Amendment #1 dated December 31, 2002 to Agreement No. 20010259

EXHIBIT 10.29

Amendment #1 dated December 31, 2002 to Agreement No. 20010259

This Amendment #1 to Agreement No. 20010259 (Amendment”) is being entered by and between Amgen USA Inc. (“Amgen”), a wholly-owned subsidiary of Amgen Inc., and Total Renal Care, Inc., a subsidiary of DaVita Inc., including the freestanding dialysis center affiliate(s) listed on Appendix B (collectively, Dialysis Center”).

WHEREAS, Amgen and Dialysis Center entered into Agreement No. 20010259 (the Agreement”) effective January 1, 2002; and

WHEREAS, the parties now wish to amend the Agreement to extend the term for an additional year, to incorporate the terms and conditions for the purchase of Aranesp^® (darbepoetin alfa) exclusively for the treatment of dialysis patients, and to modify certain incentive option provisions.

NOW, THEREFORE, in consideration of the premises and of the mutual covenants, representations and warranties set forth herein, the parties agree as follows:

SECTION 1. Definitions: References. Unless otherwise specifically defined herein, each term used in this Amendment which is defined in the Agreement shall have the meaning assigned to such term in the Agreement. Except as amended and supplemented hereby, all of the terms of the Agreement are incorporated herein by reference, shall remain and continue in full force and effect, and are hereby ratified and confirmed in all respects.

SECTION 2. Amendment of Section 1. Term of Agreement: Section 1 is hereby amended to extend the Term of the Agreement through December 31, 2003. Accordingly, Section 1 is amended and restated in its entirety to read as follows:

1.	Term of Agreement. The “Term” of this Agreement shall be defined as January 1, 2002 (“Commencement Date”) through December 31, 2003 (“Termination Date”).

Notwithstanding the foregoing, all payments, calculations, reconciliations, vesting, and other actions connected with Qualified Purchases made during the period January 1, 2002 through December 31, 2002, and the discounts and incentives for which Dialysis Center is eligible thereon, which are required by the Agreement to occur, be measured, or be performed at the end of or within specified periods in relation to the “Term”, shall continue to be required to occur, be measured, or be performed at or within the specified time periods so stated, as if the Term were to expire on December 31, 2002.

SECTION 3. Amendment of Section 2. Dialysis Center Affiliates: Section 2 is hereby amended for the period January 1, 2003 through December 31, 2003, as follows:

Dialysis Center Affiliates. Only those Dialysis Center affiliates (‘Affiliates”) listed on Appendix B which is incorporated by reference hereto and made a part of this Agreement will be eligible to participate under this Agreement. Affiliates eligible to participate under this Agreement shall be facilities owned in whole or in part by Dialysis Center or for which Dialysis Center provides management or administrative services including such services as the purchasing and billing of EPOGEN^® (Epoetin alfa) and Aranesp^® (darbepoetin alfa) (collectively, “Products”). Additions to the Affiliates listed on Appendix B may be made pursuant to the request of Dialysis Center’s corporate headquarters and are subject to approval and acknowledgment by Amgen in writing, and such approval and acknowledgment shall not be unreasonably withheld, conditioned or delayed. Dialysis Center may delete Affiliates from participation in this Agreement at any time, in its sole discretion. Amgen requires reasonable notice before the effective date of change (the “Administrative Effective Date”) for any addition or deletion of Affiliates. Notwithstanding the immediately

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

preceding sentence, Amgen agrees to coordinate with Dialysis Center’s Authorized Wholesalers (as defined in Section 4 of the Agreement) [DELETED] any and all purchases made by Dialysis Center [DELETED] pursuant to which Dialysis Center is legally authorized to purchase Products for such added Affiliate [DELETED]; all such purchases by Dialysis Center during such period shall constitute “Qualified Purchases” under this Agreement and shall be included for purposes of eligibility and calculation of each and every discount and incentive provided hereunder and in Appendix A which is incorporated by reference hereto and made a part of this Agreement, including but not limited to [DELETED] set forth in Section 2 of Appendix A for EPOGEN^® purchases and including but not limited to [DELETED] set forth in Section 1 of Appendix A for Aranesp^®, so long as Amgen is not obligated to pay the same discount or incentive attributable to the same purchases to any person or entity other than Dialysis Center. Amgen reserves the right in its reasonable discretion to terminate any Affiliates with regard to participation in this Agreement. Termination of any Affiliate by Amgen shall be effective (a) immediately in instances in which Amgen determines, in its sole discretion, that such immediate termination is required by law or order of any court or regulatory agency or as a result of negligence or willful misconduct in the use or administration of Products by such Affiliate; or (b) upon thirty (30) days prior written notice to Dialysis Center in all other instances; provided, that such termination shall be effective before the expiration of such thirty (30) days where Dialysis Center requests or consents to such earlier termination.

SECTION 4. Amendment of Section 3, Own Use: Section 3 is hereby amended for the period January 1, 2003 through December 31, 2003, as follows:

3.	Own Use. Dialysis Center hereby certifies that Products purchased hereunder shall be for Dialysis Center’s “own use” for the exclusive treatment of dialysis patients.

SECTION 5. Amendment of Section 4. Authorized Wholesalers: Section 4 is hereby amended for the period January 1, 2003 through December 31, 2003, as follows:

Authorized Wholesalers. Attached hereto as Appendix C is a complete list, as of the date of execution of this Amendment, of the wholesalers from which Dialysis Center intends to purchase Products. All of the wholesalers so designated by Dialysis Center are hereby approved by Amgen to participate in this program and are deemed “Authorized Wholesalers”. Notification of proposed changes to the list of Authorized Wholesalers must be provided to Amgen in writing at least thirty (30) days before the effective date of the proposed change; provided, however, that Amgen will use its best efforts to accept a change on fewer than thirty (30) days’ notice. Amgen reserves the right, in its reasonable discretion, to reject or terminate, with reasonable notice, any wholesaler with regard to participation in this Agreement, so long as (a) Amgen rejects or terminates such wholesaler with respect to providing Products to any and all purchasers of Products, or (b) such wholesaler independently requests Amgen to remove it as an Authorized Wholesaler for Dialysis Center. Amgen also reserves the right, in its reasonable discretion, to accept wholesalers with regards to participation in this Agreement, but Amgen agrees that it shall accept any wholesaler designated by Dialysis Center which provides Products to other purchasers approved by Amgen. Dialysis Center agrees to request all Authorized Wholesalers to submit product sales information to a third-party sales reporting organization designated by Amgen. In the event Amgen terminates any Authorized Wholesaler from which Dialysis Center is purchasing Products, Amgen will work with Dialysis Center to identify other possible Authorized Wholesalers from which Dialysis Center may purchase Products and/or, in the case of an emergency and subject to credit qualification as well as receipt and approval of an “Application for Direct Ship Account”, use reasonable efforts in attempting to establish a temporary direct purchase relationship between Dialysis Center and Amgen until such time as an alternative Authorized Wholesaler can be secured, which in no event shall exceed sixty (60) days. If Dialysis Center purchases directly from Amgen as contemplated immediately above, all purchases made from Amgen shall be deemed “Qualified Purchases” (as defined below) and all such purchases shall be accounted for in the calculation of the discounts and incentives provided for in this Agreement and in Appendix A.

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

SECTION 6. Amendment of Section 5, Qualified Purchases: Section 5 is hereby amended for the period January 1, 2003 through December 31, 2003, as follows:

5.	Qualified Purchases. Only Products purchased under this Agreement by Dialysis Center through Authorized Wholesalers (or directly from Amgen as provided in Section 4 above), as confirmed by Amgen based on sales tracking data, will be deemed “Qualified Purchases”.

SECTION 7. Amendment of Section 6, Commitment to Purchase: Section 6 is hereby amended for the period January 1, 2003 through December 31, 2003, as follows:

Commitment to Purchase. Dialysis Center agrees to purchase Products for all of its dialysis use requirements for recombinant human erythropoietin, and Amgen agrees to supply through Authorized Wholesalers all orders as placed by Dialysis Center. Notwithstanding the foregoing, Amgen expressly acknowledges and agrees that Dialysis Center may participate in clinical trials involving the administration of other products for the management of anemia in dialysis patients. Dialysis Center may purchase another brand of recombinant human erythropoietin for its dialysis use requirements only for the time, and only to the extent, that Amgen has notified Dialysis Center’s corporate headquarters in writing that Amgen cannot supply EPOGEN^® or Aranesp^® within and for the time period reasonably required by Dialysis Center. Any such notification shall be given by Amgen at least thirty (30) days prior to the date on which Amgen will cease supplying EPOGEN^® or Aranesp^® to Dialysis Center, unless an act or event described in Section 16 of the Agreement, or an order of a regulatory agency or other action arising out of patient safety concerns, requires the giving of shorter notice. In the event that Amgen fails to supply Dialysis Center with EPOGEN^® or Aranesp^® as ordered, Dialysis Center shall be entitled, at a minimum, to have the same proportion of its purchase orders fulfilled at all times as other purchasers of EPOGEN^® or Aranesp^® and, upon request, Amgen shall provide written assurances of same to Dialysis Center.

SECTION 8. Amendment of Section 8, Discounts: Section 8 is hereby amended for the period January 1, 2003 through December 31, 2003, as follows:

Discounts. Dialysis Center shall qualify for discounts and incentives subject to material compliance with the terms and conditions of this Agreement as well as the schedules and terms set forth in Appendix A. Discounts in arrears will be paid in the form of a wire transfer to Dialysis Center’s corporate headquarters, and Amgen Inc. hereby guarantees Amgen’s obligation to pay all discounts earned by Dialysis Center hereunder. Discounts in arrears will be calculated in accordance with Amgen’s discount calculation policies based on Qualified Purchases using Amgen’s standard [DELETED] as the calculation price, except as otherwise provided hereunder or as set forth in Appendix A. Payment amounts, as calculated by Amgen, must equal or exceed $100.00 for the applicable period to qualify, and are subject to audit and final determination by arbitration, as provided in Appendix A hereto. Subject to the section entitled “Termination”, in the event that Amgen is notified in writing that Dialysis Center, and/or any Affiliate(s) (the “Acquired Party”) is acquired by another entity or a change of control otherwise occurs with respect to any Acquired Party, any discounts which may have been earned hereunder for all periods preceding such acquisition or change of control shall be paid in the form of a wire transfer to Dialysis Center’s corporate headquarters, subject to the conditions and requirements described herein. For purposes of all of the discounts paid in arrears contained herein, including, without limitation, those discounts and incentives provided in Appendix A, if any Affiliates are added to or deleted from this Agreement during any [DELETED] the period January 1, 2003 through December 31, 2003 of this Amendment, Amgen shall appropriately adjust Dialysis Center’s purchases for the relevant periods (x) for deleted Affiliates, by excluding purchases by such Affiliates effective from the effective date of their deletion and during the relevant [DELETED] used for comparison, or (y) for added Affiliates, by including any purchases made by such acquired Affiliates effective from the date they are added to the list of Affiliates on Appendix B and during the relevant [DELETED] used for comparison, and by including any purchases made by any de novo

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

Affiliates commencing in the [DELETED] in which they commence operations. Amgen and Dialysis Center agree that, for purposes of determining eligibility for and calculation of all discounts and all incentives provided in this Agreement (including, without limitation, all discounts and incentives as are set forth in Appendix A), a Qualified Purchase of EPOGEN^® or Aranesp^® shall be deemed made on the date of invoice to Dialysis Center from an Authorized Wholesaler. Upon any termination of this Agreement, Amgen shall pay to Dialysis Center all discounts and incentives earned by Dialysis Center through the date of termination. Failure of Dialysis Center to qualify for or receive any particular discount or incentive hereunder shall not automatically affect its qualification for or receipt of any other discount or incentive provided under this Agreement.

SECTION 9. Amendment of Section 9. Treatment of Discounts: Section 9 is hereby amended for the period January 1, 2003 through December 31, 2003, as follows:

Treatment of Discounts. a) Dialysis Center agrees that it will properly disclose and account for any discount or other reduction in price earned hereunder, in whatever form (i.e., pricing, discount, or incentive), in a way that complies with all applicable federal, state, and local laws and regulations, including without limitation, Section 1128B(b) of the Social Security Act and its implementing regulations. Section 11 28B(b) requires that a provider of services properly disclose and appropriately reflect the value of any discount or other reduction in price earned in the costs claimed or charges made by the provider under a federal health care program, as that term is defined in Section 11288(f). Dialysis Center also agrees that, if required by such statutes or regulations, it will (i) claim the benefit of such discount received, in whatever form, in the fiscal year in which such discount was earned or the year after, (ii) fully and accurately report the value of such discount in any cost reports filed under Title XVIII or Title XIX of the Social Security Act, or a state health care program, and (iii) provide, upon request by the U.S. Department of Health and Human Services or a state agency or any other federally funded state health care program, the information furnished to Dialysis Center by Amgen concerning the amount or value of such discount. Dialysis Center’s corporate headquarters agrees that it will advise all Affiliates, in writing, of any discount received by Dialysis Center’s corporate headquarters hereunder with respect to purchases made by such Affiliates and that said Affiliates will account for any such discount in accordance with the above stated requirements.

b) In order to assist Dialysis Centers compliance with its obligations as set forth in Section 9(a) immediately above, Amgen agrees that, along with the [DELETED] delivery of its payment on the [DELETED] earned hereunder, it will provide to Dialysis Center a statement on a [DELETED] basis stating the incentives and discounts earned by Dialysis Center in a particular [DELETED] with the itemization Product purchases made in a particular [DELETED] and the [DELETED] (as defined in Appendix A, Section 3(b)), both broken down by Affiliates; and any other information that Dialysis Center may request that is reasonably available to Amgen and necessary for Dialysis Center to obtain in order to comply with its obligation as set forth in Section 9(a).

SECTION 10. Amendment of Section 10, Data Collection: Section 10 is hereby amended for the period January 1, 2003 through December 31, 2003, as follows:

10.

Data Collection. Dialysis Center agrees that it will at all times comply with all federal, state, or local laws or regulations relating to patient privacy of medical records, and that all data to be provided to Amgen pursuant to this Agreement, shall be in a form that does not disclose the identity or name of any patient or other patient-identifying information such as address, telephone number, birth date, all or part of a social security number, medical record number or prescription number. Dialysis Center and Amgen agree that not later than April 1, 2003 they will use and accept only those patient identifiers compliant with the federal medical privacy standards codified under 45 C.F.R. parts 160 and 164 pursuant to the Health Insurance Portability and Accountability Act (“HIPAA”). Dialysis Center acknowledges that the data to be supplied to Amgen pursuant to this Agreement shall be used to support verification of the discounts and incentives

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

referenced herein, as well as for Amgen-sponsored research concerning the role of EPOGEN^® in improving treatment outcomes and quality of life of dialysis patients. Dialysis Center shall consistently use a unique alpha-numeric code (which shall not be the same as part or all of the patient’s social security number) as a “case identifier” to track the care rendered to each individual patient over time, and such case identifier shall be included in the data provided to Amgen. The key or list matching patient identities to their unique case identifiers shall not be provided to Amgen personnel. In furtherance of Amgen research, Dialysis Center may agree from time to time, on terms to be negotiated separately by the parties, to use its key to update the patient care data by linking it with information concerning health outcomes, quality of life, and other pertinent data that may become available to Amgen from other sources. Any such linking of data sources shall not provide the identity of any patient to Amgen. Amgen and Amgen Inc. agree that they will maintain data supplied under this Agreement in confidence, they will not use such data to identify or contact any patient, and they will at all times comply with all federal, state, or local laws or regulations relating to patient records. [DELETED]. Amgen and Amgen Inc. shall not sell or resell any data obtained pursuant to this Agreement. Additionally, any use by Amgen or Amgen Inc. of any such data outside of Amgen, Amgen Inc. or Dialysis Center shall be in a format which does not identify Dialysis Center as the source of such data, unless otherwise permitted in writing by Dialysis Center. No reports by Amgen or Amgen Inc. concerning analyses of the data or the results of such research shall disclose the identity of any patient. Nothing in this Agreement shall limit Dialysis Center’s use of its own patient case data, including, without limitation, any and all data to be supplied to Amgen hereunder.

SECTION 11. Amendment of Section 13. Warranties: Section 13 is hereby amended for the period January 1, 2003 through December 31, 2003, as follows:

13.

Warranties. Each party represents and warrants to the other that this Amendment (a) has been duly authorized, executed, and delivered by it, (b) constitutes a valid, legal, and binding agreement enforceable against it in accordance with the terms contained herein, and (c) does not conflict with or violate any of its other contractual obligations, expressed or implied, to which it is a party or by which it may be bound. The party executing this Amendment on behalf of Dialysis Center specifically warrants and represents to Amgen that it is authorized to execute this Amendment on behalf of and has the power to bind Dialysis Center and the Affiliates to the terms set forth in this Amendment. The parties executing this Amendment on behalf of Amgen and Amgen Inc. specifically warrant and represent to Dialysis Center that they are authorized to execute this Amendment on behalf of and have the power to bind Amgen and Amgen Inc. to the terms set forth in this Amendment. Amgen warrants that the Products purchased pursuant to this Agreement (a) are manufactured in accordance with all applicable federal, state and local laws and regulations pertaining to the manufacturing of the Products including without limitation, the Federal Food, Drug, and Cosmetic Act and implementing regulations, and meet all specifications for effectiveness and reliability as required by the United States Food and Drug Administration, and (b) when used in accordance with the directions on the labeling, are fit for the purposes and indications described in the labeling. Amgen agrees that it will promptly notify Dialysis Center once it determines that there has been any material defect in any of the Products delivered to Dialysis Center.

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

SECTION 12. Amendment of Section 14, Notices: Section 14 is hereby amended for the period January 1,2003 through December 31, 2003, as follows:

14.

Notices. Any notice or other communication required or permitted hereunder (excluding purchase orders) shall be in writing and shall be deemed given or made three (3) days after deposit in the United States mail with proper postage for first-class registered or certified mail prepaid, return receipt requested, or when delivered personally or by facsimile (receipt verified and confirmed by overnight mail), or one (1) day following traceable delivery to a nationally recognized overnight delivery service with instructions for overnight delivery, in each case addressed to the parties as follows (or at such other addresses as the parties may notify each other of in writing):

If to Dialysis Center:

Total Renal Care, Inc.

00000 Xxxxxxxxx Xxxxxxxxx, Xxxxx 000

Xxxxxxxx, XX 00000-0000

Attn: Chief Financial Officer

Fax No.: (000) 000-0000

with a copy to:

Total Renal Care, Inc.

00000 Xxxxxxxxx Xxxxxxxxx, Xxxxx 000

Xxxxxxxx, XX 00000-0000

Attn: General Counsel

Fax No.: (000) 000-0000

If to Amgen:

Amgen USA Inc.

One Amgen Center Drive, M/S 37-2-B

Xxxxxxxx Xxxx, XX 00000-0000

Attn: Xxxx Xxxxxxxxxxx, Manager, Contract Administration

Fax No.: (000) 000-0000

with a copy to:

Amgen USA Inc.

One Amgen Center Drive, M/S 27-4-A

Xxxxxxxx Xxxx, XX 00000-0000

Attn: General Counsel

Fax No.: (000) 000-0000

If to Amgen Inc.:

Amgen Inc.

One Amgen Center Drive, M/S 37-2-B

Xxxxxxxx Xxxx, XX 00000-0000

Attn: Xxxx Xxxxxxxxxxx, Manager, Contract Administration

Fax No.: (000) 000-0000

with a copy to:

Amgen Inc.

One Amgen Center Drive, M/S 27-4-A

Xxxxxxxx Xxxx, XX 00000-0000

Attn: General Counsel

Fax No.: (000) 000-0000

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

SECTION 13. Amendment of Section 15. Compliance with Health Care Pricing and Patient Privacy Legislation and Statutes: Section 15 is hereby amended for the period January 1, 2003 through December 31, 2003, as follows:

15.

Compliance with Health Care Pricing and Patient Privacy Legislation and Statutes; Data Use Agreement. a) Notwithstanding anything contained herein to the contrary, in order to assure compliance, as determined by either party, in its sole discretion, with any existing federal, state or local statute, regulation or ordinance, or at any time following the enactment of any federal, state, or local law or regulation that in any manner reforms, modifies, alters, restricts, or otherwise affects the pricing of or reimbursement available for Products, including but not limited to the enactment of any reimbursement rule, guideline, final program memorandum, coverage decision, pricing decision, instruction or the like by the Centers for Medicare and Medicaid Services (“CMS”) or any of Dialysis Centers Medicare fiscal intermediaries, or any change in reimbursement systems that in any manner reforms, modifies, alters, restricts or otherwise affects the reimbursement available to Dialysis Center for any of the Products, either party may, in its sole discretion, upon thirty (30) days notice, seek to modify this Agreement in accordance with the procedure referenced below or exclude any Affiliates from participating in this Agreement unless such Affiliate(s) certifies in writing that they are, or will be, exempt from the provisions thereunder. If such affected Affiliate(s) does not so certify and is therefore excluded from participating in this Agreement, Dialysis Center and Amgen shall meet and in good faith seek to mutually agree to modify this Agreement to accommodate any such change in law or regulation, with the intent that, if possible, the essential terms and the pricing structure [DELETED] shall be retained at least at the applicable tier as in effect immediately prior to such Affiliate’s exclusion. If the parties in good faith determine such modification is not possible, the parties shall seek to modify the Agreement in another manner acceptable to both parties. If the parties, after ninety (90) days are unable to agree upon such a modification, Amgen shall be entitled to terminate the Agreement on no less than thirty (30) days’ notice. In the event there is a future change in Medicare, Medicaid, or other federal or state statute(s) or regulation(s) or in the interDretation thereof, which renders any of the material terms of this Aoreement unlawful or unenforceable, this Agreement shall continue only if amended by the Darties as a result of good faith negotiations as necessary to bring the Agreement into comDliance with such statute or regulation.

b) Notwithstanding anything contained herein to the contrary, in order to assure compliance, as determined by either party in its sole discretion, with any existing federal, state or local statute, regulation or ordinance relating to patient privacy of medical records, or at any time following the enactment of any federal, state, or local law or regulation relating to patient privacy of medical records that in any manner reforms, modifies, alters, restricts, or otherwise affects any of the data received or to be received in connection with any of the incentives contemplated under this Agreement, either party may, in its discretion, upon thirty (30) days’ notice, seek to modify this Agreement. Dialysis Center and Amgen shall meet and in good faith seek to mutually agree to modify this Agreement to accommodate any such change in law or regulation, with the intent to, if possible, retain the essential terms of the affected incentive and pricing structure. If the parties in good faith determine that such modification is not possible, the parties shall seek to modify the Agreement in another manner acceptable to both parties. If the parties, after ninety (90) days, are unable to agree upon such a modification, either party shall be entitled to terminate the affected incentive upon thirty (30) days’ notice.

(c) Notwithstanding anything contained herein to the contrary, this Agreement is effective only as of the date the parties hereto execute a mutually agreeable Data Use Agreement pursuant to which Dialysis Center may disclose a Limited Data Set of patient information to Amgen (as specified in the Data Use Agreement and which shall include, at a minimum, the data fields to be received by Amgen in connection with this Agreement) for purposes of Amgen’s Research and Public Health analyses and Dialysis Center’s Health Care Operations. Unless otherwise specifically defined in this Agreement, each capitalized term used in this

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

Section 15(c) shall have the meaning assigned to such term by HIPAA. If Dialysis Center terminates the Data Use Agreement for any reason, Amgen shall be entitled to terminate this Agreement immediately. The parties acknowledge and agree that they have entered into a Data Use Agreement (“DUA”) in connection with the disclosure to Amgen of certain patient information, as described in Section 23 of this Agreement. Without limitation of the foregoing, Amgen and Dialysis Center agree to negotiate in good faith to further amend the Agreement and/or enter into such additional agreements to the extent necessary to allow Dialysis Center to disclose to Amgen patient data (including any individually identifiable health information), and to otherwise comply with the Standards of Privacy of Individually Identifiable Health Information (the “Standards”) promulgated or to be promulgated by the Secretary of Health and Human Services in accordance with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) or other related regulations or statutes. Dialysis Center and Amgen agree that they will fully comply with all such Standards and that they will amend the Agreement and/or enter into additional agreements in order to incorporate any material terms required by the Standards prior to the compliance date specified in the regulations for such Standards. Without limiting the generality of the foregoing, Amgen and Dialysis Center specifically agree to enter into such amendment(s) or agreement(s), as may be appropriate or necessary as determined by the parties, to permit the disclosure to and access and use by Amgen of patient data (including individually identifiable health information) in order to allow the provision by Amgen of the Good Pharmaceutical Practice Support Services for EPOGEN^® as provided to Dialysis Center consistent with past practice and defined in Section 21 of this Agreement. In the event Dialysis Center and Amgen have not amended the Agreement and/or entered into such additional agreements by the compliance date for such Standards, and except for the obligations of the Parties under the DUA, (1) Dialysis Center shall be entitled to cease disclosure of patient data (including any individually identifiable health information) to Amgen in connection with Amgen’s provision of Good Pharmaceutical Practice Support Services as defined in Section 21 of this Agreement, and (2) Amgen shall be entitled to cease providing Good Pharmaceutical Practice Support Services, as defined in Section 21 of this Agreement, to Dialysis Center, in each case notwithstanding any past practice or as otherwise may be contemplated by the Agreement.”

SECTION 14. Amendment of Section 18. Entire Agreement: Section 18 is hereby amended for the period of January 1, 2003 through December 31, 2003, as follows:

18.

Entire Agreement. The Agreement (as modified by this Amendment) together with the DUA and all of the Appendices attached hereto and thereto, constitutes the entire understanding between the parties and supersedes all prior or oral written proposals, agreements or commitments pertaining to the subject matter herein and therein.

SECTION 15. Amendment of Section 19. [DELETED]: Section 19 is hereby amended for the period January 1, 2003 through December 31, 2003, as follows:

19.

[DELETED]

SECTION 16. Addition of Section 21. Good Pharmaceutical Practice Supi,ort Services for EPOGEN^®: Section 21 is hereby added for the period January 1, 2003 through December 31, 2003, as follows:

21.

Good Pharmaceutical Practice Support Services for EPOGEN^®: In order to advance the common clinical objectives of the parties under this Agreement, Amgen agrees to provide to Dialysis Center the following good pharmaceutical practice standard support services which it provides to all customers, at no additional cost or charge:

(a) Clinical support team of nephrology specialists who provide clinical information about anemia management, offer non-patient-specific advice about the use of EPOGEN^® in the treatment of patients with end-stage renal disease, and answer general questions about EPOGEN^®, anemia management, and reimbursement presented by a facility’s clinical staff;

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

(b) Patient education materials;

(d) 24-hour emergency drug information service.

Amgen agrees to furnish such services only in cooperation with Dialysis Center’s facilities, in a manner consistent with Dialysis Center’s policies and procedures, and in accordance with the terms otherwise set forth in this Agreement, including without limitation Section 22 hereof.

SECTION 17. Addition of Section 22, Access: Section 22 is hereby added for the period January 1, 2003 through December 31, 2003, as follows:

22.

Access. Amgen agrees that it and its agents and employees shall, at all times, comply with all applicable laws and regulations, and with Dialysis Center’s general policies and procedures, regulations and guidelines regarding product promotion and access to Dialysis Center’s facilities and personnel. Amgen’s discussion of its Products shall be in compliance with all applicable laws and regulations.

SECTION 18. Addition of Section 23 HIPAA Compliance/Data Use Agreement: Section 23 is hereby added for the period January 1, 2003 through December 31, 2003, as follows:

23.

HIPAA Compliance/Data Use Agreement. Amgen and Dialysis Center acknowledge and agree that not later than April 14, 2003 certain of the patient information and data delivered to Amgen hereunder must be in a format that is compliant with the privacy standards of HIPAA. In connection with the foregoing, the Parties have executed and delivered, contemporaneously herewith, a Data Use Agreement (“DUA”) which specifies the limited data set format of patient information that may be delivered to Amgen under this Agreement and the DUA. The parties acknowledge and agree that the rights and obligations of the parties under the DUA are a supplement to the rights and obligations hereunder.

SECTION 19. Amendment to Appendix A: Discount Pricing. Schedule, and Terms: Appendix A is hereby amended and restated in its entirety for the period of January 1, 2003 through December 31, 2003 to read as follows:

Pricing—Aranesp^®. During the period January 1, 2003 through December 31, 2003, Dialysis Center may purchase Aranesp^® through Authorized Wholesalers at [DELETED], which shall be equal to the [DELETED]. Amgen reserves the right to change the [DELETED] at any time. Resulting prices do not include any wholesaler markup, service fees, or other charges. No other discounts, including discounts in arrears, are applicable to Aranesp purchased under this Agreement.

Pricing—EPOGEN^®. During the period January 1, 2003 through December 31, 2003, Dialysis Center may purchase EPOGEN^® through Authorized Wholesalers at [DELETED], which shall be equal to the [DELETED]. Amgen reserves the right to change the [DELETED] at any time. Notwithstanding any such change(s), the [DELETED] that is applicable to Dialysis Center throughout the Term shall be the [DELETED]. Resulting prices do not include any wholesaler markup, service fees, or other charges. In the event that [DELETED] are effectuated at any time [DELETED] Dialysis Center’s [DELETED] for Qualified Purchases of EPOGEN^® shall [DELETED]. All discounts earned in arrears during the Term of the Amendment shall be calculated based upon the [DELETED] of this Agreement, such that any [DELETED] contained in any of the discounts or incentives set forth in this Appendix A shall [DELETED] in the [DELETED].

3.	[DELETED]. Dialysis Center may qualify for a [DELETED] provided it meets the criteria described below in this Section 3. The [DELETED] is designed to improve patient outcomes by encouraging [DELETED].¹

a.	Requirements: In order to qualify for the [DELETED] during the period January 1, 2003 through December 31, 2003, Dialysis Center’s aggregate Qualified Purchases of EPOGEN^® and Aranesp^® by all

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

Affiliates as listed on Appendix B on the effective date of this Amendment and all new approved Affiliates (whether by acquisition, to the extent that either Amgen or Dialysis Center can provide adequate data concerning such Affiliates’ purchases for the same time period from 2001, or de novo) must equal or exceed [DELETED] of the aggregate Qualified Purchases of EPOGEN^® by those same Affiliates for the same [DELETED] from 2001 as set forth in the [DELETED] contained in section 5(a) below, and as adjusted pursuant to section 5(a) (the [DELETED]). The [DELETED] shall be calculated using the formula described in Section 5(a) below. In addition, no more than [DELETED] of Dialysis Center’s [DELETED] taken on an overall basis (and not separately for each Affiliate) may have [DELETED] (as defined in Section 3(b) below) [DELETED] during the applicable [DELETED] of the period January 1, 2003 through December 31, 2003. If either of these criteria is not met during any given [DELETED] of the period January 1, 2003 through December 31, 2003, Dialysis Center will not qualify for the [DELETED] during that [DELETED]. Failure of Dialysis Center to qualify for the [DELETED] during a particular [DELETED] shall not affect Dialysis Center’s eligibility to qualify during any other [DELETED] of the period January 1, 2003 through December 31, 2003, nor shall Dialysis Center’s qualification during a particular [DELETED] automatically result in qualification during any other [DELETED]. Notwithstanding the foregoing, if Dialysis Center has not satisfied the [DELETED] for any particular [DELETED], then, at the end of the Term of this Agreement, Amgen will conduct an analysis to determine if Dialysis Center has achieved the required [DELETED]. If Dialysis Center has achieved the [DELETED], Amgen will [DELETED]. Reconciliation payments will be made [DELETED]. [DELETED] a reconciliation payment, the payment will be made within [DELETED] after [DELETED], and receipt by Amgen of all required Data as set forth in Section 3(a)(i) below. [DELETED] a reconciliation payment, [DELETED] will pay [DELETED] within [DELETED] after receipt of [DELETED].

In order to participate in the [DELETED], Dialysis Center must also provide the following data items to Amgen or to a data collection vendor specified and paid for by Amgen, on a [DELETED] basis, and no later than [DELETED] days after the end of each [DELETED]. In those cases in which Amgen directs Dialysis Center to submit the following information to a data collection vendor, Dialysis Center shall be deemed to have timely submitted the information to such data collection vendor so long as it does so on a [DELETED] basis and no later than [DELETED] days after the end of each [DELETED], regardless of the date on which such vendor, in turn, submits such information to Amgen:

[DELETED]

all [DELETED] for each dialysis patient, the date of each test, and a consistent, unique, alphanumeric identifier (sufficient to consistently track an individual patient without in any way disclosing the identity of the patient), along with the name, address and phone number of the particular Affiliate at which each patient received treatment (collectively, the “Data”); provided, however, that Dialysis Center shall be required to submit such test results only for those dialysis patients whose test results are actually determined by laboratories owned and operated by Dialysis Center. Amgen may utilize the Data for any legal purpose, and reserves the right to audit all Data, provided that any audit shall not permit access to information disclosing the identity of any patient. Under no circumstances on or after April 1, 2003 should the Data include any patient identifiable information including, without limitation, name, address, telephone number, birth date, all or part of a social security number, medical record number or prescription number. The identity of the Affiliate and of the account submitting the Data and any association with the Data will remain confidential. The [DELETED] must be derived from [DELETED] taken immediately before dialysis treatment using any [DELETED] testing method [DELETED] and must be reported to the [DELETED], and must be submitted [DELETED] in a format acceptable to Amgen. Hand written reports are not acceptable; only electronic submission of the Data will be accepted, and

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

ii)

upon execution of this Amendment, Dialysis Center shall simultaneously provide to Amgen an executed “Certification Letter”, a copy of which is attached hereto as Exhibit #1. Amgen hereby acknowledges that it has received such required Certification Letter, in a form and substance satisfactory to Amgen. Delivery of such Certification Letter shall serve to qualify Dialysis Center’s participation in the [DELETED] throughout the period January 1,2003 through December 31, 2003 of this Agreement for the limited purpose of certification of the accuracy of the data submitted to Amgen hereunder.

b.	Calculation: Assuming Dialysis Center has fulfilled all requirements as described in Section 3(a) above, the [DELETED] for Dialysis Center will be calculated as follows:

The [DELETED] for each dialysis patient will be based upon the average of all [DELETED] gathered for each patient during the applicable [DELETED] of the period January 1, 2003 through December 31, 2003. The [DELETED] of all dialysis patients with [DELETED], will be determined by [DELETED] the total [DELETED] of dialysis patients with [DELETED] by the total [DELETED] of dialysis patients treated by Dialysis Center during that [DELETED].

Payment: The [DELETED] will be calculated on a [DELETED] basis and paid to Dialysis Center’s corporate headquarters within [DELETED] days after receipt by Amgen of all required data. If any Affiliates are added to or deleted from this Agreement during any [DELETED] of the period January 1, 2003 through December 31, 2003, Amgen shall appropriately adjust Dialysis Center’s purchases for the relevant periods by including any purchases made by any acquired Affiliates during the relevant [DELETED] and also during the period(s) used for comparison, and by including any purchases made by any de novo Affiliates commencing in the [DELETED] in which they commence operations, and by excluding any purchases made by any deleted Affiliates during the relevant [DELETED] and also during the period(s) used for comparison. Payment is contingent upon meeting the [DELETED] and receipt by Amgen of all required [DELETED] Data for each corresponding [DELETED]. If the Data is received more than [DELETED] days after the last day of any [DELETED] within a given [DELETED], the total Qualified Purchases of EPOGEN^® attributable to Dialysis Center during such [DELETED] will be excluded from the calculation of the [DELETED] for that [DELETED]. Notwithstanding the foregoing, if Amgen receives all required Data from a minimum of [DELETED] of all Affiliates within the definition of “Dialysis Center” within the time frame referenced in Section 3(a) above for any [DELETED] within a given [DELETED], the total Qualified Purchases of EPOGEN^® attributable to Dialysis Center during such [DELETED] will be included in the calculation of the [DELETED] for that [DELETED]. If Amgen receives all required data from [DELETED] of all Affiliates within the definition of “Dialysis Center” within the time frame referenced in Section 3(a) above for any [DELETED] within a given [DELETED], the total Qualified Purchases of EPOGEN^® attributable to those Affiliates that have submitted the required data during such [DELETED] will be included in the calculation of the [DELETED] for that [DELETED]. If Amgen receives all required Data from less than [DELETED] of all Affiliates within the definition of “Dialysis Center” for any [DELETED] within a given [DELETED], no Qualified Purchases of Dialysis Center during such [DELETED] will be included in the calculation of the [DELETED] for that [DELETED]. At any time during the period January 1, 2003 through December 31, 2003 of this Agreement, if Amgen determines that any Affiliate(s) is consistently not submitting the required Data, Amgen reserves the right in its sole discretion to exclude such Affiliate’s Qualified Purchases of EPOGEN^® from the calculation of the [DELETED] for any relevant [DELETED]. [DELETED] payments will be made based upon the Data received from the previous [DELETED], and will equal a percentage of Dialysis Center’s total Qualified Purchases of EPOGEN^® during that [DELETED] (exclusive of any Qualified Purchases of EPOGEN^® made by Dialysis Center or any Affiliate not meeting the Data submission requirements described above) as governed by the [DELETED] schedule listed below. If Amgen determines that any Affiliate is consistently not submitting the required Data, Amgen and Dialysis Center will work collaboratively in resolving such matters. Notwithstanding the foregoing, payment for any period from January 1, 2003 through

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

December 31, 2003 that is not equivalent to a complete [DELETED] will be based on an average of the Data that is available for that period. If the EPOGEN^® package insert language or the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative Guidelines change, then Amgen and Dialysis Center will meet and in good faith seek to mutually agree to modify this Agreement to accommodate any such change, with the intent to retain the essential terms of the [DELETED]. If the parties, after ninety (90) days, are unable to agree upon such a modification, Amgen shall be entitled to terminate the [DELETED], Amgen warrants and represents that, as of the execution date of this Amendment, it has not submitted to any United States regulatory authorities any proposed changes to the EPOGEN^® package insert that would materially affect the [DELETED] throughout the Term of this Amendment. In addition, at the [DELETED], Amgen will conduct an analysis to determine if Dialysis Center has achieved the [DELETED] (contemplated by Section 3(a) above) throughout the period January 1, 2003 through December 31, 2003. If [DELETED] Dialysis Center has achieved the [DELETED], then Amgen will perform a reconciliation calculation in connection with all previous [DELETED] calculations and appropriately adjust the [DELETED] for all relevant [DELETED] during the period January 1, 2003 through December 31, 2003 in which a [DELETED] was not paid based upon the failure of Dialysis Center to attain the minimum [DELETED] growth requirement (as referenced in Section 3(a) above). However, if at the [DELETED], the [DELETED] has not been met, Amgen will perform a reconciliation calculation in connection with all previous [DELETED] payments of the period January 1, 2003 through December 31, 2003, which may result in [DELETED]. The [DELETED] payment and any other discount or incentive earned in arrears (other than the [DELETED] set forth in Section 4 below) corresponding to the last [DELETED] of the Term ([DELETED]), if any, shall not be due and owing until, and shall be subject to, reconciliation by Amgen. Reconciliation payments will be made by [DELETED], within [DELETED] days after the [DELETED] and receipt by Amgen of all required Data as set forth in Section 3(a)(i) above.

[DELETED] of all dialysis

patients with [DELETED]

[DELETED]

Percent

[DELETED]

as defined

[DELETED]

Percent

[DELETED]

as defined

[DELETED]

Percent

[DELETED]

as defined

package insert

in Section 5(a)

[DELETED]

Dialysis Center shall have the right, at its own cost and expense, at all times to audit all Data and all calculations relevant to the determination of eligibility for and amount of [DELETED] to be awarded to Dialysis Center hereunder. The parties shall meet and confer in good faith to resolve any disagreements arising out of these matters. If the parties are unable to resolve any such disagreement within ninety (90) days, the parties shall submit such disagreement to binding arbitration in accordance with the Commercial Arbitration Rules of the American Arbitration Association, except that the parties shall be entitled to expanded discovery. Dialysis Center and Amgen shall each name one arbitrator, and the arbitrators so chosen shall, within thirty (30) days thereafter, name a third neutral arbitrator. The arbitration award, as decided by a majority of the arbitrators, may be entered as a judgment in accord with applicable law by any court having jurisdiction. Venue for the arbitration shall be Los Angeles County, California. Each party shall be responsible for its own attorneys’ fees, and the costs of the arbitration and of the arbitrators shall be shared equally by the parties; provided, however, that if the decision of the arbitrators finds that either of the parties has acted in bad faith, the party acting in bad faith alone shall be required to bear one hundred percent (100%) of the costs and expenses of the arbitration and of the arbitrators, as well as one hundred percent of the attorney’s fees of the other party. The arbitrators shall have the authority to award interest in respect to any monetary award.

Vesting: Dialysis Center’s [DELETED] will vest [DELETED], subject to the reconciliation referenced above, and will be paid in accordance with the terms and conditions described in this Section 3. In the event that the [DELETED] paid to Dialysis Center [DELETED] exceed Dialysis Center’s [DELETED] the difference between the [DELETED] paid and the [DELETED] within [DELETED] after Dialysis Centers

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

receipt of [DELETED]. Similarly, in the event that Dialysis Center’s [DELETED] exceeds the [DELETED] that have been paid to Dialysis Center, [DELETED] the difference between the [DELETED] and the [DELETED] paid.

[DELETED] Data Submission: To participate in the [DELETED], Dialysis Center must electronically submit [DELETED], rather than [DELETED], measurements. Such measurements must be submitted for all dialysis patients at each Affiliate whose test results are actually determined in labs owned and operated by Dialysis Center along with all other information described in Section 3(a) above. Amgen no longer accepts [DELETED] test results.

[DELETED]. Dialysis Center shall be eligible to receive a [DELETED] if certain data elements are transmitted electronically to Amgen. The [DELETED] will be calculated as a percentage of the Qualified Purchases of EPOGEN^® attributable to Dialysis Center during the applicable [DELETED]. Failure of Dialysis Center to qualify during a particular [DELETED] shall not affect Dialysis Center’s eligibility to qualify during any other [DELETED] of the period January 1, 2003 through December 31, 2003, nor shall Dialysis Center’s qualification during a particular [DELETED] automatically result in qualification during any other [DELETED]. In order to qualify for the [DELETED], the following [DELETED] must be submitted to Amgen by all Affiliates pursuant to Section 15(c) of the Agreement in an electronic format acceptable to Amgen (Excel; Lotus 123.wki; or text file that is tab delimited, comma delimited, or space delimited): Facility ID, Patient ID (sufficient to consistently track an individual patient without in any way disclosing the identity of the patient), peritoneal dialysis (“PD”) denotation (a PD patient shall be defined as a patient who receives at least one (1) peritoneal dialysis treatment during a given month), [DELETED] delivered for each patient per treatment (but only for patients of Affiliates using the XXXX or Snappy systems), [DELETED] for each patient once per [DELETED], and all [DELETED] with their corresponding draw dates for each patient; provided, however, that Dialysis Center shall be required to submit such test results only for those dialysis patients whose test results are actually determined by laboratories owned and operated by Dialysis Center. Such [DELETED] must be submitted, on a [DELETED] basis, and no later than [DELETED] days after the end of each [DELETED]. Notwithstanding the foregoing, if Amgen receives all required data from a minimum of [DELETED] of all Affiliates within the definition of “Dialysis Center” within the time frame set forth herein for any [DELETED] within a given [DELETED], the total Qualified Purchases of EPOGEN^® attributable to Dialysis Center during such [DELETED], will be included in the calculation of the [DELETED] for that [DELETED]. If Amgen receives all required data from [DELETED] of all Affiliates within the definition of “Dialysis Center” within the time frame set forth herein for any [DELETED] within a given [DELETED], the total Qualified Purchases of EPOGEN^® attributable to those Affiliates that have submitted the required data during such [DELETED] will be included in the calculation of the [DELETED] for that [DELETED]. If Amgen receives all required data from less than [DELETED] of all Affiliates within the definition of “Dialysis Center” for any [DELETED] within a given [DELETED], no Qualified Purchases of Dialysis Center during such [DELETED] will be included in the calculation of the [DELETED] for that [DELETED]. However, if Amgen reasonably determines that any Affiliate is consistently not submitting the required data, Amgen and Dialysis Center will work collaboratively in resolving such inconsistencies. Amgen will use its best efforts to notify Dialysis Center in writing, no later than [DELETED] after the receipt and acceptance by Amgen of the Data, of the identity of all those Affiliates, if any, which have failed to meet the Data submission requirements for that [DELETED]. Amgen reserves the right in its sole discretion to exclude any consistently non-reporting Affiliate’s Qualified Purchases of EPOGEN^® from the calculation of the [DELETED] for any relevant [DELETED]. Amgen will remit any earned [DELETED] payments within [DELETED] days after the end of each [DELETED], contingent upon receipt by Amgen of all required data. The [DELETED] will vest at the end of each [DELETED] and will be reconciled at the end of each [DELETED] based on the actual Qualified Purchases of EPOGEN^® made by Dialysis Center during such [DELETED]. The reconciliation payment will be made within [DELETED] days after the end of such [DELETED]. In addition to the foregoing, the [DELETED] will also be subject to reconciliation [DELETED] and Amgen may withhold

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

payment of the [DELETED] payment subject to such reconciliation. The final reconciliation payment will be made within [DELETED] days of the [DELETED], contingent upon receipt by Amgen of all required data. Dialysis Center shall have the right, at its own cost and expense, at all times to audit all Data and all calculations relevant to the determination of eligibility for and amount of [DELETED] to be paid to Dialysis Center hereunder.

The parties shall meet and confer in good faith to resolve any disagreements arising out of these matters. If the parties are unable to resolve any such disagreement within ninety (90) days, the parties shall submit such disagreement to binding arbitration in accordance with the Commercial Arbitration Rules of the American Arbitration Association, except that the parties shall be entitled to expanded discovery. Dialysis Center and Amgen shall each name one (1) arbitrator, and the arbitrators so chosen shall, within thirty (30) days thereafter, name a third neutral arbitrator. The arbitration award, as decided by a majority of the arbitrators, may be entered as a judgment in accord with applicable law by any court having jurisdiction. Venue for the arbitration shall be Los Angeles County, California. Each party shall be responsible for its own attorneys’ fees, and the costs of the arbitration and of the arbitrators shall be shared equally by the parties; provided, however, that if the decision of the arbitrators finds that either of the parties has acted in bad faith, the party acting in bad faith alone shall be required to bear one hundred percent (100%) of the costs and expenses of the arbitration and of the arbitrators, as well as one hundred percent of the attorney’s fees of the other party. The arbitrators shall have the authority to award interest in respect to any monetary award.

5.	[DELETED]. Dialysis Center may qualify for the [DELETED] as described below.

a.	Calculation: Dialysis Center’s [DELETED] will be calculated in accordance with the following formula.

Where [DELETED] = AxB

A = [DELETED] of EPOGEN^® during the relevant [DELETED] by all Affiliates.

B = A percent in accordance with the [DELETED] schedule listed below.

C = [DELETED].

D = [DELETED].

[DELETED]

For purposes of calculating [DELETED], Amgen will [DELETED] of EPOGEN^® and Aranesp^® during each [DELETED] of the period January 1, 2003 through December 31, 2003 by all Affiliates listed on Appendix B on the Commencement Date of this Amendment and all new approved Affiliates (whether by acquisition, to the extent that either Amgen or Dialysis Center can provide adequate data concerning such Affiliates’ [DELETED], or de novo), [DELETED] of EPOGEN^®, for the [DELETED]. [DELETED] represents the actual annual [DELETED] of EPOGEN^® derived from [DELETED]. Additionally, the [DELETED] has been reconciled to address Affiliates acquired or deleted from the Agreement through [DELETED]. If any Affiliates are added to or deleted from the Agreement from [DELETED], Amgen shall appropriately adjust Dialysis Center’s [DELETED] for the relevant periods (x) for deleted Affiliates, by excluding [DELETED] by such Affiliates effective from the effective date of their deletion and during the relevant [DELETED] used for [DELETED], or (y) for added Affiliates, by including any [DELETED] made by such acquired Affiliates effective from the date they are added to the list of Affiliates on Appendix B and during the relevant [DELETED] used for [DELETED], and by including any [DELETED] made by any de novo Affiliates commencing in the [DELETED] in which they commence operations . In addition, no later than [DELETED] days following the [DELETED], Amgen will conduct an analysis to determine the [DELETED] achieved by Dialysis Center during the [DELETED], by [DELETED] of EPOGEN^® and Aranesp^® during the [DELETED] by all Affiliates listed on Appendix B on the effective date of this Amendment and all new approved Affiliates (whether by acquisition, to the extent that either Amgen or Dialysis Center can provide adequate data concerning such Affiliates’ [DELETED], or de novo) [DELETED] of EPOGEN^® for the [DELETED]. For purposes of

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

calculating the [DELETED] of EPOGEN^® and Aranesp^® [DELETED] period shall be derived using Amgen’s prevailing [DELETED] for all EPOGEN^® [DELETED] made in [DELETED] (including [DELETED] by acquired and/or deleted Affiliates as defined above), and Amgen’s prevailing [DELETED] of this Agreement ([DELETED]) for all EPOGEN^® and Aranesp^® [DELETED] made in [DELETED].

[DELETED]

Estimated payments will be made each [DELETED] within [DELETED] days after receipt by Amgen of all [DELETED] data using Amgen’s discount calculation policies, and the [DELETED] will be reconciled within [DELETED] days after [DELETED].

Vesting: Dialysis Center’s [DELETED] will vest [DELETED] and will be paid in accordance with Section 8 of this Agreement. In the event that the [DELETED] paid to Dialysis Center [DELETED] exceed Dialysis Center’s [DELETED] the difference between the [DELETED] paid and the [DELETED] within [DELETED] of Dialysis Center’s receipt of [DELETED]. Similarly, in the event that Dialysis Center’s [DELETED] exceeds the [DELETED] that have been paid to Dialysis Center, [DELETED] the difference between the [DELETED] and the [DELETED] paid.

Dialysis Center shall have the right, at its own cost and expense, at all times to audit all Data and all calculations relevant to the determination of eligibility for and amount of [DELETED] to be awarded to Dialysis Center hereunder, including, without limitation, the [DELETED] above. The parties shall meet and confer in good faith to resolve any disagreements arising out of these matters. If the parties are unable to resolve any such disagreement within ninety (90) days, the parties shall submit such disagreement to binding arbitration in accordance with the Commercial Arbitration Rules of the American Arbitration Association, except that the parties shall be entitled to expanded discovery. Dialysis Center and Amgen shall each name one arbitrator, and the arbitrators so chosen shall, within thirty (30) days thereafter, name a third neutral arbitrator. The arbitration award, as decided by a majority of the arbitrators, may be entered as a judgment in accord with applicable law by any court having jurisdiction. Venue for the arbitration shall be Los Angeles County, California. Each party shall be responsible for its own attorneys’ fees, and the costs of the arbitration and of the arbitrators shall be shared equally by the parties; provided, however, that if the decision of the arbitrators finds that either of the parties has acted in bad faith, the party acting in bad faith alone shall be required to bear one hundred percent of the costs and expenses of the arbitration and of the arbitrators, as well as one hundred percent (100%) of the attorney’s fees of the other party. The arbitrators shall have the authority to award interest in respect to any monetary award.

5.	[DELETED]. Dialysis Center may [DELETED] for the [DELETED] as described below.

Throughout the Term of this Agreement, Amgen hereby elects [DELETED] to be organized by Dialysis Center throughout the Term of this Agreement [DELETED]. Dialysis Center may, from time to time and in its sole discretion, establish or alter the [DELETED], so long as during the Term, [DELETED] will include Dialysis Center [DELETED]. In consideration for the [DELETED], and to receive all of the [DELETED] generally accorded by Dialysis Center to all [DELETED], Amgen will provide to Dialysis Center [DELETED] to Dialysis Center throughout the Term of this Agreement. Dialysis Center [DELETED] shall provide to Amgen, within [DELETED] following the [DELETED], documentation regarding [DELETED]. [DELETED] Dialysis Center in the [DELETED] within [DELETED] following the [DELETED]. [DELETED] for any period during the Term that is not [DELETED] will be based [DELETED]. Such [DELETED] immediately upon the conclusion, at any time during the Term, of the [DELETED].

Amgen may elect [DELETED] that may be organized from time to time by Dialysis Center during the Term, in addition to the [DELETED], on such additional terms and conditions as shall generally apply to [DELETED]. [DELETED] Amgen of a [DELETED] under this Section shall not entitle Amgen [DELETED] in any such [DELETED].

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

[DELETED]. The parties shall meet and confer in good faith to resolve any disagreements arising out of these matters. If the parties are unable to resolve any such disagreement within a reasonable time period, the parties shall submit such disagreement to binding arbitration in accordance with the Commercial Arbitration Rules of the American Arbitration Association, except that the parties shall be entitled to expanded discovery. Dialysis Center and Amgen shall each name one arbitrator, and the arbitrators so chosen shall, within 30 days thereafter, name a third neutral arbitrator. The arbitration award, as decided by a majority of the arbitrators, may be entered as a judgment in accord with applicable law by a court having jurisdiction. Venue for the arbitration shall be Los Angeles County, California. Each party shall be responsible for its own attorneys’ fees, and the costs of the arbitration and of the arbitrators shall be shared equally by the parties; provided, however, that if the decision of the arbitrators finds that either of the parties has acted in bad faith, the party acting in bad faith alone shall be required to bear one hundred percent (100%) of the costs and expenses of the arbitration and of the arbitrators, as well as one hundred percent (100%) of the attorney’s fees of the other party. The arbitrators shall have the authority to award interest in respect to any monetary award.

Amgen hereby acknowledges receipt of a copy of Dialysis Center’s current [DELETED] and [DELETED], and agrees to be bound by the terms thereof. Dialysis Center agrees that, except as provided in the [DELETED], none of its agents, representatives or employees (“Agents”) shall otherwise [DELETED] Amgen for any other [DELETED], for Dialysis Center or any of its agents or facilities, whether [DELETED], at any [DELETED] or pursuant to any other [DELETED]. Amgen acknowledges and agrees that, except as provided in the [DELETED], it shall not [DELETED] any such other [DELETED] to Dialysis Center, its Agents, or its facilities.

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

Appendix B

List of Dialysis Center Affiliates

ACIS	Account Name	Xxxxxxx	Xxxx	Xxxxx	Xxx
000000	Xxxxxxxxxxx Dialysis Center	0000 Xxxxxx X.	Xxxxxxxxxxx	XX	00000
208876	DaVita Chinle Dialysis Facility	U.S. Xxxxxxx 000, Xx Xxx 000	Chinle	AZ	86503
208878	DaVita of Sterling Dialysis Center	00000 Xxxxxxxx Xxxxx, Xxxxx 000	Xxxxxxxx	XX	00000
208880	Continental Dialysis Center—Manassas	0000 Xxxxxx Xxxxxx, Xxxxx 000	Xxxxxxxx	XX	00000
208881	DaVita Desert Mountain Dialysis	0000 Xxxx Xxxxxxxxxxxx Xxxx, Xxxxx 000	Xxxxxxxxxx	XX	00000
208882	DaVita Los Angeles Dialysis Center	0000 Xxxxx Xxxxxxx Xxxxxx, Xxxxx 000	Xxx Xxxxxxx	XX	00000
208885	DaVita Monterey Park Dialysis Center, Inc.	0000 Xxxxxxxxx Xxxxx, Xxxxxxxx X, Xxxxxx 100-101	Monterey Park	CA	91754
208891	DaVita—Lawrenceburg Dialysis	000 Xxxx Xxxxxxx, Xxxxx 000	Xxxxxxxxxxxx	XX	00000
208894	Renal Treatment Center—Madison	000 Xxxxxx Xxxxx Xxxx X	Xxxxxxx	XX	00000
208970	XxXxxx Xxxxxxx Dialysis Center	00000 Xxxxx Xxxxx	Xxxxxxx	XX	00000
208978	Renal Treatment Center of Fort Valley	000 Xxxxx Xxxxxxx Xxxxxxxxx	Xxxx Xxxxxx	XX	00000
208991	DaVita Midtown Atlanta	000 Xxxxxx Xxxxxx	Xxxxxxx	XX	00000
209042	Walnut Creek Dialysis Center	108 La Casa Via, Suites 000 Xxx 000	Xxxxxx Xxxxx	XX	00000
209049	Platte Place Dialysis, A Total Renal Care Facility	0000 Xxxx Xxxxxx Xxxxx	Xxxxxxxx Xxxxxxx	XX	00000
209050	DaVita—Xxxxxxxx Dialysis Center	0000 Xxx Xxxxx	Xxxxxxxx	XX	00000
209089	Mid-Town Macon Dialysis	000 Xxxxxxx Xxxxxx, Xxxxx 000	Xxxxx	XX	00000
209125	DaVita Dba: Southfield Dialysis Center	00000 Xxxxxxxxxx Xxxx, Xxxxx 000	Xxxxxxxxxx	XX	00000
209127	North Oakland Dialysis Facility	000 Xxxxx Xxxxxxxxx	Xxxxxxx	XX	00000
209334	Bay Area Dialysis Center, Inc.	0000 0xx Xxxxxx Xxxxx	Xx. Xxxxxxxxxx	XX	00000
209338	New Port Xxxxxx Kidney Center	0000 Xxxxx Xxxxxxxxx	Xxx Xxxx Xxxxxx	XX	00000
209343	Hernando Kidney Center	0000-X Xxxxxxxx Xxxxxxxxx	Xxxxxx Xxxx	XX	00000
209346	DaVita—Pompano Beach Artificial Kidney Center	0000 Xxxx Xxxxxxxx Xxxxxxxxx	Xxxxxxx Xxxxx	XX	00000
209351	Fort Lauderdale Renal Associates, Inc.	0000 Xxxxx Xxxxxxx Xxxxxxx	Xxxx Xxxxxxxxxx	XX	00000
209406	Mid-Columbia Kidney Center	000 Xxxxx 0xx Xxxxxx	Xxxxx	XX	00000
209425	Continental Dialysis Center—Springfield Trc	0000x Xxxxxxx Xxxx	Xxxxxxxxxxx	XX	00000
209426	East End Dialysis Center of Total Renal Care, Inc.	0000 Xxxx Xxxx Xxxxxx, Xxxxx 000	Xxxxxxxx	XX	00000
209439	Continental Dialysis Center—Woodbridge Dialysis	0000 Xxxxxxxxx Xxxxx	Xxxxxxxxxx	XX	00000
209507	Total Renal Care—Bedford Dba: Heb Dialysis Center	0000 Xxxxx Xxxxx, Xxxxx X	Xxxxxxx	XX	00000
209518	DaVita Dialysis	0000 Xxxxxx Xxxx	Xxxxxxx	XX	00000
209519	DaVita—Southwest San Antonio Dialysis	0000 Xxxxxxx Xxxxxxxxx	Xxx Xxxxxxx	XX	00000
209520	Total Renal Care	0000 Xxxx Xxxxxxxx	Xxx Xxxxxxx	XX	00000
209523	Total Renal Care—Victoria	0000 Xxxxxxxx Xxxxxxx Xxxxx	Xxxxxxxx	XX	00000
000000	Xxxxxx Xxxxxx Dialysis	0000x Xxxxx 0xx Xxxxxx	Xxxxxxxx	XX	00000
209751	Total Renal Care, Dba: Camp Hill Dialysis Center	000 Xxxxx 00xx Xxxxxx, Xxxxx 21, First Floor	Camp Hill	PA	17011
209754	Franklin Dialysis Center	Xxxxxxxx Xxxxxx Building, 700 Spruce Street	Philadelphia	PA	19106
209763	Total Renal Care—Exton	000 Xxxxxxxxxx Xxxxx	Xxxxx	XX	00000
209776	Renal Treatment Center—Upland	0 Xxxxxxx Xxxxxxxxx, Xxxxxxxxxxxx Xxxxxx Xxxxxxxx Xx, Xxxxx 000	Upland	PA	19013
209915	Southeastern Dialysis Center	000 Xxxxx Xxxx	Xxxxxxxxxx	XX	00000
209925	Southeastern Dialysis of Wilmington	0000 Xxxxxx Xxxxx	Xxxxxxxxxx	XX	00000
209929	Asheville Kidney Center for Dialysis—A Total Renal Care Facility	00 Xxxxxxxx Xxxxxx	Xxxxxxxxx	XX	00000
209953	Richmond Kidney Center	0000 Xxxxxxx Xxxxxxxxx	Xxxxxx Xxxxxx	XX	00000
209962	South Brooklyn Nephrology Center, Inc.	0000 Xxxxxx X.	Xxxxxxxx	XX	00000
209970	South Bronx Kidney Center	0000 Xxxxxxx Xxxxxx	Xxxxx	XX	00000
210054	DaVita—Four Corners Dialysis Center	000/000 Xxxx Xxxxxxxx	Xxxxxxxxxx	XX	00000

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

ACIS	Account Name	Xxxxxxx	Xxxx	Xxxxx	Xxx
000000	XxXxxx—Xxx Xxxxx Dialysis Center	0000 Xxxx Xxxxxxxxxx, Xxxxx 000	Xxx Xxxxx	XX	00000
210134	Renal Treatment Center—St. Louis	0000 Xxxxx Xxxxxx	Xx. Xxxxx	XX	00000
210178	DaVita Burnsville Dialysis	000 Xxxx Xxxxxxxx, Xxxxx 000	Xxxxxxxxxx	XX	00000
210179	XxXxxx Xxxx Rapids Dialysis	0000 Xxxx Xxxxxx Xxxxxxxxx, Xxxxx 000	Xxxx Xxxxxx	XX	00000
210198	Minneapolis Dialysis Center of DaVita	000 Xxxxx 0xx Xxxxxx, Xxxxx Xx00	Xxxxxxxxxxx	XX	00000
210271	Total Renal Care—Northwest Baltimore Mount Washington	0000 Xxxxx Xxxxxx	Xxxxxxxxx	XX	00000
210276	Downtown Dialysis Center	000 Xxxxx Xxxxx Xxxxxx, Xxxxx 000	Xxxxxxxxx	XX	00000
210278	Total Renal Treatment—Berlin Dialysis Center	000 Xxxxxxxx Xxxxxx, Xxxxx 000 Xxxxxx Professional Center	Berlin	MD	21811
210286	XxXxxx Xxxxxx Dialysis	000 Xxxxxx Xxxxx	Xxxxxx	XX	00000
210287	DaVita Rockville	00000 Xxxxxxxxx Xxxx, Xxxxx 000	Xxxxxxxxx	XX	00000
210335	DaVita—Tri-Parish Chronic Renal Center	0000 Xx. Xxxxxx Xxxxxx	Xxx Xxxxxxx	XX	00000
210350	DaVita—Westbank Chronic Renal Center	0000 Xxxxxxx Xxxxx Xxxxxx, Xxxxx 000	Xxx Xxxxxxx	XX	70131
210359	DaVita New Orleans	0000 Xxxxxx Xxxxxx	Xxx Xxxxxxx	XX	00000
210381	Woodland Dialysis Center	000 Xxxxxxxx Xxxxx	Xxxxxxxxxxxxx	XX	00000
210397	DaVita—Wichita Dialysis	000 Xxxxx Xxxxxx	Xxxxxxx	XX	00000
210423	Batesville Dialysis Center	000 Xxxxx Xxxx 000 Xxxxx	Xxxxxxxxxx	IN	47006
210453	Granite City Dialysis—Total Renal Care	0000 Xxxxxxxxxxxx Xxxxxx	Xxxxxxx Xxxx	XX	00000
000000	XxXxxx Xxxxx Xxxxxx Dialysis Services, Inc.	0000 Xxxxx Xxxxxxxxx Xxxxxx	Xxxxxxx	XX	00000
210461	Total Renal Care—Hyde Park Kidney Center	0000-00 Xxxx 00xx Xxxxxx	Xxxxxxx	XX	00000
210462	Lincoln Park Dialysis Services—Total Renal Care	0000 Xxxxx Xxxxxxx Xxxxxx	Xxxxxxx	XX	00000
210528	Elberton Dialysis Facility, Incorporated	000 Xxxxx Xxxxxxxx Xxxxxx	Xxxxxxxx	XX	00000
210530	DaVita of Vidalia	0000 Xxxxxx Xxxxx	Xxxxxxx	XX	00000
210544	XxXxxx Xxxxxxx Dialysis Center	000 Xxxxx 0xx Xxxxxx	Xxxxxxx	XX	00000
210546	XxXxxx Xxxxxxxxxx Dialysis Center	000 Xxxxxxxxxx Xxxxx	Xxxxxxxxxx	XX	00000
210549	DaVita—Southwest Atlanta Nephrology	0000 Xxxxxx Xxxxxx Xxxx Xxxxx	Xxxxxxx	XX	00000
210555	DaVita Jonesboro	000 Xxxxxxxxxxx Xxxx	Xxxxxxxxx	XX	00000
210588	The Center for Kidney Disease	0000 Xxxxxxxxx 00xx Xxxxxx, Xxxxx 000	Xxxxx	XX	00000
210593	Xxxxxxx Dialysis Center, Inc.	0000 Xxxxxxxxx 0xx Xxxxxx	Xxxxx	XX	00000
210604	Delray Artificial Kidney Center	00000 Xxxxx Xxxxxxxx Xxxxx, Xxxxx 000	Xxxxxx Xxxxx	XX	00000
210608	Bayonet Point—Xxxxxx Kidney Center	00000 Xxxxxxx Xxxx	Xxxxxx	XX	00000
210621	DaVita—Port Charlotte Artificial Kidney Center	0000 Xxxxx Xxxxxxx, Xxxxx 000, Xxx X00	Xxxx Xxxxxxxxx	FL	33980
210635	Interamerican Dialysis Institute, Inc.	0000 Xxxxx Xxx, Xxxxx 000	Xxxxx	XX	00000
210645	Boca Raton Artificial Kidney Center	000 Xxxxxxxxx 0xx Xxxxx	Xxxx Xxxxx	XX	00000
210651	DaVita—Panama City Dialysis	000 Xxxxxxx 000	Xxxxxx Xxxx	XX	00000
210655	Dialysis Associates of the Palm Beaches, Inc.	0000 Xxxxxxxxxx Xxxxxx	Xxxx Xxxx Xxxxx	XX	00000
210661	South Broward Artificial Kidney Center	0000 Xxxxxxxxx Xxxxxxxxx	Xxxxxxxxx	XX	00000
210684	DaVita—Grant Park Dialysis	0000 Xxxxxxxxx Xxxxxx, Xxxxxxxxx	Xxxxxxxxxx	XX	00000
210723	DaVita Pikes Peak Dialysis Center	0000 Xxxx Xx Xxxxx Xxxxxx	Xxxxxxxx Xxxxxxx	XX	00000
210725	DaVita Lakewood Dialysis Center	0000 Xxxxx Xxxxxx Xxxxxx, Xxxxx X.	Xxxxxxxx	XX	00000
210738	United Dialysis Center	0000 Xxxxxxxx Xxxxxx, Xxxxx 000	Xxxx Xxxxx	XX	00000
210748	Antelope Dialysis Center, Dba: Total Renal Care—Antelope Clinic	0000 Xxxxxx Xxxxx, Xxxxx X	Xxxxxx Xxxxxxx	XX	00000
210750	DaVita—Corona Dialysis Center	0000 Xxxxxxxxx Xxxxxx, Xxxxx 000	Xxxxxx	XX	00000
210754	DaVita Palm Desert Dialysis Center, Inc.	00-000 Xxxxxxxxx Xxx	Xxxx Xxxxxx	XX	00000
210757	XxXxxx Xxxxx Dialysis Center	0000 Xxxxx Xxxxx Xxxxxx	Xxxxxx	XX	00000
210759	DaVita—Paramount Dialysis Center	0000 Xxxxxxx Xxxxxxxxx	Xxxxxxxxx	XX	00000
210764	Satellite Dialysis Centers, Inc.	0000 Xxxxx Xxxxx Xxxxxx, Xxxxx 0	Xxxxxxx	XX	00000
210776	DaVita Pacific Coast Dialysis Center	0000 Xxxxxxxxx Xxxxxx	Xxxxxxxxx	XX	00000
210779	DaVita Wilshire Dialysis Center	0000 Xxxxxxxx Xxxxxxxxx	Xxx Xxxxxxx	XX	00000
210780	Satellite Dialysis Centers, Inc.	0000 Xxxxx Xxxxxx Xxxxxx, Xxxx Xxxxxx 0	Xxxxx Xxxx	XX	00000
210781	Satellite Dialysis Centers, Inc.	00 Xxxxxxxxx, Xxxxx 0	Xxxxxxxxxxx	XX	00000
210790	DaVita Hemet Dialysis Center	0000 Xxxxx Xxxxx Xxxxxx, Xxxxx X.	Xxx Xxxxxxx	XX	00000

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

ACIS	Account Name	Address	City	State	Zip
210796	DaVita—Xxxxx Canyon Dialysis Center	0000 Xxxx Xxxxxxxxxx Xxxxxxxxx	Xxxxxxxx	XX	00000
210799	DaVita—Piedmont Dialysis	0000 Xxxxxxxxx Xxxxxx	Xxxxxxx	XX	00000
210800	Satellite Dialysis Centers, Inc.	000 Xxxx Xxxxxxxx Xxx	Xxxxxx	XX	00000
210805	Manzanita Dialysis Center, Dba: Total Renal Care—Manzanita	0000 Xxxxxxxxx Xxxxxx, Xxxxxx 000 And 160	Carmichael	CA	95608
210806	Xxxxxxx Valley Dialysis Services, Inc.	000 Xxxxxx Xxxxxx, Xxxxx X	Xxxxxxx	XX	00000
210808	Satellite Dialysis Centers, Inc.	000 Xxxxxxx Xxxx Xxxx, Xxxxx 000	Xxx Xxxx	XX	00000
210809	DaVita—Xxxxxxx Hills Dialysis Center	0000 Xxxx Xxxx Xxxxxxxxx	Xxx Xxxxxxx	XX	00000
210815	XxXxxx Xxxxxxxx Dialysis Center	00000 Xxxxxx Xxxx	Xxxxxxxx	XX	00000
210827	Covina Dialysis Center	0000 Xxxx Xxxxxx Xxxxxx	Xxxx Xxxxxx	XX	00000
210833	Downey Dialysis Center	0000 Xxxxxxxx Xxxxxx	Xxxxxx	XX	00000
210835	Satellite Dialysis Centers, Inc.	0000 Xxxxxxx Xxxxx	Xxx Xxxx	XX	00000
210838	South Sacramento Dialysis Center, Dba: Total Renal Care—South Sacramento	0000 Xxxxxxxx Xxxxxxxxx, Xxxxx 000	Xxxxxxxxxx	XX	00000
210843	XxXxxx Xxxxxxxx Hemodialysis Center	000 Xxxxxxxx Xxxxxx	Xxxxxxxx Xxxx	XX	00000
210844	Yuba City Dialysis Center, Dba: Total Renal Care—Yuba City	0000 Xxxx Xxx Xxxxxxxxx, Xxxxx X-0	Xxxx Xxxx	XX	00000
210851	Satellite Dialysis	0000 Xxxxxx Xxxxxx	Xxxxx Xxxx	XX	00000
210852	Valley Dialysis Center	00000 Xxxx Xxxxxx	Xxx Xxxx	XX	00000
210853	Chico Dialysis Center, Dba: Total Renal Care—Chico	000 Xxxxxxxx Xxxx	Xxxxx	XX	00000
210855	Satellite Dialysis Centers, Inc.	0000 Xxxxxxxx Xxxxxx	Xxxxxxx Xxxx	XX	00000
210867	DaVita Lakewood Dialysis Center	0000 Xxxxx Xxxxxx	Xxxxxxxx	XX	00000
210872	Riverside Dialysis Center	0000 Xxxxxx Xxxxxx, Xxxxx 000	Xxxxxxxxx	XX	00000
210873	Satellite Dialysis Centers, Inc.	0000 Xxxxxx Xxxxx, Xxxxxxxx X	Xxxxxxx	XX	00000
210874	DaVita University Dialysis Center	000 Xxxxxxxxxx Xxxxxx, Xxxxx 000	Xxxxxxxxxx	XX	00000
210876	Redding Dialysis Center, Dba: Total Renal Care—Redding	0000 Xxxx Xxxxxx Xxxxx	Xxxxxxx	XX	00000
210878	Satellite Dialysis Larkspur #771	000 Xxx Xxxxxxx Xxxxx Xxxxxxxxx	Xxxxxxxxx	XX	00000
210889	Satellite Dialysis Centers, Inc.	0000 Xxxxxxxx Xxxxxx, Xxxxx 00	Xxx Xxxx	XX	00000
210893	Community Hemodialysis Unit of San Francisco	0000 Xxxxxx Xxxxxx	Xxx Xxxxxxxxx	XX	00000
210897	Kidney Dialysis Care Units	3600 East Xxxxxx Xxxxxx Xxxx, Junior Boulevard	Lynwood	CA	90262
210978	Tuba City Dialysis	000 Xxxxxxxxx Xxxxx	Xxxx Xxxx	XX	00000
210979	Total Renal Care, Dba: Scottsdale Dialysis Center	0000 Xxxx Xxxxxx Xxxxx	Xxxxxxxxxx	XX	00000
211005	Phenix City Dialysis Center	1900 Opelika Road	Phenix City	AL	36867
213230	Placerville Dialysis Center, Dba: Total Renal Care—Placerville	0000 Xxxxxxxx Xxxx Xxxx, Xxxxx X.	Xxxxxxxxxxx	XX	00000
213248	Total Renal Care—Xxxxxxx County Dialysis Facility	000 Xxxxxxx Xxxxx, Xxxxx 000	Xxxxxxxxxxx	XX	00000
213260	DaVita—Boulder Dialysis Center	0000 Xxxxxx Xxxxxx, Xxxxx 000	Xxxxxxx	XX	00000
213274	DaVita—Arden Hills Dialysis	0000 Xxxxxxxxxx Xxxxx, Xxxxx 000	Xxxxx Xxxxx	XX	00000
213279	Total Renal Care—Xxxxxxx Xxxx Xxxxxxxx	Xxxxxxx 00 Xxxxx Xxx I. 55	Crystal City	MO	63019
213287	DaVita—Bluff City Dialysis	2400 Xxxx Xxx Parkway, Suite E.	Poplar Bluff	MO	63901
213288	Mount Xxxx Dialysis	0000 Xxxx Xxx Xxxxxxx 000	Xxxxx Xxxx	XX	00000
213290	Venture Dialysis Center, Inc.	00000 Xxxxxxxxx 0xx Xxxxxx, Xxxxx 000	Xxxxx Xxxxx Xxxxx	XX	00000
213295	North Palm Beach Dialysis Center, Inc.	0000 Xxxxx Xxxx, Xxxxx 000	Xxxx Xxxxx Xxxxxxx	XX	00000
213305	Total Renal Care—Tamarac Artificial Kidney Center	0000-00 Xxxx Xxxxx Xxxx	Xxxxxxx	XX	00000
213319	DaVita—Nephrology Center of Augusta, Inc.	1238 D’Antignac Street	Augusta	GA	30901
213323	Renal Treatment Center—Columbus	0000 Xxxxxxx Xxxx Xxxxx, Xxxxx X.	Xxxxxxxx	XX	00000
213324	Dialysis Care of Mecklenburg	0000 Xxxxxxx Xxxxx	Xxxxxxxxx	XX	00000
213327	Dialysis Care of Rockingham County	000 Xxxx Xxxx’X Xxxxxxx	Xxxx	XX	00000
213331	Dialysis Care of Richmond	Highway 177 South, Behind Britthaven	Hamlet	NC	28345
213339	DaVita Milledgeville	000 Xxxxx Xxxxx Xxxxxx	Xxxxxxxxxxxxx	XX	00000

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

ACIS	Account Name	Address	City	State	Zip
213343	Dialysis Care of Xxxxx	#00 Xxxxxxxx Xxxxx, Xxxxx 0-0	Xxxxxxxxx	XX	00000
213347	Dialysis Care of Rowan	0000 X. Xxxx Xxxxx Xxxxxx	Xxxxxxxxx	XX	00000
213362	Lake County Dialysis	000 Xxxxx Xxxxxxxxx	Xxxxxxxxxxxx	XX	00000
213366	Total Renal Care Olympia Fields	0000x Xxxx Xxxxxxx Xxxxxxx	Xxxxxxxx	XX	00000
213376	Total Renal Care—Lincolnland	0000 Xxxxxx Xxxx Xxxxx	Xxxxxxxxxxx	XX	00000
213391	Garden City Dialysis Center of Total Renal Care	000 Xxxx Xxxxxx	Xxxxxx Xxxx	XX	00000
213393	Total Renal Care—Independence Dialysis	000 Xxxx Xxxxxx	Xxxxxxxxxxxx	XX	00000
213398	Xxxxxx County Dialysis Facility	000 Xxxxxxxxx Xxxxx	Xxxxxxxxxxxxxx	XX	00000
213410	DaVita—Midwest City	0000 Xxxx Xxxx Xxxxx, Xxxxx 000	Xxxxxxx Xxxx	XX	00000
213426	St. Xxxxxxx Dialysis Xxxx	0000 Xxxxxxxx Xxxxxx, Xxxxx 00	New Orleans	LA	70115
213433	Slidell Kidney Care	0000 Xxxxxx Xxxxxxxxx, Xxxxx 000	Xxxxxxx	XX	00000
213451	DaVita—Shawnee Dialysis Center	0000 Xxxxx Xxxxxxxx Xxxxxx	Xxxxxxx	XX	00000
213471	DaVita—Xxxxxxxx Dialysis	0000 Xxxxx Xxxxxxxxxx	Xxxxxxxx	XX	00000
213484	Total Renal Care—Northwest San Antonio	0000 Xxxxxxxxxxxxxx Xxxx	Xxx Xxxxxxx	XX	00000
213496	Upstate Dialysis Center, Inc.	000 Xxxxx Xxxxxx	Xxxxxxxxxx	XX	00000
213498	Greer Kidney Center, Inc.	000 Xxxxxxx Xxxxx	Xxxxx	XX	00000
213504	Meherrin Dialysis Center, Inc.	000-X Xxxxxx Xxxxxx	Xxxxxxx	XX	00000
213540	Edina Dialysis of Total Renal Care	0000 Xxxx Xxxxxx Xxxxx, Xxxxx 000	Xxxxx	XX	00000
213542	Marshall Dialysis of Total Renal Care	000 Xxxxx Xxxxx Xxxxxx	Xxxxxxxx	XX	00000
213544	Red Wing Dialysis DaVita	0000 Xxxx 0xx Xxxxxx	Xxx Xxxx	XX	00000
213547	St. Croix Falls Dialysis—Total Renal Care	000 Xxxxxxxxx Xxxx	Xx. Xxxxx Xxxxx	XX	00000
213560	Southeastern Dialysis Center, Inc.	00 Xxxxxx Xxxx Xxxxx	Xxxxxxxxxxxx	XX	00000
213561	Southeastern Dialysis of Kenansville	000 Xxxxxxx Xxxxxx	Xxxxxxxxxxx	XX	00000
213570	Georgetown On the Potomac Dialysis Center	0000 X Xxxxxx Xxxxxxxxx, Xxxxx 000	Xxxxxxxxxx	XX	00000
213582	Gulf Coast Dialysis, Inc.	0000 Xxxxxxx Xxxxx, Xxxxx 000x	Xxxx Xxxxxxxxx	XX	00000
213674	Xxxxxx Xxxx Dialysis Center, Inc.	0000 Xxxx Xxxx, Xxxxx 00	Xxxxxxxxx	XX	00000
213722	DaVita—Bhs Dialysis Services	0000 Xxxx 0000 Xxxxx	Xxxx Xxxx Xxxx	XX	00000
213723	Alhambra Dialysis Center, Dba: Total Renal Care—Alhambra	0000 Xxxxxxxx Xxxxxxxxx, Xxxxx 000	Xxxxxxxxxx	XX	00000
213727	DaVita St. Xxxx Dialysis	000 Xxxx Xxxxxx, Xxxxx 000	Xx. Xxxx	XX	00000
213728	Regional Kidney Disease Program of Total Renal Care, Dba: West St. Xxxx Dialysis	0000 Xxxxxxxxxx	Xxxx Xx. Xxxx	XX	00000
213742	DaVita—Northwest Xxxxxxx	0000 Xxxxxxxxx 00xx Xxxxxx, Xxxxx X	Xxxxxxx	XX	00000
213749	Sylva Dialysis Center	000 Xxxxxxxxx Xxxxxxx	Xxxxx	XX	00000
213820	DaVita—University Park Dialysis Center	0000 Xxxxx Xxxxxxxx Xxxxxx	Xxx Xxxxxxx	XX	00000
216245	DaVita Norwalk Dialysis Center	00000 Xxxx Xxxxxxxx Xxxxxxx	Xxxxxxx	XX	00000
216247	DaVita—Cincinnati	000 Xxxxxxxx Xxxxxxxxx Xxxxx	Xxxxxxxxxx	XX	00000
216368	XxXxxx Xxxxxx Dialysis	000 Xxxxxxxx Xxxxxxx	Xxxxxx	XX	00000
216792	XxXxxx Xxxx Lake Dialysis	000 Xxxxx Xxxxx Xxxxxx	Xxxx Xxxx	XX	00000
216796	Rosebud Dialysis of DaVita	0 Xxxxxxx Xxxxx Xxxx	Xxxxxxx	XX	00000
217091	DaVita Greater El Monte Dialysis Center	0000 Xxxxx Xxxxxx, Xxxxx X-000	Xx Xxxxx	XX	00000
217182	DaVita—Provo	0000 Xxxxx 000 Xxxx	Xxxxx	XX	00000
218763	DaVita—Xxxx	0000 Xxxxxxxx	Xxxx	IN	46408
218764	DaVita—Xxxxxxx	000 Xxxxxxx Xxxxxx	Xxxxxxx	XX	00000
219028	Northwest Kidney Center, Llp	00000 Xxxxxxxxx Xxxxxxx	Xxxxxxx	XX	00000
219160	Southeastern Dialysis Center, Inc.	000 Xxxxx Xxxxxxxxx	Xxxxxx	XX	00000
219611	Complete Dialysis Care, Inc.	0000 Xxxx Xxxxxx Xxxx	Xxxxx Xxxxxxx	XX	00000
219739	Piedmont Dialysis Center	0000 Xxxxxxxxx Xxxx, Xxxxx 000	Xxxxxxx	XX	00000
219743	DaVita—Doctors Dialysis Center of East Los Angeles	0000 Xxxx Xxxxxxxx Xxxxxxxxx, Xxxxx 000	Xxx Xxxxxxx	XX	00000
219857	DaVita—Xxxxxxx Renal Center	000 00xx Xxxxxx	Xxxxxxx	XX	00000
219952	Continental Dialysis Center—Alexandria	0000 Xxxxxxxxx Xxxxxx, Xxxxx 000	Xxxxxxxxxx	XX	00000
219968	Total Renal Care—Cape May Courthouse	000 Xxxxxxxx Xxxxx	Xxxx Xxx Xxxxxxxxxx	XX	00000

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

ACIS	Account Name	Xxxxxxx	Xxxx	Xxxxx	Xxx
000000	Xxxxxxxxx Xxxxxx Dialysis Facility (Xxxxx-Xxxxx Dialysis Facility)	0000x Xxxxxxx Xxxx	Xxxxxxxxxxxx	XX	00000
220477	Life Care Dialysis Center	000 Xxxx 00xx Xxxxxx	Xxx Xxxx	XX	00000
220649	DaVita—Hopewell Dialysis	000 Xxxx Xxxxxxxx	Xxxxxxxx	XX	00000
221169	Catskill Dialysis and Renal Disease Center	Route 42 And Xxxxx Xxxx	Monticello	NY	12701
221297	DaVita—Miami Lakes Artifical Kidney Center	00000 00xx Xxxxxx Xxxxxxxxx	Xxxxx Xxxxx	XX	00000
221360	Waterloo Dialysis Center	0000 Xxxxx Xxxxx Xxxxxx, Xxxxx 000	Xxxxxx	XX	00000
221633	Total Renal Care—Kingwood	0000 Xxxxx Xxxx, Xxxxx 000	Xxxxxxxx	XX	00000
221765	Renal Care of Buffalo, Inc.	000 Xxxxxxx Xxxx Xxxx, Xxxxx X000	Xxxxxxx	XX	00000
221767	Faribault Dialysis of Total Renal Care	000 Xxxxx Xxxxxxx Xxxxxx	Xxxxxxxxx	XX	00000
221850	Hope Again Dialysis	0000 Xxxxx Xxxxx X.X.	Xxxxxxx	XX	00000
221965	Ocean Garden Dialysis Center	0000 Xxxxx Xxxxxx	Xxx Xxxxxxxxx	XX	00000
221973	Satellite Home Care Llc—Modesto	0000 Xxxxx Xxxxxx	Xxxxxxx	XX	00000
221981	DaVita—Xxxxxx Dialysis	2645 West Elk	Duncan	OK	73533
221999	Dialysis Care of Anson County	000 Xxxx Xxxxxxx Xxxxxx	Xxxxxxxxx	XX	00000
223140	DaVita—Altus Dialysis Center	000 Xxxxx Xxxx Xxxx, Xxxxx 000	Xxxxx	XX	00000
223253	Total Renal Care—Wilmington Dialysis	000 Xxx Xxxxxxxxx, Xxxxx X0	Xxxxxxxxxx	XX	00000
223507	DaVita—East Bay Peritoneal Dialysis	00000 Xxxx 00xx Xxxxxx, Xxxxx 000	Xxx Xxxxxxx	XX	00000
223774	DaVita—North Las Vegas	0000 Xxxxxxxx Xxxxxx	Xxxxx Xxx Xxxxx	XX	00000
224112	Total Renal Care—Northeast Philadelphia	000 Xxxxx Xxxxxx	Xxxxxxxxxxxx	XX	00000
000000	Xxxxx Xxxxxxxxxxxx Dialysis Center	000 Xxxxxxxxx Xxxxxx	Xxxxxxxxxxxx	XX	00000
224329	Central City Dialysis Center	0000 Xxxxxxxxx Xxxxxx, Xxxxx 000	Xx Xxxx	XX	00000
224349	DaVita Dialysis Center of Middle Georgia	000 Xxxxxx Xxxxxx	Xxxxx	XX	00000
224554	Renal Treatment Center—Xxxx Xx. Xxxxx	000 Xxxxx Xxxxxx Street 3rd Floor	East St. Louis	IL	62201
224565	DaVita—East Wichita Dialysis	000 Xxxxx Xxxxxxxx	Xxxxxxx	XX	00000
225103	Total Renal Care Dba: Lincoln Park Capd	0000 Xxxxx Xxxxxxx, Xxxxx 0	Xxxxxxx	XX	00000
225471	DaVita—Winter Haven	400 Security Square	Winter Haven	FL	33880
225512	Honesdale Dialysis Center—A Total Renal Care Facility	Maple Avenue—Xxxxx 0—Xxxxxxxxxx Xxxx	Xxxxxxxxx	XX	00000
225679	Greenspring Dialysis Center, Inc.	0000 Xxxxxxxxxxx Xxxxxx	Xxxxxxxxx	XX	00000
225731	DaVita—Stillwater Dialysis Center	000 Xxxx Xxxx Xx Xxxx Xxxxxx, Xxxxx 000	Xxxxxxxxxx	XX	00000
000000	Xxxxxxx Xxx Community Dialysis Center	0000 Xxxxx 000xx Xxxxxx	Xxxxxxx Xxx	XX	00000
225836	Gettysburg Dialysis	00 Xxxxxxx Xxxxxx, Xxxxx X	Xxxxxxxxxx	XX	00000
225939	Renal Treatment Centers—Palmerton	000-X Xxxxxxxx Xxxxxx	Xxxxxxxxx	XX	00000
226257	DaVita—Temecula Dialysis	00000 Xxxxxx Xxxxxx Xxxxx, Xxxxx X.	Xxxxxxxx	XX	00000
226385	Flamingo Park Kidney Center	000 Xxxx 00xx Xxxxxx	Xxxxxxx	XX	00000
226403	Nephrology Center of Waynesboro	000 Xxxxx Xxxxxxx Xxxxxx	Xxxxxxxxxx	XX	00000
226418	Nephrology Center of Statesboro	4b College Plaza	Statesboro	GA	30458
226421	Xxxxxx—Denison	0000 Xxxx Xxxxxxxx Xxxx	Xxxxxxx	XX	00000
226683	DaVita Hendersonville Dialysis Center	500 Xxxxxxx Xxxxx Center, Highway 25 North	Hendersonville	NC	28792
226735	DaVita—Omni	0000 Xxxxx, Xxxxx 000	Xxxxxxx	XX	00000
226754	DaVita—Mission Dialysis of El Cajon	000 Xxxxxxxx Xxxxxxx	Xx Xxxxx	XX	00000
226851	Dialysis of Reading	0000 Xxxxxxx Xxxxxx	Xxxxxxx	XX	00000
226979	Total Renal Care—Vacaville	0000 Xxxxx Xxxxx, Xxxxx 0	Xxxxxxxxx	XX	00000
226982	DaVita—Fairfield Dialysis Center	000 Xxxxxx Xxxxxx	Xxxxxxxxx	XX	00000
226987	Total Renal Care—Lakeport	000 00xx Xxxxxx	Xxxxxxxx	XX	00000
226989	DaVita—Napa Dialysis Center	3900—C Bel Aire Plaza	Napa	CA	94558
227012	DaVita—Mountain Vista Dialysis Center	000 X. Xxxx Xxxxxxxx Xxxxxx	Xxx Xxxxxxxxxx	XX	00000
227022	Dialysis Care of Xxxxxxxxxx County	000 Xxxxxxxxxx Xxxxx	Xxxxxx Xxxx	XX	00000
227112	DaVita—Xxxxxx	1818 Xxxx Xxxxxxx, B. 104	Norman	OK	73069
227123	Xxxxxxxx Dialysis	0000 Xxxxxxxxx	Xxxxxxxx	XX	00000
000000	Xxxxx Xxxxxx Dialysis	0000 Xxxxxx Xxxxxx	Xxxxxx	XX	00000
227252	DaVita—Sunrise Dialysis Center, Inc.	00000 Xxxxxxxxx Xxxxxxxxx	Xxxxxxxxx	XX	00000
227267	DaVita—Claremore Dialysis Center	000 Xxxx Xxxx Xxxxx Xxxxx	Xxxxxxxxx	XX	00000
227272	DaVita—Tahlequah Dialysis Center	000 Xxxxx Xxxxx Xxxxxx	Xxxxxxxxx	XX	00000
227277	DaVita—Broken Arrow Dialysis Center	000 Xxxxx Xxxxx Xxxxxx	Xxxxxx Xxxxx	XX	00000

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

ACIS	Account Name	Address	City	State	Zip
227279	DaVita—Tulsa	0000 Xxxxx Xxxxxxx	Xxxxx	XX	00000
227310	DaVita Valley View Dialysis	00000 Xxxxxx Xxxxxx	Xxxxxx Xxxxxx	XX	00000
227449	Burlington Dialysis Center	000 Xxxxxxx Xxxx	Xxxxxxxxxx	XX	00000
227497	DaVita—San Leandro	000 Xxxx 00xx Xxxxxx	Xxx Xxxxxxx	XX	00000
227605	DaVita—Valparaiso	606 Lincolnway	Valparaiso	IN	46383
227684	Xxxxxxxxxx Dialysis Center	000 Xxxxx Xxxxxxx Xxxxxx	Xxxxxxxxxx	XX	00000
227863	DaVita—Dialysis Care of Franklin County	0000 Xxxxx Xxxxxxxx Xxxxxxx 00 Xxxxx	Xxxxxxxxx	XX	00000
227906	Total Renal Care Union City Dialysis Center	00000 Xxxxxxxx Xxxxx Xxxx, Xxxxx 000	Xxxxx Xxxx	XX	00000
227908	Total Renal Care—Pleasanton, Aka: Pleasanton Dialysis Center	0000 Xxxxxxxxxx Xxxx Xxxx, Xxxxxx 140 And 160	Pleasanton	CA	94588
227954	Maplewood Dialysis DaVita	0000 Xxxxx Xxxx Xxxxxx	Xxxxxxxxx	XX	00000
000000	XxXxxx Xxxxxxxxx Xxxxx	0000 Xxxx Xxxxxxxxx Xxxxxxxxx	Xxxxxxxxx Xxxxx	XX	00000
227976	Montevideo Dialysis DaVita	000 Xxxxx 00xx Xxxxxx	Xxxxxxxxxx	XX	00000
228000	DaVita—Oklahoma City	0000 Xxxx Xxxxxxxx Xxxx, Xxxxx 000	Xxxxxxxx Xxxx	XX	00000
228033	DaVita—Santa Xxx Dialysis	0000 Xxxx Xxxxx Xxxxxx	Xxxxx Xxx	XX	00000
228035	DaVita Brea Dialysis Center	000 Xxxxxxxx Xxxxxx, Xxxxx X	Xxxx	XX	00000
228047	Total Renal Care—Howell	3502 Route 0 Xxxxx, Xxxxxx Xxxxxxxx Xxxxx	Xxxxxx	XX	00000
228191	North Houston Kidney Center, L.L.P	000 Xxxx Xxxxxx Xxxx	Xxxxxxx	XX	00000
228218	Renal Treatment Center—East Macon	000 Xxxxxxxxxxx Xxxxx, Xxxxx 000	Xxxxx	XX	00000
228252	Dialysis Care of Edgecombe County	0000 Xxxxxxx Xxxxxxxxx	Xxxxxxx	XX	00000
228544	Total Renal Care—North Houston	000 Xxxxxx Xxxx	Xxxxxxx	XX	00000
228587	DaVita—Leesburg Dialysis	000 Xxxx Xxxxx Xxxxxx, Xxxxx 000-X	Xxxxxxxx	XX	00000
228591	Norfolk Dialysis Center—A Total Renal Care Facility	000 Xxxxxxx Xxxxxx	Xxxxxxx	XX	00000
228652	Pd Central	0000 Xxxxx 00xx Xxxxxx, Xxxxx 0	Xxxxxxx	XX	00000
228659	Total Renal Care—Chesapeake	0000 Xxxxxxxxx Xxxxxxxxx, Xxxxxxxxx Xx, Xxxxx 000	Xxxxxxxxxx	XX	00000
228667	DaVita Newport News Dialysis	000 Xxxxxxxxx Xxxxxx	Xxxxxxx Xxxx	XX	00000
228696	DaVita—Aurora Dialysis	0000 Xxxxx Xxxxxxx, Xxxxx 000	Xxxxxx	XX	00000
228697	DaVita—Westminster Dialysis Center	0000 Xxxxxxx Xxxxxx, Xxxx 00	Xxxxxxxxxxx	XX	00000
228704	Xxxxxxxx Dialysis Center	0000 Xxxxxx Xxxx	Xxxxxxx	XX	00000
228756	DaVita—Denver Dialysis	0000 Xxxx 00xx Xxxxxx	Xxxxxx	XX	00000
228757	DaVita South Denver Dialysis	000 Xxxx Xxxxxxx Xxxxxx	Xxxxxx	XX	00000
228768	DaVita—Littleton	000 Xxxx Xxxxxx Xxxx Xxxx	Xxxxxxxxx	XX	00000
000000	Xxxxxxx Xxxxx Dialysis DaVita	000 Xxxxxxxx Xxxx	Xxxxxxx Xxxxx	XX	00000
228976	DaVita—Lodi Community Dialysis, Inc.	0000 Xxxx Xxxx Xxxxxx, Xxxxx 000	Xxxx	XX	00000
229029	Xxxxx Xxxxx Xxxxxx Xxxxxx	000 0xx Xxxxxx	Xxxxxx	XX	00000
229034	DaVita—Buena Vista	000 Xxxxxxx 00 Xxxxx	Xxxxx Xxxxx	XX	00000
229074	Dialysis Care of Xxxxx County	0000 Xxxxx Xxxxxxxx Xxxxx	Xxxxxxxxx	XX	00000
229102	DaVita Macomb Kidney Center	11885 Xxxx 00 Xxxx Xxxx, Xxxxxx 000x-000x	Warren	MI	48093
229111	DaVita—Sparks Dialysis	0000 Xxxx Xxxxxx Xxx, Xxxxx 000	Xxxxxx	XX	00000
229133	Total Renal Care—Venice	000 Xxxxxxxxx Xxxx	Xxxxxx	XX	00000
229218	Total Renal Care—Virginia Beach	000 Xxxxxxxxxxxx Xxxxxx	Xxxxxxxx Xxxxx	XX	00000
229403	Dialysis Care of Xxxx County	000 Xxxxx Xxxx Xxxxxx	Xxxxxxx	XX	00000
229404	Dialysis Care of Xxxxxxxxxx County	000 Xxxxx Xxxx Xxxxxx	Xxxx	XX	00000
229459	Southeastern Dialysis Center of Elizabethtown	000 Xxxxxxxx Xxxxx	Xxxxxxxxxxxxx	XX	00000
229618	Total Renal Care, Dba: Southeastern Dialysis Center of Shallotte	0000 Xxxxxxxxx Xxxxxx	Xxxxxxxxx	XX	00000
229662	XxXxxx Xxxxxxxx Dialysis Center	0000 Xxxxx Xxxx Xxxxxx	Xxxxxxxx	XX	00000
229685	Total Renal Care Dialysis East	0000 Xxxxxxx Xxxx, Xxxxx X.	Xx Xxxx	XX	00000
229739	Sioux Falls Community Dialysis of XxXxxx	Xxxxxxxx Hospital, 000 Xxxx 00xx Xxxxxx, 0xx Xxxxx	Xxxxx Xxxxx	XX	00000
229797	DaVita Premier Dialysis	0000 Xxxxxxxx Xxxxxx	Xxxxxx	XX	00000
230041	Dialysis Specialists of Dallas, Dba: Elmbrook Kidney Center	0000 Xxxxxxxx, Xxxxx 000	Xxxxxx	XX	00000
230061	DaVita Dialysis	000 Xxxxxxxx Xxxxxx	Xxxxxxxxx	XX	00000

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

ACIS	Account Name	Address	City	State	Zip
230157	DaVita—Conroe Dialysis	000 Xxxxxxx Xxxxxx Xxxxxxxxx, Xxxxx 000	Xxxxxx	XX	00000
230256	DaVita—Crescent City Dialysis	0000 Xxxxxxxxx Xxxxxx, Xxxxx 0x	Xxx Xxxxxxx	XX	00000
230300	DaVita Kayenta Dialysis Facility	Xxxxxxx 000, Xx Xxx 000	Kayenta	AZ	86033
230340	Miami Beach Kidney Center	000 Xxxxxx Xxxxxxx Xxxx, Xxxxx 000	Xxxxx Xxxxx	XX	33140
230633	Port Xxxxxxx Dialysis Xxxx	00 Xxxxxxx Xxxxxx	Port Chester	NY	10573
230685	Ocala Regional Kidney Center—West	0000 Xxxxxxxxx Xxxxxxx 000, Xxxxxxxx 000, Xxxxx 000	Xxxxx	XX	34481
230708	Milford Dialysis Center—A Total Renal Care Facility	00 Xxxxx Xxxx, Xxxxxx Xxxxxxxx Xxxxxx	Xxxxxxx	XX	00000
230792	DaVita Pine City Dialysis	000 Xxxx 0xx Xxxxxx	Xxxx Xxxx	XX	00000
230899	Total Renal Care—Bridgewater Dialysis Center	0000 Xxxxx 00 Xxxx	Xxxxx Xxxxx	XX	00000
230900	Mitchell Community Dialysis of DaVita	000 Xxxxx Xxxxxx	Xxxxxxxx	XX	00000
230911	El Xxxxxxx Dialysis Center	0000 Xxxxx Xxxxxxxxxx Xxxxxxx 35 Iii Fountain Park Plaza, Suite 120	Austin	TX	78704
230926	Total Renal Care—North Philadelphia Dialysis Center	0000-0000 Xxxxxxxxxx Xxxxxx	Xxxxxxxxxxxx	XX	00000
231099	DaVita—Elk City	0000 Xxxx 0xx Xxxxxx, Xxxxx 000	Xxx Xxxx	XX	00000
231100	Renal Treatment Centers—Pocono	447 Office Plaza—000 Xxxxx Xxxxx, Xxxxx X.	Xxxx Xxxxxxxxxxx	XX	00000
231179	Renal Treatment Center—Lake Wales	0000 Xxxxx Xxxxx 00 Xxxx	Xxxx Xxxxx	XX	00000
231194	Total Renal Care—Houston Kidney Center, Cypress Station	221 H Fm 1960 West	Houston	TX	77090
231261	DaVita Dialysis West	0000 Xxxx Xxxxx Xxxxx, Xxxxx X.	Xx Xxxx	XX	00000
231283	DaVita Shiprock Dialysis Center	Us Xxxxxxx 000 Xxxxx, Xx Xxx 0000	Shiprock	NM	87420
231288	DaVita—West Mount Houston Dialysis	0000 Xxxx Xxxxx Xxxxxxx Xxxx, Xxxxx X	Xxxxxxx	XX	00000
231411	Gulf Breeze Dialysis	0000 Xxxxxxxx Xxxxx	Xxxxxxx	XX	00000
231423	Ocala Regional Kidney Center—East	0000 Xxxxxxxxx 0xx Xxxxxx	Xxxxx	XX	00000
231460	DaVita Minnetonka Dialysis Xxxx	00000 Xxxxxxxx Xxxxx	Xxxxxxxxxx	XX	00000
231577	Potrero Hill Dialysis Center	0000 Xxxxx Xxxxxx Xxxxxx, Xxxxx X	Xxx Xxxxxxxxx	XX	00000
231579	XxXxxx Xxxxxx Regional Dialysis Center	000 Xxxx Xxxxxxxxx Xxxxxx, Xxxxx 000	Xxxxxx	XX	00000
231673	DaVita—Mission Dialysis Center of San Diego	0000 Xxxxxxx Xxxxx Xxxx	Xxx Xxxxx	XX	00000
231710	DaVita Arvada Dialysis	0000 Xxxx 00xx, Xxxxx 00	Xxxxxx	XX	00000
231721	Dialysis Care of Xxxxxx County	000 Xxxxxxx Xxxxx	Xxxxxxxxxxx	XX	00000
231824	New Center Dialysis, P.C.	0000 Xxxx Xxxxx Xxxxxxxxx, Xxxxx 000	Xxxxxxx	XX	00000
231889	Sunrise Dialysis Center, Dba: Total Renal Care—Sunrise	0000 Xxxxxxx Xxxxxxxxx, Xxxxx 000	Xxxxxx Xxxxxxx	XX	00000
231977	Total Renal Care—Cleveland	000 Xxxx Xxxxxxx Xxxxxx, Xxxxx 000	Xxxxxxxxx	XX	00000
232013	Linden Dialysis	000 Xxxxx Xxxx Xxxxxx	Xxxxxx	XX	00000
232027	Total Renal Care—Chestertown	000 Xxxxx Xxxxxx	Xxxxxxxxxxx	XX	00000
232039	Delta-Sierra Dialysis Center—Total Renal Care	000 Xxxx Xxxxxxxx Xxxx Xxxxx, Xxxxx 000	Xxxxxxxx	XX	00000
232130	Novi Kidney Center, P.C.	00000 Xxxx Xxx Xxxx Xxxx	Xxxx	XX	00000
232195	Riverdale Dialysis	000 Xxxx 000xx Xxxxxx	Xxxxxxxxx	XX	00000
232253	Riverside Dialysis DaVita	000 00xx Xxxxxx Xxxxx, Xxxxx 000	Xxxxxxxxxxx	XX	00000
232257	DaVita Doctors Dialysis Center of Montebello	0000 Xxxx Xxxxxxxx Xxxxxxxxx	Xxxxxxxxxx	XX	00000
232258	DaVita Home Dialysis	000 Xxxxx Xxxxxx Xxxxxx, Xx00	Xxxxxxxxxxx	XX	00000
232512	Lake Dialysis	000 Xxxxx Xxxxx Xxxxxx	Xxxxxxxx	XX	00000
232606	Ihs—Bronx Dialysis Center	0000 Xxxxxxxxxxx Xxxx	Xxxxx	XX	00000
232647	Dialysis Center At St. Xxxx	0000 Xxxxxxxxx-Xxxxxxx Xxxx Asb First Floor	Langhorne	PA	19047
232653	Total Renal Care—Loma Vista	1382-A Lomaland	El Paso	TX	79935
232723	Pine Island Kidney Center	0000 Xxxxx Xxxx Xxxxxx Xxxx	Xxxxxxxxxx	XX	00000
232816	Renal Treatment Centers—Longview	000 Xxxxx Xxxxxxxx, Xxxxx 000	Xxxxxxxx	XX	00000
232987	Total Renal Care—Winfield	0000 Xxxx 0xx Xxxxxx	Xxxxxxxx	XX	00000
233084	Total Renal Care—Tomball Dialysis	00000-X Xxxxxxx Xxxxxxx	Xxxxxxx	XX	00000
233105	Total Renal Care—Ghent Dialysis Center	000 Xxxxxxx Xxxxxxxxx, Xxxxx 000	Xxxxxxx	XX	00000
233195	Dialysis Center of Middle Georgia	000 Xxxxx Xxxxxxx Xxxx	Xxxxxx Xxxxxx	XX	00000

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

ACIS	Account Name	Address	City	State	Zip
233257	Dialysis Center of Xxxxxxxx	000 Xx. Xxxxxx Xxxxxx	Xxxxxxxx	XX	00000
233407	DaVita—Forest Lake Dialysis Unit	0000 Xxxxx Xxxx Xxxxxx	Xxxxxx Xxxx	XX	00000
233509	DaVita—USC Kidney Center	0000 Xxxxxxx Xxxxxx	Xxx Xxxxxxx	XX	00000
233510	DaVita Hollywood Dialysis Center	0000 Xxxxxx Xxxxxxxxx	Xxx Xxxxxxx	XX	00000
233532	DaVita South San Antonio Dialysis	0000 Xxxxxxxxx Xxxxxxxx Xxxxx, Xxxxx 000	Xxx Xxxxxxx	XX	00000
233683	Total Renal Care At Union Plaza	000 Xxxxx Xxxxxx, Xxxxxxxxx, Xxxxx 000	Xxxxxxxxxx	XX	00000
233712	Xxxxxx Dialysis Center—A Total Renal Care Facility	00 Xxxxxxxxx Xxxxx	Xxxxxx	XX	00000
233797	Crystal River Dialysis Center	0000 Xxxx Xxxx Xx Xxxx Xxxxxxx	Xxxxxxx Xxxxx	XX	00000
233800	Total Renal Care—Mesa Vista Dialysis Facility	0000 Xxxxx Xxxxxx, Xxxxx X	Xx Xxxx	XX	00000
234551	Lakewood Community Dialysis Center	0000 Xxxxxxxx Xxxx Xxxxxx Xxxxxxxxx, Xxxxx X	Xxxxxxxx	XX	00000
234651	Cyfair Dialysis Center	0000 Xxxxx Xxxx, Xxxxx 000	Xxxxxxx	XX	00000
234652	Katy Dialysis Center	00000 Xxxx Xxxxxxx	Xxxx	XX	00000
234653	Memorial Dialysis	00000 Xxx Xxxx Xxxx, Xxxxx 000x	Xxxxxxx	XX	00000
234667	Xxxxxxx Dialysis Center	000 Xxxx Xxxxxxxx Xxxx	Xxxxxxx	XX	00000
234849	DaVita Printer’s Place Dialysis Center	0000 Xxxxxxxxxxxxx Xxxxxx	Xxxxxxxx Xxxxxxx	XX	00000
234928	Eastmont Dialysis Center	0000 Xxxxxxxx Xxxxxx, Xxxxx 000	Xxxxxxx	XX	00000
234932	DaVita Harbor-UCLA	00000 Xxxxx Xxxxxxx Xxxxxx	Xxxxxxxx	XX	00000
234933	Complete Dialysis Care South	000 Xxxxxxxxx 00xx Xxxxxx, Xxxxx X	Xxxx Xxxxxxxxxx	XX	00000
235075	Total Renal Care—Atlantic City	0000 Xxxxxxxx Xxxxxx	Xxxxxxxx Xxxx	XX	00000
235086	Total Renal Care—Parsons	0000 Xxxxx Xxxxxxx 00, Xxxxxxxx X. Xxxxxxx Xxxxxx Medical Center	Parsons	KS	67357
235089	Renal Treatment Center—Decatur	0000 Xxxxxxx Xxxx	Xxxxxxx	XX	00000
235090	DaVita—Xxxxxx	0000 Xxxxxxxxxx Xxxx	Xxxxxx	XX	00000
235096	DaVita Montclair Dialysis Center	0000 Xxxx Xxxxx Xxxxxx, Xxxxx 000	Xxxxxxxxx	XX	00000
235258	DaVita Michigan Kidney Center—Brighton	0000 Xxxx Xxxxx Xxxxx, Xxxxx 000	Xxxxxxxx	XX	00000
235294	XxXxxx Xxxxxxxx Dialysis	0000-0 Xxxx Xxxxx	Xxxxxxxx	XX	00000
235295	Lakeview Dialysis DaVita	000 Xxxx Xxxxxxxxx Xxxxxx	Xxxxxxxxxx	XX	00000
235296	DaVita Capitol Dialysis	000 Xxxx Xxxxxx, Xxxxx 000	Xx. Xxxx	XX	00000
235302	Atlantic Artificial Xxxxxx Xxxxxx	0 Xxxxxxxxxx Xxx West, Meridian Center #3	Eatontown	NJ	07724
235311	Waconia Dialysis DaVita	000 Xxxxx Xxxxxx, Xxxxx 000	Xxxxxxx	XX	00000
235321	University Peritoneal Dialysis Center, Dba: Total Renal Care University Peritoneal Dialysis	000 Xxxxxxxxxx Xxxxxx, Xxxxx 000	Xxxxxxxxxx	XX	00000
235367	Renal Treatment Center—Harrisburg	0000 Xxxxx Xxxxx Xxxxxx 0xx Xxxxx, Xxxx Xxxxxxxx	Xxxxxxxxxx	XX	17110
235399	DaVita—Michigan City	000 Xxxxx Xxxxx	Xxxxxxxx City	IN	46360
235532	DaVita Main Place Dialysis	000 Xxxx Xxx Xxxxxxx Xxxx	Xxxxxx	XX	00000
235556	DaVita—Xxxxxx Xxxxx	00 Xxxxx Xxxx, Xxxxx 000	Xxxxxx Xxxxx	XX	00000
235571	Elk River Kidney Center, Llc	000 Xxxxx Xxxxxx Xxxxxx	Xxxxxx	XX	00000
235634	Xxxxxx Valley Dialysis Center, Inc.	000 Xxxxx Xxxxxx Xxxx, Xxxxx 000	Xxxxxxxxx	XX	00000
235687	DaVita—Derby	000 Xxxx Xxx Xxxxxx Xxxx	Xxxxx	XX	00000
235688	Hill Country Dialysis	0000 Xxxxx Xxxxx Xxxxxx	Xxx Xxxxxx	XX	00000
235746	DaVita—Xxxxxx Dialysis	00 Xxxxx Xxxxxxx Xxxxxx	Xxxxxx	XX	00000
235772	DaVita—Munster	0000 Xxxxxxx Xxxxxx, Xxxxx X	Munster	IN	46321
235774	Xxxxxxxx Dialysis Center	000 Xxxx 00xx Xxxxxx	Xxxxxx	XX	00000
235783	Renal Treament Center of Wheaton	11941 Georgia Avenue, Wheaton Park Shopping Center	Wheaton	MD	20902
235809	Jennersville Dialysis Center—A Total Renal Care Facility	0000 Xxxx Xxxxxxxxx Xxxx Xxxxxx	Xxxx Xxxxx	XX	00000
235905	Memorial Dialysis Center	0000 Xxxxx Xxxxxxxxx Xxxxxx	Xxx Xxxxxxx	XX	00000
235931	DaVita Glendora Dialysis Center	000 Xxxx Xxxxxxxx Xxxxxxxxx	Xxxxxxxx	XX	00000
235955	Children’s Memorial Dialysis Center—Total Renal Care	0000 Xxxxx Xxxxxxx	Xxxxxxx	XX	00000
236041	Total Renal Care, Dba: North Highlands Dialysis Center	0000 Xxxx Xxxxxx	Xxxxx Xxxxxxxxx	XX	00000
236059	Total Renal Care	000 Xxxxxxxx Xxxxxx Xxxxxxxxx	Xxxxxxxxxx	XX	00000

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

ACIS	Account Name	Address	City	State	Zip
261006	Houston Kidney Center Southwest	00000 Xxxxxxxx Xxxxx, Xxxxxxxx 000, Xxxxx 000	Xxxxxxx	XX	77099
274903	Peninsula Nephrology, Inc. Dba: San Mateo Dialysis Center	0000 Xxxxx Xx Xxxxxx Xxxx	Xxx Xxxxx	XX	00000
274929	DaVita—Pipestone Dialysis Center	000 0xx Xxxxxx Xxxxxxxxx	Xxxxxxxxx	XX	00000
274930	Dialysis Care of Kannapolis	0000 Xxxxx Xxxx Xxxxxx	Xxxxxxxxxx	XX	00000
274931	Dialysis Care of North Mecklenberg	0000 Xxxxxxxxx Xxxxx	Xxxxxxxxx	XX	00000
274973	Total Renal Care of Fairfax	0000 Xxxxxxxxx Xxxxxxxxx, Xxxxx 000	Xxxxxxx	XX	00000
275219	Ocala Regional Kidney—South Unit	00000 Xx Xxxxxxx 000	Xxxx Xxxx	XX	00000
275316	Peekskill—Cortland Dialysis Center	Pike Plaza, Route 6, Suite 15	Cortlandt Manor	NY	10567
275453	Oakland Peritoneal Dialysis Center	0000 Xxxxxxx Xxxxxx, Xxxxx 000	Xxxxxxx	XX	00000
275472	Rocky Hill Connecticut	0000 Xxxxx Xxxxx Xxxxxxx	Xxxxx Xxxx	XX	00000
275487	DaVita Mission Dialysis Center	0000 Xxxxxxxx	Xxxxx Xxxxx	XX	00000
275488	DaVita—Mission Dialysis Center of Oceanside	0000-X Xx Xxxxxx Xxxx, Xxxxxx Xxxx And Country Shopping Center	Oceanside	CA	92054
275567	DaVita—Xxxxxx Dialysis	000 Xxxx Xxxx Xxxxxx, Xxxxx X	Xxxxxx	XX	00000
000000	Xxxxxx Xxxx Xxxx Dialysis Center	0000 Xxxxxx Xxxx	Xxxxx	XX	00000
275609	Queens Dialysis Center	000-00 Xxx Xxxxxx Xxxxxxxxx	Xxxxxxx	XX	00000
275809	Dialysis Center At Oxford Court	000 Xxxx Xxxxxx Xxxxx, Xxxxx X. 000	Xxxxxxxxx	XX	00000
275901	DaVita Midvalley Dialysis Center	5578 South 1900 West	Taylorsville	UT	84118
275902	DaVita Bountiful Dialysis	000 Xxxx 000 Xxxxx, Xxxxx 000	Xxxx Xxxxxxxxx	XX	00000
275948	XxXxxx Xxxxx Dialysis Center	0000 Xxxx 0xx Xxxxxx, Xxxxx X	Xxxxxx	XX	00000
276120	Xxx of Orlando, Llp	00000 Xxxx Xxxx Xxxxxxxxx	Xxxxxxx	XX	00000
000000	XxXxxx Xxxxxxxx Xxxxxxx Dialysis	0000 Xxxxxxx Xxxxxxxxx	Xxx Xxxxxxx	XX	00000
276364	DaVita Grand Blanc Dialysis	0000 Xxxxxxx Xxxxxxx	Xxxxx Xxxxx	XX	00000
276603	Antioch Dialysis Center	0000 Xxxxx Xxxx Xxxxxxxxx	Xxxxxxx	XX	00000
276604	Bay Breeze Dialysis	00000 Xxxxxxxx Xxxx	Xxxxx	XX	00000
276615	Appomattox Dialysis Center	00 Xxxx Xxx Xxxxxx	Xxxxxxxxxx	XX	00000
276630	Mcdonough Dialysis Center	000 Xxxx Xxxxxx	Xxxxxxxxx	XX	00000
276702	Total Renal Care, Dba: Xxxxx Xxxx Dialysis Center	0000 Xxxxxxxxxx Xxxxxx	Xxxxxxx	XX	00000
276807	DaVita Renal Care—UCLA Dialysis Center	000 Xxxx Xxxxxxx Xxxxx, Xxxxx 000	Xxx Xxxxxxx	XX	00000
276941	Dialysis Treatment Center	000 Xxxx Xxxxxx	Xxxxx	XX	00000
000000	Xxxx Xxxxx Dialysis	0000 Xxxxxx Xxxxxx	Xxxx Xxxxx	XX	00000
277077	Ypsilanti Dialysis Center—DaVita	2766 Washtenaw, Washetenaw Fountain Plaza	Ypsilanti	MI	48197
277104	XxXxxx Xxxxxxx Dialysis Center	000 Xxxx Xxxxx Xxxxx Xxxxxxx	Xxxxxxx	XX	00000
277257	Imperial Care, Inc.	0000 Xxxx Xxxxxxxx Xxxxxxx, 0xx Xxxxx	Xxxxxxx	XX	00000
277259	Olympic View Dialysis Center	000 00xx Xxxxxx Xxxx, Xxx-0xx Xxxxx	Xxxxxxx	XX	98112
277271	Coney Island Dialysis	00-00 Xxxxxxxx 00 Xxxxxx	Xxxxxxxx	XX	00000
277272	Yonkers Dialysis Center	000 Xxxxxxx Xxxxxx	Xxxxxxx	XX	00000
277273	Soundview Dialysis Center	0000-00 Xxxxxxxx Xxxxxxxxx	Xxxxx	XX	00000
277274	Port Washington Dialysis	00 Xxxxxxx Xxxxxxxxx	Xxxx Xxxxxxxxxx	XX	00000
277275	Lynbrook Dialysis Center	000 Xxxxxxxx Xxxxxx	Xxxxxxxx	XX	00000
277295	Total Renal Care—Xxxxx	Route 405	Xxxxx	PA	17756
277498	Dialysis Systems of Xxxxxxxxx—DaVita	000 Xxxxxxxxxx Xxxxxxxxx	Xxxxxxxxx	XX	00000
277540	DaVita Englewood Dialysis	0000 Xxxxx Xxxxxxx Xxxxxx	Xxxxxxxxx	XX	00000
277619	Dyker Heights Dialysis Center	0000 00xx Xxxxxx	Xxxxxxxx	XX	00000
277642	Purcellville Dialysis Center of Total Renal Care	000 Xxxxx Xxxxxxx Xxxxxx	Xxxxxxxxxxxx	XX	00000
277648	Rivertowne Dialysis Center At Oxon Hill	6192 Oxon Hill Road	Oxon Hill	MD	20745
277654	Xxx of Celebration	0000 Xxxxxxxxxxx Xxxxxxxxx	Xxxxxxxxxxx	XX	00000
277689	Xxxxx Dialysis Center of Total Renal Care	000 Xxxxx Xxxxxx Xxxxx 000	Xxxxx	XX	00000
278156	Total Renal Care At Xxxxx Xxxx Dialysis Center	Barns Xxxxxx Xxxxxx, Xxxxx 000, Xxxxxxxxxx Xxxxxx	Xxxxxx	XX	00000
278233	Arcadia Dialysis Center	0000 Xxxx Xxx Xxxxxx	Xxxxxxx	XX	00000
278238	DaVita—East Chicago	0000 Xxx Xxxxxx, Xxxxx 000	Xxxx Xxxxxxx	XX	00000
278248	Rose Garden Dialysis Center	000 Xxxx Xxxxxx Xxxxxx	Xxx Xxxx	XX	00000

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

ACIS	Account Name	Address	City	State	Zip
278253	El Camino Dialysis Center	0000 Xxxxx Xxxx	Xxxxxxxx Xxxx	XX	00000
278254	Evergreen Dialysis Center	0000 Xxxxx Xxxx	Xxx Xxxx	XX	00000
278534	Xxxxxxxxx Dialysis Center	0000 Xxxxxxx 00 Xxxxx	Xxxxxxxxx	XX	00000
278545	Clarkston Dialysis of DaVita	0000 Xxxxx Xxxxxxx, Xxxxx 000	Xxxxxxxxx	XX	00000
278548	Total Renal Care—South Hayward Dialysis Center	000 Xxxxxxx Xxxxxx	Xxxxxxx	XX	00000
000000	Xxx Xxxxxx Dialysis	0000 Xxx Xxxxxx Xxxxxxxxx	Xxxxxxxxxx	XX	00000
278786	Timpanogos Dialysis Center	000 Xxxxx 000 Xxxx, Xxxxx 000	Xxxxx	XX	00000
278794	Garden City Dialysis	0000 Xxxxxxx Xxxxxx	Xxxxxx Xxxx	XX	00000
000000	Xxxxxxx Xxxx Dialysis Center	0000 Xxxxxxx Xxxx	Xxxxxxxxx	XX	00000
279025	XxXxxx Xxxxxxxxxx Plaza Dialysis Center	000-000 Xxxx Xxxxxxxxxx Xxxxxxxxx	Xxx Xxxxxxx	XX	00000
279028	Total Renal Care At Richmond Community	0000 Xxxxx 00xx Xxxxxx, Xxxxx 000	Xxxxxxxx	XX	00000
280304	DaVita-South County Dialysis	0000 Xxxxx Xxxx	Xx. Xxxxx	XX	00000
280350	DaVita—Detroit Dialysis	0000 Xxxx Xxxxxxxxx	Xxxxxxx	XX	00000
280386	Nephrology Center of South Augusta	0000 Xxxxxx Xxxxxxx, Xxxxx 0x	Xxxxxxx	XX	00000
280403	DaVita of Xxxxxx City	000 Xxxxxxxxx Xxxx	Xxxxxx Xxxx	XX	00000
280404	Nephrology Center of Louisville	0000 Xxxxxxxxx Xxxxxx	Xxxxxxxxxx	XX	00000
280414	Orangevale Dialysis	0000 Xxxxxxxxx Xxxx, Xxxxx X-0	Xxxxxxxxxx	XX	00000
280489	DaVita—Okmulgee Dialysis Center	0000 Xxxxx Xxxxxxx, Xxxxx #000	Xxxxxxxx	XX	00000
280490	DaVita—Central Tulsa Dialysis	0000 Xxxxx Xx. Xxxxx Xxxxxx	Xxxxx	XX	00000
280491	DaVita—Miami Dialysis Center	000 0xx Xxxxxx Xxxxxxxxx	Xxxxx	XX	00000
280492	DaVita—Muskogee Community Dialysis	0000 Xxxxxx Xxxx Xxxxxxxxx	Xxxxxxxx	XX	00000
280495	DaVita—Xxxxxxxx Dialysis Center	000 Xxxxx 0xx Xxxxxx	Xxxxxxxx	XX	00000
280496	Pahrump Dialysis Center	0000 Xxxx Xxxxxxx Xxxxxxxxx	Xxxxxxx	XX	00000
280591	The New York United Dialysis Center	000 Xxxxxx Xxxx Xxxx	Xxxx Xxxxxxx	XX	00000
280820	DaVita Fort Xxxxxx	0000 Xxxxx 00xx Xxxxxx, Xxxxx 0	Xxxx Xxxxxx	XX	00000
280825	White Plains Dialysis Center	200 Xxxxxxxx Avenue, Space 13b	Whiteplains	NY	10601
280829	DaVita—Cherokee Dialysis Center	00 Xxxxxx Xxxxxx Xxxx	Xxxxxxxx	XX	00000
281010	DaVita Hope Dialysis Center	300 Xxxxxxxx Road	Hampton	VA	23666
281016	Seneca County Dialysis	00 Xx. Xxxxxxx Xxxxxx, Xxxxx Xxxx Center	Tiffin	OH	44883
281046	Dialysis Systems of Xxxxxxx—DaVita	0000 Xxxxxxxxx Xxxxxxxx Xxxxxx, Xxxxx X	Xxxxxxx	XX	00000
281058	Great Bridge Dialysis—Total Renal Care	000 Xxxxx Xxxxxxxxxxx Xxxxxxxxx	Xxxxxxxxxx	XX	00000
281071	Xxxxxxx Towson Dialysis Center	113 West Road	Towson	MD	21204
281079	Bloomington Dialysis DaVita	0000 Xxxxxxx Xxxxxx Xxxxx	Xxxxxxxxxxx	XX	00000
281227	DaVita—Xxxxxxx Xxxx Plaza Dialysis Center	00000 Xxxxxxxxxx Xxxxxx	Xxx Xxxxxxx	XX	00000
281338	Florin Dialysis Center—Total Renal Care	0000 Xxxxxxxx Xxxxxxxxx	Xxxxxxxxxx	XX	00000
281406	Kent Community Dialysis	00000 00xx Xxxxxx Xxxxx	Xxxx	XX	00000
281411	Queens Village Dialysis	000-00 Xxxxxxxxx Xxxxxx	Xxxxxx Xxxxxxx	XX	00000
281412	South Las Vegas Dialysis Center—DaVita	0000 Xxxxxxxxxx Xxxx	Xxx Xxxxx	XX	00000
281661	DaVita—Rialto Dialysis	0000 Xxxxx Xxxxxxxxx Xxxxxx, Xxxxx 000	Xxxxxx	XX	00000
281662	DaVita Commerce City Dialysis	0000 Xxxxx Xxxxxx	Xxxxxxxx Xxxx	XX	00000
281735	Weaverville Dialysis Center—Total Renal Care	000 Xxxxxxxx Xxxxxx	Xxxxxxxxxxx	XX	00000
281772	Bricktown Dialysis	000 Xxxx Xxxxxx Xxxxxxxxx, Xxxxx 000	Xxxxx	XX	00000
281789	Kidney Care Perry, Llc	0000 Xxxxx Xxxxx	Xxxxx	XX	00000
281992	DaVita Longmont Dialysis	0000 Xxxxx Xxxxx, Xxxxx 000	Xxxxxxxx	XX	00000
284522	DaVita Lakewood Crossing Dialysis	0000 Xxxxx Xxxxxxxxx Xxxxxxxxx	Xxxxxxxx	XX	00000
285249	DaVita—Xxxxxxxxx Dialysis Center	653 Town Center Drive, Building 2, Suite 70	Las Vegas	NV	89144
285270	Dialysis of Georgia, L.L.C.	1565 East Highway 34, Suite A	Newnan	GA	30265
285733	Home Pharmacy Services C/O Cvs Procare Pharmacy	6622 Fannin Street	Houston	TX	77006
285735	Satellite Dialysis Centers—Sunnyvale	155 North Wolfe Road	Sunnyvale	CA	94086
285886	DaVita Dialysis Unit—Hopi Health Care Center	Highway 264—Mile Marker 388	Polacca	AZ	86042
286073	Dialysis of Georgia, Llc—Gainesville	2545 Flintridge Road, Suite 130	Gainesville	GA	30501
287115	DaVita Forest Park Dialysis Center	380 Forest Parkway	Forest Park	GA	30297
305989	Independent Renal Center—DaVita	12392 Highway 40	Independence	LA	70443

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

ACIS	Account Name	Address	City	State	Zip
306244	South San Francisco Dialysis	205 Kenwood Way	South San Francisco	CA	94080
312200	DaVita of Woodstock	2001 Professional Parkway, Suite 100	Woodstock	GA	30188
314625	Puyallup Dialysis Center	716-C South Hill Park	Puyallup	WA	98373
314626	Pelham Parkway Dialysis Center	1400 Pelham Parkway South/A-1, Building 5	Bronx	NY	10461
314628	Queens Dialysis At South Flushing	71-12 Park Avenue	Flushing	NY	11365
314821	DaVita First Landing Dialysis Center	1745 Camelot Drive, Suite 100	Virginia Beach	VA	23454
317405	DaVita #476—Iris City Dialysis	521 North Expressway Village, Suite 1509	Griffin	GA	30223
317860	Dialysis of Georgia, Llc—Ellijay	91 Southside Church Street	Ellijay	GA	30540
318370	East Aurora Dialysis	482 South Chambers Road	Aurora	CO	80017
319087	Satellite Dialysis Windsor	911 Medical Center Plaza, Suite 16	Windsor	CA	95492
319171	Pearland Dialysis	6516 Broadway	Pearland	TX	77581
319589	DaVita Sapulpa Dialysis Center	9647 Ridgeview Street	Tulsa	OK	74131
319590	DaVita—Indio Dialysis	46-767 Monroe Street, Suite 101	Indio	CA	92201
319618	Lake Elsinore Dialysis	32291 Mission Trail Road, Building S.	Lake Elsinore	CA	92530
319642	DaVita Pin Oak Dialysis	1302 Pin Oak Road	Katy	TX	77494
319884	DaVita Merrillville Dialysis	9223 Taft Street	Merrillville	IN	46410
319932	DaVita—Hermiston Dialysis Center	1155 West Linda Avenue	Hermiston	OR	97838
320534	Ocala Regional Kidney Center—North	2620 West Highway 316	Citra	FL	32113
320621	DaVita Flushing Dialysis	3469 Pierson Place	Flushing	MI	48433
320622	DaVita Clinton Dialysis Center	150 South 31st Street	Clinton	OK	73601
320624	DaVita Neptune Dialysis	2180 Bradley Avenue	Neptune	NJ	07753
320625	Minneapolis North East Hennepin Dialysis	1049 10th Avenue South East	Minneapolis	MN	55414
320727	Soledad Dialysis	901 Los Coches Drive	Soledad	CA	93960
323958	DaVita St. Louis Park Dialysis	6490 Excelsior Boulevard	St. Louis Park	MN	55426
342101	Satellite Dialysis Home Training	1530 Meridian Avenue, Suite 100	San Jose	CA	95125
344531	Tustin Dialysis Center	2090 North Tustin Avenue	Santa Ana	CA	92705
344533	Chadbourn Dialysis Center	210 East Strawberry Boulevard	Chadbourn	NC	28431
344551	Fowlerville Dialysis	206 East Grand River	Fowlerville	MI	48836
344606	Bakers Ferry Dialysis #0456	3645 Bakers Ferry Road	Atlanta	GA	30331
344607	Irvine Dialysis Center	16255 Laguna Canyon Road	Irvine	CA	92618
344612	Madison Dialysis Center	302 North Highway Street	Madison	NC	27025
344838	Davison Dialysis Center	1011 South State Road	Davison	MI	48423
344957	Maryville Dialysis Center	2130 Vadalabene Drive	Maryville	IL	62062
345184	Southfield West Dialysis Center	21900 Melrose, Southfield Tech Center, Building #2	Southfield	MI	48075
345193	Northeast Wichita Dialysis Center	2630 North Webb Road, Building 100, Suite 100	Wichita	KS	67226
345205	DaVita Swannanoa Dialysis Center #1508	2305 Us Highway 70	Swannanoa	NC	28778
345241	Misson Hills Dialysis	2700 North Stanton	El Paso	TX	79902
345294	Yakima Dialysis Center #1539	110 South 9th Avenue	Yakima	WA	98902

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

Appendix C

List of Authorized Wholesalers

To ensure you receive the appropriate discount, it is important for Amgen to have your current list of Authorized Wholesalers. The following list represents the Wholesalers Amgen currently has associated with Dialysis Center’s contract. Please update the list by adding or deleting Wholesalers, as necessary.

American Medical Distributors, Inc., Subsidiary of BelIco Drug Corporation

180 Route 109

West Babylon, NY 11704

AmenSource Corporation

100 Friars Lane

Thorofare, NJ 08086

ASD Specialty Healthcare, Subsidiary of Bergen Brunswig Drug Co.

1851 Monetary Lane

Carrollton, TX 75006

Bergen Brunswig Drug Company

283 Sand Island Access Road

Honolulu, HI 96819

Bergen Brunswig Drug Company

P0 Box 5916

Orange, CA 92613

Henry Schein Incorporated

5 Harbor Park Drive

Port Washington, NY 11050

Metro Medical Supply, Inc.

1911 Church Street

Nashville, TN 37203

Metro Medical Wholesale Supply, Inc.

1911 Church Street

Nashville, TN 37203

Priority Healthcare Corporation Charise Charles Division

285 West Central Parkway Suite 1704

Altmamonte Springs, FL 32714

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

Exhibit #1

Certification Letter

, 200

Total Renal Care, Inc.

21250 Hawthorne Boulevard, Suite 800

Torrance, CA 90503

Attention: Kim Brady

RE:	EPOGEN^® (Epoetin alfa) Agreement No. 20010259 as amended

Dear

Thank you for your participation in the [DELETED]. In order for us to enroll you, we require that a duly authorized representative of your organization sign the certification below.

Upon receipt of this executed document, we will calculate the value of your incentive. If we do not receive the executed certification, we cannot provide you with this incentive.

If you have any questions regarding this letter please contact me at (805) 447-1000. Thank you for your assistance in returning this certification.

Sincerely,

Outcomes Incentive Analyst

CERTIFICATION:

On behalf of Total Renal Care, Inc. and all eligible Affiliates participating in the [DELETED] under Agreement No. 20010259 as amended, the undersigned hereby certifies that the [DELETED] data and any other data required to be submitted (herein referred to as “Data”), for each eligible Affiliate during the period January 1, 2003 through December 31, 2003 of this Agreement shall include the required Data from all dialysis patients from each such Affiliate, (excluding those patients whose data is obtained from laboratories not owned or operated by Total Renal Care, Inc.), and shall not include Data from non-patients. The party executing this document also represents and warrants that it (i) has no reason to believe that the submitted Data will be incorrect, and (ii) is authorized to make this certification on behalf of all eligible Affiliates submitting Data.

TOTAL RENAL CARE, INC.

Signature:
Print Name:
Print Title:
Date:

Amendment #1 dated December 31, 2002 to Agreement No. 20010259 (continued)

Please retain one fully executed original for your records and return the other fully executed original to Amgen.

The parties executed this Amendment as of the dates set forth below.

AMGEN USA INC.						TOTAL RENAL CARE, INC.

Signature:						Signature:
Print Name:						Print Name:
Print Title:						Print Title:
Date:						Date:

Amgen Inc. hereby agrees to be bound by certain provisions of this Agreement, as amended, as set forth herein.

AMGEN INC.

Signature:
Print Name:
Print Title:
Date:

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Amendment #1 dated December 31, 2002 to Agreement No. 20010259

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