[LOGO]
Island Group Administration, Inc.
0 Xxxxxxxx Xxxx
P.O. Drawer 0000
Xxxx Xxxxxxx, Xxx Xxxx 00000
PHONE: (000) 000-0000 o FAX: (000) 000-0000
0-000-000-0000
LETTER OF AGREEMENT
BETWEEN
ISLAND GROUP ADMINISTRATION, INC.
AND
CDS HEALTH MANAGEMENT, INC.
This Letter of Agreement, entered into this 1st day of January, 1998 will
confirm an agreement between Island Group Administration, Inc. and CDS Health
Management, Inc. for treatments rendered as a provider for our plans.
The terms of the Agreement are as follows:
Reimbursement will be * U & C as per Exhibit A.
Island Group Administration, Inc. will designate CDS Health Management, Inc. as
a Participating Provider of the Island Group Participating Provider Organization
and will inform Island Group clients of such.
Island Group Administration, Inc. will ensure that payment is made to CDS Health
Management, Inc. in a timely manner and in accordance with Exhibit A.
This Agreement shall be in full force and effect for a period of one (1) year
commencing on the date first written above and shall automatically renew for
subsequent twelve (12) month periods unless terminated by either party as
provided for herein. This Agreement is cancellable by either party, with or
without cause, with sixty (60) days written notice.
/s/ Xxxx Xxxxxx /s/ Xxxxxx X. Xxxxxx
--------------------------------------------------- --------------------------------------------------------
Signature (for Island Group) Signature (for CDS Health Management, Inc.)
Xxxx Xxxxxx Xxxxxx X. Xxxxxx
--------------------------------------------------- --------------------------------------------------------
Print Name Print Name
Exec VP President
--------------------------------------------------- --------------------------------------------------------
Title of Officer Title of Officer
1/1/98 1/1/98
--------------------------------------------------- --------------------------------------------------------
--------------------------------------------------- --------------------------------------------------------
Date Date
* Confidential treatment requested portions of this document have been omitted
by blocking out the relevant text pursuant to an application for confidential
treatment. Such blocked out omissions have been filed seperately with the
Securities and Exchange Commission. The Registrant shall furnish all omitted
schedules and exhibits to this document upon the request of the Securities and
Exchange.
[LOGO}
3 Toilsome Lane
P.O. Drawer 0000
Xxxx Xxxxxxx, Xxx Xxxx 00000
PHONE: (000) 000-0000 o FAX: (000) 000-0000
0-000-000-0000
APPLICATION FOR ISLAND GROUP ADMINISTRATION, INC.
PARTICIPATING PROVIDER NETWORK
1. All information should be typed or neatly printed.
2. If more space is needed, attach additional sheets and make reference to the
question to which you are replying.
******************************************************************************
PERSONAL IDENTIFICATION DATA
Name in Full CDS Health Management, Inc.
Date of Application 12/12/97
Office Address (List additional locations on back)
0000 Xxxxxxxxx Xxxxx Xxxxx
Naples FL 34104-6103
(City) (State) (Zip Code)
Billing Address (if different) same
Appointment Phone (000) 000-0000 Billing Phone 000-000-0000
-------------- ------------
Fax (000) 000-0000
Social Security # UPIN #
Federal I.D. # 00-0000000 Medicare Prov. # 0925330001
----------- ------------
PROFESSIONAL DATA
A. SPECIALTY Diabetes Supplies SUBSPECIALTY
Group Name
B. LICENSURES (Specify Profession)
Attach Copies:
State License # N/A Expiration Date
-------- ------------------------------
State License # N/A Expiration Date
-------- ------------------------------
State License # N/A Expiration Date
-------- ------------------------------
DEA Reg. # Expiration Date
-------------------------------------------
PAGE 1 OF 2
C. Please answer each of the following questions completely. If the answer
to any of them is yes, please provide full explanation of the details
on a separate sheet.
1. Have any disciplinary actions been initiated or are any pending
against you by any state licensure board? Yes No X
----- -----
2. Has your license to practice in any state ever been limited,
suspended, denied or revoked? Yes No X
----- -----
3. Has your DEA registration ever been limited, suspended, denied or
revoked? Yes No X
----- -----
4. Have you ever been suspended, sanctioned or otherwise restricted
from participating in any private, federal or state health insurance
program (for example, Medicare, Medicaid)? Yes No X
----- -----
5. Have you ever been convicted of a criminal offense?
Yes No X
----- -----
6. Have you ever lost or been suspended from hospital staff privileges?
Yes No X
----- -----
/s/ Xxxxxx X. Xxxxxx as President December 12, 1997
--------------------------------------------------------------------------------
SIGNATURE DATE
PLEASE ATTACH A COPY OF YOUR: CURRICULUM VITAE INSTITUTIONAL AFFILIATIONS
BOARD CERTIFICATIONS LICENSES MALPRACTICE
INSURANCE INFORMATION
Island Group Administration, Inc.
0 Xxxxxxxx Xxxx
P.O. Drawer 0000
Xxxx Xxxxxxx, Xxx Xxxx 00000
PHONE: (000) 000-0000 o FAX: (000) 000-0000
0-000-000-0000
PARTICIPATING PROVIDER NETWORK APPLICATION
******************************************************************************
TO BE COMPLETED BY PROVIDER
__X__ YES, I WISH TO BECOME A PARTICIPATING PROVIDER FOR ISLAND
GROUP ADMINISTRATION, INC.'S SELF FUNDED PLANS. PLEASE
CONSIDER THIS AS MY LETTER OF INTENT.
______ NO, I DO NOT WISH TO BE LISTED AS A PARTICIPATING PROVIDER.
NAME (PLEASE PRINT) CDS Health Management, Inc.
---------------------------------------------------------------
NAME OF GROUP
---------------------------------------------------------------
OTHERS IN GROUP
---------------------------------------------------------------
---------------------------------------------------------------
SPECIALTY/SUB SPECIALTY Diabetes Supplies
---------------------------------------------------------------
PHONE NUMBER 941-403-0500 ext. 225 FAX NUMBER 000-000-0000
--------------------------------------------- ----------------
ADDRESS (BILLING) 0000 Xxxxxxxxx Xxxxx Xxxxx
---------------------------------------------------------------
ADDRESS (OFFICE) Naples, FL. 34104
---------------------------------------------------------------
same
---------------------------------------------------------------
(PLACE OTHER OFFICE ADDRESSES/PHONES ON BACK)
OFFICE CONTACT PERSON AND TITLE Xxxxxx X. Xxxxxx, President
------------------------------------------------------
ANY PERTINENT INFORMATION REGARDING YOUR OFFICE OR PRACTICE
We are a national supply company - shipping 2 day through priority mail
-----------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------
-----------------------------------------------------------------------------------------
SIGNATURE(S) /s/ Xxxxxx X. Xxxxxx as President
-------------------------------------
DESIGNATION (MD, CD, etc.) N.A.
-------------------------------------
DATE: 12-12-97
---------------
FEDERAL TAX ID (EIN#) 00-0000000
-------------------------------------
**PLEASE ATTACH CURRENT LICENSE(S), BOARD CERTIFICATION(S), ACCREDITATION(S), CURRICULUM VITAE AND MALPRACTICE
INSURANCE.
[LOGO]
OTHER PLANS YOU ACCEPT (EMPIRE, CHOICE CARE, X.X. XXXXXX, etc.)
Multiplan, Managed Care, Inc., WPPN, BPA, Intergroup
----------------------------------------------------------------------------
----------------------------------------------------------------------------
PLEASE NOTE: TERMINATION WILL BE BY MUTUAL AGREEMENT AND WITH A 60 DAY
NOTICE IN ORDER TO NOTIFY CLIENTS AND YOUR PATIENTS.
PLEASE MAIL TO:
ISLAND GROUP ADMINISTRATION, INC.
P.O. DRAWER 5039
EAST HAMPTON, NEW YORK 11937
ATTENTION: XXXX X. XXXXXX
[LOGO]
CDS Health Management , Inc.
Island Group Administration, Inc.
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
GROUP ITEM CPT U & C * Disc.
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Battery BAT - ACC. EASY BATTERY SET (2/SET) A544 A4254 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Battery BAT - ACCUCHEK III BATTERY SET (2/SET) A544 A4254 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Battery BAT - ELITE BATTERY SET (2/SET) CR2032 A4254 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Battery BAT - TRACER II BATTERY SET (2/SET) CR2032 A4254 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Battery BAT - METER BATTERY "J" CELL A4254 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Battery BAT - ADVANTAGE BATTERY SET (2/SET) 2450 A4254 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Battery BAT - INSTANT BATTERY (EACH) [NEED 4/METER] A4254 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
CTS CTS - ACCUCHEK II & III CONTROL SOLUTION A4256 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
CTS CTS - ADVANTAGE CONTROL SOLUTION A4256 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
CTS CTS - DIASCAN CONTROL SOLUTION A4256 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
CTS CTS - EASY CONTROL SOLUTION A4256 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
CTS CTS - INSTANT CONTROL SOLUTION A4256 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
CTS CTS - ONE TOUCH CONTROL SOLUTION A4256 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
CTS CTS - PRESTIGE CONTROL SOLUTION A4256 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
CTS CTS - SURESTEP CONTROL SOLUTION A4256 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
CTS CTS - ULTRA CONTROL SOLUTION A4256 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Misc INFDZ - DISETRONIC 3 XX XXXXX CARTRIDGE 300.0216 A4232 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Misc INFMZ - MMT-103 3.0 ML RESERVOIRS 24/ A4232 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Misc INFMZ - MMT-104 BATTERY PACK 9/ E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Misc INFZ - OPSITE IV-3000 100/ K0257 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Misc INFZ - SKIN PREP WIPES 4204.00 50/ E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Misc INFZ - TEGADERM TRANSPARENT DRESSING #1624W K0257 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Misc INFZ - ADVANTA JET CAPS A4210 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Misc INFZ - POLYSKIN II TRANSPARENT TAPE DRESSING K0257 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Misc INFZ - IV PREP PADS 4210.00 50/ E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Sets INF - PURELINE COMFORT 23" 10/ A4230 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Sets INF - PURELINE COMFORT 43" A4230 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Sets INFD - CLASSIC 31" (80CM) 300.0247 A4231 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Sets INFD - CLASSIC 43" (110 CM) 300.0248 A4231 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Sets INFD - TENDER 2 31" (80 CM) 20/ 300.0263 A4230 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Sets INFD - TENDER 2 43" (110 CM) 20/ 300.0264 A4230 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Sets INFM - MMT-106 BENT NEEDLE 42" 24/ A4231 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Sets INFM - MMT-111 SOF-SET 42" 24/ A4230 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Sets INFM - MMT-115 SOF-SET QUICK RELEASE 42" 12/ A4230 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Sets INFM - MMT-116 SOF-SET QUICK RELEASE 24" A4230 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Sets INFM - MMT-133 STRAIGHT NEEDLE A4231 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Infusion Sets INFM - MMT-165 BENT NEEDLE QR 42" 24/ A4231 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Insulin INS-HUMULIN 50/50 (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
* Confidential treatment requested. Portions of this document have been
omitted by blocking out the relevant text pursuant to an Application
for Confidential Treatment. Such blocked out omissions have been filed
separately with the Securities and Exchange Commission. The Registrant
shall furnish all omitted schedules and exhibits to this document upon
the request of the Securities and Exchange Commission.
Insulin INS-HUMULIN 70/30 (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Insulin INS-HUMULIN L (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Insulin INS-HUMULIN N (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Insulin INS-HUMULIN R (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Insulin INS-HUMULIN U (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Insulin INS-ILETIN I L (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Insulin INS - ILETIN I N (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Insulin INS - ILETIN I R (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Insulin INS - NOVOLIN 70/30 (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Insulin INS - NOVOLIN L (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Insulin INS - NOVOLIN N (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Insulin INS - NOVOLIN R (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Insulin INS - XXXXXXXXX XX (VIAL) J1820 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancets LCT - COMFORT TOUCH LANCETS 100'S A4259 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancets LCT - COMFORT TOUCH LANCETS 200'S A4259 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancets LCT - GLUCOSYSTEM LANCETS 100'S A4259 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancets LCT - MONOLET LANCETS 100'S A4259 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancets LCT - MONOLET LANCETS 200'S A4259 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancets LCT - PENLET II LANCETS 200'S A4259 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancets LCT - SOFT TOUCH LANCETS 100'S A4259 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancets LCT - LANCETS (100/BOX) A4259 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancets LCT - LANCETS (200/BOX) A4259 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancets LCT - BD ULTRAFINE LANCETS 100'S A4259 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancets LCT - CLEANLET XL LANCETS 100/ A4259 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancets LCT - CLEANLET LANCETS FOR KIDS 100/ A4259 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancets LCT - SOFTCLIX LANCETS 100'S A4259 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancing Device LD - AUTOLET LITE KIT A4258 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancing Device XX - XX AUTOLANCE A4258 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancing Device LD - GLUCOLET II A4258 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancing Device LD - PENLET II A4258 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancing Device LD - DIALET LANCING DEVICE A4258 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancing Device LD - LANCING DEVICE (STANDARD LANCETS) A4258 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancing Device LD - SOFT TOUCH II A4258 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Lancing Device LD - SOFTCLIX A4258 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Meter METER - ACCUCHECK III E0607 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Meter METER - ADVANTAGE E0607 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Meter METER - DIASCAN E0607 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Meter METER - DIASCAN PARTNER E0609 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Meter METER - EASY E0607 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Meter METER - ELITE E0607 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Meter METER - ENCORE E0607 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Meter METER - INSTANT E0607 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Meter METER - MEDISENSE 2 E0607 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Meter METER - ONE TOUCH BASIC E0607 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Meter METER - PRESTIGE E0607 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Meter METER - PRECISION QID E0607 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Meter METER - SURESTEP E0607 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
* Confidential treatment requested. Portions of this document have been
omitted by blocking out the relevant text pursuant to an Application
for Confidential Treatment. Such blocked out omissions have been filed
separately with the Securities and Exchange Commission. The Registrant
shall furnish all omitted schedules and exhibits to this document upon
the request of the Securities and Exchange Commission.
Meter METER - ULTRA PLUS E0607 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Misc MSC - ALCOHOL SWABS 100'S A4245 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Misc MSC - ALCOHOL SWABS 200'S A4245 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Pen INS - CARTRIDGES HUM 70/30 (5-PACK) E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Pen INS - CARTRIDGES HUM N (5-PACK) E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Pen INS - CARTRIDGES HUM R (5-PACK) E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Pen INS - CARTRIDGES NOV 70/30 (5-PACK) E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Pen INS - CARTRIDGES NOV N (5-PACK) E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Pen INS - CARTRIDGES NOV R (5-PACK) E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Pen PEN NEEDLES - BD UF SHORT A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Pen PEN NEEDLES - NOVOFINE 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Pen PEN - BD PEN INSULIN DELIVERY DEVICE E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Pen PEN - NOVOPEN INSULIN DELIVERY DEVICE E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Pen INS - PREFILLED SYRINGES NOV 70/30 (5-PACK) E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Pen INS - PREFILLED SYRINGES NOV N (5-PACK) E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Pen INS - PREFILLED SYRINGES NOV R (5-PACK) E1399 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - ADVANTAGE 50'S A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - CHEMSTRIPS BG 50'S A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - DIASCAN 50/ A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - EASY 50'S A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - ELITE 50'S A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - ENCORE 50'S A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - EXACTECH 50'S A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - GLUCOFILM 50'S [GLUC III] A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - INSTANT 50'S A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - ONE TOUCH 50/ [MED] A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - ONE TOUCH 50'S [PRV] A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - PRESTIGE 50/ A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - [MEDISENSE 2 50'S] A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - PRECISION QID 50'S A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - EXACTECJ RSG 50/ A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - GLUCOSTIX 50'S [GLUC II] A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - SURESTEP 50'S A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - TRACER 50'S A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Strips STRIPS - ULTRA 50'S A4253 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - BD 1 CC 27G 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - B-D 28G MICROFINE IV 1 CC 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - B-D 28G MICROFINE IV1/2CC 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - B-D 28G MICROFINE IV 3/10 CC 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - B-D 29G ULTRAFINE 1 CC 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - B-D 29G ULTRAFINE1/2CC Regular 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - B-D 29G ULTRAFINE 3/10 CC Regular 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - BD UF SHORT1/2CC 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - BD UF SHORT 3/10 CC 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - MONOJECT 28 GA 1 CC 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - MONOJECT 1 CC 29ga 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - XXXXXXXX0/2CC 29ga 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
* Confidential treatment requested. Portions of this document have been
omitted by blocking out the relevant text pursuant to an Application
for Confidential Treatment. Such blocked out omissions have been filed
separately with the Securities and Exchange Commission. The Registrant
shall furnish all omitted schedules and exhibits to this document upon
the request of the Securities and Exchange Commission.
Syringes SYR - TERUMO 1 CC 27G 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - TERUMO1/2CC 27G 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - TERUMO 1 CC 29G 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Syringes SYR - TERUMO1/2CC 29G 100/ A4206 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Urine Strips URINE STRIPS - CHEMSTRIPS 7'S 100'S * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Urine Strips URINE STRIPS - DIASTIX 50'S A4250 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Urine Strips URINE STRIPS - KETO-DIASTIX 100'S A4250 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Urine Strips URINE STRIPS - KETOSTIX 100'S A4250 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Urine Strips URINE STRIPS - CLINISTIX 50'S A4250 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Urine Strips URINE STRIPS - KETOSTIX 50'S A4250 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Urine Strips URINE STRIPS - KETO-DIASTIX 50'S A4250 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
Urine Strips URINE STRIPS - CHEMSTRIP UGK 100'S A4250 * *
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
-------------------- ------------------------------------------------------------ ----------- ----------- ------------
* Confidential treatment requested. Portions of this document have been
omitted by blocking out the relevant text pursuant to an Application
for Confidential Treatment. Such blocked out omissions have been filed
separately with the Securities and Exchange Commission. The Registrant
shall furnish all omitted schedules and exhibits to this document upon
the request of the Securities and Exchange Commission.
