
9/7/2010 11:52 AM Page 143 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008411131 ERY-TAB 250 MG 000000.00
PHAR 000008411132 ERY-TAB 500 MG 000000.00
PHAR 000008411133 ERYC CAP 250 MG 000000.00
PHAR 000008411134 ERYTHROMYCIN 500 MG 000000.00
PHAR 000008411135 PREMARIN TAB 0.9 MG 000000.00
PHAR 000008411136 OGEN TAB 0.625 MG 000000.00
PHAR 000008411137 OGEN TAB 1.25 MG 000000.00
PHAR 000008411138 NALFON CAP 200 MG 000000.00
PHAR 000008411139 NALFON CAP 300 MG 000000.00
PHAR 000008411140 NALFON TAB 600 MG 000000.00
PHAR 000008411141 URISPAS TAB 100 MG 000000.00
PHAR 000008411142 TAMBOCOR TAB 100 MG 000000.00
PHAR 000008411143 PROZAC CAP 20 MG 000000.00
PHAR 000008411144 ANSAID TAB 100 MG 000000.00
PHAR 000008411145 ANSAID TAB 50 MG 000000.00
PHAR 000008411146 EULEXIN CAP 125 MG 000000.00
PHAR 000008411147 LOPID TAB 600 MG 000000.00
PHAR 000008411148 GLUCOTROL TAB 10 MG 000000.00
PHAR 000008411149 GLUCOTROL TAB 5 MG 000000.00
PHAR 000008411150 GLYBURIDE TAB 1.25MG 000000.00
PHAR 000008411151 GLYBURIDE TAB 2.5 MG 000000.00
PHAR 000008411152 GLYBURIDE TAB 5 MG 000000.00
PHAR 000008411153 GRISACTIN CAP 125 MG 000000.00
PHAR 000008411154 GRISACTIN CAP 250 MG 000000.00
PHAR 000008411155 GRISACTIN TAB 500 MG 000000.00
PHAR 000008411156 GRIS-PEG TAB 125 MG 000000.00
PHAR 000008411157 GRISACTIN ULTRA 250 000000.00
PHAR 000008411158 GRISACTIN ULTRA 330 000000.00
PHAR 000008411159 WYTENSIN TAB 4 MG 000000.00
PHAR 000008411160 WYTENSIN TAB 8 MG 000000.00
PHAR 000008411161 SUCRET LOZ #24 000000.00
PHAR 000008411162 HYDRALAZINE TAB 10MG 000000.00
PHAR 000008411163 HYDRALAZINE TAB 100 000000.00
PHAR 000008411164 ATARAX TAB 100 MG 000000.00
PHAR 000008411165 HYDROXYZINE 10 MG 000000.00
PHAR 000008411166 HYDROXYZINE 25 MG 000000.00
PHAR 000008411167 HYDROXYZINE 50 MG 000000.00
PHAR 000008411168 HYDROXYZINE 100 MG 000000.00
PHAR 000008411169 HYDROXYZINE 25 MG 000000.00
PHAR 000008411170 HYDROXYZINE 50 MG 000000.00
PHAR 000008411171 ADVIL TAB 200 MG 000000.00
PHAR 000008411172 IBUPROFEN TAB 300 MG 000000.00
PHAR 000008411173 IBUPROFEN TAB 400 MG 000000.00
PHAR 000008411174 ISORDIL TEMB TAB 40 000000.00
PHAR 000008411175 SORBITRATE CHEW 10MG 000000.00
PHAR 000008411176 SORBITRATE CHEW 5 MG 000000.00
PHAR 000008411177 LABETALOL TAB 100 MG 000000.00
9/7/2010 11:52 AM Page 144 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008411178 LABETALOL TAB 200 MG 000000.00
PHAR 000008411179 LABETALOL TAB 300 MG 000000.00
PHAR 000008411180 SYNTHROID 0.025 MG 000000.00
PHAR 000008411181 SYNTHROID TAB 0.05MG 000000.00
PHAR 000008411182 SYNTHROID 0.075 MG 000000.00
PHAR 000008411183 PROVERA TAB 2.5 MG 000000.00
PHAR 000008411184 MEGESTROL TAB 20 MG 000000.00
PHAR 000008411185 MEGESTROL TAB 40 MG 000000.00
PHAR 000008411186 METHYLDOPA TAB 125MG 000000.00
PHAR 000008411187 MEDROL ADT PAK 16 MG 000000.00
PHAR 000008411188 MEDROL DOSEPAK 4 MG 000000.00
PHAR 000008411189 ZAROXOLYN TAB 10 MG 000000.00
PHAR 000008411190 ZAROXOLYN TAB 2.5 MG 000000.00
PHAR 000008411191 ZAROXOLYN TAB 5 MG 000000.00
PHAR 000008411192 CYTOTEC TAB 200 MCG 000000.00
PHAR 000008411193 CORGARD TAB 20 MG 000000.00
PHAR 000008411194 UNIPEN CAP 250 MG 000000.00
PHAR 000008411195 NAFCILLIN TAB 500 MG 000000.00
PHAR 000008411196 NEGGRAM TAB 1 GM 000000.00
PHAR 000008411197 NEGGRAM TAB 250 MG 000000.00
PHAR 000008411198 NEGGRAM TAB 500 MG 000000.00
PHAR 000008411199 NAPROSYN TAB 250 MG 000000.00
PHAR 000008411200 NAPROSYN TAB 375 MG 000000.00
PHAR 000008411201 NAPROSYN TAB 500 MG 000000.00
PHAR 000008411202 PROCARDIA XL TAB 30 000000.00
PHAR 000008411203 PROCARDIA XL TAB 60 000000.00
PHAR 000008411204 PROCARDIA XL TAB 90 000000.00
PHAR 000008411205 MACRODANTIN 100 MG 000000.00
PHAR 000008411206 MACRODANTIN CAP 50MG 000000.00
PHAR 000008411207 NITROGLYCERIN CR 2.5 000000.00
PHAR 000008411208 NITROGLYCERIN CR 6.5 000000.00
PHAR 000008411209 NITROSTAT 0.4MG #25 000000.00
PHAR 000008411210 AVENTYL CAP 25 MG 000000.00
PHAR 000008411211 PAMELOR CAP 50 MG 000000.00
PHAR 000008411212 PAMELOR CAP 75 MG 000000.00
PHAR 000008411213 MYCOSTATIN ORAL TAB 000000.00
PHAR 000008411214 PROSTAPHLIN CAP 250 000000.00
PHAR 000008411215 PROSTAPHLIN CAP 500 000000.00
PHAR 000008411216 SERAX CAP 10 MG 000000.00
PHAR 000008411217 SERAX CAP 15 MG 000000.00
PHAR 000008411218 SERAX CAP 30 MG 000000.00
PHAR 000008411219 PANCREASE MT 10 CAP 000000.00
PHAR 000008411220 PANCREASE MT 16 CAP 000000.00
PHAR 000008411221 PANCREASE MT 4 CAPS 000000.00
PHAR 000008411222 PENICILLIN VK 250 MG 000000.00
PHAR 000008411223 PENICILLIN VK 500 MG 000000.00
PHAR 000008411224 TRENTAL TAB 400 MG 000000.00
9/7/2010 11:52 AM Page 145 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008411225 TRILAFON REPETAB 8MG 000000.00
PHAR 000008411226 TRILAFON TAB 16 MG 000000.00
PHAR 000008411227 TRILAFON TAB 2 MG 000000.00
PHAR 000008411228 TRILAFON TAB 4 MG 000000.00
PHAR 000008411229 TRILAFON TAB 8 MG 000000.00
PHAR 000008411230 PYRIDIUM TAB 100 MG 000000.00
PHAR 000008411231 PYRIDIUM TAB 200 MG 000000.00
PHAR 000008411232 NARDIL TAB 15 MG 000000.00
PHAR 000008411233 PHENOBARB TAB 100 MG 000000.00
PHAR 000008411234 PHENOBARBITAL 15 MG 000000.00
PHAR 000008411235 PHENOBARB TAB 30 MG 000000.00
PHAR 000008411236 PHENOBARB TAB 60 MG 000000.00
PHAR 000008411237 EX-LAX TABS #48 000000.00
PHAR 000008411238 VISKEN TAB 10 MG 000000.00
PHAR 000008411239 VISKEN TAB 5 MG 000000.00
PHAR 000008411240 MICRO-K 10 CAP 000000.00
PHAR 000008411241 MICRO-K CAP 8 MEQ 000000.00
PHAR 000008411242 SLOW-K TAB 600 MG 000000.00
PHAR 000008411243 CENTRAX CAP 10 MG 000000.00
PHAR 000008411244 CENTRAX CAP 5 MG 000000.00
PHAR 000008411245 MYSOLINE TAB 250 MG 000000.00
PHAR 000008411246 MYSOLINE TAB 50 MG 000000.00
PHAR 000008411247 BENEMID TAB 500 MG 000000.00
PHAR 000008411248 PRONESTYL CAP 250 MG 000000.00
PHAR 000008411249 PRONESTYL CAP 500 MG 000000.00
PHAR 000008411250 SPARINE TAB 100 MG 000000.00
PHAR 000008411251 SPARINE TAB 25 MG 000000.00
PHAR 000008411252 SPARINE TAB 50 MG 000000.00
PHAR 000008411253 INDERAL LA CAP 120MG 000000.00
PHAR 000008411254 INDERAL LA CAP 160MG 000000.00
PHAR 000008411255 PROPYLTHIOURAC 50 MG 000000.00
PHAR 000008411256 VIVACTIL TAB 5 MG 000000.00
PHAR 000008411257 MACRODANTIN CAP 25MG 000000.00
PHAR 000008411258 PYRIDOXINE TAB 100MG 000000.00
PHAR 000008411259 QUININE SULF 300 MG 000000.00
PHAR 000008411260 ZANTAC TAB 150 MG 000000.00
PHAR 000008411261 YUTOPAR TAB 10 MG 000000.00
PHAR 000008411262 MYLICON CHEW 40 MG 000000.00
PHAR 000008411263 MYLICON-80 CHEW TAB 000000.00
PHAR 000008411264 SOD BICARB TAB 325MG 000000.00
PHAR 000008411265 SOD BICARB 650 MG 000000.00
PHAR 000008411266 SODIUM CHLORIDE 1 G 000000.00
PHAR 000008411267 LURIDE 0.25 MG 000000.00
PHAR 000008411268 LURIDE LOZ 0.5 MG 000000.00
PHAR 000008411269 LURIDE LOZITABS 1 MG 000000.00
PHAR 000008411270 SOD FLUORIDE 2.2 MG 000000.00
PHAR 000008411271 SULFASALAZINE ENTAB 000000.00
9/7/2010 11:52 AM Page 146 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008411272 RESTORIL CAP 15 MG 000000.00
PHAR 000008411273 RESTORIL CAP 30 MG 000000.00
PHAR 000008411274 BRETHINE TAB 2.5 MG 000000.00
PHAR 000008411275 SELDANE TAB 60 MG 000000.00
PHAR 000008411276 ELIXOPHYLLIN SR 125M 000000.00
PHAR 000008411277 ELIXOPHYLLIN SR 250M 000000.00
PHAR 000008411278 SLO-BID GYRO CAP 100 000000.00
PHAR 000008411279 SLO-BID GYRO CAP 125 000000.00
PHAR 000008411280 SLO-BID GYRO CAP 200 000000.00
PHAR 000008411281 SLO-BID GYRO CAP 300 000000.00
PHAR 000008411282 SLO-BID GYRO CAP 50 000000.00
PHAR 000008411283 SLO-BID GYRO CAP 75 000000.00
PHAR 000008411284 SLOPHYLLIN CAP 125 M 000000.00
PHAR 000008411285 SLOPHYLLIN CAP 250 000000.00
PHAR 000008411286 SLOPHYLLIN CAP 60 MG 000000.00
PHAR 000008411287 SOMOPHYLLIN-T 100 MG 000000.00
PHAR 000008411288 SOMOPHYLLIN-T 200 MG 000000.00
PHAR 000008411289 UNIPHYL TAB 200 MG 000000.00
PHAR 000008411290 UNIPHYL TAB 400 MG 000000.00
PHAR 000008411291 THEO-24 CAP 100 MG 000000.00
PHAR 000008411292 THEO-24 CAP 200 MG 000000.00
PHAR 000008411293 THEO-24 CAP 300 MG 000000.00
PHAR 000008411294 THEOBID CAP DURACAPS 000000.00
PHAR 000008411295 THEOLAIR TAB 125 MG 000000.00
PHAR 000008411296 THEOLAIR TAB 250 MG 000000.00
PHAR 000008411297 THEOLAIR SR 250MG 000000.00
PHAR 000008411298 THEOLAIR SR 500MG 000000.00
PHAR 000008411299 THIAMINE TAB 100 MG 000000.00
PHAR 000008411300 THIAMINE TAB 50 MG 000000.00
PHAR 000008411301 TORECAN TAB 10 MG 000000.00
PHAR 000008411302 NAVANE CAP 1 MG 000000.00
PHAR 000008411303 NAVANE CAP 10 MG 000000.00
PHAR 000008411304 NAVANE CAP 2 MG 000000.00
PHAR 000008411305 NAVANE CAP 20 MG 000000.00
PHAR 000008411306 NAVANE CAP 5 MG 000000.00
PHAR 000008411307 THYROID TAB 120 MG 000000.00
PHAR 000008411308 THYROID TAB 15 MG 000000.00
PHAR 000008411309 THYROID TAB 180 MG 000000.00
PHAR 000008411310 THYROID TAB 240 MG 000000.00
PHAR 000008411311 THYROID TAB 30 MG 000000.00
PHAR 000008411312 THYROID TAB 300 MG 000000.00
PHAR 000008411313 THYROID TAB 60 MG 000000.00
PHAR 000008411314 BLOCADREN TAB 10 MG 000000.00
PHAR 000008411315 BLOCADREN TAB 20 MG 000000.00
PHAR 000008411316 BLOCADREN TAB 5 MG 000000.00
PHAR 000008411317 TOLAZAMIDE 100 MG 000000.00
PHAR 000008411318 TOLAZAMIDE 250 MG 000000.00
9/7/2010 11:52 AM Page 147 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008411319 TOLECTIN TAB 200 MG 000000.00
PHAR 000008411320 TOLECTIN DS 400 MG 000000.00
PHAR 000008411321 PARNATE TAB 10 MG 000000.00
PHAR 000008411322 STELAZINE TAB 1 MG 000000.00
PHAR 000008411323 STELAZINE TAB 2 MG 000000.00
PHAR 000008411324 ARTANE SEQUELS 5 MG 000000.00
PHAR 000008411325 TIGAN CAP 100 MG 000000.00
PHAR 000008411326 TIGAN CAP 250 MG 000000.00
PHAR 000008411327 TRYPTOPHAN TAB 0.5 G 000000.00
PHAR 000008411328 CALAN TAB 120 MG 000000.00
PHAR 000008411329 CALAN TAB 80 MG 000000.00
PHAR 000008411330 VITAMIN E CAP 1000 U 000000.00
PHAR 000008411331 VITAMIN E CAP 400 IU 000000.00
PHAR 000008411332 ZINC SULFATE 50 MG 000000.00
PHAR 000008411333 IBUPROFEN TAB 600 MG 000000.00
PHAR 000008411334 IBUPROFEN TAB 800 MG 000000.00
PHAR 000008411335 IMIPRAMINE HCL 25 MG 000000.00
PHAR 000008411336 IMIPRAMINE HCL 10 MG 000000.00
PHAR 000008411337 IMIPRAMINE HCL 50 MG 000000.00
PHAR 000008411338 TOFRANIL-PM CAP 75MG 000000.00
PHAR 000008411339 TOFRANIL-PM 150 MG 000000.00
PHAR 000008411340 TOFRANIL-PM 100 MG 000000.00
PHAR 000008411341 TOFRANIL-PM 125 MG 000000.00
PHAR 000008411342 VOLTAREN TAB 50 MG 000000.00
PHAR 000008411343 VOLTAREN TAB 75 MG 000000.00
PHAR 000008411344 CARDURA TAB 1 MG 000000.00
PHAR 000008411345 CALAN SR 180 MG TAB 000000.00
PHAR 000008411346 PRENATAL S MULTI VIT 000000.00
PHAR 000008412001 AMINOPHYLLIN TAB 200 000000.00
PHAR 000008412002 CORDARONE TAB 200 MG 000000.00
PHAR 000008412003 EMPIRIN TAB 325 MG 000000.00
PHAR 000008412004 LIORESAL TAB 20 MG 000000.00
PHAR 000008412005 CELESTONE TAB 0.6 MG 000000.00
PHAR 000008412006 BUMEX TAB 0.5 MG 000000.00
PHAR 000008412007 BUMEX TAB 1 MG 000000.00
PHAR 000008412008 BUMEX TAB 2 MG 000000.00
PHAR 000008412009 BUSPAR TAB 10 MG 000000.00
PHAR 000008412010 BUSPAR TAB 5 MG 000000.00
PHAR 000008412011 CAFFEINE 100 MG TAB 000000.00
PHAR 000008412012 CALCIUM CARB 650 MG 000000.00
PHAR 000008412013 CITRACAL TAB 000000.00
PHAR 000008412014 CALCIUM GLUC 500 MG 000000.00
PHAR 000008412015 CALCIUM GLUCONATE 1G 000000.00
PHAR 000008412016 CALCIUM LAC 325 MG 000000.00
PHAR 000008412017 CALCIUM LAC 650 MG 000000.00
PHAR 000008412018 CAPOTEN TAB 100 MG 000000.00
PHAR 000008412019 CAPOTEN TAB 25 MG 000000.00
9/7/2010 11:52 AM Page 148 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008412020 CAPOTEN TAB 50 MG 000000.00
PHAR 000008412021 CECLOR CAP 250 MG 000000.00
PHAR 000008412022 CECLOR CAP 500 MG 000000.00
PHAR 000008412023 CHLOR-TRIMETON 4 MG 000000.00
PHAR 000008412024 CHLOR-TRIMETON 12 MG 000000.00
PHAR 000008412025 CHLOR-TRIMETON 8MG 000000.00
PHAR 000008412026 TRILISATE TAB 750 MG 000000.00
PHAR 000008412027 CLONIDINE TAB 0.1 MG 000000.00
PHAR 000008412028 BREVICON #21 000000.00
PHAR 000008412029 BREVICON #28 000000.00
PHAR 000008412030 CAFERGOT PB TAB 000000.00
PHAR 000008412031 CAFERGOT TAB 000000.00
PHAR 000008412032 CORRECTOL TAB 000000.00
PHAR 000008412033 LACTINEX TABS #50 000000.00
PHAR 000008412034 QUIBRON-300 CAP 000000.00
PHAR 000008412035 SINUTAB TAB 000000.00
PHAR 000008412036 CARDIZEM TAB 30 MG 000000.00
PHAR 000008412037 CARDIZEM TAB 60 MG 000000.00
PHAR 000008412038 CARDIZEM TAB 90 MG 000000.00
PHAR 000008412039 PCE TAB 333 MG 000000.00
PHAR 000008412040 ESTRADERM 0.05 PATCH 000000.00
PHAR 000008412041 ESTRADERM 0.1 PATCH 000000.00
PHAR 000008412042 PEPCID TAB 20 MG 000000.00
PHAR 000008412043 PEPCID TAB 40 MG 000000.00
PHAR 000008412044 ORUDIS CAP 50 MG 000000.00
PHAR 000008412045 ORUDIS CAP 75 MG 000000.00
PHAR 000008412046 ZESTRIL TAB 10MG 000000.00
PHAR 000008412047 ZESTRIL TAB 20 MG 000000.00
PHAR 000008412048 ZESTRIL TAB 5 MG 000000.00
PHAR 000008412049 ESKALITH CR TAB 450 000000.00
PHAR 000008412050 MEVACOR TAB 20MG 000000.00
PHAR 000008412051 MEXITIL CAP 150 MG 000000.00
PHAR 000008412052 MEXITIL CAP 200 MG 000000.00
PHAR 000008412053 MEXITIL CAP 250 MG 000000.00
PHAR 000008412054 ANAPROX-DS TAB 000000.00
PHAR 000008412055 NOROXIN TAB 400 MG 000000.00
PHAR 000008412056 MYCOSTATIN LOZENGES 000000.00
PHAR 000008412057 CHOLEDYL SA 400 MG 000000.00
PHAR 000008412058 CHOLEDYL SA 600MG 000000.00
PHAR 000008412059 CHOLEDYL TAB 100 MG 000000.00
PHAR 000008412060 CHOLEDYL TAB 200 MG 000000.00
PHAR 000008412061 K-TABS TAB 10 MEQ 000000.00
PHAR 000008412062 TEN-K TAB 10 MEQ 000000.00
PHAR 000008412063 MINIPRESS CAP 1 MG 000000.00
PHAR 000008412064 INDERAL LA CAP 60 MG 000000.00
PHAR 000008412065 RIFADIN CAP 150 MG 000000.00
PHAR 000008412066 DISALCID CAP 500 MG 000000.00
9/7/2010 11:52 AM Page 149 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008412067 CARAFATE TAB 1 GM 000000.00
PHAR 000008412068 SULFASALAZINE 500 MG 000000.00
PHAR 000008412069 BRETHINE TAB 5 MG 000000.00
PHAR 000008412070 TOLAZAMIDE 500 MG 000000.00
PHAR 000008412071 SURMONTIL CAP 25 MG 000000.00
PHAR 000008412072 SURMONTIL CAP 50 MG 000000.00
PHAR 000008412073 VANCOCIN CAP 125 MG 000000.00
PHAR 000008412074 VANCOCIN CAP 250 MG 000000.00
PHAR 000008412075 CALAN SR TAB 240 MG 000000.00
PHAR 000008412076 RETROVIR CAP 100 MG 000000.00
PHAR 000008412077 MACROBID CAP 100 MG 000000.00
PHAR 000008413001 QUESTRAN PACK 000000.00
PHAR 000008413002 K-LYTE/CL 25 MEQ 000000.00
PHAR 000008413003 K-LYTE/CL-50 TAB 000000.00
PHAR 000008413004 LACTINEX GRAN 1 GM 000000.00
PHAR 000008413005 ERYTHROCIN TAB 250MG 000000.00
PHAR 000008413006 K-LOR 20 MEQ 000000.00
PHAR 000008413007 KATO PACKET 000000.00
PHAR 000008413008 EFFERSYLLIUM 270 G 000000.00
PHAR 000008413009 EFFERSYLLIUM PACKET 000000.00
PHAR 000008413010 KAYEXALATE 000000.00
PHAR 000008413011 KAYEXALATE POWD 454G 000000.00
PHAR 000008414001 SERENTIL TAB 50MG 000000.00
PHAR 000008416001 TYLENOL ELIXIR 4 OZ 000000.00
PHAR 000008416002 AMPICILLIN 500MG UD 000000.00
PHAR 000008416003 KEFLEX 125MG/5ML 5ML 000000.00
PHAR 000008416004 KEFLEX 250MG/5ML 5ML 000000.00
PHAR 000008416005 DIPHEN/ATROP 2.5MG/5 000000.00
PHAR 000008416006 METAMUCIL PAK SINGLE 000000.00
PHAR 000008416007 PERDIEM 100 GM 000000.00
PHAR 000008416008 PERDIEM 250 GM 000000.00
PHAR 000008416009 ROBITUSSIN DM 120 ML 000000.00
PHAR 000008416010 ROBITUSSIN-DM UD 10M 000000.00
PHAR 000008416011 ROBITUSSIN-DM UD 5ML 000000.00
PHAR 000008416012 ADVIL SUSP 100MG/5ML 000000.00
PHAR 000008416013 POT CHLOR 20 MEQ UD 000000.00
PHAR 000008416014 KCL 20% 3 OZ 000000.00
PHAR 000008416015 KCL 40MEQ/30ML UD 000000.00
PHAR 000008416016 VANCOCIN ORAL 1G/20M 000000.00
PHAR 000008417001 PROVENTIL SYRUP 3 OZ 000000.00
PHAR 000008417002 SYMMETREL SYRUP 3 OZ 000000.00
PHAR 000008417003 MILK OF BISMUTH 3 OZ 000000.00
PHAR 000008417004 DIMETANE ELIXIR 3OZ 000000.00
PHAR 000008417005 TEGRETOL 100MG/5ML 000000.00
PHAR 000008417006 CHLORAL HYDRATE 3 OZ 000000.00
PHAR 000008417007 THORAZINE SYRUP 120 000000.00
PHAR 000008417008 ACTIFED SYRUP 3 OZ 000000.00
9/7/2010 11:52 AM Page 150 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008417009 DECONAMINE SYRUP 3OZ 000000.00
PHAR 000008417010 DIMETAPP ELIXIR 3 OZ 000000.00
PHAR 000008417011 DONNAGEL SUSP 3 OZ 000000.00
PHAR 000008417012 DONNAGEL-PG 3 OZ 000000.00
PHAR 000008417013 DONNATAL ELIXIR 3 OZ 000000.00
PHAR 000008417014 ENTEX LIQUID 3 OZ 000000.00
PHAR 000008417015 NALDECON-DX LIQ 3 OZ 000000.00
PHAR 000008417016 NOVAHISTINE EXP 3 OZ 000000.00
PHAR 000008417017 NOVAHISTINE-DH 3 OZ 000000.00
PHAR 000008417018 PERI-COLACE 3 OZ 000000.00
PHAR 000008417019 PROMETHAZINE VC SYRP 000000.00
PHAR 000008417020 PROMETHAZINE VC/COD 000000.00
PHAR 000008417021 PROMETHAZINE/COD SYR 000000.00
PHAR 000008417022 QUIBRON ELIXIR 3 OZ 000000.00
PHAR 000008417023 ROBITUSSIN CF 120 ML 000000.00
PHAR 000008417024 ROBITUSSIN DAC SYRUP 000000.00
PHAR 000008417025 ROBITUSSIN SYRUP-PE 000000.00
PHAR 000008417026 ROBITUSSIN-AC 3 OZ 000000.00
PHAR 000008417027 SMP/SMZ 40-200 3 OZ 000000.00
PHAR 000008417028 TRIAMINIC SYRUP 3 OZ 000000.00
PHAR 000008417029 TUSSI-ORGANIDIN DM 000000.00
PHAR 000008417030 TUSSI-ORGANIDIN 3 OZ 000000.00
PHAR 000008417031 PERIACTIN SYRUP 3 OZ 000000.00
PHAR 000008417032 DECADRON ELIXIR 3 OZ 000000.00
PHAR 000008417033 BENTYL SYRUP 3 OZ 000000.00
PHAR 000008417034 DRAMAMINE LIQ 3 OZ 000000.00
PHAR 000008417035 BENADRYL ELIX 3 OZ 000000.00
PHAR 000008417036 BENYLIN SYRUP 3 OZ 000000.00
PHAR 000008417037 COLACE SYRUP 3 OZ 000000.00
PHAR 000008417038 COLACE LIQUID 3 OZ 000000.00
PHAR 000008417039 ILOSONE 125/5 3 OZ 000000.00
PHAR 000008417040 ILOSONE 250/5ML 3OZ 000000.00
PHAR 000008417041 EES 200MG/5ML 90ML 000000.00
PHAR 000008417042 EES 400MG/5ML 3 OZ 000000.00
PHAR 000008417043 FERGON ELIXIR 3 OZ 000000.00
PHAR 000008417044 FERINSOL SYRUP 3OZ 000000.00
PHAR 000008417045 FEOSOL ELIXIR 3 OZ 000000.00
PHAR 000008417046 PROZAC 20MG/5ML 90ML 000000.00
PHAR 000008417047 PROLIXIN ELIX 3 OZ 000000.00
PHAR 000008417048 ORGANIDIN ELIX 3 OZ 000000.00
PHAR 000008417049 LACTULOSE SYRUP 3 OZ 000000.00
PHAR 000008417050 LACTULOSE SYRUP 8 OZ 000000.00
PHAR 000008417051 ALUPENT SYRUP 3 OZ 000000.00
PHAR 000008417052 LITHIUM CITR 90ML 000000.00
PHAR 000008417053 IMODIUM 4 OZ 000000.00
PHAR 000008417054 ALDOMET 250/5ML 3OZ 000000.00
PHAR 000008417055 NEGGRAM 250/5 3 OZ 000000.00
9/7/2010 11:52 AM Page 151 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008417056 NAPROSYN SUSP 3 OZ 000000.00
PHAR 000008417057 FURADANTIN SUSP 3 OZ 000000.00
PHAR 000008417058 AVENTYL SOLN 3 OZ 000000.00
PHAR 000008417061 CHOLEDYL ELIX 3 OZ 000000.00
PHAR 000008417062 CHOLEDYL SYR 50MG/5M 000000.00
PHAR 000008417063 DITROPAN SYRUP 3 OZ 000000.00
PHAR 000008417064 PHENOBARB ELIX 3 OZ 000000.00
PHAR 000008417065 DILANTIN-125 3 OZ 000000.00
PHAR 000008417066 DILANTIN-30 3 OZ 000000.00
PHAR 000008417067 KAON-CL SF 20% 3 OZ 000000.00
PHAR 000008417068 MYSOLINE SUSP 3 OZ 000000.00
PHAR 000008417069 PHENERGAN FORTIS SYR 000000.00
PHAR 000008417070 PHENERGAN SYRUP 3 OZ 000000.00
PHAR 000008417071 PROPRANOLOL 20MG/5ML 000000.00
PHAR 000008417072 SUDAFED SYRUP 3 OZ 000000.00
PHAR 000008417073 ZANTAC SYRUP 3 OZ 000000.00
PHAR 000008417074 SORBITOL 20% 3 OZ 000000.00
PHAR 000008417075 SORBITOL 70 % 3 OZ 000000.00
PHAR 000008417076 SORBITOL 70 % 8 OZ 000000.00
PHAR 000008417077 GANTANOL SUSP 3 OZ 000000.00
PHAR 000008417078 AZULFIDINE SUSP 3 OZ 000000.00
PHAR 000008417079 GANTRISIN SUSP 3 OZ 000000.00
PHAR 000008417080 TETRACYCLINE 125/5ML 000000.00
PHAR 000008417081 ELIXOPHYLLIN 3 OZ 000000.00
PHAR 000008417082 ARTANE ELIXIR 3 OZ 000000.00
PHAR 000008417083 DEPAKENE SYRUP 3 OZ 000000.00
PHAR 000008418001 CECLOR 125/5 150 ML 000000.00
PHAR 000008418002 CECLOR 125/5 75 ML 000000.00
PHAR 000008418003 CECLOR 250/5 150 ML 000000.00
PHAR 000008418004 CECLOR 250/5 75 ML 000000.00
PHAR 000008418005 AUGMENTIN 125MG/5ML 000000.00
PHAR 000008418006 AUGMENTIN 125MG/5ML 000000.00
PHAR 000008418007 AUGMENTIN 250MG/5ML 000000.00
PHAR 000008418008 AUGMENTIN 250MG/5ML 000000.00
PHAR 000008418009 DICLOXAC 62.5/5 100 000000.00
PHAR 000008418010 DICLOXAC 62.2/5 200M 000000.00
PHAR 000008418011 DICLOXAC 62.5/5 80ML 000000.00
PHAR 000008418012 NAFCILLIN 250MG/5ML 000000.00
PHAR 000008418013 VANCOCIN ORL SOL 10G 000000.00
PHAR 000008419001 BASALJEL SUSP 360 ML 000000.00
PHAR 000008419002 AMOXICIL 125/5 80ML 000000.00
PHAR 000008419003 AMOXICILL 125/5 150M 000000.00
PHAR 000008419004 AMOXICILL 125/5 80 000000.00
PHAR 000008419005 AMOXICILL 250/5 150 000000.00
PHAR 000008419006 AMOXICILL 250/5 80 000000.00
PHAR 000008419007 AMPICILL 125/5 100ML 000000.00
PHAR 000008419008 AMPICILL 125/5 200ML 000000.00
9/7/2010 11:52 AM Page 152 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008419009 AMPICILL 250/5 100ML 000000.00
PHAR 000008419010 AMPICILL 250/5 200ML 000000.00
PHAR 000008419011 PEPTO-BISMOL 360ML 000000.00
PHAR 000008419012 PEPTO BISMOL 120 ML 000000.00
PHAR 000008419013 CASTOR OIL 60 ML 000000.00
PHAR 000008419014 KEFLEX 125/5ML 100ML 000000.00
PHAR 000008419015 KEFLEX 125/5ML 200ML 000000.00
PHAR 000008419016 KEFLEX 250/5ML 100ML 000000.00
PHAR 000008419017 KEFLEX 250/5ML 200ML 000000.00
PHAR 000008419018 LIQUI-CHAR 30 GM/120 000000.00
PHAR 000008419019 CHLORTRIMETON 120 ML 000000.00
PHAR 000008419020 THORAZINE 100/ML 240 000000.00
PHAR 000008419021 THORAZINE CON 120ML 000000.00
PHAR 000008419022 QUESTRAN 378 G 000000.00
PHAR 000008419023 CLOXACILL 125/5 100 000000.00
PHAR 000008419024 CLOXACILL 125/5 200 000000.00
PHAR 000008419025 DI-GEL 360 ML 000000.00
PHAR 000008419026 EMETROL 89 ML 000000.00
PHAR 000008419027 GAVISCON 360 ML 000000.00
PHAR 000008419028 GELUSIL 12 OZ 000000.00
PHAR 000008419029 KAOPECTATE 3 OZ 000000.00
PHAR 000008419030 KAOPECTATE 8 OZ 000000.00
PHAR 000008419031 METAMUCIL 7 OZ 000000.00
PHAR 000008419032 METAMUCIL 14 OZ 000000.00
PHAR 000008419033 THERAGRAN 120 ML 000000.00
PHAR 000008419034 TRIVIFLOR/FE 0.25MG 000000.00
PHAR 000008419035 PEPCID SUSP 40MG/5ML 000000.00
PHAR 000008419036 FER-IN-SOL 50 ML 000000.00
PHAR 000008419037 ORGANIDIN 30 ML 000000.00
PHAR 000008419038 GRIFULVIN 4 OZ 000000.00
PHAR 000008419039 ROBITUSSIN SYRUP 4OZ 000000.00
PHAR 000008419040 HALDOL CONC 2 MG/ML 000000.00
PHAR 000008419041 HYDROGEN PEROXIDE 3% 000000.00
PHAR 000008419042 LIDOCAINE 2% 100 ML 000000.00
PHAR 000008419043 LOXITANE-C 120 ML 000000.00
PHAR 000008419044 MINERAL OIL 180 ML 000000.00
PHAR 000008419045 MINOCIN SUSP 60 ML 000000.00
PHAR 000008419046 NYSTATIN SUSP 60 ML 000000.00
PHAR 000008419047 TRILAFON CONC 120 ML 000000.00
PHAR 000008419048 COMPAZINE SYP 1MG/ML 000000.00
PHAR 000008419049 SENOKOT GRAN 60 GM 000000.00
PHAR 000008419050 SENOKOT SYRUP 240 ML 000000.00
PHAR 000008419051 SENOKOT SYRUP 60 ML 000000.00
PHAR 000008419052 MYLICON DROPS 30 ML 000000.00
PHAR 000008419053 LURIDE DROPS 30 ML 000000.00
PHAR 000008419054 SOD POLYSTYRENE SULF 000000.00
PHAR 000008419055 SOD POLYSTYRENE SULF 000000.00
9/7/2010 11:52 AM Page 153 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008419056 SLO-PHYLLIN SYRUP 000000.00
PHAR 000008419057 MELLARIL 100/ML 120M 000000.00
PHAR 000008419058 MELLARIL 30MG/ML 120 000000.00
PHAR 000008419059 NAVANE CONC 30 ML 000000.00
PHAR 000008419060 STELAZINE 10/ML 60ML 000000.00
PHAR 000008419061 MAALOX PLUS EXST 150 000000.00
PHAR 000008419062 MAALOX PLUS EXST 150 000000.00
PHAR 000008420001 ELAVIL 10MG/ML 10ML 000000.00
PHAR 000008420002 COGENTIN 2MG/2ML AMP 000000.00
PHAR 000008420003 CELESTONE 3MG/ML 5ML 000000.00
PHAR 000008420004 BUMEX AMP 0.5MG/2 ML 000000.00
PHAR 000008420005 BICNU VIA 100 MG 000000.00
PHAR 000008420006 CHLORPROMAZ 50MG/2ML 000000.00
PHAR 000008420007 SANDIMMUNE 50MG/ML 5 000000.00
PHAR 000008420008 DECADRON 24MG/ML 5ML 000000.00
PHAR 000008420009 ADRIAMYCIN VIA 50MG 000000.00
PHAR 000008420010 DEPO-ESTRADIOL 25/5M 000000.00
PHAR 000008420011 PREMARIN VIA 25 MG 000000.00
PHAR 000008420012 PROLIXIN DEC 25MG/ML 000000.00
PHAR 000008420013 PROLIXIN 2.5MG/M 10 000000.00
PHAR 000008420014 GLUCAGON EMERG KIT 000000.00
PHAR 000008420015 GLUCAGON VIA 1 UNIT 000000.00
PHAR 000008420016 HALDOL DECANOATE 50 000000.00
PHAR 000008420017 TORADOL SYR 30 MG/1 000000.00
PHAR 000008420018 TORADOL SYR 60MG/2ML 000000.00
PHAR 000008420019 SERENTIL 25 MG/1 ML 000000.00
PHAR 000008420020 ROBAXIN 100MG/ML 10M 000000.00
PHAR 000008420021 METHYLDOP 250MG INJ 000000.00
PHAR 000008420022 DEPO-MEDROL 40MG/1 M 000000.00
PHAR 000008420023 DEPO-MEDROL 40MG/ML 000000.00
PHAR 000008420024 DEPO-MEDROL 80MG/ML 000000.00
PHAR 000008420025 DEPO-MEDROL 80/M 5ML 000000.00
PHAR 000008420026 M-PREDNISOLONE 125MG 000000.00
PHAR 000008420027 M-PREDNISOLONE 40MG 000000.00
PHAR 000008420028 SANDOSTATIN 0.05MG/M 000000.00
PHAR 000008420029 NORFLEX 30MG/ML 2ML 000000.00
PHAR 000008420030 PHENOBARB 130MG/ML 000000.00
PHAR 000008420031 PHENYTOIN SOD 100 MG 000000.00
PHAR 000008420032 PHENYTOIN 250MG/5ML 000000.00
PHAR 000008420033 KCL 40 MEQ/20 ML VIA 000000.00
PHAR 000008420034 PROCHLORPERAZ 10MG/2 000000.00
PHAR 000008420035 PROMETHAZINE 25MG/ML 000000.00
PHAR 000008420036 PROMETHAZINE 50MG/ML 000000.00
PHAR 000008420037 SOD CHL 0.9% 10ML ST 000000.00
PHAR 000008420038 SODIUM CHL 0.9% 50ML 000000.00
PHAR 000008420039 SOD CHLOR 0.9% 10 ML 000000.00
PHAR 000008420040 BRETHINE AMP 1 MG/ML 000000.00
9/7/2010 11:52 AM Page 154 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008420041 TORECAN 10MG/2ML AMP 000000.00
PHAR 000008420042 NAVANE 5MG/ML 2 ML V 000000.00
PHAR 000008420043 KENALOG 40MG/ML 1ML 000000.00
PHAR 000008420044 KENALOG 10MG/ML 5ML 000000.00
PHAR 000008420045 KENALOG 40MG/ML 5ML 000000.00
PHAR 000008420046 ARISTOCORT 40MG/ML 1 000000.00
PHAR 000008420047 ARISTOCORT 40MG/ML 5 000000.00
PHAR 000008420048 STELAZINE 2 MG/1 ML 000000.00
PHAR 000008420049 TRIMETHOBENZAMID 200 000000.00
PHAR 000008420050 METRODIN INJ 75IU/2 000000.00
PHAR 000008420051 WATER BACT INJ 30 ML 000000.00
PHAR 000008420052 TOFRANIL 25MG/2M AMP 000000.00
PHAR 000008421001 WATER FOR INJ 10 ML 000000.00
PHAR 000008421002 WATER FOR INJ 50 ML 000000.00
PHAR 000008430001 TRANXENE-T TAB 15 MG 000000.00
PHAR 000008430002 TRANXENE-T TAB 3.75 000000.00
PHAR 000008430003 TRANXENE-T TAB 7.5 M 000000.00
PHAR 000008430004 ATIVAN TAB 0.5 MG 000000.00
PHAR 000008430005 ATIVAN TAB 1 MG 000000.00
PHAR 000008430006 ATIVAN TAB 2 MG 000000.00
PHAR 000008434001 APAP W/COD EL 3 OZ 000000.00
PHAR 000008434002 CAPITAL W/COD 3 OZ 000000.00
PHAR 000008434003 HYCOMINE SYRUP 3 OZ 000000.00
PHAR 000008434004 HYCOTUSS EXP 3 OZ 000000.00
PHAR 000008434005 TERPIN HYD W/COD 3OZ 000000.00
PHAR 000008434006 TUSSIONEX SUSP 3 OZ 000000.00
PHAR 000008434007 DELSYM LIQ 30MG/5ML 000000.00
PHAR 000008434008 DARVON-N LIQ 3 OZ 000000.00
PHAR 000008440001 ATROPINE OPHTH OINT 000000.00
PHAR 000008440002 ATROPINE 1% OPHTH 15 000000.00
PHAR 000008440003 ISOPTO-ATROPINE 0.5% 000000.00
PHAR 000008440004 ISOPTO-ATROPINE 1% 000000.00
PHAR 000008440005 ISOPTO-ATROPINE 1% 000000.00
PHAR 000008440006 ISOPTO-ATROPINE 3% 5 000000.00
PHAR 000008440007 BETOPTIC OPHTH 10 ML 000000.00
PHAR 000008440008 BETOPTIC OPHTH 5 ML 000000.00
PHAR 000008440009 ISOP CARBACH 0.75% 000000.00
PHAR 000008440010 ISOPTO-CARBACH 0.75% 000000.00
PHAR 000008440011 ISOPTO-CARBACH 1.5% 000000.00
PHAR 000008440012 ISOPTO-CARBACH 1.5% 000000.00
PHAR 000008440013 ISOPTO-CARBACH 2.25% 000000.00
PHAR 000008440014 ISOPTO-CARBACH 3% 15 000000.00
PHAR 000008440015 CEPACOL THROAT LOZEN 000000.00
PHAR 000008440016 CHLOROMYCET OPH OINT 000000.00
PHAR 000008440017 CHLOROMYCET OTIC 15M 000000.00
PHAR 000008440018 CHLOROPTIC .5% 7.5ML 000000.00
PHAR 000008440019 CHLOROPTIC OPH OIN 000000.00
9/7/2010 11:52 AM Page 155 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008440020 AURALGAN OTIC 10 ML 000000.00
PHAR 000008440021 BLEPHAMIDE DRPS 10ML 000000.00
PHAR 000008440022 BLEPHAMIDE DRPS 5ML 000000.00
PHAR 000008440023 BLEPHAMIDE OINTMENT 000000.00
PHAR 000008440024 BSS 15 ML 000000.00
PHAR 000008440025 CEPACOL ANESTH #18 000000.00
PHAR 000008440026 CEPASTAT LOZENG #18 000000.00
PHAR 000008440027 CORTISPORIN OPH 7.5M 000000.00
PHAR 000008440028 CORTISPORIN OPH OIN 000000.00
PHAR 000008440029 CORTISPORIN SOL OTIC 000000.00
PHAR 000008440030 CORTISPORIN SUS OTIC 000000.00
PHAR 000008440031 COUGH CALMER LOZ #16 000000.00
PHAR 000008440032 DEBROX DROPS 15 ML 000000.00
PHAR 000008440033 DEBROX DROPS 30 ML 000000.00
PHAR 000008440034 DRISTAN INHALER 000000.00
PHAR 000008440035 DRISTAN SPRAY 15 ML 000000.00
PHAR 000008440036 ISOPTO-TEARS 15 ML 000000.00
PHAR 000008440037 LACRI-LUBE 3.5 G 000000.00
PHAR 000008440038 LIQUIFILM FORTE 30ML 000000.00
PHAR 000008440039 LIQUIFILM TEARS 15ML 000000.00
PHAR 000008440040 LIQUIFILM TEARS 30ML 000000.00
PHAR 000008440041 MAXITROL DROPS 5 ML 000000.00
PHAR 000008440042 MAXITROL OINT 3.5 G 000000.00
PHAR 000008440043 NAPHCON-A DROPS 15 M 000000.00
PHAR 000008440044 NEO-DECADRON OCUMETE 000000.00
PHAR 000008440045 NEO-DECADRON OPH OIN 000000.00
PHAR 000008440046 NEOSPORIN OPHTH 10ML 000000.00
PHAR 000008440047 NEOSPORIN OPHTH 3.5 000000.00
PHAR 000008440048 OPHTHOCORT OPHTH 3.5 000000.00
PHAR 000008440049 POLY-PRED OPHTH 10 M 000000.00
PHAR 000008440050 POLY PRED OPHTH 5 ML 000000.00
PHAR 000008440051 POLYSPORIN OPHTH 3.5 000000.00
PHAR 000008440052 PREFRIN-A OPHTH 15 M 000000.00
PHAR 000008440053 TEARFAIR OPH OINT 000000.00
PHAR 000008440054 TEARFAIR LIQUID 15ML 000000.00
PHAR 000008440055 TEARISOL OPHTH 15 ML 000000.00
PHAR 000008440056 TEARS PLUS 15 ML 000000.00
PHAR 000008440057 TOBRADEX SUS OPTH 5 000000.00
PHAR 000008440058 VASOCIDIN OPHTH 10 M 000000.00
PHAR 000008440059 VASOCIDIN OIN OPTHAL 000000.00
PHAR 000008440060 VASOCIDIN OPHTH 5 ML 000000.00
PHAR 000008440061 VASOCON-A OPHTH 15 M 000000.00
PHAR 000008440062 VOSOL OTIC 15 ML 000000.00
PHAR 000008440063 VOSOL OTIC 30 ML 000000.00
PHAR 000008440064 VOSOL-HC OTIC 10 ML 000000.00
PHAR 000008440065 NASALCROM SPRA 13ML 000000.00
PHAR 000008440066 DDAVP NASAL 2.5 ML 000000.00
9/7/2010 11:52 AM Page 156 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008440067 MAXIDEX DROPS 15 ML 000000.00
PHAR 000008440068 MAXIDEX DROPS 5 ML 000000.00
PHAR 000008440069 DECADRON OPHTH 3.5 G 000000.00
PHAR 000008440070 DECADRON 0.1% 5 ML 000000.00
PHAR 000008440071 DECADRON RESPIHALER 000000.00
PHAR 000008440072 DECADRON TURBINAIRE 000000.00
PHAR 000008440073 PROPINE 0.1% 10 ML 000000.00
PHAR 000008440074 PROPINE 0.1% 15 ML 000000.00
PHAR 000008440075 PROPINE 0.1% 5 ML 000000.00
PHAR 000008440076 ERYTHROMYCIN OPH OIN 000000.00
PHAR 000008440077 ERYTHROM OINT OPH UD 000000.00
PHAR 000008440078 ERYTHROMYCIN 3.5G 000000.00
PHAR 000008440079 ILOTYCIN OPHTH 3.5 G 000000.00
PHAR 000008440080 NASALIDE SPRAY 25 ML 000000.00
PHAR 000008440081 FML DROPS 10 ML 000000.00
PHAR 000008440082 FML DROPS 5 ML 000000.00
PHAR 000008440083 FML FORTE OPHTH 15ML 000000.00
PHAR 000008440084 FML FORTE OPHTH 5 ML 000000.00
PHAR 000008440085 OCUFEN OPHTH 0.03% 000000.00
PHAR 000008440086 OCUFEN OPTH 0.03% 000000.00
PHAR 000008440087 GARAMYCIN OPHTH 5 ML 000000.00
PHAR 000008440088 GARAMYCIN OPH OIN 000000.00
PHAR 000008440089 ISOPTO-HOMATROP 2% 000000.00
PHAR 000008440090 ISOPTO-HOMATROP 2% 000000.00
PHAR 000008440091 ISOPTO-HOMATROP 5% 000000.00
PHAR 000008440092 ISOPTO-HOMATROPIN 5% 000000.00
PHAR 000008440093 BETAGAN 0.5% 10 ML 000000.00
PHAR 000008440094 BETAGAN 0.5% 5 ML 000000.00
PHAR 000008440095 BETAGAN 0.5% 15 ML 000000.00
PHAR 000008440096 HMS DROPS 10 ML 000000.00
PHAR 000008440097 HMS DROPS 5 ML 000000.00
PHAR 000008440098 NATACYN OPHTH 15 ML 000000.00
PHAR 000008440099 AFRIN DROPS 20 ML 000000.00
PHAR 000008440100 AFRIN NASAL PED DRP 000000.00
PHAR 000008440101 AFRIN NASAL SPR 15ML 000000.00
PHAR 000008440102 AFRIN NASAL SPR 3ML 000000.00
PHAR 000008440103 AFRIN DROPS 30 ML 000000.00
PHAR 000008440104 NEO-SYNEPH 1% SPRAY 000000.00
PHAR 000008440105 NEO-SYNEPH NAS 1/8% 000000.00
PHAR 000008440106 NEO-SYNEPH SPR 1/2% 000000.00
PHAR 000008440107 NEO-SYNEPH NASPR 1/2 000000.00
PHAR 000008440108 NEO-SYNEPH OPH 10% 5 000000.00
PHAR 000008440109 NEO-SYNEPH OPH 2.5% 000000.00
PHAR 000008440110 NEO-SYNEPH SPR 1/4% 000000.00
PHAR 000008440111 PHENYLEPHRINE 10% UD 000000.00
PHAR 000008440112 ISOPTO-ESERINE 0.5% 000000.00
PHAR 000008440113 ESERINE 0.25% OPHTH 000000.00
9/7/2010 11:52 AM Page 157 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008440114 ISOPTO-CARPINE 0.25% 000000.00
PHAR 000008440115 ISOPTO-CARPINE 0.5% 000000.00
PHAR 000008440116 ISOPTO-CARPINE 0.5% 000000.00
PHAR 000008440117 ISOPTO-CARPINE 1% 15 000000.00
PHAR 000008440118 ISOPTO-CARPINE 1% 30 000000.00
PHAR 000008440119 ISOPTO-CARPINE 10% 1 000000.00
PHAR 000008440120 ISOPTO-CARPINE 2% 15 000000.00
PHAR 000008440121 ISOPTO-CARPINE 2% 30 000000.00
PHAR 000008440122 ISOPTO-CARPINE 3% 15 000000.00
PHAR 000008440123 ISOPTO-CARPINE 3% 30 000000.00
PHAR 000008440124 ISOPTO-CARPINE 4% 15 000000.00
PHAR 000008440125 ISOPTO-CARPINE 4% 30 000000.00
PHAR 000008440126 ISOPTO-CARPINE 6% 15 000000.00
PHAR 000008440127 ISOPTO-CARPINE 8% 15 000000.00
PHAR 000008440128 PRED FORTE OPHTH 1% 000000.00
PHAR 000008440129 PRED FORTE OPHTH 1% 000000.00
PHAR 000008440130 PRED MILD OPH 0.12% 000000.00
PHAR 000008440131 PRED MILD OPH 0.12% 000000.00
PHAR 000008440132 ISOPTO-HYOSCIN 0.25% 000000.00
PHAR 000008440133 ISOPTO-HYOSCINE 0.25 000000.00
PHAR 000008440134 OCEAN NASAL SPRAY 45 000000.00
PHAR 000008440135 BLEPH-10 EYE DROPS 5 000000.00
PHAR 000008440136 SULAMYD 10% 15 ML 000000.00
PHAR 000008440137 SULAMYD OPHTH 10% 5 000000.00
PHAR 000008440138 SULAMYD SOD OPH 30% 000000.00
PHAR 000008440139 SULAMYD OPHTH OINT 000000.00
PHAR 000008440140 GANTRISIN OPHTH 15ML 000000.00
PHAR 000008440141 GANTRISIN OPHTH 3.5 000000.00
PHAR 000008440142 ACHROMYCIN OIN OPH 000000.00
PHAR 000008440143 VISINE OPHTH 15 ML 000000.00
PHAR 000008440144 TIMOPTIC 0.25% 10 ML 000000.00
PHAR 000008440145 TIMOPTIC 0.25% 5 ML 000000.00
PHAR 000008440146 TIMOPTIC OPH 0.5% 10 000000.00
PHAR 000008440147 TIMOPTIC 0.5% 5ML 000000.00
PHAR 000008440148 TOBREX OPHTH 5 ML 000000.00
PHAR 000008440149 TOBREX OPHTH OINT 000000.00
PHAR 000008440150 CERUMENEX 12 ML 000000.00
PHAR 000008440151 CERUMENEX 6 ML 000000.00
PHAR 000008440152 VIROPTIC OPHTH 7.5 M 000000.00
PHAR 000008440153 MYDRIACYL 1% 15 ML 000000.00
PHAR 000008440154 VIRA-A OPHTH 3.5 GM. 000000.00
PHAR 000008440155 CLEAR EYES OPTH SOLN 000000.00
PHAR 000008440156 DDAVP NAS 0.01% 5 ML 000000.00
PHAR 000008443001 THERA-GESIC SOL 90ML 000000.00
PHAR 000008443002 VICKS VAPORUB 45 GM 000000.00
PHAR 000008443003 ZOVIRAX OINTMENT 5% 000000.00
PHAR 000008443004 LAVACOL 480 ML 000000.00
9/7/2010 11:52 AM Page 158 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008443005 CYCLOCORT OINT 0.1% 000000.00
PHAR 000008443006 BACITRACIN OINT 30 G 000000.00
PHAR 000008443007 AMERICAINE AER 20GM 000000.00
PHAR 000008443008 HURRICAINE SPRAY 000000.00
PHAR 000008443009 ORA-JEL 5.6 G 000000.00
PHAR 000008443010 BENZAC GEL 10 % 000000.00
PHAR 000008443011 BENZAC GEL 5% 60 GM 000000.00
PHAR 000008443012 BENZAC W GEL 10% 60 000000.00
PHAR 000008443013 BENZAC GEL 2.5% 60 G 000000.00
PHAR 000008443014 BENZAC W GEL 5% 60 G 000000.00
PHAR 000008443015 BENZAGEL-10 42.5 G 000000.00
PHAR 000008443016 BENZAGEL-10 GEL 90 G 000000.00
PHAR 000008443017 BENZAGEL-5 42.5 G 000000.00
PHAR 000008443018 BENZAGEL-5 GEL 90 GM 000000.00
PHAR 000008443019 BENZ PER 10% 30ML 000000.00
PHAR 000008443020 BENZOYL PEROX 5% 30M 000000.00
PHAR 000008443021 DESQUAM-X GEL 10% 000000.00
PHAR 000008443022 DESQUAM-X GEL 5% 000000.00
PHAR 000008443023 DESQUAM-X LIQ 5% 000000.00
PHAR 000008443024 PANOXYL GEL 10% 120 000000.00
PHAR 000008443025 PANOXYL GEL 10% 60 G 000000.00
PHAR 000008443026 PANOXYL GEL 5% 120 G 000000.00
PHAR 000008443027 PANOXYL GEL 5% 60G 000000.00
PHAR 000008443028 PERSA-GEL 10% 45 G 000000.00
PHAR 000008443029 PERSA-GEL 10% 90 G 000000.00
PHAR 000008443030 PERSA-GEL 5% 45 G 000000.00
PHAR 000008443031 PERSA-GEL 5% 90 G 000000.00
PHAR 000008443032 BETAMET DIP OINT .05 000000.00
PHAR 000008443033 BETAMETH CR 0.05% 15 000000.00
PHAR 000008443034 BETAMETH CR 0.05% 45 000000.00
PHAR 000008443035 BETAMETH OINT 0.05% 000000.00
PHAR 000008443036 DIPROLENE CREAM 15 G 000000.00
PHAR 000008443037 DIPROLENE CREAM 45 G 000000.00
PHAR 000008443038 DIPROLENE OINT 45 G 000000.00
PHAR 000008443039 DIPROSONE LOT 0.05% 000000.00
PHAR 000008443040 DIPROSONE CRE 15 G 000000.00
PHAR 000008443041 DIPROSONE CRE 0.05% 000000.00
PHAR 000008443042 DIPROSONE LOT 0.05% 000000.00
PHAR 000008443043 DIPROSONE OIN 0.05% 000000.00
PHAR 000008443044 DIPROSONE OIN 0.05% 000000.00
PHAR 000008443045 MAXIVATE CRE .05% 15 000000.00
PHAR 000008443046 MAXIVATE 0.05% 45GM 000000.00
PHAR 000008443047 BETAMETH VAL .1% OIN 000000.00
PHAR 000008443048 BETAMETHAS CR 0.1% 1 000000.00
PHAR 000008443049 BETAMETHAS 0.1% 45 G 000000.00
PHAR 000008443050 BETAMETH OIN 0.1% 15 000000.00
PHAR 000008443051 BETAMETHAS OINT 0.1% 000000.00
9/7/2010 11:52 AM Page 159 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008443052 VALISONE CR .01% 15G 000000.00
PHAR 000008443053 VALISONE CR .01% 60G 000000.00
PHAR 000008443054 VALISONE LOT 0.1% 20 000000.00
PHAR 000008443055 VALISONE LOT 0.1% 60 000000.00
PHAR 000008443056 CALAMINE LOT 120 ML 000000.00
PHAR 000008443057 GLY-OXIDE 15 ML 000000.00
PHAR 000008443058 GLY-OXIDE 60 ML 000000.00
PHAR 000008443059 CLEOCIN T 1% GEL 30 000000.00
PHAR 000008443060 CLEOCIN-T TOPICAL 30 000000.00
PHAR 000008443061 CLEOCIN-T 60 ML 000000.00
PHAR 000008443062 VIOFORM CREAM 3% 30 000000.00
PHAR 000008443063 VIOFORM OINTMENT 3% 000000.00
PHAR 000008443064 TEMOVATE CREAM 0.05% 000000.00
PHAR 000008443065 TEMOVATE CREAM 0.05% 000000.00
PHAR 000008443066 TEMOVATE OINT 0.05% 000000.00
PHAR 000008443067 TEMOVATE OINT 0.05% 000000.00
PHAR 000008443068 CATAPRES-TTS-1 (#1) 000000.00
PHAR 000008443069 CATAPRES-TTS-2 (#1) 000000.00
PHAR 000008443070 CATAPRES-TTS-3 (#1) 000000.00
PHAR 000008443071 LOTRIMIN CREAM 1% 15 000000.00
PHAR 000008443072 LOTRIMIN CREAM 1% 30 000000.00
PHAR 000008443073 LOTRIMIN CREAM 1% 45 000000.00
PHAR 000008443074 LOTRIMIN LOTION 30ML 000000.00
PHAR 000008443075 LOTRIMIN 1% 10 ML 000000.00
PHAR 000008443076 LOTRIMIN 1% 30 ML 000000.00
PHAR 000008443077 MYCELEX CREAM 1% 30 000000.00
PHAR 000008443078 MYCELEX SOL 1% 10 ML 000000.00
PHAR 000008443079 MYCELEX SOL 1% 30 ML 000000.00
PHAR 000008443080 TEGRIN SHAMPOO 112.5 000000.00
PHAR 000008443081 ZETAR SHAMPOO 180 ML 000000.00
PHAR 000008443082 AVEENO 454 GM 000000.00
PHAR 000008443083 AVEENO OIL 240 G 000000.00
PHAR 000008443084 AVEENO SOAP 96 GM 000000.00
PHAR 000008443085 A&D OINT 45GM 000000.00
PHAR 000008443086 ALPHA KERI LOT 16 OZ 000000.00
PHAR 000008443087 ALPHA KERI LOT 8 OZ 000000.00
PHAR 000008443088 AMERICAINE OINT 30 G 000000.00
PHAR 000008443089 AMMENS MED POW 6.25 000000.00
PHAR 000008443090 ANBESOL LIQ 0.31 OZ 000000.00
PHAR 000008443091 BEN GAY OINT 1.25 OZ 000000.00
PHAR 000008443092 BEN GAY OINT 90 GM 000000.00
PHAR 000008443093 BLISTEX OINT 4.2 G 000000.00
PHAR 000008443094 CALADRYL CREAM 45 GM 000000.00
PHAR 000008443095 CALADRYL LOT 180 ML 000000.00
PHAR 000008443096 CAMPHO-PHENIQUE 000000.00
PHAR 000008443097 CHLORASEPTIC #18 000000.00
PHAR 000008443098 CHLORASEPTIC 180 ML 000000.00
9/7/2010 11:52 AM Page 160 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008443099 CHLORASEPTIC 360 ML 000000.00
PHAR 000008443100 CHLORASEPTIC SPRAY 000000.00
PHAR 000008443101 CORTISPORIN CRE 7.5G 000000.00
PHAR 000008443102 CORTISPORIN OIN 15 G 000000.00
PHAR 000008443103 DESENEX OINTMENT 27 000000.00
PHAR 000008443104 DESENEX OINT 54 G 000000.00
PHAR 000008443105 DESENEX POWDER 90 G 000000.00
PHAR 000008443106 DESITIN OINT 30 G 000000.00
PHAR 000008443107 DUOFILM 15 ML 000000.00
PHAR 000008443108 EUCERIN CREAM 4 OZ 000000.00
PHAR 000008443109 GRANULEX AEROSOL 4OZ 000000.00
PHAR 000008443110 KERI CREME 75 G 000000.00
PHAR 000008443111 KERI LOTION 390 ML 000000.00
PHAR 000008443112 LOTRISONE CREAM 15 G 000000.00
PHAR 000008443113 LOTRISONE CREAM 45 G 000000.00
PHAR 000008443114 LUBRIDERM CREAM 120 000000.00
PHAR 000008443115 LUBRIDERM LOTION 480 000000.00
PHAR 000008443116 MYCOGEN II CREAM 30 000000.00
PHAR 000008443117 MYCOGEN II CREAM 60 000000.00
PHAR 000008443118 MYCOLOG II OINT 15 G 000000.00
PHAR 000008443119 MYCOLOG II OINT 30 G 000000.00
PHAR 000008443120 MYCOLOG II OINT 60 G 000000.00
PHAR 000008443121 NEOSPORIN CREAM 15 G 000000.00
PHAR 000008443122 NOXZEMA SKIN CRE 4OZ 000000.00
PHAR 000008443123 NYSTAT/TRIAMCIN OINT 000000.00
PHAR 000008443124 NYSTATIN/TRIAM 15 G 000000.00
PHAR 000008443125 NYSTATIN/TRIAM OINT 000000.00
PHAR 000008443126 NYSTATIN/TRIAMCIN CR 000000.00
PHAR 000008443127 NYSTATIN/TRIAMCIN CR 000000.00
PHAR 000008443128 ORABASE PASTE 15 G 000000.00
PHAR 000008443129 ORABASE PASTE 5 G 000000.00
PHAR 000008443130 ORABASE W/BENZOC 15G 000000.00
PHAR 000008443131 ORABASE W/BENZOC 5 G 000000.00
PHAR 000008443132 PHISODERM 5 OZ 000000.00
PHAR 000008443133 POLYSPORIN OINT 15 G 000000.00
PHAR 000008443134 POLYSPORIN OINT 30 G 000000.00
PHAR 000008443135 POLYSPORIN POWDER 000000.00
PHAR 000008443136 PRESUN 15 LOTION 60 000000.00
PHAR 000008443137 SEA BRZ ASTR LIQ 120 000000.00
PHAR 000008443138 SOLARCAINE LOT 90 ML 000000.00
PHAR 000008443139 TRIP ANTIBIO OIN 30G 000000.00
PHAR 000008443140 TRIPL ANTIBIOT INT 000000.00
PHAR 000008443141 TRIDESILON .05% 15G 000000.00
PHAR 000008443142 TRIDESILON .05% 60G 000000.00
PHAR 000008443143 TRIDESILON .05% 15G 000000.00
PHAR 000008443144 TOPICORT CR .25% 15G 000000.00
PHAR 000008443145 TOPICORT CR .25% 60G 000000.00
9/7/2010 11:52 AM Page 161 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008443146 TOPICORT GEL 15 G 000000.00
PHAR 000008443147 TOPICORT 0.05% 60 G 000000.00
PHAR 000008443148 TOPICORT OINT 0.25% 000000.00
PHAR 000008443149 TOPICORT CRE .05% 15 000000.00
PHAR 000008443150 TOPICORT CRE .05% 60 000000.00
PHAR 000008443151 DECASPRAY 25 GM 000000.00
PHAR 000008443152 DECADRON CR 0.1% 15G 000000.00
PHAR 000008443153 DECADRON CR 0.1% 30G 000000.00
PHAR 000008443154 BENADRYL CREAM 30 GM 000000.00
PHAR 000008443155 ATS TOPICAL SOL 60ML 000000.00
PHAR 000008443156 ERYMAX SOL 2% 60 ML 000000.00
PHAR 000008443157 STATICIN 1.5% 60 ML 000000.00
PHAR 000008443158 FLUONID 0.025% 15 G 000000.00
PHAR 000008443159 FLUONID SOL 0.01% 20 000000.00
PHAR 000008443160 FLUONID SOL 0.01% 60 000000.00
PHAR 000008443161 SYNALAR CR 0.025% 30 000000.00
PHAR 000008443162 SYNALAR CRE .01% 15G 000000.00
PHAR 000008443163 SYNALAR 0.01% 30 G 000000.00
PHAR 000008443164 SYNALAR CR .01% 1LB 000000.00
PHAR 000008443165 SYNALAR CR .01% 60G 000000.00
PHAR 000008443166 SYNALAR CRE .025% 15 000000.00
PHAR 000008443167 SYNALAR CR .025% LB 000000.00
PHAR 000008443168 SYNALAR CR .025% 60G 000000.00
PHAR 000008443169 SYNALAR OIN .025% 15 000000.00
PHAR 000008443170 SYNALAR OI .025% 60G 000000.00
PHAR 000008443171 SYNALAR SOL 0.01% 20 000000.00
PHAR 000008443172 SYNALAR SOL 0.01% 60 000000.00
PHAR 000008443173 SYNALAR HP CREAM 12G 000000.00
PHAR 000008443174 FLUOCINON CR .05% 15 000000.00
PHAR 000008443175 FLUOCINONID CR 0.05% 000000.00
PHAR 000008443176 LIDEX CREAM 0.05% 15 000000.00
PHAR 000008443177 LIDEX CREAM 0.05% 30 000000.00
PHAR 000008443178 LIDEX GEL 0.05% 15 G 000000.00
PHAR 000008443179 LIDEX GEL 0.05% 30 G 000000.00
PHAR 000008443180 LIDEX GEL 0.05% 60 G 000000.00
PHAR 000008443181 LIDEX OIN 0.05% 15 G 000000.00
PHAR 000008443182 LIDEX OIN 0.05% 30 G 000000.00
PHAR 000008443183 LIDEX OIN 0.05% 60 G 000000.00
PHAR 000008443184 LIDEX OINT 0.05%120G 000000.00
PHAR 000008443185 LIDEX SOL 0.05% 20 M 000000.00
PHAR 000008443186 LIDEX SOL 0.05% 60 M 000000.00
PHAR 000008443187 LIDEX-E CRE 0.05% 15 000000.00
PHAR 000008443188 LIDEX-E CRE 0.05% 30 000000.00
PHAR 000008443189 LIDEX-E CRE 0.05% 60 000000.00
PHAR 000008443190 CORDRAN SP .025 30G 000000.00
PHAR 000008443191 CORDRAN SP CRE 0.05% 000000.00
PHAR 000008443192 CORDRAN SP CRE 0.05% 000000.00
9/7/2010 11:52 AM Page 162 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008443193 CORDRAN TAPE LARGE 000000.00
PHAR 000008443194 CORDRAN TAPE SMALL 000000.00
PHAR 000008443195 GARAMYCIN CREAM 15 G 000000.00
PHAR 000008443196 GARAMYCIN OINTMENT 000000.00
PHAR 000008443197 HALOG CREAM 0.1% 15 000000.00
PHAR 000008443198 HALOG CREAM 0.1% 60 000000.00
PHAR 000008443199 PHISOHEX 1 PINT 000000.00
PHAR 000008443200 PHISOHEX 150 ML 000000.00
PHAR 000008443201 AEROSEB-HC AEROSOL 000000.00
PHAR 000008443202 CETACORT LOT 0.5% 60 000000.00
PHAR 000008443203 CORT-DOME LOT 1/4% 000000.00
PHAR 000008443204 CORT-DOME LOT 1% 30M 000000.00
PHAR 000008443205 HYDROCORTISONE 1 OZ 000000.00
PHAR 000008443206 HYDROCORT OINT .5% 000000.00
PHAR 000008443207 HYDROCORTISONE OINT 000000.00
PHAR 000008443208 HYDROCORT CR 1% 20GM 000000.00
PHAR 000008443209 HYDROCORT CR 1% 20G 000000.00
PHAR 000008443210 HYDROCORTISONE CR 1% 000000.00
PHAR 000008443211 HYTONE CRE 0.5% 000000.00
PHAR 000008443212 HYTONE CREAM 1% 30 G 000000.00
PHAR 000008443213 HYTONE CREAM 2.5% 30 000000.00
PHAR 000008443214 HYTONE LOTION 1% 000000.00
PHAR 000008443215 HYTONE OINT 1% 30 G 000000.00
PHAR 000008443216 CORTEF CREAM 15 GM 000000.00
PHAR 000008443217 CORTEF OINT 1% 20G 000000.00
PHAR 000008443218 CORTEF OINT 2.5% 5 G 000000.00
PHAR 000008443219 WESTCORT CREAM 0.2% 000000.00
PHAR 000008443220 WESTCORT CREAM 0.2% 000000.00
PHAR 000008443221 WESTCORT CREAM 0.2% 000000.00
PHAR 000008443222 NIZORAL CREAM 15 GM 000000.00
PHAR 000008443223 NIZORAL CREAM 30 GM 000000.00
PHAR 000008443224 LAC-HYDRIN 12% 5 OZ 000000.00
PHAR 000008443225 LANOLIN OIN 000000.00
PHAR 000008443226 LIDOCAINE JEL 2% 30M 000000.00
PHAR 000008443227 LIDOCAINE OINT 2.5% 000000.00
PHAR 000008443228 LIDOCAINE OINT 5% 35 000000.00
PHAR 000008443229 LIDOCAINE SOL 4% 50M 000000.00
PHAR 000008443230 KWELL CREAM 1% 60 G 000000.00
PHAR 000008443231 KWELL LOT 1% 000000.00
PHAR 000008443232 KWELL LOTION 1% 60 M 000000.00
PHAR 000008443233 KWELL SHAMPOO 1% 480 000000.00
PHAR 000008443234 KWELL SHAMPOO 60 ML 000000.00
PHAR 000008443235 PRONTO AER 1% 150 GM 000000.00
PHAR 000008443236 MICATIN CREAM 2% 30 000000.00
PHAR 000008443237 MICATIN SPRAY 2% 000000.00
PHAR 000008443238 MONISTAT KIT DUAL-PA 000000.00
PHAR 000008443239 MONISTAT SUPP 100 MG 000000.00
9/7/2010 11:52 AM Page 163 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008443240 MONISTAT SUPPOS 200M 000000.00
PHAR 000008443241 MONISTAT-3 SUP 200 M 000000.00
PHAR 000008443242 MONISTAT-7 SUPP 100 000000.00
PHAR 000008443243 MONISTAT-7 CREAM 45 000000.00
PHAR 000008443244 MONISTAT-DERM 2% 15 000000.00
PHAR 000008443245 MONISTAT-DERM 2% 30 000000.00
PHAR 000008443246 MONISTAT-DERM 2% 85 000000.00
PHAR 000008443247 MONISTAT-DERM LOT 2% 000000.00
PHAR 000008443248 MONISTAT-DERM LOT 60 000000.00
PHAR 000008443249 BACTROBAN 2% OINT 15 000000.00
PHAR 000008443250 NITRO-DUR 10MG/24H 000000.00
PHAR 000008443251 NITRO-DUR 15MG/24H 000000.00
PHAR 000008443252 NITRO-DUR 2.5MG/24 000000.00
PHAR 000008443253 NITRO-DUR 5MG/24H 000000.00
PHAR 000008443254 NITRO-DUR 7.5MG/24H 000000.00
PHAR 000008443255 NITROGLYCERIN 60G 000000.00
PHAR 000008443256 NITROL OINTMENT 30 G 000000.00
PHAR 000008443257 NITROL OINT 2% 60 GM 000000.00
PHAR 000008443258 TRANSDERM NITRO 10 000000.00
PHAR 000008443259 TRANSDERM-NITRO-15 000000.00
PHAR 000008443260 TRANSDERM NITRO 2.5 000000.00
PHAR 000008443261 TRANSDERM-NITRO-5 000000.00
PHAR 000008443262 MYCOSTATIN CREAM 30 000000.00
PHAR 000008443263 MYCOSTATIN OIN 30 G 000000.00
PHAR 000008443264 MYCOSTATIN POWDER 15 000000.00
PHAR 000008443265 NILSTAT CREAM 15 G 000000.00
PHAR 000008443266 NILSTAT OINTMENT 15 000000.00
PHAR 000008443267 NYSTATIN CREAM 15 G 000000.00
PHAR 000008443268 NYSTATIN CREAM 30 GM 000000.00
PHAR 000008443269 NYSTATIN OINT 15 G 000000.00
PHAR 000008443270 EUCERIN CREAM 454 G 000000.00
PHAR 000008443271 BETADINE 480 ML 000000.00
PHAR 000008443272 BETADINE 8 OZ 000000.00
PHAR 000008443273 BETADINE OINT 30 GM 000000.00
PHAR 000008443274 TRANSDERM-SCOP 4 DIS 000000.00
PHAR 000008443275 SELSUN BLUE SHAMPOO 000000.00
PHAR 000008443276 SELSUN BLUE 210ML 000000.00
PHAR 000008443277 SELSUN 120 ML 000000.00
PHAR 000008443278 SILVADENE CREAM 20 G 000000.00
PHAR 000008443279 SILVADENE CREAM 400 000000.00
PHAR 000008443280 SILVADENE CREAM 50 G 000000.00
PHAR 000008443281 TINACTIN CREAM 1% 15 000000.00
PHAR 000008443282 TINACTIN POW 1% 45 G 000000.00
PHAR 000008443283 TINACTIN SOL 1% 10 M 000000.00
PHAR 000008443284 TINACTIN SPRAY 100 G 000000.00
PHAR 000008443285 RETIN-A CR 0.05% 20G 000000.00
PHAR 000008443286 RETIN-A CRE 0.05% 45 000000.00
9/7/2010 11:52 AM Page 164 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008443287 RETIN-A CRE 0.1% 20G 000000.00
PHAR 000008443288 RETIN-A CR 0.025% 20 000000.00
PHAR 000008443289 RETIN-A CREAM 0.025% 000000.00
PHAR 000008443290 RETIN-A GEL 0.01% 15 000000.00
PHAR 000008443291 RETIN-A GEL 0.01% 45 000000.00
PHAR 000008443292 RETIN-A GEL .025% 15 000000.00
PHAR 000008443293 RETIN-A GEL .025% 45 000000.00
PHAR 000008443294 RETIN-A LIQ 0.05% 28 000000.00
PHAR 000008443295 ARISTOCORT CR 0.1 60 000000.00
PHAR 000008443296 ARISTOCORT-HP OIN 15 000000.00
PHAR 000008443297 ARISTOCORT 0.1% 15 G 000000.00
PHAR 000008443298 ARISTOCORT-R OIN 15G 000000.00
PHAR 000008443299 ARISTOCORT 0.1 60GM 000000.00
PHAR 000008443300 KENALOG IN ORABASE 000000.00
PHAR 000008443301 KENALOG CRE 0.025% 000000.00
PHAR 000008443302 KENALOG CR 0.025% 80 000000.00
PHAR 000008443303 KENALOG CRE 0.1% 15G 000000.00
PHAR 000008443304 KENALOG CRE 0.1% 60G 000000.00
PHAR 000008443305 KENALOG CRE 0.1% 80G 000000.00
PHAR 000008443306 KENALOG LOT .1% 15ML 000000.00
PHAR 000008443307 KENALOG LOT .1% 60ML 000000.00
PHAR 000008443308 KENALOG O .025% 15G 000000.00
PHAR 000008443309 KENALOG OIN 0.025 80 000000.00
PHAR 000008443310 KENALOG OIN 0.1% 60G 000000.00
PHAR 000008443311 KENALOG OIN 0.5% 20G 000000.00
PHAR 000008443312 KENALOG OINT 0.1% 15 000000.00
PHAR 000008443313 KENALOG SPRAY 23 GM 000000.00
PHAR 000008443314 KENALOG SPRAY 63 GM 000000.00
PHAR 000008443315 TRIAMCIN CR 0.5% 15G 000000.00
PHAR 000008443316 TRIAMCINOL CRE 0.1% 000000.00
PHAR 000008443317 MYOFLEX CREAM 10% 60 000000.00
PHAR 000008443318 DESENEX SOL 45 ML 000000.00
PHAR 000008443319 CARMOL-10 LOT 180 ML 000000.00
PHAR 000008443320 CARMOL-20 CREAM 90 G 000000.00
PHAR 000008443321 ZINC OXIDE 20% 30 G 000000.00
PHAR 000008443322 EXELDERM CRE 1% 15 G 000000.00
PHAR 000008443323 CAMPHO-PHENIQUE GEL 000000.00
PHAR 000008443324 TRIAMCINOLON OIN 0.1 000000.00
PHAR 000008443325 CLEARASIL LOT 10% 30 000000.00
PHAR 000008443326 ELOCON CR 0.1% 45GM 000000.00
PHAR 000008443327 DRITHOCREME 0.5% 50G 000000.00
PHAR 000008444001 PROVENTIL INH REFILL 000000.00
PHAR 000008444002 PROVENTIL INHALER 17 000000.00
PHAR 000008444003 PROVENTIL 0.5% SOLN 000000.00
PHAR 000008444004 PROVENTIL NEB 0.083% 000000.00
PHAR 000008444005 BECLOVENT INH 16.8 G 000000.00
PHAR 000008444006 BECONASE INHALER 000000.00
9/7/2010 11:52 AM Page 165 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008444007 BECONASE-AQ 25 ML IN 000000.00
PHAR 000008444008 VANCENASE INHALER 000000.00
PHAR 000008444009 VANCENASE AQ 25 G AE 000000.00
PHAR 000008444010 VANCERIL INHALER 000000.00
PHAR 000008444011 TORNALATE INHALER 000000.00
PHAR 000008444012 DUO-MEDIHALER 15 ML 000000.00
PHAR 000008444013 DUO-MEDIHALER 15 REF 000000.00
PHAR 000008444014 DUO-MEDIHALER 22.5ML 000000.00
PHAR 000008444015 DUO-MEDIHALER 22.5ML 000000.00
PHAR 000008444016 INTAL CAP 20 MG 000000.00
PHAR 000008444017 INTAL SOL 2 ML 000000.00
PHAR 000008444018 INTAL INHALER 14.2 G 000000.00
PHAR 000008444019 INTAL INHALER 8.1 G 000000.00
PHAR 000008444020 MEDIHALER-ERGOTAMINE 000000.00
PHAR 000008444021 AEROBID INHALER 7 GM 000000.00
PHAR 000008444022 BRONKOSOL 10 ML 000000.00
PHAR 000008444023 BRONKOSOL 30 ML 000000.00
PHAR 000008444024 BRONKOMETER 15 ML 000000.00
PHAR 000008444025 BRONKOMETER AER 10ML 000000.00
PHAR 000008444026 ISUPREL MISTOMETER 000000.00
PHAR 000008444027 MEDIHALER-ISO 15ML 000000.00
PHAR 000008444028 MEDIHALER ISO 22.5ML 000000.00
PHAR 000008444029 ALUPENT INH KIT 10 M 000000.00
PHAR 000008444030 ALUPENT INH REFILL 000000.00
PHAR 000008444031 ALUPENT SOL 5% 10 ML 000000.00
PHAR 000008444032 NITROLINGUAL SPRAY 000000.00
PHAR 000008444033 INSPIREASE BAG 000000.00
PHAR 000008444034 INSPIREASE KIT 000000.00
PHAR 000008444035 INTAL SPINHALER 000000.00
PHAR 000008444036 BRETHAIRE 7.5 ML 000000.00
PHAR 000008444037 AZMACORT 20 G BOTTLE 000000.00
PHAR 000008448001 ACETAMINOPHEN SU 120 000000.00
PHAR 000008448002 ACETAMINOPHEN SU 325 000000.00
PHAR 000008448003 ACETAMINOPHEN SU 650 000000.00
PHAR 000008448004 ASPIRIN SUPP 125 MG 000000.00
PHAR 000008448005 ASPIRIN SUP 300 MG 000000.00
PHAR 000008448006 ASPIRIN SUPP 600 MG 000000.00
PHAR 000008448007 BISACODYL SUPP 10 MG 000000.00
PHAR 000008448008 ANUSOL OINTMENT 30 G 000000.00
PHAR 000008448009 ANUSOL SUPP 000000.00
PHAR 000008448010 ANUSOL-HC SUP 000000.00
PHAR 000008448011 CAFERGOT PB SUPP 000000.00
PHAR 000008448012 CAFERGOT SUPP 000000.00
PHAR 000008448013 FLEET ENEMA - CHILD 000000.00
PHAR 000008448014 FLEET ENEMA 000000.00
PHAR 000008448015 NUPERCAINAL SUPP 000000.00
PHAR 000008448016 PREPARATION H OINT 000000.00
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008448017 PREPARATION SUPP 000000.00
PHAR 000008448018 PROCTOCREAM-HC 1% 30 000000.00
PHAR 000008448019 PROCTOFOAM-HC AER 10 000000.00
PHAR 000008448020 NUPERCAINAL CREAM 45 000000.00
PHAR 000008448021 NUPERCAINAL OIN 1 % 000000.00
PHAR 000008448022 GLYCERIN SUPP ADULT 000000.00
PHAR 000008448023 GLYCERIN SUP INFANT 000000.00
PHAR 000008448024 GLYCERIN SUPPOS PEDS 000000.00
PHAR 000008448025 CORTENEMA 60 ML 000000.00
PHAR 000008448026 PROCTOCORT CREAM 30 000000.00
PHAR 000008448027 CORTICAINE CREAM 30G 000000.00
PHAR 000008448028 FLEET MINERAL OIL EN 000000.00
PHAR 000008448029 COMPAZINE SUPP 2.5MG 000000.00
PHAR 000008448030 COMPAZINE SUPP 25 MG 000000.00
PHAR 000008448031 COMPAZINE SUPP 5 MG 000000.00
PHAR 000008448032 PROGESTERONE SUP 400 000000.00
PHAR 000008448033 PROGESTERONE SUP 100 000000.00
PHAR 000008448034 PROGESTERONE SUP 400 000000.00
PHAR 000008448035 PROGESTERONE SUPP 25 000000.00
PHAR 000008448036 PHENERGAN SUPP 12.5 000000.00
PHAR 000008448037 PHENERGAN SUPP 25 MG 000000.00
PHAR 000008448038 PHENERGAN SUPP 50 MG 000000.00
PHAR 000008448039 SENOKOT SUPP 000000.00
PHAR 000008448040 TORECAN SUPP 10 MG 000000.00
PHAR 000008448041 TRIMETHOB 100MG SUPP 000000.00
PHAR 000008448042 TRIMETHOBENZAM SUPP 000000.00
PHAR 000008448043 TUCKS CREAM 40 G 000000.00
PHAR 000008448044 TUCKS PAD #40 000000.00
PHAR 000008449001 MYCELEX-G VAGINAL #7 000000.00
PHAR 000008449002 MYCELEX-G 500 MG VAG 000000.00
PHAR 000008449003 MYCELEX-G CREAM 45 G 000000.00
PHAR 000008449004 MYCELEX-G CREAM 90 G 000000.00
PHAR 000008449005 AVC VAG CRE W/APPLIC 000000.00
PHAR 000008449006 AVC SUPPOS 000000.00
PHAR 000008449007 SULTRIN CREAM 78 G 000000.00
PHAR 000008449008 TRI SULF VAG CRE 78 000000.00
PHAR 000008449009 PREMARIN CREAM W/APP 000000.00
PHAR 000008449010 MYCOSTATIN VAGINAL 000000.00
PHAR 000008449011 NILSTAT VAG TAB 000000.00
PHAR 000008449012 BETADINE DOUCHE 000000.00
PHAR 000008472001 CHEMSTRIP BG (II) 000000.00
PHAR 000008472002 INSTA-GLUCOSE GEL 31 000000.00
PHAR 000008472003 CLINITEST KIT 000000.00
PHAR 000008472004 UROBILISTIX #50 000000.00
PHAR 000008472005 VISIDEX #10 000000.00
PHAR 000008472006 VISIDEX #25 000000.00
PHAR 000008472007 DIASTIX STRIPS #50 000000.00
9/7/2010 11:52 AM Page 167 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008472008 TES TAPE PACK 000000.00
PHAR 000008472009 URISTIX #100 000000.00
PHAR 000008472010 CHEMSTRIP 6 #100 000000.00
PHAR 000008473001 ENSURE 240 ML 000000.00
PHAR 000008473002 ENSURE PLUS 240 ML 000000.00
PHAR 000008473003 SUSTACAL PUDDING 150 000000.00
PHAR 000008474001 PHISODERM BAR 3.3 OZ 000000.00
PHAR 000008474002 CIBA VISION SAL 12OZ 000006.87
PHAR 000008600000 PHARMACY 000000.00
PHAR 000008601149 MESORIDAZINE BESYLATE TAB 10M 000003.38 250
PHAR 000008605336 CEFAZOLIN 0.5 GM IVPB 000028.80 250
PHAR 000008610001 ISOTRETINOIN 10MG CAP 000010.98
PHAR 000008610002 DANAZOL 200MG CAP 000010.70
PHAR 000008610003 DEMECLOCYCLINE HCL 150MG CAP 000010.97
PHAR 000008610004 DIASONE 165 MG 000002.17
PHAR 000008610005 NORINYL 1+50 #21 000023.30
PHAR 000008610006 LIOTRIX 30MG TAB 000002.66
PHAR 000008610007 CARBENICILLIN 382MG TAB 000008.39
PHAR 000008610008 HALOPERIDOL 0.5MG TAB 000002.72
PHAR 000008610009 ISOTRETINOIN 40MG CAP 000013.31
PHAR 000008610010 DEMECLOCYCLINE HCL 300MG TAB 000017.29
PHAR 000008610011 PHENOXYBENZAMINE 10MG CAP 000003.64
PHAR 000008610012 DICLOXACILLIN SODIUM 125MG CAP 000003.53
PHAR 000008610013 LIOTRIX 60MG TAB 000002.78
PHAR 000008610014 GELUSIL TAB 000002.07
PHAR 000008610015 NICOTINE POLACRILEX 2MG GUM 000057.26
PHAR 000008610016 DANTROLENE SODIUM 25MG CAP 000003.73
PHAR 000008610017 DECONAMINE TAB 000002.34
PHAR 000008610018 CALCIUM/ VIT D 500MG 1CAP CAP 000002.51
PHAR 000008610019 LIOTRIX 120MG TAB 000002.88
PHAR 000008610020 ORTHO-NOVUM 1/80 #21 000024.17
PHAR 000008610021 HALOPERIDOL 1 MG TAB 000002.86
PHAR 000008610022 HALOPERIDOL 2MG TAB 000002.86
PHAR 000008610023 DEMULEN 1/50 21DAY Jan-50 TAB 000042.00
PHAR 000008610024 DEMULEN 1/50 28 DAY Jan-50 TAB 000042.29
PHAR 000008610025 DANTROLENE SODIUM 50MG CAP 000006.97
PHAR 000008610026 DECONAMINE-SR CAP 000002.68
PHAR 000008610027 ETIDRONATE DISODIUM 200MG TAB 000008.44
PHAR 000008610028 LIOTRIX 180MG TAB 000002.98
PHAR 000008610029 DEMULEN 1/35 21DAY Jan-35 TAB 000038.78
PHAR 000008610030 GUANIDINE TAB 125 MG 000002.23
PHAR 000008610031 DEMULEN 1/35 28DAY Jan-35 TAB 000039.07
PHAR 000008610032 NICOTINE POLACRILEX 4MG GUM 000003.08
PHAR 000008610033 ERGOCALCIFEROL 50000U CAP 000002.65
PHAR 000008610034 VALPROIC ACID 250MG CAP 000006.88
PHAR 000008610035 DES 0.1MG 000002.06
PHAR 000008610036 DICLOXACILLIN 250 MG 000003.26
9/7/2010 11:52 AM Page 168 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610037 EXCEDRIN TAB 000002.11
PHAR 000008610038 HALODRIN TAB 000002.44
PHAR 000008610039 ISUPREL SL 15 MG 000002.70
PHAR 000008610040 PEMOLINE TAB 18. 000003.05
PHAR 000008610041 DES 0.5MG 000002.07
PHAR 000008610042 DICLOXACILLIN 500 MG 000006.87
PHAR 000008610043 FELDENE CAP 10 MG 000005.74
PHAR 000008610044 HALOPERIDOL 5MG TAB 000003.85
PHAR 000008610045 FLUOXYMESTERONE TAB 2 M 000002.74
PHAR 000008610046 ERGOLOID MESYLATES SUB 0.5 000002.57
PHAR 000008610047 DANTROLENE SODIUM 100MG CAP 000007.16
PHAR 000008610048 PREDNISONE 50MG TAB 000002.71
PHAR 000008610049 DES 0.25MG 000002.04
PHAR 000008610050 FELDENE CAP 20 MG 000006.52
PHAR 000008610051 FLUOXYMESTERONE TAB 5 M 000005.82
PHAR 000008610052 NORINYL TAB 2MG-20 000017.98
PHAR 000008610053 DARANIDE TAB 50 MG 000002.59
PHAR 000008610054 NORINYL 1+35 #21 000023.30
PHAR 000008610055 TRIAMTERENE 50MG CAP 000003.31
PHAR 000008610056 HALOPERIDOL 10MG TAB 000003.53
PHAR 000008610057 FLUOXYMESTERONE TAB 10 000006.71
PHAR 000008610058 ERGOLOID MESYLATES 1MG SUBL 000002.62
PHAR 000008610059 NORINYL 1+50 #28 000024.11
PHAR 000008610060 ADRENOSEM 2.5 MG TAB 000002.93
PHAR 000008610061 PYRIMETHAMINE 25MG TAB 000003.18
PHAR 000008610062 PREDNISONE 5MG TAB 000002.46
PHAR 000008610063 FERROUS SULFATE 1TAB TAB 000002.54
PHAR 000008610064 POTASSIUM BICARBONATE 25MEQ TA 000004.00
PHAR 000008610065 KANTREX CAP 500 MG 000007.17
PHAR 000008610066 SPIRONO/HCTZ 25/25 000002.24
PHAR 000008610067 DARICON TAB 10 MG 000002.51
PHAR 000008610068 TRAZODONE HCL 50MG TAB 000007.18
PHAR 000008610069 HALOPERIDOL 20 MG TAB 000007.14
PHAR 000008610070 ERGOLOID MESYLATE 1MG TAB 000002.75
PHAR 000008610071 KANULASE TAB 000002.53
PHAR 000008610072 MAGNESIUM GLUCONATE 500MG TAB 000002.48
PHAR 000008610073 NORINYL 1+35 #28 000024.11
PHAR 000008610074 DAYALETS TAB 000002.18
PHAR 000008610075 PREDNISONE 10MG TAB 000002.48
PHAR 000008610076 DIETHYLSTILBESTROL 1MG TAB 000002.56
PHAR 000008610077 TRIAMTERENE 100MG CAP 000003.55
PHAR 000008610078 NORINYL 1+80 #21 000022.08
PHAR 000008610079 HYDROXYUREA 500MG CAP 000007.75
PHAR 000008610080 TRAZODONE 100MG TAB 000003.72
PHAR 000008610081 DIETHYLSTILBESTROL 5MG TAB 000002.77
PHAR 000008610082 E.E.S. TAB 400 MG 000002.32
PHAR 000008610083 FEOSOL PLUS CAP 000002.21
9/7/2010 11:52 AM Page 169 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610084 NORLESTRIN 2.5/50#21 000023.01
PHAR 000008610085 KAON TAB 000002.25
PHAR 000008610086 NORINYL 1+80 #28 000022.08
PHAR 000008610087 NEOMYCIN SULF 500MG 000002.96
PHAR 000008610088 SPIRONOLACTONE 25MG TAB 000002.84
PHAR 000008610089 NORLESTRIN 1/50 #28 000022.47
PHAR 000008610090 PREDNISONE 20MG TAB 000002.64
PHAR 000008610091 NORLESTRIN 1/50 #21 000022.47
PHAR 000008610092 NORLESTRIN-FE 2.5/28 000018.40
PHAR 000008610093 PEMOLINE TAB 37. 000005.64
PHAR 000008610094 DECHOLIN 250MG TAB 000003.10
PHAR 000008610095 PREDNISONE 2.5MG TAB 000002.46
PHAR 000008610096 DEXAMETHASONE 0.5MG TAB 000002.68
PHAR 000008610097 DIHYDROTACHYSTEROL 0.125MG TAB 000003.95
PHAR 000008610098 ERYTHROMYCIN ETHYLSUC 200MG CH 000003.20
PHAR 000008610099 HYDROCORTONE 10 MG 000002.24
PHAR 000008610100 ORTHO-NOVUM 1/50 21D TAB 000037.27
PHAR 000008610101 METHENAMINE MANDELATE 500MG TA 000002.77
PHAR 000008610102 NEUTRA-PHOS 250MG CAP 000002.64
PHAR 000008610103 SPIRONOLACTONE 50MG TAB 000003.92
PHAR 000008610104 ORTHO-NOVUM 1/50 28D TAB 000037.42
PHAR 000008610105 AXID CAP 150MG 000005.71
PHAR 000008610106 HYDROCORTISONE 20MG TAB 000003.18
PHAR 000008610107 ORTHO-NOVUM 1/80 #28 000024.25
PHAR 000008610108 NICOTINIC ACID 500MG CAP 000002.47
PHAR 000008610109 TAMOXIFEN 10MG TAB 000007.78
PHAR 000008610110 PEMOLINE TAB 75M 000006.84
PHAR 000008610111 DEXAMETHASONE 0.75MG TAB 000002.71
PHAR 000008610112 DIHYDROTACHYSTEROL 0.2MG TAB 000004.09
PHAR 000008610113 ETHACRYNIC ACID TAB 25M 000003.01
PHAR 000008610114 FERROUS SULFATE 1CAP CAP 000002.81
PHAR 000008610115 HYDROMOX TAB 50 MG 000003.22
PHAR 000008610116 ORTHO-NOVUM 1/35 21D TAB 000037.27
PHAR 000008610117 ORTHO-NOVUM 1/35 28D Jan-35 TA 000037.42
PHAR 000008610118 MODICON 21DAY 0.5/35 TAB 000039.80
PHAR 000008610119 VITAMIN B COMP /C TAB 1EA 000002.52
PHAR 000008610120 ORINASE TAB 250 MG 000002.17
PHAR 000008610121 VITAMIN E 200U CAP 000002.47
PHAR 000008610122 METHENAMINE MANDELATE 1GM TAB 000003.04
PHAR 000008610123 NICOTINIC ACID 50MG TAB 000002.50
PHAR 000008610124 ALDOCLOR TAB 250 MG 000002.62
PHAR 000008610125 PHENYTOIN 50MG CHE 000002.81
PHAR 000008610126 ETHACRYNIC ACID TAB 50M 000003.28
PHAR 000008610127 CLONAZEPAM TAB 2MG 000002.88
PHAR 000008610128 HYDROPRES-25 TAB 000002.33
PHAR 000008610129 DYPHYLLINE 200MG TAB 000001.00
PHAR 000008610130 NICOTINIC ACID 100MG TAB 000002.44
9/7/2010 11:52 AM Page 170 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610131 NORFLEX TAB 000005.68
PHAR 000008610132 DIPHENOXYLATE/ATROP TAB 1EA 000002.15
PHAR 000008610133 DYPHYLLINE 400MG TAB 000007.44
PHAR 000008610134 AMOXICILLIN 250MG 250MG CHE 000002.95
PHAR 000008610135 HYDROPRES-50 TAB 000002.51
PHAR 000008610136 CEPHALEXIN 250MG CAP 000003.64
PHAR 000008610137 SPIRONOLACTONE 100MG TAB 000007.36
PHAR 000008610138 NICOTINIC ACID 25MG TAB 000002.42
PHAR 000008610139 NORGESIC TAB 000003.00
PHAR 000008610140 METHYLDOPA 250MG TAB 000002.78
PHAR 000008610141 ISOSORBIDE DINITRATE 10MG SUBL 000002.98
PHAR 000008610142 FERROUS GLUCONATE 325MG TAB 000002.53
PHAR 000008610143 MARAX TAB 000002.54
PHAR 000008610144 NIACINAMIDE 500MG TAB 000000.03
PHAR 000008610145 NORGESIC FORTE TAB 000003.38
PHAR 000008610146 DEXAMETHASONE 1.5MG TAB 000002.93
PHAR 000008610147 DILANTIN 100MG CAP 000002.92
PHAR 000008610148 CEPHALEXIN 500MG CAP 000006.78
PHAR 000008610149 MESORIDAZINE BESYLATE TAB 10M 000003.38
PHAR 000008610150 NIACINAMIDE 50MG 000002.05
PHAR 000008610151 NORTRIPTYLINE HCL 10MG CAP 000003.25
PHAR 000008610152 PROMETHAZINE HCL TAB 50M 000003.30
PHAR 000008610153 MEBARAL TAB 32 MG 000002.12
PHAR 000008610154 "DILANTIN,PHENBAR 15MG" 15MG C 000000.29
PHAR 000008610155 CHLORTHALIDONE 50MG TAB 000002.66
PHAR 000008610156 MAREZINE TAB 000002.29
PHAR 000008610157 NIACINAMIDE 100MG TAB 000000.04
PHAR 000008610158 METHYLDOPA 500MG TAB 000003.23
PHAR 000008610159 DEXAMETHASONE 2MG TAB 000003.36
PHAR 000008610160 CEPHALEXIN MONOHYDRAT 1GM TAB 000010.63
PHAR 000008610161 MARPLAN TAB 10 MG 000002.69
PHAR 000008610162 NICO-400 CAP 000002.42
PHAR 000008610163 DILANTIN-PB 30MG 30MG CAP 000002.70
PHAR 000008610164 ELAVIL TAB 10 MG 000002.23
PHAR 000008610165 FERRO-SEQUEL CAP 000002.88
PHAR 000008610166 CHLORTHALIDONE 100MG TAB 000007.04
PHAR 000008610167 MESORIDAZINE BESYLATE TAB 25M 000004.41
PHAR 000008610168 PROCARBAZINE 50MG CAP 000003.79
PHAR 000008610169 NIACIN 125MG CAP 000000.87
PHAR 000008610170 DEXAMETHASONE 4MG TAB 000003.42
PHAR 000008610171 NORTRIPTYLINE HCL 25MG CAP 000003.95
PHAR 000008610172 FERROUS SULF 325MG TAB 000002.50
PHAR 000008610173 DEXAMETHASONE 0.25MG TAB 000002.89
PHAR 000008610174 NIACIN 250MG CAP 000004.19
PHAR 000008610175 PANTHOLIN TAB 10 MG 000002.06
PHAR 000008610176 POLY-VI-FLOR 0.5MG CHE 000002.72
PHAR 000008610177 Z-BEC TAB 000002.21
9/7/2010 11:52 AM Page 171 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610178 ELAVIL TAB 25 MG 000002.41
PHAR 000008610179 CHLORTHALIDONE 25MG TAB 000002.62
PHAR 000008610180 MEASURIN TAB 000002.22
PHAR 000008610181 NICOBID TEM 500MG 000002.92
PHAR 000008610182 PAPAVERINE HCL 150MG CAP 000002.53
PHAR 000008610183 CIMETIDINE 200MG TAB 000003.86
PHAR 000008610184 INDERAL LA CAP 160MG 000006.19
PHAR 000008610185 DEXAMETHASONE 6MG TAB 000004.00
PHAR 000008610186 BROMPHENIRAMINE 4MG TAB 000002.59
PHAR 000008610187 DIHYDROTACHYSTEROL 0.125MG CAP 000009.53
PHAR 000008610188 ELDEPRYL TAB 5MG 000007.42
PHAR 000008610189 BUTALBITAL/ACET/CAFF 1TAB TAB 000003.26
PHAR 000008610190 NORETHINDRONE ACETATE 5MG TAB 000004.51
PHAR 000008610191 PAPAVERINE HYDROCHLOR 100MG TA 000002.57
PHAR 000008610192 ALDORIL-15 TAB 000002.49
PHAR 000008610193 DEXAMETHASONE 0.25MG TAB 000002.50
PHAR 000008610194 TRAZODONE HCL TAB 150 000008.38
PHAR 000008610195 ELAVIL TAB 50 MG 000002.70
PHAR 000008610196 METRONIDAZOLE 500MG TAB 000008.11
PHAR 000008610197 CLOMIPRAMINE 25MG CAP 000003.86
PHAR 000008610198 CLOMIPRAMINE 50MG CAP 000006.77
PHAR 000008610199 CLOMIPRAMINE 75MG CAP 000007.39
PHAR 000008610200 NORETHINDRONE 5MG TAB 000007.51
PHAR 000008610201 DI-GEL TAB 000002.05
PHAR 000008610202 CEFTIN TAB 250 MG 000007.95
PHAR 000008610203 IBERET TAB 000002.55
PHAR 000008610204 CEFTIN TAB 500 MG 000011.70
PHAR 000008610205 MATERNA TAB 000002.38
PHAR 000008610206 ALDORIL-25 TAB 000002.55
PHAR 000008610207 HALOPERIDOL TAB 1 MG 000002.26
PHAR 000008610208 BROMPHENIRAMINE 12MG TAB 000002.82
PHAR 000008610209 ELAVIL TAB 75 MG 000002.94
PHAR 000008610210 METRONIDAZOLE 250MG TAB 000007.16
PHAR 000008610211 IBERET-500 TAB 000002.47
PHAR 000008610212 QUARZAN CAP 2.5 MG 000002.27
PHAR 000008610213 MECLOMEN CAP 50 MG 000002.70
PHAR 000008610214 NITROGLYN-SA 2.6 MG 000002.23
PHAR 000008610215 DISOPYRAMIDE 100MG CAP 000003.38
PHAR 000008610216 ESTRATEST TAB 000003.18
PHAR 000008610217 BROMPHENIRAMINE 8MG TAB 000002.77
PHAR 000008610218 CYCLOBENZAPRINE HCL 10MG TAB 000003.84
PHAR 000008610219 PRILOSEC CAP 20 MG C 000008.82
PHAR 000008610220 NITROGLYN-SA 6.5 MG 000002.30
PHAR 000008610221 MELPHALAN 2MG TAB 000008.02
PHAR 000008610222 ORAP TAB 2 MG 000003.06
PHAR 000008610223 LACTAID TAB 3300 U 000002.17
PHAR 000008610224 ELAVIL TAB 100 MG 000003.17
9/7/2010 11:52 AM Page 172 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610225 IBERET FOLIC-500 000002.71
PHAR 000008610226 EXCEDRIN TAB 000002.10
PHAR 000008610227 MECLOMEN CAP 100 MG 000002.92
PHAR 000008610228 NITROGLYCERIN 0.15MG SUBL 000009.06
PHAR 000008610229 DISOPYRAMIDE 150MG CAP 000003.56
PHAR 000008610230 EXCEDRIN EXTRA STREN 000002.20
PHAR 000008610231 CAPOZIDE TAB 25/15 M 000003.09
PHAR 000008610232 DIMETAPP TAB 000002.23
PHAR 000008610233 SUPRAX TAB 400MG 000011.81
PHAR 000008610234 PARADIONE CAP 300 MG 000002.73
PHAR 000008610235 ETODOLAC CAP 200 000006.38
PHAR 000008610236 TREXAN TAB 50 MG 000011.04
PHAR 000008610237 CHLORPROPAMIDE 100MG TAB 000002.70
PHAR 000008610238 BROMPHEN/PHENYLPROP TAB 000002.99
PHAR 000008610239 ELAVIL TAB 150 MG 000005.65
PHAR 000008610240 TROPAMINE PLUS CAP 000002.59
PHAR 000008610241 ETODOLAC CAP 300 000006.59
PHAR 000008610242 NITROGLYCERIN 0.3MG SUBL 000009.54
PHAR 000008610243 DISOPYRAMIDE CR 100MG CAP 000003.77
PHAR 000008610244 PARADIONE CAP 150 MG 000002.41
PHAR 000008610245 FLINTSTONES CHW COMP 000002.17
PHAR 000008610246 POLY-VI-FLOR C IRON 1MG CHE 000002.63
PHAR 000008610247 DOCUSATE SODIUM CAP 100 000002.50
PHAR 000008610248 FOLIC ACID 1MG TAB 000002.68
PHAR 000008610249 DIGOXIN 0.05MG CAP 000002.69
PHAR 000008610250 METHYLPREDNISOLONE 2MG TAB 000003.04
PHAR 000008610251 DESIPRAMINE 10MG TAB 000003.43
PHAR 000008610252 CENTRUM JR TAB 000002.15
PHAR 000008610253 ALLBEE-T TAB 000000.14
PHAR 000008610254 CHLORPROPAMIDE 250MG TAB 000002.81
PHAR 000008610255 TENORETIC 50/25 TAB 000003.52
PHAR 000008610256 FLUDROCORTISONE ACETA 0.1MG TA 000003.32
PHAR 000008610257 ILOZYME TAB 000002.45
PHAR 000008610258 NITROGLYCERIN 0.6MG SUBL 000009.54
PHAR 000008610259 LITHIUM CARB CAP 150 000002.12
PHAR 000008610260 DOCUSATE SODIUM CAP 250 000002.51
PHAR 000008610261 GRISEOFULVIN ULTRAMIC 125MG TA 000000.47
PHAR 000008610262 AZATHIOPRINE 50MG TAB 000007.25
PHAR 000008610263 DIGOXIN 0.1MG CAP 000002.65
PHAR 000008610264 KETOCONAZOLE 200MG TAB 000009.91
PHAR 000008610265 DESIPRAMINE 25MG TAB 000003.50
PHAR 000008610266 COMPOUNDING FEE 000020.00
PHAR 000008610267 ALUMINUM HYDROXID 475MG CAP 000002.71
PHAR 000008610268 DOCUSATE/CASANTHRANOL 1CAP CAP000002.52
PHAR 000008610269 ELIXOPHYLLIN 200MG 000002.52
PHAR 000008610270 GRISEOFULVIN ULTRAMIC 250 MG T 000004.06
PHAR 000008610271 METHYLPREDNISOLONE 4MG TAB 000003.41
9/7/2010 11:52 AM Page 173 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610272 ALUMINUM HYDROXIDE 600MG TAB 000002.68
PHAR 000008610273 DIALOSE-PLUS CAP 000002.29
PHAR 000008610274 IBUPROFEN TAB 200 MG 000002.14
PHAR 000008610275 GRISEOFULVIN 500 MG TAB 000007.09
PHAR 000008610276 DIGOXIN 0.2MG CAP 000002.65
PHAR 000008610277 METHYLPREDNISOLONE 16MG TAB 000007.42
PHAR 000008610278 NOLAMINE TAB 000002.30
PHAR 000008610279 DESIPRAMINE 50MG TAB 000006.89
PHAR 000008610280 METAPROTERENOL SULFAT 20MG TAB 000003.41
PHAR 000008610281 DIALUME CAP 500 MG 000002.23
PHAR 000008610282 GRISEOFULVIN 250 MG TAB 000003.84
PHAR 000008610283 PROPRANOLOL HCL 10MG TAB 000003.06
PHAR 000008610284 IBUPROFEN TAB 400 MG 000002.21
PHAR 000008610285 DESIPRAMINE 75MG TAB 000007.75
PHAR 000008610286 POLY-VI-SOL CHE 000002.60
PHAR 000008610287 ALUPENT 10MG TAB 000003.12
PHAR 000008610288 ACETAZOLAMIDE 125MG TAB 000002.94
PHAR 000008610289 IBUPROFEN TAB 600 MG 000002.30
PHAR 000008610290 DIGOXIN 0.125MG TAB 000002.98
PHAR 000008610291 IBUPROFEN TAB 800 MG 000002.35
PHAR 000008610292 PERMITIL TAB 2.5 MG 000003.47
PHAR 000008610293 BROMOCRIPTINE 5MG CAP 000009.54
PHAR 000008610294 PERMITIL TAB 5 MG 000005.97
PHAR 000008610295 TUMS ANTACID 500 UD 000002.07
PHAR 000008610296 ENDURON TAB 2.5 MG 000002.38
PHAR 000008610297 NITROFURANTOIN 50MG TAB 000003.54
PHAR 000008610298 PROPRANOLOL HCL 20MG TAB 000003.34
PHAR 000008610299 MICAPO-K 8 MEQ CAP 000002.22
PHAR 000008610300 VIT B COMP W/C TAB 000002.54
PHAR 000008610301 CLOZARIL 25MG TAB 000007.25
PHAR 000008610302 ACETAZOLAMIDE 250MG TAB 000002.69
PHAR 000008610303 DISALCID TAB 500 MG 000002.46
PHAR 000008610304 DIGOXIN 0.25MG TAB 000002.68
PHAR 000008610305 LEVSIN SUB 0.125 MG 000002.41
PHAR 000008610306 LITHIUM CARB CAP 600 000002.21
PHAR 000008610307 MEDROXYPROGESTERONE 10MG TAB 000002.98
PHAR 000008610308 ACETAZOLAMIDE 500MG CAP 000004.04
PHAR 000008610309 ENDURON TAB 5 MG 000002.43
PHAR 000008610310 PROPRANOLOL HCL 40MG TAB 000003.62
PHAR 000008610311 LANOXIN TAB 0.5 MG 000002.23
PHAR 000008610312 THIORIDAZINE HCL 10MG TAB 000002.72
PHAR 000008610313 OFLOXACIN TAB 400 000010.30
PHAR 000008610314 PAPAVERINE HYDROCHLOR 150MG CA 000002.78
PHAR 000008610315 AMINOCAPROIC ACID 500MG TAB 000008.18
PHAR 000008610316 OXYBUTYNIN CHLORIDE 5MG TAB 000003.24
PHAR 000008610317 OFLOXACIN TAB 200 000009.18
PHAR 000008610318 OPTIMINE TAB 1 MG 000002.86
9/7/2010 11:52 AM Page 174 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610319 PBZ TAB 50 MG 000002.22
PHAR 000008610320 OFLOXACIN TAB 300 000010.01
PHAR 000008610321 COUMADIN TAB 1 MG 000002.78
PHAR 000008610322 CLOZARIL 100MG TAB 000011.14
PHAR 000008610323 SINEMET TAB 50/200CR 000005.87
PHAR 000008610324 ENDURONYL TAB 000002.91
PHAR 000008610325 NITROFURANTOIN 100MG TAB 000007.01
PHAR 000008610326 THIORIDAZINE HCL 15MG TAB 000002.71
PHAR 000008610327 MEBARAL TAB 50 MG 000002.17
PHAR 000008610328 PBZ TAB 25 MG 000002.18
PHAR 000008610329 PHOS FLUR 500 ML 000011.99
PHAR 000008610330 POLY-VI-SOL C IRON CHE 000002.62
PHAR 000008610332 DIUPRES-250 TAB 000002.33
PHAR 000008610333 LOPERAMIDE 2MG CAP 000003.51
PHAR 000008610335 LEVODOPA 100MG TAB 000002.87
PHAR 000008610337 PBZ-SR TAB 100 MG 000002.45
PHAR 000008610339 DIUPRES-500 TAB 000002.51
PHAR 000008610340 CHLORDIAZEPOXIDE HYDR CAP 5MG 000002.53
PHAR 000008610341 FURAZOLIDONE 100 MG TAB 000008.70
PHAR 000008610342 PROPRANOLOL HCL 80MG TAB 000004.27
PHAR 000008610343 LEVODOPA 500MG TAB 000003.29
PHAR 000008610344 THIORIDAZINE 25MG TAB 000003.25
PHAR 000008610345 "GLYCEROL, IODINATED" 30 MG TA 000002.96
PHAR 000008610346 MEBARAL TAB 100 MG 000002.23
PHAR 000008610348 AMINOPHYLLINE 100MG TAB 000002.51
PHAR 000008610349 GUAIFENESIN/PPA CAP 1 000003.28
PHAR 000008610351 PROPRANOLOL LA 80MG CAP 000007.06
PHAR 000008610352 LEVODOPA 250MG TAB 000003.14
PHAR 000008610355 PHRENILIN TAB 000002.18
PHAR 000008610357 CHLOROTHIAZIDE TAB 250 000002.68
PHAR 000008610358 INDOMETHACIN 25MG CAP 000002.83
PHAR 000008610359 THIORIDAZINE HCL 50MG TAB 000002.94
PHAR 000008610361 PEDIAMYCIN CHEW 200 000002.40
PHAR 000008610362 HYDROXYCHLOROQUINE SU 200MG TA000007.19
PHAR 000008610364 AMITRIPTYLINE 10MG TAB 000002.51
PHAR 000008610365 CHLOROTHIAZIDE TAB 500 000002.71
PHAR 000008610367 GANTANOL TAB 500 MG 000002.52
PHAR 000008610368 FUROSEMIDE 40MG TAB 000002.55
PHAR 000008610369 TOLBUTAMIDE 500 MG 000002.16
PHAR 000008610371 POLARAMINE TAB 2 MG 000002.40
PHAR 000008610373 AMITRIPTYLINE 25MG TAB 000002.52
PHAR 000008610374 GUAIFENESIN/PPA TAB 1 000003.89
PHAR 000008610376 POLARAMINE TAB 4 MG 000002.68
PHAR 000008610378 AMITRIPTYLINE 50MG TAB 000002.54
PHAR 000008610380 EPHEDRINE 25MG CAP 000002.62
PHAR 000008610382 INDOMETHACIN 50MG CAP 000003.12
PHAR 000008610383 FUROSEMIDE 80 MG TAB 000002.69
9/7/2010 11:52 AM Page 175 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610384 THIORIDAZINE HCL 100MG TAB 000002.89
PHAR 000008610386 POLARAMINE TAB 6 MG 000002.95
PHAR 000008610387 POTASS CHLOR 300MG 000002.08
PHAR 000008610388 AMMONIUM CHLORIDE 500MG TAB 000000.09
PHAR 000008610389 DOLOBID TAB 250 MG 000002.93
PHAR 000008610390 EPHEDRINE 50MG CAP 000002.72
PHAR 000008610391 GANTANOL-DS TAB 1GM 000002.57
PHAR 000008610392 THIORIDAZINE HCL 150MG TAB 000003.29
PHAR 000008610394 CHLORDIAZEPOXIDE HYDR CAP 10M 000002.75
PHAR 000008610395 AMMONIUM CHLORIDE 1GM TAB 000002.57
PHAR 000008610396 INDOMETHACIN SR 75MG CAP 000004.43
PHAR 000008610397 FUROSEMIDE 20MG TAB 000002.54
PHAR 000008610398 ORNADE SPANSULES 000002.82
PHAR 000008610401 POTASS CHLOR 1 GM 000002.13
PHAR 000008610402 ALUMINUM HYDROXIDE 600MG TAB 000002.57
PHAR 000008610403 DOLOBID TAB 500 MG 000003.16
PHAR 000008610404 ERGOTAMINE TARTRATE 2MG 000000.89
PHAR 000008610405 GANTRISIN TAB 500 MG 000002.25
PHAR 000008610408 THIORIDAZINE HCL 200MG TAB 000003.25
PHAR 000008610409 PEGANONE TAB 250 MG 000002.23
PHAR 000008610411 ALUMINUM HYDROXIDE 300MG TAB 000002.50
PHAR 000008610415 ORNEX CAP 000002.17
PHAR 000008610416 PEGANONE TAB 500 MG 000002.74
PHAR 000008610417 POVAN TAB 50 MG 000003.45
PHAR 000008610419 ANACIN TAB 000002.09
PHAR 000008610421 ERGONOVINE MALEATE 0.2MG TAB 000000.35
PHAR 000008610423 ISMELIN TAB 10 MG 000002.65
PHAR 000008610424 CHLORAMBUCIL 2MG TAB 000007.14
PHAR 000008610428 AMOXICILLIN 250MG CAP 000003.05
PHAR 000008610429 OXYMETHOLONE TAB 50M 000003.48
PHAR 000008610430 DONNATAL TAB 000002.68
PHAR 000008610431 ERYTHROMYCIN 250MG TAB 000002.69
PHAR 000008610432 ISMELIN TAB 25 MG 000003.03
PHAR 000008610433 PHYTONADIONE 5MG TAB 000003.50
PHAR 000008610436 PREDNISOLONE 5MG TAB 000002.47
PHAR 000008610438 CHLORDIAZEPOXIDE HYDR CAP 25M 000003.27
PHAR 000008610439 CLIDINIUM/CHLORDIAZ CAP 2.5 000003.59
PHAR 000008610440 MEPHENYTOIN 100MG TAB 000002.95
PHAR 000008610442 AMOXICILLIN 500MG CAP 000002.87
PHAR 000008610443 ANAPROX TAB 275 MG 000002.81
PHAR 000008610444 DONNATAL CAP 000002.63
PHAR 000008610445 GAVISCON CHE 000002.54
PHAR 000008610446 ISOCLOR TAB 000002.31
PHAR 000008610447 PYRIDOSTIGMINE BR 60MG TAB 000003.17
PHAR 000008610450 PREDNISONE 1MG TAB 000002.48
PHAR 000008610451 ANAVAR TAB 2.5 MG 000002.71
PHAR 000008610452 ISOCLOR TIMESULE 000002.62
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610453 BACLOFEN 10MG TAB 000003.15
PHAR 000008610454 PYRIDOSTIGMINE BR 180MG TAB 000003.73
PHAR 000008610455 BISMUTH SUBSALICYLATE 262MG TA 000005.83
PHAR 000008610457 PREDNISONE TAB 5 MG 000002.06
PHAR 000008610458 FLUCYTOSINE 250 MG CAP 000006.97
PHAR 000008610459 DONNATAL EXTENTAB TAB 000003.17
PHAR 000008610460 HYDROCHLOROTHIAZIDE 25MG TAB 000002.58
PHAR 000008610461 ISONIAZID 100MG TAB 000002.46
PHAR 000008610462 LIMBITROL 5-12.5 TAB 000002.69
PHAR 000008610464 PERCOGESIC TAB 000002.09
PHAR 000008610465 PREDNISONE TAB 10 MG 000002.07
PHAR 000008610466 FLUCYTOSINE 500 MG CAP 000008.98
PHAR 000008610467 ISONIAZID 300MG TAB 000002.47
PHAR 000008610472 PREDNISONE TAB 20 MG 000002.12
PHAR 000008610473 DISULFIRAM 250MG TAB 000003.76
PHAR 000008610474 DOXIDAN CAP 000002.17
PHAR 000008610475 HYDROCHLOROTHIAZIDE 50MG TAB 000002.62
PHAR 000008610478 PEGITANE TAB 1.25 MG 000002.06
PHAR 000008610481 PREDNISONE TAB 50 MG 000002.26
PHAR 000008610483 VERAPAMIL HCL 80MG TAB 000003.24
PHAR 000008610484 METHYLTESTOSTERONE 10MG TAB 000003.24
PHAR 000008610485 CYPROHEPTADINE HCL 4MG TAB 000002.52
PHAR 000008610487 "ESTROGENS, CONJUGATED" 2.5MG 000004.30
PHAR 000008610488 AMPICILLIN 250MG CAP 000002.62
PHAR 000008610489 DIMENHYDRINATE 50MG TAB 000002.87
PHAR 000008610490 LITHIUM CARB.EXT REL 300MG TAB 000002.72
PHAR 000008610491 METHYLTESTOSTERONE 25MG TAB 000004.39
PHAR 000008610493 AMPICILLIN 500MG CAP 000002.72
PHAR 000008610495 ANTI-SPASMODIC TAB 000002.01
PHAR 000008610497 ESIMIL TAB 000002.84
PHAR 000008610498 VERAPAMIL HCL 120MG TAB 000003.53
PHAR 000008610500 METHYLTESTOSTERONE 5MG 000002.86
PHAR 000008610501 PERITRATE TAB 10 MG 000002.18
PHAR 000008610502 "ESTROGENS, CONJUGATED" 1.25MG 000003.36
PHAR 000008610503 PROPANTHELINE BR 15MG TAB 000002.71
PHAR 000008610505 ANTIVERT-25 CHW 25MG 000002.67
PHAR 000008610506 DRISDOL CAP 50000 U 000002.84
PHAR 000008610507 LITHIUM CARB 300MG CAP 000002.63
PHAR 000008610508 PROPANTHELINE BR 7.5MG TAB 000003.13
PHAR 000008610509 MECLIZINE 12.5MG TAB 000003.02
PHAR 000008610511 ETHINYL ESTRADIOL 0.05MG TAB 000003.38
PHAR 000008610512 ISOSORBIDE DINITRATE 5MG SUBL 000002.84
PHAR 000008610513 METHYLERGONOVINE 0.2MG TAB 000003.29
PHAR 000008610514 PERITRATE TAB 20 MG 000002.19
PHAR 000008610515 DRIXORAL-SA TAB 000002.48
PHAR 000008610516 ETHINYL EST 0.5MG TAB 000004.38
PHAR 000008610517 METHOTREXATE 2.5MG TAB 000012.55
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610518 PERITRATE TAB 40 MG 000002.42
PHAR 000008610519 PREMARIN 0.625MG TAB 000003.32
PHAR 000008610520 QUIBRON CAP 000002.37
PHAR 000008610521 MECLIZINE 25MG TAB 000003.44
PHAR 000008610522 BISACODYL 5MG TAB 000002.46
PHAR 000008610523 ETHINYL ESTRADIOL 0.02MG TAB 000002.99
PHAR 000008610524 ISOSORBIDE DINITRATE 2.5MG SUB 000002.82
PHAR 000008610525 METOPIRONE TAB 250MG 000006.85
PHAR 000008610526 "ESTROGENS, CONJUGATED" 0.3MG 000002.98
PHAR 000008610528 QUIBRON-T,SR TAB 300 000002.41
PHAR 000008610529 METOCLOPRAMIDE HCL TAB 10M 000002.91
PHAR 000008610531 MIDAMOR TAB 5 MG 000002.54
PHAR 000008610532 PERITRATE-PB 10MG 000002.12
PHAR 000008610534 CALCITRIOL 0.25MCG CAP 000004.48
PHAR 000008610535 TRIFLUOPERAZINE HCL TAB 5MG 000004.09
PHAR 000008610536 SULFINPYRAZONE 100MG TAB 000003.11
PHAR 000008610537 ESTRADIOL 1MG TAB 000003.08
PHAR 000008610538 ISOSORBIDE DINITRATE 5MG TAB 000002.84
PHAR 000008610539 MIDRIN CAP 000003.13
PHAR 000008610540 LIMBITROL 10-25 TAB 000002.97
PHAR 000008610541 PREMARIN C METHYLTEST 0.625/5 000004.01
PHAR 000008610542 QUINIDINE GLUC 324MG TAB 000003.38
PHAR 000008610543 REGROTON TAB 000003.38
PHAR 000008610544 SULFINPYRAZONE 200MG CAP 000003.54
PHAR 000008610545 DURICEF CAP 500 MG 000006.78
PHAR 000008610546 ESTRADIOL 2MG TAB 000003.41
PHAR 000008610548 PERITRATE-SA 80MG 000002.57
PHAR 000008610549 PREMARIN C METHYLTEST 1.25/10 000007.51
PHAR 000008610550 QUININE SULFATE 260MG TAB 000003.71
PHAR 000008610552 ISOSORBIDE DINITRATE 10MG TAB 000002.90
PHAR 000008610553 MINOXIDIL 2.5MG TAB 000003.26
PHAR 000008610555 PRIMAQUINE PHOSPHATE 26.3MG TA 000003.76
PHAR 000008610556 PROCAINAMIDE SR 250MG TAB 000003.04
PHAR 000008610557 DURICEF TAB 1 GM 000009.29
PHAR 000008610558 AMITRIPTY/PERPHE 2/10 1TAB TAB 000003.53
PHAR 000008610559 MINOXIDIL 10MG TAB 000003.47
PHAR 000008610561 DIPYRIDAMOLE 25MG TAB 000003.00
PHAR 000008610563 QUINIDINE SULF CR 300MG TAB 000003.71
PHAR 000008610564 RENESE TAB 1 MG 000002.49
PHAR 000008610565 HCTZ/TRIAMTERENE TAB 000002.99
PHAR 000008610566 ISOSORBIDE DINITRATE 20MG TAB 000003.22
PHAR 000008610567 LOPID CAP 000002.63
PHAR 000008610568 PROCAINAMIDE 500MG TAB 000003.49
PHAR 000008610569 QUINIDINE SO4 300MG 000002.33
PHAR 000008610570 RENESE TAB 2 MG 000002.64
PHAR 000008610571 CALCITRIOL 0.5MCG CAP 000008.12
PHAR 000008610572 HYDRALAZINE 25MG TAB 000002.57
9/7/2010 11:52 AM Page 178 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610573 AMITRIPTY/PERPHE 2/25 1TAB TAB 000003.82
PHAR 000008610575 QUININE SULFATE 200MG CAP 000002.98
PHAR 000008610576 RENESE TAB 4 MG 000003.07
PHAR 000008610577 RONDEC TAB 000002.38
PHAR 000008610578 DICLOXACILLIN SODIUM 250MG CAP 000003.32
PHAR 000008610579 METOPROLOL 50MG TAB 000003.29
PHAR 000008610580 PRAZOSIN 1MG CAP 000003.23
PHAR 000008610581 DIPYRIDAMOLE 50MG TAB 000003.37
PHAR 000008610582 PROCAINAMIDE ER 750MG TAB 000002.71
PHAR 000008610583 RONIACOL TAB 50 MG 000002.17
PHAR 000008610584 HYDRALAZINE 50MG TAB 000002.58
PHAR 000008610585 DICLOXACILLIN SODIUM 500MG CAP 000004.06
PHAR 000008610586 AMITRIPTY/PERPHE 4/10 1TAB TAB 000003.59
PHAR 000008610587 ISORDIL SL TAB 10 MG 000002.25
PHAR 000008610588 NIFEDIPINE 10MG CAP 000003.33
PHAR 000008610589 RONIACOL TIMESPAN 000002.51
PHAR 000008610591 DYMELOR TAB 250 MG 000002.29
PHAR 000008610592 METOPROLOL 100MG TAB 000003.80
PHAR 000008610593 PRAZOSIN 2MG CAP 000003.55
PHAR 000008610594 DIPYRIDAMOLE 75MG TAB 000003.70
PHAR 000008610595 LOMOTIL TAB 2.5 MG 000002.46
PHAR 000008610596 TRIFLUOPERAZINE HCL TAB 10M 000007.33
PHAR 000008610597 VITAMIN A (SYNTHETIC) 25000U C 000003.25
PHAR 000008610598 AMITRIPTY/PERPHE 4/25 1TAB TAB 000003.94
PHAR 000008610599 ISORDIL CHEW 10 MG 000002.16
PHAR 000008610600 PROBUCOL 250MG TAB 000003.79
PHAR 000008610601 PERSISTIN TAB 000002.32
PHAR 000008610603 SALUTENSIN TAB 000003.03
PHAR 000008610605 LEVOTHYROXINE 0.1MG TAB 000002.95
PHAR 000008610606 VITAMIN A (SYNTHETIC) 50000U C 000003.88
PHAR 000008610607 DYMELOR TAB 500 MG 000002.48
PHAR 000008610608 ISORDIL TEMBID 40 MG 000002.34
PHAR 000008610610 FLUPHENAZINE TAB 1 M 000004.19
PHAR 000008610612 STILPHOSTROL TAB 50 000006.32
PHAR 000008610614 LOXIAPINE SUCCINATE CAP 5MG 000003.36
PHAR 000008610615 PRAZOSIN 5MG CAP 000006.74
PHAR 000008610616 ROBOFLAVIN 25 MG 000002.03
PHAR 000008610617 METHYSERGIDE MALEATE 2MG TAB 000008.15
PHAR 000008610618 STUARTNATAL TAB 1+1 000002.23
PHAR 000008610621 PROMETHAZINE HCL TAB 12. 000002.58
PHAR 000008610622 FLUPHENAZINE HCL TAB 2.5 000007.13
PHAR 000008610623 RIFAMPIN 300MG CAP 000008.14
PHAR 000008610625 PSEUDOEPHEDRINE HCL 30MG TAB 000002.47
PHAR 000008610626 LEVOTHYROXINE 0.15MG TAB 000002.88
PHAR 000008610627 CHLOROQUINE PHOSPHATE 500MG TA 000011.68
PHAR 000008610629 LOXAPINE SUCCINATE CAP 10M 000003.61
PHAR 000008610631 SENNA TAB 000002.66
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610632 PSEUDOEPHEDRINE HCL 60MG TAB 000002.48
PHAR 000008610633 TEGRETOL 200MG TAB 000003.04
PHAR 000008610634 ARALEN W/PRIMAQUINE 000007.74
PHAR 000008610635 FLUPHENAZINE TAB 5 M 000007.81
PHAR 000008610637 PSEUDOEPHEDRINE HCL 120MG CAP 000002.88
PHAR 000008610638 LEVOTHYROXINE 0.125MG TAB 000002.87
PHAR 000008610639 TELDRIN-TR CAP 8MG 000002.18
PHAR 000008610640 ATENOLOL 50MG TAB 000003.53
PHAR 000008610641 TRIAMCINOLONE 4MG PAK 000034.86
PHAR 000008610642 LOXIAPINE SUCCINATE CAP 25M 000006.59
PHAR 000008610643 PROMETHAZINE HCL TAB 25M 000002.80
PHAR 000008610644 FLUPHENAZINE TAB 10 000009.07
PHAR 000008610645 METHOCARBAMOL 500MG TAB 000002.59
PHAR 000008610647 TERRAMYCIN CAP 250MG 000002.75
PHAR 000008610648 TRIAMCINOLONE 2MG TAB 000003.82
PHAR 000008610649 MINOCYCLINE HCL 50MG CAP 000007.39
PHAR 000008610651 TMP/SULFAMETH 80/400 1TAB TAB 000003.49
PHAR 000008610652 SULFADIAZINE 500MG TAB 000002.63
PHAR 000008610653 TELDRIN-TR CAP 12MG 000002.36
PHAR 000008610654 TRIAMCINOLONE 4MG TAB 000007.37
PHAR 000008610655 LOXIAPINE SUCCINATE CAP 50M 000007.15
PHAR 000008610656 THYROGLOBULIN 30MG TAB 000002.58
PHAR 000008610657 ROBAXIN 750MG TAB 000002.70
PHAR 000008610658 LEVOTHYROXINE 0.2MG TAB 000002.98
PHAR 000008610659 BENZONATATE 100 MG CAP 000003.96
PHAR 000008610661 MINOCYCLINE HCL 100MG CAP 000009.11
PHAR 000008610662 SEPTRA 160/800 TAB 000003.53
PHAR 000008610663 TETRACYCLINE HCL 250MG CAP 000002.50
PHAR 000008610664 CHLORPROMAZINE HCL 50MG TAB 000002.52
PHAR 000008610665 ARLIDIN TAB 6 MG 000002.73
PHAR 000008610667 THYROGLOBULIN 65MG TAB 000002.52
PHAR 000008610668 ROBAXISAL TAB 000002.41
PHAR 000008610669 LEVOTHYROXINE 0.3MG TAB 000003.18
PHAR 000008610670 TEMARIL SPANS 5 MG 000003.11
PHAR 000008610671 THEOPHYLLINE 300MG TAB 000003.06
PHAR 000008610672 INDAPAMIDE 2.5MG TAB 000007.16
PHAR 000008610673 THIABENDAZOLE 500MG CHE 000004.46
PHAR 000008610674 THYROGLOBULIN 100MG TAB 000002.64
PHAR 000008610675 GLYCOPYRROLATE TAB 1 M 000002.74
PHAR 000008610677 TETRACYCLINE HCL 500MG CAP 000002.59
PHAR 000008610678 MEBARAL TAB 200 MG 000002.17
PHAR 000008610680 THYROGLOBULIN 200MG TAB 000002.86
PHAR 000008610681 GLYCOPYRROLATE TAB 2 M 000002.94
PHAR 000008610683 MEPROBAMATE TAB 200 000002.04
PHAR 000008610684 TEMARIL TAB 2.5 MG 000002.64
PHAR 000008610685 THEOPHYLLINE 100MG TAB 000002.86
PHAR 000008610686 CHLORPROMAZINE HCL 100MG TAB 000002.56
9/7/2010 11:52 AM Page 180 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610687 TRI-VI-FLOR 1MG CHE 000002.69
PHAR 000008610688 ARLIDIN TAB 12 MG 000003.11
PHAR 000008610689 MOLINDONE HCL 5MG TAB 000003.35
PHAR 000008610690 THYROGLOBULIN 120MG TAB 000002.74
PHAR 000008610692 SER-AP-ES TAB 000002.53
PHAR 000008610693 MEPROBAMATE TAB 400 000002.05
PHAR 000008610696 LUDIOMIL TAB 50 MG 000002.69
PHAR 000008610697 MOLINDONE HCL 10MG TAB 000003.76
PHAR 000008610700 SURFAK CAP 240 MG 000002.23
PHAR 000008610701 TAGAMET TAB 200 MG 000002.88
PHAR 000008610702 THEOPHYLLINE 200MG TAB 000002.96
PHAR 000008610703 MOLINDONE HCL 25MG TAB 000004.40
PHAR 000008610704 TRIMETHOPRIM 100MG TAB 000002.98
PHAR 000008610705 DOCUSATE CALCIUM 50MG CAP 000002.64
PHAR 000008610706 ATENOLOL 100MG TAB 000007.06
PHAR 000008610707 THEOPHYLLINE SPRINKLE 125MG CA 000002.84
PHAR 000008610708 TRIHEXYPHENIDYL HCL 2MG TAB 000002.63
PHAR 000008610709 LUDIOMIL TAB 25 MG 000002.48
PHAR 000008610710 MOLINDONE HCL 50MG TAB 000007.51
PHAR 000008610712 CARBIDOPA/LEV 10/100 TAB 000003.55
PHAR 000008610713 AMANTADINE 100MG CAP 000004.16
PHAR 000008610714 CIMETIDINE 300MG TAB 000003.88
PHAR 000008610715 THEOPHYLLINE SPRINKLE 200MG CA 000002.90
PHAR 000008610716 MOBAN TAB 100 MG 000005.92
PHAR 000008610717 PROCAINAMIDE 375MG CAP 000002.63
PHAR 000008610720 CIMETIDINE 400MG TAB 000007.30
PHAR 000008610721 THEOPHYLLINE SPRINKLE 50MG CAP 000002.74
PHAR 000008610722 CHLORPROMAZINE HCL 200MG TAB 000002.66
PHAR 000008610723 TRIHEXYPHENIDYL HCL 5MG TAB 000002.87
PHAR 000008610724 LUDIOMIL TAB 75 MG 000002.94
PHAR 000008610726 CARBIDOPA/LEV 25/100 TAB 000003.64
PHAR 000008610727 SYNALGOS CAP 000002.22
PHAR 000008610729 THEOPHYLLINE SPRINKLE 75MG CAP 000002.78
PHAR 000008610731 PROBANTHINE W/PB 000002.32
PHAR 000008610735 NORETHINDRONE 0.35MG TAB 000053.98
PHAR 000008610746 KLORVESS 20 MEQ TAB 000002.87
PHAR 000008610747 PARLODEL 2.5 MG #30 000044.80
PHAR 000008610748 BROMOCRIPTINE 2.5MG TAB 000007.91
PHAR 000008610749 OVRAL 21DAY TAB 000056.75
PHAR 000008610750 OVRAL 28DAY TAB 000057.23
PHAR 000008610751 NORGESTREL 0.075MG TAB 000018.72
PHAR 000008610752 OVULEN #21 000026.59
PHAR 000008610753 OVULEN #28 COMPACK 000026.76
PHAR 000008610754 LO/OVRAL 21DAY TAB 000039.07
PHAR 000008610755 LO/OVRAL 28DAY TAB 000039.41
PHAR 000008610756 LOESTRIN FE 20-Jan TAB 000039.78
PHAR 000008610757 LOESTRIN 21DAY 20-Jan TAB 000000.88
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610758 LOESTRIN 21DAY 1.5/30 TAB 000000.76
PHAR 000008610759 LOESTRIN C IRON 1.5/30 TAB 000021.52
PHAR 000008610761 QUINIDINE SULF 200MG TAB 000002.62
PHAR 000008610762 QUINIDINE SULF 300MG TAB 000002.96
PHAR 000008610763 CAFFEINE CITRATE TAB 000002.04
PHAR 000008610764 CLEOCIN CAP 75 MG 000002.86
PHAR 000008610765 CLINDAMYCIN 75MG CAP 000003.70
PHAR 000008610766 CLINDAMYCIN 150MG CAP 000007.74
PHAR 000008610767 CLINORIL TAB 150 MG 000003.03
PHAR 000008610768 SULINDAC 200MG TAB 000007.28
PHAR 000008610769 CLOMIPHENE 50MG TAB 000017.38
PHAR 000008610770 CLONAZEPAM TAB 0.5 000003.04
PHAR 000008610771 CLONAZEPAM TAB 1MG 000003.18
PHAR 000008610773 CO-PYRONIL-2 CAP 000002.19
PHAR 000008610775 BENZTROPINE 2MG TAB 000002.78
PHAR 000008610776 BENZTROPINE 1MG TAB 000002.58
PHAR 000008610777 COL-BENEMID TAB 000002.44
PHAR 000008610778 COLCHICINE 0.5MG TAB 000002.92
PHAR 000008610779 COMBID SPANSULE 000002.52
PHAR 000008610780 COMBIPRES TAB 0.1 MG 000002.79
PHAR 000008610781 COMBIPRES TAB 0.2 MG 000003.05
PHAR 000008610782 PROCHLORPERAZINE 5MG TAB 000003.06
PHAR 000008610783 PROCHLORPERAZINE 10MG TAB 000003.23
PHAR 000008610784 PROCHLORPERAZINE 25MG TAB 000003.60
PHAR 000008610785 PROCHLORPERAZINE 10MG CAP 000004.45
PHAR 000008610786 PROCHLORPERAZINE 15MG CAP 000007.84
PHAR 000008610787 PROCHLORPERAZINE 30MG CAP 000007.60
PHAR 000008610788 NADOLOL 40MG TAB 000006.82
PHAR 000008610789 NADOLOL 80MG TAB 000007.51
PHAR 000008610790 NADOLOL 120MG TAB 000008.14
PHAR 000008610791 NADOLOL 160MG TAB 000008.52
PHAR 000008610792 HYDROCORTISONE 10MG TAB 000002.81
PHAR 000008610793 CORTISONE ACETATE 10MG TAB 000002.89
PHAR 000008610794 CORTISONE ACETATE 25MG TAB 000003.60
PHAR 000008610795 COUMADIN 2MG TAB 000003.31
PHAR 000008610796 COUMADIN 2.5MG TAB 000003.34
PHAR 000008610797 COUMADIN 5MG TAB 000003.35
PHAR 000008610798 COUMADIN 7.5MG TAB 000003.84
PHAR 000008610799 COUMADIN 10MG TAB 000003.88
PHAR 000008610800 PENICILLAMINE 250MG CAP 000004.30
PHAR 000008610801 PENICILLAMINE 125MG CAP 000003.73
PHAR 000008610802 CYCLOSPASMOL 100 MG 000002.16
PHAR 000008610803 CYCLOSPASMOL 400 MG 000002.96
PHAR 000008610804 CYSTOSPAZ TAB 000002.44
PHAR 000008610805 CYSTOSPAZ-M CAP 000002.65
PHAR 000008610806 AMINOGLUTETHIMIDE 250MG TAB 000006.97
PHAR 000008610807 LIOTHYRONINE 50MCG TAB 000002.93
9/7/2010 11:52 AM Page 182 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610808 LIOTHYRONINE 25MCG TAB 000002.75
PHAR 000008610809 LIOTHYRONINE 5MCG TAB 000002.69
PHAR 000008610810 CYCLOPHOSPHAMIDE 50MG TAB 000010.46
PHAR 000008610811 CYCLOPHOSPHAMIDE 25MG TAB 000007.92
PHAR 000008610813 CALCIUM 250MG TAB 000002.51
PHAR 000008610814 NORDETTE TAB 000038.96
PHAR 000008610815 NORDETTE 28 DAY TAB 000039.31
PHAR 000008610822 ORTHO-NOVUM 10/11 21D 10/11 TA 000039.80
PHAR 000008610823 TOCAINIDE 600MG TAB 000007.04
PHAR 000008610824 TRANDATE TAB 300 MG 000002.94
PHAR 000008610827 ISOTRETINOIN 20MG CAP 000012.13
PHAR 000008610829 CAPOTEN TAB 12.5 MG 000002.45
PHAR 000008610830 ZOVIRAX CAP 200 MG 000002.85
PHAR 000008610831 DOCUSATE SOD 50MG CAP 000002.53
PHAR 000008610834 PYRIDOXINE HCL 50MG TAB 000002.45
PHAR 000008610835 COLCHICINE 0.6MG TAB 000002.48
PHAR 000008610836 DISOPYRAMIDE CR 150MG CAP 000004.02
PHAR 000008610837 COTAZYM 1CAP CAP 000002.80
PHAR 000008610838 QUINIDINE SULF 100MG TAB 000002.63
PHAR 000008610840 CHYMORAL TAB 50000 U 000006.89
PHAR 000008610841 COMHIST TAB 000003.52
PHAR 000008610842 COMHIST LA CAP 000003.82
PHAR 000008610843 CORTONE ACETATE 25MG 000002.72
PHAR 000008610844 CORICIDIN TAB 000002.19
PHAR 000008610845 CORICIDIN D TAB 000002.19
PHAR 000008610846 HYDROCORTISONE 5MG TAB 000002.63
PHAR 000008610847 CORTEF TAB 20 MG 000002.47
PHAR 000008610848 WYGESIC TAB 000002.48
PHAR 000008610849 PANCRELIPASE CAP 000003.11
PHAR 000008610850 INDERIDE TAB 40/25 000002.96
PHAR 000008610851 INDERIDE TAB 80/25 000003.34
PHAR 000008610852 PONSTEL CAP 000002.92
PHAR 000008610853 SALSALATE 750MG TAB 000002.71
PHAR 000008610854 RESERPINE TAB 0.1 MG 000002.02
PHAR 000008610855 RESERPINE TAB 0.25MG 000002.02
PHAR 000008610856 RESERPINE TAB 1 MG 000002.03
PHAR 000008610857 TRANDATE TAB 200 MG 000002.71
PHAR 000008610858 LINOLEIC ACID 500MG CAP 000002.77 250
PHAR 000008610859 VITAMIN B COMPLEX100 100MG TAB 000002.72 250
PHAR 000008610860 CITALOPRAM TAB 20M 000008.98 250
PHAR 000008610861 CITALOPRAM TAB 40M 000009.16 250
PHAR 000008610862 LIPOIC ACID 100MG CAP 000002.78 250
PHAR 000008610863 N-ACETYL-CYSTEINE 600MG CAP 000003.05 250
PHAR 000008610864 VITAMIN B COMPLEX 50 50MG TAB 000002.64 250
PHAR 000008610869 BICALUTAMIDE 50MG TAB 000028.74 250
PHAR 000008610870 CELEBREX 100MG CAP 000007.88 250
PHAR 000008610871 CELEBREX 200MG CAP 000010.03 250
9/7/2010 11:52 AM Page 183 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610872 AVANDIA 4MG TAB 000010.20 250
PHAR 000008610873 AVANDIA 8MG TAB 000014.66 250
PHAR 000008610874 TRIMETHOPRIM 200MG TAB 000003.09 250
PHAR 000008610876 ZIAGEN 300MG TAB 000017.37 250
PHAR 000008610877 TEGRETOL-XR 100MG TAB 000002.89 250
PHAR 000008610878 PIOGLITAZONE 15MG TAB 000010.96 250
PHAR 000008610880 DITROPAN XL 5MG TAB 000009.39 250
PHAR 000008610881 ARAVA 20MG TAB 000022.43 250
PHAR 000008610882 TIAZAC 360MG CAP 000009.32 250
PHAR 000008610884 TOPAMAX SPRNKL 15MG CAP 000007.37 250
PHAR 000008610885 METYROSINE CAP 250 000008.33 250
PHAR 000008610886 ACITRETIN CAP 10M 000019.57 250
PHAR 000008610889 PRAMIPEXOLE TAB 0.2 000006.97 250
PHAR 000008610890 SINEMET CR 25/100 TAB 000004.30 250
PHAR 000008610891 VALACYCLOVIR 500MG CAP 000011.95 250
PHAR 000008610893 TENEX 2MG TAB 000007.94 250
PHAR 000008610894 GLUCOTROL XL 10MG TAB 000003.87 250
PHAR 000008610895 ROFECOXIB TAB 25M 000010.04 250
PHAR 000008610896 ZYPREXA 2.5MG TAB 000014.91 250
PHAR 000008610897 ROFECOXIB TAB 12. 000010.04 250
PHAR 000008610898 TAMIFLU 75MG KIT 000102.96 250
PHAR 000008610899 ARTHROTEC 50/200MG TAB 000007.97 250
PHAR 000008610900 ZANAFLEX 4MG TAB 000007.00 250
PHAR 000008610901 SINGULAIR 10MG TAB 000009.92 250
PHAR 000008610903 CARBATROL 300MG CAP 000003.96 250
PHAR 000008610904 NORTRIPTYLINE 50MG CAP 000008.13 250
PHAR 000008610905 OXCARBAZEPINE TAB 150 000004.32 250
PHAR 000008610911 ZIAC 2.5/6.25MG TAB 000007.37 250
PHAR 000008610914 DOFETILIDE 0.125MG CAP 000007.37 250
PHAR 000008610915 DOFETILIDE 0.25MG CAP 000007.37 250
PHAR 000008610916 DOFETILIDE 0.5MG CAP 000007.37 250
PHAR 000008610918 RALOXIFENE 60MG TAB 000009.36 250
PHAR 000008610919 LORATADINE REDITAB TAB 10M 000010.56 250
PHAR 000008610920 MOEXIPRIL 15MG TAB 000003.91 250
PHAR 000008610921 GLYBURIDE/METFORMIN TAB 1.2 000003.81 250
PHAR 000008610922 GLYBURIDE/METFORMIN TAB 2.5 000004.08 250
PHAR 000008610923 GLYBURIDE/METFORMIN TAB 5/5 000004.08 250
PHAR 000008610924 ZONISAMIDE 100MG CAP 000008.45 250
PHAR 000008610925 CARBATROL 200MG CAP 000003.68 250
PHAR 000008610926 RISEDRONATE 5MG TAB 000008.75 250
PHAR 000008610927 RISEDRONATE 30MG TAB 000032.62 250
PHAR 000008610928 MONTELUKAST 4MG CHEW TAB 000010.47 250
PHAR 000008610929 ZIAC 5/6.25 TAB 000007.63 250
PHAR 000008610931 ALENDRONATE SOD TAB 70M 000038.14 250
PHAR 000008610933 ZIPRASIDONE 20MG CAP 000013.58 250
PHAR 000008610934 ZIPRASIDONE 40MG CAP 000013.58 250
PHAR 000008610938 CITALOPRAM TAB 10M 000006.82 250
9/7/2010 11:52 AM Page 184 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008610939 BUPROPION SR TAB 200 000009.10 250
PHAR 000008610940 ASPIRIN-EC 81MG TAB 81M 000001.46 250
PHAR 000008610982 NORVIR 100MG CAP 000008.81 250
PHAR 000008611003 PROCAINAMIDE 500MG CAP 000002.69
PHAR 000008611004 SYNKAYVITE TAB 5 MG 000002.14
PHAR 000008611005 WARFARIN SODIUM TAB 1MG 000000.00 250
PHAR 000008611006 DEXAMETHASONE MG PO 000000.00 250
PHAR 000008611007 TRIHEXYPHENIDYL HCL 5MG CAP 000003.28
PHAR 000008611008 PHENOBARBITAL TAB 15M 000002.07
PHAR 000008611009 MONOJEL GEL PACKETTE 000001.43
PHAR 000008611010 MEAT TENDERIZER UD 000001.00
PHAR 000008611011 CARBIDOPA/LEV 25/250 TAB 000003.98
PHAR 000008611012 LEVOTHYROXINE 0.025MG TAB 000002.75
PHAR 000008611013 MODICON 28DAY 0.5/35 TAB 000040.00
PHAR 000008611014 THEOBID CAP DURACAPS 000002.17
PHAR 000008611015 ORTHO-NOVUM 28DAY 777 TAB 000018.70
PHAR 000008611016 OVCON 21DAY 50 TAB 000042.46
PHAR 000008611017 SODIUM FLUORIDE 1.1MG 1.1MG CH 000002.53
PHAR 000008611018 IBUPROFEN 300MG TAB 000002.83
PHAR 000008611019 METHIMAZOLE 10MG TAB 000002.86
PHAR 000008611020 THORAZINE SPN 30MG 000002.84
PHAR 000008611021 OVCON 28DAY 0.4/35 TAB 000039.49
PHAR 000008611022 ASCORBIC ACID 250MG TAB 000002.52
PHAR 000008611023 SODIUM FLUORIDE 0.5MG CHE 000002.51
PHAR 000008611024 PROCAINAMIDE 250MG CAP 000003.97
PHAR 000008611025 DOXEPIN HCL CAP 10M 000002.70
PHAR 000008611026 LEVOTHYROXINE 0.05MG TAB 000002.75
PHAR 000008611027 TEDRAL TAB 000002.28
PHAR 000008611028 THEO-24 CAP 100 MG 000002.29
PHAR 000008611029 PHENOBARBITAL TAB 30M 000002.07
PHAR 000008611030 ASCORBIC ACID 500MG TAB 000002.48
PHAR 000008611031 SODIUM FLUORIDE 0.25MG CHE 000002.51
PHAR 000008611032 IBUPROFEN 400MG TAB 000002.80
PHAR 000008611033 THEOPHYLLINE 125MG TAB 000002.92
PHAR 000008611034 OVCON 28DAY Jan-50 TAB 000042.46
PHAR 000008611035 TRIAVIL TAB 4-10 000002.68
PHAR 000008611036 ASC.ACID CHEW 250MG 000002.05
PHAR 000008611037 MITOTANE 500MG TAB 000009.05
PHAR 000008611038 IBUPROFEN 600MG TAB 000002.93
PHAR 000008611039 DOXEPIN HCL CAP 25M 000002.95
PHAR 000008611040 LEVOTHYROXINE 0.075MG TAB 000002.78
PHAR 000008611041 CLOXACILLIN CAP 250 000003.21
PHAR 000008611042 CHLORPROMAZINE HCL 75MG CAP 000004.08
PHAR 000008611043 TRIAVIL TAB 2-10 000002.61
PHAR 000008611044 PAMELOR CAP 50 MG 000006.16
PHAR 000008611045 OVCON 21DAY 0.4/35 TAB 000039.49
PHAR 000008611046 PROPYLTHIOURACIL 50MG TAB 000002.58
9/7/2010 11:52 AM Page 185 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611047 CLOXACILLIN CAP 500 000006.41
PHAR 000008611048 THEOPHYLLINE 250MG TAB 000003.37
PHAR 000008611049 ASCRIPTIN TAB A/D 000002.09
PHAR 000008611050 ALUM HYDROX/MAGNESIUM 1TAB CHE 000002.50
PHAR 000008611051 ETHAMBUTOL HCL 100MG TAB 000003.28
PHAR 000008611052 NEOSTIGMINE BROMIDE 15MG TAB 000003.19
PHAR 000008611053 DOXEPIN HCL CAP 50M 000003.17
PHAR 000008611054 ORTHO-NOVUM 21DAY 7/7/7 TAB 000037.44
PHAR 000008611055 THEOPHYLLINE 250MG TAB 000003.04
PHAR 000008611056 CHLORPROMAZINE HCL 150MG CAP 000004.42
PHAR 000008611057 TRIAVIL TAB 2-25 000002.76
PHAR 000008611058 TRIAVIL TAB 4-25 000002.83
PHAR 000008611059 ALUM HYDROX/MAGNESIUM CHE 000002.54
PHAR 000008611060 ETHAMBUTOL HCL 400MG TAB 000007.33
PHAR 000008611061 MEDROXYPROGESTERONE 2.5MG TAB 000002.94
PHAR 000008611062 PROSTAPHLIN CAP 250 000003.12
PHAR 000008611063 THEOPHYLLINE 500MG TAB 000003.35
PHAR 000008611064 AMOXAPINE 50MG TAB 000004.56
PHAR 000008611065 NITROFURANTOIN MACRO 25MG CAP 000003.53
PHAR 000008611066 PROVERA TAB 10 MG 000002.82
PHAR 000008611067 SINEQUAN CAP 150 MG 000005.36
PHAR 000008611068 PROSTAPHLIN CAP 500 000006.07
PHAR 000008611069 CHLORPROMAZINE HCL 200MG CAP 000007.33
PHAR 000008611070 TRIDIONE CAP 300 MG 000002.41
PHAR 000008611071 HYDROXYZINE PAMOATE 25MG CAP 000002.81
PHAR 000008611072 AMOXAPINE 25MG TAB 000003.96
PHAR 000008611073 NITROSTAT 0.4 MG UD 000002.10
PHAR 000008611074 MERCAPTOPURINE 50MG TAB 000009.43
PHAR 000008611075 TEGRETOL CHEW 100MG TAB 000002.93
PHAR 000008611076 MULTI-VITAMIN TAB 000002.53
PHAR 000008611077 PERPHENAZINE 2MG TAB 000003.62
PHAR 000008611078 DIGITOXIN 0.1MG TAB 000002.51
PHAR 000008611079 DOXEPIN HCL CAP 100 000003.35
PHAR 000008611080 HYDRALAZINE 10MG TAB 000002.53
PHAR 000008611081 PERPHENAZINE 4MG TAB 000004.08
PHAR 000008611082 VICON-C CAP 000002.71
PHAR 000008611083 HYDROXYZINE PAMOATE 50MG CAP 000003.00
PHAR 000008611084 PHENOBARBITAL TAB 60M 000002.08
PHAR 000008611085 AMOXAPINE 100MG TAB 000008.56
PHAR 000008611086 NITROFURANTOIN MACROC 50MG CAP 000003.74
PHAR 000008611087 DIGITOXIN 0.2MG TAB 000002.48
PHAR 000008611088 MULT-VITAMIN W/MIN TAB 000002.54
PHAR 000008611089 THYROID 15MG TAB 000002.54
PHAR 000008611090 PERPHENAZINE 8MG TAB 000004.43
PHAR 000008611091 VICON PLUS CAP 000002.75
PHAR 000008611092 PHENOBARBITAL TAB 100 000002.05
PHAR 000008611093 AMOXAPINE 150MG TAB 000011.48
9/7/2010 11:52 AM Page 186 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611094 DIGITOXIN 0.15MG TAB 000002.46
PHAR 000008611095 DOXEPIN HCL CAP 75M 000003.18
PHAR 000008611096 THYROID 30MG TAB 000002.63
PHAR 000008611097 PERPHENAZINE 16MG TAB 000007.54
PHAR 000008611098 HYDROXYZINE PAMOATE 100MG CAP 000002.94
PHAR 000008611099 HYDRALAZINE 100MG TAB 000002.64
PHAR 000008611100 BENZTROPINE 0.5MG TAB 000002.68
PHAR 000008611101 NITROFURANTOIN MACROC 100MG CA 000007.22
PHAR 000008611102 TRILAFON REPETAB 8MG 000003.06
PHAR 000008611103 VICON FORTE CAP 000003.02
PHAR 000008611104 SERAX CAP 10 MG 000002.63
PHAR 000008611105 PHENAZOPYRIDINE HCL 100MG TAB 000002.81
PHAR 000008611106 IMIPRAMINE 10MG TAB 000003.01
PHAR 000008611107 THERAGRAN HEMATINIC TAB 000003.17
PHAR 000008611108 THYROID 60MG TAB 000002.65
PHAR 000008611109 METHYLDOPA 125MG TAB 000002.64
PHAR 000008611110 VIOKASE 1TAB TAB 000002.86
PHAR 000008611111 AMOXIL CHEW TAB 125 000002.19
PHAR 000008611112 SERAX CAP 15 MG 000002.80
PHAR 000008611113 ACTIFED TAB 000002.14
PHAR 000008611114 CHLORZOXAZONE W/ACET 000002.15
PHAR 000008611115 ASPERGUM #16 000003.63
PHAR 000008611116 NYSTATIN 1TAB TAB 000003.30
PHAR 000008611117 SINGLET TAB 000002.57
PHAR 000008611118 TRILISATE TAB 500 MG 000002.47
PHAR 000008611119 NITROGLYCERIN 2.5MG CAP 000002.58
PHAR 000008611120 VISKEN TAB 5 MG 000002.87
PHAR 000008611121 VITAMIN A CAP 100 000002.45
PHAR 000008611122 SERAX CAP 30 MG 000003.15
PHAR 000008611123 NITROGLYCERIN 6.5MG CAP 000002.60
PHAR 000008611124 TOLAZAMIDE 100 MG 000002.18
PHAR 000008611125 PHENAZOPYRIDINE HCL 200MG TAB 000003.24
PHAR 000008611126 THIAMINE HCL 50MG TAB 000002.42
PHAR 000008611127 THYROID 120MG TAB 000002.71
PHAR 000008611128 VITAMIN A CAP 25,000 000002.04
PHAR 000008611129 CALCIUM 500MG TAB 000002.62
PHAR 000008611130 ETIDRONATE DISODIUM 400MG TAB 000012.08
PHAR 000008611131 ERYTHROMYCIN 500 MG 000002.33
PHAR 000008611132 CHLORAZOXAZONE/APAP 000002.15
PHAR 000008611133 AMITRIPTYLINE 100MG TAB 000002.72
PHAR 000008611134 SLOW-K TAB 600 MG 000002.19
PHAR 000008611135 THIAMINE 100MG TAB 000002.46
PHAR 000008611136 TRINSICON CAP 000002.42
PHAR 000008611137 VISKEN TAB 10 MG 000003.11
PHAR 000008611138 VITAMIN A 50000 U 000002.05
PHAR 000008611139 SODIUM CHLORIDE 1GM TAB 000002.50
PHAR 000008611140 VOLTAREN TAB 50 MG 000003.22
9/7/2010 11:52 AM Page 187 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611141 DIAZOXIDE 50MG CAP 000007.97
PHAR 000008611142 SODIUM BICARBONATE 325MG TAB 000002.48
PHAR 000008611143 THYROID 180MG TAB 000002.96
PHAR 000008611144 CYANOCOBALAMIN 100MCG TAB 000002.46
PHAR 000008611145 CIPROFLOXACIN 250MG TAB 000009.41
PHAR 000008611146 ST JOSEPH ASA 81 MG 000002.04
PHAR 000008611147 MYLANTA CHEW TABS CHE 000002.53
PHAR 000008611148 SODIUM BICARBONATE 650MG TAB 000002.53
PHAR 000008611149 THIOGUANINE 40MG TAB 000010.85
PHAR 000008611150 THYROID 240MG TAB 000003.24
PHAR 000008611151 VITRON-C TAB 000002.11
PHAR 000008611152 ATABRINE TAB 100 MG 000002.37
PHAR 000008611153 MYLANTA CHEWABLE 000002.05
PHAR 000008611154 SOD CHLORIDE ENS 1 G 000002.13
PHAR 000008611155 THYROID 300MG TAB 000003.44
PHAR 000008611156 TRIOXSALEN 5MG TAB 000007.99
PHAR 000008611157 PROTRIPTYLINE HCL TAB 5MG 000003.35
PHAR 000008611158 NITROGLYCERIN #25 0.4MG SUBL 000010.15
PHAR 000008611159 CIPROFLOXACIN 500MG TAB 000010.14
PHAR 000008611160 BUSULFAN 2MG TAB 000007.51
PHAR 000008611161 CHLORPROMAZINE HCL 10MG TAB 000002.51
PHAR 000008611162 THYROID STRONG 60 MG 000002.04
PHAR 000008611163 TRYPTOPHAN TAB 0.5 G 000002.46
PHAR 000008611164 PROTRIPTYLINE HCL TAB 10M 000003.64
PHAR 000008611165 HYDROXYZINE HCL 10MG TAB 000002.84
PHAR 000008611166 SODIUM SALICYLATE 325MG TAB 000002.51
PHAR 000008611167 TRIMETHOBENZAMIDE 100MG CAP 000003.22
PHAR 000008611168 TUMS CHEW 500MG TAB 000003.30
PHAR 000008611169 SIMETHICONE 40MG TAB 000002.66
PHAR 000008611170 SODIUM SALICYLATE 650MG TAB 000002.54
PHAR 000008611171 CHLORPROMAZINE HCL 25MG TAB 000002.51
PHAR 000008611172 TRIMETHOBENZAMIDE HCL CAP 300 000003.26
PHAR 000008611173 TUSS-ORNADE SPANSULE 000005.61
PHAR 000008611174 LEUCOVORIN CALCIUM 5MG TAB 000010.96
PHAR 000008611175 CARISOPRODOL 350 MG TAB 000008.03
PHAR 000008611176 CIPROFLOXACIN 750MG TAB 000016.13
PHAR 000008611177 LEUCOVORIN CALCIUM 25MG TAB 000048.07
PHAR 000008611178 HYDROXYZINE HCL 25MG TAB 000002.96
PHAR 000008611179 SOMA CPD TAB 000003.33
PHAR 000008611180 TITRALAC TAB 000002.48
PHAR 000008611181 UNIPHYL TAB 200 MG 000002.34
PHAR 000008611182 WIGRAINE TAB 000002.71
PHAR 000008611183 SIMETHICONE 80MG TAB 000002.65
PHAR 000008611184 THEOPHYLLINE 400 MG TAB 000003.85
PHAR 000008611185 PROZAC 20MG CAP 000009.55
PHAR 000008611186 ACETAMINOPHEN CPL 500 000000.60
PHAR 000008611187 STANOZOLOL TAB 2MG 000003.15
9/7/2010 11:52 AM Page 188 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611188 HYDROXYZINE HCL 50MG TAB 000003.04
PHAR 000008611189 THEOPHYLLINE 100MG CAP 000002.86
PHAR 000008611190 RYNATAN TAB 000003.10
PHAR 000008611191 ACETAMINOPHEN CHE 80M 000000.60
PHAR 000008611192 X-PREP LIQUID 75 ML 000010.24
PHAR 000008611193 PRIMIDONE 250MG TAB 000003.23
PHAR 000008611194 THEOPHYLLINE 200MG CAP 000003.01
PHAR 000008611195 "ESTROGENS, CONJUGATED" 0.9MG 000003.35
PHAR 000008611196 HYDROXYZINE HCL 100MG TAB 000007.01
PHAR 000008611197 IMIPRAMINE 25MG TAB 000002.58
PHAR 000008611198 PRIMIDONE 50MG TAB 000002.71
PHAR 000008611199 XANAX TAB 0.25 MG 000002.63
PHAR 000008611200 CLOFIBRATE 500MG CAP 000004.03
PHAR 000008611201 ASPIRIN CHEW 81MG TAB 000002.42
PHAR 000008611202 IMIPRAMINE 50MG TAB 000002.68
PHAR 000008611203 NAFCILLIN SODIUM 250MG CAP 000004.42
PHAR 000008611204 ATROPINE 0.4MG TAB 000002.48
PHAR 000008611205 MYTELASE CAP 10 MG 000002.72
PHAR 000008611206 ACETAMINOPHEN CPL 325 000000.60
PHAR 000008611207 ASPIRIN-EC 325MG TAB 000002.46
PHAR 000008611208 XANAX TAB 0.5 MG 000002.77
PHAR 000008611209 ATROPINE 0.3MG TAB 000002.45
PHAR 000008611210 NALDECON TAB 000003.03
PHAR 000008611211 IMIPRAMINE PAMOATE 75MG CAP 000004.12
PHAR 000008611212 BETHANECHOL CHLORIDE 5MG TAB 000002.62
PHAR 000008611213 NALFON CAP 200 MG 000002.60
PHAR 000008611214 SORBITRATE CHEW 5 MG 000002.23
PHAR 000008611215 ALPRAZOLAM TAB 1MG 000003.42
PHAR 000008611216 NALFON CAP 300 MG 000002.69
PHAR 000008611217 IMIPRAMINE PAMOATE 150MG CAP 000007.78
PHAR 000008611218 BETHANECHOL CHLORIDE 10MG TAB 000002.64
PHAR 000008611219 SORBITRATE SL 5 MG 000002.23
PHAR 000008611220 IMIPRAMINE PAMOATE 100MG CAP 000007.66
PHAR 000008611221 AVENTYL CAP 25 MG 000002.87
PHAR 000008611222 IMIPRAMINE PAMOATE 125MG CAP 000008.36
PHAR 000008611223 AZO-GANTANOL TAB 000002.88
PHAR 000008611224 NALFON TAB 600 MG 000002.96
PHAR 000008611225 SORBITRATE SL 2.5 MG 000002.22
PHAR 000008611226 TOLECTIN TAB 200 MG 000002.70
PHAR 000008611227 RITODRINE HCL 10MG TAB 000009.97
PHAR 000008611228 AZO-GANTRISIN TAB 000002.37
PHAR 000008611229 TOLECTIN DS 400 MG 000002.94
PHAR 000008611230 BETHANECHOL CHLORIDE 25MG TAB 000002.84
PHAR 000008611231 AZULFIDINE TAB 500MG 000002.27
PHAR 000008611232 SORBITRATE ORAL 5 MG 000002.23
PHAR 000008611233 RANITIDINE 150MG TAB 000007.72
PHAR 000008611234 SULFASALAZINE 500MG TAB 000002.68
9/7/2010 11:52 AM Page 189 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611235 NAPROXEN 250MG TAB 000003.79
PHAR 000008611236 PANCRELIPASE 4000U CAP 000002.96
PHAR 000008611237 BETHANECHOL CHLORIDE 50MG TAB 000003.10
PHAR 000008611238 ETHOSUXIMIDE 250MG CAP 000003.89
PHAR 000008611239 PANCRELIPASE MT 10 10000U CAP 000003.79
PHAR 000008611240 PANCRELIPASE 16000U CAP 000007.04
PHAR 000008611241 LACTOBACILLUS ACIDOPH 1TAB TAB 000002.92
PHAR 000008611242 NAPROXEN 375MG TAB 000004.18
PHAR 000008611243 SORBITRATE ORAL 10MG 000002.27
PHAR 000008611244 TOLAZAMIDE 250 MG 000002.35
PHAR 000008611245 URISED TAB 000002.45
PHAR 000008611246 NAPROXEN 500MG TAB 000007.33
PHAR 000008611247 TOLINASE TAB 500 MG 000003.33
PHAR 000008611248 METOLAZONE 2.5MG TAB 000003.29
PHAR 000008611249 AMITRIPTYLINE 150MG TAB 000002.92
PHAR 000008611250 NAQUA TAB 4 MG 000002.68
PHAR 000008611251 SORBITRATE CHEW 10MG 000002.27
PHAR 000008611252 TORECAN TAB 10 MG 000002.43
PHAR 000008611253 FLAVOXATE HCL 100 MG TAB 000003.68
PHAR 000008611254 SPARINE TAB 10 MG 000002.21
PHAR 000008611255 METOLAZONE 5MG TAB 000003.38
PHAR 000008611256 URSODEOXYCHOLIC ACID 300MG CAP 000009.11
PHAR 000008611257 PHENELZINE SULFATE TAB 15M 000003.19
PHAR 000008611258 PROMAZINE HCL 25MG TAB 000003.16
PHAR 000008611259 PENICILLIN V K 250MG TAB 000002.54
PHAR 000008611260 AMITRIPTYLINE 75MG TAB 000002.64
PHAR 000008611261 THIOTHIXENE 1MG CAP 000003.10
PHAR 000008611262 PROMAZINE HCL 50MG TAB 000003.32
PHAR 000008611263 METOLAZONE 10MG TAB 000003.54
PHAR 000008611264 BANTHINE TAB 50 MG 000002.36
PHAR 000008611265 PROMAZINE HCL 100MG TAB 000003.61
PHAR 000008611266 PENICILLIN V K 500MG TAB 000002.65
PHAR 000008611267 ZINC SULFATE CAP 220 000002.48
PHAR 000008611268 ALUMINUM CARBONATE 500 MG CAP 000002.66
PHAR 000008611269 THIOTHIXENE 2MG CAP 000003.38
PHAR 000008611270 GUANABENZ 8MG TAB 000004.43
PHAR 000008611271 VOLTAREN TAB 75 MG 000005.48
PHAR 000008611272 DILTIAZEM HCL ER CPC 90M 000004.18
PHAR 000008611273 DILTIAZEM HCL ER CAP 120 000007.12
PHAR 000008611274 THIOTHIXENE 5MG CAP 000003.98
PHAR 000008611275 CARDURA TAB 1 MG 000003.11
PHAR 000008611276 ALLOPURINOL 100MG TAB 000002.59
PHAR 000008611277 TRIFLUOPERAZINE HCL TAB 1MG 000003.32
PHAR 000008611278 NIMODIPINE 30MG CAP 000016.06
PHAR 000008611279 ALUMINUM CARB 500MG TAB 000002.59
PHAR 000008611280 ALLOPURINOL 300MG TAB 000002.94
PHAR 000008611281 TRIFLUOPERAZINE HCL TAB 2MG 000003.76
9/7/2010 11:52 AM Page 190 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611282 VALPIN-50 TAB 000002.60
PHAR 000008611283 PROVENTIL RPTAB 4 MG 000002.64
PHAR 000008611284 THIOTHIXENE 10MG CAP 000006.83
PHAR 000008611285 EULEXIN CAP 125 MG 000005.87
PHAR 000008611286 BECOTIN CAP 000002.20
PHAR 000008611287 CALCIUM CARBONATE 750MG CHE 000003.96
PHAR 000008611288 THIOTHIXENE 20MG CAP 000007.75
PHAR 000008611289 BECOTIN T TAB 000002.22
PHAR 000008611290 VASODILAN TAB 10 MG 000002.41
PHAR 000008611291 MEGESTROL ACETATE 20 MG TAB 000003.58
PHAR 000008611292 MEGESTROL 40MG TAB 000006.72
PHAR 000008611293 VASODILAN TAB 20 MG 000002.65
PHAR 000008611294 NEGGRAM TAB 250 MG 000002.68
PHAR 000008611295 ALBUTEROL 2MG TAB 000003.11
PHAR 000008611296 BECOTIN W/C CAPS 000002.19
PHAR 000008611297 NEGGRAM TAB 500 MG 000002.95
PHAR 000008611298 ALBUTEROL 4MG TAB 000003.44
PHAR 000008611299 BELLADENAL TAB 000002.52
PHAR 000008611300 MEBENDAZOLE 100MG CHE 000014.80
PHAR 000008611301 BELLADENAL-S TAB 000002.60
PHAR 000008611302 BELLERGAL TAB 000002.28
PHAR 000008611303 BELLERGAL-S TAB 000002.99
PHAR 000008611304 NEGGRAM TAB 1 GM 000005.53
PHAR 000008611305 CHLORZOXAZONE 500MG TAB 000003.37
PHAR 000008611306 BEMINAL-FORTE W/C 000002.16
PHAR 000008611307 MISOPROSTIL 200MCG TAB 000003.68
PHAR 000008611308 DOXYCYCLINE 50MG CAP 000003.92
PHAR 000008611309 BEMINAL-500 TAB 000002.17
PHAR 000008611310 NEOMYCIN SULFATE 500MG TAB 000003.02
PHAR 000008611311 DIPHENHYDRAMINE 25MG CAP 000002.60
PHAR 000008611312 DOXYCYCLINE HYCLATE 100MG CAP 000007.21
PHAR 000008611313 DIPHENHYDRAMINE HCL 50MG CAP 000002.59
PHAR 000008611314 SODIUM FLUORIDE 2.2MG TAB 000002.23
PHAR 000008611315 PROBENECID 500MG TAB 000003.02
PHAR 000008611316 DICYCLOMINE HCL 10MG CAP 000002.51
PHAR 000008611317 DICYCLOMINE 20MG TAB 000003.05
PHAR 000008611318 GEMFIBROZIL 600MG TAB 000006.67
PHAR 000008611319 BENTYL W/PB 20MG 000002.35
PHAR 000008611320 BENTYL W/PB 10 MG 000002.26
PHAR 000008611321 CALAN SR 180 MG TAB 000005.48
PHAR 000008611322 BEROCCA TAB 000002.45
PHAR 000008611323 BILRON CAP 300 MG 000002.35
PHAR 000008611324 BILRON CAP 150 MG 000002.22
PHAR 000008611325 ZOLOFT TAB 50 MG 000006.34
PHAR 000008611326 BLOCADREN TAB 10 MG 000002.55
PHAR 000008611327 BLOCADREN TAB 20 MG 000003.14
PHAR 000008611328 TERBUTALINE SULFATE 2.5MG TAB 000002.88
9/7/2010 11:52 AM Page 191 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611329 ZOLOFT TAB 100 MG 000006.41
PHAR 000008611330 THEO-24 CAP 100 MG 000004.75
PHAR 000008611331 TRIPHASIL 21DAY TAB 000036.43
PHAR 000008611332 PYRIDOXINE TAB 25 MG 000002.02
PHAR 000008611333 ALDACTAZIDE 50/50 000002.75
PHAR 000008611334 MONOPRIL TAB 10 MG 000002.92
PHAR 000008611335 QUININE SULFATE 300MG CAP 000002.60
PHAR 000008611336 VITAMIN E CAP 200 IU 000002.04
PHAR 000008611337 VITAMIN E 400U CAP 000002.48
PHAR 000008611338 VITAMIN E 1000U CAP 000002.66
PHAR 000008611339 PYRIDOXINE HCL 100MG TAB 000002.46
PHAR 000008611340 CHEMSTRIP BG UD 1 STRIP 000002.74
PHAR 000008611341 MICRO-K CAP 8 MEQ 000002.17
PHAR 000008611342 MICRO-K 10 CAP 000002.19
PHAR 000008611343 TRANYLCYPROMINE SULF 10MG TAB 000003.34
PHAR 000008611344 GLYBURIDE 2.5MG TAB 000003.14
PHAR 000008611345 GLYBURIDE 5MG TAB 000003.35
PHAR 000008611346 MONOPRIL TAB 20 MG 000002.99
PHAR 000008611347 DEPAKOTE 250MG TAB 000003.96
PHAR 000008611348 DEPAKOTE 500MG TAB 000007.65
PHAR 000008611349 GUANABENZ 4MG TAB 000003.76
PHAR 000008611350 DIABETA TAB 1.25 MG 000002.19
PHAR 000008611351 DIABETA TAB 2.5 MG 000002.35
PHAR 000008611352 DIABETA TAB 5 MG 000002.65
PHAR 000008611353 TRI-NORINYL 21DAY 777 TAB 000023.46
PHAR 000008611354 TRI-NORINYL 28DAY 777 TAB 000035.50
PHAR 000008611355 ENALAPRIL 2.5MG TAB 000003.65
PHAR 000008611356 ANSAID TAB 100 MG 000003.26
PHAR 000008611357 VOLTAREN TAB 25 MG 000002.45
PHAR 000008611358 VOLTAREN TAB 50 MG 000002.88
PHAR 000008611359 ORTHO-NOVUM 28DAY 10/11 TAB 000040.00
PHAR 000008611360 VOLTAREN TAB 75 MG 000003.07
PHAR 000008611361 HISMANAL TAB 10 MG 000006.18
PHAR 000008611362 OS-CAL-FORTE TAB 000002.16
PHAR 000008611363 MYCELEX 10MG TAB 000007.20
PHAR 000008611364 CENTRAX CAP 5 MG 000002.67
PHAR 000008611365 CENTRAX CAP 10 MG 000002.78
PHAR 000008611366 DEXAMETHASONE 1MG TAB 000002.92
PHAR 000008611367 HYDROCODONE BIT/APAP TAB 5/5 000003.68
PHAR 000008611368 CLONIDINE 0.2MG TAB 000002.96
PHAR 000008611369 MODURETIC TAB 5/50 000002.58
PHAR 000008611370 DESIPRAMINE 150MG TAB 000010.43
PHAR 000008611371 HYDROCHLOROTZ/TRIAMT TAB 1 T 000004.10
PHAR 000008611372 RESTORIL CAP 15 MG 000002.72
PHAR 000008611373 RESTORIL CAP 30 MG 000002.80
PHAR 000008611374 NORTRIPTYLINE HCL 75MG CAP 000009.24
PHAR 000008611375 ERYTHROMYCIN 250MG CAP 000003.23
9/7/2010 11:52 AM Page 192 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611376 GLIPIZIDE 5 MG TAB 000003.13
PHAR 000008611377 GLIPIZIDE 10 MG TAB 000003.82
PHAR 000008611378 TERFENADINE 60 MG TAB 000003.46
PHAR 000008611379 SELDANE-D TAB 000003.30
PHAR 000008611380 ACYCLOVIR 200MG CAP 000004.43
PHAR 000008611381 CAPOTEN 12.5MG TAB 000003.49
PHAR 000008611382 TOCAINIDE 400MG TAB 000004.26
PHAR 000008611383 TRANDATE TAB 100 MG 000002.47
PHAR 000008611384 LABETALOL 100MG TAB 000003.28
PHAR 000008611385 LABETALOL 200MG TAB 000003.48
PHAR 000008611386 LABETALOL 300MG TAB 000003.83
PHAR 000008611387 AMOXICILLIN/CLAVULANI 250MG TA 000008.77
PHAR 000008611388 AMOXICILLIN/CLAVULANI 500MG TA 000010.38
PHAR 000008611389 TRIPHASIL #21 000024.94
PHAR 000008611390 TRI-PHASIL 7/7/7 TAB 000037.88
PHAR 000008611391 WELLBUTRIN TAB 100MG 000002.77
PHAR 000008611392 ORTHO-NOVUM 28 7/7/7 000025.05
PHAR 000008611393 POLY-VIT FLOR 1MG CHE 000002.72
PHAR 000008611394 OS-CAL-PLUS TAB 000002.16
PHAR 000008611395 DESIPRAMINE 100MG TAB 000008.68
PHAR 000008611396 BLOCADREN TAB 5 MG 000002.50
PHAR 000008611397 PSEUDOEPH/TRIPROLIDIN 1TAB TAB 000002.66
PHAR 000008611398 COTAZYM CAP 000002.24
PHAR 000008611399 ISOSORBIDE DINITRATE 40MG TAB 000003.29
PHAR 000008611400 SLOPHYLLIN CAP 60 MG 000002.29
PHAR 000008611401 SLOPHYLLIN CAP 125 M 000002.37
PHAR 000008611402 SLOPHYLLIN CAP 250 000002.46
PHAR 000008611403 PRENATAL S MULTI VIT 000002.11
PHAR 000008611405 IBUPROFEN 800MG TAB 000002.97
PHAR 000008611406 TORADOL TAB 10 MG 000005.43
PHAR 000008611407 RIDAURA CAP 3 MG 000003.37
PHAR 000008611408 MERITAL CAP 50 MG 000002.56
PHAR 000008611409 GLYBURIDE 1.25MG TAB 000002.84
PHAR 000008611410 PENTOXIFYLLINE 400MG TAB 000003.36
PHAR 000008611411 ESTROPIPATE 1.25MG TAB 000006.66
PHAR 000008611412 ESTROPIPATE 0.625MG TAB 000006.13
PHAR 000008611413 PANCREATIN TAB 000002.22
PHAR 000008611414 SUCRET LOZ #24 000004.60
PHAR 000008611415 NEPTAZINE TAB 50 MG 000002.94
PHAR 000008611416 ELIXOPHYLLIN SR 250M 000002.66
PHAR 000008611417 ELIXOPHYLLIN SR 125M 000002.54
PHAR 000008611418 IBUPROFEN 200MG TAB 000000.60
PHAR 000008611419 DRISTAN TAB 000002.26
PHAR 000008611420 PROPRANOLOL LA 120MG CAP 000007.20
PHAR 000008611421 PROPRANOLOL LA 160MG CAP 000007.94
PHAR 000008611422 ACIDULIN 340 MG 000002.25
PHAR 000008611423 ALKA-SELTZER TAB #36 000008.29
9/7/2010 11:52 AM Page 193 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611424 EX-LAX TABS #48 000002.41
PHAR 000008611425 ERGOSTAT SL 2 MG 000002.59
PHAR 000008611426 METHYLPREDNISOLONE 16MG KIT 000028.78
PHAR 000008611427 METHYLPREDNISOLONE 4MG KIT 000019.09
PHAR 000008611428 THEO-24 CAP 200 MG 000004.82
PHAR 000008611429 THEO-24 CAP 300 MG 000004.87
PHAR 000008611430 TAVIST TAB 2.68 MG 000003.16
PHAR 000008611431 TAVIST-1 TAB 1.34 MG 000002.87
PHAR 000008611432 TAVIST-D TAB 000003.08
PHAR 000008611433 THEOPHYLLINE 100MG CPC 000002.88
PHAR 000008611434 THEOPHYLLINE 50MG CPC 000002.80
PHAR 000008611435 THEOPHYLLINE 200MG CPC 000003.11
PHAR 000008611436 THEOPHYLLINE 300MG CPC 000003.24
PHAR 000008611437 NAFCILLIN TAB 500 MG 000006.17
PHAR 000008611438 ASCORBIC ACID 100MG TAB 000002.42
PHAR 000008611439 PENICILLIN G K 250MG TAB 000002.65
PHAR 000008611440 FLECAINIDE 100MG TAB 000007.16
PHAR 000008611441 GRISEOFULVIN 125 MG CAP 000003.00
PHAR 000008611442 GRISEOFULVIN 250 MG CAP 000003.74
PHAR 000008611443 GRISEOFULVIN 500 MG TAB 000007.16
PHAR 000008611444 GRISEOFULVIN ULTRAMIC 125 MG T 000003.35
PHAR 000008611445 GRISEOFULVIN ULTRAMIC 250 MG T 000004.01
PHAR 000008611446 GRISEOFULVIN ULTRAMIC 330 MG T 000007.01
PHAR 000008611447 COTAZYM-S CAP 000002.33
PHAR 000008611448 CALAN TAB 80 MG 000002.58
PHAR 000008611449 VERAPAMIL HCL 120MG TAB 000003.74
PHAR 000008611450 ERYTHROMYCIN 500MG TAB 000002.92
PHAR 000008611451 ERYTHROMYCIN 333MG TAB 000003.02
PHAR 000008611452 ERY-TAB 500 MG 000002.64
PHAR 000008611453 DEMECLOCYCLINE HCL 150MG TAB 000011.66
PHAR 000008611454 TRINALIN TAB 000002.99
PHAR 000008611455 ANSAID TAB 50 MG 000002.99
PHAR 000008611456 ALKA-SELTZR UD #2 000012.31
PHAR 000008611457 ENALAPRIL 5MG TAB 000004.06
PHAR 000008611458 ENALAPRIL 10MG TAB 000004.13
PHAR 000008611459 ENALAPRIL 20MG TAB 000007.73
PHAR 000008611460 ESGIC TAB 000004.96
PHAR 000008611461 ESGIC CAP 000004.93
PHAR 000008611462 DOXYCYCLINE 100MG TAB 000012.13
PHAR 000008611463 NIFEDIPINE XL 30MG TAB 000007.18
PHAR 000008611464 NIFEDIPINE XL 60MG TAB 000008.92
PHAR 000008611465 NIFEDIPINE XL 90MG TAB 000009.23
PHAR 000008611466 CLONIDINE 0.3MG TAB 000003.11
PHAR 000008611467 THEOPHYLLINE 75MG CPC 000002.76
PHAR 000008611468 THEOPHYLLINE 125MG CPC 000002.89
PHAR 000008611469 DILTIAZEM HCL ER CPC 60M 000003.78
PHAR 000008611470 DANAZOL 100MG CAP 000008.34
9/7/2010 11:52 AM Page 194 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611471 SKELAXIN TAB 400 MG 000002.26
PHAR 000008611472 MAXZIDE 37.5-25 MG 000002.44
PHAR 000008611473 NADOLOL 20MG TAB 000004.31
PHAR 000008611474 WELLBUTRIN TAB 75 MG 000002.58
PHAR 000008611475 SANDIMMUNE 100MG CAP 000016.69
PHAR 000008611476 PRAVACHOL TAB 10 MG 000006.26
PHAR 000008611477 VERAPAMIL HCL SR 180MG TAB 000007.15
PHAR 000008611478 OMEPRAZOLE 20MG CAP 000011.77
PHAR 000008611479 THEOPHYLLINE 450MG TAB 000003.25
PHAR 000008611480 SANDIMMUNE 25MG CAP 000007.78
PHAR 000008611481 HYTRIN TAB 5 MG 000005.63
PHAR 000008611482 HYTRIN TAB 10 MG 000005.63
PHAR 000008611483 COUMADIN 1MG TAB 000003.28
PHAR 000008611484 QUININE SULFATE 325MG CAP 000002.72
PHAR 000008611485 DIAGNOSTIC TEST STRP 1STRIP 000001.48
PHAR 000008611486 DIAGNOSTIC TST STRP 1STRIP 000002.10
PHAR 000008611487 FLUCONAZOLE 50 MG TAB 000014.26
PHAR 000008611488 FLUCONAZOLE 100 MG TAB 000019.66
PHAR 000008611489 FLUCONAZOLE 200 MG TAB 000029.10
PHAR 000008611490 TERAZOSIN 1MG TAB 000008.51
PHAR 000008611491 TERAZOSIN 2MG TAB 000008.51
PHAR 000008611492 VERAPAMIL HCL 40MG TAB 000003.08
PHAR 000008611493 EXOSURF INH 001819.33
PHAR 000008611494 ALTACE CAP 5 MG 000002.96
PHAR 000008611495 PAXIL 20MG TAB 000008.89
PHAR 000008611496 K-PHOS TAB NEUTRAL 000002.17
PHAR 000008611497 ZOVIRAX TAB 800 MG 000009.67
PHAR 000008611498 LEVOTHYROXINE 0.112MG TAB 000002.92
PHAR 000008611499 MORCIZINE HCL 200MG TAB 000004.08
PHAR 000008611500 MORCIZINE HCL 250MG TAB 000004.48
PHAR 000008611501 MORCIZINE HCL 300 MG TAB 000007.30
PHAR 000008611502 MISOPROSTIL 100MCG TAB 000003.41
PHAR 000008611503 ZORPRIN TAB 800 MG 000002.46
PHAR 000008611504 CARDIZEM CD CAP 240 000006.11
PHAR 000008611505 LOTENSIN TAB 10 MG 000002.83
PHAR 000008611506 CALCIUM ACETATE 667MG TAB 000002.60
PHAR 000008611507 K-DUR CR 10 MEQ TAB 000002.25
PHAR 000008611508 PANCREATIN 1CAP CAP 000003.25
PHAR 000008611509 PHOSPHOLIPID SUS 25M 002001.22
PHAR 000008611510 CEBOCAP 000010.00
PHAR 000008611511 VITAMIN B-12 TAB 1MG 000002.09
PHAR 000008611512 AMBIEN TAB 5 MG 000006.24
PHAR 000008611513 AMOXICILLIN 125MG CHE 000002.72
PHAR 000008611514 DEPAKOTE 125MG TAB 000003.21
PHAR 000008611515 ACYCLOVIR 800MG TAB 000012.46
PHAR 000008611516 EFFEXOR TAB 75 MG 000003.30
PHAR 000008611517 EFFEXOR TAB 100 MG 000005.38
9/7/2010 11:52 AM Page 195 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611518 SELEGILINE HCL 5MG TAB 000010.33
PHAR 000008611519 BENAZEPRIL 5MG TAB 000003.54
PHAR 000008611520 BENAZEPRIL 10MG TAB 000003.82
PHAR 000008611521 BENAZEPRIL 20MG TAB 000003.54
PHAR 000008611522 BENAZEPRIL 40MG TAB 000003.54
PHAR 000008611523 TEMAZEPAM CAP 15M 000003.92
PHAR 000008611524 TEMAZEPAM CAP 30M 000004.03
PHAR 000008611525 FLECAINIDE 50MG TAB 000003.54
PHAR 000008611526 VIOKASE POW 000000.00
PHAR 000008611527 KETOROLAC 10MG TAB 000006.78
PHAR 000008611528 ETOPOSIDE CAP 50M 000063.10
PHAR 000008611529 PRENATAL S TAB 000002.54
PHAR 000008611531 CLARITHROMYCIN 500MG TAB 000010.70 250
PHAR 000008611533 DILTIAZEM HCL CD 180MG CPC 000007.26 250
PHAR 000008611534 DILTIAZEM HCL CD 240MG CPC 000007.72 250
PHAR 000008611535 DILTIAZEM HCL CD 300MG CPC 000008.56 250
PHAR 000008611536 PROPAFENONE 150MG TAB 000007.01 250
PHAR 000008611538 PRAVACHOL 10MG TAB 000009.36 250
PHAR 000008611539 PRAVACHOL 20MG TAB 000009.71 250
PHAR 000008611540 DIVALPROEX SPRINKLES 125MG CAP 000003.14 250
PHAR 000008611542 DIDANOSINE 25MG TAB 000003.18 250
PHAR 000008611543 ISOSORBIDE MONONITRAT 20MG TAB 000003.71 250
PHAR 000008611545 AZITHROMYCIN 250MG TAB 000022.36 250
PHAR 000008611546 DAPSONE 100MG TAB 000002.72 250
PHAR 000008611547 ATENOLOL 25MG TAB 000004.16 250
PHAR 000008611548 K-PHOS NEUTRAL TAB 000002.63 250
PHAR 000008611552 NICARDIPINE 20MG CAP 000003.13 250
PHAR 000008611553 NICARDIPINE 30MG CAP 000003.55 250
PHAR 000008611554 ZOLOFT 50MG TAB 000008.89 250
PHAR 000008611555 SERTRALINE HYDROCHLOR 100MG TA 000008.95 250
PHAR 000008611556 HYOSCYAMINE SULFATE 0.125MG TA 000002.96 250
PHAR 000008611559 DILTIAZEM HCL CD 120 MG CAP 000004.10 250
PHAR 000008611560 BETAPACE 80MG TAB 000008.12 250
PHAR 000008611561 BETAPACE 160MG TAB 000010.33 250
PHAR 000008611562 BETAPACE 240MG TAB 000011.99 250
PHAR 000008611568 PROZAC 10MG CAP 000010.25 250
PHAR 000008611570 ONDANSETRON 4MG TAB 000024.07 250
PHAR 000008611577 AMLODIPINE 2.5MG TAB 000007.37 250
PHAR 000008611578 AMLODIPINE 5MG TAB 000007.18 250
PHAR 000008611579 AMLODIPINE 10MG TAB 000008.71 250
PHAR 000008611581 PROPAFENONE 300MG TAB 000008.72 250
PHAR 000008611585 POTASSIUM CHLORIDE 8MEQ CAP 000002.70 250
PHAR 000008611587 PROSCAR 5MG TAB 000008.59 250
PHAR 000008611588 FOSINOPRIL 10MG TAB 000003.67 250
PHAR 000008611589 METOPROLOL SUCCINATE TBC 50M 000003.32 250
PHAR 000008611592 CISAPRIDE 10MG TAB 000003.95 250
PHAR 000008611593 FELBAMATE 600MG TAB 000003.59 250
9/7/2010 11:52 AM Page 196 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611594 ONDANSETRON 8MG TAB 000050.50 250
PHAR 000008611596 DIDANOSINE 50MG TAB 000003.95 250
PHAR 000008611598 PERGOLIDE MESYLATE 0.25MG TAB 000004.00 250
PHAR 000008611599 CEFUROXIME AXETIL 250 MG TAB 000012.60 250
PHAR 000008611601 ADEKS TAB 000002.94 250
PHAR 000008611602 CARBIDOPA/LEV 50/200 TAB 000007.39 250
PHAR 000008611603 ZALCITABINE 0.375MG TAB 000008.48 250
PHAR 000008611604 FELBAMATE 400MG TAB 000003.43 250
PHAR 000008611606 DAPSONE 25MG TAB 000002.77 250
PHAR 000008611607 SIMVASTATIN 20MG TAB 000011.65 250
PHAR 000008611608 ISRADIPINE 2.5MG CAP 000003.37 250
PHAR 000008611610 DIAGNOSTIC TESTSTRP 1STRIP 000001.42 250
PHAR 000008611611 CHEMSTRIP-10 UD 1 STRIP 000002.16 250
PHAR 000008611614 TICLOPIDINE HCL 250MG TAB 000007.18 250
PHAR 000008611616 LEVOCARNITINE 330MG TAB 000004.10 250
PHAR 000008611621 VERAPAMIL HCL SR 120MG TAB 000004.02 250
PHAR 000008611622 ISOSORBIDE MONONITRAT 60MG TAB 000007.26 250
PHAR 000008611624 OXAPROZIN 600MG CAP 000007.95 250
PHAR 000008611628 LEVOTHYROXINE 0.088MG TAB 000002.84 250
PHAR 000008611632 GLUCOTROL XL 5MG TAB 000003.14 250
PHAR 000008611638 LAMOTRIGINE TAB 25M 000008.86 250
PHAR 000008611639 LAMOTRIGINE TAB 100 000007.78 250
PHAR 000008611643 MYCOPHENOLATE 250MG CAP 000008.17 250
PHAR 000008611644 LOSARTAN 25MG TAB 000007.50 250
PHAR 000008611645 LOSARTAN 50MG TAB 000007.50 250
PHAR 000008611650 NEPHRO-VITE TAB 000002.62 250
PHAR 000008611651 TRAMADOL HCL TAB 50 000004.01 250
PHAR 000008611652 ADALAT CC 30MG TAB 000002.75 250
PHAR 000008611653 ADALAT CC 60MG TAB 000007.64 250
PHAR 000008611654 ADALAT CC 90MG TAB 000008.29 250
PHAR 000008611670 PIMOZIDE TAB 2MG 000004.00 250
PHAR 000008611671 HYOSCYAMINE TIMECAP 0.375MG CA 000003.83 250
PHAR 000008611674 AMOXICILLIN/CLAVULANI 875MG TA 000013.16 250
PHAR 000008611675 ACYCLOVIR 400MG TAB 000005.90 250
PHAR 000008611676 ACTIVATED CHARCOAL CAP 000002.64 250
PHAR 000008611680 CARVEDILOL 6.25MG TAB 000008.14 250
PHAR 000008611681 COREG 3.125MG TAB 000008.14 250
PHAR 000008611689 ATORVASTATIN 10MG TAB 000008.86 250
PHAR 000008611690 ATORVASTATIN 20MG TAB 000011.08 250
PHAR 000008611691 ATORVASTATIN 40MG TAB 000013.56 250
PHAR 000008611693 ACARBOSE 25MG TAB 000003.22 250
PHAR 000008611694 ACARBOSE 50MG TAB 000003.22 250
PHAR 000008611695 ACARBOSE 100MG TAB 000003.50 250
PHAR 000008611706 NISOLDIPINE 10MG TAB 000002.80 250
PHAR 000008611707 NISOLDIPINE 20MG TAB 000004.40 250
PHAR 000008611708 NISOLDIPINE 30MG TAB 000002.80 250
PHAR 000008611714 LANSOPRAZOLE 15MG CAP 000010.93 250
9/7/2010 11:52 AM Page 197 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611715 LANSOPRAZOLE 30MG CAP 000011.27 250
PHAR 000008611716 DONEPEZIL HCL 10MG TAB 000012.38 250
PHAR 000008611717 DONEPEZIL HCL 5MG TAB 000012.38 250
PHAR 000008611718 ZAFIRLUKAST 20MG TAB 000004.08 250
PHAR 000008611719 BUPROPION SR 100MG TAB 000007.48 250
PHAR 000008611720 BUPROPION SR 150MG TAB 000007.68 250
PHAR 000008611721 EFFEXOR XR 150MG CAP 000009.20 250
PHAR 000008611722 EFFEXOR XR 75MG CAP 000009.48 250
PHAR 000008611723 SAQUINAVIR 200MG CAP 000007.15 250
PHAR 000008611724 OMEPRAZOLE 10MG CAP 000012.29 250
PHAR 000008611725 CLOPIDOGREL BISULF 75MG TAB 000010.21 250
PHAR 000008611727 LEVOFLOXACIN 250MG TAB 000019.70 250
PHAR 000008611728 LEVOFLOXACIN 500MG TAB 000022.21 250
PHAR 000008611729 ANASTROZOLE TAB 1MG 000018.79 250
PHAR 000008611730 ZYRTEC 5MG TAB 000008.82 250
PHAR 000008611732 NEVIRAPINE 200MG TAB 000013.97 250
PHAR 000008611734 DESMOPRESSIN ACET 0.1MG TAB 000008.56 250
PHAR 000008611735 DESMOPRESSIN ACET 0.2MG TAB 000010.66 250
PHAR 000008611740 LITHIUM CARBONATE 150MG CAP 000002.58 250
PHAR 000008611741 CLINDAMYCIN 300MG CAP 000011.45 250
PHAR 000008611745 TOLTERODINE TARTRATE TAB 2MG 000007.59 250
PHAR 000008611746 SERZONE 100MG TAB 000005.62 250
PHAR 000008611747 NAFAZODONE HCL 150MG TAB 000005.62 250
PHAR 000008611748 SERZONE 200MG TAB 000005.62 250
PHAR 000008611749 NEFAZODONE HCL TAB 50M 000004.74 250
PHAR 000008611755 FLOMAX 0.4MG CAP 000007.90 250
PHAR 000008611756 SINGULAIR CHEW 5MG TAB 000010.01 250
PHAR 000008611759 ALENDRONATE SOD TAB 10M 000008.22 250
PHAR 000008611760 ALENDRONATE SOD 5MG TAB 000008.22 250
PHAR 000008611762 ALBUTEROL 4MG ER TAB 4MG TAB 000004.02 250
PHAR 000008611763 CEFPROZIL 250MG TAB 000011.11 250
PHAR 000008611764 CEFPROZIL 500MG TAB 000018.18 250
PHAR 000008611765 ESTROPIPATE 2.5MG TAB 000008.04 250
PHAR 000008611766 GLIMEPIRIDE 1MG TAB 000002.90 250
PHAR 000008611767 GLIMEPIRIDE 2MG TAB 000003.23 250
PHAR 000008611768 HYDROCHLOROTZ/SPRINO TAB 25/ 000003.47 250
PHAR 000008611769 PRAMIPEXOLE 1MG TAB 000008.90 250
PHAR 000008611770 BIPERIDEN 2MG TAB 000003.05 250
PHAR 000008611771 TOLAZAMIDE 500MG TAB 000003.52 250
PHAR 000008611772 VENLAFAXINE XR 37.5MG CAP 000008.41 250
PHAR 000008611774 SIMVASTATIN 10MG TAB 000008.73 250
PHAR 000008611775 TACROLIMUS 0.5MG CAP 000008.43 250
PHAR 000008611776 PRANDIN 2MG TAB 000004.19 250
PHAR 000008611777 TIAGABINE 4MG TAB 000007.18 250
PHAR 000008611778 TEGRETOL XR 200MG TAB 000003.38 250
PHAR 000008611779 TEGRETOL XR 400MG TAB 000004.35 250
PHAR 000008611780 SUSTIVA 200MG CAP 000014.26 250
9/7/2010 11:52 AM Page 198 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008611782 ONDANSETRON ODT TAB 4MG 000032.23 250
PHAR 000008611783 ONDANSETRON ODT TAB 8MG 000050.49 250
PHAR 000008611789 ONDANSETRON TAB 24M 000147.76 250
PHAR 000008611791 PRANDIN 1MG TAB 000004.01 250
PHAR 000008611792 LAMOTRIGINE CHEWABLE TAB 5MG 000009.00 250
PHAR 000008611793 AVANDIA 2MG TAB 000008.72 250
PHAR 000008611794 BAYCOL 0.3MG TAB 000008.14 250
PHAR 000008611801 OMEPRAZOLE 40MG CAP 000017.63 250
PHAR 000008611802 CALCIUM/VIT D 500MG TAB 000002.52 250
PHAR 000008611803 DIDANOSINE 200MG TAB 000013.36 250
PHAR 000008611805 NATEGLINIDE 60MG TAB 000004.40 250
PHAR 000008611806 NATEGLINIDE 120MG TAB 000004.47 250
PHAR 000008611810 ZALEPLON 5MG CAP 000008.93 250
PHAR 000008611811 GLIPIZIDE XL 2.5MG TAB 000003.19 250
PHAR 000008611812 SIMVASTATIN 40MG TAB 000013.79 250
PHAR 000008611839 DULOXETINE HCL CAP 20M 000007.95 250
PHAR 000008611840 DULOXETINE HCL CAP 30M 000008.90 250
PHAR 000008611841 DULOXETINE HCL CAP 60M 000008.90 250
PHAR 000008611845 METOPROLOL SUCCINATE TAB 25M 000002.35 250
PHAR 000008612001 TERBUTALINE SULFATE 5MG TAB 000003.07
PHAR 000008612002 BRONDECON TAB 000002.39
PHAR 000008612003 MINIPRESS CAP 1 MG 000002.63
PHAR 000008612004 BREVICON 21DAY 0.5/35 TAB 000027.96
PHAR 000008612005 BUMETANIDE 0.5MG TAB 000002.93
PHAR 000008612006 BUMETANIDE 1MG TAB 000003.12
PHAR 000008612007 BUTAZOLIDIN 100 MG 000002.66
PHAR 000008612008 ERGOTAMINE/CAFF 1TAB TAB 000006.62
PHAR 000008612009 CAFERGOT PB SUP 000003.98
PHAR 000008612010 CALCIUM CARB 650MG 000002.10
PHAR 000008612011 CALCIUM GLUCONATE 1 GM TAB 000002.71
PHAR 000008612012 CALCIUM GLUCONATE 500MG TAB 000002.58
PHAR 000008612013 CALCIUM LACTATE 325MG TAB 000002.48
PHAR 000008612014 CALCIUM LACTATE 650MG TAB 000002.53
PHAR 000008612015 CANTIL TAB 000002.90
PHAR 000008612016 CAPTOPRIL 25MG TAB 000003.67
PHAR 000008612017 CAPTOPRIL 50MG TAB 000006.97
PHAR 000008612018 CAPTOPRIL 100MG TAB 000007.76
PHAR 000008612019 BREVICON 28DAY 0.5/35 TAB 000036.49
PHAR 000008612020 VERAPAMIL HCL SR 240MG TAB 000007.62
PHAR 000008612021 BUSPAR 5MG TAB 000003.81
PHAR 000008612022 LACTOBACILLUS U 1TAB TAB 000012.77
PHAR 000008612023 FANSIDAR TAB 000007.91
PHAR 000008612024 LITHIUM TAB 300 MG 000002.14
PHAR 000008612025 HIPREX 1GM TAB 000007.52
PHAR 000008612026 NORFLOXACIN 400MG TAB 000007.92
PHAR 000008612027 SUCRALFATE 1GM TAB 000003.79
PHAR 000008612028 CARDILATE CHEW 10 MG 000002.28
9/7/2010 11:52 AM Page 199 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008612029 CARDILATE SL 5 MG 000002.30
PHAR 000008612030 ERYTHRITYL TETRANITRA 10MG SUB 000003.59
PHAR 000008612031 CARDIOQUIN TAB 000003.00
PHAR 000008612032 DILTIAZEM 30MG TAB 000003.21
PHAR 000008612033 DILTIAZEM 60MG TAB 000003.67
PHAR 000008612034 CASCARA TAB 325 MG 000002.12
PHAR 000008612035 CITRACAL TAB 000002.11
PHAR 000008612036 ENKAID CAP 25 MG 000002.76
PHAR 000008612037 CLONIDINE 0.1MG TAB 000002.83
PHAR 000008612038 ENKAID CAP 35 MG 000003.14
PHAR 000008612039 CEFACLOR 250MG CAP 000008.60
PHAR 000008612040 CEFACLOR 500MG CAP 000012.22
PHAR 000008612041 ENKAID CAP 50 MG 000005.52
PHAR 000008612042 DILTIAZEM HCL 90MG TAB 000006.67
PHAR 000008612043 SALSALATE 500MG CAP 000002.86
PHAR 000008612044 ANACIN TABS #12 000005.87
PHAR 000008612045 LOMUSTINE 10MG CAP 000013.56
PHAR 000008612046 LOMUSTINE 40MG CAP 000031.20
PHAR 000008612047 LOMUSTINE 100MG CAP 000054.97
PHAR 000008612048 BETAMETHASONE 0.6MG TAB 000007.49
PHAR 000008612049 METHSUXIMIDE 300MG CAP 000003.85
PHAR 000008612050 METHSUXIMIDE 150MG CAP 000003.25
PHAR 000008612051 LOVASTATIN 20MG TAB 000009.07
PHAR 000008612052 FAMOTIDINE TAB 20 000007.99
PHAR 000008612053 CHARCOAL TAB 000002.04
PHAR 000008612054 CHENIX TAB 250 MG 000003.10
PHAR 000008612055 FAMOTIDINE TAB 40 000010.96
PHAR 000008612056 NYSTATIN LOZ 200,000 U 000004.49
PHAR 000008612057 CHLORPHENIRAMINE MALE TAB 8 M 000002.84
PHAR 000008612058 CHLOR-TRIMETON 12 MG 000002.40
PHAR 000008612059 TENEX 1MG TAB 000007.09
PHAR 000008612060 CHLOROMYCETIN 250 MG 000003.00
PHAR 000008612061 LISINOPRIL 5MG TAB 000004.31
PHAR 000008612062 LISINOPRIL 10MG TAB 000004.37
PHAR 000008612063 LISINOPRIL 20MG TAB 000004.51
PHAR 000008612064 ZIDOVUDINE 100MG CAP 000008.02
PHAR 000008612065 DEVROM CHEWABLE TAB 000002.08
PHAR 000008612066 CHOLEDYL TAB 100 MG 000002.22
PHAR 000008612067 CHOLEDYL TAB 200 MG 000002.29
PHAR 000008612068 CHOLEDYL SA 400 MG 000002.29
PHAR 000008612069 CHOLEDYL SA 600MG 000002.34
PHAR 000008612070 NELOVA 0.5/35E #21 000014.38
PHAR 000008612071 CHOLOXIN TAB 2 MG 000003.55
PHAR 000008612072 CHOLOXIN TAB 4 MG 000005.91
PHAR 000008612073 NELOVA 0.5/35E #28 000014.38
PHAR 000008612074 NELOVA 1/35E #21 000014.38
PHAR 000008612075 CHLORPHENIRAMINE MALE 4 MG TAB 000002.66
9/7/2010 11:52 AM Page 200 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008612076 QUIBRON-300 CAP 000002.67
PHAR 000008612077 CYCLOSPASMOL CAP 200 000002.53
PHAR 000008612078 ISOSORBIDE DINITRATE 40MG CAP 000003.40
PHAR 000008612079 DAMASON-P TAB 000002.92
PHAR 000008612080 SURMONTIL CAP 50 MG 000003.12
PHAR 000008612081 SURMONTIL CAP 25 MG 000002.68
PHAR 000008612082 RIFAMPIN 150MG CAP 000008.02
PHAR 000008612083 PAPASE TAB 000002.50
PHAR 000008612084 PHENURONE TAB 500 MG 000002.50
PHAR 000008612085 SULFASALAZINE 500MG TAB 000002.66
PHAR 000008612086 PYRAZINAMIDE 500MG TAB 000007.02
PHAR 000008612087 SINUTAB TAB 000002.14
PHAR 000008612088 CORRECTOL TAB 000002.64
PHAR 000008612089 AMIODARONE 200MG TAB 000010.39
PHAR 000008612090 MEXILETINE HCL 150MG CAP 000004.00
PHAR 000008612091 MEXILETINE HCL 200MG CAP 000004.30
PHAR 000008612092 MEXILETINE HCL 250MG CAP 000007.01
PHAR 000008612093 K-TABS TAB 10 MEQ 000002.29
PHAR 000008612094 KETOPROFEN 50MG CAP 000004.54
PHAR 000008612095 KETOPROFEN 75MG CAP 000007.18
PHAR 000008612096 SUPROL CAP 200 MG 000002.60
PHAR 000008612097 BUMETANIDE 2MG TAB 000003.79
PHAR 000008612098 EMPIRIN TAB 325 MG 000002.07
PHAR 000008612099 TRILISATE TAB 750 MG 000002.69
PHAR 000008612100 LITHIUM CARB 450MG TAB 000003.33
PHAR 000008612101 AMINOPHYLLINE 200MG TAB 000002.52
PHAR 000008612102 TOLAZAMIDE 500 MG 000002.84
PHAR 000008612103 NEUTRA-PHOS-K 000002.15
PHAR 000008612104 VANCOMYCIN HCL 125MG CAP 000011.20
PHAR 000008612105 VANCOMYCIN HCL 250MG CAP 000025.21
PHAR 000008612106 GUAIFENESIN 600 MG TBC 000003.16
PHAR 000008612107 BACLOFEN 20MG TAB 000003.72
PHAR 000008612108 OXSORALEN CAP 10 MG 000006.11
PHAR 000008612109 ESTRADIOL PATCH 0.05MG PAT 000029.18
PHAR 000008612110 ESTRADERM 0.1 PATCH 000006.37
PHAR 000008612111 NELOVA 1/35E #28 000014.38
PHAR 000008612112 MACROBID CAP 100 MG 000005.90
PHAR 000008612113 KUTRASE CAP 000002.48
PHAR 000008612114 TEN-K TAB 10 MEQ 000002.18
PHAR 000008612115 ADALAT CAP 20 MG 000003.12
PHAR 000008612116 PROPRANOLOL LA 60MG CAP 000004.38
PHAR 000008612117 POLY-VI-FLOR 0.25MG CHE 000002.72
PHAR 000008612118 CAFFEINE 100 MG TAB 000002.14
PHAR 000008612119 CALCIUM CARBONATE 600MG TAB 000002.44
PHAR 000008612120 ANAPROX-DS TAB 000003.28
PHAR 000008612121 VOLTAREN TAB 25 MG 000002.49
PHAR 000008612122 VOLTAREN TAB 50 MG 000002.94
9/7/2010 11:52 AM Page 201 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008612123 VOLTAREN TAB 75 MG 000003.14
PHAR 000008612124 PCE TAB 333 MG 000002.91
PHAR 000008612125 PROPULSID TAB 10 MG 000002.86
PHAR 000008612126 ASACOL TAB 400 MG 000002.72
PHAR 000008612127 VENLAFEXINE HCL 25MG TAB 000003.79
PHAR 000008612128 VENLAFAXINE HCL TAB 50M 000003.88
PHAR 000008612129 EFFEXOR 75MG TAB 000007.01
PHAR 000008612130 VENLAFEXINE HCL 37.5MG TAB 000003.83
PHAR 000008612131 EFFEXOR 100MG TAB 000007.14
PHAR 000008612132 RISPERIDONE 1MG TAB 000009.36
PHAR 000008612133 BUFFERIN TAB 000002.06
PHAR 000008612134 BUSPAR 10MG TAB 000007.26
PHAR 000008612135 RISPERIDONE 2MG TAB 000012.39
PHAR 000008612136 RISPERIDONE 3MG TAB 000013.76
PHAR 000008612137 POTASSIUM CHLORIDE 20MEQ TAB 000003.14
PHAR 000008612138 POTASSIUM CHLORIDE 10MEQ TAB 000002.80 250
PHAR 000008612140 NITROFURANTION MONOHY 100MG CA 000007.37 250
PHAR 000008612144 ASACOL 400MG TAB 000003.87 250
PHAR 000008612151 TERAZOSIN 5MG CAP 000008.51 250
PHAR 000008612152 TERAZOSIN 10MG CAP 000008.51 250
PHAR 000008612156 FELODIPINE 5MG TAB 000004.04 250
PHAR 000008612157 FELODIPINE 10MG TAB 000007.75 250
PHAR 000008612159 MAGNESIUM (ELE) 64MG TAB 000002.69 250
PHAR 000008612161 ESTRATEST TAB 000004.00 250
PHAR 000008612164 SANDIMMUNE 50MG CAP 000009.30 250
PHAR 000008612165 TACROLIMUS 5MG CAP 000035.09 250
PHAR 000008612166 TACROLIMUS 1MG CAP 000009.74 250
PHAR 000008612172 FLUVASTATIN 20MG CAP 000007.51 250
PHAR 000008612173 FLUVASTATIN 40MG CAP 000007.51 250
PHAR 000008612174 TORSEMIDE 5MG TAB 000003.22 250
PHAR 000008612175 TORSEMIDE 10MG TAB 000003.28 250
PHAR 000008612176 TORSEMIDE 20MG TAB 000003.35 250
PHAR 000008612177 TORSEMIDE 100MG TAB 000008.81 250
PHAR 000008612179 NEORAL 100MG CAP 000015.48 250
PHAR 000008612180 NEORAL 25MG CAP 000007.47 250
PHAR 000008612181 METFORMIN 500MG TAB 000003.26 250
PHAR 000008612182 METFORMIN 850MG TAB 000003.86 250
PHAR 000008612183 LAMIVUDINE 150MG TAB 000012.85 250
PHAR 000008612196 VIT B-12 1000MCG TAB 000002.54 250
PHAR 000008612198 CLARITIN-D 24HR TAB 1TA 000010.13 250
PHAR 000008612200 SUMATRIPTAN SUCC 25MG TAB 000031.85 250
PHAR 000008612201 SUMATRIPTAN SUCC 50MG TAB 000035.33 250
PHAR 000008612202 METOPROLOL SUCC TAB 100 000004.04 250
PHAR 000008612204 SIMVASTATIN 5MG TAB 000008.00 250
PHAR 000008612205 LISINOPRIL 5MG TAB 000004.28 250
PHAR 000008612206 LISINOPRIL 10MG TAB 000004.34 250
PHAR 000008612207 LISINOPRIL 20MG TAB 000004.48 250
9/7/2010 11:52 AM Page 202 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008612213 GANCICLOVIR 250MG CAP 000013.43 250
PHAR 000008612219 MYCOPHENOLATE 500MG CAP 000014.52 250
PHAR 000008612222 GANCICLOVIR 500MG CAP 000022.07 250
PHAR 000008612224 LAMIVUDINE HBV 100MG TAB 000014.16 250
PHAR 000008612225 ZIDOVUDINE 300MG TAB 000015.73 250
PHAR 000008612226 CLIMARA 0.1MG PATCH 000014.43 250
PHAR 000008612232 RISPERIDONE TAB 0.5 000010.27 250
PHAR 000008612235 RISPERIDONE 0.25MG TAB 000010.27 250
PHAR 000008612236 LEVETIRACETAM 250MG TAB 000007.83 250
PHAR 000008612237 LEVETIRACETAM 500MG TAB 000008.50 250
PHAR 000008612238 NELFINAVIR 250MG TAB 000009.67 250
PHAR 000008612249 OLANZAPINE DT 5MG TAB 000017.46 250
PHAR 000008612250 OLANZAPINE DT 10MG TAB 000022.94 250
PHAR 000008612251 ZIPRASIDONE 60MG CAP 000013.58 250
PHAR 000008612252 ZIPRASIDONE 80MG CAP 000013.58 250
PHAR 000008612253 SEVELAMER 800MG TAB 000007.45 250
PHAR 000008612256 RAMIPRIL 10MG CAP 000007.87 250
PHAR 000008612258 ZIAC 10/6.25MG TAB 000007.63 250
PHAR 000008612259 BISOPROLOL 10MG TAB 000007.63 250
PHAR 000008612263 MEDROXYPROGESTERONE 5MG TAB 000004.39 250
PHAR 000008612264 TRANDOLAPRIL 1MG TAB 000003.98 250
PHAR 000008612265 TRANDOLAPRIL 2MG TAB 000003.98 250
PHAR 000008612266 TRANDOLAPRIL 4MG TAB 000003.98 250
PHAR 000008613000 NEUTRA-PHOS PKTS 250MG PKT 000002.98 250
PHAR 000008613001 COLYTE 2000 ML 000037.00
PHAR 000008613002 SODIUM POLYSTYRENE 1GM POW 000000.60 250
PHAR 000008613003 CHYMORAL-100 000008.00
PHAR 000008613004 KAYEXALATE 000000.60
PHAR 000008613005 KAYEXALATE POWD 454G 000202.93
PHAR 000008613006 LITHIUM 8MEQ/5ML 10 000003.01
PHAR 000008613007 LITHIUM CIT 8MEQ/5ML 000002.86
PHAR 000008613013 ELECTROLYTE SOL/PEG 000029.17
PHAR 000008613014 SODIUM POLY-NICU UD 1 1GM POW 000003.16 250
PHAR 000008613064 POTASSIUM CHLORIDE 20MEQ PAK 000004.13
PHAR 000008613065 KATO PACKET 000002.69
PHAR 000008613078 EFFERSYLLIUM PACKET 000002.33
PHAR 000008613079 EFFERSYLLIUM 270 G 000010.33
PHAR 000008613080 LACTOBACILLUS U GRA 000003.40
PHAR 000008613081 CHOLESTYRAMINE 4GM PKT 000007.18
PHAR 000008613082 CHARCOAL POWDER 120 000008.40
PHAR 000008613083 K-LYTE/CL-50 TAB 000005.45
PHAR 000008613084 K-LYTE/CL 25 MEQ 000002.80
PHAR 000008613102 ERYTHROCIN TAB 250MG 000002.21
PHAR 000008613105 NEFAZODONE HCL TAB 100 000006.97 250
PHAR 000008613106 NEFAZODONE HCL TAB 150 000003.95 250
PHAR 000008613107 NEFAZODONE HCL TAB 200 000003.95 250
PHAR 000008613108 GABAPENTIN 300MG CAP 000006.98 250
9/7/2010 11:52 AM Page 203 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008613109 CRIXIVAN 400MG CAP 000010.36 250
PHAR 000008613110 LITHIUM CARB 600MG CAP 000002.71 250
PHAR 000008613111 PAXIL 30MG TAB 000009.76 250
PHAR 000008613112 GABAPENTIN 100MG CAP 000003.26 250
PHAR 000008613115 GABAPENTIN 400MG CAP 000006.96 250
PHAR 000008613116 TRIMIPRAMINE MALEATE CAP 50M 000006.89 250
PHAR 000008613117 NABUMETONE 500MG TAB 000004.24 250
PHAR 000008613118 WELLBUTRIN 75MG TAB 000004.11 250
PHAR 000008613119 WELLBUTRIN 100MG TAB 000006.70 250
PHAR 000008613120 PAROXETINE HCL 40MG TAB 000003.89 250
PHAR 000008613121 PAXIL 10MG TAB 000009.41 250
PHAR 000008613122 DEXTROSE 40% 80GM GEL 000009.55 250
PHAR 000008613123 ASTEMIZOLE TAB 000008.95 250
PHAR 000008613124 PHENYLPROP/BROM EXTND TAB 000003.17 250
PHAR 000008613125 HCTZ/TRIAMTERENE TAB 000004.07 250
PHAR 000008613126 NALTREXONE HCL 50MG TAB 000012.98 250
PHAR 000008613127 CEBOCAP BLUE CAP 000003.02 250
PHAR 000008613128 CEBOCAP GREEN CAP 000003.02 250
PHAR 000008613129 CEBOCAP ORANGE CAP 000003.02 250
PHAR 000008613130 STAVUDINE 15MG CAP 000012.56 250
PHAR 000008613131 STAVUDINE 20MG CAP 000012.88 250
PHAR 000008613132 STAVUDINE 30MG CAP 000013.48 250
PHAR 000008613133 STAVUDINE 40MG CAP 000014.08 250
PHAR 000008613134 LORATADINE TAB 10M 000009.41 250
PHAR 000008613135 MIRTAZAPINE TAB 15M 000008.47 250
PHAR 000008613136 MIRTAZAPINE TAB 30M 000000.00 250
PHAR 000008613137 NIZATIDINE BMC 150MG CAP 000007.75 250
PHAR 000008613138 TOPIRAMATE TAB 25M 000007.13 250
PHAR 000008613139 TOPIRAMATE TAB 100 000010.19 250
PHAR 000008613140 TOPIRAMATE TAB 200 000011.02 250
PHAR 000008613141 ZYPREXA 5MG TAB 000014.75 250
PHAR 000008613142 OLANZAPINE 7.5MG TAB 000014.23 250
PHAR 000008613143 OLANZAPINE 10MG TAB 000018.73 250
PHAR 000008613144 ETODOLAC TAB 400 000007.44 250
PHAR 000008613145 SEROQUEL 25MG TAB 000006.96 250
PHAR 000008613146 SEROQUEL 100MG TAB 000008.93 250
PHAR 000008613147 QUETIAPINE FUMARATE 200MG TAB 000012.66 250
PHAR 000008613148 ESCITALOPRAM OXALATE TAB 10 000003.40 250
PHAR 000008613149 ESCITALOPRAM OXALATE TAB 20 000003.55 250
PHAR 000008613150 ATOMOXETINE HCL 10MG CAP 10M 000007.81 250
PHAR 000008613151 ATOMOXETINE HCL 18MG CAP 18M 000007.81 250
PHAR 000008613152 ATOMOXETINE HCL 25MG CAP 25M 000007.81 250
PHAR 000008613153 ATOMOXETINE HCL 40MG CAP 40M 000007.81 250
PHAR 000008613155 OXCARBAZEPINE 300MG TAB 300 000004.85 250
PHAR 000008613156 ARIPIPAZOLE 10MG TAB 10 000026.40 250
PHAR 000008613157 ARIPIPAZOLE 15MG TAB 15 000026.40 250
PHAR 000008613158 ARIPIPAZOLE 20MG TAB 20 000037.34 250
9/7/2010 11:52 AM Page 204 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008613159 ARIPIPAZOLE 30MG TAB 30 000037.34 250
PHAR 000008613160 FEXOFENADINE HCL TAB 30M 000001.76 250
PHAR 000008613161 FEXOFENADINE HCL TAB 60M 000003.53 250
PHAR 000008613162 INSULIN (GLARGINE) SOL 100 000012.00 250
PHAR 000008613163 INSULIN (NOVOLOG)UD SOL 1DO 000012.00 250
PHAR 000008613164 INSULIN BR (HUMAN) INJ 100 000086.40 250
PHAR 000008613165 INSULIN HUMULIN50/50 SUS 1DO 000012.00 250
PHAR 000008613166 INSULIN HUMALOG75/25 SOL 1DO 000012.00 250
PHAR 000008613167 INSULIN NOVO (NPH) INJ 100 000012.00 250
PHAR 000008613168 INSULIN HUMAN LENTE SOL 100 000012.00 250
PHAR 000008613169 INSULIN NOVO REGULAR SOL 100 000012.00 250
PHAR 000008613170 MEMANTINE HCL 5MG TAB 5MG 000005.83 250
PHAR 000008613171 MEMANTINE HCL 10MG TAB 10M 000005.83 250
PHAR 000008613172 BECLOMETHASONE 80MCG INH 7.3 000165.98 250
PHAR 000008613173 BECLOMETHASONE 40MCG INH 7.3 000131.76 250
PHAR 000008613174 RIVASTIGMINE TART. CAP 1.5 000007.07 250
PHAR 000008613175 RIVASTIGMINE TART. CAP 3 M 000007.07 250
PHAR 000008613176 RIVASTIGMENT TART OS LIQ 2MG 000006.50 250
PHAR 000008613177 HYDROCODONE BIT/APAP TAB 1TA 000004.42 250
PHAR 000008613178 OLANZAPINE 10MG VIAL INJ 1MG 000000.00 250
PHAR 000008613179 RISPERIDONE M-TAB TAB 0.5 000009.43 250
PHAR 000008613180 RISPERIDONE M-TAB TAB 1MG 000011.00 250
PHAR 000008613181 RISPERIDONE M-TAB TAB 2MG 000017.73 250
PHAR 000008613182 MIRTAZAPINE SOLTAB TAB 15M 000006.55 250
PHAR 000008613183 MIRTAZAPINE SOLTAB TAB 30M 000008.46 250
PHAR 000008613184 BUPRENORPHINE HCL SL TAB 2MG 000006.78 250
PHAR 000008613185 BUPRENORPHINE HCL TAB 8MG 000011.98 250
PHAR 000008614001 RISPERIDONE 4MG TAB 000016.61
PHAR 000008614002 ZINC OXIDE 454G JAR 20% OIN TO 000019.15
PHAR 000008614003 MESORIDAZINE BESYLATE TAB 50M 000003.89
PHAR 000008614004 MESORIDAZINE BESYLATE TAB 100 000004.22
PHAR 000008614005 RAMIPRIL 1.25MG CAP 000003.32
PHAR 000008614006 RAMIPRIL 2.5MG CAP 000004.26
PHAR 000008614007 RAMIPRIL 5MG CAP 000004.39
PHAR 000008614008 FLUVOXAMINE MALEATE 50MG TAB 000007.55 250
PHAR 000008614009 FLUVOXAMINE MALEATE 100MG TAB 000007.63 250
PHAR 000008615001 VISTARIL ORAL SYRINGE 000004.50
PHAR 000008615002 XXX 000004.50
PHAR 000008615003 XXX 000005.80
PHAR 000008615004 DIMETANE ORAL SYR 000004.50
PHAR 000008615005 XXX 000004.50
PHAR 000008615006 XXX 000005.80
PHAR 000008615008 XXX 000004.50
PHAR 000008615012 XXX 000004.50
PHAR 000008615014 XXX 000004.50
PHAR 000008615016 XXX 000004.50
PHAR 000008615021 XXX 000005.80
9/7/2010 11:52 AM Page 205 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008615023 XXX 000005.80
PHAR 000008615024 XXX 000005.80
PHAR 000008615027 XXXX 000005.80
PHAR 000008615029 XXX 000005.80
PHAR 000008615031 XXX 000005.80
PHAR 000008615033 XXX 000004.50
PHAR 000008615036 SOD POLYSTYRENE SYR 000004.50
PHAR 000008615038 XXX 000004.50
PHAR 000008615040 XXX 000005.80
PHAR 000008615041 XXX 000004.50
PHAR 000008615042 XXX 000005.80
PHAR 000008615043 PROMETHAZINE PLAIN S 000004.50
PHAR 000008615136 METHOTREXATE OS 2MG SYR 000000.00 250
PHAR 000008615148 PREDNISOLONE OS 1MG SYR 000006.60 250
PHAR 000008615149 PREDNISOLONE OS 3MG SYR 000006.60 250
PHAR 000008615154 ATOMOXETINE HCL 60MG CAP 60M 000007.81 250
PHAR 000008615272 VANCOCIN ORAL SYR 000063.72
PHAR 000008615450 XXX 000004.50
PHAR 000008615451 XXX 000005.80
PHAR 000008615454 XXX 000005.80
PHAR 000008615456 XXX 000005.80
PHAR 000008615458 XXX 000004.50
PHAR 000008615460 XXX 000004.50
PHAR 000008615462 XXX 000004.50
PHAR 000008615464 XXX 000004.50
PHAR 000008615466 XXX 000004.50
PHAR 000008615468 XXX 000004.50
PHAR 000008615470 XXX 000004.50
PHAR 000008615472 XXX 000004.50
PHAR 000008615474 XXX 000004.50
PHAR 000008615476 XXX 000004.50
PHAR 000008615478 XXX 000004.50
PHAR 000008615480 XXX 000005.80
PHAR 000008615482 XXX 000004.50
PHAR 000008615484 XXX 000004.50
PHAR 000008615486 XXX 000004.50
PHAR 000008615488 XXX 000005.80
PHAR 000008615490 XXX 000004.50
PHAR 000008615493 XXX 000004.50
PHAR 000008615495 XXX 000004.50
PHAR 000008615497 XXX 000004.50
PHAR 000008615499 XXX 000004.50
PHAR 000008615501 XXX 000004.50
PHAR 000008615503 XXX 000004.50
PHAR 000008615505 XXX 000004.50
PHAR 000008615507 XXX 000004.50
PHAR 000008615509 XXX 000004.50
9/7/2010 11:52 AM Page 206 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008615511 XXX 000005.80
PHAR 000008615513 XXX 000004.50
PHAR 000008615515 XXX 000004.50
PHAR 000008615517 XXX 000004.50
PHAR 000008615519 XXX 000005.80
PHAR 000008615521 XXX 000004.50
PHAR 000008615523 XXX 000004.50
PHAR 000008615525 XXX 000005.80
PHAR 000008615527 XXX 000005.80
PHAR 000008615529 XXX 000004.50
PHAR 000008615531 XXX 000004.50
PHAR 000008615533 XXX 000004.50
PHAR 000008615535 XXX 000004.50
PHAR 000008615537 XXX 000004.50
PHAR 000008615539 XXX 000004.50
PHAR 000008615541 XXX 000004.50
PHAR 000008615543 XXX 000004.50
PHAR 000008615545 XXX 000004.50
PHAR 000008615547 XXX 000005.80
PHAR 000008615549 XXX 000004.50
PHAR 000008615551 XXX 000004.50
PHAR 000008615553 XXX 000004.50
PHAR 000008615555 XXX 000004.50
PHAR 000008615557 XXX 000005.80
PHAR 000008615559 XXX 000004.50
PHAR 000008615562 XXX 000004.50
PHAR 000008615564 XXX 000005.80
PHAR 000008615566 XXX 000005.80
PHAR 000008615568 XXX 000004.50
PHAR 000008615570 XXX 000005.80
PHAR 000008615572 XXX 000005.80
PHAR 000008615574 XXX 000005.80
PHAR 000008615576 XXX 000005.80
PHAR 000008615578 XXX 000004.50
PHAR 000008615580 XXX 000005.80
PHAR 000008615582 XXX 000005.80
PHAR 000008615584 XXX 000005.80
PHAR 000008615586 XXX 000004.50
PHAR 000008615588 XXX 000005.80
PHAR 000008615590 XXX 000004.50
PHAR 000008615592 XXX 000004.50
PHAR 000008615594 XXX 000005.80
PHAR 000008615596 XXX 000005.80
PHAR 000008615598 XXX 000005.80
PHAR 000008615600 XXX 000005.80
PHAR 000008615602 XXX 000005.80
PHAR 000008615604 XXX 000005.80
9/7/2010 11:52 AM Page 207 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008615606 XXX 000005.80
PHAR 000008615608 XXX 000005.80
PHAR 000008615610 XXX 000004.50
PHAR 000008615612 LACTULOSE OS 000006.60
PHAR 000008615614 XXX 000005.80
PHAR 000008615616 XXX 000004.50
PHAR 000008615618 XXX 000005.80
PHAR 000008615620 XXX 000004.50
PHAR 000008615622 XXX 000004.50
PHAR 000008615624 XXX 000005.80
PHAR 000008615626 XXX 000004.50
PHAR 000008615628 XXX 000005.80
PHAR 000008615630 XXX 000004.50
PHAR 000008615632 XXX 000004.50
PHAR 000008615634 XXX 000005.80
PHAR 000008615636 XXX 000005.80
PHAR 000008615638 XXX 000004.50
PHAR 000008615640 XXX 000004.50
PHAR 000008615642 XXX 000004.50
PHAR 000008615644 XXX 000004.50
PHAR 000008615646 XXX 000005.80
PHAR 000008615648 XXX 000004.50
PHAR 000008615650 XXX 000005.80
PHAR 000008615651 CEFPODOXIME OS 20MG SUS 000008.40 250
PHAR 000008615652 XXX 000005.80
PHAR 000008615654 XXX 000004.50
PHAR 000008615656 XXX 000004.50
PHAR 000008615658 XXX 000005.80
PHAR 000008615660 XXX 000004.50
PHAR 000008615662 XXX 000004.50
PHAR 000008615664 XXX 000005.80
PHAR 000008615666 XXX 000005.80
PHAR 000008615668 XXX 000004.50
PHAR 000008615670 XXX 000005.80
PHAR 000008615672 XXX 000005.80
PHAR 000008615674 XXX 000004.50
PHAR 000008615676 XXX 000005.80
PHAR 000008615678 XXX 000004.50
PHAR 000008615680 XXX 000005.80
PHAR 000008615682 XXX 000005.80
PHAR 000008615684 XXX 000005.80
PHAR 000008615686 XXX 000005.80
PHAR 000008615688 XXX 000004.50
PHAR 000008615690 XXX 000004.50
PHAR 000008615692 XXX 000004.50
PHAR 000008615694 XXX 000004.50
PHAR 000008615696 XXX 000004.50
9/7/2010 11:52 AM Page 208 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008615698 XXX 000004.50
PHAR 000008615700 XXX 000004.50
PHAR 000008615702 XXX 000004.50
PHAR 000008615704 XXX 000004.50
PHAR 000008615706 XXX 000004.50
PHAR 000008615708 XXX 000004.50
PHAR 000008615710 XXX 000004.50
PHAR 000008615712 XXX 000004.50
PHAR 000008615714 XXX 000004.50
PHAR 000008615716 XXX 000004.50
PHAR 000008615718 XXX 000004.50
PHAR 000008615720 XXX 000004.50
PHAR 000008615722 XXX 000004.50
PHAR 000008615724 XXX 000004.50
PHAR 000008615726 XXX 000004.50
PHAR 000008615728 XXX 000004.50
PHAR 000008615730 XXX 000005.80
PHAR 000008615732 XXX 000004.50
PHAR 000008615734 XXX 000004.50
PHAR 000008615736 XXX 000004.50
PHAR 000008615881 XXX 000004.50
PHAR 000008615883 XXX 000004.50
PHAR 000008615885 XXX 000004.50
PHAR 000008615887 XXX 000004.50
PHAR 000008615891 XXX 000004.50
PHAR 000008615893 XXX 000004.50
PHAR 000008615895 XXX 000004.50
PHAR 000008615897 XXX 000004.50
PHAR 000008615898 XXX 000005.80
PHAR 000008615900 XXX 000005.80
PHAR 000008615902 XXX 000005.80
PHAR 000008615904 XXX 000004.50
PHAR 000008615906 XXX 000004.50
PHAR 000008615908 XXX 000004.50
PHAR 000008615910 XXX 000005.80
PHAR 000008615912 XXX 000005.80
PHAR 000008615914 XXX 000004.50
PHAR 000008615916 XXX 000005.80
PHAR 000008615918 XXX 000004.50
PHAR 000008615919 XXX 000004.50
PHAR 000008615922 XXX 000004.50
PHAR 000008615924 XXX 000005.80
PHAR 000008615926 XXX 000004.50
PHAR 000008615928 XXX 000004.50
PHAR 000008615930 XXX 000005.80
PHAR 000008615932 XXX 000005.80
PHAR 000008615934 XXX 000004.50
9/7/2010 11:52 AM Page 209 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008615937 XXX 000004.50
PHAR 000008615939 XXX 000005.80
PHAR 000008615951 ROBITUSSIN-CF OS SYR 000006.60 250
PHAR 000008615952 AMIODARONE OS 5MG SYR 000006.60 250
PHAR 000008615954 CEFPROZIL OS 50MG SUS 000008.40 250
PHAR 000008615955 CLARITHROMYCIN OS 50MG SUS 000008.40 250
PHAR 000008615960 RITONAVIR OS 80MG 000038.86 250
PHAR 000008615961 MYCOPHENOLATE OS 200MG/ML 000030.24 250
PHAR 000008616001 POLIOVIRUS LIVE TRIVA 1 DOSE S 000030.78
PHAR 000008616002 LOMOTIL 0.5MG/ML LIQ 60ML 000020.65
PHAR 000008616003 ACETAMINOPHEN BTL SOL 32M 000011.40
PHAR 000008616004 TYLENOL EL 1 GM/30ML 000008.91
PHAR 000008616005 CEPHALEXIN 250MG/5ML 50MG SUS 000003.79
PHAR 000008616006 KEFLEX 250MG/5ML 5ML 000005.58
PHAR 000008616007 AMPICILLIN 125MG UD 25MG SUS 000002.90
PHAR 000008616008 AMPICILLIN 250MG UD 50MG SUS 000003.05
PHAR 000008616009 AMOXICILLIN 125MG UD 25MG SUS 000008.50
PHAR 000008616010 AMOXICILLIN 250MG UD 50MG SUS 000008.86
PHAR 000008616011 METAMUCIL 1 PKT 000002.86
PHAR 000008616012 PERDIEM 100 GM 000008.04
PHAR 000008616013 PERDIEM 250 GM 000015.25
PHAR 000008616014 POTASSIUM CL 10% 40 1.334MEQ P 000003.10
PHAR 000008616015 GUAIFENESIN SYR 000003.14
PHAR 000008616016 GUAIFENESIN SYR 000003.14
PHAR 000008616017 ROBITUSSIN UD 15 ML 000002.52
PHAR 000008616018 GUAIFENESIN/DEXTROMET PO 000003.10
PHAR 000008616019 GUAIFENESIN/DEXTROMET PO 000003.12
PHAR 000008616020 MAGNESIUM HYDROXIDE 10 ML PO 000003.02
PHAR 000008616021 MAGNESIUM HYDOX/CASCA SUS 000003.23
PHAR 000008616022 POTASSIUM CL 10% 20 1.334MEQ P 000003.10
PHAR 000008616023 POTASSIUM IODIDE 1GM 000016.33
PHAR 000008616024 VANCOMYCIN 1GM 000111.60
PHAR 000008616025 LIDOCAINE VISCOUS 2% 000008.03
PHAR 000008616026 PEN VK 125MG/5 ML 000002.55
PHAR 000008616027 PEN VK 250MG/5ML 000002.59
PHAR 000008616028 ACETAMINOPH 320/10ML 000002.45
PHAR 000008616029 AMPICILLIN 500MG 100MG SUS 000007.01
PHAR 000008616030 POTASSIUM CL BTL 20% PO 000010.58
PHAR 000008616031 GUAIFENESIN/DEXTROMET PO 000008.93
PHAR 000008616032 PERDIEM GRANULES 6 G 000002.27
PHAR 000008616033 PARALDEHYDE 30ML VIAL 000020.82
PHAR 000008616034 IBUPROFEN SUSP 120ML 000014.26
PHAR 000008616035 ACETAMINOPHEN 160MG SOL 32M 000002.88 250
PHAR 000008616037 PHENYTOIN UD 25MG SUS 000003.76 250
PHAR 000008616039 DIPHENHYDRAMINE 5 UD 2.5MG ELI 000002.93 250
PHAR 000008616041 IPECAC SYR 000007.98 250
PHAR 000008616043 THEOPHYLLINE UD 5.33MG 000003.06 250
9/7/2010 11:52 AM Page 210 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008616044 PHENOBARB ELIX 20MG/5ML 000003.00 250
PHAR 000008616045 ALUM HYDR/MAGN/SIMETH SUS 000002.08 250
PHAR 000008616046 CHLORAL HYDRATE 100MG SYR 000002.90 250
PHAR 000008616047 AMINOPHYLLINE 375MGUD 25MG 000003.41 250
PHAR 000008616048 IBUPROFEN UD 100MG SUSP 000008.25 250
PHAR 000008616050 FERROUS SULF 300MG UD LIQ 000002.95 250
PHAR 000008616052 "VITAMINS,MULTIUD " 5ML PO 000001.94 250
PHAR 000008616057 CIMETIDINE UD 300MG LIQ 000009.91 250
PHAR 000008616058 DIGOXIN UD 2.5ML ELX 000006.87 250
PHAR 000008616060 DOCUSATE SOD UD 10ML 000003.05 250
PHAR 000008616062 FUROSEMIDE 40MG UD SOL 000007.50 250
PHAR 000008616064 LACTULOSE 20GM/30ML UD 000010.09 250
PHAR 000008616065 LITHIUM CITRATE 8MEQ/5ML UD 000003.70 250
PHAR 000008616066 NYSTATIN UD 500,000U SUSP 000006.82 250
PHAR 000008616069 VALPROIC ACID 250MG UD SYRUP 000008.29 250
PHAR 000008617001 PAREPECTOLIN SUS 000017.46
PHAR 000008617002 PHENOBARB ELIX 180ML 4MG/ML 000012.71
PHAR 000008617003 PEDIACOF SYP 000011.60
PHAR 000008617004 TRIPROLIDINE/PSEUDO SYR 000013.96
PHAR 000008617005 ACTIFED W/COD 3 OZ 000012.65
PHAR 000008617006 VALPROIC ACID BTL 50MG SYR 000034.98
PHAR 000008617007 FERROUS SULFATE 44MG/ML ELI 000011.35
PHAR 000008617008 MALT EXT LIQ 1ML 000019.07
PHAR 000008617009 DEXAMETHASONE BTL 0.1MG 000013.72
PHAR 000008617010 KAON-CL SF 20% 3 OZ 000010.28
PHAR 000008617011 DEMAZIN SYRUP 4 OZ 000009.10
PHAR 000008617012 METHENAMINE MANDELATE 50MG SUS000022.32
PHAR 000008617013 METHENAMINE MANDELATE 100MG SU 000027.35
PHAR 000008617014 FERROUS SULFATE 3.6MG/ML ELX 000013.52
PHAR 000008617015 MARAX-DF SYRUP 3 OZ 000012.48
PHAR 000008617016 PHENYTOIN BTL 25MG SUS 000025.36
PHAR 000008617017 DILANTIN-30 3 OZ 000011.69
PHAR 000008617018 MEDIUM CHAIN TRIGLY OIL PO 000008.76
PHAR 000008617019 PHENERGAN EXP 3 OZ 000004.61
PHAR 000008617020 METHYLDOPA BTL 50MG/ML SUS 000005.66
PHAR 000008617021 MAG SULFATE 50% 30 M 000003.00
PHAR 000008617022 DIMETANE EXPECT 3 OZ 000004.62
PHAR 000008617023 DIMETAPP 120ML ELIX 000011.13
PHAR 000008617024 ERYTHROMYCIN ES 125 SUS 25M 000019.67
PHAR 000008617025 ERYTHROMYCIN ES 250 SUS 50M 000027.24
PHAR 000008617026 PROMETHAZINE HCL BTL 1.25MG/M 000011.41
PHAR 000008617027 PROMETHAZ/CODEINE ELI SYR 000013.55
PHAR 000008617028 PHENERG VC E/COD 3OZ 000008.82
PHAR 000008617029 THEOPHYLLINE BTL 5.33MG ELI 000013.09
PHAR 000008617030 METAPROTERENOL SULFAT 2MG SYR 000017.45
PHAR 000008617031 NOVAHISTINE-DH 3 OZ 000010.83
PHAR 000008617032 NOVAHISTINE EXP 3 OZ 000011.01
9/7/2010 11:52 AM Page 211 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008617033 AMBENYL EXP 3 OZ 000009.98
PHAR 000008617034 AMINOCAPROIC ACID 250MG SYR 000098.24
PHAR 000008617035 OXYBUTYNIN CHLORIDE 1MG SYR 000020.69
PHAR 000008617036 NITROFURANTOIN BTL 5MG SUS 000026.84
PHAR 000008617037 FURAZOLIDONE 3.3333MG PO 000025.10
PHAR 000008617038 "GLYCEROL, IODINATED" 12MG ELI 000025.96
PHAR 000008617039 ENTEX 000017.10
PHAR 000008617040 ERYTHROMYCIN ETH 200 40MG SUS 000013.98
PHAR 000008617041 ERYTHROMYCIN ETH 400 80MG SUS 000017.05
PHAR 000008617042 SODIUM CITRATE/POTASS SYR 000013.16
PHAR 000008617043 CHLOROTHIAZIDE SUSP 90ML 000005.57
PHAR 000008617044 GANTANOL SUSP 3 OZ 000018.03
PHAR 000008617045 GANTRISIN SUSP 3 OZ 000012.60
PHAR 000008617046 DONNAGEL SUS 000012.00
PHAR 000008617047 DONNAGEL-PG SUS 000013.55
PHAR 000008617048 SAFFLOWER OIL BTL T 000006.00
PHAR 000008617049 PYRIDOSTIGMINE BR 12MG/ML SYR 000015.40
PHAR 000008617050 PREDNISONE 90ML LIQ 000020.02
PHAR 000008617051 DOCUSATE/CASANTHRANOL SYR 000014.62
PHAR 000008617052 CYPROHEPTADINE 2MG/5M 0.4MG/ML 000016.82
PHAR 000008617053 DIMENHYDRINATE 120ML LIQ 000013.84
PHAR 000008617054 QUIBRON ELIXIR 3 OZ 000011.68
PHAR 000008617055 METOCLOPRAMIDE HCL SYR 1MG 000015.77
PHAR 000008617056 PSEUDOEPHEDRINE HCL 6MG/ML SYR 000005.53
PHAR 000008617057 TETRACYCLINE HCL 25MG PO 000012.52
PHAR 000008617058 AROMATIC ELIXIR ELI 000005.54
PHAR 000008617059 DEXTROSE SYRP BTL SYR 000010.85
PHAR 000008617060 AMANTADINE 10MG/ML 90ML 000027.65
PHAR 000008617061 CIMETIDINE 60MG/ML 90ML LIQ 000073.08
PHAR 000008617062 TRIHEXYPHENIDYL HCL 0.4MG ELI 000016.98
PHAR 000008617063 MONOJEL PACKETTE #1 000001.02
PHAR 000008617064 ARTHROPAN LIQ 3 OZ 000004.65
PHAR 000008617065 TRIAMINIC SYRUP 3 OZ 000009.34
PHAR 000008617066 NEOMYCIN SOL 25MG/ML 90ML 000010.22
PHAR 000008617067 HYDROXYZINE PAM BTL 5MG SUS 000037.61
PHAR 000008617068 DONNATAL ELI 000014.50
PHAR 000008617069 HYDROXYZINE HCL BTL 2MG SYR 000013.12
PHAR 000008617070 ORGANIDIN DM 000023.21
PHAR 000008617071 AMINOPHYLLINE 21MG 000020.29
PHAR 000008617072 PRIMIDONE 50MG/ML 90ML 000025.09
PHAR 000008617073 SORBITOL BTL 70% 000009.79
PHAR 000008617074 SULFASALAZINE BTL 50MG SUS 000014.62
PHAR 000008617075 ETHOSUXIMIDE BTL 50MG SYR 000026.45
PHAR 000008617076 SORBITOL UD 000005.00
PHAR 000008617077 NEGGRAM 250/5 3 OZ 000018.46
PHAR 000008617078 VI-DAYLIN W/IRON 3OZ 000010.13
PHAR 000008617079 NEO-CALGLUCON SYRUP SYR 000015.04
9/7/2010 11:52 AM Page 212 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008617080 DIPHENHYDRAMINE BTL 2.5MG ELI 000014.93
PHAR 000008617081 DICYCLOMINE HCL BTL 2MG SYR 000016.07
PHAR 000008617082 DIPHENHYDRAMINE BTL 2.5MG SYR 000012.17
PHAR 000008617083 MILK OF BISMUTH 3 OZ 000011.16
PHAR 000008617084 BRONDECON ELIX 3 OZ 000011.75
PHAR 000008617085 LACTULOSE 240ML/BTL 000017.52
PHAR 000008617086 CEROSE-DM EXP 3 OZ 000010.20
PHAR 000008617087 CHERACOL W/COD 3 OZ 000010.56
PHAR 000008617088 CHOLEDYL ELIX 3 OZ 000009.73
PHAR 000008617089 LITHIUM CITRATE 60MG SYR 000014.16
PHAR 000008617090 CO-PYRONIL SUSP 3 OZ 000010.59
PHAR 000008617091 DOCUSATE SOD 90ML LIQ 000014.02
PHAR 000008617092 DOCUSATE SOD 90ML LIQ 000014.58
PHAR 000008617093 GREEN GODESS SUS 000014.40
PHAR 000008617094 TMP/SULFAMETHBTL 8/40MG SUS 000012.67
PHAR 000008617095 SOMOPHYLLIN-DF 3 OZ 000015.43
PHAR 000008617096 SOD CITRATE/CITRIC AC 000011.84
PHAR 000008617097 FLUPHENAZINE ELI 0.5 000042.62
PHAR 000008617098 DIMETAPP 1.25ML ELX 000006.60
PHAR 000008617099 PROZAC 20MG/5ML 90ML 000076.44
PHAR 000008617100 DIMETAPP 2.5ML ELX 000006.60
PHAR 000008617101 DIMETAPP UD 000004.50
PHAR 000008617102 DIMETAPP 5ML ELX 000006.60
PHAR 000008617103 DIMETAPP 1/4 TSP UD 000004.50
PHAR 000008617104 XXX 000005.80
PHAR 000008617105 DIMETAPP 1/2 TSP UD 000004.50
PHAR 000008617106 NYSTATIN 200,000U SUSP 000008.40
PHAR 000008617107 TYLENOL ELIX 1 GR UD 000004.50
PHAR 000008617108 ACETAMINOPHEN/COD ELI 12MG ELI 000002.48
PHAR 000008617109 SHOHL'S SOLU 500 ML SOL 1ML 000012.00
PHAR 000008617110 TYLENOL ELIX 1/2 GR 000002.05
PHAR 000008617111 IMURAN 10MG/ML 3 OZ 000017.00
PHAR 000008617112 TYLENOL ELIX 1 GR UD 000004.50
PHAR 000008617113 TYLENOL 1.25 GR UD SYR 000004.50
PHAR 000008617114 XXX 000004.50
PHAR 000008617115 TYLENOL 1.5 GR UD SYR 000004.50
PHAR 000008617116 XXX 000004.50
PHAR 000008617118 XXX 000004.50
PHAR 000008617120 TYLENOL 160MG/5ML UD 000004.50
PHAR 000008617122 XXX 000004.50
PHAR 000008617124 ACETAMINOPHEN 256MG SOL 32M 000002.83
PHAR 000008617125 SHOHL'S SOLUTION 1L TOP 000018.00
PHAR 000008617127 DRISDOL UNIT DOSE 000003.80
PHAR 000008617128 XXX 000004.50
PHAR 000008617130 LOPERAMIDE 0.2MG/ML 120ML 000011.77
PHAR 000008617131 CHLORAL HYDRATE 100MG SYR 000011.72
PHAR 000008617134 CHLORPROMAZINE HCL 10MG SYR 000035.82
9/7/2010 11:52 AM Page 213 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008617135 GLYCERIN 1.25GM/M 000000.01
PHAR 000008617137 FERROUS GLUCONATE 60MG ELI 000012.78
PHAR 000008617139 ROBITUSSIN DAC SYRUP 000011.69
PHAR 000008617140 DECONAMINE SYRUP 3OZ 000010.56
PHAR 000008617141 ROBITUSSIN-PE SYR 000012.98
PHAR 000008617142 GUAIFENISEN AC SYR 000017.76
PHAR 000008617143 PROMETHAZINE VC SYRP 000007.92
PHAR 000008617144 PROMETHAZINE/COD SYR 000008.39
PHAR 000008617145 PROMETHAZINE VC/COD 000008.50
PHAR 000008617148 ROBITUSSIN-CF SYR 000009.70
PHAR 000008617149 PRELONE 3MG/ML OS 000005.50 250
PHAR 000008617150 NALDECON-DX LIQ 3 OZ 000009.57
PHAR 000008617151 SORBITOL 20% BTL 20% 000011.00
PHAR 000008617152 TUSSI-ORGANIDIN DM 000013.35
PHAR 000008617153 FERROUS SULFATE ELIX 000007.53
PHAR 000008617155 CHLORAL HYDRATE SOLN 000003.80
PHAR 000008617156 ANTACID UD ML 1ML 000003.00
PHAR 000008617157 CHOLEDYL SYR 50MG/5M 000009.59
PHAR 000008617158 PROPRANOLOL HCL 3OZ 4MG/ML 000016.50
PHAR 000008617159 INDOMETHACIN SUSP 90ML 000018.96
PHAR 000008617160 LACTULOSE BTL SYR 000009.96
PHAR 000008617161 SORBITOL 70% BTL 70% 000011.00
PHAR 000008617162 PROMETHAZINE HCL BTL 5MG/ML SY 000018.90
PHAR 000008617163 CARBAMAZEPINE 20MG SUS 000015.55
PHAR 000008617164 BROMPHENIRAMINE 0.4MG ELI 000012.42
PHAR 000008617165 DOXYCYCLINE CA BTL 10MG/ML SYR 000045.56
PHAR 000008617166 DOXYCYCLINE MONO BTL 5MG SUS 000017.94
PHAR 000008617167 NAPROXEN BTL 25MG SUS 000018.71
PHAR 000008617168 ALBUTEROL SUSP 0.4MG SYR 000017.18
PHAR 000008617169 NORTRIPTYLINE BTL 2MG/ML 000020.10
PHAR 000008617170 RANITIDINE HCL BTL 15MG SYR 000050.72
PHAR 000008617171 DRISDOL UNIT DOSE 000003.80
PHAR 000008617172 XXX 000005.80
PHAR 000008617174 ACYCLOVIR 200MG/5ML 40MG SUS 000028.67 250
PHAR 000008617177 DIPHENHYDRAMINE 10 UD 2.5MG EL 000001.91 250
PHAR 000008617181 FLUOXETINE HCL 4MG PO 000093.53 250
PHAR 000008617182 ZIDOVUDINE SYR BTL 10MG SYR 000026.27 250
PHAR 000008617186 LORAZEPAM CONC LIQ 2MG 000012.00 250
PHAR 000008617187 ISONIAZID BTL 10MG SYR 000014.00 250
PHAR 000008617189 SUCRALFATE SUSP 90ML 000015.83 250
PHAR 000008617194 ACETAMINOPHEN 80MG SOL 32M 000006.60 250
PHAR 000008617196 MCT OIL UD SYR 1 ML OIL PO 000004.20 250
PHAR 000008617197 CIMETIDINE 300MG/5ML SYR 60M 000027.02 250
PHAR 000008617593 CEFPROZIL OS SUS 25M 000007.00 250
PHAR 000008617900 RISPERIDONE UD 0.5MG SOL 000014.18 250
PHAR 000008617953 CEFPROZIL OS 25MG SUS 000008.40 250
PHAR 000008618001 NAFCILLIN 250MG/5ML 000019.28
9/7/2010 11:52 AM Page 214 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008618002 PENICILLIN V K 125/5 25MG SUS 000007.61
PHAR 000008618003 PENICILL V K 125/5 25MG SUS 000009.11
PHAR 000008618004 PENICILLIN V K 250/5 50MG SUS 000008.22
PHAR 000008618005 PENICILLIN V K 250/5 50MG SUS 000010.07
PHAR 000008618006 VANCOMYCIN HCL 10GM 83.33MG 000420.95
PHAR 000008618007 CEFACLOR 125MG/5ML 25MG SUS 000022.76
PHAR 000008618008 CECLOR 125/5 150 ML 000030.37
PHAR 000008618009 CECLOR SUS 50MG/ML 000042.79
PHAR 000008618010 CECLOR 250/5 150 ML 000050.23
PHAR 000008618011 CLINDAMYCIN 75MG/5ML 15MG SUS 000020.33
PHAR 000008618012 COLYMYCIN S SUSP 000026.07
PHAR 000008618013 DICLOXACILLIN 12.5MG SUS 000016.04
PHAR 000008618014 DICLOXAC 62.5/5 80ML 000011.61
PHAR 000008618015 DICLOXACILLIN 12.5MG SUS 000027.04
PHAR 000008618016 PEN VK 250MG/5ML 200 000010.51
PHAR 000008618017 AMOXICILLIN/CLAVULANI 125MG/5 000041.10
PHAR 000008618018 AUGMENTIN 125MG/5ML 000014.70
PHAR 000008618019 AMOXICILLIN/CLAVULANI 250MG/5 000073.31
PHAR 000008618020 AUGMENTIN 250MG/5ML 000026.19
PHAR 000008618025 AMOXICIL/CLAVULANATE 80MG SUS 000051.66 250
PHAR 000008618026 AMOXICIL/CLAVULANATE 80MG SUS 000064.08 250
PHAR 000008618027 AMOXICIL/CLAVULANATE 80MG SUS 000094.26 250
PHAR 000008618028 CEFPODOXIME PROXETIL 20MG SUS 000104.06 250
PHAR 000008618029 MYCOPHENOLATE SUSP 175ML 000480.02 250
PHAR 000008619001 HALEY'S MO 8 OZ 000004.14
PHAR 000008619002 GRISEOFULVIN 25MG/ML SUS 000033.32
PHAR 000008619003 ATTAPULGITE PO 000009.91
PHAR 000008619004 PROCHLORPERAZINE 1MG/ML SYR 000030.06
PHAR 000008619005 FERROUS SULFATE 125MG/ML DRP 000017.15
PHAR 000008619006 KEFLEX 125/5ML 100ML 000014.04
PHAR 000008619007 KEFLEX 125/5ML 200ML 000025.70
PHAR 000008619008 CEPHALEXIN 250MG/5ML 50MG SUS 000011.45
PHAR 000008619009 KEFLEX 250/5ML 100ML 000024.77
PHAR 000008619010 KEFLEX 250/5ML 200ML 000046.72
PHAR 000008619011 NYSTATIN BTL SUS 000012.35
PHAR 000008619012 DIHYDROTACHYSTEROL 0.2MG 000079.37
PHAR 000008619013 DI-GEL 360 ML 000007.68
PHAR 000008619014 POLY-VI-FLOR 0.5MG 000018.66
PHAR 000008619015 SERENTIL CON 25MG/ML 000040.73
PHAR 000008619016 EMETROL 89 ML 000009.95
PHAR 000008619017 NOVAFED-A 120 ML 000007.81
PHAR 000008619018 POLY-VI-SOL 000014.83
PHAR 000008619019 DIGOXIN BOTTLE 0.05MG ELI 000017.08
PHAR 000008619020 POLY-VI-SOL WITH IRON 000014.83
PHAR 000008619021 "GLYCEROL, IODINATED" 12MG 000043.94
PHAR 000008619022 MAALOX PLUS EXT STR 000007.53
PHAR 000008619023 PHOSPHO-SODA 45ML 000004.23
9/7/2010 11:52 AM Page 215 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008619024 PEDIALYTE 960 ML CAN 000007.56
PHAR 000008619025 AMPICILL 125/5 100ML 000006.91
PHAR 000008619026 AMPICILL 125/5 200ML 000008.61
PHAR 000008619027 AMPICILL 250/5 100ML 000008.04
PHAR 000008619028 AMPICILL 250/5 200ML 000010.75
PHAR 000008619029 AMOXICIL 125/5 80ML 000010.37
PHAR 000008619030 ERYTHROMYCIN/SULFISOX 40MG SUS 000019.88
PHAR 000008619031 PEDIAZOLE 150 ML 000025.91
PHAR 000008619032 ERYTHROMYCIN/SULFISOX 40MG SUS 000038.78
PHAR 000008619033 LASIX 10 MG/ML 60 ML 000013.40
PHAR 000008619034 LASIX 10MG/ML 120ML 000019.20
PHAR 000008619035 IPECAC SYR 000002.60
PHAR 000008619036 THIORIDAZINE HCL 30MG PO 000045.65
PHAR 000008619037 THIORIDAZINE HCL 100MG PO 000115.67
PHAR 000008619038 PENICILLIN G K 250/5 50MG SYR 000008.33
PHAR 000008619039 PENICILLIN G K 250/5 50MG SYR 000010.27
PHAR 000008619040 PENICILLIN G K 125/5 25MG SUS 000007.80
PHAR 000008619041 GLYCERIN 50% 000039.96
PHAR 000008619042 GAVISCON SUS 000012.79
PHAR 000008619043 BISMUTH SUBSALICYLATE 360ML SU 000008.71
PHAR 000008619044 METAMUCIL 14 OZ 000012.52
PHAR 000008619045 METAMUCIL 7 OZ 000008.02
PHAR 000008619046 LIQUIPRIN 35 ML 000007.32
PHAR 000008619047 PYRANTEL PAMOATE 50MG SUS 000061.01
PHAR 000008619048 CHOLESTYRAMINE 210GM PWD 000055.37
PHAR 000008619049 ERGOCALCIFEROL 8000U 000094.31
PHAR 000008619050 GUAIFENESIN SYR 000008.42
PHAR 000008619051 MINERAL OIL OIL PO 000005.06
PHAR 000008619052 DIAZOXIDE 50MG/ML 30ML 000154.90
PHAR 000008619053 TRIFLUOPERAZINE HCL CON 10M 000156.74
PHAR 000008619054 PETROGALAR 16 OZ 000006.76
PHAR 000008619055 PEDIALYTE PLAIN SOL 1EA 000000.00
PHAR 000008619056 VITAMIN A 50000U 000061.24
PHAR 000008619057 VITAMIN E 50U 000063.65
PHAR 000008619058 SENNA GRANULES 60GM 326MG GRA 000013.90
PHAR 000008619059 SENNA SYR 60ML BOTTLE 000016.73
PHAR 000008619060 SENNA SYR 240ML BOTTLE 000040.25
PHAR 000008619061 CHLORHEXIDINE GLUCONA 480ML 000019.70
PHAR 000008619062 LOXITANE-C 120 ML 000200.34
PHAR 000008619063 MINOCYCLINE HCL 10MG SUS 000042.98
PHAR 000008619064 THIABENDAZOLE 100MG SUS 000032.33
PHAR 000008619065 TEMARIL SYRUP 120 ML 000018.54
PHAR 000008619066 CHLORPROMAZINE CONC 30MG SYR 000050.82
PHAR 000008619067 THORAZINE 100/ML 240 000145.86
PHAR 000008619068 LUGOL'S 000008.72
PHAR 000008619069 TRI-VI-FLOR 0.25MG 0.25MG 000017.36
PHAR 000008619070 MONOJEL PACKETS #12 000006.21
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008619071 TRI-VI-SOL 000013.96
PHAR 000008619072 TRI-VI-SOL W IRON 000013.96
PHAR 000008619073 ISOSORBIDE 45% 000039.07
PHAR 000008619074 CLOXACILL 125/5 100 000015.40
PHAR 000008619075 CLOXACILL 125/5 200 000029.89
PHAR 000008619076 "VITAMINS,MULTI " PO 000009.86
PHAR 000008619077 MAALOX PLUS 30 ML 000005.06
PHAR 000008619078 HALDOL CONC UD 000005.80
PHAR 000008619079 PAIN COCKTAIL 1 DOSE SUS 000015.60
PHAR 000008619080 SIMETHICONE DROPS 30ML 000017.95
PHAR 000008619081 FAMOTIDINE SUS 8MG 000116.21
PHAR 000008619082 ACETAMINOPHEN DRP 100 000010.25
PHAR 000008619083 SPARINE SYRUP 4 OZ 000009.90
PHAR 000008619084 ALUMINUM CARB SUSP 80MG SUS 000012.01
PHAR 000008619085 THIOTHIXENE HCL 5MG PO 000040.19
PHAR 000008619086 CASTOR OIL 60 ML 000004.08
PHAR 000008619087 CEVISOL DROPS 50 ML 000011.44
PHAR 000008619088 CHLORTRIMETON 120 ML 000008.02
PHAR 000008619089 HYDROCORTISONE CYP 2MG SUS 000027.23
PHAR 000008619090 CHLOROMYCETIN SUSP 000017.31
PHAR 000008619091 AMOXICILL 125/5 150M 000008.73
PHAR 000008619092 HALOPERIDOL 2MG PO 000201.60
PHAR 000008619093 MUCOSITIS COCKTAIL 1APP SUS 000021.60
PHAR 000008619094 POLY-VI-FLOR WITH IRO 0.5MG 000018.66
PHAR 000008619095 AMOXICILL 125/5 80 000007.71
PHAR 000008619096 BISMUTH SUBSALICYLATE 120ML SU 000004.92
PHAR 000008619097 MUCOSITIS COCKTAIL 1APP SUS 000036.00
PHAR 000008619098 ATTAPULGITE PO 000007.27
PHAR 000008619099 AMOXICILLIN SUS 50MG/ML 000013.99
PHAR 000008619100 GELUSIL 12 OZ 000009.34
PHAR 000008619101 MAALOX PLUS EXST 150 000005.67
PHAR 000008619102 MAALOX PLUS EXST 150 000005.35
PHAR 000008619103 AMOXICILL 250/5 100 000011.62
PHAR 000008619104 AMOXICILL 250/5 150 000049.14
PHAR 000008619105 SODIUM FLUOR DRPS SOL 0.1 000015.97
PHAR 000008619106 MAGALDRATE SUS 000008.88
PHAR 000008619107 ROBITUSSIN-AC 2 OZ 000009.00
PHAR 000008619108 POLY-VI-FLOR WITH IRO 0.25MG 000018.62
PHAR 000008619109 CHARCOAL 50 GM/240ML 000008.80
PHAR 000008619110 LIDOCAINE VISCOUS 2% 000010.62
PHAR 000008619111 SOD POLYSTYRENE SULF 000100.76
PHAR 000008619112 HALDOL CONC UD 000005.80
PHAR 000008619113 ALUM HYDR/MAGN/SIMETH SUS 000002.59
PHAR 000008619114 SODIUM POLYSTYR SUSP 0.25GM SU 000000.00 250
PHAR 000008619115 SOD POLYSTYREN 5 GM 000004.00
PHAR 000008619116 SOD POLYSTYREN 10 GM 000008.04
PHAR 000008619117 SOD POLYSTYRE 20 GM 000016.10
9/7/2010 11:52 AM Page 217 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008619118 SOD POLYSTYRE 30 GM 000024.17
PHAR 000008619119 SOD POLYSTYRE 40 GM 000032.23
PHAR 000008619120 SOD POLYSTYRE 50 GM 000040.30
PHAR 000008619121 SOD POLYSTYRE 60 GM 000048.36
PHAR 000008619124 AMOXICILL 250/5 80 000009.94
PHAR 000008619125 PEDIASURE RTU LIQ 1CA 000000.00
PHAR 000008619126 FUROSEMIDE SOL 60ML 000015.64
PHAR 000008619127 FUROSEMIDE SOL 120ML 000028.04
PHAR 000008619128 MAGNESIUM CITRATE 000003.12
PHAR 000008619129 PERPHENAZINE 3.2MG PO 000052.56
PHAR 000008619131 THIORIDAZINE HCL 5MG SUS 000069.67 250
PHAR 000008619132 DIGOXIN BOTTLE 0.05MG ELI 000028.08 250
PHAR 000008619134 ALUM HYDROX/MAGN EXTR SUS 000006.55 250
PHAR 000008619136 SANDIMMUNE 50ML SOL 100MG/ML 000503.65
PHAR 000008619137 HYDROGEN PEROXIDE 3% 000005.02
PHAR 000008619138 TRI-VI-FLOR 0.5MG 0.5MG 000017.51
PHAR 000008619139 TRI-VI-FLOR 0.25MG IR 0.25MG 000017.46
PHAR 000008619140 THEOPHYLLINE BTL 5.33MG 000014.82
PHAR 000008619141 DOXEPIN HCL CON 10M 000040.96
PHAR 000008619142 LIQUI-CHAR 30 GM/120 000008.22
PHAR 000008619143 MYLANTA-II SUSP 360 000008.01
PHAR 000008619144 MYLANTA 150 ML 000003.51
PHAR 000008619145 MYLANTA-II 150 ML 000004.57
PHAR 000008619146 ALUMINUM HYDROX SUS 000005.20
PHAR 000008619147 ALTERNAGEL 150 ML 000004.60
PHAR 000008619148 CALCIUM CARBONATE/GLY PO 000007.85
PHAR 000008619149 MAGALDRATE 108MG/ML SUS 000008.88
PHAR 000008619150 ALUM HYDROX/MAGNESIUM SUS 000009.58
PHAR 000008619151 MAALOX-TC 12 OZ 000010.39
PHAR 000008619152 POLY-VI-FLOR 0.25MG 000018.66
PHAR 000008619154 GOLYTELY 4000 ML 000017.45
PHAR 000008619156 HCTZ SOL 10MG/ML 90ML 000013.27 250
PHAR 000008619158 HYOSCYAMINE SULF 15ML 0.125MG 000027.48 250
PHAR 000008619161 "CHARCOAL,ACTIVA. 50GM" 208.3M 000015.12 250
PHAR 000008619162 "CHARCOAL,ACTIVAT 25GM" 208.3M 000012.34 250
PHAR 000008619164 SODIUM POLYST UD BTL 0.25GM SU 000031.14 250
PHAR 000008619167 PRELONE1DOSE 3MG/ML SYR 000008.40 250
PHAR 000008619172 MEGESTROL SUSP 240ML 000151.87 250
PHAR 000008619176 NEORAL 50ML SOL 100MG/ML 000638.99 250
PHAR 000008619179 MESORIDAZINE CONC LIQ 25M 000096.37 250
PHAR 000008619184 ALUMINUM HYDROX SUSP SUS 000013.33 250
PHAR 000008619186 PREDNISOLONE BTL 1MG SYR 000030.86 250
PHAR 000008619187 CYCLOSPORINE(SANG) SOL 100 000611.76 250
PHAR 000008619188 PREDNISOLONE BTL 3MG SYR 000130.58 250
PHAR 000008619190 RISPERIDONE SOL 30ML 000181.26 250
PHAR 000008619191 LORATADINE BTL SYR 1MG 000046.39 250
PHAR 000008619198 CIPRO SUS 50MG/ML 100ML 000145.66 250
9/7/2010 11:52 AM Page 218 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008619199 CIPRO SUS 100MG/ML 100ML 000170.33 250
PHAR 000008619200 CHILD'S BENADRYL 118ML 000009.01 250
PHAR 000008620001 CHORIONIC GONADOTROPI 500 U IN 000141.60
PHAR 000008620002 ACHROMYCIN IV 500 MG 000087.00
PHAR 000008620003 ANA BEESTING KIT 000023.45
PHAR 000008620004 ACHROMYCIN IM 250 MG 000060.00
PHAR 000008620005 CORTICOTROPIN 40U GEL IM 000141.60
PHAR 000008620006 AMIKACIN 500MG INJ 250 000237.60
PHAR 000008620007 PHYSOSTIGMINE SALICYL 1MG INJ 000066.00
PHAR 000008620008 BICILLIN C-R 2.4MMU 600000UN 000126.00
PHAR 000008620009 CYTOSAR U VIA 100MG/ 000033.00
PHAR 000008620010 METHYLPREDNISOLONE AC 80MG INJ 000060.00
PHAR 000008620011 CHORIONIC GONADOTROPI 1000 U I 000495.72
PHAR 000008620012 ACHROMYCIN IM 100 MG 000033.00
PHAR 000008620013 CORTICOTROPIN 40U IM 000157.20
PHAR 000008620014 CORTICOTROPIN 80U GEL IM 000192.00
PHAR 000008620015 PENICILLIN G BENZATH SYR 600 000048.00
PHAR 000008620016 CYTOSAR-U VIA 500MG/ 000109.00
PHAR 000008620017 METHYLPREDNISOLONE AC 80MG INJ 000172.80
PHAR 000008620018 IMMUNE GLOBULIN 16.50% INJ 000002.16
PHAR 000008620019 HEPARIN SODIUM 100 U IV 000017.40
PHAR 000008620020 SKIN TEST-HISTOPLAS 0.1ML INJ 000009.60
PHAR 000008620021 CHORIONIC GONADOTROPI 5000 U I 000874.54
PHAR 000008620022 ACHROMYCIN IV 250 MG 000060.00
PHAR 000008620023 ACTHAR 25 U/1 ML VIA 000077.00
PHAR 000008620024 AMINOPHYLLINE 25MG INJ 000022.80
PHAR 000008620025 PENICILLIN G BENZATH SYR 600 000141.60
PHAR 000008620026 SODIUM BICARB SYR 1MEQ SYR 000111.60
PHAR 000008620027 NEOSAR VIA 100MG 000029.00
PHAR 000008620028 MEDROXYPROGESTERONE 400MG INJ 000922.98
PHAR 000008620029 FUROSEMIDE 20MG INJ 000017.40
PHAR 000008620030 GAMIMUNE VIA 50 ML 000286.00
PHAR 000008620031 "UROKINASE 250,000U " 500000U 001242.61
PHAR 000008620032 AMINOPHYLL 500MG/20M 000018.00
PHAR 000008620033 BICNU 100MG INJ 000274.82
PHAR 000008620034 SOD BICARB SYR 5MEQ 000046.00
PHAR 000008620035 SERENTIL 25 MG/1 ML 000024.00
PHAR 000008620036 TESTOSTERONE CYPIONAT 100MG IN 000172.80
PHAR 000008620037 FUROSEMIDE 40MG INJ 000017.40
PHAR 000008620038 HEPARIN 10,000/ML 4M 000033.00
PHAR 000008620039 SKIN TEST-TRICHOPHYT INJ 000009.60
PHAR 000008620040 DOPAMINE AMP 200 MG 000033.00
PHAR 000008620041 UROKINASE OPEN-CATH INJ 500 000237.60
PHAR 000008620042 BLEOMYCIN 15U INJ 000827.54
PHAR 000008620043 SODIUM BICARB SYR PED 1MEQ SYR 000086.40
PHAR 000008620044 NAVANE 5MG/ML 2 ML V 000022.00
PHAR 000008620045 MEDROXYPROGESTERONE 400MG INJ 000297.68
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008620046 DEFEROXAMINE MES VIAL 500MG IV 000066.00
PHAR 000008620047 FUROSEMIDE 100MG INJ 000066.00
PHAR 000008620048 GENTAMICIN 20MG INJ 000017.40
PHAR 000008620049 HEPARIN SODIUM 10000U SYR 000020.40
PHAR 000008620050 INAPSINE 2.5MG/ML 5M 000046.00
PHAR 000008620051 AMMONIUM CL VIAL 5MEQ INJ 000038.40
PHAR 000008620052 TORADOL SYR 60MG/2ML 000037.00
PHAR 000008620053 MEDROXYPROGESTERONE 100MG INJ 000217.20
PHAR 000008620054 DEXTROSE 50% VIAL 0.5GM IV 000031.80
PHAR 000008620055 GENTAMICIN 80MG INJ 000017.40
PHAR 000008620056 HEPARIN 1000 U/ML 10 000016.00
PHAR 000008620057 PROPRANOLOL HCL INJ 1MG 000038.40
PHAR 000008620058 DOPAMINE SYR 200 MG 000042.00
PHAR 000008620059 MUMPS VIRUS VACCINE L 1 DOSE I 000098.40
PHAR 000008620060 PONTOCAINE AMP 0.2% 000018.00
PHAR 000008620061 SUCCINYLCHOLINE VIAL 500MG IV 000060.00
PHAR 000008620062 ANTIVENIN INJ 10ML 001738.80
PHAR 000008620063 TERBUTALINE SULFATE 1MG INJ 000017.40
PHAR 000008620064 MAGNESIUM SULFATE SYR 50 000060.00
PHAR 000008620065 DIHYDROERGOTAMINE MES 1MG INJ 000066.00
PHAR 000008620066 ESTRADIOL/TESTOSTERON INJ 000048.00
PHAR 000008620067 ACETAZOLAMIDE VIAL 500MG INJ 000157.20
PHAR 000008620068 GENTAMICIN 800MG/20ML INJ 000075.60
PHAR 000008620069 HEPARIN SODIUM VIAL 1000U IV 000025.80
PHAR 000008620070 INDIGOTINDISULFONATE 8MG INJ 000075.60
PHAR 000008620071 SUCCINYLCHOLINE 10ML 20MG IV 000028.80
PHAR 000008620072 HYDRALAZINE 20MG INJ 000020.40
PHAR 000008620073 INTROPIN 200 MG SYR 000098.00
PHAR 000008620074 DANTROLENE 20MG VIAL 0.286MG I 000237.60
PHAR 000008620075 DEPO-TESTADIOL 10ML 000098.00
PHAR 000008620076 HEPARIN SODIUM 20000U IV 000031.80
PHAR 000008620077 TRIAMCINOLONE ACETONI 40MG INJ 000042.00
PHAR 000008620078 LEUCOVORIN CALCIUM 50MG INJ 000237.60
PHAR 000008620079 MECHLORETHAMINE HCL 0.5MG 000075.60
PHAR 000008620080 TETRACAINE HCL 1% INJ 000042.00
PHAR 000008620081 ADRENALIN AMP 1:1000 000012.00
PHAR 000008620082 PHYTONADIONE 2MG INJ 000022.80
PHAR 000008620083 BRETYLIUM 500 MG VIAL 50MG INJ 000038.40
PHAR 000008620084 CALCIUM CHLOR10%(SYR) 10%/ML S 000075.60
PHAR 000008620085 NANDROLONE DECANOATE 100MG INJ 000141.60
PHAR 000008620086 GLUCAGON 1MG INJ 000192.00
PHAR 000008620087 HEPARIN SODIUM 1000 U IV 000048.00
PHAR 000008620088 PREDNISOLONE TEBUTATE 20MG SUS 000042.00
PHAR 000008620089 DOPAMINE 400MG/10 ML 000052.00
PHAR 000008620090 KETAJECT 10MG/ML 50M 000068.00
PHAR 000008620091 EPINEPHRINE HCL VIAL 1MG INJ 000066.00
PHAR 000008620092 THIAMINE HCL 100MG INJ 000017.40
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008620093 AQUA MEPHYTON 25MG 000020.00
PHAR 000008620094 BUMETANIDE 0.5MG VIAL 0.25MG I 000020.40
PHAR 000008620095 DOPAMINE HCL 400 SYRI 40MG IV 000054.00
PHAR 000008620096 NANDROLONE DECANOATE 50MG INJ 000042.00
PHAR 000008620097 TESTOSTERONE CYPIONAT 200MG IN 000237.60
PHAR 000008620098 PHENYTOIN INJ 50MG/ML 000020.40
PHAR 000008620099 HEPATITIS B IMMUNE GL INJ 002059.64
PHAR 000008620100 HEPATITIS B VIRUS VAC 20MCG IN 000539.65
PHAR 000008620101 CALCITONIN 200IU INJ 000192.00
PHAR 000008620102 EPINEPHRINE HCL 0.1MG/ML SYR 000086.40
PHAR 000008620103 DEXAMETHASONE INJ 24MG INJ 000386.75
PHAR 000008620104 PHENYTOIN SODIUM 50MG INJ 000028.80
PHAR 000008620105 HALOPERIDOL 5MG INJ 000054.00
PHAR 000008620106 DOPAMINE 800 MG/5 ML 000068.00
PHAR 000008620107 KETAMINE HCL 10ML VIA 50MG INJ 000129.60
PHAR 000008620108 LEUCOVORIN CALCIUM 100MG INJ 000066.00
PHAR 000008620109 MITOMYCIN 5MG INJ 000445.64
PHAR 000008620110 POTASSIUM ACETATE INJ 2ME 000028.80
PHAR 000008620111 DOXORUBICIN 10MG INJ 000217.20
PHAR 000008620112 AQUA MEPHYTON 50MG 000077.00
PHAR 000008620113 CA CHLORIDE 1 GM SYR 000052.00
PHAR 000008620114 DIPTH/TETANUS PEDS 000022.80
PHAR 000008620115 DOPAMINE HCL 800 SYRI 80MG IV 000192.00
PHAR 000008620116 MITOMYCIN 20MG INJ 001153.87
PHAR 000008620117 POTASSIUM CHLORIDE INJ 2ME 000042.00
PHAR 000008620118 POTASSIUM PHOSPHATE INJ 3MM 000111.60
PHAR 000008620119 ALPROSTADIL 500MCG INJ 000550.24
PHAR 000008620120 PASS MEDS FEE 000005.00
PHAR 000008620121 DOXORUBICIN 50MG INJ 000717.60
PHAR 000008620122 CALCIUM CHLOR10%(MG) 100MG INJ 000017.40
PHAR 000008620123 MAG SULFATE SYR 5 GM 000052.00
PHAR 000008620124 ESTRADIOL/TESTOSTERON INJ 000172.80
PHAR 000008620125 CHLOROTHIAZIDE 500MG INJ 000060.00
PHAR 000008620126 HEPARIN SODIUM 100U IV 000017.40
PHAR 000008620127 DECADRON INJ 4MG/ML 1ML 000017.40
PHAR 000008620128 PREDNISOLONE TEBUTATE 20MG SUS 000126.00
PHAR 000008620130 NOREPINEPHRINE BITART INJ 1MG 000111.60
PHAR 000008620131 PHYTONADIONE 10MG INJ 000034.80
PHAR 000008620132 LIDOCAINE 50MG 1% SYR 000075.60
PHAR 000008620133 DELALUTIN INJ 250MG 000052.00
PHAR 000008620134 DOBUTAMINE HCL VIAL 12.5MG IV 000228.00
PHAR 000008620135 HEPARIN SODIUM 10U IV 000017.40
PHAR 000008620136 DEXAMETHASONE 4MG INJ 000022.80
PHAR 000008620137 DIGOXIN 0.25MG INJ 000020.40
PHAR 000008620138 METOPROLOL INJ 5MG/5ML 000042.00
PHAR 000008620139 PRE-PEN AMP 000042.00
PHAR 000008620140 PROTAMINE SULF 50MG 10MG INJ 000048.00
9/7/2010 11:52 AM Page 221 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008620141 ALCOHOL ABSOLUTE,USP INJ 99% 000075.60
PHAR 000008620142 ARALEN 250MG/5ML 000042.00
PHAR 000008620143 DEXTROSE 50% SYR 50% SYR 000111.60
PHAR 000008620144 DELALUTIN 250/ML 5ML 000133.00
PHAR 000008620145 DIMENHYDRINATE 50MG INJ 000020.40
PHAR 000008620146 HEXADROL 10MG/ML 10M 000109.00
PHAR 000008620147 LANOXIN 0.1MG/ML 1ML 000016.00
PHAR 000008620148 LORFAN 1 MG/1 ML 000014.00
PHAR 000008620149 PREDNISOL 25M/ML 10M 000022.00
PHAR 000008620150 PROTAMINE SULF 250MG 10MG INJ 000126.00
PHAR 000008620151 METHYLDOPATE HCL 50MG INJ 000034.80
PHAR 000008620152 DELALUTIN 125/M 10ML 000143.00
PHAR 000008620153 DACARBAZINE 100MG INJ 000086.40
PHAR 000008620154 HISTALOG AMP 50 MG 000012.00
PHAR 000008620155 HYDROXYZINE HCL VIAL 50MG IM 000017.40
PHAR 000008620156 VERAPAMIL HCL VIAL 2.5MG INJ 000025.80
PHAR 000008620157 PROPIOMAZINE HCL 20MG INJ 000034.80
PHAR 000008620158 MMR II INJ 000042.00
PHAR 000008620159 GOLD SODIUM THIOMALAT 50MG INJ 000352.94
PHAR 000008620160 "ESTROGENS, CONJ 25MG " 5MG IN 000141.60
PHAR 000008620161 AMINOCAPROIC ACID 250MG IV 000048.00
PHAR 000008620162 ARAMINE VIA 1 % 000042.00
PHAR 000008620163 EPINEPHRINE HCL 0.1MG/ML SYR 000075.60
PHAR 000008620164 TESTOSTERONE ENANTHAT 200MG IN 000217.20
PHAR 000008620165 HISTAMINE PHOSPHATE PO 000025.80
PHAR 000008620166 HYPERTET 250 U INJ 000029.00
PHAR 000008620167 ISOPROTERENOL HCL AMP INJ 200 000028.80
PHAR 000008620168 LARGON 20MG/ML 2ML 000020.00
PHAR 000008620169 MVI-12 VIALS IV 000025.80
PHAR 000008620170 MYOCHRYSINE 50MG/ML 000042.00
PHAR 000008620171 TRIMETHAPHAN CAMSYLAT 50MG INJ 000157.20
PHAR 000008620172 HISTAMINE 0.275MG/ML 000016.00
PHAR 000008620173 RABIES IMMUNE GLOB 2M 150U INJ 000361.12
PHAR 000008620174 ISOPROTERENOL HCL AMP 200MCG I 000111.60
PHAR 000008620175 NALOXONE HCL AMP 0.4MG INJ 000048.00
PHAR 000008620176 PRISCOLINE 25/ML 10M 000068.00
PHAR 000008620177 TRIAMCINOLONE DIACETA 40MG INJ 000048.00
PHAR 000008620178 ESTRADIOL VAL 100MG 20MG INJ 000206.40
PHAR 000008620179 TORADOL SYR 30 MG/1 000037.00
PHAR 000008620180 DIAZOXIDE 300MG INJ 000237.60
PHAR 000008620181 TRIAMCINOLONE ACETONI 10MG INJ 000048.00
PHAR 000008620182 FLUPHENAZINE INJ 2.5 000237.60
PHAR 000008620183 QUINIDINE GLUC 800MG/10ML INJ 000086.40
PHAR 000008620184 PHENOBARBITAL 130MG INJ 000019.20
PHAR 000008620185 TRIAMCINOLONE DIACETA 40MG SUS 000086.40
PHAR 000008620186 EDETATE CALCIUM DISOD 200MG IN 000172.80
PHAR 000008620187 ESTRADIOL VAL 200MG 40MG INJ 000263.09
9/7/2010 11:52 AM Page 222 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008620188 DACARBAZINE 200MG INJ 000141.60
PHAR 000008620189 GENTAMICIN INTRATHEC 2MG INJ 000025.80
PHAR 000008620190 TRIAMCINOLONE ACETONI 40MG INJ 000141.60
PHAR 000008620191 MVI PEDS VIAL IV 000054.00
PHAR 000008620192 NALOXONE NEO 0.02MG/ 000024.00
PHAR 000008620193 FLUPHENAZINE DECANOAT INJ 25M 000217.20
PHAR 000008620194 QUINIDINE SULF 200MG INJ 000025.80
PHAR 000008620195 ARISTOCORT INTRAL 25 000098.00
PHAR 000008620196 CALCIUM GLUCON10%(MG) 100MG IN 000020.40
PHAR 000008620197 ESTRADIOL VAL 50MG 10MG INJ 000172.80
PHAR 000008620198 ETHACRYNATE SOD 50MG INJ 000126.00
PHAR 000008620199 SKIN TEST-CANDIDA 0.1ML INJ 000009.60
PHAR 000008620200 MAGNESIUM SULFATE INJ 500 000017.40
PHAR 000008620201 PHENYLEPHRINE HCL 10MG INJ 000054.00
PHAR 000008620202 FLUPHENAZINE ENANTHAT INJ 25M 000377.14
PHAR 000008620203 PHENTOLAMINE 10MG INJ 000157.20
PHAR 000008620204 TRIAMCINOLONE HEXACET 20MG SUS 000126.00
PHAR 000008620205 INDOCYANINE GREEN 25MG INJ 000141.60
PHAR 000008620206 ESTRADIOL VAL 20MG 20MG INJ 000098.40
PHAR 000008620207 AMITRIPTYLINE INJ 10MG 000060.00
PHAR 000008620208 MANNITOL 25% INJ 50ML 000042.00
PHAR 000008620209 PROCAINAMIDE 1GM INJ 000075.60
PHAR 000008620210 REGLAN 10MG/2ML 10ML 000042.00
PHAR 000008620211 PHENOBARBITAL 65MG INJ 000019.20
PHAR 000008620212 LORAZEPAM INJ 4MG 000481.46
PHAR 000008620213 BETAMETHASONE SODIUM 3MG INJ 000086.40
PHAR 000008620214 ESTRADIOL CYPIONATE 5MG INJ 000098.40
PHAR 000008620215 ASPARAGINASE INJ 100 000228.00
PHAR 000008620216 NITROGLYCERIN 50MG 5MG INJ 000075.60
PHAR 000008620217 PROCAINAMIDE 1GM INJ 000075.60
PHAR 000008620218 METHYLPREDNISOLONE AC 40MG INJ 000038.40
PHAR 000008620219 SKIN TEST-COCCI 0.1ML SQ 000012.00
PHAR 000008620220 BUPIVACAINE 0.25/50M 000037.00
PHAR 000008620221 NITROGLYCERIN 25MG V 000098.00
PHAR 000008620222 NEOSTIGMINE METHYLSUL 0.25MG 000017.40
PHAR 000008620223 METOCLOPRAMIDE HCL 5MG INJ 000022.80
PHAR 000008620224 ATROPINE 0.5 MG 0.1MG SYR 000075.60
PHAR 000008620225 CELESTONE SOLUSPAN 6MG INJ 000126.00
PHAR 000008620226 METHYLPREDNISOLONE AC 40MG INJ 000126.00
PHAR 000008620227 EMETE-CON VIA 50 MG 000027.00
PHAR 000008620228 SKIN TEST-TUBERCULIN 25U INJ 000009.60
PHAR 000008620229 BUPIVACAINE 0.25/50 000033.00
PHAR 000008620230 VECURONIUM 10MG VIAL 1MG INJ 000141.60
PHAR 000008620231 NEOSTIGMINE METHYLSUL 0.5MG IN 000020.40
PHAR 000008620232 REGONOL 2ML AMP 000012.00
PHAR 000008620233 ATROPINE SYR 1MG/10M 000046.00
PHAR 000008620234 EPHEDRINE AMPS 50MG INJ 000017.40
9/7/2010 11:52 AM Page 223 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008620235 SKIN TEST-TUBERCULIN 5U INJ 000009.60
PHAR 000008620236 NORFLEX 30MG/ML 2ML 000033.00
PHAR 000008620237 NEOSTIGMINE METHY 10M 0.5MG IN 000075.60
PHAR 000008620238 METHOCARBAMOL 100MG INJ 000038.40
PHAR 000008620239 ESTRADURIN VIA 40 MG 000120.00
PHAR 000008620240 ATROP,BREVIT,ANECT 000040.00
PHAR 000008620241 BUPIVACAINE 0.5/30 000029.00
PHAR 000008620242 PROCAINE HCL 2% 000028.80
PHAR 000008620243 SKIN TEST-TUBERCULIN 1U INJ 000009.60
PHAR 000008620244 GLYCOPYRROLATE INJ 0.2 000075.60
PHAR 000008620245 ATROPINE 0.4MG INJ 000017.40
PHAR 000008620246 FLUORESCEIN 10% 000075.60
PHAR 000008620247 SKIN TEST-ASPERGILLUS INJ 000012.00
PHAR 000008620248 PROCAINE HCL 1% INJ 000086.40
PHAR 000008620249 SKIN TEST-MUMPS ANTIG INJ 0.1 000009.60
PHAR 000008620250 ROBINUL 0.2MG/ML 1ML 000012.00
PHAR 000008620251 ATROPINE 0.3MG INJ 000017.40
PHAR 000008620252 FLUOROURACIL 500MG INJ 000020.40
PHAR 000008620253 VITAMIN A 50000U INJ 000126.00
PHAR 000008620254 BUPIVACAINE 0.5% MDV 5MG INJ 000060.00
PHAR 000008620255 NALBUPHINE 10MG INJ 000025.80
PHAR 000008620256 SANDIMMUNE 250MG INJ 000157.20
PHAR 000008620257 MEASLES VIRUS VACCINE 0.5ML IN 000086.40
PHAR 000008620258 DAUNORUBICIN 20MG INJ 000520.93
PHAR 000008620259 FOLIC ACID 5MG INJ 000086.40
PHAR 000008620260 MEPIVACAINE HCL 1% INJ 000066.00
PHAR 000008620261 BUPIVAC 0.75/30ML AM 000033.00
PHAR 000008620262 VINCRISTINE 1MG INJ 000172.80
PHAR 000008620263 SCOPOLAMINE SDV 0.3MG INJ 000020.40
PHAR 000008620264 BACITRACIN 50000U INJ 000066.00
PHAR 000008620265 CEVALIN AMP 500 MG 000012.00
PHAR 000008620266 FUDR 0.5 GM VIAL 000241.46
PHAR 000008620267 MEPIVACAINE HCL 1.50% INJ 000086.40
PHAR 000008620268 MAREZINE AMP 50 MG/M 000012.00
PHAR 000008620269 PAPAVERINE 60MG/2ML 000012.00
PHAR 000008620270 SECRETIN VIAL 75U INJ 000667.27
PHAR 000008620271 SEPTRA INJ 000018.00
PHAR 000008620272 ASCORBIC ACID 500MG INJ 000025.80
PHAR 000008620273 AMPHOTERICIN B INJ 5MG 000141.60
PHAR 000008620274 MERUVAX II PKG 1 DOS 000077.00
PHAR 000008620275 PARALDEHYDE 5ML AMP 000014.00
PHAR 000008620276 MEPIVACAINE HCL 2% INJ 000075.60
PHAR 000008620277 SEPTRA 20 ML VIAL 000052.00
PHAR 000008620278 CHOLERA VACCINE 1.5ML INJ 000060.00
PHAR 000008620279 PYRIDOSTIGMINE BROMID 5MG INJ 000017.40
PHAR 000008620280 PAVULON 2MG/ML 2ML 000029.00
PHAR 000008620281 SODIUM ACETATE VIAL 2MEQ INJ 000034.80
9/7/2010 11:52 AM Page 224 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008620282 SEPTRA 10 ML VIAL 000029.00
PHAR 000008620283 CHYMODIACTIN 10000 U 001328.13
PHAR 000008620284 METHYLERGONOVINE 0.2MG INJ 000025.80
PHAR 000008620285 PAVULON 2MG/ML 5ML 000060.00
PHAR 000008620286 SODIUM BICARB VIAL 1MEQ 000048.00
PHAR 000008620287 METHOTREXATE 20MG IV 000046.00
PHAR 000008620288 PANCURONIUM BR 10MG 1MG INJ 000086.40
PHAR 000008620289 SODIUM CL VIAL 2.5MEQ IV 000025.80
PHAR 000008620290 BENZTROPINE INJ 1MG 000048.00
PHAR 000008620291 METHOTREXATE 50MG VI 000068.00
PHAR 000008620292 SODIUM CL BACTER 10ML 0.90% IV 000017.40
PHAR 000008620293 COLCHICINE 1MG/2ML 0.5MG INJ 000028.80
PHAR 000008620294 METHYLENE BLUE 1% INJ 000048.00
PHAR 000008620295 COMPAZINE 10MG/2ML 000018.00
PHAR 000008620296 METHYLENE BLUE 1% INJ 000075.60
PHAR 000008620297 PERCORTEN PI 25MG/ML 000133.00
PHAR 000008620298 DIGOXIN IMMUNE 38MG INJ 001843.13
PHAR 000008620299 CORTEF 50MG/ML 5ML 000077.00
PHAR 000008620300 METOCURINE IODIDE 2MG INJ 000141.60
PHAR 000008620301 PERGONAL 75 U/2 ML 000158.00
PHAR 000008620302 CORTISONE ACETATE 50MG INJ 000141.60
PHAR 000008620303 METHOTREXATE 20MG INJ 000025.80
PHAR 000008620304 CORTROSYN 0.25MG/ML 000046.00
PHAR 000008620305 METHOTREXATE 50MG INJ 000086.40
PHAR 000008620306 DIMERCAPROL 100MG INJ 000172.80
PHAR 000008620307 DACTINOMYCIN 0.5MG INJ 000075.60
PHAR 000008620308 SECRETIN-KABI 10U/ML 000214.50
PHAR 000008620309 PLICAMYCIN 2.5MG INJ 000282.07
PHAR 000008620310 PHENERGAN 50MG/ML AM 000012.00
PHAR 000008620311 SOD IODIADE 1GM AMP 000014.00
PHAR 000008620312 DIPHENHYDRAMINE VIAL 50MG INJ 000017.40
PHAR 000008620313 COUMADIN VIA 50 MG 000042.00
PHAR 000008620314 HEPATITIS B VIRUS VAC 10MCGG I 000562.30
PHAR 000008620315 MICONAZOLE 200MG 10MG INJ 000192.00
PHAR 000008620316 PHENERGAN 25MG/ML AM 000012.00
PHAR 000008620317 SODIUM PHOS VIAL INJ 3MM 000025.80
PHAR 000008620318 DICYCLOMINE HCL AMP 10MG INJ 000086.40
PHAR 000008620319 OXYTOCIN VIA 10 U/ML 000012.00
PHAR 000008620320 CRYSTODIGIN 0.2MG/ML 000012.00
PHAR 000008620322 PITRESSIN TANNATE 5U 000020.00
PHAR 000008620323 SOLGANAL 50MG/ML 10 000205.76
PHAR 000008620324 BEROCCA AMP 000016.00
PHAR 000008620325 VASOPRESSIN 20U 000054.00
PHAR 000008620326 BIAVAX II PKG 1 DOSE 000109.00
PHAR 000008620327 PITUITRIN S 20U/ML 000042.00
PHAR 000008620328 BICILLIN C-R 1.2MMU 600000UN 000060.00
PHAR 000008620329 PENICILLIN G PROCAINE 6000000 000031.80
9/7/2010 11:52 AM Page 225 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008620330 CISPLATIN 10MG INJ 000172.80
PHAR 000008620331 CISPLATIN 50MG INJ 000530.64
PHAR 000008620332 HYDROCORT NA (.1) INJ 50M 000022.80
PHAR 000008620333 BICILLIN CR 600MU 600000UN SYR 000038.40
PHAR 000008620334 RANITIDINE HCL 25MG INJ 000031.80
PHAR 000008620335 HYDROCORT NA (.25) INJ 125 000054.00
PHAR 000008620336 HYDROCORT NA (.5) INJ 125 000098.40
PHAR 000008620337 PNEUMOCOCCAL POLYSACC 0.5ML IN 000024.00
PHAR 000008620338 HYDROCORT NA (1) INJ 125 000141.60
PHAR 000008620339 DEXPANTHENOL VIAL 250MG INJ 000066.00
PHAR 000008620340 IRON DEXTRAN INJ 50M 000192.00
PHAR 000008620341 IMFERON 10 ML VIAL 000109.00
PHAR 000008620342 METHYLPRED NA INJ 62. 000141.60
PHAR 000008620343 RABIES VACCINE HUMAN INJ 000548.52
PHAR 000008620344 METHYLPRED NA INJ 125 000157.20
PHAR 000008620345 DROPERIDOL INJ 2.5 000042.00
PHAR 000008620346 METHYLPRED NA INJ 40M 000020.40
PHAR 000008620347 METHYLPRED NA INJ 62. 000042.00
PHAR 000008620348 SODIUM TETRADECYL AMP 1% INJ 000075.60
PHAR 000008620349 SODIUM TETRADECYL AMP 3% INJ 000086.40
PHAR 000008620350 PROMAZINE HCL 50MG INJ 000048.00
PHAR 000008620351 BUTORPHANOL 2MG VIAL 2MG INJ 000054.00
PHAR 000008620352 BUTORPHANOL 20MG VIAL 2MG INJ 000247.20
PHAR 000008620353 BUTORPHANOL 1MG VIAL 1MG INJ 000048.00
PHAR 000008620354 STELAZINE 2MG/ML 10M 000120.00
PHAR 000008620355 DIETHYLSTILBESTROL DI 50MG INJ 000086.40
PHAR 000008620356 STREPTOKINASE 250K VI 250000U 000386.42
PHAR 000008620357 STREPTOKINASE 750K U 0.75MU IV 000739.16
PHAR 000008620358 STREPTOMYCIN 1 GM VIA 1GM 000022.80
PHAR 000008620359 EPINEPHRINE 5MG INJ 000157.20
PHAR 000008620360 EPINEPHRINE 5MG INJ 000025.80
PHAR 000008620361 LEVOTHYROXINE VIAL 500MCG INJ 000172.80
PHAR 000008620362 LEVOTHYROXINE VIAL 200MCG INJ 000048.00
PHAR 000008620363 SYNTHROID 100MCG VIA 000109.00
PHAR 000008620364 CIMETIDINE 300MG INJ 000034.80
PHAR 000008620365 EDROPHONIUM 10MG INJ 000034.80
PHAR 000008620366 EDROPHONIUM 10MG INJ 000126.00
PHAR 000008620367 TESTOSTERONE PROPIONA 100MG IN 000042.00
PHAR 000008620368 TESTOSTERONE 100MG INJ 000048.00
PHAR 000008620369 TESTOSTERONE 50MG INJ 000034.80
PHAR 000008620370 TESTOSTERONE 25MG INJ 000025.80
PHAR 000008620371 TETANUS/DIPHTHER INJ 000024.00
PHAR 000008620372 TETANUS TOXOID ADSORB 5ML INJ 000086.40
PHAR 000008620373 TETANUS TOXOID ADSORB 0.5ML SY 000025.80
PHAR 000008620374 ESTRONE 20MG 2MG INJ 000126.00
PHAR 000008620375 THIAMINE 100MG/ML 30 000018.00
PHAR 000008620376 THIOTEPA 15MG INJ 000322.30
9/7/2010 11:52 AM Page 226 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008620377 THORAZINE 25MG/ML 1M 000014.00
PHAR 000008620378 THORAZINE 50MG/2ML 000016.00
PHAR 000008620379 PROTIRELIN 500MCG INJ 000141.60
PHAR 000008620380 TRIMETHOBENZAMIDE 200MG INJ 000031.80
PHAR 000008620381 IMIPRAMINE 25MG INJ 000022.80
PHAR 000008620382 TORECAN 10MG/2ML AMP 000016.00
PHAR 000008620383 ATRACURIUM BESYALTE 10MG INJ 000141.60
PHAR 000008620385 TRIDIL AMP 5 MG/ML 000052.00
PHAR 000008620386 CARBOPROST TROMETHAM 250MCG IN000157.20
PHAR 000008620387 E-FEROL VIAL 10 ML 000029.00
PHAR 000008620388 NACL 0.9% BACT. 30ML 000012.00
PHAR 000008620389 PITOCIN INJ 10U 000017.40
PHAR 000008620390 HEPARIN 10000/ML 4ML 000052.00
PHAR 000008620391 HEPARIN SODIUM 10000U SQ 000025.80
PHAR 000008620392 HEPARIN SODIUM 1000U IV 000017.40
PHAR 000008620393 DIGOXIN 0.1MG INJ 000038.40
PHAR 000008620394 AMPICILLIN 125MG INJ 000016.00
PHAR 000008620395 AMPICILLIN VIAL 250MG INJ 000020.40
PHAR 000008620396 AMPICILLIN INJ 500MG VL 000017.40
PHAR 000008620397 AMPICILLIN VIAL 1GM INJ 000025.80
PHAR 000008620398 AMPICILLIN VIAL INJ 2GM 000038.40
PHAR 000008620399 METHICILLIN SODIUM 1GM PO 000042.00
PHAR 000008620400 SCOPOLAMINE SDV 0.4MG INJ 000017.40
PHAR 000008620401 CYANOCOBALAMIN 100MCG INJ 000020.40
PHAR 000008620402 CYANOCOBALAMIN 1000MCG INJ 000020.40
PHAR 000008620403 SODIUM CHLORIDE 0.90% IV 000025.80
PHAR 000008620410 ISOPROTERENOL HCL 200MCG SYR 000086.40
PHAR 000008620411 NALBUPHINE 20MG INJ 000022.80
PHAR 000008620412 RUBELLA VIR VAC/LIVE 1DOSE INJ 000075.60
PHAR 000008620413 DESMOPRESSIN ACET 4MCG INJ 000111.60
PHAR 000008620414 NITROPRUSSIDE-SODIUM 25MG INJ 000000.00
PHAR 000008620415 INSULIN - UNIT DOSE 000010.00
PHAR 000008620416 LABETALOL 100MG INJ 000172.80
PHAR 000008620417 INAMRINONE INJ 100MG/20ML 000247.20
PHAR 000008620418 GENTAMICIN 20 MG VIA 000014.00
PHAR 000008620419 KANAMYCIN 75MG/2 ML 000027.00
PHAR 000008620420 PENICILLIN G POTASS INJ 500 000017.40
PHAR 000008620421 PENICILLIN G POTASS 5MU INJ 000028.80
PHAR 000008620422 TOBRAMYCIN SULFATE 1.2GM PWD I 000393.36
PHAR 000008620423 BUMETANIDE 2.5MG VIAL 0.25MG I 000054.00
PHAR 000008620424 BUMETANIDE 1MG VIAL 0.25MG INJ 000025.80
PHAR 000008620425 WATER BACT INJ 30 ML 000012.00
PHAR 000008620426 LIDOCAINE/EPINEPHRINE 000034.80
PHAR 000008620427 HT FACTORATE 1000 U 000720.00
PHAR 000008620428 SANDOGLOBULIN INJ 3GM 000603.59
PHAR 000008620429 IMMUNE SERUM GLOBULIN 6GM INJ 000786.24
PHAR 000008620430 CEFAZOLIN 1GM INJ 000025.80
9/7/2010 11:52 AM Page 227 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008620431 AZATHIOPRINE 100MG INJ 000247.20
PHAR 000008620432 TOBRAMYCIN 80MG INJ 000054.00
PHAR 000008620433 PROMAZINE HCL 25MG INJ 000066.00
PHAR 000008620434 FLAGYL VIAL 500 MG 000060.00
PHAR 000008620436 LORAZEPAM INJ 2MG 000385.20
PHAR 000008620437 KETAMINE HCL 5ML VIA INJ 100 000129.60
PHAR 000008620438 VECURONIUM 20MG VIAL 1MG INJ 000206.40
PHAR 000008620439 LORAZEPAM INJ 2MG 000025.80
PHAR 000008620440 LORAZEPAM INJ 4MG 000098.40
PHAR 000008620441 FACTREL VIAL 100 MCG 000158.00
PHAR 000008620442 RIBAVIRINVIAL 6GM INH 002011.44
PHAR 000008620443 VIRAZOLE 3 G 000230.00
PHAR 000008620444 FLUOGEN 0.5 ML VIAL 000010.00
PHAR 000008620445 PROMAZINE HCL 50MG INJ 000157.20
PHAR 000008620446 DOXAPRAM HCL 20ML VIA 20MG IV 000206.40
PHAR 000008620447 CHLORAMPHENICOL 1 G 000024.00
PHAR 000008620448 SYNKAYVITE 10 MG AMP 000016.00
PHAR 000008620449 CEFTRIAXONE SODIUM 1GM INJ 000172.80
PHAR 000008620450 IMMUNE SERUM GLOBULIN 1GM INJ 000252.07
PHAR 000008620451 KETAMINE HCL 20ML VIA 10MG INJ 000068.40
PHAR 000008620453 DEXAMETHASONE VIAL 10MG INJ 000098.40
PHAR 000008620454 COMPAZINE INJ 5MG/ML 2ML 000025.80
PHAR 000008620455 PHENERGAN INJ 25MG/ML 1ML 000017.40
PHAR 000008620456 PROMETHAZINE HCL 50MG INJ 000017.40
PHAR 000008620457 EPINEPHRINE HCL AMP 1MG INJ 000017.40
PHAR 000008620458 CHLORPROMAZINE 50MG 25MG INJ 000017.40
PHAR 000008620459 CHLORPROMAZ 50MG/2ML 000012.00
PHAR 000008620460 PYRIDOXINE HCL 100MG INJ 000017.40
PHAR 000008620461 KANAMYCIN 1 GM/3 ML 000087.00
PHAR 000008620462 HT FACTORATE VIA 225 000179.00
PHAR 000008620463 HT FACTORATE 250 U 000317.85
PHAR 000008620464 HT FACTORATE VIA 325 000253.50
PHAR 000008620465 HT FACTORATE VIA 375 000292.50
PHAR 000008620466 HT FACTORATE VIA 550 000396.00
PHAR 000008620467 HT FACTORATE VIA 700 000234.00
PHAR 000008620468 MONOCID 1 GM/10 ML 000098.00
PHAR 000008620469 CEFTRIAXONE SODIUM 2GM INJ 000247.20
PHAR 000008620471 LUPRON INJ 2.8ML/KIT 000450.00
PHAR 000008620472 CLINDAMYCIN 600MG/4M 000068.00
PHAR 000008620473 CLINDAMYCIN 300MG 150MG INJ 000054.00
PHAR 000008620474 CLINDAMYCIN 900MG 150MG INJ 000126.00
PHAR 000008620475 VANCOMYCIN 500MG INJ 000054.00
PHAR 000008620476 EMBOLEX 0.7 ML AMP 000020.00
PHAR 000008620477 PEDIATRIC PAIN FORMU 000013.00
PHAR 000008620478 PRISCOLINE INJ 25MG/ML 000098.40
PHAR 000008620479 NITROPRUSSIDE NA VIAL 25MG INJ 000054.00
PHAR 000008620480 YUTOPAR 10 MG/ML 5ML 000087.00
9/7/2010 11:52 AM Page 228 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008620481 KINEVAC 5 MCG VIAL 000098.00
PHAR 000008620482 MAG SULF 50% 10 ML 000068.00
PHAR 000008620483 NALOXONE HCL 10ML VIA 0.4MG IN 000192.00
PHAR 000008620485 PROTROPIN 5 MG VIAL 000462.00
PHAR 000008620486 BUPIVAC 0.25/EPI 10M 000018.00
PHAR 000008620487 PENTAGASTRIN 0.25MG INJ 000172.80
PHAR 000008620488 MAGNESIUM SULFATE INJ 4.0 000017.40
PHAR 000008620489 M-PREDNISOLONE 40MG 000016.00
PHAR 000008620490 M-PREDNISOLONE 125MG 000033.00
PHAR 000008620491 GLYCOPYRROLATE INJ 0.2 000017.40
PHAR 000008620492 GLYCOPYRROL 1MG/5ML 000018.00
PHAR 000008620493 NEOSTIGMINE METHYLSUL 1MG INJ 000111.60
PHAR 000008620494 ATROPINE 20ML MDV 0.4MG INJ 000017.40
PHAR 000008620495 MUROMONAB CD3 INJ 1MG 002070.66
PHAR 000008620496 INTERFERN ALFA-2B-3 INJ 10M 000157.20
PHAR 000008620497 INTERFERN ALFA-2B-10 INJ 5MU 000358.38
PHAR 000008620498 CEFOTAXIME 1GM VIAL 1GM INJ 000075.60
PHAR 000008620499 PENICILLIN G BENZATH SYR 600 000075.60
PHAR 000008620500 HEPARIN SODIUM 10000U INJ 000054.00
PHAR 000008620501 HEPARIN LOCK 1/ML UD 000012.00
PHAR 000008620502 GLUCAGON 1 MG INJ 000192.00
PHAR 000008620507 METRODIN INJ 75IU/2 000165.00
PHAR 000008620508 ATIVAN INJ - UD 000025.00
PHAR 000008620509 PAVULON INJ - UD 000018.00
PHAR 000008620510 CIBACALCIN 0.5MG/ML 000037.00
PHAR 000008620511 DESMOPRESSIN ACET 10M 4MCG INJ 000610.49
PHAR 000008620512 METUBINE - UNIT DOSE 000018.00
PHAR 000008620513 DEXAMETH 10MG/ML UD 000016.00
PHAR 000008620514 BUPIVACAINE UNIT DOS 000014.00
PHAR 000008620515 ETIDRONATE DISODIUM 50MG 000247.20
PHAR 000008620516 DOPAMINE HCL 200 VIAL 40MG IV 000028.80
PHAR 000008620517 DOPAMINE HCL 400 VIAL 80MG IV 000042.00
PHAR 000008620518 AMIKACIN (STUDY) 000036.00
PHAR 000008620519 HEPATITIS B VAC PEDS INJ 20M 000141.60
PHAR 000008620521 "LATRODECTUS MACTANS, " 2.5ML 000141.60
PHAR 000008620523 FACTOR VIII 540 IU 000466.56
PHAR 000008620524 CHLORDIAZEPOXIDE AMP INJ 50M 000054.00
PHAR 000008620525 HALOPERIDOL DECANOATE 50MG INJ 000157.20
PHAR 000008620527 ALTEPLASE (TPA) 50MG 003795.00
PHAR 000008620528 CAFFEINE SODIUM 125MG INJ 000042.00
PHAR 000008620530 MONOCLATE 255 U 000379.44
PHAR 000008620531 ACTHAR HP GEL 40U/ML 000052.00
PHAR 000008620532 NEOMYCIN INJ 500 MG 000029.00
PHAR 000008620533 BUPIVACAINE 0.75/10M 000020.00
PHAR 000008620534 NESACAINE-CE 3% 30ML 000037.00
PHAR 000008620535 TOBRAMYCIN 20MG INJ 000031.80
PHAR 000008620544 LUPRON INJ KIT 5.6ML 000662.50
9/7/2010 11:52 AM Page 229 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008620545 NAFCILLIN 1GM VIAL 000038.40
PHAR 000008620546 METHOTREXATE 100MG INJ 000060.00
PHAR 000008620547 METHOTREXAT 250MG IN 000179.00
PHAR 000008620548 SOMATROPIN VIAL 5MG 000655.20
PHAR 000008620549 MITOXANTRONE 20MG INJ 001553.47
PHAR 000008620550 PENTAMIDINE 20MG INJ 000355.50
PHAR 000008620551 HEPATITIS B VIRUS VAC 10MCG IN 000237.60
PHAR 000008620552 ERGOTRATE INJ 0.2MG 000012.00
PHAR 000008620553 ESMOLOL HCL 2.5GM SOL 250 000274.52
PHAR 000008620554 LOXITANE INJ 50 MG/M 000029.00
PHAR 000008620555 CEFUROXIME 1.5GM VIAL 150MG IN 000086.40
PHAR 000008620556 CEFAMANDOLE 1 GM VIA 000042.00
PHAR 000008620557 BUPIVAC 0.5/EPI 30ML 000027.00
PHAR 000008620558 CEFOXITIN INJ 1 GM 000042.00
PHAR 000008620559 DOXYCYCLINE HYCLATE 10MG IV 000111.60
PHAR 000008620560 BUPIVACAINE 0.25/30M 000022.00
PHAR 000008620561 ETOMIDATE 40MG VIAL 2MG 000141.60
PHAR 000008620562 LIDOCAINE 1.5% 20 ML 000033.00
PHAR 000008620563 LIDOCAINE 1.5%/EPINEP 1.50% IN 000075.60
PHAR 000008620564 HEPARIN SODIUM 10U IV 000090.00
PHAR 000008620566 BUPIVAC 0.5/EPI 30ML 000027.00
PHAR 000008620567 CEFOXITIN INJ 2 GM 000077.00
PHAR 000008620568 BUPIVAC 0.25% 30ML A 000029.00
PHAR 000008620569 LIDO 1%/EPI 30ML AMP 000037.00
PHAR 000008620570 LIDOCAINE 1.5/20 AMP 000027.00
PHAR 000008620571 LIDOC 1.5/EPI 30ML A 000037.00
PHAR 000008620572 LIDOC 5/GLUC 7.5 2ML 000029.00
PHAR 000008620573 LIDOC 1% 30ML AMP ST 000033.00
PHAR 000008620574 LIDOCAINE 2% 5ML AMP 000020.00
PHAR 000008620575 BUTORPHANOL 4MG VIAL 2MG 000086.40
PHAR 000008620576 RABIES IMMU GLOB 10ML 150U INJ 002001.00
PHAR 000008620577 HEPATITIS B VIRUS VAC 10MCG IN 000192.00
PHAR 000008620580 ALTEPLASE (TPA) 20MG 001518.00
PHAR 000008620581 RITODRINE HCL VIAL 15MG 000337.50
PHAR 000008620582 ENALAPRIL VIAL 1.25MG INJ 000141.60
PHAR 000008620583 CEFUROXIME 750 MG 000042.00
PHAR 000008620584 BRETYLIUM 500MG 50MG SYR 000048.00
PHAR 000008620585 OCTREOTIDE ACETATE 0.5MG AMP 000192.00
PHAR 000008620586 OCTREOTIDE ACETATE 0.5MG AMP 000034.80
PHAR 000008620587 OCTREOTIDE ACETATE 0.1MG AMP 000054.00
PHAR 000008620588 ANTIHEMOPHILIC FACTOR SOL 1UN 000001.01 250
PHAR 000008620591 ANTIHEMOPHILIC FACTOR SOL 1UN 000001.25
PHAR 000008620594 FACTOR 8 (KOATE-HT) 000000.61
PHAR 000008620596 ANTIHEMOPHILIC FACTOR SOL 1UN 000001.12
PHAR 000008620601 FACTOR IX 000000.51
PHAR 000008620609 LABETALOL 200MG INJ 000237.60
PHAR 000008620612 ESMOLOL HCL 100 MG SOL 10M 000111.60
9/7/2010 11:52 AM Page 230 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008620613 INTERFERN ALFA-2B-25 INJ 5MU 000776.51
PHAR 000008620614 EPOETIN ALFA 2000U 000141.60
PHAR 000008620618 EPOETIN ALFA 10000U 000432.00
PHAR 000008620619 EPOETIN ALFA 4000U 000217.20
PHAR 000008620620 VARICELLA-ZOSTER IMMU 100U 000840.00
PHAR 000008620627 PIPERACILLIN SODIUM 2GM INJ 000075.60
PHAR 000008620628 ATROPINE 1MG INJ 000017.40
PHAR 000008620629 CEFAZOLIN 500MG INJ 000022.80
PHAR 000008620630 SKIN TEST-TETANUS INJ 000012.00
PHAR 000008620631 XYLOCAINE 2%/EPINEPH INJ 000075.60
PHAR 000008620632 ATROPINE 0.4MG/0.5ML 000012.00
PHAR 000008620633 HEPATITIS B VAC ADULT INJ 20M 000141.60
PHAR 000008620634 PYRIDOXINE HCL 100MG INJ 000022.80
PHAR 000008620635 DOPAMINE HCL 800 VIAL 160MG IV 000086.40
PHAR 000008620636 CALCITRIOL 1MCG INJ 000086.40
PHAR 000008620637 TRIFLUOPERAZINE HCL INJ 2MG 000025.80
PHAR 000008620638 ANTIHEMOPHILIC FACTOR INJ 1UN 000002.16
PHAR 000008620649 SODIUM CL 10ML SDV 0.90% IV 000017.40
PHAR 000008620653 PROLASTIN 000460.80
PHAR 000008620657 GAMIMUNE N 5% 10 ML 000151.00
PHAR 000008620658 GAMIMUNE N 5% 50 ML 000371.28
PHAR 000008620659 HYATE:C INJ 000000.00 250
PHAR 000008620663 LIDOCAINE 1% 0.3 ML 000006.00
PHAR 000008620666 PRALIDOXIME CL 1 GM 50MG INJ 000157.20
PHAR 000008620668 ANTIHEMOPHILIC FACTOR SOL 1UN 000001.26 250
PHAR 000008620672 KETOROLAC 60MG INJ 000060.00 250
PHAR 000008620673 KETOROLAC 30MG INJ 000060.00 250
PHAR 000008620676 ERYTHROMYCIN 1GM VIAL 50MG 000075.60 250
PHAR 000008620677 EPOETIN ALFA 3000U 000192.00 250
PHAR 000008620678 LIDOCAINE 2GM IV 200MG 000126.00 250
PHAR 000008620680 ISONIAZID INJ 100MG/ML 000098.40 250
PHAR 000008620684 ADENOSINE 6MG 3MG INJ 000141.60 250
PHAR 000008620685 NAFARELIN ACETATE 2MG NASL 000474.24 250
PHAR 000008620689 XYLOCAINE 1.5%EPINEPH INJ 000025.80 250
PHAR 000008620696 GALLIUM 25MG INJ 000369.58 250
PHAR 000008620697 ONDANSETRON 20ML INJ 2MG 000717.92 250
PHAR 000008620703 LIDOCAINE 100MG 2% SYR 000022.80 250
PHAR 000008620704 ATROPINE 0.5MG INJ 000017.40 250
PHAR 000008620707 HYALURONIDASE 150UU INJ 000048.00 250
PHAR 000008620708 NEUPOGEN INJ 300MCG/ML 000516.90 250
PHAR 000008620709 NEUPOGEN INJ 480MCG/1.6ML 000768.32 250
PHAR 000008620710 KETOROLAC 15MG INJ 000054.00 250
PHAR 000008620711 NALOXONE HCL 1MG VIAL 1MG INJ 000111.60 250
PHAR 000008620712 ANTIHEMOPHILIC FACTOR SOL 1UN 000001.67 250
PHAR 000008620719 DOXACURIUM CL 5ML VIA 1MG IV 000172.80 250
PHAR 000008620720 LEUCOVORIN CALCIUM 350MG INJ 000496.58 250
PHAR 000008620721 HEPARIN SODIUM 10U IV 000025.80 250
9/7/2010 11:52 AM Page 231 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008620723 HEPARIN SODIUM 100U IV 000028.80 250
PHAR 000008620731 IMMUNE GLOB 16.5% 2ML 000098.40 250
PHAR 000008620734 ETOMIDATE 20MG VIAL 2MG 000141.60 250
PHAR 000008620739 DIPRIVAN EML 10MG/ML 000098.40 250
PHAR 000008620741 BUPIVACAINE 0.5% AMP 5MG 000066.00 250
PHAR 000008620743 HEPATITIS B VIRUS VAC 20MCG IN 000141.60 250
PHAR 000008620744 ANTITHROMBIN III (HUM 1UNIT 000000.00 250
PHAR 000008620758 COAGULATION FACTOR IX 500UNITS 000000.00 250
PHAR 000008620787 ALTEPLASE (TPA) 100MG 007590.00 250
PHAR 000008620788 STREPTOKINASE 1.5MU V 1.5MU 001307.80 250
PHAR 000008620792 CEFTRIAXONE SODIUM 500MG INJ 000111.60 250
PHAR 000008620793 DILTIAZEM HCL VIAL 5MG INJ 000141.60 250
PHAR 000008620796 MEDROXYPROGESTERONE 150MG SUS 000192.00 250
PHAR 000008620797 TETANUS IMMUNE GLOBUL 250U INJ 000247.20 250
PHAR 000008620801 ANTIHEMOPHILIC FACTOR SOL 1UN 000001.08 250
PHAR 000008620802 HEP B IMM GLOB 1ML 000588.00 250
PHAR 000008620806 DIPRIVAN EML 10MG/ML 000192.00 250
PHAR 000008620808 INSULIN HUM(REG) UD SOL 1DO 000012.00 250
PHAR 000008620809 INSULIN HUM 70/30 1DOSE SUS SQ 000012.00 250
PHAR 000008620811 INSULIN HUMAN (L) SOL 100 000012.00 250
PHAR 000008620812 INSULIN, ZINC PORK-L SUS 100 000012.00 250
PHAR 000008620813 INSULIN, ZINC (L) SUS 100 000012.00 250
PHAR 000008620815 INSULIN HUMAN (NPH) SUS 100 000012.00 250
PHAR 000008620816 INSULIN, PORK (NPH) SUS 100 000012.00 250
PHAR 000008620817 INSULIN, (NPH) SUS 100 000012.00 250
PHAR 000008620819 INSULIN HUMAN (REG) SOL 100 000012.00 250
PHAR 000008620820 INSULIN, PORK (REG) SOL 100 000012.00 250
PHAR 000008620821 INSULIN, (REG) SOL 100 000012.00 250
PHAR 000008620822 INSULIN, PORK (REG) SOL 500 000012.00 250
PHAR 000008620824 INSULIN ULTRALENTE SUS 100 000012.00 250
PHAR 000008620837 HYOSCYAMINE SULF AMP 0.5MG INJ 000048.00 250
PHAR 000008620839 TORSEMIDEVIAL 10MG INJ 000031.80 250
PHAR 000008620840 TORSEMIDEVIAL 10MG INJ 000042.00 250
PHAR 000008620841 INSULIN HUM 50/50 1DOSE SUS SQ 000012.00 250
PHAR 000008620842 INTERFERN ALPHA-2B 5 10MU INJ 000217.20 250
PHAR 000008620846 ZIDOVUDINEVIAL 10MG INJ 000111.60 250
PHAR 000008620854 APROTININ VIAL 10000KIU INJ 000604.80 250
PHAR 000008620855 APROTININ VIAL 10000KIU INJ 001058.40 250
PHAR 000008620859 HEPATITIS B VACC SYR 20MCG INJ 000141.60 250
PHAR 000008620887 OPRELVEKIN 5MG INJ 000703.87 250
PHAR 000008620888 DIPRIVAN EML 10MG/ML 000270.00 250
PHAR 000008620896 DALTEPARIN SYR 500 000141.60 250
PHAR 000008620914 DEXAMETHASONE INJ 10M 000022.80 250
PHAR 000008620920 DALTEPARIN SYR 250 000098.40 250
PHAR 000008621001 SPECTINOMYCIN HCL VIA 4GM INJ 000157.20
PHAR 000008621002 TUBOCURARINE CHLORIDE 3MG INJ 000075.60
PHAR 000008621003 BETHANECHOL INJ INJ 5MG 000038.40
9/7/2010 11:52 AM Page 232 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008621004 IMITREX 6 MG VIAL 000120.00
PHAR 000008621005 VASOXYL 20MG/ML 1ML 000060.00
PHAR 000008621006 VINBLASTINE 10MG VIAL 1MG INJ 000192.00
PHAR 000008621007 ETOPOSIDE 100MG INJ 000336.56
PHAR 000008621008 VIDARABINE 200MG INJ 000237.60
PHAR 000008621009 "WATER, STER. 50ML VIA" INJ 000022.80
PHAR 000008621010 "WATER, STER. 10ML VIA" INJ 000017.40
PHAR 000008621011 WYAMINE 15MG/ML 10ML 000046.00
PHAR 000008621012 WYAMINE 30MG/ML 10ML 000068.00
PHAR 000008621013 PENICILLIN G PROCAINE 600000U 000075.60
PHAR 000008621014 PENICILLIN G PROCAINE 600000U 000038.40
PHAR 000008621015 PENICILLIN G PROCAINE 600000U 000025.80
PHAR 000008621016 HYALURONIDASE 150U INJ 000126.00
PHAR 000008621017 WYDASE 150 U/ML 10ML 000077.00
PHAR 000008621018 LIDOCAINE 1GM VIAL 40MG INJ 000020.40
PHAR 000008621019 LIDOCAINE 2GM VIAL 40MG INJ 000022.80
PHAR 000008621020 LIDOCAINE 0.50% MDV 000031.80
PHAR 000008621021 LIDOCAINE 1% MDV 000017.40
PHAR 000008621022 LIDOCAINE PF 1% AMP 000020.40
PHAR 000008621023 LIDOCAINE 1% 20 ML 000012.00
PHAR 000008621024 LIDOCAINE 2% MDV 000028.80
PHAR 000008621025 LIDOCAINE 2% MDV 000017.40
PHAR 000008621026 LIDOCAINE PF 2% AMP 000042.00
PHAR 000008621027 LIDOCAINE PF 2% AMP 000020.40
PHAR 000008621028 LIDOCAINE 1% MDV 000025.80
PHAR 000008621029 LIDOCAINE PF 1% AMP 000017.40
PHAR 000008621030 LIDOCAINE/EPINEPHRINE INJ 000017.40
PHAR 000008621031 LUPRON DEPOT 3.75MG KIT 001431.45 250
PHAR 000008621033 FLUMAZENIL 0.1MG INJ 000157.20 250
PHAR 000008621034 FLUMAZENIL 0.1MG INJ 000206.40 250
PHAR 000008621035 EDROPHONIUM 10MG IV 000038.40 250
PHAR 000008621036 ATENOLOL INJ 0.5MG 000025.80 250
PHAR 000008621040 MIVACURIUM CHLORIDE 2MG INJ 000098.40 250
PHAR 000008621041 SUMATRIPTAN INJ 6MG 000217.20 250
PHAR 000008621042 PERPHENAZINE 5MG INJ 000038.40 250
PHAR 000008621044 INFLUENZA VIRUS VAC I INJ 0.5 000038.40 250
PHAR 000008621045 BUPIVACAINE/EPI 0.50% 000066.00 250
PHAR 000008621046 DIPTHER/PERTUS/TETA N INJ 000041.75 250
PHAR 000008621047 FLUMAZENIL 0.1MG INJ 000111.60 250
PHAR 000008621050 LOVENOX 30MG SYR 000098.40 250
PHAR 000008621054 INTERFERN ALPHA-2A 36MU INJ 001013.12 250
PHAR 000008621066 ONDANSETRON SDV INJ 2MG 000141.60 250
PHAR 000008621078 INSULIN (HUMALOG)UD SOL 1DO 000012.00 250
PHAR 000008621091 LOVENOX 40MG SYR 000154.22 250
PHAR 000008621092 LOVENOX 60MG SYR 000215.20 250
PHAR 000008621093 LOVENOX 80MG SYR 000262.92 250
PHAR 000008621094 LOVENOX 100MG SYR 000298.66 250
9/7/2010 11:52 AM Page 233 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008621095 BUPIVACAINE/EPI SDV 0.25% INJ 000054.00 250
PHAR 000008621100 PREVNAR VAC 0.5ML 000261.00 250
PHAR 000008621112 INSULIN NOVO(REG)UD SOL 1DO 000012.00 250
PHAR 000008622001 DILTIAZEM HCL VIAL 5MG INJ 000086.40
PHAR 000008622003 DIPHENHYDRAMINE SYR 50MG INJ 000020.40 250
PHAR 000008622004 TACROLIMUS 5MG INJ 000416.26 250
PHAR 000008622005 ROCURONIUMVIAL 10MG INJ 000126.00 250
PHAR 000008622023 RAPLON 20MG/ML 5ML 000111.60 250
PHAR 000008623001 CORTROSYN 0.25 MG 000052.00
PHAR 000008624003 DEXTROSE 25% SYR 25% SYR 000075.60 250
PHAR 000008625000 SODIUM CHLORIDE VIAL INJ 000002.98 250
PHAR 000008626001 BICILLIN C-R 900/300 000037.00
PHAR 000008626003 CEFOTETAN DISODIUM INJ 100 000075.60 250
PHAR 000008626010 BACLOFEN INTRATHECAL 0.5MG KIT 000604.80 250
PHAR 000008629000 MESORIDAZINE BESYL INJ 25M 000066.00 250
PHAR 000008629001 GLYCERIN INJ 100% 2 000030.00
PHAR 000008630001 CODEINE SULFATE 15MG TAB 000004.22
PHAR 000008630002 MEPERIDINE 100MG TAB 000008.56
PHAR 000008630003 DRONABINOL 2.5MG CAP 000012.24
PHAR 000008630004 PENTOBARBITAL SODIUM 100MG CAP 000004.55
PHAR 000008630005 DRONABINOL 5MG CAP 000018.48
PHAR 000008630006 DRONABINOL 10MG CAP 000030.96
PHAR 000008630007 MORPHINE SULF SR 60MG TAB 000011.70
PHAR 000008630008 TUINAL CAP 100 MG 000002.84
PHAR 000008630009 LORAZEPAM 2MG TAB 000008.63
PHAR 000008630010 APOMORPHINE TAB 6 MG 000003.34
PHAR 000008630011 ALPRAZOLAM 0.25MG TAB 000004.90
PHAR 000008630012 ALPRAZOLAM 0.5MG TAB 000004.92 250
PHAR 000008630013 OXYCODONE/ASPIRIN TAB 000004.76
PHAR 000008630014 LORAZEPAM 1MG TAB 000005.41 250
PHAR 000008630015 TUINAL CAP 200 MG 000003.11
PHAR 000008630016 LORAZEPAM 0.5MG TAB 000004.98
PHAR 000008630017 COCAINE HCL TAB 135 000008.78
PHAR 000008630018 CODEINE SULFATE 60MG TAB 000004.93
PHAR 000008630019 MORPHINE SULF SR 15MG TAB 000005.17 250
PHAR 000008630021 PERCODAN-DEMI TAB 000003.26
PHAR 000008630022 ALPRAZOLAM 2MG TAB 000009.46 250
PHAR 000008630023 ASCRIPTIN W/COD #2 000002.96
PHAR 000008630024 ATIVAN TAB 0.5 MG 000003.08
PHAR 000008630025 CODEINE SULFATE 30MG TAB 000004.33
PHAR 000008630026 DEXTROAMPHETAMINE SPA 15MG CAP000004.94
PHAR 000008630027 DILAUDID 4MG TAB 000004.89
PHAR 000008630028 PRELUDIN TAB 25 MG 000003.02
PHAR 000008630029 SECOBARBITAL SODIUM 100MG CAP 000004.04
PHAR 000008630030 ASCRIPTIN W/COD #3 000003.10
PHAR 000008630031 METHADONE HCL 5MG TAB 000004.18
PHAR 000008630032 PRELUDIN ENDURETS 75 000006.51
9/7/2010 11:52 AM Page 234 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008630033 SECOBARBITAL SODIUM 50MG CAP 000003.83
PHAR 000008630034 METHADONE HCL 10MG TAB 000004.24
PHAR 000008630035 PRELUDIN ENDURETS 50 000003.33
PHAR 000008630036 CHLORAL HYDRATE 500MG CAP 000003.89
PHAR 000008630037 MEPERIDINE 50MG TAB 000004.73
PHAR 000008630038 LEVO DROMORA 2MG TAB 000004.80
PHAR 000008630039 FLURAZEPAM 15MG CAP 000004.45
PHAR 000008630041 FLURAZEPAM 30MG CAP 000004.52
PHAR 000008630042 DARVOCET-N-50 1TAB TAB 000004.14
PHAR 000008630043 DARVOCET-N-100 1TAB TAB 000004.62
PHAR 000008630044 PROPOXYPHENE HCL 32MG CAP 000003.86
PHAR 000008630045 PROPOXYPHENE HCL 65MG CAP 000004.27
PHAR 000008630046 DARVON COMPOUND 32MG 32MG CAP 000003.86
PHAR 000008630047 DARVON COMPOUND 65MG 65MG CAP 000004.27
PHAR 000008630048 DARVON WITH ASPIRIN 1 CAP CAP 000004.15
PHAR 000008630049 PROPOXYPHENE NAPSYLAT 100MG TA 000004.73
PHAR 000008630050 DARVON-N WITH ASPIRIN 1 TAB 000004.37
PHAR 000008630051 EMPIRIN W/COD 15MG 000002.96
PHAR 000008630052 EMPIRIN W/COD 30MG 000002.96
PHAR 000008630053 EMPIRIN W/COD 60MG 000003.39
PHAR 000008630054 FIORINAL CAP 000004.78
PHAR 000008630055 FIORINAL TAB 000004.49
PHAR 000008630057 METHADONE HCL 10MG INJ 000019.20 250
PHAR 000008630058 FIORINAL WITH COD CAP 000008.14
PHAR 000008630059 HALCION TAB 0.25 MG 000003.38
PHAR 000008630060 HALCION TAB 0.5 MG 000003.29
PHAR 000008630061 HYCODAN TAB 5 MG 000003.23
PHAR 000008630062 IONAMIN-15 CAP 000003.65
PHAR 000008630063 IONAMIN-30 CAP 000003.79
PHAR 000008630064 CHLORAL HYDRATE 250MG CAP 000003.77
PHAR 000008630065 PLACIDYL CAP 750 MG 000003.10
PHAR 000008630066 PLACIDYL CAP 500 MG 000003.60
PHAR 000008630067 PLACIDYL CAP 200 MG 000003.67
PHAR 000008630068 PLACIDYL CAP 100 MG 000002.95
PHAR 000008630069 HYDROC/ACET 10/650 TAB 000003.35 250
PHAR 000008630071 MORPHINE SULF SR 100MG TAB 000013.87 250
PHAR 000008630072 TALWIN-CPD CAP 000003.44
PHAR 000008630073 MORPHINE SULF SR 60MG TAB 000010.69 250
PHAR 000008630074 TUSSIONEX CAP 000003.36
PHAR 000008630075 TUSSIONEX TAB 000003.38
PHAR 000008630076 MORPHINE SULF SR 30MG TAB 000008.34 250
PHAR 000008630077 ACETAMINOPHEN/COD 15MG TAB 000004.08
PHAR 000008630078 ACETAMINOPHEN/COD 30MG TAB 000004.09
PHAR 000008630079 ACETAMINOPHEN/COD 60MG TAB 000004.48
PHAR 000008630080 DIAZEPAM TAB 2MG 000003.91
PHAR 000008630081 DIAZEPAM TAB 5MG 000004.06
PHAR 000008630082 DIAZEPAM TAB 10M 000004.33
9/7/2010 11:52 AM Page 235 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008630083 CLORAZEPATE DIPOTASSI TAB 7.5 000007.58
PHAR 000008630084 CLORAZEPATE DIPOTASSI TAB 15 000008.72
PHAR 000008630085 MORPHINE SULF SR 15MG TAB 000004.70
PHAR 000008630086 CLORAZEPATE DIPOTASSI TAB 3.7 000007.04
PHAR 000008630087 MS CONTIN 30 MG TAB 000003.71
PHAR 000008630090 METHYLPHENIDATE SR 20MG TAB 000008.29
PHAR 000008630091 DEXTROAMPHETAMINE SRL 10MG CAP000004.66
PHAR 000008630092 DEXTROAMPHETAMINE SRL 5MG CAP 000004.44
PHAR 000008630094 DEXTROAMPHETAMINE SRL 5MG TAB 000003.98
PHAR 000008630095 DILAUDID 1MG TAB 000004.01
PHAR 000008630096 DILAUDID 2MG TAB 000004.45
PHAR 000008630097 DILAUDID 3MG TAB 000004.42
PHAR 000008630098 FIORINAL W/COD #1 000003.28
PHAR 000008630099 FIORINAL W/COD #2 000003.38
PHAR 000008630100 HALCION TAB 0.125 MG 000003.49
PHAR 000008630101 MORPHINE SULF SR 30MG TAB 000009.14
PHAR 000008630102 OXYCODONE/ACETAMINOPH TAB 000004.66
PHAR 000008630103 METHYLPHENIDATE HCL TAB 10M 000004.37
PHAR 000008630104 METHYLPHENIDATE HCL 20MG TAB 000005.08
PHAR 000008630105 METHYLPHENIDATE HCL 5MG TAB 000004.14
PHAR 000008630106 SOMA CPD W/COD TAB 000004.22
PHAR 000008630107 SYNALGOS-DC CAP 000003.50
PHAR 000008630108 PENTAZOCINE/NALOXONE 1TAB TAB 000005.04
PHAR 000008630109 TENUATE DOSPAN 75 MG 000003.80
PHAR 000008630110 ACETAMINOPHEN/COD 7.5MG TAB 000004.00
PHAR 000008630112 AMPHETAMINE 10MG TAB 000004.54 250
PHAR 000008630113 AMPHETAMINE TAB 20M 000005.17 250
PHAR 000008630114 OXYCODONE SR 10MG TAB 000006.79 250
PHAR 000008630115 OXYCODONE SR 20MG TAB 000009.80 250
PHAR 000008630117 ALPRAZOLAM 1MG TAB 000004.10 250
PHAR 000008630118 CHLORDIAZEPOXIDE HYDR CAP 5MG 000003.04 250
PHAR 000008630119 CHLORDIAZEPOXIDE HYDR CAP 10M 000003.30 250
PHAR 000008630120 CHLORDIAZEPOXIDE HYDR CAP 25M 000003.92 250
PHAR 000008630121 CLONAZEPAM 2MG TAB 000003.46 250
PHAR 000008630122 CLONAZEPAM 0.5MG TAB 000003.65 250
PHAR 000008630123 CLONAZEPAM 1MG TAB 000003.82 250
PHAR 000008630124 LOMOTIL 2.5MG TAB 000002.58 250
PHAR 000008630125 FLUOXYMESTERONE 2 MG TAB 000003.29 250
PHAR 000008630126 FLUOXYMESTERONE 5 MG TAB 000006.98 250
PHAR 000008630127 FLUOXYMESTERONE 10 MG TAB 000008.05 250
PHAR 000008630128 HYDROCODONE BIT/APAP TAB 1TA 000004.42 250
PHAR 000008630129 MEPROBAMATE 200MG TAB 000002.45 250
PHAR 000008630130 MEPROBAMATE 400MG TAB 000002.46 250
PHAR 000008630131 OXYMETHOLONE 50MG TAB 000004.18 250
PHAR 000008630132 PEMOLINE 18.75MG TAB 000003.66 250
PHAR 000008630133 PEMOLINE 37.5MG TAB 000006.77 250
PHAR 000008630134 PEMOLINE 75MG TAB 000008.21 250
9/7/2010 11:52 AM Page 236 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008630135 PHENOBARBITAL 15MG TAB 000002.48 250
PHAR 000008630136 PHENOBARBITAL 30MG TAB 000002.48 250
PHAR 000008630137 PHENOBARBITAL 60MG TAB 000002.50 250
PHAR 000008630138 PHENOBARBITAL 100MG TAB 000002.46 250
PHAR 000008630139 STANOZOLOL 2MG TAB 000003.78 250
PHAR 000008630140 TEMAZEPAM 15MG CAP 000003.99 250
PHAR 000008630141 TEMAZEPAM 30MG CAP 000004.03 250
PHAR 000008630146 HYDROCODONE/ACET TAB 1TA 000004.90 250
PHAR 000008631001 MORPHINE SULFATE I.R 10MG TAB 000004.08
PHAR 000008631002 NEMBUTAL 30 MG CAP 000002.80
PHAR 000008631003 TUSSEND TAB 000003.18
PHAR 000008631004 MORPHINE SULFATE I.R 15MG TAB 000004.08
PHAR 000008631005 PENTOBARBITAL SODIUM 50MG CAP 000004.27
PHAR 000008631006 MORPHINE IMMED.REL. 30MG TAB 000004.42
PHAR 000008631007 ZOLPIDEM TARTRATE 10MG TAB 000007.99 250
PHAR 000008631008 ZOLPIDEM TARTRATE 5MG TAB 000008.27 250
PHAR 000008631009 DEXTROAMPHETAMINE TAB 5MG 000004.00 250
PHAR 000008631010 DEXTROAMPHETAMINE TAB 10M 000004.36 250
PHAR 000008631011 TESTOLACTONE 50MG TAB 000009.66 250
PHAR 000008631013 AMPHETAMINE 5MG TAB 000004.68 250
PHAR 000008631014 AMPHETAMINE TAB 30M 000009.74 250
PHAR 000008631015 OXYCODONE SUST. REL. TAB 40M 000015.11 250
PHAR 000008631016 METHYLPHENIDATE 18MG TAB 000011.00 250
PHAR 000008631017 MODAFINIL 100MG TAB 000014.61 250
PHAR 000008631018 METHYLPHENIDATE 36MG TAB 000011.27 250
PHAR 000008631019 METHYLPHENIDATE ER TAB 27M 000011.27 250
PHAR 000008633001 FENTANYL ORALET 400MCG PO 000000.00 250
PHAR 000008633002 FENTANYL ORALET 200MCG PO 000054.44 250
PHAR 000008633003 FENTANYL ORALET 300MCG PO 000000.00 250
PHAR 000008634001 COCAINE HCL POW 000036.00
PHAR 000008634002 METHADONE HCL 1MG/ML 000015.35
PHAR 000008634003 MORPHINE SULF 3 OZ 000011.11
PHAR 000008634004 OPIUM TINCTURE 3 OZ 000029.08
PHAR 000008634005 CAPITAL WITH COD SUS 000014.22
PHAR 000008634006 PROPOXYPHENE NAP BTL 10MG/ML S 000017.52
PHAR 000008634007 ROXICET SOLUTION 3OZ 000010.47
PHAR 000008634008 PAREGORIC 0.4MG TIN 000013.10
PHAR 000008634009 TERPIN HYD W/COD 3OZ 000009.71
PHAR 000008634010 TUSSEND EXP 3 OZ 000012.01
PHAR 000008634011 MEPERIDINE 10MG/ML 90ML 000027.66
PHAR 000008634012 PENTOBARBITAL SODIUM 4MG ELI 000023.70
PHAR 000008634013 HYCODAN SYRUP 3 OZ 000014.24
PHAR 000008634014 PARELIXIR 180 ML 000004.64
PHAR 000008634015 MORPHINE SULF SOL 2MG/ML 000005.40
PHAR 000008634016 TUSSEND LIQUID 3 OZ 000011.87
PHAR 000008634017 TUSSIONEX SUSP BTL SUS 000026.58
PHAR 000008634018 HYCOMINE SYRUP 3 OZ 000014.20
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008634019 DELSYM LIQ 30MG/5ML 000009.84
PHAR 000008634020 ACETAMINOPHEN/COD 2.4MG/ML ELI 000014.33
PHAR 000008634021 HYCOTUSS EXP 3 OZ 000014.10
PHAR 000008634022 DIAZEPAM SOLN U.D. 000005.80
PHAR 000008634023 MORPH SULF ORAL UD 000005.80
PHAR 000008634024 HYDROMORPHONE/GUAIFEN SYR 000017.50
PHAR 000008634026 OPIUM TINCTURE UD 000004.50
PHAR 000008634031 MORPHINE SULFATE 4MG 000008.40 250
PHAR 000008634035 MEPERIDINE 10MG/1ML LIQ 000000.79 250
PHAR 000008634037 MORPHINE SULFATE 20MG 000001.32 250
PHAR 000008634042 PAREGORIC 0.4MG PO 000006.60 250
PHAR 000008634044 HYDROCODE/ACET BTL PO 000020.00 250
PHAR 000008634048 OPIUM SPECIAL DILUT SOL 0.4 000006.60 250
PHAR 000008634050 VICOPROFEN TAB 000005.60 250
PHAR 000008636001 BELLADONNA/OPIUM 16A SUP PR 000010.87
PHAR 000008636002 DILAUDID 3MG SUP 000011.39
PHAR 000008637001 AMOBARBITAL NA 500MG INJ 000062.40
PHAR 000008637002 CODEINE 60MG/2ML 30MG INJ 000019.20
PHAR 000008637003 MEPERIDINE HCL INJ 25M 000019.20
PHAR 000008637004 MEPERIDINE 50MG INJ 000019.20
PHAR 000008637005 PENTAZOCINE LACTATE 30MG INJ 000033.60
PHAR 000008637006 CODEINE 30MG INJ 000019.20
PHAR 000008637007 MEPERIDINE 100MG INJ 000019.20
PHAR 000008637008 LEVO DROMORA INJ 2MG/ML 000027.60
PHAR 000008637009 MEPERIDINE 75MG INJ 000019.20
PHAR 000008637010 ALFENTANIL 2ML 500MCG IV 000055.20
PHAR 000008637011 MORPHINE SULFATE INJ 15M 000019.20
PHAR 000008637012 HYDROMORPHONE HCL AMP INJ 1MG 000021.60
PHAR 000008637013 MORPHINE SULFATE INJ 10M 000019.20
PHAR 000008637014 HYDROMORPHONE HCL AMP INJ 2MG 000019.20
PHAR 000008637015 MORPHINE SULFATE INJ 8MG 000019.20
PHAR 000008637016 MORPHINE 10MG/10ML 000027.00
PHAR 000008637017 HYDROMORPHONE HCL AMP INJ 4MG 000021.60
PHAR 000008637018 PENTOBARBITAL SODIUM 50MG INJ 000024.60
PHAR 000008637019 DOLOPHINE 10MG/ML 000013.00
PHAR 000008637020 NISENTIL 40MG/ML AMP 000017.00
PHAR 000008637021 INNOVAR 2ML AMP 000054.00
PHAR 000008637022 INNOVAR 5 ML AMP 000090.00
PHAR 000008637023 OXYMORPHONE HCL 1.5MG INJ 000038.40
PHAR 000008637024 FENTANYL 100MCG INJ 000024.60
PHAR 000008637025 FENTANYL 250MCG INJ 000033.60
PHAR 000008637026 FENTANYL AMP 10 ML 000034.00
PHAR 000008637027 FENTANYL 1000MCG INJ 000088.80
PHAR 000008637028 SUFENTANIL CITR. AMP 50MCG 000088.80
PHAR 000008637029 SUFENTANIL CIT. AMP 50MCG 000145.20
PHAR 000008637030 SUFENTANIL CIT AMP 50MCG 000222.00
PHAR 000008637031 METHOHEXITAL SODIUM 50MG PO 000055.20
9/7/2010 11:52 AM Page 238 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008637032 METHOHEXITAL SODIUM 5 GM PO 000210.00
PHAR 000008637033 PENTOTHAL SYR 500 MG 000047.00
PHAR 000008637035 ALFENTANIL 5ML 500MCG IV 000088.80
PHAR 000008637036 ALFENTANIL 10ML 500MCG IV 000145.20
PHAR 000008637037 BREVITAL - UNIT DOSE 000014.00
PHAR 000008637038 TALWIN AMP 30 MG 000017.00
PHAR 000008637039 MORPHINE SULFATE INJ 0.5 000068.40
PHAR 000008637040 MORPHINE SULFATE 1MG INJ 000078.00
PHAR 000008637041 DIAZEPAM INJ INJ 5MG 000024.60
PHAR 000008637042 VERSED 10 MG/2 ML 000054.00
PHAR 000008637043 DILAUDID-HP INJ 10MG/ML 000100.80
PHAR 000008637044 VERSED 25MG/5ML VIAL 000112.00
PHAR 000008637045 MIDAZOLAM HCL 5MG 5MG INJ 000062.40
PHAR 000008637047 VERSED INJ 1MG/ML 5ML 000086.40
PHAR 000008637048 SURITAL 0.5 GM UD 000011.00
PHAR 000008637051 THIOPENTAL SODIUM 250MG SYR 000062.40
PHAR 000008637052 FENTANYL PAT 25M 000078.00 250
PHAR 000008637053 FENTANYL PAT 50M 000129.60 250
PHAR 000008637054 FENTANYL PAT 75M 000160.80 250
PHAR 000008637055 FENTANYL PAT 100 000194.40 250
PHAR 000008637056 MIDAZOLAM HCL 2MG 1MG INJ 000036.00 250
PHAR 000008637057 MEPERIDINE 300MG PCA SYRINGE 000088.80 250
PHAR 000008637058 MIDAZOLAM HCL 50MG 5MG INJ 000261.62 250
PHAR 000008637061 MORPHINE SULFATE PCA 1MG 000086.40 250
PHAR 000008637063 MEPERIDINE 25MG INJ 000019.20 250
PHAR 000008639001 SECONAL 50MG/ML 20ML 000030.00
PHAR 000008639002 SECONAL INJ - UD 000013.00
PHAR 000008640001 TETRACYCLINE HCL 1% OIN OPHT 000019.42
PHAR 000008640002 BENZEDREX INHALER 000005.58
PHAR 000008640003 CEPASTAT LOZENG #18 000004.44
PHAR 000008640004 TRIETHANOLAMINE OLEAT 10% TOP 000026.51
PHAR 000008640005 CHLORAMPHENICOL 1% OIN OPHT 000019.20
PHAR 000008640006 CARBACHOL 0.75%/ML OPHT 000027.90
PHAR 000008640007 PHYSOSTIGMINE SALICYL 0.50% OP 000018.28
PHAR 000008640008 ZINCFRIN OPHTH 15 ML 000012.73
PHAR 000008640009 FML DROPS 5 ML 000015.23
PHAR 000008640010 NEO-CORTEF OPHTH 3.5 000012.00
PHAR 000008640011 OXYMETAZOLINE HCL 0.05% SPR NA 000010.75
PHAR 000008640012 SULFACETAMIDE/PREDNIS 0.2%/GM 000004.73
PHAR 000008640013 TRIETHANOLAMINE OLEAT 10% TOP 000039.82
PHAR 000008640014 CHLOROMYCET DRO OPHT 000015.09
PHAR 000008640015 CARBACHOL 2.25%/ML OPHT 000029.86
PHAR 000008640016 HOMATROPINE HBR 5% OPH OPHT 000027.30
PHAR 000008640017 ZOLYSE 750 U 9 ML 000035.56
PHAR 000008640018 FML DROPS 10 ML 000022.45
PHAR 000008640019 GYNE LOTRIMIN TAB #7 000017.74
PHAR 000008640020 NEO-CORTEF OPHTH 5 M 000011.89
9/7/2010 11:52 AM Page 239 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008640021 OXYMETAZOLINE HCL 0.05% DRP NA 000011.00
PHAR 000008640022 SULFACETAMIDE/PREDNIS 0.2%/ML 000022.79
PHAR 000008640023 CHLORAMPHENICOL 0.50% OPHT 000034.96
PHAR 000008640024 CARBACHOL 1.5%/ML OPHT 000028.87
PHAR 000008640025 HOMATROPINE HBR 2% OPH OPHT 000022.92
PHAR 000008640026 GYNE/LOTRIM CREAM 1% 000017.02
PHAR 000008640027 NEO-DELTA-CORTEF 5 M 000012.10
PHAR 000008640028 TETRACYCLINE HCL 1% SUS OPHT 000013.09
PHAR 000008640029 SULFACETAMIDE/PREDNIS 0.2%/ML 000035.47
PHAR 000008640030 CHLOROPTIC OPH OIN 000014.39
PHAR 000008640031 CARBACHOL 3%/ML OPHT 000030.76
PHAR 000008640032 HOMATROPINE HBR 2% OPH OPHT 000018.12
PHAR 000008640033 NEO-DELTA-CORTEF 3.5 000008.95
PHAR 000008640034 GENTAMICIN OPHT AUG 15MG OPH O 000023.51
PHAR 000008640035 TOBRADEX SUS OPTH 5 000029.25
PHAR 000008640036 OXYMETAZOLINE HCL UD 0.05% SPR 000002.42
PHAR 000008640037 CHLORAMPHENICOL 0.50% OPHT 000020.59
PHAR 000008640038 ISOPTO-CARBACH 1.5% 000024.50
PHAR 000008640039 HOMATROPINE HBR 5% OPH OPHT 000019.62
PHAR 000008640040 OXYMETAZOLINE HCL 0.05% SPR NA 000014.21
PHAR 000008640041 BALANCED SALT SOLUTIO OPTH 000012.49
PHAR 000008640042 COLLYRIUM 180 ML 000007.93
PHAR 000008640043 ISOPTO-CARBACH 0.75% 000023.25
PHAR 000008640044 SCOPOLAMINE OPTH 5ML 0.25% OPH 000018.12
PHAR 000008640045 CEPACOL ANESTH #18 000004.98
PHAR 000008640046 COLY-MYCIN-S SUS OTIC 000020.80
PHAR 000008640047 SCOPOLAMINE OPTH 15ML 0.25% OP 000022.92
PHAR 000008640048 COLY-MYCIN-S SUS OTIC 000035.29
PHAR 000008640049 PILOCARPINE HCL 10% OPHT 000030.16
PHAR 000008640050 ISOPTO-TEARS 15 ML 000010.58
PHAR 000008640051 CORTISPORIN OPTHALMIC OIN OPHT 000027.26
PHAR 000008640052 PILOCARPINE HCL 6% OPHT 000022.55
PHAR 000008640053 LACRI-LUBE OIN OPHT 000015.49
PHAR 000008640054 OXYMETAZOLINE HCL 0.03% DRP NA 000009.54
PHAR 000008640055 CEPACOL THRO LOZ 000001.15
PHAR 000008640056 CORTISPORIN OPH SUSP 000010.95
PHAR 000008640057 ISOPTO-CARPINE 4% 30 000018.04
PHAR 000008640058 LIQUIFILM FORTE 30ML 000014.78
PHAR 000008640059 ALBALON-A EYE DROPS 000014.36
PHAR 000008640060 CORTISPORIN OTIC SUS OTIC 000030.78
PHAR 000008640061 PILOCARPINE HCL 4% OPHT 000020.98
PHAR 000008640062 LIQUIFILM TEARS 30ML 000014.41
PHAR 000008640063 ATROPINE OPHTH OINT 1% OIN OPH 000011.27
PHAR 000008640064 CORTISPORIN OTIC OTIC 000030.78
PHAR 000008640065 ISOPTO-CARPINE 3% 30 000018.04
PHAR 000008640066 LIQUIFILM TEARS 15ML 000011.95
PHAR 000008640067 AURALGAN OTIC DROPS 000008.62
9/7/2010 11:52 AM Page 240 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008640068 CYCLOPENTOLATE HCL 1%/ML OPTH 000012.12
PHAR 000008640069 PILOCARPINE HCL 0.50% OPHT 000019.55
PHAR 000008640070 MAXIDEX OINT 3.5 G 000016.16
PHAR 000008640071 BACITRACIN OPHTH OINT 500U OIN 000008.47
PHAR 000008640072 CYCLOPENTOLATE HCL 1%/ML OPTH 000018.12
PHAR 000008640073 PILOCARPINE HCL 1% OPHT 000019.55
PHAR 000008640074 DEXAMETHASONEOPHT 0.10% OPHT 000028.80
PHAR 000008640075 CYCLOPENTOLATE HCL 1%/ML OPTH 000034.80
PHAR 000008640076 ISOPTO-CARPINE 0.5% 000017.10
PHAR 000008640077 DEXAMETHASONE OPTH 0.10% OPHT 000045.00
PHAR 000008640078 CYCLOGYL 1% 2 ML 000009.29
PHAR 000008640079 PILOCARPINE HCL 0.25% OPHT 000019.55
PHAR 000008640080 MAXITROL ML SUS OPHT 000030.60
PHAR 000008640081 CYCLOGYL 1% 5 ML 000013.66
PHAR 000008640082 PILOCARPINE HCL 8% OPHT 000027.30
PHAR 000008640083 MAXITROL OIN OPHT 000030.60
PHAR 000008640084 CYCLOGYL 1% 15 ML 000022.63
PHAR 000008640085 PILOCARPINE HCL 3% OPHT 000020.98
PHAR 000008640086 ACETYLCHOLINE OPHTH 10MG DRP O 000030.36
PHAR 000008640087 CYCLOPENTOLATE HCL 2%/ML OPTH 000016.32
PHAR 000008640088 ISOPTO-CARPINE 2% 30 000017.10
PHAR 000008640089 CYCLOPENTOLATE HCL 2%/ML OPTH 000023.22
PHAR 000008640090 PILOCARPINE HCL 2% OPHT 000019.78
PHAR 000008640091 MUROCOLL-2 OPHT 000019.02
PHAR 000008640092 CYCLOPENTOLATE HCL 2%/ML OPTH 000040.80
PHAR 000008640093 ISOPTO-CARPINE 1% 30 000017.10
PHAR 000008640094 TROPICAMIDE 0.50% OPHT 000034.80
PHAR 000008640095 DACRIOSE OPHT 000009.70
PHAR 000008640096 TROPICAMIDE 1% OPHT 000036.30
PHAR 000008640097 DACRIOSE OPHT 000013.66
PHAR 000008640098 DACRIOSE OPHT 000010.56
PHAR 000008640099 NASALCROM SPRA 13ML 000022.00
PHAR 000008640100 CARBAMIDE PEROXIDE 6.50% OTIC 000014.24
PHAR 000008640101 FLUNISOLIDE 0.03% INH 000041.42
PHAR 000008640102 CARBAMIDE PEROXIDE 6.50% OTIC 000011.02
PHAR 000008640103 NATAMYCIN 5% SUS OPHT 000142.87
PHAR 000008640104 DEXAMETHASONE 0.05% OIN OPHT 000012.73
PHAR 000008640105 NEO-SYNEPH NAS 1% 30 000007.25
PHAR 000008640106 DEXAMETHASONE SOL 0.1 000029.40
PHAR 000008640107 PHENYLEPHRINE HCL 2.50% DRP OP 000031.70
PHAR 000008640108 DEXAMETHASONE 12.6GM 84MCG INH 000043.09
PHAR 000008640109 NEO-SYNEPH NAS 1/4% 000006.77
PHAR 000008640110 DECADRON TURBINAIRE 000031.09
PHAR 000008640111 PHENYLEPHRINE HCL 10% DRP OPHT 000030.70
PHAR 000008640112 "LYPRESSIN, NASAL " 8ML SPR 000063.65
PHAR 000008640113 PHENYLEPHRINE HCL 0.13% DRP NA 000009.46
PHAR 000008640114 ENUCLENE DROPS 15 ML 000010.54
9/7/2010 11:52 AM Page 241 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008640115 PHENYLEPHRINE HCL 0.50% SPR NA 000010.07
PHAR 000008640116 EPINEPHRINE HCL OPHTH 0.25% OP 000036.96
PHAR 000008640117 NEO-SYNEPH NAS 1/2% 000006.94
PHAR 000008640118 EPINEPHRINE HCL OPHTH 1% OPHT 000044.89
PHAR 000008640119 PHENYLEPHRINE HCL 0.50% DRP NA 000009.04
PHAR 000008640120 EPINEPHRINE HCL OPHTH 0.50% OP 000042.60
PHAR 000008640121 EPINEPHRINE HCL OPHTH 2% OPHT 000052.75
PHAR 000008640122 DEXAMETHASONE/NEOMYCI OPHT 000023.21
PHAR 000008640123 EPINEPHRINE BITARTRAT 2% OPHT 000026.46
PHAR 000008640124 NEOSPORIN OPTH SOL OPHT 000027.00
PHAR 000008640125 EPPY-N OPHTH 0.5% 000011.79
PHAR 000008640126 NEOSPORIN OPTH OINT OIN OPHT 000027.00
PHAR 000008640127 EPPY-N OPHTH 1% 7.5 000012.23
PHAR 000008640128 SODIUM CL NASAL SPRY NASL 000008.28
PHAR 000008640129 PHYSOSTIGMINE SULFATE 0.25% OI 000020.93
PHAR 000008640130 PROPARACAINE HCL 0.50% OPTH 000001.22
PHAR 000008640131 GENTAMICIN OPHT OINT 0.30% OPH 000022.30
PHAR 000008640132 GLYCERIN OPH OPHT 000031.14
PHAR 000008640133 GENTAMICIN OPHT SOL 0.30% OPH 000022.30
PHAR 000008640134 OPHTHOCORT OIN OPHT 000022.99
PHAR 000008640135 HYDROXYPROPYL METHYLC 2.50% OP 000019.20
PHAR 000008640136 OTOBIONE OTIC 5 ML 000012.36
PHAR 000008640137 MEDRYSONE 1% SUS OPHT 000021.18
PHAR 000008640138 OTOBIOTIC 15 ML 000016.36
PHAR 000008640139 OTRIVIN DROPS 0.1% 000009.45
PHAR 000008640140 MEDRYSONE 1% SUS OPHT 000034.85
PHAR 000008640141 OTRIVIN NASAL SPRAY 000008.39
PHAR 000008640142 DEMECARIUM BROMIDE 0.13% OPHT 000022.20
PHAR 000008640143 P1 E1 15 ML 000016.16
PHAR 000008640144 DEMECARIUM BROMIDE 0.25% OPHT 000023.40
PHAR 000008640145 P2 E1 OPHTH 15 ML 000016.16
PHAR 000008640146 ILOTYCIN OPHTH 3.5 G 000008.46
PHAR 000008640147 P4 E1 OPHTH 15 ML 000016.79
PHAR 000008640148 PREDNISOLONE SODIUM P 0.13% OP 000020.14
PHAR 000008640149 PHENYLEPHRINE 10% UD 000006.53
PHAR 000008640150 PREDNISOLONE SODIUM P 1% OPHT 000020.14
PHAR 000008640151 ECHOTHIOPHATE 0.03% 0.3MG/ML O 000034.85
PHAR 000008640152 ATROPINE OPHTH 0.50% OPHT 000016.32
PHAR 000008640153 ECHOTHIOPHATE 0.06% 0.6MG/ML O 000036.00
PHAR 000008640154 ATROPINE OPHTH 3% OPHT 000017.52
PHAR 000008640155 ECHOTHIOPHATE 0.125% 1.25MG/M 000039.06
PHAR 000008640156 ATROPINE OPHTH 1% OPHT 000017.22
PHAR 000008640157 ECHOTHIOPHATE 0.25% 12.5MG/M O 000042.65
PHAR 000008640158 ISOPTO-ATROPINE 1% 000013.98
PHAR 000008640159 POLY PRED OPHT 000027.82
PHAR 000008640160 OCUMYCIN OIN OPHT 000009.64
PHAR 000008640161 TETRACAINE HCL 0.50% OPHT 000027.94
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008640162 PREDNISOLONE ACETATE 1% SUS OP 000021.30
PHAR 000008640163 PREDNISOLONE ACETATE 1% SUS OP 000037.81
PHAR 000008640164 PREDNISOLONE ACETATE 0.13% SUS 000021.42
PHAR 000008640165 PREDNISOLONE ACETATE 0.13% SUS 000031.06
PHAR 000008640166 PREFRIN-A OPHTH 15 M 000013.13
PHAR 000008640167 DIPIVEFRIN 0.1% 0.10% OPHT 000027.83
PHAR 000008640168 SILVER NITRATE OPTH 1% OPHT 000003.82
PHAR 000008640169 IDOXURIDINE 0.50% OIN OPHT 000026.46
PHAR 000008640170 IDOXURIDINE 15ML OPHT 000030.18
PHAR 000008640171 SULFACETAMIDE NS 3.5G 10% OIN 000022.30
PHAR 000008640172 SULFACETAMIDE NA 15ML 30% OPHT 000030.14
PHAR 000008640173 SULFACETAMIDE NA 15ML 10% OPHT 000028.90
PHAR 000008640174 OXYTOCIN 40U SPR NASL 000051.82
PHAR 000008640175 OXYTOCIN 40U SPR NASL 000091.44
PHAR 000008640176 TEARISOL OPHT 000014.02
PHAR 000008640177 TEARS NATURALE 15 ML 000010.58
PHAR 000008640178 TEARS NATURALE 30 ML 000012.75
PHAR 000008640179 TEARS PLUS 15ML OPTH 000014.52
PHAR 000008640180 TETRACAINE HCL 0.50% DRP OPHT 000005.20
PHAR 000008640181 TIMOLOL MALEATE 0.50% OPHT 000028.79
PHAR 000008640182 TIMOLOL MALEATE 0.25% OPHT 000022.75
PHAR 000008640183 TIMOLOL MALEATE 0.25% OPHT 000044.09
PHAR 000008640184 TIMOLOL MALEATE 0.50% OPHT 000042.16
PHAR 000008640185 TOBRAMYCIN SULFATE 0.30% OPHT 000029.10
PHAR 000008640186 VASOCIDIN OPHTH 5 ML 000014.20
PHAR 000008640187 VASOCIDIN OPHTH 10 M 000016.78
PHAR 000008640188 VASOCIDIN OIN OPTHAL 000013.12
PHAR 000008640189 VASOCON OPHT 000021.50
PHAR 000008640190 NAPHAZOLINE HCL 0.10% DRP OPHT 000021.50
PHAR 000008640191 VIDARABINE 3% OIN TOP 000031.12
PHAR 000008640192 TRIFLURIDINE 1% OPHT 000070.76
PHAR 000008640193 TETRAHYDROZOLINE HCL 0.05% OPH 000009.20
PHAR 000008640194 VOSOL OTIC 30 ML 000035.79
PHAR 000008640195 ACETIC ACID 2% OTIC 000044.47
PHAR 000008640196 ACETIC ACIDHC 2% OTIC 000054.70
PHAR 000008640197 DESMOPRESSIN RHINAL T 0.01% NA 000095.86
PHAR 000008640198 SULFACETAMIDE NA 5ML 10% OPHT 000021.50
PHAR 000008640199 PONARIS NASAL EMOLLI 000009.75
PHAR 000008640200 DIPIVEFRIN OPTH 5ML 0.10% OPHT 000016.62
PHAR 000008640201 DIPIVEFRIN 0.1% 0.10% OPHT 000039.04
PHAR 000008640202 ESERINE OPH 0.25% 4G 000006.22
PHAR 000008640203 SODIUM CL NASAL DRPS 0.90% NAS 000003.12
PHAR 000008640204 CORTISPORIN OPTHALMIC SUS OPTH 000027.26
PHAR 000008640205 SALIVART SPRAY 75 GM 000010.80
PHAR 000008640206 CETYLPYRIDINIUM CHLOR LOZ 000002.48
PHAR 000008640207 ATROPINE 1% OPHTH 15 000011.38
PHAR 000008640208 ERYTHROMYCIN 0.5% 3.5GM OPHT 000009.36
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008640209 ERYTHROM OINT OPH UD 000005.88
PHAR 000008640210 BETAXOLOL HCL 0.50% DRP OPHT 000029.70
PHAR 000008640211 BETAXOLOL HCL 0.50% OPHT 000054.30
PHAR 000008640212 DEXAMETHASONE/NEOMYCI OIN OPHT000012.73
PHAR 000008640213 NAPHCON-A DROPS 15 M 000014.60
PHAR 000008640214 DRISTAN INHALER 000004.06
PHAR 000008640215 DRISTAN SPRAY 15 ML 000005.79
PHAR 000008640216 SALIVART SPRAY 25 GM 000008.92
PHAR 000008640217 CLEAR EYES OPTH SOLN 000008.02
PHAR 000008640218 TEARFAIR OINT 3.5 G 000005.97
PHAR 000008640219 TEARFAIR OPHT 000008.58
PHAR 000008640220 LEVOBUNOLOL HCL 0.50% OPHT 000019.25
PHAR 000008640221 LEVOBUNOLOL HCL 0.50% OPHT 000031.96
PHAR 000008640222 TOBRAMYCIN SULFATE 0.30% OIN O 000029.10
PHAR 000008640223 POLY PRED OPHT 000040.79
PHAR 000008640224 ANTIPYRINE/BENZOCAINE OTIC 000019.14
PHAR 000008640225 SULFISOXAZOLE 3.5GM 4% OIN OPH 000010.68
PHAR 000008640226 SULFISOXAZOLE 15ML 4% OPHT 000016.84
PHAR 000008640227 TEARFAIR OIN OPHT 000009.90
PHAR 000008640228 FLURESS 5 ML OPH 000012.23
PHAR 000008640229 PHENYLEPHRINE HCL 0.25% SPR NA 000009.74
PHAR 000008640230 GENTAMICIN OPHT AUG 15MG OPH O 000031.92
PHAR 000008640231 LUBRIFAIR OPTH 000010.44
PHAR 000008640232 PHENYLEPHRINE 2.5% 2ML 000003.00
PHAR 000008640233 TROPICAMIDE 1% 3ML 000018.29
PHAR 000008640234 PIERCE'S SOLUTION 000025.00
PHAR 000008640235 NEO-SYNEPH OPH 2.5% 000002.50
PHAR 000008640236 RETINAL ANESTH. SOLN 000027.00
PHAR 000008640237 PILOCARPINE HCL 1% OPHT 000005.20
PHAR 000008640238 PILOCARPINE HCL 2% OPHT 000005.20
PHAR 000008640239 ERYTHROMYCIN OPH OIN 000005.92
PHAR 000008640240 P3 E1 OPHTH 15 ML 000016.48
PHAR 000008640241 CEFAZOLIN OPTH50MG/ML 50MG OPH 000030.24
PHAR 000008640242 CARBACHOL0.01% 0.01%/ML 000042.79
PHAR 000008640243 BSS IRRIG SOLN 500ML 000031.75
PHAR 000008640244 FLUOROMETHOLONE 0.10% OPH OPHT000020.99
PHAR 000008640245 FLUOROMETHOLONE 0.10% OPH OPHT000046.33
PHAR 000008640246 FLURBIPROFENOPTH 0.30% OPTH 000040.69
PHAR 000008640247 MAXIM-M 3.8 OZ 000007.90
PHAR 000008640248 MAXIM-M 0.25 OZ 000001.98
PHAR 000008640249 TOBREX AUGMENTED 5ML 000020.00
PHAR 000008640250 TOBREX 15MG/ML 15ML 000050.00
PHAR 000008640251 PHENYLEPHRINE HCL 1% SPR NASL 000010.48
PHAR 000008640252 LEVOBUNOLOL HCL 0.50% OPHT 000072.25
PHAR 000008640253 DDAVP NAS 0.01% 5 ML 000131.31
PHAR 000008640254 FLURBIPROFEN 0.03% OPH OPHT 000022.18
PHAR 000008640255 POLYTRIM OPTH 10 ML 000024.69
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008640256 SULFACETAMIDE NA 5ML 10% OPHT 000019.74
PHAR 000008640257 COUGH CALMER LOZ #16 000002.16
PHAR 000008640258 PROPARACAINE HCL 0.50% DRP OPT 000031.92
PHAR 000008640259 REFRESH OPTH 0.3ML 000001.34
PHAR 000008640260 NASACORT AERO 10GM 000055.24
PHAR 000008640261 LEVOBUNOLOL HCL 0.25% OPHT 000022.21
PHAR 000008640262 PHENYLEPHRINE HCL 0.25% DRP NA 000009.46 250
PHAR 000008640263 DESMOPRESSIN SPRAY 0.01% NASL 000157.57 250
PHAR 000008640264 GENTAMICIN OPHT SOL 0.30% OPH 000012.16 250
PHAR 000008640265 CIPROFLOXACIN 0.3% 0.30% OPHT 000025.18 250
PHAR 000008640266 CIPROFLOXACIN 0.3% 0.30% OPHT 000047.52 250
PHAR 000008640267 BACITRACIN/NEOMYCIN OIN OPTH 000008.98 250
PHAR 000008640269 DEXACIDIN SUS OPHT 000016.63 250
PHAR 000008640270 LUBRIFAIR OIN OPHT 000008.11 250
PHAR 000008640271 SULFACETAMIDE NA 3.5G 10% OIN 000021.12 250
PHAR 000008640276 BUTORPHANOL SPRAY 10MG/ML NASL 000084.98 250
PHAR 000008640279 PILOCARPINE HCL 4% GEL OPHT 000036.30 250
PHAR 000008640280 CROMOLYN SODIUM INHL 000059.09 250
PHAR 000008640283 BETAXOLOL HCL 0.25% SUS OPHT 000029.70 250
PHAR 000008640287 DICLOFENAC SOD OPTH 0.10% OPHT 000042.47 250
PHAR 000008640289 TOBRADEX OPHTH OINT GM OIN OPH 000062.16 250
PHAR 000008640293 ATROPINE OPTH 1% OPTH 000005.20 250
PHAR 000008640298 TRUSOPT 2% OPHTH DRP 000043.01 250
PHAR 000008640301 CYCLOGYL 0.5% SOL 2ML 000013.20 250
PHAR 000008640302 XALATAN 0.005% OPHTH DRP 000073.79 250
PHAR 000008640304 IMITREX 20MG SPRAY 000037.71 250
PHAR 000008640306 TOBRADEX OPHTH SOL. OPHT 000057.36 250
PHAR 000008640307 BRIMONIDINE TARTRATE SOL 0.1 000041.04 250
PHAR 000008640308 CIPRO/HYDROCORT OTIC SUS OTIC 000092.90 250
PHAR 000008640309 KETOROLAC TROMETH 0.50% DRP OP 000075.98 250
PHAR 000008640310 OLOPATADINE 0.10% DRP OPHT 000097.20 250
PHAR 000008640311 OFLOXACIN OTIC 0.30% OTIC 000057.65 250
PHAR 000008640312 BRINZOLAMIDE 1% SUS OPHT 000042.84 250
PHAR 000008640313 ATROVENT NSL SPY 0.03% 000078.92 250
PHAR 000008640314 COSOPT OPHT SOL 5ML 000080.21 250
PHAR 000008640315 FLUNISOLIDE SOL 0.0 000079.29 250
PHAR 000008640316 RHINOCORT NASL INH 7GM 000074.12 250
PHAR 000008640318 MURO-128 OPH OINT 5% 3.5GM 000025.08 250
PHAR 000008640320 OPCON-A OPHT SOL 15ML 000009.36 250
PHAR 000008640324 CILOXAN 0.3% OPHT OIN 3.5GM 000076.31 250
PHAR 000008643001 VITAMIN A&D OINT OIN TOP 000005.26
PHAR 000008643002 AEROSEB-HC AEROSOL 000017.23
PHAR 000008643003 ALUMINUM PASTE 1 LB 000026.50
PHAR 000008643004 "OATMEAL, COLLOIDAL " COL 000011.38
PHAR 000008643005 COLLOIDAL OATMEAL 50% BAR PO 000008.08
PHAR 000008643006 BACITRACIN OINT 30GM OIN TOP 000007.68
PHAR 000008643007 BENISONE CR .025% 15 000008.56
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643008 BENZOIN CPD TNCT 4OZ 000011.76
PHAR 000008643009 CLORPACTIN 2 GM 000006.92
PHAR 000008643010 EUCERIN CREAM 454 G 000015.15
PHAR 000008643011 ERYTHROMYCIN 2% TOP 000027.12
PHAR 000008643012 BENZOCAINE 20% OIN TOP 000007.96
PHAR 000008643013 COAL TAR EMU 000021.38
PHAR 000008643014 BENISONE C .025% 60 000016.43
PHAR 000008643015 TNCTR BENZOIN SPRAY 000007.68
PHAR 000008643016 CAMPHOR/MENTHOL OIN TOP 000002.42
PHAR 000008643017 COMPOUND W TOP 000010.68
PHAR 000008643018 CROTAMITON CRE TOP 000017.41
PHAR 000008643019 FLUOCINONIDE OINT 0.05% OIN TO 000028.94
PHAR 000008643020 EUCERIN CREAM 4 OZ 000004.60
PHAR 000008643021 ALPHA KERI LOT 8 OZ 000009.28
PHAR 000008643022 AMM MERCURY OIN 30 G 000005.49
PHAR 000008643023 METHYL SALICYL/MENTHO OIN TOP 000010.20
PHAR 000008643024 BENISONE GEL 0.025% 000009.04
PHAR 000008643025 BENZOYL PEROXIDE 10% LOT TOP 000009.30
PHAR 000008643026 BOROFAX OINT 52.5 G 000008.67
PHAR 000008643027 CORDRAN OIN 0.025% 000014.61
PHAR 000008643028 DIFLORASONE 0.05% CRE TOP 000035.04
PHAR 000008643029 FLUOCINONIDE OINT 0.05% OIN TO 000061.58
PHAR 000008643030 ALPHA KERI LOT 16 OZ 000014.59
PHAR 000008643031 ANESTACON SOL 240 ML 000019.29
PHAR 000008643032 DIPHENHYDRAMINE 30GM 1% CRE TO 000010.43
PHAR 000008643033 BENISONE GEL 0.025% 000016.43
PHAR 000008643034 BENZOYL PEROXIDE 5% LOT TOP 000008.84
PHAR 000008643035 BRASIVOL PASTE 123 G 000010.28
PHAR 000008643036 CORDRAN OIN 0.025% 000018.73
PHAR 000008643037 DIFLORASONE 0.05% CRE TOP 000045.41
PHAR 000008643038 FLUOCINONIDE CREAM 0.05% CRE T 000035.82
PHAR 000008643039 FLUOCINONIDE CREAM 0.05% CRE T 000039.30
PHAR 000008643040 AQUACARE LOT 240 ML 000009.35
PHAR 000008643041 BENADRYL CREAM 60 GM 000010.24
PHAR 000008643042 BENZOYL PEROXIDE 10% GEL 000020.52
PHAR 000008643043 POVIDONE-IODINE 10% OIN TOP 000013.06
PHAR 000008643044 BRASIVOL PASTE 153 G 000010.28
PHAR 000008643045 CORDRAN OIN 0.05% 000013.63
PHAR 000008643046 DIFLORASONE 0.05% CRE TOP 000074.38
PHAR 000008643047 FLUOCINONIDE OINT 0.05% OIN TO 000039.30
PHAR 000008643048 LIDEX CREAM 0.05% 15 000018.03
PHAR 000008643049 MICONAZOLE NITRATE 2% CRE TOP 000034.85
PHAR 000008643050 AQUACARE-HP CRE 75 G 000008.50
PHAR 000008643051 BENZAGEL-10 GEL 90 G 000013.87
PHAR 000008643052 POVIDONE-IODINE 10% TOP 000014.69
PHAR 000008643053 BRASIVOL PASTE 180 G 000010.28
PHAR 000008643054 CORDRAN OIN 0.05% 000032.72
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643055 DIFLORASONE 0.05% OIN TOP 000035.04
PHAR 000008643056 LIDEX-E CRE 0.05% 15 000018.03
PHAR 000008643057 MICONAZOLE NITRATE 2% CRE TOP 000019.78
PHAR 000008643058 LURIDE SOL 250 ML 000016.55
PHAR 000008643059 EPINEPHRINE HCL TOPIC 0.10% TO 000016.79
PHAR 000008643060 AQUACARE-HP LOT 8 OZ 000009.30
PHAR 000008643061 BENZOYL PEROXIDE 5% GEL 000021.23
PHAR 000008643062 BRASIVOL PASTE 195 G 000010.28
PHAR 000008643063 CORDRAN LOT 0.05% 000032.72
PHAR 000008643064 DIFLORASONE 0.05% OIN TOP 000045.41
PHAR 000008643065 LIDEX-E CRE 0.05% 30 000025.64
PHAR 000008643066 MICONAZOLE NITRATE 2% CRE TOP 000060.38
PHAR 000008643067 F-E-P CREAM 15 G 000011.14
PHAR 000008643068 SALICYLIC ACID 30GM 6% GEL 000027.07
PHAR 000008643069 LOPROX CREAM 1% 30 G 000018.00
PHAR 000008643070 TRIAMCINOLNE ACE 0.5% 0.50% OI 000037.25
PHAR 000008643071 BENZAGEL-5 GEL 90 GM 000013.60
PHAR 000008643072 BUF-PUF SPONGE 000007.12
PHAR 000008643073 CORDRAN LOT 0.05% 000013.63
PHAR 000008643074 DIFLORASONE 0.05% OIN TOP 000074.38
PHAR 000008643075 LIDEX-E CRE 0.05% 60 000042.74
PHAR 000008643076 MICONAZOLE NITRATE 2% LOT TOP 000028.13
PHAR 000008643077 MICROFIBRILLER COLLAG 1GM POW 000121.76
PHAR 000008643078 MODUCAL POW 390 000000.00
PHAR 000008643079 NYSTATIN TOPICAL 15GM POW 000035.41
PHAR 000008643080 TRIAMCINOLNE ACE 0.5% 0.50% CR 000010.38
PHAR 000008643081 BENZAGEL-10 42.5 G 000011.33
PHAR 000008643082 FLURANDRENOLIDE 0.05% CRE TOP 000018.96
PHAR 000008643083 FLUONID CRE 0.01% 000009.73
PHAR 000008643084 NEOSPORIN-G UNITDOSE 000002.00
PHAR 000008643085 NEOMYCIN SULFATE 0.50% OIN TOP 000008.40
PHAR 000008643086 MICROFIBRILLER COLLAG 70 X 35 000154.61
PHAR 000008643087 NEO-CORTEF OIN 1% 5 000009.98
PHAR 000008643088 NEO-DELTA-CORTEF 20G 000018.31
PHAR 000008643089 NEO-SYNALAR CRE 15 G 000017.02
PHAR 000008643090 TRIAMCINOLNE ACE 0.1% 0.10% OI 000035.62
PHAR 000008643091 BENZOIN TIN 000012.13
PHAR 000008643092 POVIDONE-IODINE 10% TOP 000019.63
PHAR 000008643093 CALADRYL LOT TOP 000006.35
PHAR 000008643094 FLURANDRENOLIDE 0.05% CRE TOP 000046.10
PHAR 000008643095 FLUONID SOL 0.01% 20 000016.60
PHAR 000008643096 ANGEL PASTE 9 OZ 000032.00
PHAR 000008643097 NEOMYCIN SULFATE 0.50% OIN TOP 000009.82
PHAR 000008643098 MYCOLOG OINT 15 GM 000013.25
PHAR 000008643099 NEO-CORTEF 0.5% 20G 000014.50
PHAR 000008643100 TRIAMCINOLONE ACETONI 0.10% OI 000014.93
PHAR 000008643101 CALADRYL LOT 180 ML 000006.82
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643102 FLURANDRENOLIDE 0.03% CRE TOP 000020.41
PHAR 000008643103 FLUONID CRE 0.01% 000014.91
PHAR 000008643104 LOROXIDE LOTION 25 G 000012.53
PHAR 000008643105 NEO-CORTEF CRE 1% 20 000023.86
PHAR 000008643106 NEO-SYNALAR CRE 30 G 000025.44
PHAR 000008643107 BENZAC GEL 2.5% 60 G 000016.23
PHAR 000008643108 TRIPLE ANTIBIOTIC OIN TOP 000006.95
PHAR 000008643109 BENZAC W GEL 5% 60 G 000016.60
PHAR 000008643110 AUREOMYCIN OIN 3% 30 000012.37
PHAR 000008643111 BETADINE 1 GALLON 000030.58
PHAR 000008643112 CALADRYL CRE TOP 000006.65
PHAR 000008643113 FLURANDRENOLIDE 4MCG TOP 000020.28
PHAR 000008643114 FLUOCINOLONE 0.01% 0.01% TOP 000053.44
PHAR 000008643115 CLOTRIMAZOLE 1% CRE TOP 000018.02
PHAR 000008643116 MYCOLOG CREAM 60 GM 000034.66
PHAR 000008643117 NEO-SYNALAR CRE 60 G 000042.44
PHAR 000008643118 NEOSPORIN AEROSOL 000012.59
PHAR 000008643119 NITROL OINT 2% 60 GM 000012.77
PHAR 000008643120 AUREOMYCIN OIN 3 % 000008.76
PHAR 000008643121 POVIDONE-IODINE SKIN 7.50% TOP 000013.18
PHAR 000008643122 CALAMINE 120ML LOT TOP 000002.96
PHAR 000008643123 FLURANDRENOLIDE 7.5CM TOP 000042.50
PHAR 000008643124 FLUOROURACIL 1% TOP 000051.60
PHAR 000008643125 CLOTRIMAZOLE 1% CRE TOP 000029.62
PHAR 000008643126 MYCOLOG OINTMENT 60 000034.66
PHAR 000008643127 NEO-CORTEF OIN 1% 20 000023.86
PHAR 000008643128 NEOSPORIN OINT 0.9GM OIN TOP 000002.74
PHAR 000008643129 NEOSPORIN-G CREAM 15 000007.89
PHAR 000008643130 AVEENO 454 GM 000008.64
PHAR 000008643131 CALDESENE POWD 60G 000003.73
PHAR 000008643132 FLUOROURACIL 1% CRE TOP 000051.60
PHAR 000008643133 CLOTRIMAZOLE 1% TOP 000016.52
PHAR 000008643134 NEO-CORTEF 2.5% 5G 000014.84
PHAR 000008643135 NEOSPORIN POWDER 10G 000010.17
PHAR 000008643136 NEOSPORIN GU 000015.59
PHAR 000008643137 VICK'S VAPOR RUB 1GM OIN 000003.00
PHAR 000008643138 OLIVE OIL 60ML OIL PO 000004.06
PHAR 000008643139 PANOXYL GEL 10% 60 G 000012.73
PHAR 000008643140 CAMPHO-PHENIQUE TOP 000006.04
PHAR 000008643141 CORDRAN-N OINT 15 G 000014.63
PHAR 000008643142 FORMALDEHYDE SOL 37% 000001.01
PHAR 000008643143 CLOTRIMAZOLE 1% TOP 000031.30
PHAR 000008643144 NEOSPORIN GU AMP 000008.66
PHAR 000008643145 NITRODUR 5CM (1) 000005.47
PHAR 000008643146 ORABASE PASTE PST TOP 000008.39
PHAR 000008643147 PANOXYL GEL 10% 120 000017.05
PHAR 000008643148 POLYSORB HYDRATE 60 000008.20
9/7/2010 11:52 AM Page 248 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643149 QUESTRAN UNIT DOSE 000005.30
PHAR 000008643150 CAMPHOR GUM 30 GM 000001.97
PHAR 000008643151 CORDRAN-N OINT 30 G 000017.72
PHAR 000008643152 AMPHOTERICIN B 3% OIN TOP 000045.90
PHAR 000008643153 LUBRIDERM CRE TOP 000010.84
PHAR 000008643154 NITRO-DUR 10CM (1) 000005.63
PHAR 000008643155 ORABASE PASTE PST TOP 000011.27
PHAR 000008643156 BENZOYL PEROXIDE 2.50% GEL 000018.60
PHAR 000008643157 POLYSORB HYDRATE 454 000015.10
PHAR 000008643158 RENACIDIN POWDER 300 000026.40
PHAR 000008643159 SILVER SULFADIAZINE 1% CRE TOP 000042.76
PHAR 000008643160 CAMPHOR-SPIRIT 60 ML 000002.25
PHAR 000008643161 CORDRAN-N OINT 60 G 000035.38
PHAR 000008643162 AMPHOTERICIN B 3% CRE TOP 000050.32
PHAR 000008643163 LUBRIDERM LOT TOP 000006.19
PHAR 000008643164 MYCOLOG CREAM 30 GM 000019.38
PHAR 000008643165 PANOXYL GEL 5% 120 G 000016.43
PHAR 000008643166 COAL TAR SHA TOP 000018.28
PHAR 000008643167 TRETINOIN 0.05% CRE TOP 000041.76
PHAR 000008643168 SILVER SULFADIAZINE 1% CRE TOP 000006.78
PHAR 000008643169 FLUOCINOLON CR 0.01% 0.01% CRE 000030.29
PHAR 000008643170 UREA 10% LOT TOP 000011.92
PHAR 000008643171 CORDRAN-N CREAM 15 G 000014.63
PHAR 000008643172 AMPHOTERICIN B 3% LOT TOP 000063.61
PHAR 000008643173 MAMMOL OINTMENT 26 G 000009.14
PHAR 000008643174 MYCOLOG OINTMENT 30 000019.38
PHAR 000008643175 NITRO-DUR 15CM (1) 000005.38
PHAR 000008643176 PBZ CREAM 2% 30 G 000009.42
PHAR 000008643177 COAL TAR SHA TOP 000013.99
PHAR 000008643178 TRETINOIN 0.10% CRE TOP 000049.94
PHAR 000008643179 SILVER SULFADIAZINE 1% CRE TOP 000013.02
PHAR 000008643180 UREA 20% CRE TOP 000012.02
PHAR 000008643181 CORDRAN-N CREAM 30 G 000018.90
PHAR 000008643182 NITROFURAZONE 0.20% OIN TOP 000017.51
PHAR 000008643183 MEDROL 1/4% 30GM 000018.03
PHAR 000008643184 NITRO-DUR 20CM (1) 000005.38
PHAR 000008643185 ORABASE/BENZOCAINE PST TOP 000009.10
PHAR 000008643186 PERSA-GEL 5% 45 G 000011.86
PHAR 000008643187 TRETINOIN 0.05% TOP 000061.39
PHAR 000008643188 ANGEL PASTE 4 OZ 000022.00
PHAR 000008643189 FLUOCINOLONE 0.03% CRE TOP 000051.04
PHAR 000008643190 CELESTONE CREAM 15 G 000011.97
PHAR 000008643191 CORDRAN-N CREAM 60 G 000035.38
PHAR 000008643192 NITROFURAZONE 0.20% CRE TOP 000022.27
PHAR 000008643193 MEDROL 1/4% 7.5G 000007.80
PHAR 000008643194 LANOLIN/MINERAL OIL CRE TOP 000012.40
PHAR 000008643195 ORABASE/BENZOCAINE PST TOP 000012.67
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643196 PERSA-GEL 10% 45 G 000012.10
PHAR 000008643197 TRETINOIN 0.05% CRE TOP 000074.06
PHAR 000008643198 STOP GEL 0.4% 60 G 000010.96
PHAR 000008643199 SURGILUBE 127.5 G 000002.02
PHAR 000008643200 CETACAINE TOP 000097.54
PHAR 000008643201 CORT-DOME LOT 1/4% 000023.29
PHAR 000008643202 FURACIN CREAM 14 G 000007.51
PHAR 000008643203 MEDROL 0.1% OIN 7.5G 000011.10
PHAR 000008643204 LANOLIN/MINERAL OIL OIL TOP 000008.71
PHAR 000008643205 BENZOCAINE 10% GEL 000009.29
PHAR 000008643206 PERSA-GEL 5% 90 G 000016.90
PHAR 000008643207 TRETINOIN 0.03% GEL 000035.14
PHAR 000008643208 FLUOCINOLONE 0.025% 0.03% OIN 000051.04
PHAR 000008643209 DESONIDE 0.05% CRE TOP 000046.15
PHAR 000008643210 HYDROCORTISONE 0.5% 0.50% LOT 000022.85
PHAR 000008643211 CORT-DOME LOT 1% 30M 000031.65
PHAR 000008643212 GENTAMICIN CREAM 0.10% CRE TOP 000026.93
PHAR 000008643213 MERCUROCHROME 30 ML 000002.67
PHAR 000008643214 NEO-CORTEF OIN 2.5% 000038.45
PHAR 000008643215 NUTRACORT LOT 0.25% 000012.85
PHAR 000008643216 PERSA-GEL 10% 90 G 000017.38
PHAR 000008643217 TRETINOIN 0.03% GEL 000073.06
PHAR 000008643218 STATICIN 1.5% 60 ML 000022.34
PHAR 000008643219 SYNALAR CR .01% 1LB 000065.76
PHAR 000008643220 HYDROCORTISONE 1% 1% LOT TOP 000028.06
PHAR 000008643221 HYDROCORTISONE ACETAT OIN 000013.87
PHAR 000008643222 GENTAMICIN OINTMENT 0.10% OIN 000026.93
PHAR 000008643223 MERTHIOLATE 1 PINT 000012.73
PHAR 000008643224 NUTRACORT LOT 0.5% 000013.35
PHAR 000008643225 HEXACHLOROPHENE 3% TOP 000176.84
PHAR 000008643226 TRETINOIN 0.01% GEL 000034.92
PHAR 000008643227 FLUOCINOLONE 0.025% 0.03% CRE 000021.36
PHAR 000008643228 NITROGLYCERIN 0.1MG/HR PAT 000007.37
PHAR 000008643229 DESONIDE 0.05% CRE TOP 000017.87
PHAR 000008643230 CORTEF OINT 1% 20G 000018.86
PHAR 000008643231 CARBAMIDE PEROXIDE 6.5%/ML OTI 000017.10
PHAR 000008643232 MERTHIOLATE 120ML 000005.55
PHAR 000008643233 NUTRACORT LOT 1% 60 000015.66
PHAR 000008643234 TRETINOIN 0.01% GEL 000072.52
PHAR 000008643235 FLUOCINOLONE 0.025% 0.03% OIN 000021.36
PHAR 000008643236 THROMBIN 1000U TOP 000053.10
PHAR 000008643237 DESONIDE 0.05% OIN TOP 000017.87
PHAR 000008643238 VALISONE CR .01% 15G 000011.20
PHAR 000008643239 VIOFORM CREAM 3% 30 000009.33
PHAR 000008643240 CORTEF CREAM 15 GM 000007.01
PHAR 000008643241 CARBAMIDEPEROXIDE 10%/ML 000010.00
PHAR 000008643242 NUTRACORT LOT 1% 120 000022.63
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643243 HYDROCORTISONE OINT 000006.28
PHAR 000008643244 ST-37 360 ML 000008.65
PHAR 000008643245 BENZAC GEL 5% 60 GM 000017.48
PHAR 000008643246 SYNALAR CR .025% LB 000151.26
PHAR 000008643247 DESONIDE 0.05% OIN TOP 000046.15
PHAR 000008643248 VALISONE CR .01% 60G 000022.24
PHAR 000008643249 VIOFORM OINTMENT 3% 000009.33
PHAR 000008643250 CETAPHIL LOT 480 ML 000011.59
PHAR 000008643251 CORTEF OINTMENT 15 G 000006.90
PHAR 000008643252 HALOG CREAM 0.1% 15 000023.49
PHAR 000008643253 MICONAZOLE NITR 30GM 2% CRE TO 000015.44
PHAR 000008643254 PHISOHEX 1 PINT 000019.21
PHAR 000008643255 SALIVA SUBSTITUTE 000008.98
PHAR 000008643256 SYNALAR SOL 0.01% 60 000034.69
PHAR 000008643257 THROMBOSTAT 5000 000025.41
PHAR 000008643258 UNIBASE 454 GM 000014.77
PHAR 000008643259 BETAMETHASONE VALERAT 0.10% CR 000013.76
PHAR 000008643260 HALOG CREAM 0.1% 60 000051.82
PHAR 000008643261 MICONAZOLE NITRATE 2% TOP 000011.27
PHAR 000008643262 HEXACHLOROPHENE 3% TOP 000020.09
PHAR 000008643263 COLLAGENASE 250UNITS OIN TOP 000044.27
PHAR 000008643264 FLUOCINOLONE 0.01% 0.01% TOP 000028.25
PHAR 000008643265 THROMBIN W/DIL 10000U TOP 000061.92
PHAR 000008643266 VALISONE OIN 0.1% 15 000015.70
PHAR 000008643267 VIOFORM HC MILD 30GM 000014.46
PHAR 000008643268 HYDROCORTISONE 0.2% 0.20% CRE 000019.32
PHAR 000008643269 CHLORASEPTIC LOZ 000004.85
PHAR 000008643270 CORTISPORIN CRE TOP 000026.62
PHAR 000008643271 HALOTEX CREAM 30 GM 000024.22
PHAR 000008643272 MICONAZOLE NITRATE 2% LOT TOP 000046.37
PHAR 000008643273 COLLAGENASE 250UNITS OIN TOP 000080.82
PHAR 000008643274 FLUOCINOLON CR.0.01% 0.01% CRE 000016.39
PHAR 000008643275 THROMBIN W/DIL 20000U TOP 000111.46
PHAR 000008643276 BETAMETHASONE VALERAT 0.10% OI 000014.06
PHAR 000008643277 VIOFORM-HC OIN 20 GM 000017.74
PHAR 000008643278 HYDROCORTISONE VAL45G 0.20% CR 000039.41
PHAR 000008643279 CHLORASEPTIC SPRAY 000004.81
PHAR 000008643280 CORTISPORIN OIN TOP 000037.63
PHAR 000008643281 HALOTEX SOLN 10 ML 000013.73
PHAR 000008643282 SYNALAR HP CREAM 12G 000026.84
PHAR 000008643283 TOLNAFTATE 1% POW 000009.84
PHAR 000008643284 NITROGLYCERIN 0.2MG/HR PAT 000007.43
PHAR 000008643285 BETAMETHASONE VALERAT 0.10% LO 000031.03
PHAR 000008643286 VIOFORM-HC CRE MILD 000015.68
PHAR 000008643287 HYDROCORTISONE VAL60G 0.20% CR 000045.20
PHAR 000008643288 CLINDAMYCIN 1% TOP 1% TOP 000019.69
PHAR 000008643289 SPECTAZOLE CREAM 30G 000018.34
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643290 HALOTEX SOLN 30 ML 000025.95
PHAR 000008643291 SALICYLIC ACID BTL 1.8%ML LOT 000019.36
PHAR 000008643292 TEGRIN SHAMPOO 112.5 000007.58
PHAR 000008643293 TOLNAFTATE 1% TOP 000011.16
PHAR 000008643294 BETAMETHASONE VALERAT 0.10% LO 000058.52
PHAR 000008643295 VIOFORM-HC CREAM 20 000017.74
PHAR 000008643296 WHITFIELD'S OINT OIN TOP 000007.44
PHAR 000008643297 CLEOCIN-T 60 ML 000024.21
PHAR 000008643298 SEBULEX SHAMPOO 240 000011.92
PHAR 000008643299 TOLNAFTATE 1% CRE TOP 000011.86
PHAR 000008643300 VANOXIDE LOTION 25 G 000011.84
PHAR 000008643301 SALICYLIC ACID BTL 4% SHA TOP 000011.28
PHAR 000008643302 SPECTAZOLE CREAM 15G 000012.70
PHAR 000008643303 HIBICLENS 120 ML 000006.13
PHAR 000008643304 SEBULEX SHAMPOO 120 000009.00
PHAR 000008643305 TOLNAFTATE 1% TOP 000011.08
PHAR 000008643306 VANOXIDE LOTION 50 G 000016.32
PHAR 000008643307 HIBICLENS 240 ML 000008.23
PHAR 000008643308 COAL TAR/SALICYLIC AC SHA TOP 000020.23
PHAR 000008643309 TINVER LOTION 120 ML 000016.73
PHAR 000008643310 NITROGLYCERIN 0.4MG/HR PAT 000007.80
PHAR 000008643311 VANOXIDE-HC LOT 25GM 000015.31
PHAR 000008643312 BENZAC GEL 10% 60 GM 000017.98
PHAR 000008643313 DEXTRANOMER BEADS 25GM TOP 000036.94
PHAR 000008643314 HIBICLENS 480 ML 000009.81
PHAR 000008643315 SELENIUM SULF SHAMPOO 2.50% SH 000019.91
PHAR 000008643316 DESOXIMETASONE 0.25% CRE TOP 000027.00
PHAR 000008643317 NITROGLYCERIN 0.6MG/HR PAT 000008.11
PHAR 000008643318 VEHICLE-N LOTION 50 000009.29
PHAR 000008643319 DEXTRANOMER BEADS 60GM TOP 000075.18
PHAR 000008643320 SELENIUM SULF SHAMPOO 1% SHA T 000009.53
PHAR 000008643321 DESOXIMETASONE 0.25% CRE TOP 000058.44
PHAR 000008643322 VELVACHOL CREAM 454 000018.63
PHAR 000008643323 LIDOCAINE 5% OIN TOP 000019.00
PHAR 000008643324 DEXTRANOMER BEADS 120GM TOP 000142.43
PHAR 000008643325 SELENIUM SULF SHAMPOO 1% SHA T 000012.30
PHAR 000008643326 DESOXIMETASONE 0.05% CRE TOP 000019.50
PHAR 000008643327 LIDOCAINE JELLY 2% GEL 000021.90
PHAR 000008643328 DEXAMETHASONE 0.10% CRE TOP 000018.88
PHAR 000008643329 HIBICLENS 960 ML 000015.21
PHAR 000008643330 TRANSDERM-SCOP 4 DIS 000018.98
PHAR 000008643331 LIDOCAINE OINT 35G 5% OIN TOP 000019.48
PHAR 000008643332 DEXAMETHASONE 0.10% CRE TOP 000028.38
PHAR 000008643333 HIBICLENS SOL 1 GAL 000053.11
PHAR 000008643334 DESOXIMETASONE 0.05% CRE TOP 000044.64
PHAR 000008643335 SUTILAINS OINT 14.2G 1GM OIN T 000060.38
PHAR 000008643336 LIDOCAINE TOPICAL 4% TOP 000022.72
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643337 DEXAMETHASONEAER 25 0.04% TOP 000022.66
PHAR 000008643338 SPECTAZOLE CREAM 85G 000035.58
PHAR 000008643339 TOPICYCLINE SOL 70 M 000031.38
PHAR 000008643340 LIDOCAINE SPR 10% 60 000051.25
PHAR 000008643341 BENZOCAINE TOP 000007.54
PHAR 000008643342 HYDROCORTISONE 1% 1% CRE TOP 000027.49
PHAR 000008643343 TOPSYN GEL 0.05% 15 000012.36
PHAR 000008643344 COAL TAR 1% SHA TOP 000019.55
PHAR 000008643345 DESENEX SOL 45 ML 000007.75
PHAR 000008643346 HYDROCORTISONE 0.5% 0.50% CRE 000010.15
PHAR 000008643347 TOPSYN GEL 0.05% 60 000025.04
PHAR 000008643348 ZINC OXIDE OINT 30GM 20% OIN T 000008.27
PHAR 000008643349 ZINC UNDECYLENATE OIN TOP 000014.71
PHAR 000008643350 HYTONE CREAM 1% 30 G 000009.33
PHAR 000008643351 ACYCLOVIR 5% OIN TOP 000055.03
PHAR 000008643352 ZINC UNDECYLENATE POW 000011.02
PHAR 000008643353 ILOTYCIN OINT 1% 15G 000008.19
PHAR 000008643354 DESITIN OINT 120 G 000005.76
PHAR 000008643355 IONIL-T SHAMPOO 120 000009.16
PHAR 000008643356 DESITIN 40% OIN TOP 000005.02
PHAR 000008643357 DESITIN OINT 60 G 000004.21
PHAR 000008643358 GEL-KAM 129 GM 000010.31
PHAR 000008643359 DESQUAM-X GEL 10% 000011.66
PHAR 000008643360 TRIAMCINOLONE ACETONI 0.03% CR 000013.92
PHAR 000008643361 DESQUAM-X GEL 5% 000011.54
PHAR 000008643362 TRIAMCINOLONE ACETONI 0.10% CR 000041.22
PHAR 000008643363 BENZOYL PEROXIDE 5% TOP 000019.55
PHAR 000008643364 KENALOG CRE 0.1% 15G 000013.30
PHAR 000008643365 METHYLBENZETHONIUM CL POW 000005.62
PHAR 000008643366 KENALOG OIN 0.5% 20G 000036.60
PHAR 000008643367 METHYLBENZETHONIUM CL POW 000002.96
PHAR 000008643368 KENALOG CRE 0.1% 80G 000033.44
PHAR 000008643369 METHYLBENZETHONIUM OIN TOP 000004.30
PHAR 000008643370 TRIAMCINOLONE ACETONI 0.03% OI 000030.46
PHAR 000008643371 METHYLBENZETHONIUM OIN TOP 000003.54
PHAR 000008643372 TRIAMCINOLONE ACETONI 0.03% OI 000012.76
PHAR 000008643373 DIPROSONE CRE 0.05% 000034.08
PHAR 000008643374 KENALOG OIN 0.1% 60G 000029.03
PHAR 000008643375 DIPROSONE CRE 15 G 000018.28
PHAR 000008643376 TRIAMCINOLONE ACETONI 0.10% PS 000019.55
PHAR 000008643377 BETAMETHASONE DIPROPI 0.05% OI 000031.03
PHAR 000008643378 TRIAMCINOLONE ACETONI 0.10% LO 000053.08
PHAR 000008643379 BETAMETHASONE DIPROPI 0.05% OI 000055.33
PHAR 000008643380 KENALOG LOT .1% 15ML 000017.71
PHAR 000008643381 BETAMETHASONE DIPROPI 0.05% LO 000038.66
PHAR 000008643382 KENALOG SPRAY 23 GM 000015.70
PHAR 000008643383 BETAMETHASONE DIPROPI 0.05% LO 000069.66
9/7/2010 11:52 AM Page 253 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643384 TRIAMCINOLONE ACETONI 0.2MG TO 000038.41
PHAR 000008643385 BETAMETHASONE DIPROPI 85GM TOP 000031.03
PHAR 000008643386 KERI CREME 1GM CRE 000010.30
PHAR 000008643387 DOME-PASTE BANDAGES 000019.08
PHAR 000008643388 KERI LOTION LOT TOP 000012.95
PHAR 000008643389 CALAMINE/ZINC GELATIN TOP 000022.34
PHAR 000008643390 KOMED LOTION 52.5 ML 000012.48
PHAR 000008643391 DOMEBORO PACK 000002.46
PHAR 000008643392 KOMED-HC LOT 0.5% 60 000016.23
PHAR 000008643393 NITROGLYCERIN 2% OINT 30GM 000003.60
PHAR 000008643394 LINDANE CREAM 1% CRE TOP 000020.96
PHAR 000008643395 DOMEBORO TUBE 000003.58
PHAR 000008643396 LINDANE LOTION 1% LOT TOP 000015.73
PHAR 000008643397 SALICYLIC/LACTIC ACID TOP 000015.59
PHAR 000008643398 LINDANE LOTION 1% LOT TOP 000121.88
PHAR 000008643399 E-FEROL OINT 45 G 000016.92
PHAR 000008643400 LINDANE SHAMPOO 1% SHA TOP 000018.32
PHAR 000008643401 E-FEROL OINT 60 GM 000016.92
PHAR 000008643402 LINDANE SHAMPOO 1% SHA TOP 000116.00
PHAR 000008643403 FLUOROURACIL 5% CRE TOP 000052.67
PHAR 000008643404 LANOLIN 30GM OIN TOP 000004.27
PHAR 000008643405 FLUOROURACIL 2% TOP 000034.97
PHAR 000008643406 LANOLIN, TOILET 30 G 000004.50
PHAR 000008643407 FLUOROURACIL 5% TOP 000045.08
PHAR 000008643408 LAVACOL 480 ML 000003.60
PHAR 000008643409 ELASE OINTMENT 30 GM 000044.08
PHAR 000008643410 FLUOCINONIDE CREAM 0.05% CRE T 000016.14
PHAR 000008643411 ELASE-CHLOROMYCETIN 000047.00
PHAR 000008643412 HYDROQUINONE CRE 15GM 2% CRE T 000018.62
PHAR 000008643413 HYDROQUINONE 4% CRE TOP 000027.62
PHAR 000008643414 ELDOQUIN CREAM 2% 15 000011.15
PHAR 000008643415 HYDROQUINONE CRE 30GM 2% CRE T 000031.66
PHAR 000008643416 HYDROQUINONE LOT 15ML 2% LOT T 000017.46
PHAR 000008643417 HYDROQUINONE CRE 30GM 4% CRE T 000045.07
PHAR 000008643418 HYDROQUINONE CRE 15GM 4% CRE T 000017.70
PHAR 000008643419 CHLORASEPTIC 360 ML 000007.59
PHAR 000008643420 DEXTRANOMER BEADS 4GM TOP 000003.97
PHAR 000008643421 ELASE VIAL 000030.06
PHAR 000008643422 MONISTAT-7 SUPP 000007.52
PHAR 000008643423 MICONAZOLE NITRATE 2% CRE TOP 000027.86
PHAR 000008643424 NYSTATIN 15GM OIN TOP 000013.25
PHAR 000008643425 NYSTATIN 15GM CRE TOP 000013.40
PHAR 000008643426 NYSTATIN 30GM CRE TOP 000035.83
PHAR 000008643427 NYSTATIN 30GM OIN TOP 000035.83
PHAR 000008643428 BENZAC W GEL 10% 60 000017.10
PHAR 000008643429 LIDEX SOL 0.05% 20 M 000022.29
PHAR 000008643430 FLUOCINONIDE SOLUTION 0.05% TO 000060.11
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643431 METHYL SALICYL/MENTHO OIN TOP 000005.96
PHAR 000008643432 NITROGLYCERIN 2% OIN TOP 000013.07
PHAR 000008643433 DESOXIMETASONE 0.05% GEL 000021.78
PHAR 000008643434 DESOXIMETASONE 0.05% GEL 000053.70
PHAR 000008643435 TRIAMCINOLONE ACETONI 0.03% CR 000035.80
PHAR 000008643436 BAG BALM 10 OZ 000003.58
PHAR 000008643437 TRIAMCINOLONE ACETONI 0.10% CR 000011.59
PHAR 000008643438 LOTRIMIN CREAM 1% 45 000022.84
PHAR 000008643439 NYSTATIN CREME 30GM 1GM CRE TO 000009.91
PHAR 000008643440 MYCOLOG CREAM 15 G 000013.25
PHAR 000008643441 HALOTEX CREAM 15 G 000014.42
PHAR 000008643442 HYDROCORTISONE 1% 1% OIN TOP 000016.75
PHAR 000008643443 POLYSPORIN OIN TOP 000011.77
PHAR 000008643444 POLYSPORIN OIN TOP 000009.50
PHAR 000008643445 SCOPOLAMINE DISC #1 1.5MG DIS 000011.28
PHAR 000008643446 BENZOCAINE 20% TOP 000021.00
PHAR 000008643447 PYRITHIONE ZINC SHA TOP 000010.62
PHAR 000008643448 PYRITHIONE ZINC TOP 000010.31
PHAR 000008643449 PYRITHIONE ZINC 2% SHA TOP 000011.80
PHAR 000008643450 EAR PLUGS-SLEEPWELL OTIC 000002.48
PHAR 000008643451 LIDEX OINT 0.05%120G 000066.66
PHAR 000008643452 TETRACYCLINE HCL 3% OIN TOP 000018.46
PHAR 000008643453 TRIAMCINOLONE ACETONI 0.10% CR 000015.70
PHAR 000008643454 CYCLOCORT OINT 0.1% 000035.26
PHAR 000008643455 BETADINE OINT 30 GM 000009.80
PHAR 000008643456 CLONIDINE PATCH 0.1 0.1MG PAT 000017.94
PHAR 000008643457 CLONIDINE PATCH 0.2 0.2MG PAT 000026.92
PHAR 000008643458 CLONIDINE PATCH 0.3 0.3MG PAT 000035.45
PHAR 000008643459 VASELINE JELLY 52.5 000002.77
PHAR 000008643460 VASELINE JELLY 112.5 000003.90
PHAR 000008643461 COMPLEX 15 LOTION 000010.78
PHAR 000008643462 COMPLEX 15 CREAM 120 000011.56
PHAR 000008643463 EUCERIN CRE TOP 000005.81
PHAR 000008643464 NEOSPORIN CREAM 15 G 000007.56
PHAR 000008643465 FLUONID 0.025% 15 G 000014.10
PHAR 000008643466 FLUONID 0.025% 60 G 000025.81
PHAR 000008643467 FLUONID 0.025% 15 G 000014.00
PHAR 000008643468 FLUONID 0.025% 60 G 000025.64
PHAR 000008643469 BETAMETHASONE VALERAT 0.10% CR 000009.95
PHAR 000008643470 LOTRISONE CRE TOP 000027.76
PHAR 000008643471 LOTRISONE CRE TOP 000054.36
PHAR 000008643472 CETYLPYRIDINIUM CHLOR PO 000004.20
PHAR 000008643473 PHISODERM 5 OZ 000005.08
PHAR 000008643474 KENALOG OINT 0.1% 15 000013.21
PHAR 000008643475 ESTAR GEL 90 G 000014.55
PHAR 000008643476 MYCELEX CREAM 1% 30 000017.58
PHAR 000008643477 MYCELEX SOL 1% 10 ML 000011.31
9/7/2010 11:52 AM Page 255 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643478 MYCELEX SOL 1% 30 ML 000018.68
PHAR 000008643479 PRESUN 15 LOTION 60 000013.53
PHAR 000008643480 MAFENIDE ACETATE 120GM CRE TOP 000066.48
PHAR 000008643481 NYSTATIN/TRIAMCINONOL 1GM OIN 000022.00
PHAR 000008643482 NYSTATIN/TRIAMCINOLON 1GM OIN 000038.63
PHAR 000008643483 NYSTATIN/TRIAMCINOLON 1GM OIN 000061.43
PHAR 000008643484 NYSTATIN/TRIAMCIN CR 000006.50
PHAR 000008643485 MYCOGEN II 30GM TUBE 1GM CRE T 000011.82
PHAR 000008643486 MYCOGEN II 1GM CRE TOP 000016.14
PHAR 000008643487 POLYSPORIN POW 000016.27
PHAR 000008643488 COLLODION FLEXIBLE 000005.13
PHAR 000008643489 MYOFLEX CREAM 10% 60 000007.75
PHAR 000008643490 FLUOCINOLONE 0.1% CR. 0.10% CR 000019.63
PHAR 000008643491 SALICYLIC ACID BTL 2% SHA TOP 000010.98
PHAR 000008643492 KETOCONAZOLE CRE 15GM 2% CRE T 000020.99
PHAR 000008643493 KETOCONAZOLE CRE 30GM 2% CRE T 000036.79
PHAR 000008643494 BETAMET DIP OINT .05 000008.92
PHAR 000008643495 BETAMETHASONE DIPROP 0.05% OIN 000067.22
PHAR 000008643496 BETAMETHASONE DIPROP 0.05% CRE 000037.10
PHAR 000008643497 BETAMETHASONE DIPROP 0.05% CRE 000067.22
PHAR 000008643498 LASAN CREAM 0.1% 65 000013.23
PHAR 000008643499 LASAN CREAM 0.2% 65 000013.56
PHAR 000008643500 LASAN CREAM 0.4% 65 000014.51
PHAR 000008643501 LASAN HP CREAM 1% 65 000014.95
PHAR 000008643502 LASAN OINT 0.4% 60 G 000014.84
PHAR 000008643503 EXSEL SHAMPOO 120 ML 000013.98
PHAR 000008643504 HYDROCORTISONE CR 1% 000006.28
PHAR 000008643505 NITROGLYCERIN 0.1MG/HR PAT 000007.06
PHAR 000008643506 NITROGLYCERIN 0.2MG/HR PAT 000007.09
PHAR 000008643507 NITROGLYCERIN 0.3MG/HR PAT 000007.37
PHAR 000008643508 NITROGLYCERIN 0.4MG/HR PAT 000007.37
PHAR 000008643509 NITROGLYCERIN 0.6MG/HR PAT 000007.58
PHAR 000008643510 FLUOCINONIDE GEL 0.05% GEL 000061.58
PHAR 000008643511 FLUOCINONIDE GEL 0.05% GEL 000028.94
PHAR 000008643512 FLUOCINONIDE GEL 0.05% GEL 000039.30
PHAR 000008643513 MICONAZOLE NITR. DUAL 1PAK PAK 000041.11
PHAR 000008643514 BENZAMYCIN GEL GEL 000026.77
PHAR 000008643515 BENZAC GEL 5% 60 G 000013.23
PHAR 000008643516 HYDROCORTISONE 0.50% CRE 000007.68
PHAR 000008643517 CHLORASEPTIC 000009.47
PHAR 000008643518 CLOTRIMAZOLE 1% LOT TOP 000032.36
PHAR 000008643519 MICONAZOLE NITRATE 200MG SUP V 000038.66
PHAR 000008643520 MONISTAT SUPPOS 200M 000011.32
PHAR 000008643521 MICONAZOLE NITRATE 100MG SUP V 000027.86
PHAR 000008643522 MONISTAT SUPP 100 MG 000007.52
PHAR 000008643523 LAC-HYDRIN 12% 5 OZ 000014.06
PHAR 000008643524 ZINC UNDECYLENATE 27G OIN TOP 000010.98
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643525 SYNALAR CR 0.025% 30 000018.92
PHAR 000008643526 NYSTATIN CRE 15GM 15GM CRE TOP 000008.27
PHAR 000008643527 ARISTOCORT CR 0.1 60 000026.08
PHAR 000008643528 NITROGLYCERIN 2% OIN TOP 000016.01
PHAR 000008643529 EUCERIN CREAM 454 G 000015.15
PHAR 000008643530 POLYSPORIN SPRAY TOP 000010.51
PHAR 000008643531 GRANULEX AEROSOL 4OZ 000019.55
PHAR 000008643532 TEMOVATE CREAM 0.05% 000029.83
PHAR 000008643533 TEMOVATE OINT 0.05% 000029.83
PHAR 000008643534 TEMOVATE CREAM 0.05% 000022.06
PHAR 000008643535 TEMOVATE OINT 0.05% 000022.06
PHAR 000008643536 CAPSAICIN 0.25% CRM 45GM 000040.18
PHAR 000008643537 CLINDAMYCIN 1% GEL 000031.38
PHAR 000008643538 PSORCON OINT 0.05% 3 000026.91
PHAR 000008643539 MAXIVATE CRE .05% 15 000017.97
PHAR 000008643540 NYSTATIN/TRIAMCINOLON CRE TOP 000008.98
PHAR 000008643541 THROMBIN W/DIL 5000U TOP 000036.23
PHAR 000008643542 DESOXIMETASONE 0.25% OIN TOP 000027.00
PHAR 000008643543 NYSTATIN/TRIAMCINOLON CRE TOP 000011.66
PHAR 000008643544 MUPIROCIN 2% OIN TOP 000034.51
PHAR 000008643545 BETAMETHASONE VALERAT 0.10% OI 000010.08
PHAR 000008643546 BETAMETHASONE DIPROPI 0.05% CR 000013.04
PHAR 000008643547 BETAMETH OINT 0.05% 000012.52
PHAR 000008643548 BETAMETHASONE DIPROPI 0.05% CR 000019.49
PHAR 000008643549 THROMBOGEN 10,000 U 000206.64
PHAR 000008643550 THROMBOGEN 10,000 U 000419.80
PHAR 000008643551 THICK-IT #2 8OZ. 000012.45
PHAR 000008643552 PSORCON OINT 0.05%60 000048.39
PHAR 000008643553 AQUAPHOR OINT 3.25OZ 000008.48
PHAR 000008643554 MERTHIOLATE 3/4 OZ 000003.93
PHAR 000008643555 NYSTATIN/TRIAMCINOLON OIN TOP 000012.30
PHAR 000008643556 BETAMETH VAL .1% OIN 000007.24
PHAR 000008643557 NYSTATIN/TRIAMCINOLON OIN TOP 000009.18
PHAR 000008643558 NYSTATIN OINT 15GM 1GM OIN TOP 000008.44
PHAR 000008643559 METHYL SALICYLATE OIL OIL TOP 000003.73
PHAR 000008643560 TRIPLE ANTIBIOTIC OIN TOP 000007.94
PHAR 000008643561 HYDROCORT CR 1% 20G 000005.98
PHAR 000008643562 HYDROCORT CR 1% 20GM 000005.98
PHAR 000008643563 PRONTO AER 1% 150 GM 000008.49
PHAR 000008643564 GELATIN 50 TOP 000034.37
PHAR 000008643565 GELATIN 100 TOP 000041.80
PHAR 000008643566 STOMAHESIVE POWDER POW 000014.00
PHAR 000008643567 PRAMOSONE LOT 2.5% 000018.85
PHAR 000008643568 PRAMOSONE LOT 1% 120 000018.50
PHAR 000008643569 TRETINOIN 0.03% CRE TOP 000072.06
PHAR 000008643570 TRETINOIN 0.03% CRE TOP 000040.68
PHAR 000008643571 BENZOCAINE TOP 000013.72
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643572 HYDROCORTISONE 0.5% 0.50% OIN 000007.44
PHAR 000008643573 ELOCON OIN 0.1% 15 G 000018.65
PHAR 000008643574 MAXIVATE 0.05% 45GM 000037.61
PHAR 000008643575 TRIAMCINOLONE ACETONI 0.10% OI 000011.64
PHAR 000008643576 HYDROCORTISONE 2.5% 2.50% OIN 000030.36
PHAR 000008643577 HYTONE LOTION 1% 000030.34
PHAR 000008643578 BACITRACIN/POLYMYXIN OIN TOP 000007.92
PHAR 000008643579 BACITRACIN/POLYMYXIN OIN TOP 000009.24
PHAR 000008643580 AMERICAINE AER 20GM 000007.12
PHAR 000008643581 SOLARCAINE LOT 90 ML 000007.44
PHAR 000008643582 CALMOSEPTINE 113 GM OIN TOP 000009.72
PHAR 000008643583 THERA-GESIC SOL 90ML 000008.08
PHAR 000008643584 BAG BALM 1OZ OIN TOP 000004.50
PHAR 000008643585 PEPPERMINT OIL NF 30ML 000007.04
PHAR 000008643586 CAMPHO-PHENIQUE GEL 000008.56
PHAR 000008643587 OXY-10 ACNE LOT 30 M 000009.51
PHAR 000008643588 SILVER SULFADIA TUBE 1% CRE TO 000007.66
PHAR 000008643589 CLEARASIL LOT 10% 30 000008.26
PHAR 000008643590 PERMETHRIN 1% TOP 000018.86
PHAR 000008643591 NICOTINE 7MG PAT 000012.32
PHAR 000008643592 NICOTINE 14MG PAT 000012.74
PHAR 000008643593 NICOTINE 21MG PAT 000013.20
PHAR 000008643594 ACYCLOVIR 3GM 5% OIN TOP 000023.35
PHAR 000008643595 TERAZOL 7 CRM 45GM 000059.63
PHAR 000008643596 VITAMIN E 3000U CRE TOP 000006.96
PHAR 000008643597 BENZOCAINE 7.50% GEL 000007.57
PHAR 000008643598 TRIAMCINOLNE ACE 0.1% 0.10% CR 000027.98
PHAR 000008643599 HABITROL 21 MG/24HR 000009.02
PHAR 000008643600 AQUAPHOR OIN TOP 000024.12
PHAR 000008643601 ZOSTRIX-HP CRE 60 GM 000054.58
PHAR 000008643602 LIDOCAINE SPRAY 10% 000065.06
PHAR 000008643603 EAR PLUGS OTIC 000005.81
PHAR 000008643604 CARMEX OINT JAR 000002.71
PHAR 000008643605 NITROGLYCERIN 2% OIN TOP 000002.82
PHAR 000008643606 MOMETASONE FUROATE 0.10% OIN T 000028.18
PHAR 000008643607 VITAMIN E OIL 1 OZ. 000007.63
PHAR 000008643608 NIX RINSE 1% 60ML 000014.02
PHAR 000008643610 MOMETASONE FUROATE 0.10% OIN T 000050.62 250
PHAR 000008643612 ELIMITE CRM 5% 60GM 000028.03 250
PHAR 000008643613 MOMETASONE FUROATE 0.10% CRE T 000041.69 250
PHAR 000008643614 MOMETASONE FUROATE 0.10% CRE T 000022.38 250
PHAR 000008643623 SWEEN CREAM CRE TOP 000012.52 250
PHAR 000008643624 MICONAZOLE NITRATE 2% TOP 000010.39 250
PHAR 000008643626 STOMAHESIVE PASTE PST TOP 000017.30 250
PHAR 000008643634 LIDOCAINE HCL GEL UD 2% GEL 000013.80 250
PHAR 000008643641 DIFLORASONE DIACETAT 0.05% CRM 000062.14 250
PHAR 000008643654 NICOTINE 7MG PAT 000011.66 250
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008643655 NICOTINE 14MG PAT 000011.66 250
PHAR 000008643656 NICOTINE 21MG PAT 000011.66 250
PHAR 000008643657 HYDROCORTISONE 2.5% 2.50% CRM 000018.17 250
PHAR 000008643658 TESTOSTERONE 5MG PAT 000007.98 250
PHAR 000008643659 LANOLIN ANHYDROUS CR 60GM CR 000012.49 250
PHAR 000008643661 ORAJEL BABY LIQUID 0.45OZ 000008.15 250
PHAR 000008643663 CALMOSEPTINE UD 5ML 000001.66 250
PHAR 000008643665 METROGEL 0.75% 30GM 000062.52 250
PHAR 000008643673 BACTROBAN 2% OINT 22GM 000071.95 250
PHAR 000008643676 PENCICLOVIR 1% CRM 1.5GM 000045.53 250
PHAR 000008643678 TESTOSTERONE 2.5MG PAT 000010.05 250
PHAR 000008643681 LAC-HYDRIN 12% CRM 280GM 000077.60 250
PHAR 000008644001 METAPROTERENOL SULFAT 5% NEB 000022.45
PHAR 000008644002 METAPROTERENOL SULFAT 5% INH 000031.15
PHAR 000008644003 DUO-MEDIHALER 22.5ML 000031.50
PHAR 000008644004 CROMOLYN SODIUM 20MG CAP 000003.47
PHAR 000008644005 CROMOLYN SODIUM INHL 000017.40
PHAR 000008644006 ISOPROTERENOL HCL 0.50% INH 000137.90
PHAR 000008644007 MUCOMYST 20% 10 ML 000025.46
PHAR 000008644008 BECLOVENT 16.8GM 000086.64
PHAR 000008644009 DUO-MEDIHALER 22.5ML 000033.66
PHAR 000008644010 INTAL SPINHALER 000012.60
PHAR 000008644011 ISOPROTERENOL HCL 0.50% INH 000037.25
PHAR 000008644012 EPINEPHRINE BITARTRAT 7MG INH 000035.42
PHAR 000008644013 ACETYLCYSTEINE 20% SOL 200 000099.26
PHAR 000008644014 ALBUTEROL INHALER 17GM INH 000037.27
PHAR 000008644015 ALUPENT 0.6% 2.5ML 000003.43
PHAR 000008644016 BECLOMETHASONE DIPROP NAS 25G 000079.98
PHAR 000008644017 DUO-MEDIHALER 15 REF 000024.58
PHAR 000008644018 ISOPROTERENOL HCL 1% INH 000038.74
PHAR 000008644019 MEDIHALER-ERGOTAMINE 000042.10
PHAR 000008644020 MUCOMYST 10% 10 ML 000022.25
PHAR 000008644021 DUO-MEDIHALER 15 ML 000026.86
PHAR 000008644022 MUCOMYST 10% 30 ML 000053.17
PHAR 000008644023 ISOETHARINE MESYLATE 0.61% INH 000037.84
PHAR 000008644024 ISOPROTERENOL MIST-O 0.25% INH 000046.45
PHAR 000008644025 MEDIHALER ISO 22.5ML 000031.26
PHAR 000008644026 BRONKOMETER AER 20ML 000015.54
PHAR 000008644027 ISUPREL MIST 22.5ML 000016.11
PHAR 000008644028 MEDIHALER-ISO 15ML 000024.46
PHAR 000008644029 BRONKOSOL 10 ML 000014.68
PHAR 000008644030 BRONKOSOL 30 ML 000036.64
PHAR 000008644031 ALUPENT INH REFILL 000016.72
PHAR 000008644032 BRETHAIRE 7.5 ML INH 000018.64
PHAR 000008644033 TERBUTALINE SULFATE 7.5ML INH 000032.34
PHAR 000008644034 PROVENTIL INH REFILL 000022.22
PHAR 000008644035 VANCENASE INHALER 000030.47
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008644036 TRIAMCINOLONE ACETONI 100MCG I 000061.61
PHAR 000008644037 FLUNISOLIDE 0.03% INH 000069.07
PHAR 000008644038 TORNALATE INHALER 000024.32
PHAR 000008644039 CROMOLYN SODIUM INHL 000088.55
PHAR 000008644040 CROMOLYN SODIUM INHL 000057.62
PHAR 000008644041 ISOETHARINE HCL 1% INH 000028.79
PHAR 000008644042 ISOETHARINE HCL 1% INH 000070.96
PHAR 000008644043 NITROGLYCERIN 0.4MG 000022.78
PHAR 000008644044 INSPIRESE BAG 1BAG 000004.91
PHAR 000008644045 INSPIRESE KIT 1BAG 000018.19
PHAR 000008644046 BECLOMETHASONE INHALE INH 16. 000072.00
PHAR 000008644047 IPRATROPIUM BROMIDE 14GM INH 000043.20
PHAR 000008644048 ISOETHARINE MESYLATE 0.61% INH 000046.73
PHAR 000008644049 ALBUTEROL NEB SOLN 0.08% INH 000027.04
PHAR 000008644050 BECLOMETHASONE AQUEOU 25GM INH000112.34
PHAR 000008644051 BECONASE-AQ 25 ML IN 000031.87
PHAR 000008644052 ACETYLCYSTEINE 10% SOL 100 000012.05
PHAR 000008644053 ACETYLCYSTEINE 20% SOL 200 000014.22
PHAR 000008644054 ALBUTEROL NEB SOL 0.50% INH 000006.00
PHAR 000008644055 PROVENTIL NEB 0.083% 000005.74
PHAR 000008644057 PENTAMIDINE 300MG NEB 000355.50 250
PHAR 000008644058 AEROCHAMBER INH DEV 000036.98 250
PHAR 000008644060 BECONASE INH 7GM 000045.26 250
PHAR 000008644062 TRIAMCINOLONE ACETONI METERED 000057.19 250
PHAR 000008644063 NEDOCROMIL SODIUM 16.2GM INH 000066.02 250
PHAR 000008644070 DORNASE ALFA 2.5M AMP 1MG INH 000052.68 250
PHAR 000008644073 IPRATROPIUM SOL UD 0.02% INH 000008.60 250
PHAR 000008644074 ACETYLCYSTEINE VIAL SOL 20% 000178.25 250
PHAR 000008644075 SALMETEROL XINAFOATE 1DOSE INH 000097.80 250
PHAR 000008644077 CALCITONIN NASAL SOL 000055.66 250
PHAR 000008644080 FLONASE NASAL SPRAY 000103.65 250
PHAR 000008644081 FLUTICASONE PROP. 44MCG INH 000084.53 250
PHAR 000008644082 FLUTICASONE PROP. 110MCG INH 000103.51 250
PHAR 000008644083 FLUTICASONE PROP. 220MCG INH 000161.56 250
PHAR 000008644084 NEDOCROMIL UD PUFF IDOSE INH 000000.00 250
PHAR 000008644085 AZELASTINE NASAL SP. 34ML NASL 000087.14 250
PHAR 000008644086 PONARIS NASAL EMMLNT 1 OZ NASL 000014.89 250
PHAR 000008644087 COMBIVENT INH 14.7GM 000075.72 250
PHAR 000008644090 RELENZA 5MG INH KIT 000086.45 250
PHAR 000008644092 PULMICORT INH 200MCG 000229.87 250
PHAR 000008644099 ADVAIR 100/50MCG INH 000206.76 250
PHAR 000008644100 ADVAIR 250/50MCG INH 000261.40 250
PHAR 000008644101 ADVAIR 500/50MCG INH 000258.86 250
PHAR 000008648001 PROGESTERONE SUP 400 000006.60
PHAR 000008648002 ACETAMINOPHEN SUP 120 000003.22
PHAR 000008648003 ERGOTAMINE/CAFFEINE 1SUPP SUP 000011.50
PHAR 000008648004 FLEET PEDIATRIC ENEMA ENE 000000.00
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008648005 PROCTOFOAM-HC RECT 000031.99
PHAR 000008648006 CHLORAL HYDRATE 500MG SUP PR 000007.16
PHAR 000008648007 WITCH HAZEL PADS PAD 1EA 000007.78
PHAR 000008648008 TRIMETHOBENZAMIDE 100MG SUP 000003.40
PHAR 000008648009 CAFERGOT PB SUPP 000008.11
PHAR 000008648010 MINERAL OIL ENEMA ENE RECT 000007.00
PHAR 000008648011 PENTOBARBITAL SODIUM 120MG SUP 000013.54
PHAR 000008648012 ACETAMINOPHEN SUP 650 000002.84
PHAR 000008648013 PROCHLORPERAZINE 2.5MG SUP PR 000008.36
PHAR 000008648014 FLEET ENEMA ENE 000000.00
PHAR 000008648015 RECTAL MEDICONE SUPP 000002.34
PHAR 000008648016 PENTOBARBITAL SODIUM 60MG SUP 000012.76
PHAR 000008648017 ACETAMINOPHEN SUP 325 000002.81
PHAR 000008648018 PROCHLORPERAZINE 5MG SUP PR 000008.76
PHAR 000008648019 GLYCERIN ADULT SUPP SUP PR 000002.62
PHAR 000008648020 RECT MEDIC OIN 45GM 000007.75
PHAR 000008648021 PENTOBARBITAL SODIUM 200MG SUP 000014.06
PHAR 000008648022 PROCHLORPERAZINE 25MG SUP PR 000009.71
PHAR 000008648023 GLYCERIN SUP INFANT 000002.14
PHAR 000008648024 RECT MEDIC SUP HC 000002.73
PHAR 000008648025 CORT-DOME SUPP 15 MG 000005.94
PHAR 000008648026 SENOKOT SUPP 000006.00
PHAR 000008648027 AMINOPHYLLINE 250MG SUP PR 000002.84
PHAR 000008648028 CORTENEMA ENE 60ML 000015.80
PHAR 000008648029 DIBUCAINE SUP PR 000003.06
PHAR 000008648030 CHLORPROMAZINE 25MG SUP PR 000009.88
PHAR 000008648031 AMINOPHYLLINE 500MG SUP PR 000002.93
PHAR 000008648032 CORTICAINE CREAM 30G 000010.50
PHAR 000008648033 DIBUCAINE 0.50% CRE TOP 000009.13
PHAR 000008648034 CHLORPROMAZINE HCL 100MG SUP P 000011.23
PHAR 000008648035 ANUSOL OIN TOP 000009.86
PHAR 000008648036 HYDROCORTISONE 10% 10% TOP 000060.96
PHAR 000008648037 DIBUCAINE 1% OIN TOP 000012.91
PHAR 000008648038 TIGAN SUPP PED 100MG 000005.54
PHAR 000008648039 ANUSOL SUP PR 000003.10
PHAR 000008648040 DERMA MEDICONE 30 GM 000006.85
PHAR 000008648041 ANUSOL HC SUPP SUP PR 000006.78
PHAR 000008648042 PROMETHAZINE HCL SUP 12. 000008.27
PHAR 000008648043 TIGAN SUPP 200 MG 000005.82
PHAR 000008648044 ANUSOL HC 30GM 2.50% CRE PR 000032.11
PHAR 000008648045 BISACODYL 10MG SUP 000002.56
PHAR 000008648046 PROMETHAZINE HCL SUP 50M 000009.90
PHAR 000008648047 TORECAN SUPP 10 MG 000003.21
PHAR 000008648048 ASPIRIN 120MG SUPP 120MG SUP P 000002.84
PHAR 000008648049 PROMETHAZINE HCL SUP 25M 000008.78
PHAR 000008648050 WITCH HAZEL CRE 40GM 50% CRE T 000010.19
PHAR 000008648051 PREPARATION H OIN RECT 000010.58
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008648052 WIGRAINE SUPP 000006.00
PHAR 000008648053 PREPARATION H SUP PR 000003.19
PHAR 000008648054 WYANOID SUPP 000002.40
PHAR 000008648055 HYDROCORTISONE 1% 1% CRE PR 000029.89
PHAR 000008648056 WYANOID-HC SUPP 000002.85
PHAR 000008648057 ASPIRIN 300MG SUPP 300MG SUP P 000002.86
PHAR 000008648058 ASPIRIN 600MG SUPP 600MG SUP P 000002.88
PHAR 000008648059 TRIMETHOBENZAMIDE 200MG SUP 000003.11
PHAR 000008648060 PROGESTERONE SUPP 25 000002.98
PHAR 000008648061 PROGESTERONE SUP 100 000005.95
PHAR 000008648062 PROGESTERONE SUP 400 000006.60
PHAR 000008648063 DIBUCAINE 1% OIN 000009.85
PHAR 000008648064 PROCTOFOAM AEROSOL 000012.88
PHAR 000008648065 INDOMETHACIN 50MG SUPP 000007.40
PHAR 000008648066 CORT-DOME SUPPOS 25 000007.21
PHAR 000008648067 CORTICAINE SUPPOS 000002.89
PHAR 000008648068 ASPIRIN SUPP 125 MG 000002.13
PHAR 000008648069 CEO-TWO SUPPOS 000002.77
PHAR 000008648070 PENTOBARBITAL SODIUM 30MG SUP 000011.76
PHAR 000008648071 PROCTOCREAM-HC 1% CRE TOP 000028.87
PHAR 000008648072 GLYCERIN SUPP PEDS SUP PR 000007.24
PHAR 000008648073 CHLORAL HYDRATE 650MG SUP PR 000003.38
PHAR 000008648074 CHLORAL HYDRATE 325 MG SUP PR 000009.30 250
PHAR 000008648075 HYDROCORTISONE 25MG SUP PR 000003.52 250
PHAR 000008648078 MESALAMINE 4GM ENE PR 000017.96 250
PHAR 000008648079 SODIUM POLYST ENEMA 0.25GM SUS 000036.17 250
PHAR 000008649001 AVC SUPPOS 000005.86
PHAR 000008649002 DIENESTROL 0.01% CRE VAG 000038.81
PHAR 000008649003 CLOTRIMAZOLE 100MG TAB VAG 000023.16
PHAR 000008649004 TERAZOL-3 VAG SUPP 000031.26
PHAR 000008649005 "ESTROGENS, CONJUGATED" 42.5GM 000050.41
PHAR 000008649006 DINOPROSTONE 20MG SUP VAG 000152.14
PHAR 000008649007 SULFABENZAMIDE CRE VAG 000043.63
PHAR 000008649008 MYCOSTATIN VAGINAL 000003.26
PHAR 000008649009 ORTHO-GYNOL JEL, REF 000010.06
PHAR 000008649010 SULTRIN SUP VAG 000007.48
PHAR 000008649011 AVC VAG CRE W/APPLIC 000029.94
PHAR 000008649012 AVC/DIENEST SUP - UD 000003.07
PHAR 000008649013 AVC/DIENEST CREAM 000018.20
PHAR 000008649014 CLOTRIMAZOLE 1% CRE VAG 000022.31
PHAR 000008649015 MYCELEX-G CREAM 90 G 000030.69
PHAR 000008649016 POVIDONE-IODINE-DOUCH 0.25% VA 000006.80
PHAR 000008649017 METROGEL 0.75% 30GM 000030.88
PHAR 000008649018 NYSTATIN VAGINAL TAB VAG 000003.35
PHAR 000008649019 CLOTRIMAZOLE 500MG TAB VAG 000027.68
PHAR 000008649020 TAVIST SYRP 4 OZ 000035.02
PHAR 000008649021 TRIPLE SULFA CRE VAG 000011.45
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Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008649022 MASSENGILL DCHE 180M 000002.43
PHAR 000008649024 DINOPROSTONE VAG SYR 0.5 MG GE 000142.87 250
PHAR 000008649025 CLINDAMYCIN 2% CRE VAG 000044.44 250
PHAR 000008649026 METRONIDAZOLE 0.75% 0.75% GEL 000056.95 250
PHAR 000008650001 CEFAMANDOL PB 000052.00
PHAR 000008650014 CEFTIZOXIME PB 000072.00
PHAR 000008650027 CEFAZOLIN PB 000115.00
PHAR 000008650040 CEFOPERAZ PB 000105.00
PHAR 000008650053 CEFOTAXIM PB 000245.44
PHAR 000008650066 CEFOXITIN PB 000052.00
PHAR 000008650079 CEFUROXIM PB 000072.00
PHAR 000008650086 MOXALACT PB 000072.00
PHAR 000008650099 CEFONICID PB 000105.00
PHAR 000008650112 CEFTRIAXONE PB 000105.00
PHAR 000008650128 CEFORANIDE 000055.00
PHAR 000008650156 CEFORANIDE PB 000072.00
PHAR 000008650168 CEFTAZIDIME/PB 000078.00
PHAR 000008650178 CEFTRIAXONE/PB 000615.12
PHAR 000008650188 CEFOTAN/PB 000065.00
PHAR 000008650334 CEFAZOLIN PIGGYBACK INJ 100 000038.40 250
PHAR 000008650335 CEFAZOLIN 0.25GM IVPB 000028.80 250
PHAR 000008650336 CEFAZOLIN 0.5 GM 000024.00 250
PHAR 000008650337 CEFAZOLIN 0.75GM IVPB 000034.80 250
PHAR 000008650338 CEFAZOLIN 1GM IVPB 000038.40 250
PHAR 000008650339 CEFAZOLIN 1.5GM IVPB 000049.20 250
PHAR 000008650340 CEFAZOLIN 2GM IVPB 000057.60 250
PHAR 000008650341 CEFAZOLIN 2.5 GM IVPB 000069.60 250
PHAR 000008650342 CEFAZOLIN 3GM IVPB 000074.40 250
PHAR 000008650343 CEFAZOLIN 3.5GM IVPB 000093.60 250
PHAR 000008651001 CARBENIC PB 000022.00
PHAR 000008651016 NAFCILLIN PB 000043.00
PHAR 000008651031 PEN G K PB 000020.00
PHAR 000008651042 PEN G SOD PB 000043.00
PHAR 000008651053 TICARCILL PB 000029.00
PHAR 000008651069 METHICILL PB 000043.00
PHAR 000008651082 PIPERACILL PB 000055.00
PHAR 000008651092 MEZLOCILL PB 000031.00
PHAR 000008651107 PEN G K PB 000020.00
PHAR 000008651129 PEN G SOD PB 000043.00
PHAR 000008651134 OXACILLIN/PB 000043.00
PHAR 000008651145 TIMENTIN/PB 000072.00
PHAR 000008651151 NAFCILLIN PB 000037.00
PHAR 000008651166 CARBENIC PB 000034.00
PHAR 000008651181 PEN G K PB 000031.00
PHAR 000008651192 PEN G SOD PB 000043.00
PHAR 000008651203 TICARCILL PB 000091.00
PHAR 000008651219 METHICILL PB 000043.00
9/7/2010 11:52 AM Page 263 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008651232 PIPERACILL PB 000055.00
PHAR 000008652001 GENTAMIC PB 000072.00
PHAR 000008652019 TOBRAMYC PB 000284.09
PHAR 000008652037 TOBRAMYC PEDS PB 000027.00
PHAR 000008652042 GENT PEDS PB 000020.00
PHAR 000008652047 AMPICILL PB 000115.00
PHAR 000008652063 AMIKACIN PB 000221.49
PHAR 000008652068 AMIKACIN PB 000115.00
PHAR 000008652069 AMIKACIN [C] INJ 250 000417.85
PHAR 000008652074 AMIKACIN (PEDS) 000115.00
PHAR 000008652081 GENTAM INTRATHECAL 000024.00
PHAR 000008652088 GENTAMIC PB 000072.00
PHAR 000008652106 TOBRAMYC PB 000480.77
PHAR 000008652123 AMIKACIN PB 000221.49
PHAR 000008652141 UNASYN PB 000065.00
PHAR 000008653001 ACYCLOVIR PB 000138.00
PHAR 000008653006 CHLORAMPH PB 000034.00
PHAR 000008653018 ERYTHROMY PB 000055.00
PHAR 000008653028 CLINDAMYC PB 000096.00
PHAR 000008653035 METRONIDAZ PB 000020.00
PHAR 000008653042 VANCOMYCIN 1GM INJ 000118.27
PHAR 000008653050 DOXYCYCLIN PB 000031.00
PHAR 000008653057 AZTREONAM/PB 000115.00
PHAR 000008653065 TETRACYC PB 000096.00
PHAR 000008653074 PENTAMID PB 000105.00
PHAR 000008653077 METRONIDAZOLE/PB 000072.00
PHAR 000008653082 SEPTRA PB 000078.00
PHAR 000008653109 PENTAM PB 000323.21
PHAR 000008653116 PRIMAXIN/PB 000096.00
PHAR 000008653128 CLINDAMYCIN/PB 000096.00
PHAR 000008653140 VANCOMYCIN 50MG PB 000028.80 250
PHAR 000008653141 VANCOMYCIN 100MG PB 000031.80 250
PHAR 000008653142 VANCOMYCIN 150MG PB 000034.80 250
PHAR 000008653143 VANCOMYCIN 200MG PB 000042.00 250
PHAR 000008653144 VANCOMYCIN 250MG PB 000045.00 250
PHAR 000008653145 VANCOMYCIN 500MG PB 000069.60 250
PHAR 000008653146 VANCOMYCIN 750MG PB 000093.60 250
PHAR 000008653147 VANCOMYCIN 1GM PB 000112.80 250
PHAR 000008653148 VANCOMYCIN 1.25GM PB 000138.00 250
PHAR 000008653149 VANCOMYCIN 1.5GM PB 000151.20 250
PHAR 000008653150 VANCOMYCIN 2GM PB 000181.20 250
PHAR 000008653151 GANCICLOVIR 000126.00
PHAR 000008653160 FLUCONAZOLE 000211.25
PHAR 000008653174 VANCOMYCIN 2.5GM PB 000199.20 250
PHAR 000008653175 VANCOMYCIN 3GM PB 000224.40 250
PHAR 000008654001 ALBUMIN PB 000105.00
PHAR 000008654002 AMINOPHYLLIN PB 000036.04
9/7/2010 11:52 AM Page 264 of 322
Loma Linda Behavioral Medicine Center
OSHPD ID 106364014
Fed Tax ID # 33-0245579
PHARMACY CDM
As of June 1, 2005
PHAR 000008654003 AMINOPHYL PB 100MG 000018.02
PHAR 000008654004 AMINOPHYL PB 250MG 000024.38
PHAR 000008654005 AMINOPHYL PB 500MG 000036.04
PHAR 000008654006 AMINOPHYL PB 1 GM 000061.48
PHAR 000008654007 AMINOPHYL PB 1.5GM 000074.20
PHAR 000008654008 AMINOPHYL PB 2 GM 000100.70
PHAR 000008654009 VASOTEC/PB 000100.70
PHAR 000008654010 VASOTEC/PB 0.625 MG 000038.16
PHAR 000008654011 VASOTEC/PB 1.25 MG 000067.84
PHAR 000008654012 VASOTEC/PB 1.875 MG 000091.16
PHAR 000008654013 VASOTEC/PB 2.5 MG 000100.70
PHAR 000008654014 CALC GLUC PB 000065.00
PHAR 000008654015 VASOTEC/PB 3.125 MG 000121.90
PHAR 000008654016 VASOTEC/PB 3.75 MG 000133.56
PHAR 000008654017 VASOTEC/PB 4.375 MG 000144.16
PHAR 000008654018 VASOTEC/PB 5 MG 000151.58
PHAR 000008654019 VASOTEC/PB 5.625 MG 000163.24
PHAR 000008654020 VASOTEC/PB 6.25 MG 000168.54
PHAR 000008654021 VASOTEC/PB 6.875 MG 000173.84
PHAR 000008654022 VASOTEC/PB 7.5 MG 000183.88
PHAR 000008654023 AMINOPHYLLIN PB 000027.00
PHAR 000008654024 VASOTEC/PB 8.125 MG 000198.30
PHAR 000008654025 VASOTEC/PB 8.75 MG 000212.75
PHAR 000008654026 VASOTEC/PB 9.375 MG 000227.20
PHAR 000008654027 VASOTEC/PB 10 MG 000241.64
PHAR 000008654028 PHENOBARB PB 000018.02
PHAR 000008654029 PHEN