hueston hennigan llp - the patient safety league randy scott...jeff wilkerson (284044;...

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HUESTON HENNIGAN LLP John C. Hueston (164921; [email protected]) Alison Plessman (250631; [email protected]) Jeff Wilkerson (284044; [email protected]) 620 Newport Center Drive, Suite 1300 Newport Beach, California 92660-6324 Telephone: (949) 229-8640 Facsimile: (949) 775-0898 STATE COMPENSATION INSURANCE FUND Linda S. Platisha (195281; [email protected]) 1750 E. Fourth St., 5th Floor Santa Ana, CA 92705 Telephone: (714) 347-6130 Fax: (714) 347-6145 Attorneys for Plaintiff STATE COMPENSATION INSURANCE FUND, a Public Enterprise Fund and Independent Agency of the State of California

UNITED STATES DISTRICT COURT

CENTRAL DISTRICT OF CALIFORNIA

SOUTHERN DIVISION STATE COMPENSATION INSURANCE FUND,

Plaintiff, v. MICHAEL D. DROBOT, SR., an individual; MICHAEL R. DROBOT, JR., an individual; FAUSTINO BERNADETT, an individual; HEALTHSMART PACIFIC INC., a California corporation; HEALTHSMART PACIFIC INC. d/b/a PACIFIC HOSPITAL OF LONG BEACH, a California corporation; LONG BEACH PAIN CENTER MEDICAL CLINIC, INC., a California corporation; INTERNATIONAL IMPLANTS, LLC, a California limited liability company; PACIFIC SPECIALTY PHYSICIAN MANAGEMENT, INC., a California corporation; INDUSTRIAL PHARMACY MANAGEMENT LLC, a California limited liability company; CALIFORNIA PHARMACY MANAGEMENT LLC, a California limited liability company; COASTAL EXPRESS PHARMACY, INC., a California corporation; LONG BEACH PRESCRIPTION PHARMACY, a California corporation; MEDS MANAGEMENT GROUP, LLC, a California limited liability

) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) )

Case No. 13-00956 AG (CWx) THIRD AMENDED COMPLAINT OF PLAINTIFF STATE COMPENSATION INSURANCE FUND FOR:

(1) 18 U.S.C. § 1962(c) (CIVIL RICO);

(2) 18 U.S.C. § 1962(d) (CIVIL RICO CONSPIRACY);

(3) FRAUD; AND

(4) UNFAIR COMPETITION (Bus. & Prof. Code § 17200)

[JURY TRIAL DEMANDED]

Third Amended Complaint, Case No. 13-00956 AG (CWx)

Case 8:13-cv-00956-AG-CW Document 593-2 Filed 05/16/15 of 221 Page ID #:10749

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company; DANIEL CAPEN, and individual; SOUTHWESTERN ORTHOPEDIC MEDICAL CORP. D/B/A/ DOWNEY ORTHOPEDIC MEDICAL GROUP, a California corporation; SOUTHWESTERN ORTHOPEDIC MEDICAL CORP, D/B/A CHANNEL ISLANDS ORTHOPEDIC, a California corporation; DANIEL CAPEN MD, A PROFESSIONAL CORPORATION, a California corporation; WESTLAKE SURGICAL MEDICAL ASSOCIATES, INC., a California Corporation; JOHN LARSEN, an individual; JOHN LARSEN, MD, A PROFESSIONAL CORPORATION, a California Corporation; ANDREW JARMINSKI, an individual; INLAND INCARE MEDICAL ASSOCIATES, INC., a California corporation; INLAND INCARE OF SAN BERNARDINO MEDICAL GROUP, INC., a California corporation; ARJ MEDICAL, INC., a California corporation; JEFFREY CATANZARITE, an individual; CENTER FOR BETTER HEALTH, A MEDICAL GROUP, INC., D/B/A SOUTHLAND SPINE AND REHABILITATION, a California corporation; KHALID B. AHMED, an individual; KHALID BASHIR AHMED, M.D., A PROFESSIONAL CORPORATION, a California corporation; AHMED POMONA MEDICAL GROUP, INC., a California corporation; JACK H. AKMAKJIAN, an individual; JACK H. AKMAKJIAN, M.D. INC., a California corporation; GERALD ALEXANDER, an individual, GERALD J. ALEXANDER, ORTHOPAEDIC SURGERY, INC., A MEDICAL CORPORATION, a California corporation; NEWPORT COAST SPINE, INC., a California corporation; IAN ARMSTRONG, an individual; IAN I.T. ARMSTRONG, M.D., INC., a California corporation; MICHAEL E. BARRI, an individual; JOJASO MANAGEMENT, INC. a California corporation; TRISTAR MEDICAL GROUP, PROFESSIONAL CORP., a California corporation; MITCHELL G. COHEN, an individual; MITCHELL G. COHEN, M.D., INC., a California corporation; THOMAS HAIDER, an individual; HAIDER SPINE CENTER MEDICAL GROUP, INC., a California corporation; SALMA JASON MONICA, LP, a California limited partnership; CATALINO DUREZA, an individual; CATALINO D. DUREZA, M.D., INC., a California corporation;

) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) )

- 1 - Third Amended Complaint, Case No. 13-00956 AG (CWx)


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CALIFORNIA NEUROSURGICAL AND SPINE ASSOCIATES, A MEDICAL CORPORATION, a California corporation; MAXIMUS MEDICAL GROUP, A MEDICAL CORPORATION, a California corporation; TIMOTHY HUNT, an individual; ALLIED MEDICAL GROUP, INC., a California corporation; ALAN C. IVAR, an individual; GRIFFIN MEDICAL GROUP, INC., a California corporation; SOUTH COAST REHABILITATION CENTER, INC., a California corporation; EDWARD KOMBERG, an individual; TRI-COUNTY MEDICAL GROUP, INC., a California corporation; TRI-CITY HEALTH GROUP, INC., a California corporation; PHILIP A. SOBOL, an individual; SOBOL ORTHOPEDIC MEDICAL GROUP, INC., a California corporation; RICHARD MULVANIA, an individual; RICHARD L. MULVANIA, MD, INC., a California corporation; SERGE OBUKHOFF, an individual; SERGE OBUKHOFF, MD, PROFESSIONAL CORPORATION, a California corporation; DAVID PAYNE, an individual; DAVID H. PAYNE, M.D., INC., a California corporation; HAMID RAHMAN, an individual; RANDY ROSEN, an individual; MOSAIC MEDICAL MANAGEMENT, a California corporation; ISMAEL SILVA, an individual; STARBASE, INC., a California corporation; HEALTHPOINTE MEDICAL GROUP, INC., a California corporation; ISRAEL CHAMBI, an individual; RUSSELL NELSON, an individual; NELSON SPINE INSTITUTE, INC., a California corporation LOKESH S. TANTUWAYA, an individual; DR. LOKESH S. TANTUWAYA, M.D., INC., a California corporation; JACOB TAUBER, an individual; JACOB E. TAUBER, M.D., A PROFESSIONAL CORPORATION, a California corporation; ASSAD MICHAEL MOHEIMANI, an individual; COAST SPINE AND SPORTS MEDICAL CORPORATION, a California corporation; JASON BERNARD, an individual; PROGRESSIVE ORTHOPEDIC SOLUTIONS, LLC, a California corporation;

Defendants.

) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) )



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TABLE OF CONTENTS

Page

I. SUMMARY OF ACTION .............................................................................. 1

A. Initial Pleadings and Drobot Sr.'s Plea Agreement ............................... 3

B. Overview of the Surgical Defendant Enterprise ................................... 8

C. Overview of the Pharmacy Defendant Enterprise .............................. 10

D. Connections Between the Surgical and Pharmacy Enterprises ........................................................................................... 12

E. Provider Defendants' and Marketer Defendants' Knowing Agreement to and Participation in the Enterprises ............................. 19

II. THE PARTIES .............................................................................................. 21

A. Plaintiff ................................................................................................ 21

B. Individual Defendants ......................................................................... 21

C. Surgical, Pharmacy, and Administrative Defendants and Control Allegations ............................................................................. 22

D. Provider Defendants ............................................................................ 29

E. Marketer Defendants ........................................................................... 58

F. DOE Defendants ................................................................................. 60

III. JURISDICTION AND VENUE .................................................................... 61

IV. STATE FUND AND ITS CLAIMS PROCESS ........................................... 61

V. FRAUDULENT SCHEMES BY THE SURGICAL DEFENDANT ENTERPRISE ...................................................................... 64

A. Fraudulent Scheme re: Spinal Implants/Surgeries (All Defendants) ......................................................................................... 64

B. Billing State Fund for Treatments and Services That Were the Product of Illegal Kickbacks and Referral Fees (All Defendants) ......................................................................................... 77

C. Fraudulent Scheme to Overbill Services By Unbundling/Upcoding, Including Unbundling and Overbilling re: Toxicology Screening (Pacific Hospital, Long Beach Pain, and Drobot Sr.) ...................................................... 80

D. Fraudulent Scheme re: Nurse Billing (Pacific Hospital and Drobot Sr.) ........................................................................................... 84

- i - Third Amended Complaint, Case No. 13-00956 AG (CWx)


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Page

E. Fraudulent Scheme re: Autologous Transfusion Billing (Pacific Hospital and Drobot Sr.) ........................................................ 86

F. Fraudulent Scheme re: Duplicate Radiology Billing (Long Beach Pain and Drobot Sr.) ................................................................ 87

VI. FRAUDULENT SCHEMES BY THE PHARMACY DEFENDANT ENTERPRISE ...................................................................... 89

A. Lack of Licenses, Corporate Practice of Medicine, and Payment of Illegal Referral Fees (CPM, IPM, MMG, Administrative Defendants, Individual Defendants, All Provider Defendants except Drs. Akmakjian, Chambi, Tantuwaya, and Moheimani) .............................................................. 89

1. Lack of Licenses ....................................................................... 89

2. Corporate Practice of Medicine ................................................ 94

3. Payment of Referral Fees and Fee-Splitting Agreements ............................................................................... 98

B. Overbilling and Pricing Manipulation (Pharmacy Defendants, Drobot Sr., Drobot Jr., All Provider Defendants except Drs. Akmakjian, Chambi, Moheimani, and Tantuwaya) ................................................................................. 101

1. Background on Drug Pricing .................................................. 101

2. Defendants' Schemes .............................................................. 103

3. 2001-2007 Overbilling Through AWP Manipulation ............ 105

4. Specific Examples .................................................................. 108

C. Double-Billing of Prescriptions (CPM, IPM, LBPP, Coastal, Drobot Sr., and Drobot Jr.) ................................................. 111

D. Double-Billing of Prescriptions after Global Settlements (CPM, IPM, LBPP, and Drobot Jr.) .................................................. 113

E. The Global Settlements (CPM, IPM, LBPP, Drobot Sr., Drobot Jr., and All Provider Defendants except Drs. Akmakjian, Chambi, Tantuwaya, and Moheimani) .......................... 114

VII. STATE FUND UNCOVERS DEFENDANTS' WELL-CONCEALED FRAUD .............................................................................. 115

FIRST CAUSE OF ACTION (Civil RICO 18 U.S.C. § 1962(c)) ........................ 117

- ii - Third Amended Complaint, Case No. 13-00956 AG (CWx)


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Page

A. Individual Defendants, Surgical Defendants, and Administrative Defendants Formed an Association-in-Fact Enterprise .......................................................................................... 118

B. Individual Defendants, Surgical Defendants, and Administrative Defendants Each Conducted the Enterprise's Affairs ............................................................................ 120

C. The Surgical Defendant Enterprise Engaged in a Pattern of Racketeering Activity, Consisting of Mail and Wire Fraud Violations .......................................................................................... 121

D. The Surgical Defendant Enterprise Affected Interstate Commerce ......................................................................................... 122

E. State Fund Relied on the Surgical Defendant Enterprise's Misrepresentations and Suffered Financial Injury As a Result ................................................................................................. 123

SECOND CAUSE OF ACTION (Civil RICO 18 U.S.C. § 1962(c)) ................... 124

A. Individual Defendants, Pharmacy Defendants, and Administrative Defendants Formed an Association-in-Fact Enterprise .......................................................................................... 124

B. Individual Defendants, Pharmacy Defendants, and Administrative Defendants Each Conducted the Affairs of the Enterprise .................................................................................... 126

C. The Pharmacy Defendant Enterprise Engaged in a Pattern of Racketeering Activity, Consisting of Mail and Wire Fraud Violations ................................................................................ 127

D. The Pharmacy Defendant Enterprise Affected Interstate Commerce ......................................................................................... 129

E. State Fund Relied on the Pharmacy Defendant Enterprise's Misrepresentations and Suffered Financial Injury as a Result ................................................................................................. 130

THIRD CAUSE OF ACTION (Civil RICO Conspiracy 18 U.S.C. § 1962(d)) .................................................................................................... 131

A. Each Defendant Knew of and Agreed to Facilitate the Surgical Defendant Enterprise's Criminal Purpose ........................... 131

B. Each Defendant Committed Predicate Acts In Furtherance of the Enterprise's Criminal Purpose ................................................ 132

C. State Fund Suffered Injury From the Predicate Acts Committed In Furtherance of the Enterprise's Criminal Purpose .............................................................................................. 133

- iii - Third Amended Complaint, Case No. 13-00956 AG (CWx)


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Page

FOURTH CAUSE OF ACTION (Civil RICO Conspiracy 18 U.S.C. § 1962(d)) .................................................................................................... 134

A. Each Defendant Knew of and Agreed to Facilitate the Pharmacy Defendant Enterprise's Criminal Purpose ........................ 134

B. Each Defendant Committed Predicate Acts In Furtherance of the Enterprise's Criminal Purpose ................................................ 134

C. State Fund Suffered Injury From the Predicate Acts Committed In Furtherance of the Enterprise's Criminal Purpose .............................................................................................. 136

FIFTH CAUSE OF ACTION (Fraud) ................................................................... 136

SIXTH CAUSE OF ACTION (Business & Professions Code § 17200) .............. 139

PRAYER FOR RELIEF ........................................................................................ 141

- iv - Third Amended Complaint, Case No. 13-00956 AG (CWx)


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Plaintiff State Compensation Insurance Fund ("State Fund") alleges as

follows in this federal question action, over which this court has jurisdiction

pursuant to 28 U.S.C. § 1331 and 28 U.S.C. § 1367(a).

I. SUMMARY OF ACTION

1. State Fund provides workers' compensation insurance to California

employers, with no financial obligation to the public, and is the largest provider of

workers' compensation insurance in California. When a covered employee suffers

an on-the-job injury, State Fund's primary goal is to insure that the injured worker

receives proper medical treatment by a provider. The provider is then supposed to

bill State Fund for the procedures performed or medicine supplied under the

appropriate workers' compensation guidelines.

2. Defendants conspired to subvert this process and defraud State Fund in

connection with the submission and collection of fraudulent insurance bills for

medical services, medical hardware, and medications. Through two connected

enterprises, Defendants and their coconspirators engaged in an elaborate kickback

scheme designed to game the workers' compensation system and cheat State Fund

out of many millions of dollars. The scheme inflicted damage not only on State

Fund, but on California's workers, who were used as pawns to maximize ill-gotten

profits, and California's employers, forced to pay not only inflated medical costs but

higher workers' compensation insurance rates.

3. The illegal kickback scheme was carried out through a complex web of

interconnected businesses and individuals, including medical providers, pharmacies,

medical management companies, repackagers, distributors, healthcare "marketers,"

and others. Defendant Michael D. Drobot, Sr., at various times, owned and/or

operated, among other related entities, Defendants Healthsmart Pacific, Inc.

("Healthsmart"), Healthsmart Pacific, Inc. d/b/a Pacific Hospital of Long Beach

("Pacific Hospital"), Long Beach Pain Center Medical Clinic, Inc. ("Long Beach

Pain"), and International Implants, LLC ("International Implants") (collectively the,



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"Surgical Defendants"), at least until October 2013, when he has indicated that he

sold Pacific Hospital's assets to College Health Enterprises ("CHE"). Defendant

Michael D. Drobot, Jr. owns and operates, among other related entities, California

Pharmacy Management LLC ("CPM"), Industrial Pharmacy Management LLC

("IPM"), Long Beach Prescription Pharmacy ("LBPP"), Coastal Express Pharmacy,

Inc. ("Coastal"), and Meds Management Group LLC ("MMG") (the "Pharmacy

Defendants"). Defendant Dr. Faustino Bernadett, at various times, owned and/or

operated, among other related entities, Healthsmart, Pacific Hospital, and Long

Beach Pain. Defendants Drobot Sr., Drobot Jr., and Dr. Bernadett are collectively

referred to herein as the "Individual Defendants."

4. As described below, the Surgical and Pharmacy Defendants are

connected not only through shared patients and doctors, but through Pacific

Specialty Physician Management, Inc. ("PSPM") and First Medical Management,

Inc. ("FMM") (collectively the "Administrative Defendants"). The Administrative

Defendants coordinated the activities between the Surgical and Pharmacy

Defendants, medical providers, and suppliers, among others.

5. Defendants Jason Bernard and Progressive Orthopedic Solutions, LLC

are referred to herein as the "Marketer Defendants." The remaining named

Defendants are healthcare providers or associated entities, and they are referred to

collectively herein as the "Provider Defendants." They are Dr. Daniel Capen;

Southwestern Orthopedic Medical Corp. d/b/a Downey Orthopedic Medical Group;

Southwestern Orthopedic Medical Corp. d/b/a Channel Islands Orthopedic; Daniel

Capen MD, a Professional Corporation; Westlake Surgical Medical Associates, Inc.;

Dr. John Larsen; John Larsen MD, a Professional Corporation; Dr. Andrew

Jarminski, Inland Incare Medical Associates, Inc.; Inland Incare of San Bernardino

Medical Group, Inc.; ARJ Medical, Inc.; Jeffrey Catanzarite, D.C.; Center for Better

Health, a Medical Group, Inc. d/b/a Southland Spine and Rehabilitation; Dr. Khalid

B. Ahmed; Khalid Bashir Ahmed, M.D., a Professional Corporation; Ahmed



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Pomona Medical Group, Inc.; Dr. Jack H. Akmakjian; Jack H. Akmakjian, M.D.,

Inc.; Dr. Gerald Alexander; Gerald J. Alexander, Orthopaedic Surgery, Inc., a

Medical Corporation; Newport Coast Spine, Inc.; Dr. Ian Armstrong; Ian I.T.

Armstrong, M.D., Inc.; Michael E. Barri, D.C.; Tristar Medical Group, Professional

Corp.; Dr. Mitchell G. Cohen; Mitchell G. Cohen, M.D., Inc.; Dr. Thomas Haider;

Haider Spine Center Medical Group, Inc.; Salma Jason Monica, LP; Dr. Catalino

Dureza; Catalino D. Dureza, M.D., Inc.; California Neurosurgical and Spine

Associates, a Medical Corporation; Maximus Medical Group, a Medical

Corporation; Dr. Timothy Hunt; Allied Medical Group, Inc; Alan C. Ivar, D.C.;

Griffin Medical Group, Inc.; South Coast Rehabilitation Center, Inc.; Edward

Komberg, D.C.; Tri-County Medical Group, Inc.; Tri-City Health Group, Inc.;

Dr. Philip A. Sobol; Sobol Orthopedic Medical Group, Inc.; Dr. Richard Mulvania,

Richard L. Mulvania MD, Inc.; Dr. Serge Obukhoff; Serge Obukhoff, MD,

Professional Corporation; Dr. David Payne; David H. Payne, M.D., Inc.; Dr. Hamid

Rahman; Dr. Randy Rosen; Mosaic Medical Management, Inc.; Dr. Ismael Silva;

Starbase, Inc.; Healthpointe Medical Group, Inc.; Dr. Israel Chambi; Dr. Russell

Nelson; Nelson Spine Institute, Inc.; Dr. Lokesh S. Tantuwaya; Dr. Lokesh S.

Tantuwaya M.D., Inc.; Dr. Jacob Tauber; Jacob E. Tauber, M.D., a Professional

Corporation; Dr. Assad Michael Moheimani; and Coast Spine and Sports Medical

Corporation.

A. Initial Pleadings and Drobot Sr.'s Plea Agreement

6. State Fund filed its initial complaint in June 2013 and its First

Amended Complaint ("FAC") in August 2013, alleging causes of action pursuant to

the Racketeer Influenced and Corrupt Organizations Act ("RICO") for civil

violations and conspiracy, common-law fraud, and California's Unfair Competition

Law ("UCL," or California Business and Professions code section 17200, et seq.).

State Fund alleged that Defendants conspired to defraud State Fund by, among other

things, entering into illegal agreements designed to inflate the costs of certain



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medical procedures and medications, paying kickbacks to doctors for referring

patients to preferred facilities and for using preferred products or medications,

engaging in illegal fee-sharing agreements, and overbilling and double-billing State

Fund for medical charges. State Fund further alleged that it had been defrauded into

paying illegally inflated costs for spinal surgeries through Defendants' use of

fraudulent invoices for medical hardware issued by companies controlled by

Defendants.

7. After the filing of the FAC, Drobot Sr. pled guilty to workers'

compensation fraud against State Fund and others. On February 20, 2014, Drobot

Sr. signed a guilty plea agreement with the U.S. Attorney's Office ("Plea

Agreement"), admitting to much of the conduct alleged in State Fund's First

Amended Complaint, including the payment of illegal kickbacks through the use of

shell entities, "co-schemers," and conspiracy to commit fraud upon insurers,

including State Fund. See USA v. Drobot ("Plea Agreement"), 8:14-cr-000034-JLS-

DOC-7, at 8-18 (C.D. Cal. Feb. 21, 2014). This Plea Agreement was entered on

April 24, 2014, before the Honorable Josephine L. Staton. USA v. Drobot, 8:14-cr-

000034-JLS-DOC-20 (C.D. Cal. Apr. 24, 2014).

8. Drobot Sr. admitted in the Plea Agreement that, beginning in or around

1998 and continuing through in or around November 2013, he "conspired with

dozens of doctors, chiropractors, marketers and others to pay kickbacks in return for

those persons to refer thousands of patients to Pacific Hospital for spinal surgeries

and other medical services including "other types of surgeries, magnetic resonance

imaging, toxicology, durable medical equipment, and other services" paid for

primarily through the Federal Employees' Compensation Act ("FECA") and the

California Workers' Compensation System ("CWCS"). Plea Agreement at 15.

9. Drobot Sr. further admitted: "To help generate the monies for the

kickback payments, defendant used a co-schemers company or his own company

International Implants ("I2"), located in Newport Beach, California, to fraudulently



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inflate the price of medical hardware purchased by Pacific Hospital to be used in the

spinal surgeries." Id. at 14. "In paying the kickbacks, inflating the medical

hardware costs, and submitting the resulting claims for spinal surgeries and medical

services, defendant and his co-conspirators acted with the intent to defraud workers'

compensation insurance carriers and to deprive the patients of their right to honest

services." Id.

10. To conceal the illegal kickbacks from workers' compensation insurance

carriers, including State Fund, Drobot Sr. admitted that he and his co-conspirators

"entered into bogus contracts under which the kickback recipients purported to

provide services to defendant's companies to justify the kickback payments. The

services and other items of value discussed in those contracts were, in fact, generally

not provided to Pacific Hospital or were provided at highly inflated prices. The

compensation to the kickback recipient was actually based on the number and type

of surgeries they referred to the hospital. These contracts included, among others,

the following: collection agreements, option agreements, research and development

agreements, lease and rental agreements, consulting agreements, marketing

agreements, and management agreements." Id. at 17.

11. The Plea Agreement also confirms, much as State Fund's FAC had

alleged: "As defendant and his co-conspirators knew, federal and California law

prohibited paying or receiving the aforementioned kickbacks for the referral of

patients for medical services. Defendant and his co-conspirators also knew that the

insurance carriers would be unwilling to pay claims for medical services that were

obtained through such illegal kickbacks. Moreover, defendant and his co-

conspirators knew that the insurance carriers would be unwilling to pay claims for

spinal surgery hardware that were artificially inflated and substantially above the

manufacturer's price. However, defendant and his co-conspirators deliberately did

not disclose to the insurance carriers the kickbacks, the inflation of the medical

hardware, or the fact that I2 was owned and controlled by defendant and was not a



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manufacturer of such hardware. Rather, at some point, defendant and his co-

conspirators included on I2's invoices stamps falsely stating that I2 was an 'FDA

registered manufacturer.'" Id. at 16-17.

12. Third-party discovery in this litigation has confirmed the use of the

"bogus" contracts described in the Plea Agreement by Defendants in furtherance of

their conspiracy. In fact, discovery thus far has revealed the existence of numerous

such agreements between the Surgical, Pharmacy, and Administrative Defendants,

on the one hand, and the Provider Defendants on the other.

13. For example, Drobot Sr., through PSPM, entered into an "Option

Agreement" with Dr. Serge Obukhoff on or around March 15, 2010. The Option

Agreement purports to grant PSPM the exclusive right or "option" to purchase the

unspecified assets of Dr. Obukhoff's orthopedic medical practice. Pursuant to the

agreement, PSPM was to make monthly payments to Dr. Obukhoff of $50,000 in

"readily accessible cash" as purported consideration for the grant of the option. It

was contemplated that PSPM would make, in the aggregate, payments equal to

$10,000,000 for the "Option," "taking into account the Option Payments previously

made to [Dr. Obukhoff]." On information and belief, payments contemplated by

this agreement were not really "Option Payments" but illegal kickbacks to be paid to

Dr. Obukhoff for performing spinal implant surgeries at Pacific Hospital using

devices from International Implants or another coschemer's company and/or for the

referral of patients to the Surgical or Pharmacy Defendants. Drobot Sr. admitted in

the Plea Agreement that he paid a kickback to "S.O." in connection with a spinal

surgery performed by "S.O." on at least one occasion. In fact, according to payment

records produced by Dr. Obukhoff, PSPM paid such kickbacks to Dr. Obukhoff on

numerous occasions, paying Dr. Obukhoff at least $2,307,500 in purported "option

payments" between April 10, 2010 and March 18, 2013.

14. Similarly, the Individual Defendants, through the Pharmacy

Defendants, entered into "Physician Office Dispensing Management Agreements"



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with physicians pursuant to which the physicians purportedly engaged the Pharmacy

Defendants to "implement and maintain a Pharmacy Program in Physician's various

offices and places of practice for Physician's patients covered under the California

Workers' Compensation Program." In reality, these "Physician Office Dispensing

Management Agreements" were fee-splitting agreements through which the

Pharmacy Defendants paid kickbacks to physicians for referring patients to the

Surgical Defendants and to the pharmacies run by Pharmacy Defendants and for

prescribing the most lucrative medications to their patients. While the agreements

provided that the physicians were responsible for purchasing the product necessary

for the pharmacy programs, financials statements produced in this litigation show

that, in practice, the physicians committed almost nothing in the way of financial,

capital, or human resources to the pharmacy program. Instead, the Pharmacy

Defendants purchased the drugs, provided the pharmacy techs and other employees

for the pharmacies, and controlled which drugs would be listed on the formularies.

If drugs listed on the formularies were not lucrative enough, they were removed by

Drobot Jr. The Pharmacy Defendants' "management fee" was calculated as a

percentage of "gross collections after deducting the costs of drugs sold and other

direct pharmacy costs, including collections and advances." Thus, the physicians

never bore any financial risk and were paid simply for prescribing medications to

their patients and referring them to the pharmacies run by the Pharmacy Defendants.

15. For example, under his "management agreement" with Defendant

CPM, Defendant Dr. Daniel Capen was paid $2,434,211.06 in 2006 after CPM

recovered more than $6 million in cash collections. CPM (not Dr. Capen) incurred

drug costs of less than $500,000, but billed over $8 million for those drugs. Dr.

Capen purportedly wrote over 30,000 prescriptions in 2006, and averaged 123

prescriptions per day in March alone. CPM also "loaned" Dr. Capen another

$115,000 for the year to cover his "Air Charter Expenses," $55,463 in



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"advancements," and $21,000 in "other reductions." CPM distributed to itself

$2,149,988.87 for the year.

16. As detailed below with regard to particular providers, the "Pharmacy

Management Agreements" were also used as vehicles to pay kickbacks for medical

services performed at or referred to Pacific Hospital. Doctors that performed

surgeries at, or referred surgical patients to other doctors to perform surgeries at,

Pacific Hospital were often paid "advances" under their purported "management"

agreements with Pharmacy Defendants in exchange for such referrals. These

advances were often "written off" later—they were never reasonably expected to be

repaid.

17. As detailed below, many medical providers, including the Provider

Defendants, have (or had) contracts with both Pacific Hospital and CPM/IPM, as

well as with PSPM, International Implants, and other coconspirator entities.1

B. Overview of the Surgical Defendant Enterprise

18. In Section V below, State Fund articulates separate, yet connected,

schemes conducted by the Surgical Defendant Enterprise to defraud State Fund

while simultaneously concealing the misconduct. The schemes are:

(a) As admitted in the Plea Agreement, forming and using shell

corporations, or using a co-schemer's company, to grossly and fraudulently

increase the bills to State Fund for medical hardware used in Pacific

Hospital's surgeries. For example, Drobot Sr. created International Implants

and represented it as an implant manufacturer. In reality, International

1 Several Defendants, including, but not limited to, Dr. Daniel Capen, , Dr. Andrew Jarminski, Dr. Timothy Hunt, Dr. Randy Rosen, and Mosaic Medical Management, have refused to produce their agreements and communications with other Defendants, invoking their Fifth Amendment rights against self-incrimination. Dr. Richard Mulvania was deposed, and invoked the Fifth Amendment and refused to provide testimony in response to any questions relating to his relationship with the Individual Defendants, agreements with the Entity Defendants, or his work with (or even knowledge of the existence of) any other Provider Defendant. Likewise, Messrs. Drobot Sr. and Drobot Jr. have invoked their Fifth Amendment rights and refused to testify about most of the allegations in this Second Amended Complaint, including agreements with medical providers.



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Implants simply bought implants from other manufacturers across the country

and then grossly inflated the price at which it resold the implants to Pacific

Hospital, which Pacific Hospital then billed to State Fund as the implant's

actual cost.

(b) As further admitted in the Plea Agreement, conspiring with dozens of

doctors, chiropractors, marketers, and others, including the Provider and

Marketer Defendants, to pay kickbacks in return for those persons to refer

thousands of patients to Pacific Hospital for spinal surgeries and other

medical services including "other types of surgeries, magnetic resonance

imaging, toxicology, durable medical equipment, and other services," and/or

in exchange for the medical providers agreeing to use certain equipment or

devices, including devices from International Implants.

(c) Billing for services at substantially higher rates than allowed under

controlling regulations by, among other things, "upcoding" and "unbundling"

items in their billings. "Upcoding" is a practice of using medical treatment

codes in the submission of insurance claims that represent a substantially

higher billing price than the set amount for the actual services rendered.

Similarly, many procedures, such as surgeries, are, by regulation, charged at a

rate bundling together a number of necessary elements or pieces of equipment

for the procedure. Instead of simply charging the bundled rate, the Surgical

Defendants here took particular items or steps involved in the procedure,

"unbundled" them, and billed them separately, resulting in a significantly

higher bill. For example, Pacific Hospital would bill State Fund separately

for toxicology tests using five different codes and charging for all of them,

even though one code covered all of the administered tests.

(d) Billing Pacific Hospital Registered Nurse First Assistants separately as

assistant surgeons, when nurses are considered part of the procedure's cost (a

particular type of "unbundling").



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(e) Billing State Fund separately for autologous transfusions (a procedure

used to save the patient's blood during surgeries), when that cost is included,

by regulation, in the bundled cost of inpatient admission.

(f) Double-billing State Fund for the technical component for radiology

procedures performed at Long Beach Pain, which was also billed by the

owner of the equipment used for the procedures. Long Beach Pain was

managed by Pacific Hospital.

19. The involved Defendants concealed this course of conduct for over a

decade (although Long Beach Pain and International Implants were formed later),

by falsifying invoices and purchase orders, submitting fraudulent bills, hiding the

common ownership of the entities in the enterprise, concealing the true nature of the

business relationship with providers, and obstructing State Fund's attempts to

investigate any issues. While State Fund may have caught certain instances of

overbilling and double billing from time to time, Defendants misrepresented these to

be mere mistakes; State Fund was misled into making additional payments, as

Defendants concealed the fraudulent enterprise of kickbacks, falsified invoices, and

sham agreements giving rise to the multifaceted "sub-schemes" designed to cheat

the workers' compensation system from all angles.

C. Overview of the Pharmacy Defendant Enterprise

20. The Individual Defendants also conducted many of the same fraudulent

schemes using pharmacies and the medication management companies that they

formed and operated. As discussed in Paragraphs 33, 55-56, supra, Drobot Sr.

owned and created CPM and IPM, while Drobot, Jr. ran the companies on a day-to-

day basis. Dr. Bernadett worked with Drobot Sr. and Drobot Jr. to funnel monies

through the Pharmacy Entities to doctors that performed services at, or referred

patients to, Pacific Hospital—approving of and facilitating the use of the pharmacy



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entities as vehicles for kickback payments. 2 According to the Pharmacy

Defendants' discovery responses, Drobot Jr. purchased CPM and IPM from his

father in mid-2010, after being President of these entities for a number of years.

Drobot Jr. is also the CEO and a director of the other Pharmacy Defendants,

including Coastal, MMG, and LBPP. LBPP is a subsidiary of CPM/IPM. The

Pharmacy Defendant Enterprise is responsible for orchestrating at least the

following schemes designed to defraud State Fund:

(a) Engaging in activity with respect to prescribed medications without

having the licenses required by law, violating the prohibitions against the

corporate practice of medicine, and paying kickbacks through sham

agreements, all the while concealing the unlawful conduct from State Fund

and misrepresenting the nature of their businesses.

(b) Overbilling State Fund through a variety of schemes, including billing

for medications at rates up to ten times the prices at established retail

pharmacies, and well above workers' compensation guidelines. For example,

to maximize their profits prior to March 1, 2007, the Individual and Pharmacy

Defendants fraudulently manipulated drug pricing benchmarks through their

2 For example, in a July 2008 email from Drobot Jr. to Dr. Bernadett, Drobot Jr. notes that IPM has made $60,000 in payments on behalf of Pacific Hospital and PSPM, including "$10,000 for two spine procedures performed at PHLB [in] July," "$20,000 for [Defendant Alan] Ivar for February" and "$30,000 made up of $18,000 [to Defendant Jeffrey] Catanzarite and $12,000 [to Defendant Alan] Ivar was paid by IPM in May." Drobot Jr. also noted that "[Defendant Dr. Ian] Armstrong did a spine at Pacific last week and IPM need to recover $5000" and that Defendant Dr. David Payne "did/or is doing a spine this week with International Implant equipment, thus will need $8k. IPM is the legal conduit to this agreement until something else takes its place." In another email, Drobot Jr. writes to, among others, Dr. Bernadett, noting that he will "hold all IPM checks to [Defendant] Capen . . . until we receive the 85k for the month"; an IPM employee responds noting that IPM has "received the July $25k PSPM today. We've also received the August $60k from International Implants."



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ownership interests in (or other associations with) drug repackagers. When

the opportunity for such manipulation closed in 2007, Defendants and their

related entities looked for other ways to game the system; for example, by

focusing more heavily on compound or other lucrative medications, ancillary

services, and urine drug testing.

(c) Double-billing for prescriptions already billed by other Defendants in

the scheme. For example, CPM and IPM duplicated bills for thousands of

prescriptions submitted to State Fund, with each entity billing State Fund for

the same drugs, claim, and date of service. LBPP and Coastal also submitted

duplicate bills.

(d) Rebilling State Fund on claims even after those particular claims had

been settled and paid by State Fund.

Again, while State Fund may have caught certain instances of overbilling and

double billing, Defendants misrepresented these to be mere mistakes; State Fund

was misled into making additional payments, as Defendants concealed the

fraudulent enterprise of kickbacks, unlicensed corporate practice of medicine,

prescription pushing, and sham agreements giving rise to the multifaceted "sub-

schemes" designed to cheat the workers' compensation system.

21. In so doing, each of the Defendants violated, among other laws, the

Racketeer Influenced and Corrupt Organizations Act, 18 U.S.C. §§ 1961 et seq.

("RICO") with their many predicate acts.

D. Connections Between the Surgical and Pharmacy Enterprises

22. Defendants acted together with a common purpose to obtain more

money from State Fund than was rightfully owed. While the Surgical Defendant

Enterprise and Pharmacy Defendant Enterprise provided somewhat different

services to workers' compensation claimants, both Surgical and Pharmacy

Defendants were connected through a well-orchestrated kickback scheme and aimed



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to defraud State Fund through fraudulent billing practices. The Individual

Defendants often coordinated their activities through the Administrative Defendants.

23. Among other things, FMM acted as an out-sourced human resources

department for the Surgical and Pharmacy Defendants, supplying employees,

generating payroll, and providing information technology services. PSPM entered

into contracts with medical groups and providers and also provided information

technology support. FMM and PSPM both facilitated the payment of illegal

kickbacks by controlling the flow of human as well as monetary capital between the

Surgical and Pharmacy Defendant Enterprises.

24. Coordination between and among the Defendants was used to increase

profits and ensure a steady stream of income both to Defendants at the expense of

workers' compensation insurers and employers. The document shown below,

recently produced by Essence Group Holdings, Inc., a company in which Drobot Sr.

invested and which acquired pharmaceutical repackaging companies DRx and

Wellinx, demonstrates the interconnected fee-splitting arrangement among

Defendants.



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25. This suggests that PSPM was to act as the management company for

both CPM/IPM and Pacific Hospital, coordinating the efforts of CPM/IPM and

Pacific Hospital and facilitating payments to "MDs" of $20,000 per month or more

and splitting profits with them. The goal of the overarching enterprise was to

increase the number of patients flowing through this connected group of Defendants

and to thereafter submit fraudulent bills to State Fund in connection with the

medical services provided to them (often those services offering Defendants the

highest profit margins). Defendants pursued and accomplished their goals under the

direction of the Individual Defendants using a variety of methods: inflating bills

(sometimes through "middleman" or shell companies), double-billing with other

entities, concealing the true cost and nature of the services or medications provided,

and concealing the true nature of their businesses and contractual relationships with

medical providers and groups in order to hide their illegal activities.3

26. As a specific example of PSPM's control over the practices of

contracting physicians (and corporate practice of medicine), PSPM wrote a letter to

doctors in 2006 reminding them that PSPM controlled all referrals from the doctors,

including surgeries, pain management, pharmaceuticals, and psychiatric evaluations.

The letter explicitly states that "[a]ccording to our management agreement all

referrals from your office are to be coordinated by PSPM." PSPM then went on to

specifically demand referrals for: pain management physicians, psychological and

psychiatric consultations, MRIs, and durable medical equipment. The paragraph on

psychological and psychiatric consultation referrals demands that all referrals be

3 The document also references "DME" and "MRI." In his deposition on October 24, 2014, Matthew Umbs—Pharmacy Defendants' CFO and/or economic consultant—testified that another Drobot Jr. entity, Advanced Pharmacy Services, received "commissions" from durable medical equipment ("DME") companies in connection with DME sales to certain customers. Drobot Sr. also has a DME company, PSPM-DME, Inc., to which State Fund has paid over $4 million. In his Plea Agreement, Drobot Sr. admitted to paying kickbacks for DME and MRIs. Plea Agreement at 15.



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"through PSPM to Dr. Zubrick," no matter the patient's wishes nor the physician's

judgment, because referring to other specialists "severely reduces the revenue from

our management contracts." The letter makes clear that PSPM "need[s] this revenue

in order to survive and [ ] must take an aggressive approach to ensure [PSPM]

capture[s] all revenues that are available."

27. The letter, signed by Drobot Sr., also directs the physician to complete

"an accounts receivable purchase agreement" in order for CPM to be able to collect

payments from State Fund under its own tax identification number for

pharmaceuticals prescribed through its in-office physician dispensing programs.

Then, despite instructing physicians to sign those purchase agreements, PSPM

assures physicians that "we can proceed as normal to collect a significant amount of

receivable from State Fund" and that nothing would change from the existing

management agreements in which physicians were to receive a percentage of the

collections. The letter asks the physician to fax the sham agreement to Drobot Jr.'s

attention, and closes with an exhortation to "Help Us Keep The Pharmacy Alive."

28. In another example of PSPM's control over the physicians' practices,

Drobot Sr. sends an email on January 4, 2010 to Defendant Dr. Mulvania, who had a

dispensing agreement with IPM, stating "PSPM cannot survive without a reduction

in expenses . . . what we need to accomplish with your office is the elimination of

paying your PA and your malpractice insurance. This is a $20,000 per month

reduction in our costs and a $20,000 increase in yours." Thus, the physician

assistants ("PAs") who often prescribed medications under CPM/IPM's dispensing

agreements with medical providers were, on information and belief, hired and paid

by PSPM or FMM.

29. To assist in coordinating the scheme, the Individual, Pharmacy, and

Surgical Defendants share the same offices, the same addresses, and the same

personnel. For example, in a prior case, Drobot Jr. submitted a sworn declaration

admitting that: "CPM does not employ or pay pharmacy technicians. The pharmacy



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technicians are obtained through a third-party registry, First Medical Management

("FMM"), owned by Michael Drobot, Sr., my father."4 The coordination and

oversight of the Individual Defendants facilitated the Defendants' efforts towards the

common goal of defrauding State Fund. The Individual Defendants helped ensure

the participation of medical providers and groups, including the Provider

Defendants, in the fraud schemes and coordinated the payment of illegal kickbacks,

referral fees, and fee-splitting arrangements between medical providers and groups

(including the Provider Defendants), marketers and other referral sources (including

the Marketer Defendants), and the Individual and Entity Defendants.

30. Moreover, corporate formalities were often ignored by the Surgical,

Pharmacy, and Administrative Defendants. For example, in a series of emails

recently produced by third-party Seaspine, Inc., a "Staff Accountant" for PSPM

represented International Implants in communications to Seaspine, Inc., using a

"@healthsmartcorp.com" email address.5 Then, only a few months later, the same

employee represented International Implants as a "Staff Accountant" for FMM,

using the same email address.

31. Similarly, Vonda Ray, another FMM employee, simultaneously

represented IPM, CPM, LBPP, and Advanced Practice Services (another entity

4 Declaration of Michael Drobot in Support of Special Motion to Strike Complaint ¶ 9, Zenith Ins. Co. v. CPM, Los Angeles Superior Court, Case No. BC406917.

5 On information and belief, Healthsmart Corporation was the "corporate umbrella" or "corporate office" under which other Drobot-controlled entities were created and/or managed, including CPM and IPM. In 2001, Healthsmart Corporation changed its name to First Medical Staffing, Inc., and in 2002, the name was changed to First Medical Management, Inc. Thus, California Secretary of State records suggest that Healthsmart Corporation and Defendant FMM are the same entity.



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owned by Drobot Jr.), as shown in an email produced in this litigation by

Defendants.

32. Thus, FMM and PSPM, as with other entities run by the Individual

Defendants, were conduits for the conduct of the other entities and individuals in the

Surgical and Pharmacy Defendant Enterprises.6

33. Furthermore, the Surgical and Pharmacy Defendants are connected

through the Individual Defendants, all of whom were involved in both enterprises.

Defendants admit that Drobot Sr. concurrently owned and managed the Surgical

Defendants and the Pharmacy Defendants at least until 2010. While Drobot Sr.

owned the Pharmacy Defendants, Drobot Jr. ran them, serving as Chief Operating

Officer of CPM and IPM since around the time of their formation in 2002 and 2003,

respectively. On information and belief, Drobot Jr. also served as President of CPM

at least as early as 2006. According to CPM and IPM, Drobot Sr.'s ownership

interests in CPM and IPM were transferred to Drobot Jr. in 2010.

34. Drobot Jr. was also involved in the Surgical Defendant Enterprise. For

example, documents produced in this litigation show Drobot Jr. facilitating the

referral of patients to Defendant Pacific Hospital while encouraging doctors to

contract with CPM/IPM. In an email to Defendant Dr. Richard Mulvania dated

November 10, 2010, Drobot Jr. states, "attached above you will find the original 4

Spine cases that I faxed… with a confirmed delivery notice. Like the 5 I gave you

today, please do what you can to make sure that the cases go to Pacific if there is a

need for surgery. If you engage [IPM] again I believe I can send 10-15 of these a

month." Two days later the spinal surgeon responds to Drobot Jr., declining to

engage IPM despite Drobot Jr.'s promise that IPM would "guarantee" a minimum

6 In his deposition on October 15, 2014, Drobot Sr. invoked his Fifth Amendment right against self-incrimination nearly every time he was questioned about the conduct of PSPM and FMM, resulting in over fifty invocations during his deposition on topics relating to PSPM and FMM.



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payment of $40,000 for the surgeon's pharmaceutical business, but assuring, "[o]n

the patients you referred, if you still want me to see them, I will be sure to do

surgery at Pacific Hospital if they come to surgery." Drobot Jr. replies, "please see

them and send them to Pacific."

35. Similarly, other emails show Drobot Jr. facilitating the payment of

monthly "rent" to Defendant Dr. Jacob Tauber, a physician who referred spinal

cases to Pacific Hospital, pursuant to what appears to be a sham sublease agreement

between the physician and PSPM (an agreement signed by Drobot Sr.). The

documents further suggest that Drobot Jr. arranged for monthly payments of at least

$15,000 to be made to Dr. Tauber for his pharmaceutical referrals under a purported

dispensing agreement with CPM. When asked about the purported "rent" payments

to this physician, Drobot Jr.'s role in facilitating those payments, and CPM's

dispensing agreement with the physician, Drobot Sr. invoked his Fifth Amendment

right against self-incrimination and refused to respond.

36. Furthermore, according to Pacific Hospital testimony during a Rule

30(b)(6) deposition on September 26, 2014, Drobot Jr. also worked at Pacific

Hospital in the Purchasing Department for at least some period of time, focusing on

the supply chain "because that was his specialty." According to this testimony, this

department was responsible for negotiating purchases and discounts of "every

supply that's used in the hospital." Drobot Sr. himself confirmed during his

deposition on October 15, 2014 that Drobot Jr. worked for Pacific Hospital,

including that he negotiated some contracts on behalf of the hospital.

37. Drobot Jr. also had a Pacific Hospital email address (i.e.,

[email protected]) and a Healthsmart Corporation email address (i.e.,

[email protected]).

38. Additionally, around 2011, Drobot Jr. started Advanced Lab-Services,

Inc. ("Advanced Lab"), which billed State Fund for lab services performed on

patients of physicians who had agreements with one of the Pharmacy Defendants



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and/or patients who were scheduled for surgery at Pacific Hospital or treatment at

Long Beach Pain. Another Drobot Jr. entity, Advanced Practice Services,

coordinated the lab services for the physicians. When the Pharmacy Defendants'

CFO, Matthew Umbs, was questioned about these entities during his deposition on

October 24, 2014, counsel for the Pharmacy Defendants instructed him not to

answer.

39. Thus, the Defendants are connected through a vast network of entities

owned or controlled by the Individual Defendants. State Fund records indicate that

over 8,700 claims submitted to State Fund for reimbursement involve at least one

Surgical Defendant and one Pharmacy Defendant, further indicating a connected

flow of patients between and among these Defendant groups.

E. Provider Defendants' and Marketer Defendants' Knowing

Agreement to and Participation in the Enterprises

40. The Provider Defendants and Marketer Defendants all knowingly

facilitated the schemes of the Individual Defendants, Surgical Defendants,

Pharmacy Defendants, and Administrative Defendants (collectively, the "Individual

and Entity Defendants"). The Provider Defendants did so by accepting illegal

kickbacks and referral fees (both for referring patients to Defendants' pharmacies

and for performing or referring surgeries at or to Pacific Hospital), allowing the

operation of illegal pharmacy operations in their offices, allowing their names and

signatures to be used in bills submitted to State Fund, and providing the medical

services or prescriptions underlying the bills to State Fund with knowledge of the

nature of the Individual and Entity Defendants' activities, with the intent to facilitate

those illegal activities, and with knowledge and expectation that that the fraudulent

insurance bills for medical and surgical goods and services provided to these

patients would be sent either on paper through the United States mail or

electronically through interstate wire. The Provider Defendants also signed bills and

reports containing certifications, either explicit or implicit, that the bills and reports



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submitted were not the product of fraud or illegal referral and kickback fees, and/or

did not contain material omissions. These certifications were false, as each Provider

Defendant accepted illegal kickbacks from the Individual and Entity Defendants.

The Provider Defendants had knowledge or expectation that the bills and reports

containing these certifications would be sent either on paper through the United

States mail or electronically through interstate wire.

41. Many of the Provider Defendants, including Khalid Ahmed, Gerald

Alexander, Ian Armstrong, Daniel Capen, Mitchell Cohen, Catalino Dureza,

Timothy Hunt, Ismael Silva, Alan Ivar, Andrew Jarminski, John Larsen, Richard

Mulvania, Hamid Rahman, Philip Sobol, Edward Komberg, and Jacob Tauber, also

signed sham "lien purchase agreements" in 2006 and 2007 purporting to sell their

pharmaceutical accounts receivables or "liens" to the Pharmacy Defendants so that

the Pharmacy Defendants could collect on the bills they submitted to State Fund.

These defendants did so with knowledge that these agreements would be provided to

State Fund to induce State Fund to pay Pharmacy Defendants. In reality, however,

the Pharmacy Defendants promised the Provider Defendants that nothing would

change as a result of their signing the "lien purchase agreements" required by State

Fund and assured the Provider Defendants that the illegal fee-splitting arrangements

would remain in place. Financial documents produced in this case confirm that,

indeed, the lien purchase agreements did not change the financial arrangements

between Pharmacy Defendants and the Provider Defendants.

42. The Marketer Defendants knowingly facilitated the schemes of the

Individual and Entity Defendants by negotiating for and accepting illegal kickbacks

and referral fees for steering patients to medical facilities owned or managed by the

Individual and Provider Defendants. The Marketer Defendants did so with

knowledge of the nature of the Individual and Entity Defendants' activities, with the

intent to facilitate those illegal activities, and with knowledge and expectation that

that the fraudulent insurance bills for medical and surgical goods and services



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provided to these patients would be sent either on paper through the United States

mail or electronically through interstate wire.

43. State Fund brought this action to recoup payments made to Defendants,

who concealed the system of illegal kickbacks, fee-splitting, corporate practice of

medicine, and other misconduct, as described below, and to prevent future

fraudulent activity by Defendants and others.

II. THE PARTIES

A. Plaintiff

44. State Fund is a self-supporting, non-profit public enterprise fund that

was established by the California Legislature pursuant to California Insurance Code

§§ 11770 et seq. State Fund provides workers' compensation insurance to California

employers with no financial obligation to the public and is the largest provider of

workers' compensation insurance in California.

B. Individual Defendants

45. Drobot Sr., on information and belief, is a resident of Corona Del Mar,

CA. His links to, and control of, the relevant entities and other Defendants are set

forth in detail in the next section, as demonstrated in part through public records,

including California Secretary of State records.

46. Drobot Jr. is the son of Defendant Drobot Sr. On information and

belief, Drobot Jr. is a resident of Orange County, CA. His links to, and control of,

the relevant entities and other Defendants are also set forth in detail in the next

section, as demonstrated in part through public records, including California

Secretary of State records.

47. Defendant Dr. Faustino Bernadett is an anesthesiologist and pain

management specialist who has a long-standing relationship with Defendants

Drobot Sr. and Drobot Jr. His links to, and control of, the relevant entities and other

Defendants are set forth in detail in the next section, as demonstrated in part through

public records, including California Secretary of State Records. In short,



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Dr. Bernadett was intimately involved in the conduct alleged in this Complaint. For

example, an April 2010 email produced in this case establishes his knowledge of

kickback payments to physicians, including Defendants in this case, in connection

with spinal surgeries, including one agreement with Defendant Dr. Jack Akmakjian

that blatantly provided for a payment of $15,000 per surgery, paid only if Dr.

Akmakjian used International Implants devices. A November 2009 email shows his

involvement in a conversation about which of the Entity Defendants would pay 15%

"collection fees" to Defendant Alan Ivar for surgeries he referred that used

International Implants hardware. And a July 2008 email produced in this matter

shows that Dr. Bernadett was aware of and facilitated payments to medical

providers through Defendant IPM.

C. Surgical, Pharmacy, and Administrative Defendants and Control

Allegations

48. Defendant Healthsmart is, and at all relevant times was, a California

corporation, with its principal place of business at 2776 Pacific Avenue, Long

Beach, CA 90806. In 1996, Drobot Sr. signed the Certificate of Amended

Incorporation of Healthsmart, filed with the California Secretary of State on

December 24, 1996, as its President, and in 1997, filed a Certificate of

Determination for Healthsmart, as Chairman of the Board and President (filed with

the California Secretary of State on March 18, 1997). In the most recent Statements

of Information on file with the California Secretary of State, Drobot Sr. was listed as

Chief Executive Officer and a Director of Healthsmart.

49. Defendant Pacific Hospital was at all relevant times a California

corporation, and a for-profit hospital that specialized in surgeries in general, and

orthopedic and spinal surgeries in particular, with its principal place of business at

2776 Pacific Avenue, Long Beach, CA 90806, up until its assets were purportedly

sold around October 2013. See the above paragraph regarding Drobot Sr.'s control

of the Healthsmart entity which, on information and belief, mirrored that of Pacific



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Hospital. Further, Pacific Hospital filed a corporate disclosure statement in this

case, listing Abrazos Healthcare, Inc. ("Abrazos") as the parent corporation;

California Secretary of State records indicate that Abrazos is located at 20377 SW

Acacia Street, Newport Beach, CA 92660, which is the headquarters for the

Pharmacy Defendants described below. Drobot Sr. is listed as the principal of

Abrazos. The disclosure statement also references Mickey Medical, Inc. as the

holding company of Abrazos; California Secretary of State records list Mickey

Medical, Inc. as having the same Acacia Street address, with Drobot Sr. as the

principal. Pacific Hospital also occupied 1740 Pacific Avenue, Long Beach, CA

90813, which was owned by Mickey Motors, LLC up until August 2013. Secretary

of State records reflect that Drobot Sr. is the manager of Mickey Motors, LLC.

50. According to financial statements and testimony obtained during

discovery, Pacific Hospital was owned until 2004 by (1) a revocable trust

established by Drobot Sr.; (2) Healthsmart MSO, an entity affiliated with Drobot Sr.

through direct and indirect ownership interests; and (3) a number of physicians. In

2004, Pacific Hospital repurchased the shares of common stock held by physicians

and was then fully owned by entities owned or controlled by Drobot Sr. In August

2005, through a complicated purchase transaction, Abrazos became either the sole

or majority shareholder of Pacific Hospital (according to financial statements,

Abrazos was the sole shareholder; according to testimony from Dr. Bernadett,

Drobot Sr. maintained an ownership interest in Pacific Hospital). At that time,

Abrazos was owned by Dr. Bernadett or by entities or trusts that he owned or

controlled, although Defendant Dr. Daniel Capen later acquired a 10 percent interest

in Abrazos. In October 2010, the Bernadett Family Trust, the majority shareholder

in Abrazos, sold its 90% ownership interest in Abrazos to Michael D. Drobot

Revocable Trust and Mickey Medical, Inc., an entity owned by Drobot Sr.

51. During the time period in which Abrazos was the sole or primary

shareholder of Pacific Hospital (and prior to and after the acquisition of Abrazos by



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Mickey Medical), Drobot Sr. continued to operate as Pacific Hospital's Chief

Executive Officer, and maintained significant financial interests in, and control over,

Pacific Hospital. For example, at the time of the Abrazos acquisition, Pacific

Hospital executed promissory notes payable over several years to repurchase Drobot

Sr.'s common stock in Pacific Hospital. Also, until December 31, 2009, Future

Opportunities, LLC, an entity owned by Drobot Sr.'s revocable trust and the

Bernadett Family Trust, provided Pacific Hospital with a revolving line of credit of

$8,500,000. At the close of 2010, Pacific Hospital had a note payable to Future

Opportunities of more than $7 million. Pacific Hospital was also involved in many

other related-party transactions with companies owned and/or controlled by Drobot

Sr. during this time period.

52. Many of the employees of Healthsmart and Pacific Hospital were

supplied by Defendant FMM and many of the properties occupied by Pacific

Hospital were purportedly leased by Defendant PSPM. Indeed, documents

produced in this litigation reveal significant payments made from Pacific Hospital to

FMM and PSPM.

53. Defendant Long Beach Pain is, and at all relevant times was, a

California corporation. Long Beach Pain, on information and belief, has a physical

location at 2760 Pacific Avenue, Long Beach, CA 90806 (the same block as Pacific

Hospital), and, on information and belief, is associated with Pacific Hospital in

terms of patient referrals, doctor privileges, and industry publications. According to

California Secretary of State records, Long Beach Pain headquarters are also located

at 20377 SW Acacia Street, Newport Beach, CA 92660. According to a recent

Statement of Information on file with the California Secretary of State (May 18,

2012), Drobot Sr. is listed as Chief Executive Officer, Secretary, and a director of

Long Beach Pain. Further, Long Beach Pain has filed a corporate disclosure

statement in this Court noting that PSPM is its parent corporation. At least until

October 2010, Long Beach Pain Center was 100% owned by the Bernadett Family



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Trust. As of December 31, 2010 and 2009, Pacific Hospital had an outstanding

balance due from Long Beach Pain of approximately $7,556,000 and $5,950,000,

which represented "Pain Center patient receivables" purportedly owned by the

Hospital pursuant to a "management agreement."

54. Defendant International Implants is, and at all relevant times was, a

California limited liability company. International Implants is also located at 20377

SW Acacia Street, Newport Beach, CA. The involvement of International Implants

is laid out in the Plea Agreement for Defendant Drobot Sr., USA v. Drobot, No.

8:14-cr-00034-JLS-DOC-7 at 14-16 (C.D. Cal. Feb. 21, 2014). International

Implants was owned and controlled by Drobot Sr. according to the Plea Agreement,

and, on information and belief, was not only staffed with employees from Defendant

FMM, but was also involved with PSPM (both Drobot Sr.-controlled entities). In

particular, according to the 2009 and 2010 financial statements of Abrazos,

International Implants was 100% owned by SI Venture Partners, LLC, which in turn

was owned 47.5% by Drobot Sr., 47.5% by PSPM (which in turn was majority

owned by the Bernadett Family Trust and by Drobot Sr.), and 5% by the Chief

Compliance Officer of the Hospital.

55. Defendant IPM is, and at all relevant times was, a California

corporation. At the time the original Complaint was filed, IPM's website states that

it helps dispense medications to patients in doctor's offices, and, according to

California Secretary of State records, is also located at 20377 SW Acacia Street,

Newport Beach, CA, although it states that IPM also has a sales office located in

Baltimore, Maryland. IPM also leased property from Mickey Motors, LLC through

at least 2013, while Drobot Sr. served as manager of Mickey Motors, LLC. In the

Statement of Information filed with the California Secretary of State on September

7, 2007, Drobot Sr. was listed as the sole manager for IPM. In its May 31, 2011

Statement of Information, Drobot Jr. was listed as the sole manager. Drobot Jr.



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acted as an officer of IPM since around the time of its formation in 2003. IPM was

also staffed with employees from FMM.

56. Defendant CPM underwent a merger in or around 2010 and became

IPM, on information and belief. Following the merger, CPM was no longer a valid

California entity and had no right to conduct business, on information and belief.

CPM nonetheless continued to bill State Fund for prescription medications well into

2012. According to California Secretary of State records, CPM is (or was) also

located at 20377 SW Acacia Street, Newport Beach, CA 92660. In the Certificate

of Merger on file with the California Secretary of State, dated January 28, 2010 but

filed August 17, 2010, Drobot Sr. signed as the manager of both the surviving entity

(IPM) and the disappearing entity (CPM). Drobot Jr. served as Chief Operating

Officer of CPM since around the time of its formation in 2002. Drobot Jr. also

served as President of CPM at least as early as 2006. Drobot Jr.'s role included, for

example, representing CPM at a Public Hearings before the State of California

Department of Industrial Relations (see Transcript of Public Hearing at 74-76,

Workers' Compensation Proposed Regs., Official Medical Fee Schedule –

Pharmaceuticals, Oct. 31, 2006) and negotiating and entering contracts on behalf of

CPM. According to Drobot Sr.'s deposition testimony, Drobot Jr. "ran the operation

on a day-to-day basis underneath [Drobot Sr.'s] direction," including entering into

contracts on behalf of CPM. Furthermore, both Individual Defendants

simultaneously held an ownership interest in CPM before it merged into IPM.

Drobot Sr.'s ownership interests in CPM were transferred to Drobot Jr. in 2010.

CPM was also staffed with employees from FMM.

57. Defendant Coastal is, and at all relevant times was, a California

corporation. According to California Secretary of State records, Coastal's principal

executive office is also located at 20377 SW Acacia Street, Newport Beach, CA

92660, with an additional street address of 2632 Pacific Avenue in Long Beach. In

the most recent Statement of Information with the California Secretary of State



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(October 29, 2010), Drobot Jr. is listed as the Chief Executive Officer, Chief

Financial Officer and a director of Coastal. Coastal also leased property from the

Drobot Sr.'s entity Mickey Motors, LLC, through at least mid-2013.

58. Defendant LBPP is, and at all relevant times was, a California

corporation. According to California Secretary of State records, LBPP's executive

office is also located at 20377 SW Acacia Street, Newport Beach, CA 92660, and

also has a place of business on Pacific Avenue in Long Beach, CA (near Pacific

Hospital). In response to requests for admission, Defendant LBPP admitted that

Drobot Sr. "associated with and acted on behalf of [LBPP] from its inception until

late July or early August, 2010 when Michael D. Drobot, Sr. sold his interests in

certain aspects of [LBPP] to Michael R. Drobot, Jr." In its most recent Statement of

Information filed with the California Secretary of State (December 28, 2011),

Drobot Jr. is listed as the Chief Executive Officer, Secretary, and a director. An

organization chart produced in this litigation indicates that LBPP was a subsidiary of

CPM, with Drobot Jr. acting as President of the enterprise.

59. Defendant MMG is, and at all relevant times was, a California limited

liability company. According to California Secretary of State records, MMG is also

located at 20377 SW Acacia Street, Newport Beach, CA 92660. In MMG's Articles

of Incorporation, filed with the California Secretary of State on March 21, 2011,

Drobot Jr. is listed as the initial agent for service of process, and in the Statement of

Information filed on April 13, 2011, Drobot Jr. is listed as the sole manager for

MMG. On information and belief, MMG was also staffed with employees from

FMM.

60. Defendant PSPM is, and at all relevant times was, a California

corporation, with its principal place of business also at 20377 SW Acacia Street,

Newport Beach, CA 92660. PSPM is the parent entity of Long Beach Pain and

holds a significant ownership interest in International Implants. In PSPM's Articles

of Incorporation, filed with the California Secretary of State on May 1, 1998, Drobot



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Sr. is listed as the initial agent for service of process, and on PSPM's Statement of

Information filed on May 31, 2011 Drobot Sr. is the only officer listed (the

subsequent Statement of Information filed on May 19, 2013 indicates that there was

no change in the preceding statement). According to financial statements produced

in this case, from August 31, 2005 to January 1, 2008, PSPM was 47% owned by

the Bernadett Family Trust, 36% owned by Drobot Sr., and 17% owned by "three

other parties affiliated with the Company." In 2007 and 2006 alone, PSPM received

approximately $5,350,000 and $4,300,000, respectively, for purported "management

services" provided to Pacific Hospital's orthopedic surgery program. As described

below, on information and belief, the Individual Defendants used PSPM to enter

into fraudulent agreements with medical providers and medical groups, including,

but not limited to, option and rental agreements, in order to conceal the payment of

kickbacks for the medical providers' participation in the Defendants' fraud schemes.

Upon information and belief, PSPM was the alter ego of the Individual Defendants

and a conduit of CPM, IPM, Healthsmart, International Implants, and LB Pain.

61. Defendant FMM is, and at all relevant times was, a California

corporation. According to California Secretary of State records, FMM is also

located at 20377 SW Acacia Street, Newport Beach, CA 92660. According to

Secretary of State records, FMM was formerly First Medical Staffing, Inc., which

was formerly Healthsmart Corporation. Drobot Sr. signed as the President and

Secretary of FMM on the October 9, 2002 Certificate of Amendment to the Articles

of Incorporation. The April 15, 2014 Statement of Information for FMM indicates

that Drobot Sr. is the Chief Executive Officer, Randolph Taylor is the Secretary, and

G. William Hammer is the Chief Financial Officer of FMM. FMM entered into

various agreements with the Pharmacy Defendants and Surgical Defendants,

pursuant to which they, among other things, supplied employees to those

Defendants. Moreover, according to the recent deposition testimony of Matthew

Umbs, FMM not only supplied employees, but it also provided information



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technology services to the Pharmacy and Surgical Defendants. Upon information

and belief, FMM was the alter ego of the Individual Defendants and a conduit of the

other Drobot-controlled entities.

62. Collectively, these entities are referred to herein as the "Entity

Defendants."

63. The overlap in ownership, officers, personnel, management, addresses,

and operations demonstrate that the Entity Defendants and Individual Defendants

are alter egos of each other. Corporate formalities were often ignored. On

information and belief, many of the entities did not maintain corporate meeting

minutes or regularly elect directors. Furthermore, the Individual Defendants acted

with disregard for the separate nature of each entity. On information and belief, the

Drobots owned and/or controlled several other entities that similarly functioned as

mere conduits through which the overall scheme was implemented. The Individual

Defendants' network of shell companies ensured that their unlawful acts remain

hidden and victims and the courts are unable to easily identify the responsible party

or track the flow of money.

D. Provider Defendants

64. Dr. Capen. Defendant Dr. Daniel Capen is, on information and belief,

a resident of Los Angeles County, CA. He is an orthopedic spine surgeon who has

had a longstanding relationship with the Individual Defendants. He held a financial

ownership interest in Abrazos Healthcare, Inc., the parent company of Healthsmart,

until the sale of Pacific Hospital in October 2013. Dr. Capen performed spinal

surgeries at Pacific Hospital, using hardware ordered from International Implants

and other co-schemers' companies, that were billed to State Fund both by Pacific

Hospital and by Dr. Capen. Dr. Capen performed and billed for such surgeries

starting no later than 2004 and ending no earlier than 2012. Dr. Capen also referred

patients for surgeries to be performed at Defendant Long Beach Pain. Dr. Capen

received illegal kickback payments from Entity Defendants for these surgeries and



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referrals, and for using International Implants hardware, and knowingly received

patient referrals from marketers who were paid kickbacks for those referrals. Two

examples of surgeries performed at Pacific Hospital by Dr. Capen using devices

from International Implants, and billed to State Fund, are included in Exhibit 2.

65. Dr. Capen also had agreements with CPM and IPM. Under these

agreements with CPM and IPM, Dr. Capen knowingly allowed the Individual

Defendants to control and operate illegal pharmacy operations out of his practices in

exchange for payments. CPM and IPM, with Dr. Capen's cooperation, billed large

volumes of pharmaceuticals to State Fund at prices greatly in excess of actual cost,

beginning no later than 2005 and ending no earlier than 2012.7 Dr. Capen was paid

kickbacks through his agreements for referring patients to the pharmacies, for

referring patients to Pacific Hospital, for referring patients to Long Beach Pain, and

for using International Implants hardware. He also signed bills and reports (and/or

allowed Entity Defendants to sign bills on his behalf), which were submitted to State

Fund, and which contained certifications, either explicit or implicit, that the bills and

reports submitted were not the product of fraud or illegal referral and kickback fees,

and/or did not contain material misrepresentations or omissions.

66. Since the filing of State Fund's original complaint, Dr. Capen has been

indicted on charges of receiving kickbacks for prescribing compound medications in

excess of $2,500,000, accepting rebates for patient referrals, and filing false claims

with numerous insurers including State Fund in connection with a separate scheme

7 The dates provided here, and in subsequent paragraphs discussing billing by the Pharmacy Defendants with the cooperation of the various Provider Defendants, are not intended to delimit entirely the period in which the Provider Defendants facilitated or engaged in fraudulent billing by or with the Pharmacy Defendants. Instead, these dates reflect the dates of the initial billings identified in financial records produced by Pharmacy Defendants in this matter. Those records may not be complete, and additional fraudulent billing occurred after the initial bills were sent. Additionally, payments by State Fund on such fraudulent bills occurred subsequent to the billings themselves.



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organized by Kareem Ahmed. State of California v. Charbonnet, Case No.

14ZF0334 (Cal. Sup. Ct. June 17, 2014).

67. Dr. Capen practiced at Defendant Southwestern Orthopedic Medical

Corp. d/b/a Downey Orthopedic Medical Group ("Downey Ortho") where

Defendants Dr. John Larsen, Dr. Richard Mulvania, Dr. Andrew Jarminski, Dr.

Russell Nelson, and Dr. Faustino Bernadett also practiced. Downey Ortho is located

at 7700 Imperial Hwy. Ste. R, Downey, CA 90242. This practice was "managed"

by PSPM. Dr. Capen also practiced at Defendant Southwestern Orthopedic Medical

Corp. d/b/a Channel Islands Orthopedic ("Channel Islands") where Defendants

Dr. Jarminski, and Dr. John Larsen also practiced. Channel Islands is located at

1700 Lombard St., Ste. 110, Oxnard, CA 93030. Dr. Capen also practiced at

Defendant Allied Medical Group, Inc. ("Allied"), located at 15901 Hawthorne

Blvd., Ste. 250, Lawndale, CA 90260 and 4237 Atlantic Ave., Long Beach, CA

90807 where Defendants Dr. Jarminski and Dr. Timothy Hunt. Dr. Capen

knowingly submitted fraudulent bills to State Fund through Defendants Downey

Ortho, Channel Islands, Allied, Daniel Capen MD, a Professional Corporation, and

Westlake Surgical Medical Associates, Inc., which, according Secretary of State

records, is located at 20377 SW Acacia St., Ste. 110, Newport Beach, CA 92660

along with most of the Entity Defendants. When Dr. Capen was subpoenaed for

documents prior to this Third Amended Complaint, he refused to produce any

documents under his Fifth Amendment Right against self-incrimination.

68. Dr. Larsen. Defendant Dr. John Larsen is, on information and belief, a

resident of Los Angeles County, CA. He is an orthopedic spine surgeon.

Dr. Larsen performed spinal surgeries at Pacific Hospital, using hardware ordered

from International Implants and other co-schemers' companies, that were billed to

State Fund both by Pacific Hospital and by Dr. Larsen. Dr. Larsen performed and

billed for such surgeries starting no later than 2004 and ending no earlier than 2011.

Dr. Larsen received illegal kickback payments from Entity Defendants for these



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surgeries and for using International Implants hardware. Dr. Larsen entered into

multiple agreements with PSPM under which he received illegal kickback

payments. Two examples of surgeries performed at Pacific Hospital by Dr. Larsen

using devices from International Implants, and billed to State Fund, are included in

Exhibit 2.

69. Dr. Larsen also had agreements with CPM and IPM. Under these

agreements with CPM and IPM, Dr. Larsen knowingly allowed the Individual


exchange for payments. CPM and IPM, with Dr. Larsen's cooperation, billed large

volumes of pharmaceuticals to State Fund at prices greatly in excess of actual cost,

beginning no later than 2005 and ending no earlier than 2010. Dr. Larsen was paid

kickbacks through his agreements with Pharmacy Defendants for referring patients

to the pharmacies, for referring patients to Pacific Hospital, for performing surgeries

at Pacific Hospital, and for using International Implants hardware. He also signed

bills and reports (and/or allowed Entity Defendants to sign bills on his behalf),

which were submitted to State Fund, and which contained certifications, either

explicit or implicit, that the bills and reports submitted were not the product of fraud

or illegal referral and kickback fees, and/or did not contain material

misrepresentations or omissions.

70. Dr. Larsen practiced at Downey Ortho where Defendants Dr. Daniel

Capen, Dr. Richard Mulvania, Dr. Andrew Jarminski, Dr. Russell Nelson, and

Dr. Faustino Bernadett also practiced. He also worked at Channel Islands where

Dr. Capen, and Dr. Jarminski also practiced. Dr. Larsen submitted fraudulent bills

to State Fund through Downey Ortho and Channel Islands, and Defendant John

Larsen, MD, A Professional Corporation, which, according to Secretary of State

records, is located at 32107 Lindero Canyon Rd. Ste. 235, Westlake Village, CA

91361.



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71. Dr. Jarminski. Defendant Dr. Andrew Jarminski is, on information

and belief, a resident of Los Angeles County, CA. He specializes in general surgery

and occupational medicine. Dr. Jarminski received kickbacks from Entity

Defendants for referring patients to Pacific Hospital for spinal surgeries, using

hardware from International Implants or another co-schemer's company, that were

billed to State Fund both by Pacific Hospital and by Dr. Jarminski. Dr. Jarminski

was often the assistant surgeon for those surgeries. Dr. Jarminski referred or

assisted in, and billed for, such surgeries starting no later than 2005 and ending no

earlier than 2012. Two examples of surgeries performed at Pacific Hospital using

devices from International Implants, and billed to State Fund, in which

Dr. Jarminski was the assistant surgeon, are included in Exhibit 2.

72. Dr. Jarminski also had agreements with CPM and IPM. Under these

agreements with CPM and IPM, Dr. Jarminski knowingly allowed the Individual


exchange for payments. CPM and IPM, with Dr. Jarminski's cooperation, billed

large volumes of pharmaceuticals to State Fund at prices greatly in excess of actual

cost, beginning no later than 2005 and ending no earlier than 2012. Dr. Jarminski

was paid kickbacks through his agreements with Pharmacy Defendants for referring

patients to the pharmacies, for assisting in spinal surgeries, and for referring patients

to Pacific Hospital. He also signed bills and reports (and/or allowed Entity

Defendants to sign bills on his behalf), which were submitted to State Fund, and

which contained certifications, either explicit or implicit, that the bills and reports


did not contain material misrepresentations or omissions.

73. Since the filing of State Fund's original complaint, Dr. Jarminksi has

been indicted on charges of receiving kickbacks of $1.9 million for prescribing

compound medications, accepting rebates for referrals, submitting false claims to

numerous insurers including State Fund, and involuntary manslaughter in



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connection with a separate scheme organized by Kareem Ahmed. State of

California v. Charbonnet, Case No. 14ZF0334 (Cal. Sup. Ct. June 17, 2014); State

of California v. Ahmed, Case No. 14ZF0335 (Cal. Sup. Ct. June 17 2014).

74. Dr. Jarminski practiced at Downey Ortho where Defendants Dr. Daniel

Capen, Dr. John Larsen, Dr. Richard Mulvania, Dr. Russell Nelson, and

Dr. Faustino Bernadett also practiced. He worked practiced at Channel Islands

where Dr. Daniel Capen and Dr. John Larsen also practiced. He also practiced at

Allied where Defendants Dr. Capen and Dr. Timothy Hunt also practiced. He also

worked with Defendant Dr. Thomas Haider at Haider Spine Center Medical Group,

Inc. He submitted fraudulent bills to State Fund through Downey Ortho, Channel

Islands, Allied, ARJ Medical, Inc., Inland Incare Medical Associates, Inc., and

Inland Incare of San Bernardino Medical Group, Inc. Defendants Inland Incare

Medical Associates, Inc. and ARJ Medical, Inc. are located, according to Secretary

of State records, at 212 Capistrano Circle, Fullerton, CA 92835. Defendant Inland

Incare of San Bernardino Medical Group, Inc. is located, according to Secretary of

State records, at 155 West Hospitality Lane Suite 175, San Bernardino, CA, 92408.

75. Jeffrey Catanzarite, D.C. Defendant Jeffrey Catanzarite, D.C. is, on

information and belief, a resident of Orange County, CA. He is a chiropractor who

is the principal at Defendant The Center for Better Health, a Medical Group, Inc.

d/b/a/ Southland Spine and Rehabilitation, Inc. ("Southland Spine"). Catanzarite

received kickbacks for referring patients to Pacific Hospital for spinal surgeries,

using hardware from International Implants or another co-schemer's company, that

were billed to State Fund.

76. Catanzarite also had agreements with CPM, IPM, and MMG. Under

these agreements, Catanzarite knowingly allowed the Individual Defendants to

control and operate illegal pharmacy operations out of his practices in exchange for

payments. CPM and IPM, with Catanzarite's cooperation, billed large volumes of

pharmaceuticals to State Fund at prices greatly in excess of actual cost, beginning no



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later than 2003 and ending no earlier than 2012. Catanzarite was paid kickbacks

through his agreements with Pharmacy Defendants for referring patients to the

pharmacies and for referring patients to Pacific Hospital.8 He also influenced and

facilitated the submission of fraudulent bills and reports by licensed physicians

operating out of the medical practices he owned and operated. These bills and

reports were submitted to State Fund, and contained certifications, either explicit or

implicit, that the bills and reports submitted were not the product of fraud or illegal

referral and kickback fees, and/or did not contain material misrepresentations or

omissions.

77. Defendant Dr. Jack Akmakjian practiced with Catanzarite out of

Southland Spine. Catanzarite submitted or facilitated the submission of fraudulent

bills to State Fund through Southland Spine. Southland Spine, according to

Secretary of State Records, is located at 1520 Nutmeg Place, Suite 260, Costa Mesa,

CA 92626.

78. Dr. Ahmed. Defendant Dr. Khalid B. Ahmed is, on information and

belief, a resident of Los Angeles County, CA. He is an orthopedic spine surgeon.

Dr. Ahmed performed spinal surgeries at Pacific Hospital, using hardware ordered


State Fund both by Pacific Hospital and by Dr. Ahmed. Dr. Ahmed performed and

billed for such surgeries starting no later than 2004 and ending no earlier than 2008.

Dr. Ahmed received illegal kickback payments from Entity Defendants for those

surgeries and for using International Implants hardware, and knowingly received

patient referrals from marketers who were paid kickbacks for those referrals.

Dr. Ahmed entered into contracts with PSPM under which he received some of the

illegal kickback payments. Two examples of surgeries performed at Pacific

8 As discussed below, Catanzarite was also involved with another Drobot Jr. entity that provided toxicology tests, and emails show Drobot Jr. encouraging Catanzarite to perform more tests.



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Hospital by Dr. Ahmed using devices from International Implants, and billed to

State Fund, are included in Exhibit 2.

79. Dr. Ahmed also had agreements with CPM and IPM. Under these

agreements with CPM and IPM, Dr. Ahmed knowingly allowed the Individual


exchange for payments. CPM and IPM, with Dr. Ahmed's cooperation, billed large

volumes of pharmaceuticals to State Fund at prices greatly in excess of actual cost.

Dr. Ahmed was paid kickbacks through his agreements with Pharmacy Defendants

for referring patients to the pharmacies, for referring patients to Pacific Hospital, for

performing surgeries at Pacific Hospital, and for using International Implants

hardware. He also signed bills and reports (and/or allowed Entity Defendants to

sign bills on his behalf), which were submitted to State Fund, and which contained

certifications, either explicit or implicit, that the bills and reports submitted were not

the product of fraud or illegal referral and kickback fees, and/or did not contain

material misrepresentations or omissions.

80. Dr. Ahmed owns and operates Defendants Khalid Bashir Ahmed, MD,

A Professional Corporation and Defendant Ahmed Pomona Medical Group, Inc.,

through which he submitted fraudulent bills for pharmaceutical and surgical services

to State Fund and which, according to Secretary of State Records, are located at

4511 Rosemead Blvd., Pico Rivera, CA 90660. Dr. Ahmed has also submitted bills

through Defendant Healthpointe Medical Group, Inc. ("Healthpointe"), which is

owned and operated by Defendant Dr. Ismael Silva. When Dr. Ahmed was

subpoenaed for documents prior to the filing of this Third Amended Complaint, he

objected to the production of certain documents based on his Fifth Amendment

Right against self-incrimination.

81. Dr. Akmakjian. Defendant Dr. Jack H. Akmakjian is, on information

and belief, a resident of Riverside County, CA. He is an orthopedic spine surgeon.

Dr. Akmakjian performed spinal surgeries at Pacific Hospital, using hardware



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ordered from International Implants and other co-schemers' companies, that were

billed to State Fund both by Pacific Hospital and by Dr. Akmakjian. Dr. Akmakjian

performed and billed for such surgeries starting no later than 2009 and ending no

earlier than 2013. Dr. Akmakjian received illegal kickback payments from Entity

Defendants for these surgeries and for using International Implants hardware.

Dr. Akmakjian received the illegal kickback payments through agreements with the

Entity Defendants. Two examples of surgeries performed at Pacific Hospital by

Dr. Akmakjian using devices from International Implants, and billed to State Fund,

are included in Exhibit 2.

82. Dr. Akmakjian worked with Defendant Jeffrey Catanzarite at

Defendant Southland Spine. Dr. Akmakjian billed for pharmaceuticals under

contracts between IPM or MMG and Southland Spine. Under these illegal

contracts, Dr. Akmakjian knowingly allowed the Individual Defendants through

IPM and MMG to operate their illegal pharmacy operations out of his practice at

Southland Spine in exchange for payments. IPM and MMG, with Dr. Akmakjian's

cooperation, billed large volumes of pharmaceuticals to State Fund at prices greatly

in excess of actual cost, beginning no later than 2010 and ending no earlier than

2012. He also signed bills and reports (and/or allowed Entity Defendants to sign

bills on his behalf), which were submitted to State Fund, and which contained

certifications, either explicit or implicit, that the bills and reports submitted were not

the product of fraud or illegal referral and kickback fees, and/or did not contain

material misrepresentations or omissions.

83. Dr. Akmakjian also submitted fraudulent bills through his entity

Defendant Jack H. Akmakjian, M.D., Inc., which is located in Riverside County,

CA.

84. Dr. Chambi. Defendant Dr. Israel Chambi is, on information and

belief, a resident of Orange County, CA. On information and belief, he is a

neurological surgeon specializing in brain, spine, and nerve surgeries. Dr. Chambi



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performed spinal surgeries at Pacific Hospital, using hardware ordered from

International Implants and other co-schemers' companies, that were billed to State

Fund both by Pacific Hospital and by Dr. Chambi. These surgeries were performed

starting no later than 2010 and ending no earlier than 2011. Dr. Chambi received

illegal kickback payments from Entity Defendants for the surgeries and for using

International Implants hardware. The payments were made through agreements

between Dr. Chambi and the Entity Defendants, including an agreement under

which Dr. Chambi was specifically promised a percentage payment for all

collections for International Implants devices. Two examples of surgeries

performed at Pacific Hospital by Dr. Chambi using devices from International

Implants, and billed to State Fund, are included in Exhibit 2.

85. Dr. Chambi also signed bills and reports (and/or allowed Entity





86. Dr. Alexander. Defendant Dr. Gerald Alexander is, on information

and belief, a resident of Riverside County, CA. He is an orthopedic spine surgeon.

Dr. Alexander performed spinal surgeries at Pacific Hospital, using hardware


billed to State Fund both by Pacific Hospital and by Dr. Alexander. Dr. Alexander


earlier than 2011. Dr. Alexander received illegal kickback payments from Entity

Defendants for these surgeries and for using International Implants hardware. Dr.

Alexander received the illegal kickback payments though agreements with the

Entity Defendants. Two examples of surgeries performed at Pacific Hospital by Dr.

Alexander using devices from International Implants, and billed to State Fund, are

included in Exhibit 2.



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87. Dr. Alexander also had agreements with CPM. Under these

agreements with CPM, Dr. Alexander knowingly allowed the Individual Defendants

to control and operate illegal pharmacy operations out of his practices in exchange

for payments. CPM, with Dr. Alexander's cooperation, billed large volumes of

pharmaceuticals to State Fund at prices greatly in excess of actual cost beginning no

later than 2006 and ending no earlier than 2007. He also signed bills and reports

(and/or allowed Entity Defendants to sign bills on his behalf), which were submitted

to State Fund, and which contained certifications, either explicit or implicit, that the

bills and reports submitted were not the product of fraud or illegal referral and

kickback fees, and/or did not contain material misrepresentations or omissions.

88. Dr. Alexander submitted fraudulent bills through his entities Defendant

Gerald J. Alexander, Orthopaedic Surgery, Inc. which, according to Secretary of

State records, is located at 333 City Blvd. West Suite 1700, Orange, CA 92868 and

Defendant Newport Coast Spine, Inc., which, according to Secretary of State

records, is located at 930 South 4th Street, Ste. 150, Las Vegas, NV, 89101. Dr.

Alexander also worked with Dr. Thomas Haider and others at Haider Spine Center

Medical Group, Inc. and wrote prescriptions billed by Pharmacy Defendants at

Haider Spine Center Medical Group, Inc.

89. Dr. Armstrong. Defendant Dr. Ian Armstrong is, on information and


Dr. Armstrong performed spinal surgeries at Pacific Hospital, using hardware


billed to State Fund both by Pacific Hospital and by Dr. Armstrong. Dr. Armstrong


earlier than 2012. Dr. Armstrong received illegal kickback payments from Entity

Defendants for these surgeries and for using International Implants hardware.

Dr. Armstrong received these kickback payments under various agreements with

the Entity Defendants. Two examples of surgeries performed at Pacific Hospital by



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Dr. Armstrong using devices from International Implants, and billed to State Fund,

are included in Exhibit 2.

90. Dr. Armstrong had agreements with CPM and IPM. Under these

agreements with CPM and IPM, he knowingly allowed the Individual Defendants to


payments. CPM and IPM, with Dr. Armstrong's cooperation, billed large volumes

of pharmaceuticals to State Fund at prices greatly in excess of actual cost beginning

no later than 2005 and ending no earlier than 2012. Dr. Armstrong was paid

kickbacks through his agreements with Pharmacy Defendants for referring patients

to the pharmacies, for performing surgeries at Pacific Hospital, and for using

International Implants hardware. He also signed bills and reports (and/or allowed

Entity Defendants to sign bills on his behalf), which were submitted to State Fund,

and which contained certifications, either explicit or implicit, that the bills and


and/or did not contain material misrepresentations and omissions.

91. Dr. Armstrong submitted fraudulent bills through his entity, Defendant

Ian I.T. Armstrong, M.D., Inc., which, according to Secretary of State records, is

located at 3831 Hughes Ave. #105, Culver City, CA 90232.

92. Michael E. Barri, D.C. Defendant Michael E. Barri, D.C. is, on

information and belief, a resident of Orange County, CA. He is a chiropractor.

Barri referred patients for surgeries to be performed at Defendant Long Beach Pain.

Barri received illegal kickback payments from Entity Defendants for these referrals.

93. Barri also entered into agreements with IPM. Under these agreements

with IPM, he knowingly allowed the Individual Defendants to control and operate

illegal pharmacy operations out of his practices in exchange for payments. IPM,

with Barri's cooperation, billed large volumes of pharmaceuticals to State Fund at

prices greatly in excess of actual cost beginning no later than 2009 and ending no

earlier than 2012. Barri was paid kickbacks through his agreements with Pharmacy



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Defendants for referring patients to the pharmacies and for referring patients to

Long Beach Pain. He also influenced and facilitated the submission of fraudulent

bills and reports by licensed physicians operating out of the medical practices he

owned and operated. These bills and reports were submitted to State Fund, and

contained certifications, either explicit or implicit, that the bills and reports



94. Barri owns and operates Defendants Jojaso Management, Inc.

("Jojaso") and TriStar Medical Group, a Professional Corporation ("TriStar"), which

are, based on California Secretary of State records, located at 999 N. Tustin Ave.,

Santa Ana, CA 92705 and 876 Mountain Ave., Suite 200(I), Upland, CA 91786,

respectively. Barri submitted fraudulent bills to State Fund through TriStar.

Defendants Dr. Andrew Jarminski and Dr. Richard Mulvania both practiced at

TriStar.

95. Dr. Cohen. Defendant Dr. Mitchell Cohen is, on information and

belief, a resident of Orange County, CA. He is an orthopedic spine surgeon. Dr.

Cohen performed spinal surgeries at Pacific Hospital, using hardware ordered from


Fund by both Pacific Hospital and Dr. Cohen. Dr. Cohen performed such surgeries

beginning no later than 2006 and ending no earlier than 2012. Dr. Cohen knowingly

received patient referrals from others who were paid kickbacks for those referrals.

Dr. Cohen received illegal kickback payments from Entity Defendants for the

surgeries and for using International Implants hardware. Dr. Cohen entered into

multiple agreements with Entity Defendants under which he received these illegal

kickback payments. Two examples of surgeries performed at Pacific Hospital by

Dr. Cohen using devices from International Implants, and billed to State Fund, are

included in Exhibit 2.



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96. Dr. Cohen also had agreements with CPM. Under these agreements

with CPM, he knowingly allowed the Individual Defendants to control and operate

illegal pharmacy operations out of his practices in exchange for payments. CPM,

with Dr. Cohen's cooperation, billed large volumes of pharmaceuticals to State Fund

at prices greatly in excess of actual cost beginning no later than 2005 and ending no

earlier than 2007. Dr. Cohen was paid kickbacks through his agreements with

Pharmacy Defendants for referring patients to the pharmacies, for performing

surgeries at Pacific Hospital, and for using International Implants hardware. He also

signed bills and reports (and/or allowed Entity Defendants to sign bills on his

behalf), which were submitted to State Fund, and which contained certifications,

either explicit or implicit, that the bills and reports submitted were not the product of

fraud or illegal referral and kickback fees, and/or did not contain material


97. Dr. Cohen submitted fraudulent bills through his business entity

Defendant Mitchell G. Cohen, MD, Inc., which, according to Secretary of State

Records, is located at 11160 Warner Ave., Ste. 305, Fountain Valley, CA 92708.

98. Dr. Haider. Defendant Dr. Thomas Haider is, on information and

belief, a resident of Riverside County, CA. He is an orthopedic spine surgeon who

formerly owned implant manufacturer Seaspine, Inc., which sold implants to

International Implants that were then used in surgeries at Pacific Hospital. Dr.

Haider himself performed spinal implant surgeries at Pacific Hospital, which were

billed to State Fund by both Pacific Hospital and Dr. Haider, using Seaspine devices

that Pacific Hospital "purchased" through International Implants. The prices at

which International Implants invoiced these Seaspine devices to Pacific Hospital

(which invoices were included in the bills sent to and paid by State Fund) were

grossly inflated over the prices actually paid. Dr. Haider received illegal kickback

payments from Entity Defendants for the surgeries and for using International

Implants hardware. Dr. Haider performed such surgeries beginning no later than



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2010 and ending no later than 2012. Dr. Haider entered into multiple agreements

with Entity Defendants under which he received these illegal kickback payments.

Two examples of surgeries performed at Pacific Hospital by Dr. Haider using

devices from International Implants, and billed to State Fund, are included in

Exhibit 2.

99. Dr. Haider had agreements with IPM. Under these agreements with

IPM, he knowingly allowed the Individual Defendants to control and operate illegal

pharmacy operations out of his practices in exchange for payments. IPM, with Dr.

Haider's cooperation, billed large volumes of pharmaceuticals to State Fund at

prices greatly in excess of actual cost, beginning no later than 2010 and ending no

later than 2012. He also signed bills and reports (and/or allowed Entity Defendants

to sign bills on his behalf), which were submitted to State Fund, and which

contained certifications, either explicit or implicit, that the bills and reports



100. Dr. Haider owns and operates Defendant Haider Spine Center Medical

Group, Inc. ("Haider Spine"), located at 6276 Rivercrest Dr., Riverside, CA 92507.

Defendant Dr. Andrew Jarminski worked with Dr. Thomas Haider at Haider Spine,

where Defendant Dr. Randy Rosen also practiced, and each of them submitted

fraudulent bills to State Fund through Haider Spine. Dr. Haider also owns and

operates Defendant Salma Jason Monica, LP, located at 4500 Brockton Avenue, Ste.

201, Riverside, CA 92501, which was used to receive illegal kickback payments on

behalf of Dr. Haider.

101. Dr. Dureza. Defendant Dr. Catalino Dureza is, on information and

belief, a resident of Kern County, CA. He is an orthopedic spine surgeon.

Dr. Dureza performed spinal surgeries at Pacific Hospital, using hardware ordered


State Fund both by Pacific Hospital and by Dr. Dureza. Dr. Dureza performed these



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surgeries beginning no later than 2004 and ending no later than 2009. Dr. Dureza

received illegal kickback payments from Entity Defendants for the surgeries and for

using International Implants hardware. Dr. Dureza received these kickback

payments under various agreements with the Entity Defendants. Two examples of

surgeries performed at Pacific Hospital by Dr. Dureza using devices from

International Implants, and billed to State Fund, are included in Exhibit 2.

102. Dr. Dureza had agreements with CPM and IPM. Under these



payments. CPM and IPM, with Dr. Dureza's cooperation, billed large volumes of


later than 2005 and ending no earlier than 2010. Dr. Dureza was paid kickbacks


pharmacies, for performing surgeries at Pacific Hospital, and for using International

Implants hardware. He also signed bills and reports (and/or allowed Entity





103. Dr. Dureza submitted fraudulent bills to State Fund through his medical

corporations Defendant Catalino D. Dureza, M.D., Inc., which, according to

Secretary of State records, is located at 2323 16th Street, Ste. 303, Bakersfield, CA

93301, and California Neurosurgical and Spine Associates, a Medical Corporation,

which, according to Secretary of State records, is located in Riverside County, CA.

Dr. Dureza also owns and controls Defendant Maximus Medical Group, a Medical

Corporation, which according to Secretary of State records, is located in Riverside

County, CA, and through which Dr. Dureza was paid kickback payments.



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104. Dr. Hunt. Defendant Dr. Timothy Hunt is, on information and belief,

a resident of Orange County, CA. He is an orthopedic surgeon. Dr. Hunt referred

spinal surgeries to Pacific Hospital, to be performed using hardware ordered from


Fund. Dr. Hunt received illegal kickback payments from Entity Defendants for

these referrals. These kickbacks were paid through multiple agreements with the

Entity Defendants.

105. Dr. Hunt had agreements with CPM and IPM. Under these agreements

with CPM and IPM, he knowingly allowed the Individual Defendants to control and

operate illegal pharmacy operations out of his practices in exchange for payments.

CPM and IPM, with Dr. Hunt's cooperation, billed large volumes of


later than 2005 and ending no earlier than 2012. Dr. Hunt was paid kickbacks


pharmacies and for referring surgeries to Pacific Hospital. He also signed bills and

reports (and/or allowed Entity Defendants to sign bills on his behalf), which were

submitted to State Fund, and which contained certifications, either explicit or



omissions.

106. Dr. Hunt owns and operates Defendant Allied Medical Group, Inc.

("Allied"), which has a location in Lawndale, CA and Long Beach, CA

(collectively, Dr. Hunt and Allied shall be referred to as "Hunt Defendants"). Dr.

Hunt practices with Defendants Dr. Daniel Capen and Dr. Andrew Jarminski at

Allied and each doctor has submitted fraudulent bills to State Fund through Allied.

Dr. Hunt also submitted fraudulent bills through non-party Intercommunity Medical

Group, which was owned by his father, the late Dr. Robert Hunt.



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107. Alan Ivar, D.C. Defendant Alan Ivar, D.C. is, on information and

belief, a resident of Orange County, CA. He is a chiropractor. Ivar was paid

kickbacks by Pacific Hospital for referring patients for surgeries to be performed at

Long Beach Pain and for referring patients for spinal surgeries to be performed at

Pacific Hospital using hardware from International Implants. These kickbacks were

paid through various agreements between Ivar and the Entity Defendants.

108. Ivar had agreements with CPM and IPM. Under these agreements with

CPM and IPM, he knowingly allowed the Individual Defendants to control and

operate illegal pharmacy operations out of his practices in exchange for payments.

CPM and IPM, with Ivar's cooperation, billed large volumes of pharmaceuticals to

State Fund at prices greatly in excess of actual cost beginning no later than 2005 and

ending no earlier than 2012. Ivar was paid kickbacks through his agreements with

Pharmacy Defendants for referring patients to the pharmacies and for referring

patients to Pacific Hospital. He also influenced and facilitated the submission of

fraudulent bills and reports by licensed physicians operating out of the medical

practices he owned and operated. These bills and reports were submitted to State

Fund, and contained certifications, either explicit or implicit, that the bills and



109. Ivar owns and operates Defendant Griffin Medical Group, Inc.

("Griffin") and Defendant, South Coast Rehabilitation Center, Inc. ("South Coast

Rehab"), which according to Secretary of State records, are located at 1650 Adams

Ave., Costa Mesa, CA 92626. Defendant Dr. Lokesh Tantuwaya practiced out of

Griffin. Ivar submitted fraudulent bills to State Fund through Griffin and accepted

kickback payments through both Griffin and South Coast Rehab.

110. Edward Komberg, D.C. Defendant Edward Komberg, D.C. is, on

information and belief, a resident of Los Angeles County, CA. He is a chiropractor.

Dr. Komberg referred patients for services and surgeries to be performed at



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Defendant Long Beach Pain. He received kickback payments for these referrals

from Entity Defendants.

111. Komberg had agreements with CPM. Under these agreements with

CPM, he knowingly allowed the Individual Defendants to control and operate illegal

pharmacy operations out of his practices in exchange for payments. CPM, with

Komberg's cooperation, billed large volumes of pharmaceuticals to State Fund at


earlier than 2007. Komberg was paid kickbacks through his agreements with


patients to Pacific Hospital. He also influenced and facilitated the submission of

fraudulent bills and reports by licensed physicians operating out of the medical

practices he owned and operated. These bills and reports were submitted to State

Fund, and contained certifications, either explicit or implicit, that the bills and



112. Komberg owns and operates Defendant Tri-County Medical Group

("Tri-County"), which, according to Secretary of State records is located at 1200

Wilshire Blvd Ste. 308, Los Angeles, CA 90017 and Defendant Tri-City Health

Group, Inc. ("Tri-City"), which, according to Secretary of State records, is located at

1145 E. San Antonio Dr. Ste. A, Long Beach, CA 90807. Defendant Dr. Mitchell

Cohen practiced out of Tri-County. Komberg submitted fraudulent bills to State

Fund through Tri County and accepted kickbacks through Tri-City.

113. Dr. Moheimani. Defendant Dr. Assad Michael Moheimani is, on

information and belief, a resident of Orange County, CA. He is an orthopedic spine

surgeon. Dr. Moheimani performed spinal surgeries at Pacific Hospital, using

hardware ordered from International Implants and other co-schemers' companies,

that were billed to State Fund both by Pacific Hospital and by Dr. Moheimani.

Dr. Moheimani performed these surgeries beginning no later than 2009 and ending



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no earlier than 2011. Dr. Moheimani received illegal kickback payments from

Entity Defendants for the surgeries and for using International Implants hardware.

Two examples of surgeries performed at Pacific Hospital by Dr. Moheimani using


Exhibit 2.

114. Dr. Moheimani submitted fraudulent bills to State Fund through

Defendant Coast Spine and Sports Medical Corporation, which is principally located

at 902 N. Grand, Santa Ana, CA 92706. He also signed bills and reports (and/or





115. Dr. Mulvania. Defendant Dr. Richard Mulvania is, on information

and belief, a resident of Orange County, CA. He is an orthopedic spine surgeon.

Dr. Mulvania performed spinal surgeries at Pacific Hospital, using hardware ordered


State Fund both by Pacific Hospital and by Dr. Mulvania. Dr. Mulvania performed

these surgeries beginning no later than 2004 and ending no earlier than 2012.

Dr. Mulvania received illegal kickback payments from Entity Defendants for the

surgeries and for using International Implants hardware. Two examples of surgeries

performed at Pacific Hospital by Dr. Mulvania using devices from International


116. Dr. Mulvania had agreements with CPM and IPM. Under these



payments. CPM and IPM, with Dr. Mulvania's cooperation, billed large volumes of


later than 2005 and ending no later than 2011. He also signed bills and reports



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117. Dr. Mulvania submitted fraudulent bills to State Fund through

Defendant Richard L. Mulvania, MD, Inc., which, according to Secretary of State

records, is located at 9930 Research Dr. Suite 100, Irvine, CA 92648. Dr. Mulvania

also practiced at Downey Ortho where Dr. Daniel Capen, Dr. John Larsen, Dr.

Andrew Jarminski, Dr. Russell Nelson, and Dr. Faustino Bernadett also practiced.

118. Dr. Obukhoff. Defendant Dr. Serge Obukhoff is, on information and


Dr. Obukhoff performed spinal surgeries at Pacific Hospital, using hardware ordered


State Fund both by Pacific Hospital and by Dr. Obukhoff. Dr. Obukhoff performed

these surgeries beginning no later than 2004 and ending no earlier than 2012.

Dr. Obukhoff received illegal kickback payments from Entity Defendants for the

surgeries and for using International Implants hardware. Two examples of surgeries

performed at Pacific Hospital by Dr. Obukhoff using devices from International


119. Dr. Obukhoff had agreements with CPM. Under these agreements with


pharmacy operations out of his practices in exchange for payments. CPM, with Dr.

Obukhoff's cooperation, billed large volumes of pharmaceuticals to State Fund at


earlier than 2007. He also signed bills and reports (and/or allowed Entity





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120. Dr. Obukhoff submitted fraudulent bills to State Fund through

Defendant Serge Obukhoff, MD, Professional Corporation, which is located,

according to Secretary of State records, in Santa Monica, CA.

121. Dr. Payne. Defendant Dr. David Payne is, on information and belief, a

resident of Orange County, CA. He is an orthopedic spine surgeon. Dr. Payne

performed spinal surgeries at Pacific Hospital, using hardware ordered from


Fund both by Pacific Hospital and by Dr. Payne. Dr. Payne performed these

surgeries beginning no later than 2006 and ending no earlier than 2011. Dr. Payne

received illegal kickback payments from Entity Defendants for the surgeries and for

using International Implants hardware. Two examples of surgeries performed at

Pacific Hospital by Dr. Payne using devices from International Implants, and billed

to State Fund, are included in Exhibit 2.

122. Dr. Payne had agreements with IPM. Under these agreements with

IPM, he knowingly allowed the Individual Defendants to control and operate illegal

pharmacy operations out of his practices in exchange for payments. IPM, with Dr.

Payne's cooperation, billed large volumes of pharmaceuticals to State Fund at prices

greatly in excess of actual cost beginning no later than 2008 and ending no later than

2009. Dr. Payne was paid kickbacks through his agreements with Pharmacy

Defendants for referring patients to the pharmacies, for performing surgeries at

Pacific Hospital, and for using International Implants hardware. He also signed bills

and reports (and/or allowed Entity Defendants to sign bills on his behalf), which

were submitted to State Fund, and which contained certifications, either explicit or



omissions.



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123. Dr. Payne submitted fraudulent bills through his business entity,

Defendant David H. Payne, MD, Inc., which, according to Secretary of State

Records, is located in Orange County, CA.

124. Dr. Rahman. Defendant Dr. Hamid Rahman is, on information and

belief, a resident of Riverside County, CA. On information and belief, he is an

orthopedic surgeon specializing knee, hand, and shoulder surgery. Dr. Rahman

referred spinal surgeries to Pacific Hospital, to be performed using hardware ordered


State Fund. Dr. Rahman received illegal kickback payments from Entity

Defendants for these surgeries.

125. Dr. Rahman had agreements with CPM. Under these agreements with



Dr. Rahman's cooperation, billed large volumes of pharmaceuticals to State Fund at


earlier than 2007. He also signed bills and reports (and/or allowed Entity





126. Dr. Rosen. Defendant Dr. Randy Rosen is, on information and belief,

a resident of Riverside County, CA. He is an anesthesiologist and pain management

specialist that performed many procedures at Long Beach Pain that were billed to

State Fund. Dr. Rosen also referred spinal surgeries to Pacific Hospital, to be

performed using hardware ordered from International Implants and other co-

schemers' companies, that were billed to State Fund. Dr. Rosen received kickbacks

from the Entity Defendants for referring patients to Pacific Hospital for spinal



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surgeries, including surgeries with International Implants hardware, that were billed

to State Fund, and for performing procedures at Long Beach Pain.

127. Dr. Rosen had agreements with IPM and MMG. Dr. Rosen also

prescribed medications through Haider Spine's agreement with IPM. Under these

agreements with IPM and MMG, he knowingly allowed the Individual Defendants

to control and operate illegal pharmacy operations out of his practices in exchange

for payments. IPM and MMG, with Dr. Rosen's cooperation, billed large volumes

of pharmaceuticals to State Fund at prices greatly in excess of actual cost beginning

no later than 2010 and ending no earlier than 2012. He also signed bills and reports





128. Since the filing of State Fund's original complaint, Dr. Rosen has been

indicted on charges of receiving kickbacks for prescribing compound medications in

excess of $600,000, accepting rebates for patient referrals, and filing false claims

with numerous insurers including State Fund in connection with a separate scheme

organized by Kareem Ahmed. State of California v. Charbonnet, Case No.

14ZF0334 (Cal. Sup. Ct. June 17, 2014).

129. Dr. Rosen accepted kickbacks through Defendant Mosaic Medical

Management, Inc., which based on Secretary of State Records, is located at 1600

Rosecrans Avenue, Building 7, 4th Floor, Manhattan Beach, CA 90266. Emails

produced in this case show Dr. Rosen and Liza Vismanos (who, on information and

belief, is Dr. Rosen's wife) emailing Dr. Bernadett regarding patients referred to

Drs. Moheimani and Capen and inquiring about an "independent contractor"

agreement.

130. Dr. Silva. Defendant Dr. Ismael Silva is, on information and belief, a

resident of Orange County, CA. He is an orthopedic surgeon referred spinal



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surgeries to Pacific Hospital, to be performed using hardware ordered from


Fund. Dr. Silva received illegal kickback payments from Entity Defendants for the

referrals. Dr. Silva received these kickbacks, at least in part, through an agreement

between PSPM and Defendant Starbase, Inc. ("Starbase"), which, according to

Secretary of State records, is located at 2244 Faraday Ave., Carlsbad, CA 92008.

131. Dr. Silva had agreements with CPM. Under these agreements with

CPM he knowingly allowed the Individual Defendants to control and operate illegal


Dr. Silva's cooperation, billed large volumes of pharmaceuticals to State Fund at


later than 2007. Dr. Silva was paid kickbacks through his agreements with


patients to Pacific Hospital. He also signed bills and reports (and/or allowed Entity





132. Dr. Silva operates a network of clinics under Defendant Healthpointe

Medical Group, Inc. ("Healthpointe"), which has locations throughout Southern

California. Dr. Ahmed also practiced with Dr. Silva at Healthpointe. Dr. Silva

submitted fraudulent bills to State Fund through Healthpointe.

133. Dr. Sobol. Defendant Dr. Philip Sobol is, on information and belief, a

resident of Los Angeles County, CA. On information and belief, he is an orthopedic

surgeon specializing in hand surgery. Dr. Sobol referred spinal surgeries to Pacific

Hospital, to be performed using hardware ordered from International Implants and

other co-schemers' companies, that were billed to State Fund, and referred patients



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to Long Beach Pain for surgeries that were billed to State Fund. Dr. Sobol received

illegal kickback payments from Entity Defendants for these surgeries and referrals.

134. Dr. Sobol had agreements with CPM and IPM. Under these



payments. CPM and IPM, with Dr. Sobol's cooperation, billed large volumes of


later than 2005 and ending no earlier than 2012. Dr. Sobol was paid kickbacks


pharmacies, for performing surgeries at Pacific Hospital, and for referring surgeries

to Pacific Hospital and Long Beach Pain. He also signed bills and reports (and/or





135. Dr. Sobol submitted fraudulent bills to State Fund through Defendant

Sobol Orthopedic Medical Group, Inc., which, according to Secretary of State

records, is located at 8618 S. Sepulveda Blvd., Ste. 130, Los Angeles, CA 90045.

136. Dr. Nelson. Defendant Dr. Russell Nelson is, on information and

belief, a resident of Ventura County, CA. He is an orthopedic spine surgeon.

Dr. Nelson performed spinal surgeries at Pacific Hospital that were billed to State

Fund both by Pacific Hospital and by Dr. Nelson. These surgeries were performed

beginning no later than 2003 and ending no earlier than 2007. Dr. Nelson received

illegal kickback payments from Entity Defendants for performing these surgeries at

Pacific Hospital. These kickbacks were paid through multiple agreements with the

Entity Defendants. Two examples of surgeries performed at Pacific Hospital by Dr.

Nelson, and billed to State Fund, are included in Exhibit 2.



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137. Dr. Nelson had agreements with CPM. Under these agreements with


pharmacy operations out of his practices in exchange for payments. CPM, with Dr.

Nelson's cooperation, billed large volumes of pharmaceuticals to State Fund at

prices greatly in excess of actual cost. He also signed bills and reports (and/or





138. Dr. Nelson submitted fraudulent bills to State Fund through Defendant

Nelson Spine Institute, Inc., which, according to Secretary of State records, is

located at 110 Jensen Ct., Suite 1-C, Thousand Oaks, CA 91360. Dr. Nelson also

practiced at Downey Ortho where Dr. Daniel Capen, Dr. Richard Mulvania,

Dr. John Larsen, Dr. Andrew Jarminski, and Dr. Faustino Bernadett also practiced.

139. Dr. Lokesh Tantuwaya. Defendant Dr. Lokesh Tantuwaya is, on

information and belief, a resident of San Diego County, CA. He is an orthopedic

spine surgeon. Dr. Tantuwaya performed spinal surgeries at Pacific Hospital, using

hardware ordered from International Implants and other co-schemers' companies,

that were billed to State Fund both by Pacific Hospital and by Dr. Tantuwaya.

Dr. Tantuwaya performed such surgeries beginning no later than 2010 and ending

no earlier than 2012. Dr. Tantuwaya received illegal kickback payments from

Entity Defendants for the surgeries and for using International Implants hardware.

Two examples of surgeries performed at Pacific Hospital by Dr. Tantuwaya using


Exhibit 2.

140. Dr. Tantuwaya submitted fraudulent bills to State Fund through

Defendant Lokesh S. Tantuwaya, M.D., Inc., which according to Secretary of State

records, is located at 7830 Clairmont Mesa Blvd. Ste. 203, San Diego, CA 92111.



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Dr. Tantuwaya also practiced out of Griffin with Defendant Ivar. He also signed

bills and reports (and/or allowed Entity Defendants to sign bills on his behalf),

which were submitted to State Fund, and which contained certifications, either

explicit or implicit, that the bills and reports submitted were not the product of fraud

or illegal referral and kickback fees, and/or did not contain material


141. Dr. Jacob Tauber. Defendant Dr. Jacob Tauber is, on information and

belief, a resident of Los Angeles County, CA. He is an orthopedic surgeon.

Dr. Tauber performed many non-spinal surgeries at PHLB that were billed to State

Fund. Dr. Tauber referred spinal surgeries to Pacific Hospital, to be performed

using hardware ordered from International Implants and other co-schemers'

companies, that were billed to State Fund. Dr. Tauber received kickbacks for

referring patients to Pacific Hospital for spinal surgeries, using hardware from

International Implants or another co-schemer's company, that were billed to State

Fund, and for performing non-spinal surgeries at Pacific Hospital.

142. Dr. Tauber had agreements with CPM and IPM. Under these



payments. CPM and IPM, with Dr. Tauber's cooperation, billed large volumes of


later than 2005 and ending no earlier than 2012. Dr. Tauber was paid kickbacks


pharmacies, for referring patients to Pacific Hospital, and for performing surgeries

at Pacific Hospital. He also signed bills and reports (and/or allowed Entity







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143. Dr. Tauber submitted fraudulent bills to State Fund through Defendant

Jacob E. Tauber, MD, a Professional Corporation, which is located, which,

according to Secretary of State records, is located at 9033 Wilshire Blvd., Ste. 401,

Beverly Hills, CA 90211.

144. Collectively, the medical providers named herein and their associated

medical practices and corporations are referred to as the "Provider Defendants."

E. Marketer Defendants

145. Jason Bernard. Defendant Jason Bernard is, on information and

belief, a resident of Los Angeles County, CA. He was a manager of Defendant

Progressive Orthopedic Solutions, LLC ("Progressive"), which, according to

Secretary of State records, is located in Santa Fe Springs, CA. Progressive is a

supplier of durable medical equipment and medical supplies. However, on

information and belief, Progressive also operated as a spinal implant distributor, not

unlike International Implants. Bernard, through Progressive, worked as a marketer,

referring patients to physicians for services, including spinal fusions surgeries, to be

performed at Pacific Hospital and services at LB Pain. In an email recently

produced in this litigation, Bernard sent Drobot Sr. and Dr. Bernadett two

spreadsheets, one showing "a list of 85 patients that have been identified by their

PTP [Primary Treating Physician], as strong candidates for spine surgery," and the

other showing "250+ patients that we have sent to the PSPM network of

physicians." In this same email, Bernard also stated that he "hosted and event with

Dr [sic] Larsen and several attorneys" that "went extremely well." And "[f]rom that

meeting Dr [sic] Larsen received 5 cases that same week and a few more cases the

following week." Bernard was paid kickback payments the referrals like these that

resulted in surgeries being performed at Pacific Hospital. These payments were

made to Bernard, at least in part, through a "collections" agreement whereby he was

a paid a percentage of the amount collected on surgeries he referred. Bernard

referred patients to physicians, including, but not limited to, Defendants Dr. Daniel



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Capen, Dr. John Larsen, Dr. Andrew Jarminski, Dr. Richard Mulvania, and Dr. Jack

Akmakjian.

146. Collectively, Bernard and Progressive are referred to as “Marketer

Defendants”

F. DOE Defendants

147. State Fund is unaware of the true names and capacities, whether

individual, corporate, associate or otherwise, of those defendants named herein as

DOES 1 through 10, inclusive. State Fund sues DOES 1 through 10 by fictitious

names. State Fund will seek leave to amend this complaint to show their true names

and capacities when the same have been ascertained. Said defendants are sued as

principals, and all of the acts performed by them as agents, servants or employees

were performed within the scope and course of their authority and employment.

State Fund is informed and believes, and thereon alleges, that each of the fictitiously

named defendants is responsible for the events, harm, and damages as alleged

herein.

148. State Fund is further informed and believes, and thereon alleges, that

each of the defendants was the co-conspirator of each and every other defendant

and, in performing the acts herein alleged, was acting within the scope of such

conspiracy, and that such actions were reasonably foreseeable to each of the other

co-conspirators, and/or were taken with the express or implied consent of each of

the other co-defendants.

149. The named and DOE defendants are occasionally referred to

collectively as "Defendants."

III. JURISDICTION AND VENUE

150. This Court has subject matter jurisdiction over this action pursuant to

28 U.S.C. § 1331 because it arises under 18 U.S.C. § 1961 et. seq., the Racketeering

Influenced and Corrupt Organizations Act ("RICO"). This Court has supplemental

jurisdiction over State Fund's state law claims under 28 U.S.C. § 1367(a).



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151. Venue is proper in the Central District of California under 28 U.S.C.

§ 1391, because all or almost all Defendants reside in this District, and a substantial

portion of the events or omissions giving rise to the claims herein occurred in this

District. Venue is proper in the Southern Division because, based on information

from the California Secretary of State and other sources, a majority of Defendants

reside in this Division, and Plaintiff State Fund has an office in Santa Ana.

IV. STATE FUND AND ITS CLAIMS PROCESS

152. State Fund provides workers' compensation insurance policies to

employers, under which medical treatment and compensation benefits are provided

to employees who are injured or become ill during the course of employment, or due

to employment-related injury. In California, every employer is required to carry

insurance to cover the cost of occupational injuries and illnesses. This is also true

for California offices or branches of multistate or multinational corporations,

meaning the system itself has a significant impact on interstate commerce.

153. State Fund pays medical providers for medical services provided to

covered workers, including spinal implants, other spinal surgeries, and a wide

variety of other procedures. State Fund also pays medical providers for prescription

drugs supplied to injured workers.

154. In order to receive reimbursement from State Fund for Medical

Services, providers submit a Health Insurance Claim Form or other types of bills to

State Fund. The Health Insurance Claim Form includes, among other things,

warning language that any person who knowingly files a claim containing any

misrepresentation or any false, incomplete, or misleading information may be guilty

of a criminal act punishable under law and may be subject to civil penalties.

155. State Fund does not knowingly pay for fraudulent bills, including:

(a) bills for office visits or medical services not provided; (b) bills for unnecessary

medical services; (c) bills that are the product of a provider's employment of

runners, cappers, or steerers to solicit or obtain patients for the medical provider; (d)



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bills involving illegal kickbacks; (e) bills that are "upcoded"; (f) bills that are

"unbundled"; and (g) bills that are artificially inflated. State Fund does not

knowingly reimburse unlicensed providers or entities, or those who engage in illegal

activity such as kickbacks and the corporate practice of medicine, which are

violations of the California Labor and Insurance Codes. State Fund also attempts to

adhere to all California guidelines and regulations on costs.9

156. State Fund is generally required to pay all bills within a relatively short

statutory period of time pursuant to the California Labor Code and attendant

regulations, or face large penalties, with some exceptions. As such, State Fund has a

limited ability to review each bill and corresponding claim prior to paying within the

requisite time period. The schemes described in this Amended Complaint are not

readily apparent upon the face of the bills, and Defendants have actively sought to

conceal their various schemes. This, along with the sheer volume of bills State Fund

processes on a daily basis and the fact that State Fund is the largest workers'

compensation carrier, makes detection of this fraudulent behavior extremely

difficult. While State Fund was sometimes able to detect certain instances of

overbilling or double billing, it could not catch them all; Defendants knew this and

took advantage of it, purposefully overwhelming the system to maximize their

chances of getting their fraudulently inflated bills reimbursed.

157. At all times relevant to this Second Amended Complaint, medical

providers or their representatives submitted insurance bills to State Fund manually

(on paper) through the United States mail or electronically through interstate wire.

Representative mailings and/or wire communications for each particular scheme,

broken down by entity Defendant, have been lodged with the Court. For each claim

9 Some medical procedures are governed by an Official Medical Fee Schedule ("OMFS"), pursuant to Title 8, Article 5.5, Sections 9790 et seq. of the California Code of Regulations. The OMFS was promulgated by the Administrative Director of the Division of Workers' Compensation to rein in medical costs and generally ties provider reimbursement to a multiplier of Medicare's rates for the same service.



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submitted, State Fund would send an explanation of benefits ("EOB") and/or related

correspondence to the provider via U.S. Postal Service. State Fund also reimbursed

providers by sending payment through the United States mail.

158. State Fund has paid Pacific Hospital around $125 million (see ¶ 162, n.

10) and Long Beach Pain around $7.585 million for services purportedly rendered

by Pacific Hospital and Long Beach Pain pursuant to workers' compensation

policies, not including sums paid on liens, global settlements and other payments.

This includes at least 16,490 bills for services, including spinal surgery and

implants.

159. State Fund has also paid over $60 million to the Pharmacy Defendants,

not including sums paid on liens, global settlements, and other payments. Of the

over $60 million paid to the Pharmacy Defendants, over $30 million related to

claims for injured workers who were also treated by the Surgical Defendants.

160. On information and belief, State Fund is one of the largest victims of

Defendants' unlawful behavior. State Fund has suffered millions of dollars in

damage as a result of the payments it has made to the Surgical Defendants,

Pharmacy Defendants, Provider Defendants, and their coconspirators for these

procedures, medical services, and prescriptions. State Fund would not have paid

Defendants or their coconspirators had it known of their unlawful and fraudulent

misconduct.

161. State Fund is informed and believes, and thereon alleges, that the

Defendants engaged in the following schemes to defraud, broken out by Defendant,

particular scheme, and particular examples of each such scheme. This information

is based on discovery in this litigation, the Plea Agreement, and State Fund's review

of bills and internal reports, which was prompted by the reported service of federal

warrants on Pacific Hospital's and IPM's offices in April 2013 (Section VII below,

"State Fund Uncovers Defendants' Well-Concealed Fraud").



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V. FRAUDULENT SCHEMES BY THE SURGICAL DEFENDANT

ENTERPRISE

A. Fraudulent Scheme re: Spinal Implants/Surgeries (All Defendants)

162. From 1998 to the present, State Fund has received thousands of bills

and claims relating to spinal surgery from Pacific Hospital. Many of these surgeries

were performed, and were also billed, by Dr. Daniel Capen, Dr. John Larsen,

Dr. Khalid Ahmed, Dr. Jack Akmakjian, Dr. Gerald Alexander, Dr. Ian Armstrong,

Dr. Mitchell Cohen, Dr. Thomas Haider, Dr. Israel Chambi, Dr. Catalino Dureza,

Dr. Andrew Jarminski (as an assistant surgeon), Dr. Assad Moheimani, Dr. Richard

Mulvania, Dr. Serge Obukhoff, Dr. David Payne, Dr. Russell Nelson, and

Dr. Lokesh Tantuwaya (collectively "Implant Provider Defendants"). The spinal

implant/surgery claims that Pacific Hospital and the Implant Provider Defendants

submitted to State Fund were fraudulent.10

163. Before January 1, 2013, providers were entitled to reimbursement

provided under the Official Medical Fee Schedule for the cost of spinal implants.

Because the reimbursement amount depends on how much the provider paid for the

implant, Pacific Hospital and Drobot Sr. sought to defraud State Fund by

establishing shell entities, and holding them out as manufacturers of spinal implants,

according to the Plea Agreement. The Implant Provider Defendants, Drobot Sr., and

Pacific Hospital then arranged to acquire spinal hardware from the shell entities or a

"co-schemer's company" at fraudulently excessive costs under the names of the

Implant Provider Defendants. These Defendants knew the fraudulent invoices did

not reflect the actual or reasonable cost of the implants, which was significantly

lower.

10 State Fund reserves the right to amend its Third Amended Complaint to add additional claims and increased damages if material is uncovered in discovery or through expert analysis. State Fund continues to investigate, for example, the approximately $125 million in payments to Pacific Hospital as well as payments made to the Pharmacy Defendants and related entities.



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164. In or around August of 2007, Drobot Sr. formed International Implants.

Pacific Hospital, Drobot Sr., and International Implants represented International

Implants as a manufacturer of spinal implants. Such a manufacturer must be

registered with the United States Food and Drug Administration ("FDA"). In fact,

many of the International Implants invoices submitted to State Fund included the

legend that it was an "FDA registered manufacturer." See Plea Agreement at 17.

However, State Fund, pursuant to its investigation, discovered that the FDA lists

International Implants as a "repackager," not a manufacturer.

165. This scheme centers on inflating the prices of implants used in spinal

surgery. Physicians performing surgeries at Pacific Hospital would "order" implants

from an implant repackager, including International Implants. The repackager

would purchase the implants from a manufacturer of implants like Seaspine, Inc.,

Alphatec Spine, Inc., and US Spine, Inc., and then would "sell" the implants to

Pacific Hospital at a grossly inflated price. Pacific Hospital would then typically

double the price of the "documented" cost from International Implants and often

added an additional charge. Pacific Hospital then would bill State Fund the grossly

inflated prices. A kickback is paid to the Provider Defendant or Marketer Defendant

who referred and/or performed the surgery at Pacific Hospital using the implants

from International Implants or another coconspirator company under the guise of an

unrelated contractual agreement.

166. These charges are fraudulent because Pacific Hospital actually pays

only a small percentage of the prices reflected on the invoices or purchase orders

submitted to State Fund, in addition to being illegal because of the kickbacks

provided.

167. To create the illusion that Pacific Hospital actually paid the grossly

inflated prices, International Implants, for example, transmitted to Pacific Hospital

invoices listing the fraudulent prices. Pacific Hospital then sent these invoices or

purchase orders reflecting the same fraudulent prices to State Fund, representing that



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it had paid the false wholesale invoice or purchase order amounts. In reality, the

price on the invoice and purchase order is not the actual and reasonable cost of the

implant, but is grossly inflated.

168. Pacific Hospital also sent claims forms and progress reports to State

Fund with certifications as to the propriety of the bills and underlying procedures.

The medical providers who signed these forms, or allowed them to be electronically

signed and submitted on their behalf, signed subject to the various certifications,

knowing that they were false or recklessly without knowledge of their truth or

falsity.

169. By engineering and participating in these sham transactions, the

Implant Provider Defendants, the referring Provider Defendants, the Marketer

Defendants, Pacific Hospital, and the Individual Defendants reaped substantial

profit from the scheme, as described in more detail below.

170. The involved Defendants misrepresented that: (a) the costs Pacific

Hospital purportedly incurred in purchasing implants from International Implants or

another coconspirator entity were the actual and reasonable cost of the implants,

when in fact the prices reflected on the invoices were much greater than the prices

actually paid to manufacturers; (b) the supplies were ordered by a physician based

on medical necessity and the independent medical judgment of the physician, when

in fact the involved Defendants and their coconspirators were influencing the

medical decisions of physicians, including the Provider Defendants, by providing

them with kickbacks and controlling their medical operations through fraudulent

management contracts; and (c) Pacific Hospital and International Implants (or

another co-schemer company) were independent companies conducting bona fide

business transactions, when in fact the Drobot Sr. owned and/or controlled both

Pacific Hospital and International Implants.

171. These Defendants each knew or believed that these statements were

false and/or misleading. They made the false and/or misleading statements and



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certifications to induce State Fund and others to overpay for the medical services

and supplies provided.

172. Defendants made use of the United States mail and interstate wires in

furtherance of their scheme, by sending the bills and supporting documentation to

State Fund through the United States mail or interstate wires. They also collected

their checks from State Fund via the U.S. Postal Service.

173. As an example, Exhibit 1.A contains documents from Pacific Hospital

and International Implants, sent to State Fund, to commit precisely this type of fraud

on State Fund on or shortly after September 2, 2011.

a. On or shortly after September 2, 2011, Pacific Hospital

submitted a bill to State Fund (Claim #SP401079) via the U.S. Postal Service for,

among other things, spinal implants. Pacific Hospital billed the spinal implants and

related hardware at $161,952.00, which Pacific Hospital and other Defendants knew

misrepresented the amount of reimbursement to which Pacific Hospital was entitled.

State Fund was also provided, via the U.S. Postal Service, with two invoices from

International Implants purportedly showing the prices paid by Pacific Hospital for

these items. The invoices listed prices for spinal implant hardware several times

higher than the prices Pacific Hospital actually paid. Pacific Hospital purchase

orders were also submitted with the bills. The purchase orders listed the same items

and the same prices as the International Implants invoices.

b. Both invoices from International Implants represent that

"International Implants is an FDA Registered Manufacturer." One of the invoices,

dated August 15, 2011, shows the following supplies were purchased from

International Implants, along with the fraudulent prices Pacific Hospital purportedly

paid:



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Qty Product ID Description I.I. Price Each Total

1 64715-106 Novel XS-Peek 5 Degrees

Medium Spacer 14mm x 12mm x

5mm

$4,000.00 $4,000.00

1 64713-106 8-5, Novel XS Peek 5mm $4,000.00 $4,000.00

1 64713-105 8-5, Novel XS Peek 6mm $4,000.00 $4,000.00

1 64713-107 8-5, Novel XS Peek 7mm $4,000.00 $4,000.00

1 61001-014 Anterior Cervical Plate LVL 1,

Assy, 14mm, TI

$3,385.00 $3,385.00

1 61003-054 Anterior Cervical Plate Level 3

Assembly, 54mm

$4,407.00 $4,407.00

9 61340-014 4.0mm Variable Angle Self-

Tapping Screw 14mm

$692.00 $6,228.00

3 61345-014 4.5mm Variable Angle Self-

Tapping Screw 14mm, TI

$786.00 $2,368.00

2 64715-105 M-5, Novel XS-Peek 5mm $4,000.00 $8,000.00

c. Pacific Hospital represented the prices above as the actual cost of

the implants and other hardware, but the prices actually paid for these items, based

on the Distribution Agreement between Alphatec and International Implants (see

Exhibit 1.B), show they were not:

Qty Product ID

Description I.I. Price Alphatec Price

Spread % Markup

1 64715-106 Novel XS-Peek 5

Degrees Medium

$4,000.00 $875.00 $3,125.00 357%



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Spacer 14mm x 12mm

x 5mm

1 64713-106 8-5, Novel XS Peek

5mm

$4,000.00 $875.00 $3,125.00 357%

1 64713-105 8-5, Novel XS Peek

6mm

$4,000.00 $875.00 $3,125.00 357%

1 64713-107 8-5, Novel XS Peek

7mm

$4,000.00 $875.00 $3,125.00 357%

1 61001-014 Anterior Cervical Plate

LVL 1, Assy, 14mm,

TI

$3,385.00 $873.00 $2,512.00 288%

1 61003-054 Anterior Cervical Plate

Level 3 Assembly,

54mm

$4,407.00 $1,136.00 $3,271.00 288%

9 61340-014 4.0mm Variable Angle

Self-Tapping Screw

14mm

$692.00 $178.00 $514.00 289%

3 61345-014 4.5mm Variable Angle

Self-Tapping Screw

14mm, TI

$786.00 $202.00 $584.00 289%

2 64715-105 M-5, Novel XS-Peek

5mm

$4,000.00 $875.00 $3,125.00 357%

d. For each of these items, International Implants listed a price on

its invoices that far exceeded what it paid Alphatec—which in these examples

represented the actual cost of the implants and other hardware. On the first invoice,

International Implants—and thus, Pacific Hospital—actually paid $9,467.00 for the

implants and hardware, not the $40,378.00 represented on the invoice submitted to

State Fund. Similarly, the second invoice from International Implants that was



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submitted to State Fund, dated August 16, 2011, purports to charge Pacific Hospital

$33,621 for implants and hardware that actually cost Pacific Hospital $8,838.

e. When the items listed on the two invoices from International

Implants are priced using the Alphatec Distribution Agreement, the total comes to

$18,305. In other words, under the Alphatec Distribution Agreement, Pacific

Hospital effectively paid only $18,305 for the items listed on the two invoices from

International Implants, yet billed State Fund around $148,148.00 for the same

items—more than eight times the amount it paid. State Fund paid approximately

$110,000 for the implants listed on the invoices from International Implants, which

is over six times the actual cost.

f. State Fund paid at least $202,660 in total on bills from Pacific

Hospital relating to the spinal surgery procedure under this claim, relying on

certifications that the bill was not the product of an illegal kickback or other

fraudulent activity in addition to the fraudulent purchase orders and invoices

submitted by Pacific Hospital.

174. As another example, Exhibit 1.C contains documents from Pacific

Hospital and International Implants, sent to State Fund, to commit precisely this

type of fraud on or shortly after March 30, 2010.

a. On or shortly after March 30, 2010, Pacific Hospital submitted a

bill to State Fund (Claim #01067019) via the U.S. Postal Service for, among other

things, spinal implants. Pacific Hospital billed the spinal implants and related

hardware at $90,282.00, which Pacific Hospital and other Defendants knew


State Fund was also provided, via the U.S. Postal Service, with a Pacific Hospital

purchase order and International Implant invoice purportedly showing the prices

paid by Pacific Hospital for these items. The purchase order listed prices for spinal

implants and hardware several times higher than the prices Pacific Hospital actually

paid.



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b. The purchase order lists the following supplies from

International Implants, along with the fraudulent prices Pacific Hospital supposedly

paid: Qty Product ID Description I.I. Price Each Total

4 62065-45 6.5 x 45 Poly Implant Screw $2,364.00 $9,456.00

2 62075-40 7.5 x 40 Poly Implant $2,364.00 $4,728.00

2 64815-012 12mm SD Peek $6,009.00 $12,018.00

2 64815-014 9 x 25 x 14 SD Med Peek $6,009.00 $12,018.00

6 22015 Set Screw $396.00 $2,376.00

2 62004-07 70mm Rod Curved $868.00 $,1,736.00

1 11-2053 Medium Cross Link $2,734.00 $2,734.00


the implants and other hardware, but the prices actually paid for these items, based

on the Distribution Agreement between Alphatec and International Implants

(Exhibit 1.B) show they were not: Product ID Description I.I. Price Alphatec

Price Spread %

Markup

62065-45 6.5 x 45 Poly Implant Screw

$2,364.00 $712.50 $1,651.50 232%

62075-40 7.5 x 40 Poly Implant $2,364.00 $712.50 $1,651.50 232%

64815-012 12mm SD Peek $6,009.00 $1,250.00 $4,759.00 381%

64815-014 9 x 25 x 14 SD Med Peek

$6,009.00 $1,250.00 $4,759.00 381%

22015 Set Screw $396.00 $95.00 $301.00 317%

62004-07 70mm Rod Curved $868.00 $142.50 $725.50 509%

11-2053 Medium Cross Link $2,734.00 $775.00 $1,959.00 252%



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d. For each of these items, International Implants listed a price that

far exceeded what it paid Alphatec—which in these examples represented the actual

cost of the implants and other hardware.

e. Pacific Hospital billed State Fund $90,282.00 for the items on

the March 30, 2010 purchase order. When the items on the Pacific Hospital

purchase order are priced using Alphatec Distribution Agreement, the total comes to

$10,905.00. In other words, under the Alphatec Distribution Agreement, Pacific

Hospital effectively paid only $10,905.00 for the items listed on the Pacific Hospital

purchase order, yet billed State Fund $90,282.00 for the same items, more than eight

times the amount it paid. State Fund paid around $51,395.94 for the implants listed

on the purchase order from International Implants, over four times the actual cost of

those implants.




fraudulent activity in addition to the fraudulent invoices and purchases orders

submitted by Pacific Hospital. Another $13,250 was paid directly to the surgeon

that billed on this claim, Defendant Dr. Daniel Capen.

175. As another example, Exhibit 1.D contains documents from Pacific

Hospital and International Implants, to commit precisely this type of fraud on State

Fund on or shortly after March 17, 2009.

a. On or shortly after March 17, 2009, Pacific Hospital submitted a

bill to State Fund (Claim #01048725) via the U.S. Postal Service for, among other

things, spinal implants. Pacific Hospital billed the spinal implants and related

hardware at $83,980.00, which Pacific Hospital and other Defendants knew


State Fund was also provided, via the U.S. Postal Service, with a Pacific Hospital

purchase order, and other supporting documents from International Implants,



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purportedly showing the prices paid by Pacific Hospital for these items. The

purchase order lists prices for spinal implants and hardware several times higher

than the prices Pacific Hospital actually paid.

b. The purchase order lists the following supplies from

International Implants, along with the fraudulent prices Pacific Hospital purportedly

paid: Qty Product ID Description I.I. Price Each Total

2 62004-06 80mm Rod Precontoured $789.00 $1578.00

6 22015 Set Screw $360.00 $2,160.00

3 62055-45 5.5 x 45 Multi Screw $2,149.00 $6,447.00

1 62055-40 5.5 x 40 Implant Screw $2,149.00 $2,149.00

2 62065-40 6.5 x 40 Poly Implant Screw $2,149.00 $4,298.00

1 11-2053 Medium Cross Link $2,485.00 $2,485.00

4 64113-110 10 xx 20 x 10 LCC Peek Cage $5,485.00 $21,940.00


the implants, but the prices actually paid for these items, based on the Distribution

Agreement between Alphatec and International Implants (Exhibit 1.B), show they

were not: Product

ID Description I.I. Price Alphatec

Price Spread %

Markup 62004-06 80mm Rod Precontoured $789.00 $118.75 $670.25 564%

22015 Set Screw $360.00 $95.00 $265.00 279%

62055-45 5.5 x 45 Multi Screw $2,149.00 $712.50 $1,436.50 202%

62055-40 5.5 x 40 Implant Screw $2,149.00 $712.50 $1,436.50 202%

62065-40 6.5 x 40 Poly Implant

Screw

$2,149.00 $712.50 $1,436.50 202%

11-2053 Medium Cross Link $2,485.00 $775.00 $1,710.00 221%



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64113-110 10 xx 20 x 10 LCC Peek

Cage

$5,485.00 $1,704.00 $3,781.00 222%

d. For each of these items, Pacific Hospital listed a price that far

exceeded what it paid Alphatec—which in these examples represented the actual

cost of the implants.

e. Defendants billed State fund $83,980.00 for the items supplied

on the April 23, 2009 purchase order. When the items on that purchase order are

priced using the Alphatec Distribution Agreement, the total comes to $11,195.00. In

other words, Pacific Hospital effectively paid $11,195.00 for these items, yet billed

State Fund $83,980.00—more than seven times what it paid. State Fund paid

around $41,290.00 for the implants from International Implants, which is over three

times the actual cost.




fraudulent activity in addition to the fraudulent invoices and purchase orders

submitted by Pacific Hospital. Another $16,018 was paid directly to the surgeon

that billed on this claim, Defendant Dr. Richard Mulvania.

176. Defendants created, provided, and/or facilitated the provision of such

fraudulent invoices and purchase orders to State Fund when Pacific Hospital billed

State Fund for spinal implants and related hardware, including, but not limited to,

the bills listed in the document titled "Pacific Hospital – Spinal Hardware," lodged

with the Court, in order to induce State Fund to overpay for spinal implants. These

Defendants caused the fraudulent invoices and purchase orders to be mailed and

wired to State Fund. State Fund reasonably relied on the misrepresentations in these

fraudulent bills and on the misrepresentations in invoices and purchase orders in

issuing payment on the bills. As these Defendants expected, payment was delivered

via the U.S. Postal Service.



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177. Based on State Fund's bill review, International Implants provided

around 75% of the spinal implants that Pacific Hospital billed to State Fund since

International Implants' formation in 2007. As Defendants knew and intended,

International Implants fraudulently listed excessive prices for its spinal implants and

related equipment. State Fund relied on Defendants' claims and invoices.

178. As described below, Pacific Hospital paid, or caused to be paid through

the Entity Defendants or other related entities, fees to physicians and others,

including the Provider Defendants and the Marketer Defendants, for referring

patients to Pacific Hospital and certain affiliates and for ordering and using

International Implants hardware in performing those surgeries. Such referral fees

are illegal under California and federal law, as admitted and established in the Plea

Agreement. Once referred, the hardware could be overbilled in the manner set forth

above.

179. Pacific Hospital paid, or caused to be paid through the Entity

Defendants or other related entities, the illegal referral fees with proceeds from the

fraudulently excessive spinal implant and other fees it charged insurers, including

State Fund. These payments were made to medical providers and others, including

the Provider Defendants and Marketer Defendants, via fraudulent and illegal

contracts, including so-called management agreements, consulting agreements,

rental agreements, option agreements, collection agreements, rental agreements,

option agreements, collection agreements, research and development agreements,

marketing agreements, and pharmacy management agreements. This illegal scheme

allowed Pacific Hospital to acquire additional patients, while further defrauding

State Fund.

180. As described further below, the Individual Defendants were responsible

for devising the fraudulent scheme, and received and controlled profits from it.

State Fund is informed and believes, and thereon alleges that the Individual

Defendants conducted periodic meetings with medical professionals, staff, and other



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employees in order to give direction and oversee the scheme. Drobot Sr. was,

according to California Secretary of State records, Chief Executive Officer and a

director of Healthsmart d/b/a Pacific Hospital. Drobot Sr. admitted in the Plea

Agreement that he owns International Implants. Additionally, International

Implants is located at the same office as the Pharmacy and the Administrative

Defendants. Abrazos Healthcare, Inc., alleged as Pacific Hospital's parent

corporation, and Mickey Medical, Inc., also share the same office address and have

Drobot Sr. as the principal, according to California Secretary of State records.

Moreover, documents produced by third parties show that Drobot Jr. not only sent

providers spinal surgery patient referrals, requesting that they be performed at

Pacific Hospital, but he also facilitated the payment of illegal kickbacks to providers

for those surgeries, under the guise of, for example, rent payments.

181. With the exception of Dr. Bernadett (who is not a spinal surgeon), the

Individual and Entity Defendants have never been licensed medical providers.

Thus, the Individual and Entity Defendants had to conspire with licensed physicians,

including the Provider Defendants, to perform the surgeries and to generate the

fraudulent claims and bills using the providers' names and signatures in order to

fraudulently induce State Fund into paying them. Without the participation of the

providers, the other Defendants would not have been able to execute their fraudulent

schemes.

B. Billing State Fund for Treatments and Services That Were the

Product of Illegal Kickbacks and Referral Fees (All Defendants)

182. As admitted in the Plea Agreement, Defendants conspired with dozens

of doctors, chiropractors, marketers and others to pay kickbacks in return for those

persons to refer thousands of patients to Pacific Hospital for spinal surgeries and

other medical services including "other types of surgeries, magnetic resonance

imaging, toxicology, durable medical equipment, and other services," and/or in

exchange for the medical providers agreeing to use certain equipment or devices,



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including devices from International Implants or a co-schemer's company. The

individuals and entities that were paid these kickbacks included the Provider

Defendants and the Marketer Defendants.

183. To facilitate and conceal the payment of these kickbacks, Pacific

Hospital—often through the various Entity Defendants or other related entities—

entered into fraudulent contracts with providers and others, including the Provider

Defendants and the Marketer Defendants, under the guise of management

agreements, consulting agreements, rental agreements, option agreements, collection

agreements, research and development agreements, and marketing agreements.

184. These fraudulent contracts also allowed the Defendants to control or

influence the medical decisions of the providers, including the Provider Defendants,

resulting in bills generated by providers that were driven by financial considerations

rather than the needs of the patients.

185. California Bus. & Prof. Code § 650(a) forbids this specific conduct in

prohibiting "the offer, delivery, receipt, or acceptance" by or to any licensed medical

provider or chiropractor "of any rebate, refund, commission, preference, patronage

dividend, discount, or other consideration, whether in the form of money or

otherwise, as compensation or inducement for referring patients, clients, or

customers to any person." Moreover, California Bus. & Prof. Code §§ 652

and 652.5 provide that violations of the article constitute misdemeanors as to any

and all persons, whether or not licensed. California Insurance Code §§ 750 and 754

similarly prohibit offering or paying referral fees for services or goods for which

reimbursement will or may be made by an insurer.

186. Many of the bills and various reports submitted to State Fund for

services, including reports by the Provider Defendants, contained representations

that the provider had "not offered, delivered, received or accepted any rebate,

refund, commission, preference, patronage, dividend, discount or other

consideration, whether in the form of money or otherwise, as compensation or



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inducement for any referred examination or evaluation" or words to similar effect,

or that the bills and/or reports contained no material misrepresentations or

omissions. Provider Defendants knew and intended that these representations were

false, and knew that State Fund would not have paid for goods or services rendered

absent such misrepresentations.

187. Two of the "Overt Acts" that Drobot Sr. admitted to in the Plea

Agreement specifically involve Pacific Hospital submitting a fraudulent bill to State

Fund. Drobot Sr. admitted that, "[o]n or about November 10, 2009, defendant

caused a check in the amount of $43,650.00 from SCIF to be sent by mail to Pacific

Hospital in reimbursement for a claim for spine surgery on patient J.M. performed

by doctor C.D., which claim was induced by the payment of a kickback to J.C."

Plea Agreement at 19. State Fund paid at least $89,624.99 on the fraudulent bills

relating to this surgery. The "C.D." referred to in the plea agreement is Defendant

Dr. Catalino Dureza. "J.C." is Defendant Jeffrey Catanzarite, D.C.

188. Drobot Sr. also admitted that "[o]n or about April 14, 2010, [he]

caused a check in the amount of $90,467.80 from SCIF to be sent by mail to Pacific

Hospital in reimbursement for a claim for spine surgery on patient L.T. performed

by doctor M.C., which claim was induced by the payment of a kickback to P.S."

Plea Agreement at 20. State Fund paid at least $141,532.80 on the fraudulent bills

relating to this surgery. The "M.C." referred to in the plea agreement is Defendant

Dr. Mitchell Cohen. "P.S." is Defendant Dr. Philip Sobol.

189. Pacific Hospital, PSPM, FMM, CPM, IPM, and MMG (detailed further

below), among other Drobot-related entities, entered into various contractual

agreements with medical providers and medical groups and other individuals,

including Provider Defendants and Marketer Defendants. These contractual

agreements included rental agreements, management agreements, option

agreements, consulting agreements, lending agreements, and pharmaceutical

dispensing agreements. As Drobot Sr. admitted in the Plea Agreement, through



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these agreements Defendants remitted referral fees to medical providers and groups

under the guise of contracts for legitimate services.

190. For example, Drobot Sr., through PSPM, entered into an "Option

Agreement" with Dr. Serge Obukhoff on or around March 15, 2010. The Option

Agreement purports to grant PSPM the exclusive right or "option" to purchase the

unspecified assets of Dr. Obukhoff's orthopedic medical practice. Pursuant to the

agreement, PSPM was to make monthly payments to the surgeon of $50,000 in

"readily accessible cash" as purported consideration for the grant of the option. It

was contemplated that PSPM would make, in the aggregate, payments equal to

$10,000,000 for the "Option," "taking into account the Option Payments previously

made to [the surgeon]."

191. On information and belief, payments contemplated by this agreement

were not really "Option Payments" but illegal kickbacks to be paid to the surgeon

for performing spinal implant surgeries at Pacific Hospital using devices from

International Implants or another coschemer's company and/or for the referral of

patients to the Surgical or Pharmacy Defendants. Drobot Sr. admitted in the Plea

Agreement that he paid a kickback to an individual in connection with a spinal

surgery performed by that individual on at least one occasion. Plea Agreement at

21. In fact, according to payment records produced by Dr. Obukhoff, PSPM paid

such kickbacks on numerous occasions, paying Dr. Obukhoff at least $2,307,500 in

purported "Option Payments" between April 10, 2010 and March 18, 2013. When

asked at his deposition whether he or Pacific Hospital paid kickbacks through

purported option agreements, Drobot Sr. invoked the Fifth Amendment.

192. Furthermore, as alleged in paragraphs 170, 178-180, supra, Drobot Jr.

sent spinal surgery patient cases to providers, requesting that the surgeries be

performed at Pacific Hospital, and facilitated the payment of the kickbacks for

referrals of patients to Pacific Hospital. Medical providers, including Provider



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Defendants, also received kickbacks for referrals of patients to Pacific Hospital

through CPM and IPM.

193. The Plea Agreement further establishes that this scheme, as well as the

scheme in the previous subsection, has operated to defraud State Fund since 1998

through at least 2013.

C. Fraudulent Scheme to Overbill Services By Unbundling/Upcoding,

Including Unbundling and Overbilling re: Toxicology Screening

(Pacific Hospital, Long Beach Pain, and Drobot Sr.)

194. The Surgical Defendants generated substantial bills by "upcoding"

claims and billing double or triple the approved rate for services. The Surgical

Defendants represented that higher and more complex services were provided than

actually were and represented that codes with higher billing rates were justified,

when, in fact, they were not. Both Pacific Hospital and Long Beach Pain overbilled

their services through upcoding.

195. The Surgical Defendants have also repeatedly submitted bills to State

Fund with "unbundled" services. A surgical procedure's rate often "bundles"

elements such as surgical gloves, trays, and other equipment, including them in the

procedure's cost. The Surgical Defendants billed for the surgical procedure while

also billing State Fund for the individual elements or pieces of equipment involved

in performing the procedure. This practice amounts to double-billing on the

bundled elements, and it substantially increases the billed amounts.

196. By providing upcoded and unbundled bills to State Fund (through the

United States mail and interstate wires, as described above), the Surgical Defendants

provided State Fund with fraudulent bills, purportedly signed or reviewed by

medical providers. Defendants knew the upcoded and unbundled charges did not

reflect the actual or reasonable cost of the services. By submitting upcoded and

unbundled bills, Defendants represented that the services they rendered justified a

higher billing than was appropriate.



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197. When State Fund receives a bill that is upcoded, unbundled, or

overbilled, State Fund generally pays the approved rates for that procedure and

indicates to the billing provider that if it disagrees with the amount of the payment,

to send additional documentation showing that the services rendered were above and

beyond what is normally provided for the particular treatment (upon which the rates

are based). Despite such requests, the Surgical Defendants typically did not (and do

not) submit any additional documentation to justify the excess billing. Instead,

Surgical Defendants routinely filed liens against State Fund with the Workers'

Compensation Appeals Board ("WCAB") and then sought (and continue to seek) to

collect for the balance of the amount billed ("Liens").11

198. Lodged with the Court is a spreadsheet documenting hundreds of

instances where Pacific Hospital engaged in unbundling and upcoding for individual

services (titled "Pacific Hospital – Unbundling and Upcoding"). The spreadsheet

contains the claim number, the document mailed or wired, the approximate date it

was sent, the billed amount, and an explanation of the issue.

199. Also lodged with the Court is a spreadsheet documenting hundreds of

instances where Long Beach Pain engaged in unbundling and upcoding for

individual services (titled "Long Beach Pain – Unbundling and Upcoding"). The

spreadsheet contains the claim number, the document mailed or wired, the

approximate date it was sent, the billed amount, and an explanation of the issue.

11 State Fund does not assert that the procedure of filing Liens before the WCAB constitutes independently actionable fraud – the fraud is the attempt to collect more for services than the authorized rate. However, the lien process helps to conceal the fraud and puts additional pressure on State Fund to settle such claims quickly, whether or not a proper investigation can take place. Accordingly, State Fund asserts the remedy of rescission of certain settlements for fraudulent claims involving Liens, or damages if rescission is not available. Plainly, if the Lien represents an attempt to collect on an illegal bill, such as one representing a transaction involving an illegal kickback, referral, or false certification, the act of filing a lien does not cleanse the prior fraud.



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200. As a particular and discrete example, Pacific Hospital practiced

unbundling and upcoding in its bills for urine toxicology services, allegedly

rendered at the request of doctors treating workers' compensation patients.

201. In these bills, Pacific Hospital billed State Fund using a batch of CPT

codes, including those for a urine drug screen (80101), chromatography (82541),

creatinine (82570), molecular diagnostic tests (83896), and opiates (83925). State

Fund has identified four separate issues with respect to these bills for toxicology

testing, which resemble and relate to many of the other schemes alleged in this

Amended Complaint.

202. First, CPT code 80101 has been out of usage since January 1, 2011,

according to Medicare regulations, but Pacific Hospital continued to use it

throughout 2012.

203. Second, these toxicology tests – allegedly ordered to monitor usage of

prescribed opiates – are performed using simple "dipstick" cups, similar to over-the-

counter pregnancy tests which show immediate results on the cup. The non-defunct

CPT codes listed above are reserved for "confirmatory" testing, which is more

complicated and intensive and usually performed in a laboratory. Pacific Hospital,

nevertheless, uses these codes to bill State Fund each time it administers a simple

toxicology test—an example of upcoding.

204. Third, confirmatory testing for opiates would include the other tests for

creatinine, chromatography, and molecular diagnostic tests. By unbundling these

tests from the opiate test, Pacific Hospital charged more for the test than

contemplated by the bundle.

205. Fourth, starting in or around May 2012, Pacific Hospital ceased billing

for toxicology directly, apparently in order to submit claim amounts higher than

Pacific Hospital's contracts allowed. Pacific Hospital has occasionally agreed, via

contracts with networks and insurers, to fee schedules for certain services, including

its toxicology reports. Beginning in May 2012, State Fund began receiving bills



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from UDT Solutions, discussed above, which was not a party to these contracts.

According to UDT Solution's website, the president of UDT Solutions was Jennifer

Ensminger, the daughter of Drobot Sr., who was also listed by various sources as the

Chief Executive Officer of Pacific Hospital. According to its website's contact

page, UDT Solutions shared a physical address with Pacific Hospital (2776 Pacific

Avenue). State Fund received toxicology bills from UDT Solutions even though the

bills state that the testing was performed at Pacific Hospital. Accordingly, Pacific

Hospital was attempting to avoid its lower contract rates for the toxicology bills,

resulting in inflated bills and payments. By passing its upcoded and unbundled bills

for toxicology services through UDT Solutions without informing State Fund,

Pacific Hospital inflated further the amounts it billed State Fund.

206. Through this toxicology scheme, Pacific Hospital, acting by itself or

through UDT Solutions or other Drobot entities, has billed and received payments in

(at least) the hundreds of thousands of dollars. Lodged with the Court is a

spreadsheet containing sixty particular examples of the toxicology scheme just

described (titled "Pacific Hospital – Toxicology Overbilling"). This spreadsheet

lists upcoded and unbundled bills for toxicology services, with claim numbers,

approximate dates of service, the provider, and other details, including which entity

sent each bill. It includes thirty representative examples of unbundled and upcoded

bills sent to State Fund by Pacific Hospital and another thirty sent by UDT

Solutions. These Defendants concocted this scheme to mislead State Fund into

paying inflated prices for these tests; State Fund reasonably relied on these

misrepresentations in making payments.

207. On information and belief, the involved Defendants were responsible




employees in order to give direction and oversee the scheme. Drobot Sr. is,



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according to California Secretary of State records, Chief Executive Officer and a

director of Healthsmart d/b/a Pacific Hospital as well as Long Beach Pain. As

documented above, Drobot Sr. and Drobot Jr. have worked together in numerous

business ventures, sharing control and personnel through management contracts.

D. Fraudulent Scheme re: Nurse Billing (Pacific Hospital and Drobot

Sr.)

208. At Pacific Hospital, a Registered Nurse First Assistant ("RNFA") was

provided during most surgeries. Based on State Fund's review, Pacific Hospital had

a pattern and practice of billing RNFAs as "assistant surgeons," allowing it to

double-bill the services provided by its RNFAs. This is a particular example of

"unbundling," where State Fund is charged for the "bundle" and then again for the

separated service.

209. California's OMFS, which is modeled on the federal Medicare system,

already accounts for services performed by RNFAs in setting reimbursement rates

for inpatient medical services. 8 CCR § 9798.22(b) provides that the "maximum

payment for inpatient medical services includes reimbursement for all of the

inpatient operating costs specified in Title 42, Code of Federal Regulations, Section

412.2(c)." 42 CFR § 412(c) in turn provides that inpatient operating costs include

"routine nursing services." 42 CFR § 413.53(b) defines "routine services" to mean

"the regular room, dietary, and nursing services … and the use of equipment and

facilities for which a separate charge is not customarily made."

210. California law does not allow providers to seek separate reimbursement

for inpatient medical services rendered by an RNFA: "Except for physician services,

all fees shall be in accordance with the fee-related structure and rules of the relevant

Medicare and Medi-Cal payment systems . . . ." Cal. Lab. Code § 5307.1.

211. As one example of this type of fraud, on or shortly after November 17,

2010, Pacific Hospital sent State Fund claim number 05597226 (date of surgery

November 12, 2010), which included a bill of $11,000.00 for the services of an



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RNFA, who was listed in the surgical report as an assistant surgeon, even while the

report recorded that the individual's proper position was an RNFA.

212. Lodged with the Court is a spreadsheet (titled "Pacific Hospital –

RNFA Billing") with thirty examples of an RNFA—whose services are supposed to

be included within the bundled charge for the procedure—billed separately from

Pacific Hospital while still using Pacific Hospital's tax identification number. In

each bill, Pacific Hospital misrepresented that it was entitled to payment for

purported services rendered by an RNFA when such cost, under the OMFS, was

included in the bundled rate for the procedure. Defendants made the false and

misleading statements to induce State Fund to overpay for the medical procedures

purportedly provided.

213. These Defendants thus misrepresented the services provided and their

right to collect these additional payments, in addition to reimbursement for inpatient

medical services, for the services of an RNFA. They made these misrepresentations

in furtherance of their scheme to double-bill and overbill State Fund for the services

of an RNFA. State Fund reasonably relied on the misrepresentations in Pacific

Hospital's bills in issuing payment on the admission and RNFA bills. As these

Defendants expected, payment was delivered via the U.S. Postal Service.

214. On information and belief, Drobot Sr. was responsible for devising the

fraudulent scheme, and received and controlled profits from it. State Fund is

informed and believes, and thereon alleges that Drobot Sr. gave direction and

oversaw the fraudulent overbilling schemes, given his control of Pacific Hospital

and related entities as specified above.

E. Fraudulent Scheme re: Autologous Transfusion Billing (Pacific

Hospital and Drobot Sr.)

215. During some surgeries, autologous blood transfusion technologies are

used to save the patient's blood. The machines (one brand of which goes by the

name "Cellsaver") are often provided by a third party during surgeries. The use of



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this technology is, according to the standard procedures (including Medicare

procedures), bundled as a part of inpatient admission.

216. Pacific Hospital, however, engaged in an apparent practice of not

paying the third-party provider (often Cardiovascular Plus). This most often led to

the third-party provider billing the cost directly to State Fund, effectively

unbundling this particular charge that should have been included in Pacific

Hospital's inpatient admission charge.

217. This particular instance of unbundling happens with Pacific Hospital

admissions. Lodged with the Court is a spreadsheet with over thirty examples of a

separate invoice coming from a third-party provider for autologous blood

transfusion technologies, when the service should have been included in the Pacific

Hospital bundled admission charge (titled "Pacific Hospital – Autologous

Transfusions").

218. These Defendants misrepresented the services provided and their right

to collect these additional payments (in addition to reimbursement for inpatient

medical services) for autologous blood transfusion services. They made these

misrepresentations in furtherance of their scheme to double-bill and overbill State

Fund for these services. State Fund reasonably relied on the misrepresentations in

Pacific Hospital's claims and on the misrepresentations in purchase orders in issuing

payment on the admission and third-party bills. As Defendants expected, payment

was delivered via the U.S. Postal Service.



informed and believes, and thereon alleges that Drobot Sr. gave direction and

oversaw the fraudulent overbilling scheme, given their control of Pacific Hospital

and related entities as specified above.



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F. Fraudulent Scheme re: Duplicate Radiology Billing (Long Beach

Pain and Drobot Sr.)

220. State Fund's review uncovered that Long Beach Pain uses outside

radiology services on numerous occasions, often on claimants involving Pacific

Hospital as well. Long Beach Pain is or was managed by Pacific Hospital, and is

also owned by Drobot Sr. These services are generally billed to State Fund by the

outside vendor, yet Long Beach Pain bills State Fund for them as well, even though

a Pacific Hospital representative indicated at deposition that there would be no

reason to bill for technical radiology services provided by a third party. For

example, for a number of services provided by Saddleback Portable X-Ray

("Saddleback") for spinal X-Rays, Long Beach Pain billed for the same technical

component as Saddleback, resulting in duplicate billing. Radiology services, under

the physician OMFS, can be split up into technical and professional (physician)

components, or billed globally. Long Beach Pain splits up the components and bills

State Fund for both, while the owner of the equipment (Saddleback) also bills for

the technical component. While the "unbundling" here is allowed by the

regulations, the double–billing, of course, is not. Because these billings are

submitted by two wholly different entities, it is very difficult for State Fund to catch

this duplication without a searching and time-intensive review.

221. As specific examples, same-service bills were received from Long

Beach Pain and Saddleback on State Fund Claim Number 01341571 (date of service

July 15, 2011) and Claim Number SP199038 (date of service June 3, 2011). This

pattern has continued since at least 2007, and Long Beach Pain continues to bill for

services rendered by a third-party provider and paid to that provider. Lodged with

the Court is a spreadsheet of thirty such examples (titled "Long Beach Pain –

Duplicate Radiology Billing") with separate claim numbers, CPT codes, and dates

of service.



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222. Long Beach Pain knowingly misrepresented its right to collect these

additional payments. Long Beach Pain knew that the third-party providers directly

billed State Fund—not Long Beach Pain—for their radiology services, yet billed

State Fund for those same services, claiming "reimbursement" for services they

neither provided nor paid for. These misrepresentations were made in furtherance

of their scheme to double-bill and overbill State Fund for these services. State Fund

reasonably relied on the misrepresentations in Long Beach Pain's bills in accepting,

processing, and paying them in full or in part. As Defendants expected, payment

was delivered via the U.S. Postal Service.



informed and believes, and thereon alleges that Drobot Sr. conducted periodic

meetings with medical professionals, staff, and other employees in order to give

direction and oversee the scheme. Drobot Sr. is, according to California Secretary

of State records, Chief Executive Officer and a director of Healthsmart d/b/a Pacific

Hospital as well as Long Beach Pain. The alleged parent of Long Beach Pain,

PSPM, shares the same office address and Drobot Sr. is the principal, according to

California Secretary of State records.

VI. FRAUDULENT SCHEMES BY THE PHARMACY DEFENDANT

ENTERPRISE

224. The Surgery Defendant Enterprise shares much in common with the

Pharmacy Defendant Enterprise, including the Individual Defendants as operators,

owners, officers and directors; offices and addresses; submission of bills for services

or pharmaceuticals provided or prescribed by the same medical providers; the

provision of employees and management services by the same Administrative

Defendants; and similar methods of defrauding State Fund, including the referral of

spine patients to doctors (for surgeries to be performed at Pacific Hospital) in

connection with inducing these doctors to engage CPM/IPM. The Pharmacy



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Defendants shared many patients with the Surgical Defendants; as noted above, of

the over $60 million paid to the Pharmacy Defendants by State Fund, more than $30

million of it can be traced to patients who received services from the Surgical

Defendants.

225. The five schemes below are all closely related to the Surgery Defendant

Enterprise schemes, but are broken out separately because they some contain unique

elements.

A. Lack of Licenses, Corporate Practice of Medicine, and Payment of

Illegal Referral Fees (CPM, IPM, MMG, Administrative

Defendants, Individual Defendants, All Provider Defendants except

Drs. Akmakjian, Chambi, Tantuwaya, and Moheimani12)

1. Lack of Licenses

226. CPM and IPM, entered into "Physician Office Dispensing Program

Management Agreements" with physicians and other medical providers, including

Provider Defendants, pursuant to which the providers purportedly retained the

Pharmacy Defendants to "implement and maintain a Pharmacy Program in

Physician's various offices and places of practice for Physician's patients covered

under the California Workers' Compensation Program." Pursuant to these

agreements, CPM and IPM would receive a share of the profits generated by the

filling of prescription drugs in return for managing the "Pharmacy Program."

227. But rather than simply assisting the physicians in the management of

their dispensing programs, CPM and IPM controlled nearly every aspect these

programs. They chose the suppliers, purchased the drugs, employed and supervised

(through FMM) the pharmacy technicians and other employees who dispensed the

drugs, determined which drugs could and could not be listed on the formularies,

provided monetary incentives to push providers to overprescribe or to prescribe the

12 For purposes of this Section VI.A., the term "Provider Defendants" should be read to exclude Drs. Akmakjian, Chambi, Tantuwaya, and Moheimani.



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most lucrative medications, covered direct pharmacy costs, submitted bills for

reimbursement to insurers, and ultimately controlled the flow of money and how

much physicians would be paid for their prescriptions. On information and belief,

FMM also provided the physicians' assistants to the providers, who would prescribe

medications to patients.

228. Deposition testimony of the Pharmacy Defendants' CFO, Matthew

Umbs, confirms that CPM and IPM had complete control over the funds paid to

pharmaceutical repackagers and over the funds received from insurers in the form of

reimbursements. For example, while the dispensing agreements provided that the

physicians were responsible for purchasing the medications necessary for the

pharmacy programs, instead, CPM and IPM purchased the medications directly

from pharmaceutical repackagers with funds held in a "physician lockbox account,"

an account controlled by CPM and IPM and to which the physicians had no access.

The Pharmacy Defendants' "management fee" was generally "50% of gross

collections after deducting the costs of drugs sold and other direct pharmacy costs,

including collections and advances." Upon reimbursement from State Fund,

Pharmacy Defendants would control the funds, determine whether or not to

"paydown" or "write off" the advances paid to the medical providers, including the

Provider Defendants (which were purportedly paid to enable the medical providers

to purchase the pharmaceuticals, even though CPM and IPM in fact did the

purchasing), and provide the physicians with some portion of the profits from the

reimbursements.

229. Thus, the physicians, including the Provider Defendants, never bore

any significant out-of-pocket financial risk and were paid simply for prescribing

medications to their patients and referring them to the pharmacies run by the

Pharmacy Defendants, which were often exam rooms in the same building as the

physicians' office buildings. The fee-splitting agreements were therefore simply

vehicles through which CPM and IPM paid kickbacks to physicians for referring



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patients to the pharmacies run by CPM and IPM, and for prescribing lucrative

medications to their patients. Financial documents produced in this case show that

this was true for the Provider Defendants, who did not bear any costs of medications

or operational costs, but were simply paid a percentage of profits each month (or, in

many cases, large "advances" which were often later written off). The amounts paid

under these pharmacy agreements did not reflect the fair market value of the

services provided. For example, in 2006, Dr. Capen and CPM were both paid

around $2 million each for drugs that cost CPM only $500,000. The pharmacy

agreements also often drove the Provider Defendants to write prescriptions at an

alarming, implausible rate. For example, Dr. Capen purportedly wrote over 30,000

prescriptions in 2006, and averaged 123 prescriptions per day in March of that year,

indicating that he was writing prescriptions for medications not dispensed or

overprescribing medications to his patients. Similarly, in 2005, Defendant Dr.

Khalid Ahmed entered into an agreement with PSPM pursuant to which he would be

paid $450,000 per month for medication and surgery referrals to the Entity

Defendants. In 2006, he purportedly wrote nearly 23,000 prescriptions, and

averaged 92 prescriptions per day in March of that year. He was paid nearly $2.7

million in "advances" for writing those prescriptions in 2006, for drugs that cost

CPM only $327,039. When the Drobots were questioned about the dispensing

agreements, they regularly invoked their Fifth Amendment rights against self-

incrimination.

230. This conduct violates the restrictions placed on provider dispensaries

set forth in California Bus. & Prof. Code § 4170. Moreover, by illegally operating

physician dispensaries, CPM and IPM also acted as pharmacies under California

Bus. & Prof. Code § 4037, which defines "pharmacy" as "includ[ing], but not

limited to, any area, place, or premises…from which the controlled substances,

dangerous drugs, or dangerous devices are furnished, sold, or dispensed at retail."



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Yet neither CPM nor IPM ever had pharmacy licenses, nor were they licensed

medical providers.

231. CPM and IPM acted also acted as wholesalers, despite the fact that

CPM never had a wholesaler license, and IPM's wholesaler license expired on

September 1, 2012, according to California state public records.

232. Under California Bus. & Prof. Code § 4043,"wholesaler" means and

includes a person who acts as a wholesale merchant, broker, jobber, customs broker,

reverse distributor, agent, or a nonresident wholesaler, who sells for resale, or

negotiates for distribution, or takes possession of, any drug or device included in

California Bus. & Prof. Code § 4022. A wholesaler license is required by any

business that distributes, brokers, or transacts the sale or return of dangerous drugs

or dangerous devices into or within California to other wholesalers, practitioners, or

pharmacies.

233. Here, CPM and IPM, not the physicians, purchased the drugs from the

pharmaceutical repackagers. They also controlled all, or nearly all, aspects of the

pharmacy operations for the physicians. At the very least, then, CPM and IPM

acted as "brokers" for the acquisition of pharmaceuticals for the physicians, meaning

that under California Bus. & Prof. Code § 4160, they required a license from the

California Board of Pharmacy to operate.

234. According to California state public records, after a 2005 inspection of

CPM, the California Board of Pharmacy on October 28, 2005 ordered CPM to cease

and desist operations so long as CPM did not have a license. In response, CPM

assured the California Board of Pharmacy that it had ceased operations and had

transferred its contracts to IPM. CPM also stated that it intended to operate "as a

broker, the same as IPM," and thus was applying for a wholesale license.

235. Above is an excerpt from a letter to the California Board of Pharmacy

dated December 6, 2005, where CPM represented that "all operations did cease [as



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of October 28, 2005] and all contracts were assigned or transferred to IPM in order

that we would be compliant with the Board's orders."

236. Despite this representation to the Pharmacy Board, CPM never ceased

operation—indeed, it billed State Fund for over 7,000 prescriptions from October

28, 2005 through the end of 2005 alone. No license was ever issued to CPM, yet

CPM continued its operations, including billing State Fund, through 2012.

237. On information and belief, Defendant MMG also ran pharmacies out of

physicians’ offices and used the physicians’ names to submit bills to State Fund.

According to California state public records, MMG, like CPM, was never licensed

in any capacity by the Board of Pharmacy when it submitted these bills to State

Fund.

238. CPM, IPM, and MMG misrepresented the services they provided and

their right to collect payment. Lacking the required license and/or authority, these

Defendants misrepresented their right to collect from State Fund in furtherance of

their scheme to overbill State Fund for prescriptions. State Fund reasonably relied



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on the misrepresentations in receiving, processing, paying, and settling the invoices

and bills from these Defendants. Each Defendant requested payment from State

Fund through the United States mail and/or interstate wires, and payments were

delivered via the U.S. Postal Service or wires.

239. On information and belief, the Individual Defendants were responsible

for devising the fraudulent scheme to bill without license or authority, and received

and controlled profits from it. State Fund is informed and believes, and thereon

alleges that the Individual Defendants gave direction and oversaw the fraudulent

scheme, through their control over the Pharmacy Defendants, Administrative

Defendants, and related entities as specified above. All the Pharmacy Defendants

share the same address and the Individual Defendants were involved in their

ownership and management structure.

2. Corporate Practice of Medicine

240. The Medical Practice Act, California Bus. and Prof. Code section 2052,

provides: "Any person who practices or attempts to practice, or who holds himself

or herself out as practicing...[medicine] without having at the time of so doing a

valid, unrevoked, or unsuspended certificate...is guilty of a public offense."

California Bus. and Prof. Code section 2400, within the Medical Practice Act,

provides in pertinent part: "Corporations and other artificial entities shall have no

professional rights, privileges, or powers."

241. The policy expressed in Business and Professions Code against the

corporate practice of medicine is intended to prevent unlicensed persons, like

Defendants, from interfering with or influencing the physician's professional

judgment. For example, the following types of decisions and activities should not

be delegated to an unlicensed person, including Defendants: (1) determining what

diagnostic tests, medications, or treatments are appropriate for a particular

condition; (2) determining the need for referrals to, or consultation with, another

physician/specialist; (3) selection and hiring/firing of health staff and medical



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assistants; (4) decisions regarding coding and billing procedures for patient care

services; (5) determining the selection of medical equipment and medical supplies

for the medical practice; and (6) arranging for, advertising, or providing medical

services rather than only providing administrative staff and services for a physician's

medical practice (i.e., non-physician exercising controls over a physician's medical

practice, even where physicians own and operate the business).

242. Here, Defendants interfered with or influenced the physicians'

professional judgment, including the Provider Defendants, by paying them for

patient referrals and for prescribing medications or tests (or using devices) that

would yield the greatest profit margins, regardless of whether those decisions were

in the best interests of their patients. Indeed, as discussed in paragraphs 26 and 27,

supra, PSPM wrote a letter to doctors in 2006 reminding them that PSPM controlled

all referrals from the doctors, including surgeries, pain management,

pharmaceuticals, and psychiatric evaluations. The letter explicitly states that

"[a]ccording to our management agreement all referrals from your office are to be

coordinated by PSPM." PSPM then goes on to specifically demand referrals for:

pain management physicians, psychological and psychiatric consultations, MRIs,

and durable medical equipment.

243. The Pharmacy Defendants' similarly took control of the physicians'

pharmacy programs through their "Physician Office Dispensing Program

Management Agreements." Indeed, on information and belief, and as evidenced by

financial statements produced in this case with regard to the Provider Defendants,

the physicians committed almost nothing in the way of financial, capital, or human

resources to the pharmacy program. Instead, the Pharmacy Defendants purchased

the medications from vendors of their choosing, selected, hired, and supervised the

pharmacy technicians and other health staff for the pharmacies, dispensed the drugs

through their employees, controlled which drugs would be listed on the formularies,

and submitted bills to State Fund for collection. When the costs of certain



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pharmaceuticals escalated (e.g., Wellbutrin), making them less lucrative from

Drobot Jr.'s perspective, he unilaterally decided that those pharmaceuticals needed

to be removed from the formularies.

244. Moreover, documents recently produced in this litigation demonstrate

that the Pharmacy Defendants went so far as to actually form or attempt to form

sham corporations for the medical providers in order to collect against State Fund.

In a letter dated February 1, 2005, CPM explained to a medical provider that in

order to avoid issues with collecting on bills submitted to State Fund, CPM had

"formed a new California Professional Corporation for [the provider] at no expense

to [the provider] and [ ] obtained a new EIN for the new corporation." The letter

included a list of forms that were "necessary to complete the formation of" the

corporation and offered to "maintain the Corporation's Minute book in our office."

Drobot Jr. is copied on this letter and the letter is signed by Randolph Taylor, who,

according to Drobot Sr., served as a paralegal for Drobot Sr.'s former counsel,

Michael Tichon.

245. Recently produced documents also show that the Pharmacy Defendants

and Drobot Jr.—through newly created entities—sought to expand their control over

physician decision making by branching into urinary drug testing and ancillary

durable medical equipment ("DME") services.

246. On information and belief, Drobot Jr., through IPM or his more

recently formed entity, Advanced Practice Services, would coordinate and control

physicians' "UDT testing" within their practices in much the same way they

controlled the pharmaceutical dispensing. IPM or Advanced Practice Services

would dictate what testing the providers should perform and place a "UDT

technician" in a provider's facility. Moreover, recently produced documents show

Defendants, or entities controlled by them, making set monthly payments to

physicians in exchange for their agreeing to perform a certain number of UDT tests

per month, regardless of patient need. And other emails show Drobot Jr.



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encouraging Defendant Catanzarite to perform more UDT testing, again regardless

of need. In response, Catanzarite assures Drobot Jr. that he would be "investigating

what is going on with the UDT testing" at his facility. Another Drobot Jr. entity,

Advanced Lab, would submit bills to State Fund for the lab services.

247. When the Pharmacy Defendants' CFO, Matthew Umbs, was asked

about these UDT entities in his deposition, counsel for the Pharmacy Defendants

instructed him not to answer. Umbs also refused to answer questions about his own

recently formed urinalysis laboratory, US Lab LLC, for which the Planning

Commission of the City of Newport Beach recently approved a conditional use

permit for the laboratory located at 20377 Acacia Street, the same address listed for

many of the Defendants (as described above).

248. Similarly, Pharmacy Defendants' CFO, Matthew Umbs, recently

testified at his deposition that another entity owned by Drobot Jr., Advanced

Pharmacy Services, received "commissions" from DME companies whenever such

companies sold their products (e.g., back braces) to certain "customers" –

presumably physicians associated with Pharmacy Defendants. Drobot Sr. also has a

DME company, PSPM-DME, Inc., to which State Fund has paid over $4 million.

On information and belief, Pharmacy Defendants' exercised control over physicians'

professional judgment through these types of arrangements, which were simply

vehicles through which the Pharmacy Defendants paid kickbacks to physicians for

referring patients to the Pharmacy Defendants (and other Drobot-controlled entities),

for medications, UDT testing, and DME.

249. The Provider Defendants each knowingly relinquished control over

their medical practices to the Individual and Pharmacy Defendants, who were not

licensed medical providers (or even licensed pharmacies), by allowing them to

operate pharmacies in the physician's office and direct or influence the Provider

Defendants as to which pharmaceuticals could and could not be prescribed. These

medical providers thus assisted the Individual and Pharmacy Defendants in their



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violation of the California Corporate Practice of Medicine Doctrine, codified in

California Bus. & Prof. Code §§ 2400 and 2052. Accordingly, the agreements

under which the Pharmacy Defendants billed State Fund were illegal because they

allowed for the corporate practice of medicine by unlicensed lay corporations.

3. Payment of Referral Fees and Fee-Splitting Agreements

250. On information and belief, as discussed above, the Pharmacy

Defendants paid kickbacks to medical providers, including the Provider Defendants,

in the form of "advances" for the purchase of pharmaceuticals under the "Physician

Office Dispensing Program Management Agreements" and through illegal fee-

splitting agreements. In reality, the Pharmacy Defendants, not the physicians,

purchased the pharmaceuticals from repackagers and other suppliers (often

obtaining substantial "rebates" in light of their ownership interests in or other

associations with these repackagers/suppliers, thereby increasing profit margins).

Physicians did not incur any significant out-of-pocket expense in connection with

these pharmaceutical purchases because CPM and IPM wrote the checks for such

purchases using funds from a bank account controlled by them.

251. In other words, the physicians, including Provider Defendants, kept the

sizable monthly advances as payment for referring patients to the pharmacies run by

the Pharmacy Defendants in the physicians' offices. On information and belief,

additional kickbacks were paid to physicians pursuant to the fee-splitting provisions

in the Physician Office Dispensing Program Management Agreements after the

Pharmacy Defendants were reimbursed by State Fund. The fee-splitting provisions

typically provided that the physicians were entitled to 50% of the collections after

costs. Many also specified a minimum, "guaranteed" monthly payment for the

physicians.

252. The Individual Defendants asked medical providers to sign sham

medical lien purchase agreements to satisfy State Fund's requests for proof that the

Pharmacy Defendants had the right to collect directly on the claims submitted by



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them, all the while assuring the medical providers that the fee-splitting arrangement

would stay intact despite the purported "sale" of the claims to the Pharmacy

Defendants. Financial statements produced in this matter as to the Provider

Defendants show that these "lien purchase agreements" provided to State Fund were

false and fraudulent. While the agreements signed by the Provider Defendants and

the Pharmacy Defendants, and provided to State Fund, purport to provide that

Pharmacy Defendants will purchase the Provider Defendants' claims, the financial

statements show that this did not occur. Instead, the Pharmacy Defendants'

relationship with the Provider Defendants continued as it had before, with the

Provider Defendants receiving either "advances," a percentage of profits, or both

after the date of the lien purchase agreements. The Provider Defendants never

intended to enforce or abide by the terms of "lien purchase agreements," and signed

them only to facilitate the fraudulent billing of the Pharmacy Defendants.13

253. Moreover, doctors were encouraged to sign CPM/IPM contracts with

the promise that spinal surgery referrals (to be performed at Pacific Hospital) would

be made as consideration for the contract (e.g., Drobot Jr.'s emails to Dr. Richard

Mulvania). CPM/IPM also "subsidized" PSPM and Pacific Hospital by paying

kickbacks to medical providers, including Defendants Dr. Khalid Ahmed, Dr. Ian

Armstrong, Jeffrey Catanzarite, Dr. Timothy Hunt, Dr. Philip Sobol, Alan Ivar, and

Dr. Ismael Silva, for the referral of patients to Pacific Hospital. PSPM and FMM

provided another "bridge" between the Pharmacy Defendants Enterprise and the

Surgical Defendants Enterprise. On information and belief, in recruiting medical

13 In some cases, some of the Provider Defendants did begin accepting payment for purported "claims purchases" years after the "lien purchase" agreements were signed with different entities. However, these "claims purchases" were not bona fide, and the amounts paid often bore no reasonable economic relationship to the claims purchased. Instead, these "claims purchases" were disguised kickbacks paid for referring patients to the pharmacy programs or referring patients to or performing surgeries at Pacific Hospital.



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providers and other coconspirators to participate in their scheme, the Individual

Defendants marketed the strength of the overall enterprise as a "full-service"

operation, whereby patients could be recruited at all points of service—from pain

management to medications to diagnostic testing to DME to spinal fusion surgery.

PSPM's management allowed it (and related Drobot Sr. entity FMM) to control the

medical practices of physicians from all angles.

254. Had State Fund known that the claims submitted by the Pharmacy

Defendants were the byproduct of illegal kickback and fee-splitting arrangements, it

would not have paid on those claims.

255. In addition to the prohibitions against such referral fees and kickbacks

contained in California Bus. & Prof. Code §§ 650, 652, and 652.5 and California

Insurance Code §§ 750 and 754, California Lab. Code § 139.3 specifically prohibits

this conduct in the worker's compensation context, including, but not limited to, the

referral of patients for "pharmacy goods" to entities in which the physician has a

"financial interest" and payment for a referred evaluation or consultation. California

Lab. Code § 139.3(f) also provides, "No insurer, self insurer, or other payor shall

pay a charge or lien for any goods or services resulting from a referral in violation of

this section." Many medical providers, including Provider Defendants, submitted

certifications to State Fund along with their claims for reimbursement that they had

not violated California Lab. Code § 139.3 or had "not offered, delivered, received or

accepted any rebate, refund, commission, preference, patronage, dividend, discount

or other consideration, whether in the form of money or otherwise, as compensation

or inducement for any referred examination or evaluation," or otherwise stating their

compliance with the law and/or that the bills contained no material omissions.

256. Furthermore, since the contracts between the medical providers and

Pharmacy Defendants violated California Bus. & Prof. Code §§650, 652, 652.5,

2400, 2052, 4022, 4037, 4043, 4160, and 4170, Cal. Ins. Code §§ 750, 754, and

1871.4, California Lab. Code § 139.3, 3215, and 3820, and Penal Code 549 and 550,



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among other laws, they are illegal. As mentioned above, illegal contracts are void

and unenforceable; the Pharmacy Defendants therefore had no standing to submit

the bills to State Fund or receive payment for them.

B. Overbilling and Pricing Manipulation (Pharmacy Defendants,

Drobot Sr., Drobot Jr., All Provider Defendants except Drs.

Akmakjian, Chambi, Moheimani, and Tantuwaya14)

257. The Pharmacy Defendants—acting as the purported "assignees" of

medical providers, including the Provider Defendants—engaged in an overbilling

scheme against State Fund, similar to that of the Surgical Defendants, only with

medications. From 2002 to the present, the Pharmacy Defendants and the Provider

Defendants have billed over half a million prescription drugs to State Fund. State

Fund has paid out over $60 million to these Defendants based on these bills.

1. Background on Drug Pricing

258. All drugs intended for retail sale are identified by an eleven-digit

National Drug Code ("NDC") that is listed with the FDA. The NDC is used to

identify the drug delivered to the patient. The first five digits of the NDC identify

the company that manufactured and/or packaged the drug, the middle four digits

identify the drug ingredient and dosage, and the last two digits identify package size.

259. Once a drug gets repackaged by a repackager it gets assigned a new

NDC. The first five NDC digits are changed to correspond to the repackager. Thus,

when a repackager sells a drug to a retailer and that drug gets dispensed to a patient,

the reported NDC identifies the repackager, not the manufacturer.

260. Each NDC has associated with it pricing benchmarks reported by the

manufacturer or repackager that are published in commercial publications. The two

benchmarks relevant to this action are the wholesale acquisition cost ("WAC") and

average wholesale price ("AWP").

14 For purposes of this Section VI.B., the term "Provider Defendants" should be read to exclude Drs. Akmakjian, Chambi, Tantuwaya, and Moheimani.



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261. A drug's wholesale acquisition cost ("WAC") is the baseline price at

which the drug's manufacturer sells the drug to wholesalers/repackagers. While

WAC may not represent a wholesaler's actual acquisition cost (as wholesalers may

obtain modest discounts off the WAC), it is the baseline price at which the

manufacturer sells the drug to wholesalers. Due to a competitive market, drug

wholesaler margins on their sales to retailers tend to be thin. As a result, the WAC

serves as the de facto baseline price for two different transactions: (1) the price a

wholesaler pays the manufacturer to acquire the drug, and (2) the price a retailer

pays a wholesaler to acquire the drug.

262. A drug's average wholesale price or "AWP" is the nominal price at

which wholesalers sell that drug to retailers, including pharmacies and physicians

who operate in-office dispensaries. Historically, a drug's AWP is set directly or

indirectly by its manufacturer. The Red Book, a trade publication that publishes

AWPs and other data for thousands of drugs, explains that "[w]hen the manufacturer

does not provide an AWP or markup formula from which AWP can be calculated,

the AWP will be calculated by applying a standard 20% markup over the

manufacturer supplied WAC." A repackager is also free to report its own AWPs for

any drugs it repackages. Since each NDC comes with its own AWP, any firm that

repackages can set both a new NDC and a new AWP.

263. AWP is important because it is used as a baseline for reimbursement by

end payors, including State Fund, to retailers for drugs provided to patients. This

results in a system where the amount retailers pay wholesalers for drugs is pegged to

the drug's WAC, but the amount retailers get paid (i.e., receive in reimbursement) is

pegged to the drug's AWP. The amount by which a drug's AWP exceeds its WAC

creates a "spread" between the actual cost of the drug to the retailer and the

reimbursement paid to the retailer by an insurer.



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2. Defendants' Schemes

264. Pharmacies and repackagers can increase their profits by increasing the

"spread." Given the proliferation of NDC codes and generic medications, it

becomes difficult to track the actual prescription and the actual price.

265. Since they began billing State Fund, the Pharmacy Defendants have

engaged in a massive overbilling scheme whereby they billed up to ten or more

times the price of basic-over-the-counter medication. As discussed above, in 2006,

CPM billed approximately $8 million for drugs prescribed by Defendant Dr. Capen;

it purchased those drugs for only $500,000. Excessive amounts were charged for

tablets, and occasionally, the same provider billed the same prescription twice on the

same day. For example, IPM consistently billed $3.50 for 20 mg of omeprazole (an

antacid) per tablet. Omeprazole is available, over the counter, for approximately

$0.40 per tablet.

266. As with medical procedures and the Surgical Defendants, State Fund

indicates to the billing provider that if it disagrees with the amount of the payment

for prescriptions, it should send additional documentation in support of the claimed

amount. Despite such requests, the Pharmacy Defendants typically did not (and do

not) submit any additional documentation to justify the excess billing. Instead, the

Pharmacy Defendants routinely send additional bills to State Fund and take other

actions to collect additional amounts, as detailed below.

267. For each of the five Pharmacy Defendants, a spreadsheet specifying

particular examples listing medication overbilling has been lodged with the Court,

with claim numbers, dates of mailing or wiring, amounts, and descriptions (titled

"CPM – Overbilling;" "IPM – Overbilling;" titled "LBPP – Overbilling;" "MMG –

Overbilling;" and "Coastal – Overbilling").

268. CPM and IPM have billed for compound medications as well, which

are generally topical creams that contain more than one drug in the ingredients.

CPM consistently billed the entire costs of these medications based on the highest-



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priced drug in the combination, even when that drug represents the smallest

percentage (for example, 10% or less) of the total ingredients. A spreadsheet of

examples of this misconduct is lodged with the Court (titled "CPM – Overbilling

Compounds").

269. State Fund reasonably relied on the Pharmacy Defendants' and Provider

Defendants' fraudulent bills and invoices in paying for the services and

prescriptions. Based on State Fund's review of billing runs and particular bills, the

bills submitted by the Pharmacy Defendants and Provider Defendants contained

false statements, primarily that the alleged cost of prescriptions provided to covered

workers was the actual or reasonable cost of those pharmaceuticals. On information

and belief, each Defendant in the Pharmacy Defendant Enterprise knew that these

bills contained false statements, which were made to induce State Fund to grossly

overpay for the prescriptions provided.

270. The bills and accompanying forms submitted by the Pharmacy

Defendants and Provider Defendants (as well as other medical providers) also

contained false certifications by the providers and/or material omissions or

misrepresentations.




Defendants gave direction and oversaw the fraudulent overbilling scheme, given

their control of the Pharmacy Defendants and related entities as specified above. All

the Pharmacy Defendants share the same address, and involve the Individual

Defendants in their ownership and management structure.

3. 2001-2007 Overbilling Through AWP Manipulation

272. A more particular kind of overbilling scheme was carried out by the

Pharmacy, Individual Defendants, and Provider Defendants from 2001 to 2007, in



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an attempt to exploit the then-existing regulatory structure which, like the spinal

implant structure, often based charges on middleman charges.

273. From 2001 to 2007, the "spread" between a drug's AWP and WAC had

a predictable standard dictated by industry custom. For most drugs, the market

understood and expected a spread of about 20%. For example, a particular NDC

might have a published WAC (e.g., $100 for a 100 count bottle) and a published

AWP typically 1.20 times its WAC (e.g., $120). A retailer who bought this drug at

WAC and sold it at AWP would pocket the $20—the spread. The standard spread

thus allowed retailers a 20% return on each drug they dispense (and sometimes

more).15

274. From 2001-2007, the Pharmacy Defendants, Individual Defendants,

and Provider Defendants, on information and belief, enacted a complex scheme

where Individual Defendants and Pharmacy Defendants acquired or partnered with

repackagers, allowing them to engineer spreads over 600% by having the

repackagers report wildly inflated AWPs and/or by having the repackagers provide

them with steep rebates or discounts. Defendants and the repackagers they

conspired with knew these inflated AWPs were nowhere near the "average

wholesale price" paid by retailers, nor were they remotely tethered to the drugs'

WACs. Once these inflated AWPs were published, Defendants billed State Fund

and others based on these fraudulent AWPs, allowing the Defendants to reap returns

in excess of 600% per transaction. Provider Defendants also had knowledge of the

massive spread between the drugs' acquisition prices and their reported AWPs, since

Provider Defendants were provided with financial statements by the Pharmacy

Defendants, which contained the costs of goods sold for each month.

15 A retailer who pays exactly WAC (e.g., $100) and bills exactly AWP (e.g., $120) would see a 20% profit. But retailers often pay below WAC (due to discounts on the WAC from the manufacturer to wholesaler, passed on to the retailer). And retailers often bill above AWP—until 2007, California generally allowed retailers to bill generic drugs at 1.4 times AWP.



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275. For drugs prescribed before March 2007, the amount a retailer could

charge for drugs depended on whether its NDC was listed in the Medi-Cal fee

schedule. For NDCs not listed in the Medi-Cal fee schedule, California law

generally authorized payment for generic drugs at 1.4 times the drug's AWP; brand

name drugs were generally paid at 1.1 times the drug's AWP.

276. Because State Fund and other workers' compensation insurers were

required by law to reimburse retailers based on AWP for drugs whose NDC was not

listed in the Medi-Cal fee schedule, State Fund relied on AWP data published in

commercial publications such as the Red Book. This reliance was well known to the

Defendants, who, on numerous occasions, actively induced State Fund and others to

rely on the Red Book's published AWPs. When State Fund denied payment on one

of IPM's many excessive bills, CPM often responded with data taken from the Red

Book showing the relevant AWP (which State Fund later discovered during its

investigation was fraudulently inflated).

277. Defendants conducted a scheme in which the repackagers under their

control vastly overstated the AWPs of many drugs in the data they reported to Red

Book and other drug pricing publications. After the inflated AWPs were published,

the involved Defendants would continue to pay the same price to acquire their

drugs, but they would now charge State Fund much more, claiming that

reimbursement was pegged to the published AWPs. This artificial, fraudulent

inflation of reported AWP data led to enormous spreads, which, on information and

belief, Pharmacy Defendants split with physicians, including Provider Defendants,

as part of the payment of kickbacks for referrals and for the use of CPM or IPM's

services and pharmacy technicians.

278. The kickback fees incentivized providers, including the Provider

Defendants, to only order drugs through CPM or IPM's preferred repackagers (who

offered the opportunity for huge profit margins through inflated AWPs and sizeable



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rebates and/or discounts) and to direct their patients fill their prescriptions at the

pharmacies run by the Pharmacy Defendants in the providers' offices.

279. CPM frequently chose to buy from the repackager DRx. This choice

was deliberate. In his deposition, Drobot Sr. admitted that he and Drobot Jr.

invested in Essence Group Holdings, Inc., the parent company of DRx and another

pharmaceutical repackager, Wellinx. On information and belief, the Individual

Defendants exerted control over DRx by demanding rebates on pharmaceuticals in

exchange for access to the medical providers' (including Provider Defendants')

pharmaceutical business, which the Individual Defendants controlled through CPM,

IPM, and MMG. The Individual Defendants had arranged for DRx to report

fraudulently high AWPs to the Red Book. Defendants would order from DRx drugs

with wildly inflated AWPs and then bill insurers at least 1.4 times these AWPs.

280. This scheme to systematically overbill State Fund and other insurers by

fraudulently reporting inflated AWPs ran from 2001 through March 2007. It

effectively ended in March 2007 after California scrapped its AWP-based

reimbursement model for repackagers (the effect is not retroactive, however, so

claims with dates of service before March 2007 continue to be reimbursed under the

AWP-based formula). However, Defendants continue to contract with

pharmaceutical repackagers to receive "rebates" or "refunds" based on the volume of

drugs they were able to broker and dispense with the cooperation of medical

providers, including the Provider Defendants.

4. Specific Examples

281. After acquiring an ownership share in Essence Group Holdings

Corporation, the parent company of DRx and Wellinx, Defendants began to falsify

the AWP data that DRx reported to the Red Book.

282. For instance, DRx reported an AWP of $185.40 for 60 tablets of 150

mg Ranitidine. Yet an invoice from DRx produced in another litigation reveals that

DRx actually sold 60 tablets of 150mg Ranitidine to CPM for just $5.26 during the



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same period. Assuming DRx sold Ranitidine to CPM at its wholesale acquisition

cost, the AWP-WAC spread comes out to 3,424%—many, many times over the

standard industry markup. DRx also reported an AWP of $177.00 for 60 tablets of

350mg Carisoprodol. A relatively contemporaneous DRx invoice shows DRx sold

the same amount of the same medication for $8.12, a spread of 2,079%.

283. The $185.40 AWP for DRx's Ranitidine is over nine times the drug's

federal upper limit ("FUL") of $20.47—the maximum amount a state Medicaid

program is permitted to reimburse providers for the drug. Before 2007, a drug's

FUL was calculated as 150% of the lowest published AWP for therapeutically

equivalent products (e.g., the same generic drug from a different manufacturer or

repackager). The same drug has recently been available over the counter for $0.135

per 150mg tablet, amounting to $8.10 for 60 tablets. IPM billed $259.56 (1.4 times

AWP) for a drug it had purchased for $5.26 and that retails for $8.10—a 4,900%

markup over CPM's actual acquisition cost, and a 3,200% markup over the drug's

retail price.

284. As another example, on or shortly after October 26, 2006, CPM and the

Individual Defendants used the United States mail in furtherance of their scheme to

defraud. CPM submitted a bill to State Fund (Claim #01114173) via the U.S. Postal

Service for drugs one of its physicians had prescribed and dispensed to a patient at

Pacific Hospital for $815.34, which CPM and other Defendants knew

misrepresented the amount of reimbursement to which CPM was entitled.

285. All the drugs for this particular bill have NDCs beginning with

"55045," indicating that DRx had supplied all the dispensed drugs. Defendants used

DRx's fraudulently reported AWPs to charge State Fund excessive amounts for the

drugs dispensed. In doing so, Defendants knowingly misrepresented DRx's AWPs,

which it knew to be fraudulently inflated and false. For example, CPM billed State

Fund $255.30 for Carisprodol by multiplying DRx's fraudulent AWP—$177.00—by



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1.4 and adding a $7.50 dispensing fee. DRx's reported AWP for Carisprodol is over

20 times higher than what it actually charges CPM for the drug: $8.12.

286. As another example on this bill, CPM billed State Fund $267.06 for

Ranitidine by multiplying DRx's fraudulent AWP—$185.40—by 1.4 and adding a

$7.50 dispensing fee. DRx's reported AWP for Ranitidine is over 34 times higher

than what it actually charges CPM for the drug: $5.26.

287. These Defendants knew and intended that the submitted invoice

misrepresented the pharmaceuticals' AWPs, and each knew that the reported AWPs

were grossly misleading by industry standards. CPM, Individual Defendants, and

the Provider Defendants reported and/or billed the fraudulent AWPs in order to

induce State Fund to overpay for drugs prescribed by the Provider Defendants (and

other CPM physicians). CPM, with the knowledge and approval of the Provider

Defendants, caused the fraudulent bills—based off fraudulent AWPs—to be mailed

by mailing it to State Fund. State Fund reasonably relied on the misrepresentations

in CPM's bill in issuing payment on the bill of at least $552.96. As CPM, the

Provider Defendants, and the Individual Defendants expected, payment was

delivered via the U.S. Postal Service.

288. CPM thus partnered with repackagers such as DRx and Wellinx to offer

physicians drugs at one price, while billing State Fund at much higher prices, using

those repackagers' fraudulently inflated AWPs. Lodged with the Court is a

spreadsheet with representative examples of CPM overbilling State Fund based on

the repackagers' fraudulent AWPs (titled "CPM – AWP Manipulation"). Each

example is identified by claim number, date of service, NDC, repackager (DRx or

Wellinx), the provider, and amount billed.

289. Based on the management agreements with PSPM and FMM as well as

with CPM and IPM directly, the difference between the actual cost of the drug and

the reimbursement paid—the spread—is split between CPM and the prescribing

physician. As a result of this fee-splitting arrangement, CPM provided the



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physicians it contracted with, including the Provider Defendants, significant

incentives. For certain drugs, the enormous spread between the drugs' actual cost

and their reported AWPs gave physicians a significant incentive to prescribe and

dispense these drugs—even when better alternatives existed—in order to share in

the outsized profits. Moreover, many of the patients referred to CPM/IPM for

medications were referred to Pacific Hospital for treatments as well, making the

illegal kickback scheme even more lucrative when the patients were induced to have

prescriptions filled by the Pharmacy Defendants.

290. The Pharmacy and Individual Defendants hid their scheme by using

privately held out-of-state repackagers, such as DRx and Wellinx, to manipulate

AWPs for CPM's benefit, and by concealing their ownership interests in these

repackagers. Defendants meanwhile wielded DRx's and Wellinx's fraudulent AWPs

to demand excessive payments from insurers.

291. At all relevant times (i.e., 2001-2007), the Individual Defendants

owned and controlled CPM, pursuant to California and Secretary of State records.

Drobot Jr. was the President of CPM. As President, Drobot Jr. managed and

operated CPM's affairs. In managing and operating CPM's affairs, Drobot Jr.

collaborated with his father Drobot Sr. as well as with the Administrative

Defendants. The Provider Defendants knowingly facilitated the Pharmacy

Defendants operations.

C. Double-Billing of Prescriptions (CPM, IPM, LBPP, Coastal,

Drobot Sr., and Drobot Jr.)

292. Pursuant to its investigation, State Fund has uncovered three related

schemes in which the Pharmacy Defendants, excepting MMG, double-billed State

Fund for the same prescriptions going to the same claimant, but through different

processes. Each of these Pharmacy Defendants, as purported assignees of medical

providers, coordinated with the others to submit bills that another Defendant had

already submitted to State Fund. On information and belief (see below), the



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Pharmacy Defendants identified and shared the information required to double-bill

drugs that another Pharmacy Defendant had dispensed and already billed for.

293. First, even though CPM was supposedly terminated (in large part for

the lack of a license as described in Section VI.A) by the Individual Defendants in

or around 2009, it continued to bill State Fund for medications into 2012, often

duplicating bills for the same medications that were submitted by IPM. Lodged

with the Court is a spreadsheet of such double-billing (titled "CPM & IPM –

Duplicate Billing,") by claim number, date, prescribing provider, and CPT or NDC

codes). Indeed, on at least one occasion in 2012, an IPM claim was settled, and

State Fund was told by a representative of IPM to (and unwittingly did) use CPM's

tax identification number.

294. Second, as with IPM and CPM, Coastal, on information and belief, was

created by the Individual Defendants to take over the business of LBPP, with the

transition occurring in approximately 2011. In 2013, Coastal began to bill for some

dates of service that had previously been billed by LBPP. The bills from Coastal

have the same date of service, NDC number, and same medication in the same

quantities. This double-billing occurred even after State Fund had been fraudulently

induced to settle with LBPP on a number of bills on a consolidated basis (see

Section VI.C, below). Lodged with the Court is a spreadsheet of Coastal-LBPP

duplicative billing examples (titled "Coastal & LBPP – Duplicate Billing").

295. Third, Coastal billed State Fund for medications – with the same date

of service by the same physician for the same pharmaceuticals – that were also

billed through Express Scripts, State Fund's network pharmacy provider, with which

Coastal has a contract. Coastal directly billed prescriptions are at higher rates than

Express Scripts, which is one reason Coastal is required to bill through Express

Scripts. Yet Coastal has engaged in a practice of billing both directly and through

Express Scripts for the same medication. Lodged with the Court is a spreadsheet of

such double-billing (titled "Coastal & Express – Duplicate Billing").



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296. State Fund reasonably relied on the Pharmacy Defendants' and Provider

Defendants' fraudulent bills and invoices for these prescriptions that were double-

billed by (a) CPM and IPM; (b) Coastal and LBPP; and (c) Coastal and Express

Scripts. Based on State Fund's review of billing runs and particular bills, the bills

submitted by these Defendants contained false statements, primarily that the alleged

cost of prescriptions provided to covered workers was the actual or reasonable cost

of those pharmaceuticals and had not been paid or billed by others. On information

and belief, the Pharmacy Defendants made the false statements in the duplicative

bills to induce State Fund to overpay for the prescriptions provided.





employees of the fraudulent providers in order to give direction and oversee the

fraudulent overbilling scheme, given their control of the Pharmacy Defendants and

related entities as specified above. Indeed, the constant phasing in and out of the

Pharmacy Defendants and other entities show the control and intentional direction

of this enterprise.

D. Double-Billing of Prescriptions after Global Settlements (CPM,

IPM, LBPP, and Drobot Jr.)

298. State Fund's investigation also led it to review certain settlement

agreements State Fund entered with Defendants related to liens Defendants brought

before the WCAB based on their billings to State Fund. State Fund was unaware of

Defendants' pattern of racketeering activity and other misconduct when it entered

into the settlement agreements with the Defendants named therein.

299. As mentioned above, State Fund entered into one global settlement

(meaning it resolved multiple claims and liens) with CPM on August 25, 2010,

another with CPM and IPM both on May 19, 2011, and a third with LBPP on July 2,



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2012. State Fund detected that CPM and IPM had submitted a huge number of

duplicate claims; State Fund tried to deny duplicate payments, and tried to guard

against the submission of duplicate claims in the future in those agreements. While

State Fund did detect some of the duplicate bills, CPM and IPM claimed they were

mere mistakes and continued to submit duplicate claims after the settlement.

300. Even after inducing State Fund to enter into the 2010, 2011, and 2012

settlements, Pharmacy Defendants CPM and LBPP continued to bill State Fund and

seek payments for claims that were part of the Global Settlements and supposedly

resolved, and in some circumstances, received additional payments. Lodged with

the Court are two spreadsheets containing examples of CPM (now IPM) and LBPP

continuing to bill State Fund for claims that were a part of these Global Settlements

after the Global Settlements were concluded. (titled, "CPM – Billing After

Settlement" and "LBPP – Billing After Settlement"). State Fund did detect some of

these duplicate billings, and is not attempting to recover twice on bills it detected

but did not pay.

301. A fourth global settlement proposed in 2013 fell apart because CPM

and IPM were again commingling their claims. As State Fund's in-house counsel

notified Drobot Jr.: "I would note that IPM and Cal Pharmacy comingled their AR

[accounts receivable] for our consideration. This was not disclosed to State Fund

until we recently called it to their attention. It is the improper comingling of the AR

that has caused the current delay." This 2013 settlement was not consummated

before federal and state agencies raided the offices of CPM, IPM, and Pacific

Hospital as described below.

E. The Global Settlements (CPM, IPM, LBPP, Drobot Sr., Drobot Jr.,

and All Provider Defendants except Drs. Akmakjian, Chambi,

Tantuwaya, and Moheimani)

302. The Global Settlements with CPM, IPM, and LBPP contained

"Representations & Warranties" clauses providing that each party to the agreement



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"is not aware of any duress, menace, fraud, coercion, or undue influence which has

caused any Party to enter into this Agreement." See Ex. 1-3 to Counterclaim of

CPM, IPM, and LBPP (Dkt. No. 67) (three global settlement agreements from 2010,

2011 and 2012). Further, as described in Section VI.A, the settlement agreements

specifically contemplate that Pharmacy Defendants had the authority to settle claims

on behalf of the medical providers because they had the right, title, or interest to the

claims at issue.

303. State Fund is seeking rescission of the settlement agreements because

of the fraud perpetrated on it in the course of submitting fraudulent bills and

fraudulently inducing State Fund to settle them. The inflated prices and double-

billing, as alleged above, were meant to make State Fund pay far larger amounts on

these claims than otherwise warranted. If State Fund had known the true nature of

Pharmacy Defendants' businesses and the scope of the fraudulent enterprise, it

would not have settled with these defendants. State Fund relied on Pharmacy

Defendants' representations that they had authority to collect and settle the claims at

issue—as stated in the agreements themselves—and relied on Pharmacy Defendants'

representations that they were not aware of any fraud causing State Fund to enter

into the settlement agreements.

304. Yet, Pharmacy Defendants were fully aware of their fraudulent

activities and billing practices. Not only were Pharmacy Defendants paying illegal

kickbacks to providers, engaging in the corporate practice of medicine, and running

pharmacies and purchasing pharmaceuticals without licenses, among other things,

they were also intentionally misrepresenting and concealing the nature of their

arrangements with medical providers from State Fund.

305. Indeed, before paying bills submitted by the Pharmacy Defendants and

before entering into the Global Settlements, State Fund demanded that the Pharmacy

Defendants provide copies of their contracts with providers to demonstrate the

Pharmacy Defendants' right to collect from State Fund. Pharmacy Defendants



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deliberately determined to withhold or alter certain agreements with medical

providers—e.g., those which showed the amount of guaranteed "advances" being

paid to medical providers in exchange for their pharmaceutical business—to

"protect the innocent." Furthermore, other documents show the Individual

Defendants asking medical providers to sign sham medical lien purchase agreements

to satisfy State Fund's requests, all the while assuring the medical providers that the

fee-splitting arrangement would stay intact despite the purported "sale" of the claims

to the Pharmacy Defendants.

VII. STATE FUND UNCOVERS DEFENDANTS' WELL-CONCEALED

FRAUD

306. Defendants have concealed the fraudulent schemes from State Fund by

submitting the same or similar bills for procedures and materials over the course of

years. Defendants never indicated they had inflated the costs of procedures or

materials in their bills to State Fund. Defendants continued to represent that they

were billing State Fund for their actual and reasonable costs. Defendants also did

not disclose the connections between and among their related entities, repeatedly

discontinuing entities and forming others, while using different tax identification

numbers, knowing that State Fund, operating in good faith in the workers'

compensation system, could not keep track of morphing entities and

schemes. Defendants did not disclose the true contractual relationships with

medical providers, including the Provider Defendants, or the involvement of the

Administrative Defendants. Indeed, the Plea Agreement with Drobot Sr. indicates

that their undetected schemes had been perpetrated against a number of workers'

compensation insurers since at least 1998.

307. The Surgical and Pharmacy Defendants also filed Liens at the WCAB

on the basis of their fraudulent bills, similarly contending before the WCAB that the

bills were legitimate and that the Defendants were legally entitled to full payment.



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308. As noted, the workers' compensation system provides for, among other

things, accelerated treatment and submission and payment of bills, and in certain

circumstances, penalties against an insurer when payment of a bill is delayed. State

Fund's limited resources as a public enterprise fund and non-profit state agency,

along with the massive number of bills it receives each day, make the early

detection of fraud—especially complex schemes involving multiple sophisticated

entities—difficult, if not impossible. State Fund had no reasonable opportunity to

investigate Defendants' individual bills or the schemes as a whole, and had no

reason to suspect the extent and systemic nature of the fraud conducted by the

Defendants.

309. On April 5, 2013, as reported by numerous publications and media

outlets, the corporate offices of Pacific Hospital and IPM were served with search

warrants by federal and state authorities, including but not limited to the United

States Postal Service, the Federal Bureau of Investigation, the Internal Revenue

Service, the investigatory arm of the United States Department of Defense, and the

California Department of Insurance. The search warrants remain under seal in this

Court, so that State Fund still does not know the details, except for those disclosed

in the Plea Agreement.

310. On the basis of these reports, State Fund has conducted (and continues

to refine) an in-depth review of billings from and payments to the Surgical and

Pharmacy Defendants, including reviews of ownership structure, control by the

Individual Defendants, and patterns of claims. The investigation included the

review of thousands of bill runs, thousands of individual bills, and thousands of

other records including Secretary of State documents, medical regulations and

schedules, and industry and trade publications. The initial complaint in this action

was filed on June 24, 2013. Moreover, a qui tam action against some of the

Defendants (including Pacific Hospital and Drobot Sr.) was unsealed in Sacramento

Superior Court in late July 2013.



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311. Accordingly, State Fund has discovered the various fraudulent schemes

described above. These schemes are extensive and go far beyond the traditional

relationship of providers and insurers in the workers' compensation system. Given

the mass of data and complexity of the schemes, State Fund's investigation is

continuing. Defendants' billings demonstrate a systematic course of conduct to

defraud State Fund, in violation of the core purpose of the workers' compensation

system: the quick and efficient treatment of injured workers. Defendants' fraudulent

schemes make health care more expensive and less efficient for workers'

compensation claimants, and negatively impact honest providers.

312. As a result of the active fraudulent concealment of the conspiracy, State

Fund asserts the tolling of the applicable statute of limitations affecting the causes of

action by State Fund.

FIRST CAUSE OF ACTION

(Civil RICO 18 U.S.C. § 1962(c))

(Against Surgical Defendants, Individual Defendants, and Administrative

Defendants)

313. State Fund incorporates by reference the allegations in paragraphs 1-19,

22-223, and 306-312 of this Complaint as though fully set forth herein.

314. State Fund, Pacific Hospital, International Implants, Long Beach Pain,

PSPM, FMM, Dr. Bernadett, Drobot Sr., and Drobot Jr. are each "persons" as

defined in 18 U.S.C. § 1961(3).

A. Individual Defendants, Surgical Defendants, and Administrative

Defendants Formed an Association-in-Fact Enterprise.

315. The Individual Defendants, Surgical Defendants, and Administrative

Defendants (in this First Cause of Action, shortened to "Defendants" with

exceptions noted below), including their employees and agents, formed an

association-in-fact enterprise within the meaning of 18 U.S.C. § 1961(4), the

"Surgical Defendant Enterprise."



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316. The Surgical Defendant Enterprise is an ongoing organization

consisting of both corporations and individuals that associated for common and

shared purposes, including: (a) the fraudulent billing and overbilling of spinal

implants through the use of illegal kickbacks and fee-splitting; (b) the fraudulent

billing and overbilling of other medical services using sham contracts designed to

hide the corporate practice of medicine; (c) deriving increased profits from the

activities of the enterprise; and (d) concealing the fraudulent nature of the

enterprise's activities. See supra paragraphs 162-223. Lodged with the Court are

the following spreadsheets containing non-exhaustive, representative samples of

predicate acts committed in furtherance of the alleged fraudulent schemes:

• Pacific Hospital – Spinal Hardware (Section V.A)

• Pacific Hospital – Unbundling and Upcoding (Section V.C)

• Long Beach Pain – Unbundling and Upcoding (Section V.C)

• Pacific Hospital – Toxicology Overbilling (Section V.C)

• Pacific Hospital – RNFA Billing (Section V.D)

• Pacific Hospital – Autologous Transfusions (Section V.E)

• Long Beach Pain – Duplicate Radiology Billing (Section V.F) 317. Drobot Sr. owns and/or controls each of the Surgical Defendants.

Specifically, Drobot Sr. owns and/or controls Pacific Hospital and Long Beach Pain

(and is an officer and director of both), as well as International Implants. Moreover,

International Implants registered the same business address with the California

Secretary of State as the Pharmacy Defendant entities now under Drobot Jr.'s

control, including CPM, IPM, Coastal, and LBPP, as well as the Administrative

Defendants, PSPM and FMM. Dr. Bernadett owned and/or controlled each of the

Surgical Defendants from at least 2005-2010. Specifically, Dr. Bernadett owned

and/or controlled Pacific Hospital and Long Beach Pain, as well as International

Implants. Drobot Jr., according to Pacific Hospital testimony, also worked in the

Purchasing Department of Pacific Hospital, used Healthsmart Corp. and Pacific



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Hospital email addresses, referred patients to spinal surgeons for surgery at Pacific

Hospital, facilitated the payment of kickbacks to medical providers, and directed the

Pharmacy Defendant Entities at the same address as many Surgical Defendants.

Thus, on information and belief, State Fund alleges that the Individual Defendants

coordinated with one another and with the Surgical Defendants to implement and

disguise the enterprise's schemes.

318. The enterprise functioned as a continuing unit as evidenced by the

numerous, ongoing transactions between its members. For example, since 2007

International Implants has provided Pacific Hospital with over 75% of Pacific

Hospital's spinal implant equipment, with numerous fraudulent invoices being

exchanged between the entities and distributed to State Fund. Indeed, patients have

been shuffled back and forth between the surgical and pharmacy sides, with over

$30 million of the over $60 million paid by State Fund to the Pharmacy Defendants

representing patients who were also used in the Surgical schemes. Further, over

8,700 claims submitted to State Fund involved treatment by both a Pharmacy

Defendant and a Surgical Defendant.

B. Individual Defendants, Surgical Defendants, and Administrative

Defendants Each Conducted the Enterprise's Affairs

319. International Implants supplied Pacific Hospital with fraudulent

invoices, knowing that the invoices would be used in furtherance of the enterprise's

scheme to overbill spinal implants. Pacific Hospital participated in the enterprise by

submitting fraudulent invoices and bills containing false certifications by the

Provider Defendants to State Fund, in furtherance of the enterprise's scheme to

overbill spinal implants. Long Beach Pain participated in the affairs of the

enterprise by submitting fraudulent bills to State Fund and other insurers, in

furtherance of the enterprise's scheme to overbill medical services. See supra

paragraphs 162-223. Drobot Sr. owns and directs the activities of Pacific Hospital

(at least until it was recently sold), Long Beach Pain, and International Implants;



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Abrazos Healthcare, Inc. (the parent corporation of Pacific Hospital) and

International Implants have registered the same business address with the California

Secretary of State as the Pharmacy Defendant entities now under Drobot Jr.'s

control, including CPM, IPM, Coastal, and LBPP, as well as the Administrative

Defendants, PSPM and FMM. Emails show Drobot Jr. facilitated the payment of

kickbacks, referred spine patients to doctors in connection with getting them to sign

management agreements with IPM/CPM (for surgeries to be performed at Pacific

Hospital), and according to Pacific Hospital testimony, also worked in the

Purchasing Department of Pacific Hospital. Thus, State Fund alleges that, on

information and belief, working with one another, the Individual Defendants

directed their respective entities in carrying out the enterprise's schemes.

320. The Administrative Defendants participated in both enterprises by

"leasing" or providing employees to facilitate and conceal that the Surgical and

Pharmacy Defendants were engaging in kickbacks, the corporate practice of

medicine, and illegal fee-splitting. The Administrative Defendants' contracts were

designed to, and did, hide the true nature of what the fraud in which the other

Defendants were engaged from State Fund and other insurers.

C. The Surgical Defendant Enterprise Engaged in a Pattern of

Racketeering Activity, Consisting of Mail and Wire Fraud

Violations

321. The Surgical Defendant Enterprise engaged in a pattern of racketeering

activity by committing multiple acts of mail fraud, in violation of 18 U.S.C. § 1341,

and wire fraud, in violation of 18 U.S.C. § 1343. Pacific Hospital and Long Beach

Pain each caused the fraudulent use of United States mail and interstate wires by

sending thousands of fraudulent bills and invoices via U.S. Postal Service or

electronically, in furtherance of the scheme to overbill spinal surgeries, including

spinal implants, and other medical services. International Implants caused the

fraudulent use of United States mail by providing Pacific Hospital with fraudulent



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invoices, intending and foreseeing that the invoices would be mailed in furtherance

of the enterprise's scheme to overbill spinal implants. The Provider Defendants

generated the fraudulent bills and allowed them to be submitted under their names

as licensed medical professionals, knowing the bills would be submitted to State

Fund through the U.S. Postal Service or electronically.

322. Defendants engaged in a pattern of racketeering activity by directing

Surgical Defendants to use the United States mail and interstate wires in furtherance

of the overbilling schemes, in violation of 18 U.S.C. § 1341 and 18 U.S.C. § 1343.

In furtherance of the enterprise's overbilling schemes, Drobot Sr. arranged for:

International Implants to mail and wire fraudulent invoices to Pacific Hospital;

Pacific Hospital to mail and wire fraudulent bills and invoices to State Fund; Long

Beach Pain to mail and wire fraudulent bills to State Fund; and Pacific Hospital,

through the Administrative Defendants, to mail and wire illegal payments to medical

providers, including the Provider Defendants, and marketers, including the Marketer

Defendants. Drobot Jr. acted in furtherance of the enterprise's schemes through his

patient referrals and by facilitating the payment of kickbacks to providers, along

with his involvement with the Administrative Defendants. Defendants made these

arrangements intending to defraud State Fund and others by making them overpay

for spinal surgeries, including spinal implants, and other medical services.

323. Defendants also used, and caused the use of, the United States mail and

interstate wires to submit other correspondence and documents in furtherance of the

Surgical Defendant Enterprise, including communications designed to conceal the

enterprise's fraudulent activities.

D. The Surgical Defendant Enterprise Affected Interstate Commerce

324. The Surgical Defendant Enterprise could not have been carried out

without the United States mail or interstate wires, which were used for the

submission of the fraudulent bills, correspondence about them, and payment on

them.



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325. Further, on information and belief, the Surgical Defendant Enterprise's

schemes cheated State Fund and other workers' compensation insurers out of

hundreds of millions of dollars. The cost of this fraud is passed on, at least in part,

to employers who purchase workers' compensation insurance in California. Many

employers with California employees have their principal place of business outside

California. Many employers are also publicly traded companies, with shareholders

spread across the United States. The Surgical Defendant Enterprise's racketeering

injured both in-state and out-of state employers and their shareholders, therefore

affecting interstate commerce. Provider fraud affects the premiums charged for

workers' compensation insurance for these multi-state and international employers.

326. The spinal implants were shipped by interstate commerce carriers,

including United States mail services. On information and belief, many of the

spinal implants were manufactured outside of California and shipped into

California.

327. As alleged in a prior RICO action brought by Defendant CPM against

another insurer, the interstate nature of many companies and the mobility of

employees means that the business of workers' compensation insurance, even for

only California workers, dramatically impacts interstate commerce. This is

confirmed by the federal nature of the investigation revealed earlier this year, with

participation by the United States Postal Service as well as the Federal Bureau of

Investigation.

E. State Fund Relied on the Surgical Defendant Enterprise's

Misrepresentations and Suffered Financial Injury As a Result.

328. In carrying out their fraudulent schemes, Defendants knew that State

Fund would rely on the accuracy of the Defendants' misrepresentations in order to

set proper reimbursement amounts.

329. In addition, Defendants knew that State Fund reimburses medical

providers in accordance with the California Labor Code and regulations



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promulgated thereunder. Defendants were keenly aware of these laws and

regulations, and made specific misrepresentations intending and foreseeing that

State Fund would rely on these misrepresentations in complying with law, causing

Defendants to be overpaid.

330. State Fund reasonably relied on Defendants' misrepresentations.

Defendants' violations of 18 U.S.C. § 1962(c) directly and proximately caused State

Fund substantial injury to business and property by causing State Fund to overpay

many millions of dollars in inflated reimbursements for spinal implants and other

medical services. State Fund would not have made these overpayments had

Defendants not engaged in their pattern of racketeering activity. Defendants'

racketeering activity also caused State Fund to incur out-of-pocket costs and related

expenses that would otherwise not have been incurred.

331. As a direct and proximate result of Defendants' unlawful racketeering

activity, State Fund suffered damages in an amount to be proven at trial. However,

as alleged above, State Fund would not have done business with Defendants had it

known of the well-concealed fraud, so that State Fund claims all amounts it paid to

Defendants under these false pretenses as damages, since Defendants had no right to

it.

332. Under the provisions of 18 U.S.C. § 1964(c), Defendants are jointly

and severally liable to State Fund for three times the damages that State Fund has

suffered, plus the costs of bringing this suit, including reasonable attorneys' fees.

SECOND CAUSE OF ACTION

(Civil RICO 18 U.S.C. § 1962(c))

(Against Pharmacy Defendants, Individual Defendants, and Administrative

Defendants)


20-161 and 224-312 of this Complaint as though fully set forth herein.



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334. State Fund, Drobot Sr., Drobot Jr., Dr. Bernadett, each of the Pharmacy

Defendants, FMM, and PSPM are "persons" as that term is defined in 18 U.S.C. §

1961(3).

A. Individual Defendants, Pharmacy Defendants, and Administrative

Defendants Formed an Association-in-Fact Enterprise.

335. Individual Defendants, Pharmacy Defendants, Administrative

Defendants and their employees and agents formed an association-in-fact enterprise

within the meaning of 18 U.S.C. § 1961(4) (the Pharmacy Defendant Enterprise).

336. The Pharmacy Defendant Enterprise is an ongoing business

organization consisting of both corporations and individuals that are and have been

associated for common or shared purposes, including: (a) running pharmacies and

purchasing and selling drugs without a license to do so and collecting

reimbursements; (b) overbilling for drugs sold, including past manipulation of

AWPs; (c) double-billing with each other for medications paid for by State Fund,

including after claims had been resolved; (d) entering into fraudulent contracts and

engaging in the corporate practice of medicine, and misrepresenting their right to

bill State Fund; (e) deriving increased profits from the activities of the enterprise;

and (f) concealing the fraudulent nature of the enterprise's activities. See supra

paragraphs 224-312. Lodged with the Court are the following spreadsheets

containing non-exhaustive, representative samples of predicate acts committed in

furtherance of the alleged fraudulent schemes:

• CPM – Overbilling (Section VI.B)

• Coastal – Overbilling (Section VI.B)

• IPM – Overbilling (Section VI.B)

• LBPP – Overbilling (Section VI.B)

• MMG – Overbilling (Section VI.B)

• CPM – Overbilling Compounds (Section VI.B)

• CPM – AWP Manipulation (Section VI.C)



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• CPM & IPM – Duplicate Billing (Section VI.C)

• Coastal & Express – Duplicate Billing (Section VI.C)

• Coastal & LBPP – Duplicate Billing (Section VI.C)

• CPM – Billing After Settlement (Section VI.D)

• LBPP – Billing After Settlement (Section VI.D) 337. Individual Defendants own and control each of the Pharmacy

Defendants, or owned and controlled them in the past. Individual Defendants

coordinated with one another and with Pharmacy Defendants to implement and

disguise the enterprise's schemes. Drobot Jr., who now owns and controls the

Pharmacy Defendants, coordinated with Drobot Sr., who formerly owned CPM and

IPM, to implement the enterprise's schemed to run pharmacies and purchase and sell

drugs without the required licenses. Dr. Bernadett approved and facilitated the

payment of kickbacks and other illegal fees to Provider Defendants through the

Pharmacy Defendants. As noted above, CPM replaced IPM, and Coastal apparently

replaced or took over for LBPP, and IPM used LBPP in its business.

338. Individual Defendants also coordinated with DRx and Aidarex, owned

by Drobot Sr. and Drobot Jr., in implementing the enterprise's scheme of reporting

and disseminating fraudulent AWPs and overbilling for drugs. The Individual

Defendants and the Pharmacy Defendants further coordinated with the repackagers

in arranging for these drugs to be shipped to physicians and patients. The enterprise

functioned as a continuing unit as evidenced by the numerous, ongoing transactions

between its members. For example, from 2001 through at least 2007, DRx provided

drugs to Pharmacy Defendants and/or the physicians with whom the Pharmacy

Defendants contracted. The enterprise's functioning as a continuing unit is further

evidenced by Individual Defendants' common ownership and/or control over each of

the Pharmacy Defendants and the repackagers with whom they conspired, and the

medical providers' continued involvement.



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339. The Administrative Defendants and CPM/IPM also entered into

contracts with providers, including the Provider Defendants, at the Individual

Defendants' guidance and direction, which led to unlicensed activity, the illegal

corporate practice of medicine and improper fee-splitting.

B. Individual Defendants, Pharmacy Defendants, and Administrative

Defendants Each Conducted the Affairs of the Enterprise

340. Each Pharmacy Defendant participated in the affairs of the Pharmacy

Defendant Enterprise. For example, to conceal the enterprise's fraudulent activities,

each Pharmacy Defendant, acting under the direction of the Individual Defendants,

implemented practices of overbilling certain medications. The Pharmacy

Defendants also coordinated with one another in submitting duplicate bills to State

Fund, for example, by sharing with each other the information needed to submit

duplicate claims.

341. Individual Defendants conducted the affairs of the Pharmacy Defendant

Enterprise by devising the enterprise's schemes and operating the enterprise's

members in furtherance of those schemes. Individual Defendants own and control

each of the Pharmacy Defendants. For example, Drobot Jr. is currently the owner

and the President and CEO of IPM/CPM; in this capacity, he directed and managed

CPM's participation in the Pharmacy Defendant Enterprise. Drobot Jr. further

conducted the affairs of the Pharmacy Defendant Enterprise by entering into

contracts with physicians and repackagers (such as DRx and Aidarex) on

IPM/CPM's behalf. Drobot Sr. conducted the affairs of the Pharmacy Defendant

Enterprise by owning CPM/IPM and directing its activities at least until 2010, as

well as acquiring DRx, on information and belief, in order to manipulate its AWPs.

See supra paragraphs 48-63, 152-161, 279, 281-291. Dr. Bernadett conducted the

affairs of the enterprise by approving and facilitating the payment of kickbacks and

other illegal fees to medical providers, including Provider Defendants, through the

Pharmacy Defendants.



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342. The Pharmacy Defendant Enterprise has or had additional connections

to the Surgical Enterprise as well. Patients have been shuffled back and forth

between the surgical and pharmacy sides, with over $30 million of the $60 million

paid by State Fund to the Pharmacy Defendants representing patients who were also

used in the Surgical Scheme. Over 8,700 claims submitted to State Fund involved

treatment by both a Pharmacy Defendant (or by physicians with whom they

contracted) and a Surgical Defendant.

C. The Pharmacy Defendant Enterprise Engaged in a Pattern of

Racketeering Activity, Consisting of Mail and Wire Fraud

Violations

343. Pharmacy Defendants engaged in a pattern of racketeering activity by

committing multiple acts of mail fraud, in violation of 18 U.S.C. § 1341, and wire

fraud, in violation of 18 U.S.C. § 1343. Each Pharmacy Defendant caused the

fraudulent use of United States mail or interstate wires by sending, via U.S. Postal

Service or electronically, bills where it misrepresented its right to reimbursement for

drugs on which it had no right to collect. Each Pharmacy Defendant also caused the

fraudulent use of United States mail or interstate wires by sending fraudulently

inflated bills; some of these bills contained further misrepresentations in the form of

falsified AWP data. Pharmacy Defendants mailed and wired their fraudulent bills

intending to defraud State Fund and others, making them overpay for the drugs sold.

344. Individual Defendants engaged in a pattern of racketeering activity by

directing Pharmacy Defendants and their repackagers to use the United States mail

and interstate wires in furtherance of the enterprise's schemes, in violation of 18

U.S.C. § 1341 and § 1343. In furtherance of the enterprise's schemes, Individual

Defendants arranged for, among other things: Pharmacy Defendants to misrepresent,

via interstate mail and wire, their right to reimbursement for drugs they had no right

to sell; Pharmacy Defendants to enter into improper contracts and activities with

providers as well as Administrative Defendants which provided for the illegal



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corporate practice of medicine, illegal fee-splitting, and unlicensed pharmacy work;

and Pharmacy Defendants to overbill State Fund via interstate mail and wire.

Individual Defendants made these arrangements intending to defraud State Fund and

others, making them overpay for the drugs sold.

345. Pharmacy Defendants shared patients and providers with the Surgical

Defendant Enterprise. On information and belief, Defendants by contract agreed to

share certain proceeds from the enterprise's activities with physicians who referred

patients to the pharmacies run by Defendants in the physicians' offices. Defendants

thus provided physicians with a strong financial incentive to prescribe drugs and

refer the patients to Defendants—an incentive that often counseled against the best

interests of the physicians' patients, resulting in bills for medically unnecessary

pharmaceuticals.

346. Defendants also used and caused the use of the United States mail and

interstate wires to submit other correspondence and documents in furtherance of the

Pharmacy Defendant Enterprise, including communications and contractual

agreements with the Entity Defendants designed to conceal the enterprise's

fraudulent activities.

D. The Pharmacy Defendant Enterprise Affected Interstate

Commerce

347. The Pharmacy Defendant Enterprise could not have been carried out

without the United States mail and interstate wires, which were used for the

submission of the fraudulent bills, correspondence about them, and payment on

them.

348. Further, on information and belief, the Pharmacy Defendant

Enterprise's schemes cheated State Fund and other workers' compensation insurers

out of millions of dollars. The cost of this fraud is passed on, at least in part, to

employers who purchase workers' compensation insurance in California. Many

employers with California employees have their principal place of business outside



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California. Many employers are also publicly traded companies, with shareholders

spread across the United States. The Pharmacy Defendant Enterprise's pattern of

racketeering injured both in-state and out-of-state employers and their shareholders,

therefore affecting interstate commerce. Provider fraud affects the premiums

charged for workers' compensation insurance for these multi-state and international

employers and entities.

349. As alleged in a prior RICO action brought by CPM against another

insurer, the interstate nature of many companies and the travel and transport of

employees means that the business of workers' compensation insurance, even for

California workers, dramatically impacts interstate commerce. This is confirmed by

the federal nature of the investigation revealed earlier this year, with participation by

the United States Postal Service as well as the Federal Bureau of Investigation.

350. CPM/IPM also partnered with at least one medical group in Indiana,

OrthoIndy, and used LBPP to dispense prescription medications to individuals

living there. IPM's website also lists an apparent business office in Maryland, and

promotes itself as a nationwide manager of prescriptions for physicians.

E. State Fund Relied on the Pharmacy Defendant Enterprise's

Misrepresentations and Suffered Financial Injury as a Result

351. In carrying out their fraudulent schemes, the Pharmacy Defendants,

Administrative Defendants, and Individual Defendants knew that State Fund would

rely on the accuracy of the Defendants' misrepresentations in order to set proper

reimbursement amounts.

352. The Pharmacy Defendants, Administrative Defendants, and Individual

Defendants knew that State Fund reimburses medical providers in accordance with

the California Labor Code and regulations promulgated thereunder. Pharmacy and

Individual Defendants were aware of these laws and regulations and made specific

misrepresentations intending and foreseeing that State Fund would rely on these

misrepresentations in order to comply with law, causing Defendants to be overpaid.



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353. State Fund reasonably relied on Defendants' misrepresentations.

Defendants' violations of 18 U.S.C. § 1962(c) directly and proximately caused State

Fund substantial injury to business and property by causing State Fund to overpay

millions of dollars in inflated reimbursements for the drugs that Pharmacy

Defendants illegally sold. State Fund would not have made these payments had

Defendants not engaged in their pattern of racketeering activity. Defendants'

racketeering activity also caused State Fund to incur out-of-pocket costs and related

expenses that would not have otherwise been incurred.

354. As a direct and proximate result of Defendants' unlawful racketeering

activity, State Fund suffered damages in an amount to be proven at trial. However,

as alleged above, State Fund would not have done business with Defendants had it

known of the well-concealed fraud, so that State Fund claims all amounts it paid to

Defendants under these false pretenses as damages, since Defendants had no right to

these funds.

355. Under the provisions of 18 U.S.C. § 1964(c), each of the Individual

Defendants, each of the Pharmacy Defendants, and each of the Administrative

Defendants are jointly and severally liable to State Fund for three times the damages

that State Fund has suffered, plus the costs of bringing this suit, including

reasonable attorneys' fees.

THIRD CAUSE OF ACTION

(Civil RICO Conspiracy 18 U.S.C. § 1962(d))

(Against All Defendants)


22-223, 306-312, and 313-332 of this Complaint as though fully set forth herein.

357. State Fund, Pacific Hospital, International Implants, Long Beach Pain,

PSPM, FMM, Dr. Bernadett, Drobot Sr., Drobot Jr., and each of the other Entity,

Provider Defendants, and Marketer Defendants are each "persons" as defined in 18

U.S.C. § 1961(3).



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A. Each Defendant Knew of and Agreed to Facilitate the Surgical

Defendant Enterprise's Criminal Purpose

358. Defendants formed an agreement to violate 18 U.S.C. § 1962(c). Each

of these Defendants knew of the nature of Surgical Defendant Enterprise's

conspiracy to defraud State Fund by overbilling State Fund for spinal implants and

other medical procedures while taking active steps to conceal the fraud. Drobot Jr.

acted in furtherance of the enterprise's schemes through his patient referrals and by

facilitating the payment of kickbacks to providers, along with his involvement with

the Administrative Defendants.

359. Each Defendant agreed to join this conspiracy, agreed to commit at

least two predicate acts, and each agreed to commit, facilitate, or participate in a

pattern of racketeering activity in furtherance of the conspiracy.

B. Each Defendant Committed Predicate Acts In Furtherance of the

Enterprise's Criminal Purpose

360. During the existence of the conspiracy, each of the Defendants agreed

to the commission of multiple predicate acts in furtherance of the conspiracy to

overbill State Fund, and committed, facilitated, or participated in the commission of

at least two predicate acts.

361. Pacific Hospital agreed to and did commit multiple instances of mail

and wire fraud in furtherance of the conspiracy by mailing and wiring fraudulently

inflated bills and invoices. International Implants agreed to facilitate Pacific

Hospital's pattern of racketeering by supplying Pacific Hospital with fraudulent

invoices.

362. Long Beach Pain, under the same ownership as the other Pharmacy

Defendants, agreed to and did commit multiple instances of mail and wire fraud by

mailing and wiring fraudulent bills.

363. Individual Defendants agreed to and did commit multiple instances of

mail and wire fraud by directing Surgical Defendants to commit the predicate acts



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above, intending and foreseeing that the acts of mail and wire fraud would follow in

the ordinary course of business. Individual Defendants also agreed to and did

conduct the enterprise's affairs. Among other things, on information and belief,

Individual Defendants conducted the enterprise's affairs by devising its schemes,

obtaining profits from them, and meeting with the Surgical Defendants' employees

and medical providers in order to direct the schemes.

364. Provider Defendants agreed and did commit multiple instances of mail

and wire fraud by committing and facilitating the predicate acts above, intending

and foreseeing that the acts of mail and wire fraud would follow in the ordinary

course of business. Provider Defendants also agreed to and did conduct the

enterprise's affairs. Among other things, Provider Defendants conducted the

enterprise's affairs by generating fraudulent documents, making material

misrepresentations to State Fund, accepting kickbacks from the Entity Defendants,

and meeting with the Individual Defendants and employees of the Surgical

Defendants in order to further the schemes.

365. Marketer Defendants agreed and did commit multiple instances of mail

and wire fraud by committing and facilitating the predicate acts above, intending

and foreseeing that the acts of mail and wire fraud would follow in the ordinary

course of business. Marketer Defendants also agreed to and did conduct the

enterprise's affairs. Among other things, Marketer Defendants conducted the

enterprise's affairs by arranging for surgeries to be performed by the Provider

Defendants, directing the Provider Defendants to use fraudulently-inflated hardware,

accepting and paying kickbacks, and meeting with the Individual Defendants,

Provider Defendants, and employees of the Surgical Defendants in order to further

the schemes.

366. Specific examples of predicate acts committed in furtherance of the

conspiracy are provided in paragraphs 162-223 and in the spreadsheets lodged with

the Court.



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C. State Fund Suffered Injury From the Predicate Acts Committed In

Furtherance of the Enterprise's Criminal Purpose

367. The predicate acts of mail and wire fraud that Defendants agreed to and

did commit directly and proximately caused State Fund to suffer substantial injury

to its business and property, as alleged in greater detail above.

368. Under the provisions of 18 U.S.C. § 1964(d), Defendants are jointly

and severally liable to State Fund for three times the damages that State Fund has

suffered, plus the costs of bringing this suit, including reasonable attorneys' fees.

FOURTH CAUSE OF ACTION

(Civil RICO Conspiracy 18 U.S.C. § 1962(d))

(Against Pharmacy Defendants, Individual Defendants, Administrative

Defendants, and All Provider Defendants except Drs. Akmakjian, Chambi,

Tantuwaya, and Moheimani16)


20-161, 224-312, and 333-355 of this Complaint as though fully set forth herein.

370. State Fund, the Individual Defendants, each of the Administrative

Defendants, each of the Provider Defendants, and each of the Pharmacy Defendants

are "persons" as that term is defined in 18 U.S.C. § 1961(3).

A. Each Defendant Knew of and Agreed to Facilitate the Pharmacy

Defendant Enterprise's Criminal Purpose

371. Pharmacy Defendants, Administrative Defendants, and Individual

Defendants formed an agreement to violate 18 U.S.C. § 1962(c). Each Defendant

knew of the Pharmacy Defendant Enterprise's conspiracy to defraud State Fund by

submitting fraudulent bills and overbilling State Fund for drugs that the enterprise

illegally sold while taking active steps to conceal the fraud. Each Defendant agreed

16 For purposes of this Fourth Cause of Action, the term "Provider Defendants" should be read to exclude Drs. Akmakjian, Chambi, Tantuwaya, and Moheimani.



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to join this conspiracy, and each agreed to commit, facilitate, or participate in a

pattern of racketeering activity in furtherance of the conspiracy.

B. Each Defendant Committed Predicate Acts In Furtherance of the

Enterprise's Criminal Purpose.

372. During the existence of the conspiracy, each of the Defendants agreed

to the commission of multiple predicate acts in furtherance of the conspiracy to

overbill State Fund, and committed, facilitated, or participated in the commission of

at least two predicate acts.

373. Each of the Pharmacy Defendants agreed to and did mail or wire State

Fund bills for drugs it had illegally purchased and sold, and had no right to collect

on. Each did so with intent to defraud State Fund, in furtherance of the conspiracy.

Each of the Pharmacy Defendants also agreed to and did mail or wire State Fund

bills with fraudulently inflated drug prices. Each did so with intent to defraud State

Fund, in furtherance of the conspiracy.

374. Through the Individual and Administrative Defendants, the Pharmacy

Defendants shared patients and doctors with the Surgical Defendant Enterprise.

Individual Defendants agreed to and did commit multiple instances of mail and wire

fraud by directing Pharmacy Defendants to commit the predicate acts above,

intending and foreseeing that the acts of mail and wire fraud would follow in the

ordinary course of business. Individual Defendants also agreed to and did conduct

the enterprise's affairs. Among other things, Individual Defendants conducted the

enterprise's affairs by devising its schemes, obtaining profits from the schemes, and

conducting meetings with medical providers and the Pharmacy Defendants'

employees in order to direct the schemes.

375. Provider Defendants agreed and did commit multiple instances of mail

and wire fraud by committing the predicate acts above, intending and foreseeing that

the acts of mail and wire fraud would follow in the ordinary course of business.

Provider Defendants also agreed to and did conduct the enterprises affairs. Among



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other things, Provider Defendants conducted the enterprise's affairs by generating

the fraudulent documents, accepting kickbacks from the Entity Defendants, making

material misrepresentations to State Fund, and meeting with the Individual

Defendants and employees of the Pharmacy Defendants in order to further the

schemes.

376. Specific examples of predicate acts committed in furtherance of the

conspiracy are provided in paragraphs 162-223 and in the spreadsheets lodged with

the Court.

C. State Fund Suffered Injury From the Predicate Acts Committed In

Furtherance of the Enterprise's Criminal Purpose

377. The predicate acts of mail and wire fraud that Defendants agreed to and

did commit directly and proximately caused State Fund to suffer substantial injury

to its business and property, as described in more detail above.

378. Under the provisions of 18 U.S.C. § 1964(d), the Individual

Defendants, Administrative Defendants, Pharmacy Defendants, and Provider

Defendants are jointly and severally liable to State Fund for three times the damages

that State Fund has suffered, plus the costs of bringing this suit, including

reasonable attorneys' fees.

FIFTH CAUSE OF ACTION

(Fraud)


379. State Fund incorporates by reference the allegations in paragraphs 1-

312, 313-332, 333-355, and 356-378 of this Complaint as though fully set forth

herein.

380. As alleged in detail above, Defendants made material

misrepresentations to State Fund, and/or concealed and/or suppressed material facts

from State Fund. Such misrepresentations included false billings for spinal

surgeries and other medical services including "other types of surgeries, magnetic



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resonance imaging, toxicology, durable medical equipment, [] other services," and

medications. Each Defendant also made misrepresentations and/or concealed facts

with the intent that State Fund not discover its fraudulent schemes.

381. The misrepresentations and omissions by Defendants were material and

were false and misleading, and Defendants knew they were material and were false

and misleading at the time they were made or, at a minimum, Defendants acted with

reckless disregard for the truth or falsity of the representations or omissions.

382. Defendants misrepresented, concealed and/or suppressed these facts

with the intent to deceive and influence the actions of State Fund, including

intending to have State Fund pay the fraudulent billings, as well as to stop any

investigation of the challenged practices.

383. State Fund reasonably and justifiably relied to its detriment on each

Defendant's misrepresentations. At the time State Fund acted in reliance on

Defendants' misrepresentations, State Fund was unaware of the representations'

falsity and of the facts Defendants concealed and suppressed. State Fund would

have acted differently if it had known the true facts. In particular, State Fund would

not have paid Defendants' fraudulent claims, and State Fund would have contested

(or contested further) Defendants' false billings.

384. As a direct and proximate result of Defendants' misrepresentations,

State Fund suffered damages in an amount to be proven at trial, but in an amount not

less than the monies paid to Defendants because of their fraudulent schemes with

respect to spinal surgeries and other medical services including "other types of

surgeries, magnetic resonance imaging, toxicology, durable medical equipment, []

other services," medications, and overbilling.

385. As explained above, State Fund was induced by the foregoing

fraudulent schemes to enter into settlement agreements with certain of the

Defendants on various dates, including but not limited to the Global Settlements and

settlement agreements dated April 20, 2004 and September 1, 2009 with Surgical



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Defendants ("Surgical Settlement Agreements"). State Fund's consent to enter into

these settlement agreements was obtained by Defendants' fraud, including the

misrepresentations and omissions articulated above. With respect to the Surgical

Settlement Agreements, Drobot Sr. has admitted to perpetrating fraud on insurance

carriers, including State Fund, since 1998.

386. With respect to the Pharmacy Global Settlements, these

misrepresentations and omissions included, but were not limited to, those that

represented the parties were aware of no fraud in entering into the Global

Settlements, as well as the representations that the Pharmacy Defendants were the

proper parties in interest and were legally entitled to collect on the claims, which

were in the Global Settlements themselves.

387. These misrepresentations by Drobot Jr. and Pharmacy Defendants were

made with the intent to induce State Fund to rely thereon, and State Fund did in fact

rely thereon. State Fund would not have settled these claims if it had known

Defendants' fraudulent activities and billings and that Defendants had engaged in the

foregoing misrepresentations and omissions.

388. Indeed, collectively, the contracts between the Provider Defendants

(and other medical providers) and the other Defendants violated California Bus. &

Prof. Code §§650, 652, 652.5, 2400, 2052, 4022, 4037, 4043, 4160, and 4170,

Insurance Code §§ 750, 754, and 1871.4, California Penal Code §§ 549 and 550,

and California Lab. Code §§ 139.3 and 3215, among other laws. Accordingly, they

are illegal and therefore void and unenforceable; the Defendants therefore had no

standing to submit the bills to State Fund or receive payment for them.

389. Consequently, the settlement agreements constitute void and/or

voidable contracts, and State Fund seeks rescission of them (including the return to

State Fund of payments plus interest), or if rescission is not available, damages in an

amount to be proven at trial.



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390. In making the above false statements, Defendants acted with a

conscious disregard for the rights of State Fund, and thus are guilty of oppression,

fraud, and malice pursuant to California Civil Code § 3294. State Fund is entitled to

recover punitive damages from Defendants in an amount to be proven at trial.

SIXTH CAUSE OF ACTION

(Business & Professions Code § 17200)


391. State Fund incorporates by reference the allegations in paragraphs 1-

312, 313-332, 333-355, 356-378, and 379-390 of this Complaint as though fully set

forth herein.

392. Defendants' schemes involving fraudulent misrepresentations and

omissions to State Fund constitute unlawful, unfair, or fraudulent business acts and

practices, under what is commonly known as the California Unfair Competition Law

("UCL"), California Bus. & Prof. Code §§ 17200 et seq.

393. Each Defendant violated Section 17200's prohibition against engaging

in an unlawful act or practice through conduct that violates, among other things,

RICO, 18 U.S.C. § 1962, as described herein. Through their unfair and improper

practices, State Fund suffered injury by virtue of Defendants' billing.

394. Defendants further violated Section 17200's prohibition against

engaging in an unlawful act or practice through conduct that violates, among other

things:

a. California Bus. & Prof. Code §§ 2400 and 2052 by entering into

illegal contracts that would allow the Pharmacy, Surgical, Individual, and

Administrative Defendants to exercise lay or corporate control over medical

decisions without the required license, which runs afoul of the corporate practice of

medicine doctrine (Pharmacy, Surgical, Individual, Administrative Defendants, and

Provider Defendants);



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b. California Lab. Code § 139.3, 3215, 3820, directly or by aiding

and abetting and conspiring with each other to enter into illegal fee-splitting

arrangements and provide Provider Defendants and other physicians with monetary

incentives for referrals of patients for clinical laboratory, diagnostic imaging goods,

pharmacy goods, evaluations, and consultations, among other services and

treatments (All Defendants);

c. California Bus. & Prof. Code §§ 650, 652, and 652.5, directly or

by aiding and abetting violations by Provider Defendants and other physicians, by

entering into illegal fee-splitting arrangements and by providing Provider

Defendants and other physicians with monetary incentives to refer patients to Entity

Defendants, to prescribe and dispense particular drugs or provide particular services,

and to use particular devices, hardware, implants, or equipment from specified

suppliers (All Defendants);

d. California Insurance Code §§ 750, 754, and 1871.4 and Penal

Code 549 and 550, by presenting and negotiating false or fraudulent claims and by

soliciting, offering, and paying referral fees for the referral of patients to Pacific

Hospital or other operations controlled and/or owned by Defendants, e.g., the

physician office dispensing programs "managed" by the Pharmacy Defendants, so

that they could submit insurance claims to State Fund for reimbursement, or

soliciting, accepting, or referring any business to or from any other Defendant with

the knowledge that, or with reckless disregard for whether, the Defendant for or

from whom the solicitation or referral was made, or the individual or entity who was

solicited or referred, intended to violate Section 550 of the Penal Code or Section

1871.4 of the Insurance Code (All Defendants).

e. California Bus. & Prof. Code §§ 4022, 4037, 4043, 4160, and

4170, by operating as a pharmacy, pharmaceutical wholesaler, and prescriber

dispensary and submitting claims for reimbursement without the required licenses,

and by aiding and abetting Provider Defendants and other physicians in the violation



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of section 4170 (Pharmacy, Individual, Administrative Defendants, and Provider

Defendants).

395. In addition to being unlawful and fraudulent, each of Defendants'

schemes to defraud State Fund constituted unfair business acts and practices under

§ 17200.

396. Defendants' unfair and unlawful practices were performed in

California. For example, the fraudulent billings were sent to and received by State

Fund in California.

397. State Fund has suffered injury to its business and property as a direct

and proximate result of Defendants' unfair and unlawful practices.

398. Defendants have fraudulently received up to hundreds of millions of

dollars from State Fund as a direct and proximate result of their unfair and unlawful

practices. Defendants have been unjustly enriched, and it would be inequitable to

allow Defendants to retain the monies they obtained from State Fund through fraud

or other unfair practices. Disgorgement should be awarded so as to achieve

substantial justice between the parties.

PRAYER FOR RELIEF

WHEREFORE, State Fund prays for judgment against all Defendants as

follows:

1. For compensatory damages in an amount to be proven at trial, and

treble damages under the RICO statute in the first cause of action (Surgical

Defendant Enterprise/Civil RICO);


treble damages under the RICO statute in the second cause of action (Pharmacy

Defendant Enterprise/Civil RICO);


treble damages under the RICO statute in the third cause of action (Surgical

Defendant Enterprise/Civil RICO Conspiracy);



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treble damages under the RICO statute in the fourth cause of action (Pharmacy

Defendant Enterprise/Civil RICO Conspiracy);

5. For an award of compensatory damages in an amount to be proven at

trial, plus an award of punitive and exemplary damages pursuant to the fifth cause of

action (fraud);

6. For restitution and disgorgement of unjust enrichment, plus interest,

pursuant to all appropriate causes of action;

7. For rescission of the settlement agreements pursuant to all appropriate

causes of action;

8. For an award of attorneys' fees and costs, pursuant to all appropriate

causes of action; and

9. For such other and further relief as the Court may deem just and proper.

Dated: May 8, 2015 IRELL & MANELLA LLP

By: /s/ John C. Hueston

John C. Hueston Attorneys for Plaintiff State

Compensation Insurance Fund



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JURY TRIAL DEMAND

As it did in its initial and First Amended Complaint and Second Amended

Complaint, State Fund continues to demand a trial by jury of all issues so triable on

the claims alleged herein.

DATED: May 8, 2015 Respectfully submitted, HUESTON HENNIGAN LLP

By: /s/ John C. Hueston

John C. Hueston Attorneys for Plaintiff State Compensation Insurance Fund



0.0

EXHIBIT 1-A

TO THIRD AMENDED COMPLAINT


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EXHIBIT 1-B TO THIRD AMENDED

COMPLAINT



DISTRIBUTION AGREEMENT

THIS DISTRIBUTION AGREEMENT (this "Agreement") is made and entered into effective as of July 10, 2008, by and between Alphatec Spine, Inc., a California corporation, (the "Company"), and International Implants, LLC a limited liability company (the "Distributor").

RECITALS

WHEREAS, Distributor desires to obtain the right to market and sell the Products developed by Company in the Territory (as such term is defined below);

NOW, THEREFORE, for good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, and intending to be legally bound, the parties hereby agree as follows:

1. Appointment and Acceptance. Subject to the terms and conditions of this Agreement, in connection with the distribution, marketing and sale of the products listed in Exhibit A and the instrumentation associated with such products (the "Products"), the Company hereby appoints Distributor as the exclusive distributor of the Products (other than as set forth on Exhibit B) in the territory set forth on Exhibit B attached hereto (the "Territory"), and Distributor hereby accepts such appointment. Company hereby grants to Distributor, and Distributor hereby accepts, a non-exclusive, non-royalty bearing license to use any trademarks, trade names or copyrights owned by the Company (the "Trademarks") solely in connection with the distribution, marketing and sale of the Products in the Territory.

2. Scope of Appointment. Distributor shall be Company's exclusive distributor in the Territory (other than as set forth in this Agreement) (without any rights to distribute, market or sell the Products outside of the Territory).

3. I£!!!!. Unless earlier terminated as provided in this Agreement, this Agreement shall be for an initial term of two years from the date hereof. The parties to this Agreement may only extend the term of this Agreement in a written document executed by both parties. It is agreed by the parties hereto that no inference shall be drawn from the execution of this Agreement as to any subsequent renewals of this Agreement by either party hereto.

4. Certain Representations, Warranties and Covenants of the Distributor. Distributor represents, warrants and covenants that it, its affiliates and agents will comply with all laws, rules, ordinances, requirements of governmental agencies, and regulations applicable to the promotion, pricing, marketing, distribution and sale of the Products, including, without limitation (i) the requirements of the FDA, (ii) the Anti-kickback Safe Harbors established by Office of the Inspector General of the United States and any comparable state statute, (iii) the applicable provisions of the federal "False Claims Act" and any comparable state statute. Distributor agrees that neither it nor any of its affiliates or agents shall offer, grant or withhold any money, object or service of value to any healthcare professional for purposes of influencing any clinical decision made by such healthcare professional to use or not use the Products. Distributor agrees that it shall abide by those portions of ASI's Code of Conduct that address interactions with healthcare

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professionals (see http://atec.client.shareholder.com/docwnentdisplay.cfm?DocumentID=900). In addition, Distributor agrees that it shall promptly notify the Company in the event that the Distributor, or members of the Distributor's ownership acquire an ownership interest in any medical facility to which the Distributor sells Products. In no event shall the Distributor sell a Product for a price that is higher than the price set forth in the Company's then-current published United State's price list for Products. The Distributor agrees to allow the Company to audit its books and records, solely for the purposes of confirming Distributor's compliance with this Section 4, upon two (2) business days' notice. A breach of this Section 4 by Distributor shall constitute a material breach of this Agreement.

5. Purchase of Products by Distributor; Consigned Inventory.

5.1 Pricing. Subject to the terms of this Agreement, Company will supply to Distributor, and Distributor will purchase, Distributor's requirements of Products, subject to Section 6 below, in such quantities as Distributor shall order for the prices shown on Exhibit A attached hereto. On or shortly following the anniversary of the Effective Date the parties shall meet to discuss whether it is appropriate to adjust the prices for the subsequent year. The negotiation of any new pricing shall be conducted in good faith by both parties and shall take into account, without limitation, (i) the volume of Products purchased by Distributor in the prior year and whether such amount exceeded the anticipated amounts, and (ii) the then-current price list of the Company's Products.

5.2 Samples. Subject to the terms of this Agreement, Company will supply to Distributor, and Distributor will purchase, Distributor's requirements of Product samples (the "Samples"), subject to Section 6 below, in such quantities as Distributor shall order for the prices set forth on the Company's then-current price list for the Samples.

5.3 Consigned Inventory. From time to time, the Company may consign certain Products or related instrwnentation to the Distributor. The Company will retain all right, title and interest in and to such Products and instrumentation (the "Consigned Inventory"). The Distributor will hold said Consigned Inventory in a fiduciary capacity. If any Consigned Inventory is returned damaged, then the Company, to the extent possible, will repair or refurbish the Consigned Inventory and invoice Distributor for the cost of said repairs and handling. If any Consigned Inventory is lost, missing, stolen, or cannot be repaired, then the Company shall invoice Distributor for the 100% of the Company's list price of such Consigned Inventory. Upon the termination or expiration of this Agreement, or upon the request of the Company, the Distributor shall immediately, and at its own expense, return all Consigned Inventory in its possession or control to the Company. The Distributor agrees and acknowledges that all loaner Consignment Inventory shall be subject to the Company's then-current Loaner Inventory Policy. The Distributor further agrees and acknowledges that the Company shall not be obligated to provide it with more than 21 sets of Consignment Inventory at any one time.

5.4 Minimum Purchase Commitment. During each three month period of the Agreement (each such period a "Quarter"), Distributor agrees to make a minimum purchase of any mix of Products, including Samples, from Company in the following amounts: Quarter 1 -$200,000; Quarter 2 - $200,000; Quarter 3 - $200,000; and Quarter 4 - $200,000 (each amount

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for such Quarter shall be referred to as the "Minimum Purchase Commitment"). In the event Distributor fails to purchase the Minimum Purchase Commitment specified above in the time periods set forth above, the Company shall have the right to terminate this Agreement for cause at any time effective upon written notice to Distributor. Within 60 days of the end of the first 12-month period of the term of this Agreement, Distributor and the Company shall use their respective good faith commercial best efforts to agree in writing on the Minimum Purchase Commitment for the second 12-month period of the term of this Agreement. If Distributor and the Company are unable to agree on the Minimum Purchase Commitment for such time period, or any subsequent time period if the Agreement is renewed, then the Minimum Purchase Commitment for each Quarter shall be equal to 130% of the Minimum Purchase Commitment for the same Quarter in the preceding year.

5.5 Purchase Orders. Prior to purchasing Products Distributor shall provide Company with a firm purchase order, a form of which is attached hereto as Exhibit C, specifying the Products it desires to purchase and a desired shipment date for the Products. Such purchase order, upon acceptance by the Company, shall be deemed to be incorporated into this Agreement and any conflicts between the purchase order and the terms of this Agreement shall be governed by the terms of this Agreement. Such shipment date shall be no less than 60 days from the date of such purchase order. Company shall have 20 days to notify Distributor of rejection of such purchase order. The Company shall not have any liability for arising from the rejection of any purchase order, provided that such rejection was delivered within such 20-day notice period. If no notice of rejection is given, the binding order shall be considered accepted by Company. Company shall make commercially reasonable efforts to fill such purchase order with Products within the scheduled delivery times set forth on such order.

6. Delivery, Payment Terms and Inspection.

6.1 Delivery. All prices are F.O.B. place of manufacture, and are exclusive of all transportation, insurance, customs and import duties, value added and sales taxes and other charges relating to or arising out of the supply of the Products and Samples to Distributor. All orders for Products and Samples shall contain no provisions that are inconsistent with such terms or those hereof (and to the extent they do, any such inconsistent provision shall be ineffective). Upon resale of Products by Distributor, Distributor shall make only those representations, and give only such warranties that are permitted under the rules, regulations and guidelines of the FDA.

6.2 Payment Terms. For the time period beginning on the Effective date and ending six months thereafter, within no more than 120 days of delivery of the Products by the Company, the Distributor will remit payment to the Company (the "Sales Agent Payment"). In connection with all orders placed after the date that is six months after the Effective Date, the Sales Agent Payment shall be due and payable no more than 90 days of delivery of the Products by the Company. Commencing on the applicable due date, interest shall accrue on any amounts which remain unpaid at the lower of either the rate of twelve percent (12.0%) per annum or the maximum rate allowed by applicable law. All invoices, and all payments therefore, shall be in U.S. dollars.

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6.3 Inspection. Distributor will inspect each shipment of Products and Samples for obvious damage when Distributor receives the shipment. If Distributor finds an obviously damaged or defective Product or Sample, it will provide written notice to Company, describe the damage or defect and request a return authorization form. The notice and request for return must be provided within 10 days following receipt of the shipment (the day of receipt will be counted as one of the days) or the Products and Samples will be deemed accepted by Distributor. If there is no notice or request for return by Distributor during the 10-day period, or the damage or defect is due to the act or omission of Distributor, then Company will have no obligation to replace the Products and Samples and Distributor will pay for the Product and Samples. Company will pay for the shipment and insurance for the return of damaged or defective Products and Samples and for other authorized returns. Subject to Section 10.2, the only remedy available to Distributor for an obviously damaged or defective Product or Sample is to receive a replacement. Distributor will not receive any refunds of amounts paid or credits toward future payments to Company.

7. Limited Warranty. Without limiting the obligations owed by the Company in accordance with Section 10.2 and subject to the provisions set forth therein, the Company warrants that, under normal use and service and when used in accordance with specifications supplied by Company, the Products sold by Company to Distributor will be of merchantable quality (the "Limited Warranty"). If any Products sold to Distributor do not comply with such warranty, Company will, at its option and expense, correct, repair, or replace, refund the purchase price or issue credit against Distributor's outstanding balance hereunder for any defective Product provided, that, in all such cases that reasonably sufficient evidence is produced by Distributor to establish that the Product is defective. The Limited Warranty will be void and Company will not have any obligation to honor the Limited Warranty, or have liability for any breach of warranty to Distributor, if (a) Products are (i) used for any use outside the Field, or (ii) used in combination with any product not manufactured or supplied by Company, or (b) if Distributor: (z) alters, changes or damages the Products or any component of the Products (unless consent is obtained pursuant to Section 14); or (y) distributes a Product that it has actual knowledge is defective or damaged. Distributor shall not pass through Company's Limited Warranty to end-users of the Products. Distributor shall be free to establish the terms of any warranty it wishes to extend to its customers. Company shall have no liability to end-user customers of Distributor under the Limited Warranty.

8. Warranty Disclaimers and Limitation. OTHER THAN THE LIMITED WARRANTY, COMPANY MAKES NO OTHER WARRANTIES, EXPRESSED OR IMPLIED, WITH RESPECT TO THE PRODUCTS AND ALL WARRANTIES OF MERCHANTABILITY AND FITNESS FOR ANY PARTICULAR PURPOSE ARE EXPRESSLY AND SPECIFICALLY EXCLUDED AND DISCLAIMED.

9. Limitation of Liability. COMPANY'S LIABILITY UNDER THE LIMITED WARRANTY SET FORTH IN SECTION 7 OR OTHERWISE WITH RESPECT TO THE PRODUCTS OR THEIR USE (INCLUDING LIABILITY FOR CONTRACT, NEGLIGENCE OR OTHERWISE IN TORT) IS LIMITED EXCLUSIVELY TO THE REMEDIES PROVIDED IN SECTION 7 AND 10, AND NO OTHER RIGHT OR REMEDY WILL BE AVAILABLE TO ANY PERSON OR ENTITY. IN NO EVENT WILL COMP ANY BE LIABLE TO ANY

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PERSON OR ENTITY FOR ANY SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES TO PERSON OR PROPERTY OR LOSS OF PROFITS OF ANY PERSON OR ENTITY RESULTING FROM ANY CAUSE WHATSOEVER, EVEN IF COMPANY HAS BEEN ADVISED, KNEW OR SHOULD HA VE KNOWN OF THE POSSIBILITY OF SUCH DAMAGES OR LOSS OF PROFITS. NO PERSON OR ENTITY IS AUTHORIZED TO EXTEND OR IN ANY WAY VARY COMPANY'S OBLIGATIONS HEREUNDER OR IN CONNECTION HEREWITH. ANY REPRESENTATION OR WARRANTY MADE BY ANY SALES REPRESENTATIVE, DISTRIBUTOR OR OTHER AGENT OR REPRESENTATIVE OF COMPANY WHICH IS NOT SPECIFICALLY SET FORTH HEREIN, SHALL NOT BE BINDING UPON COMPANY. SOME STATES AND JURISDICTIONS OUTSIDE OF THE UNITED STATES DO NOT ALLOW A LIMITATION OR EXCLUSION OF IMPLIED WARRANTIES, OR LIABILITY FOR INCIDENTAL OR CONSEQUENTIAL DAMAGES, SO THE ABOVE LIMITATION OR EXCLUSION MAY NOT APPLY. DISTRIBUTOR ACKNOWLEDGES THAT THE ALLOCATION OF RISKS AND BENEFITS UNDER THIS AGREEMENT IS BASED ON, AND THE AMOUNTS PAID UNDER THIS AGREEMENT WOULD BE GREATER IN THE ABSENCE OF, THE LIMITATIONS DESCRIBED ABOVE.

10. Indemnity.

10.1 Indemnification by Distributor. Subject to the provisions set forth in Sections 7, 10 and 20, Distributor shall indemnify and hold harmless Company and its officers, directors, employees, agents and affiliates (the "Company Indemnitees") from all claims, damages, losses, costs and expenses (including reasonable attorneys' fees) (the "Liabilities") which a Company Indemnitee may incur to the extent that such Liabilities arise out of or result from: (i) the sale or distribution of Products damaged or rendered defective by Distributor, (ii) any representation or warranty given by Distributor with respect to the Products (other than the labeling of the Products as approved by the FDA and other than as approved pursuant to Section 14), (iii) the sale by Distributor of a Product as combined with any product not manufactured or supplied by Company, (iv) Distributor's breach of the terms of this Agreement (including without limitation Section 4 or sales of the Products outside the Territory), or (v) the negligence, recklessness, gross negligence, or willful misconduct of any Distributor Indemnitee (as defined below).

10.2 Indemnification by Company. Company shall indemnify and hold harmless Distributor and its officers, directors, employees, agents and affiliates (the "Distributor Indemnitees") from all Liabilities which Distributor may incur by reason of (i) any Products sold or furnished by Company which result in injury, illness or death to the extent that such claims arise out of or result from the failure of the Products to meet the Products Limited Warranty set forth in Section 7, (ii) Company's breach of the terms of this Agreement, (iii) Product recalls (in accordance with the provisions of Section 20) or (iv) the negligence, recklessness, gross negligence, or willful misconduct of any Company Indemnitee.

10.3 Indemnification Procedures. The party seeking indemnification hereunder (the "Indemnified Party") shall: (i) give the other party (the "Indemnifying Party") notice of the relevant claim, which notice shall specify with reasonable particularity the basis of such claim, (ii) cooperate with the Indemnifying Party, at the Indemnifying Party's expense, in

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the defense of such claim and (iii) give the Indemnifying Party the right to control the defense and settlement of any such claim, except that the Indemnifying Party shall not enter into any settlement that affects the Indemnified Party's rights or interest without the Indemnified Party's prior written approval. The Indemnified Party shall have no authority to settle any such claim.

11. Insurance. Distributor will procure and maintain in full force and effect such liability insurance policies, in such amounts, as are reasonable for distribution companies that purchase the amount of orthopedic medical devices that are purchased by the Distributor, protecting Distributor, its officers, employees, representatives and agents against any Liabilities arising from the operation of Distributor's business as it relates to the Products, including, without limitation, the sale and distribution of the Products. Distributor shall make provision for workers' compensation, unemployment and similar coverage with respect to the operation of its business. Copies of certificate of insurance shall be delivered to Company to show Distributor's compliance herewith and such certificates shall not be cancelled or materially altered without at least thirty days' notice to Company. The obligations of this Section shall survive the termination or expiration of this Agreement for one year.

12. Statements and Claims. Except as approved in writing by Company or by way of written communication provided by Company, Distributor shall not engage in any discussion regarding any Company products other than the Products. Distributor shall refer customer inquiries regarding all Company products to the Company representative designated in Section 28. Distributor shall limit its statements and claims regarding the Products, including as to efficacy and safety, to those consistent with the product labeling and the promotional materials. Distributor shall not add, delete or modify claims of efficacy or safety in the promotion of the Products, nor make any changes (including underlining or otherwise highlighting any language or adding any notes thereto) in the promotional materials, nor shall Distributor make any untrue or misleading statements or comments about the Products or any of Company's or its affiliate's employees, competitors or any of its or their products. Distributor shall promote the Products in strict adherence to regulatory and professional requirements, and to all applicable laws, including, but not limited to, the United States Federal Food, Drug and Cosmetic Act of 1938, as amended, and the regulations promulgated thereunder (the "Act").

13. Use of Trademarks. Except as granted in this Agreement, Distributor has no rights in or to the Trademarks, or any other trademarks, trade names or copyrights owned or used by Company and Distributor agrees that it shall not in any way infringe upon, harm, contest or otherwise impair the rights of Company to the Trademarks. All material containing Trademarks shall be used solely in connection with the distribution, marketing and sale of the Products, and distinguishing and identifying them. Distributor may not use any of the Trademarks in its corporate title or the corporate title of any corporation it controls or is affiliated with in connection with the distribution, marketing or sale of the Products, without the written consent of Company, which shall not be unreasonably withheld. If it becomes necessary, because of conflicts with trademarks or trade names used by third parties, to develop non-conflicting marks and names for certain parts of the Territory, Distributor shall so inform Company, and such new marks and names shall be developed by Company, and shall belong to Company, subject to Distributor's license to use them pursuant to the terms of this Agreement.

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14. Alterations to Products and Labeling. Without Company's prior written consent Distributor shall make no changes, additions or alterations whatever to the Products, or to Company's packaging, Trademarks or labels.

15. Sales Material and Advertising. Distributor shall: (a) submit to, and obtain the written approval of, Company with regard to all publications, sales brochures, letterheads, technical bulletins or other such materials before any such material is used in commerce by Distributor; and (b) submit to Company for approval any advertising relating to the Products prepared or used by Distributor. Notwithstanding the foregoing, (i) such approval shall be presumed if Company has not responded to Distributor's written request therefore within 30 days of receipt by Company of such written request and (ii) Distributor shall not be required to submit advertising which has been prepared by Company and which has not been altered by Distributor.

16. FDA Disbarment. Distributor agrees that in the course of the sale, promotions and distribution of the Product as contemplated by this Agreement, that it will not use in any capacity the services of any person who has been debarred or disqualified by the FDA pursuant to the Generic Drug Enforcement Act of 1992 or any other equivalent or successor state or federal statutes, rules or regulations. Distributor agrees and undertakes to promptly (i) notify the Company in writing if it becomes aware that any person involved in the sale, promotion or distribution of Products pursuant to this Agreement has been debarred or disqualified or proceedings have been initiated with respect to any debarment or disqualification, and (ii) if requested by the Company, certify in writing that it has not used the services of any such person in any capacity in performing the sale, promotion or distribution of the Products.

17. Non-Solicitation. Distributor shall not, during the term of this Agreement and for a period of one year thereafter, directly or indirectly, on its own behalf or on behalf of any other person, partnership, association, corporation or other entity, solicit (either orally or in writing), or in any manner attempt to influence or induce any employee of the Company, or any of its subsidiaries or affiliates, to leave the employment of the Company or the respective subsidiary or affiliate, as the case may be.

18. Regulatory Approvals, Field of Use, Complaints and Recalls. Company shall be solely responsible, and shall bear all costs associated with obtaining and maintaining regulatory approval for Products in the U.S. Distributor shall be solely responsible, and shall bear all costs associated with billing and for collecting fees associated with distribution of the Products. The Products shall be sold strictly for use in surgical applications involving the human spine as approved by the FDA (the "Field"). The Products shall not be sold for use outside of the Field. Distributor acknowledges that the FDA or other applicable regulatory authorities may narrow the Field at any time. Distributor agrees (i) to promptly notify the Company in writing of the following: (a) any serious regulatory action relating to the Products; (b) any material complaints regarding the Products or the related instrumentation; or ( c) any adverse incidents that may be subject to the United States Food and Drug Administration's (the "FDA") Medical Device Reporting regulation (to the extent that Distributor is actually aware of any of the foregoing in (a) through (c)); and (ii) to comply with recalls or general corrective actions initiated by the Company.

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19. Confidentiality and Intellectual Property.

19.1 Confidentiality. All confidential or proprietary information furnished by Distributor to Company or any of its affiliates, or by Company to Distributor or any of its affiliates, during the term of this Agreement ("Confidential Information") including, without limitation, any specification, design information, Product information, quality assurance plans, marketing strategies, business plans and strategies, Inventions (whether or not the subject of Patents), trade secrets, know-how, cost and profit data, distribution and marketing plans, and business and financial information, shall be kept confidential by the party receiving it. The party receiving Confidential Information shall not disclose it or make use of it, except for purposes authorized by this Agreement, nor disclose any Confidential Information to any person or firm unless previously authorized in writing to do so; provided, however, that the receiving party may disclose it as necessary to responsible officers, employees and agents for the purposes of performing its obligations under this Agreement, provided that such employees, officers and agents shall have assumed like obligations of confidentiality in writing. The receiving party may disclose Confidential Information as required by government and regulatory agents for the purposes of performing its obligations under this Agreement, provided that a request is made that such information be kept confidential by such government or regulatory agents. The foregoing limitations on the use and disclosure of Confidential Information shall not apply to information which:

(a) at the time of disclosure is, or thereafter lawfully becomes, part of the public domain through no fault, act or omission of the receiving party, its employees, officers, or agents; or

(b) was otherwise in the receiving party's lawful possession prior to disclosure as shown by its written records; or

( c) is subsequently rightfully obtained by the receiving party from a third party who has the legal right to disclose it, without an obligation to keep such information confidential; or

(d) is released from confidential status by mutual agreement of the parties.

Except as required by law or as contemplated in this Agreement, Distributor and Company shall keep the existence and terms of this Agreement, as well as any discussions and/or materials provided in connection herewith, strictly confidential, and shall each make all commercially reasonable efforts to maintain such confidentiality, including restricting employees' access to the terms of the Agreement on a "need to know" basis, limiting copies and ensuring that all employees privy to the terms of this Agreement shall undertake like obligations of confidentiality. Upon expiration or termination of this Agreement for any reason, the receiving party shall immediately (in its sole discretion) destroy or deliver to the supplying party all reproductions, copies, extract or the like of any documents or other media containing any Confidential Information of the other party.

19.2 Intellectual Property. Distributor acknowledges and agrees that any patent on the Products acquired by the Company or any of its subsidiaries and any patent applications on the Products filed by the Company or any of its subsidiaries (the "Patents") are

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the sole and exclusive property of the Company and that throughout the term of this Agreement and following its termination or expiration, Distributor will not do anything inconsistent with such ownership, will not directly or indirectly challenge the title of the Company or any of its subsidiaries to the same and will not attack the validity of such Patents. Distributor shall submit to the Company all inventions, discoveries and ideas concerning any modifications and improvements relating to the Products and related instrumentation (the "Inventions"). Further, all such Inventions are, and shall remain, the sole property of the Company. Distributor hereby assigns to the Company all of its rights, title and interest to Inventions, and shall take such actions as is necessary to vest such rights and interests in the Company and shall require its employees and agents to take similar actions to vest ownership of such Inventions in the Company.

20. Recalls. Company shall be solely responsible for the costs, decision and execution for a Product recall. Distributor shall fully cooperate and reasonably assist Company in the event of a recall. If any, or all, of the Products are recalled due to the act or omission of the Company, then within 60 days after the recall, Company will replace the recalled Products. Other than as set forth in Section 10.2, the only obligations of Company for recalled Products are to: (a) replace the recalled Products; and (b) pay for the shipping and insurance for retrieving the recalled Products and shipping replacements. Following a recall, if Company cannot replace the recalled Products or is not able to provide Distributor with replacement Products for more than 60 days, then Company will refund to Distributor: (a) all amounts paid to Company by Distributor for the recalled Products that are not replaced; and (b) all shipping and insurance paid by Distributor for the recalled Products. If any, or all, of the Products are recalled solely due to the act or omission of Distributor, then, in addition to any of the remedies available to the Company at law or at equity: (a) Distributor will pay for all shipping and insurance to return the Products to Company; and (b) Distributor shall be obligated to immediately order Products to replace the recalled Products.

21. Distributor Independence; Use of Independent Representatives. Distributor shall operate as an independent contractor, and Distributor is not an agent of Company for any purpose pursuant to this Agreement. Distributor's employees and agents are not employees of Company. Distributor does not have the right to use independent representatives, distributors or any other non-employee third party for the promotion, marketing, advertising, sale or distribution of the Products.

22. Termination. This Agreement shall be subject to termination by Company upon: (a) failure by Distributor to pay any sums due to Company hereunder within 15 days of the applicable due date, or (b) a material breach by Distributor of any terms and conditions of this Agreement, which breach is not cured within 20 days of notice thereof by Company. This Agreement shall be subject to termination by Distributor upon a material breach by Company of any terms and conditions of this Agreement, which breach is not cured within 20 days of notice thereof by Distributor. This Agreement shall be subject to termination by either party upon the bankruptcy or receivership of the other party.

23. Effect of Termination. Upon termination of this Agreement by the Company pursuant to Section 22 or Section 26, Distributor shall cease the sale and distribution of the

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Products and shall cease using the Trademarks, and the license for use of such Trademarks shall terminate. Upon any termination of this Agreement by the Distributor pursuant to Section 22 or Section 26, or upon the expiration of this Agreement: (a) Distributor shall return to Company all Consigned Inventory, except an amount of Consigned Inventory reasonably necessary for the Distributor to sell Products for a period of one year after such termination or expiration of this Agreement (the "Sell-Off Period"), which Consigned Inventory shall be returned at the expiration of the Sell-Off Period, (b) Distributor shall cease the sale and distribution of the Products and shall cease using the Trademarks, and the license for use of such Trademarks shall terminate, provided that the Distributor shall be able to sell its remaining inventory of Products during the Sell-Off Period, (c) Distributor shall execute and deliver all other documents reasonably required by Company to accomplish and evidence a complete termination of this Agreement and the surrender by Distributor of all rights hereunder, and (d) at Company's election, Company will purchase from Distributor all Products held by Distributor at the price paid Company for such Products (plus the cost of removing such Products from Distributor's premises and shipping them to another location in the event that the Agreement is terminated by the Distributor due to the breach of the Company). The termination or expiration of this Agreement shall not affect the rights of Company to receive, or the obligation of Distributor to make payment for, Products ordered by Distributor prior to the termination or expiration date, whether shipped by Company before or after such date.

24. Governmental Approvals. Nothing in this Agreement shall require either party to take any action which would violate any governmental regulation or law to which either of them is subject. Distributor shall obtain in the Territory such governmental approvals, licenses or permits as may be necessary to effectuate the purposes of this Agreement, and shall comply with all local laws, regulations and rulings of governmental bodies having jurisdiction over Distributor's business, in respect of the sale of the Products, including, without limitation, the Act.

25. Taxes. Distributor shall pay all taxes, duties, tariffs or similar charges imposed on the sale or transfer of the Products by any taxing authority other than any tax on the income of Company.

26. Force Majeure. Neither party shall be held responsible for any delay or failure in performance of any part of this Agreement to the extent such delay or failure is caused by fire, flood, strike, civil, governmental or military authority, or act of God. When a party's delay or nonperformance continues for a period of at least ninety (90) days due to any such event, the other party may terminate this Agreement.

27. Assignability. This Agreement may not be assigned by either party except with the written consent of the other party, provided that the Company shall be entitled to assign its rights and obligations under this Agreement to a successor in interest in connection with a merger of the Company or the sale ofall or substantially all of the Company's assets.

28. Notice. All notices, requests or other communications pursuant to this Agreement shall be in writing and addressed as follows:

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If to Company: Alphatec Spine, Inc. 2051 Palomar Airport Road, Suite 100 Carlsbad, California 92011 Telephone: 760-431-9286 Facsimile: 760-431-1624 Attention: Chief Operating Officer

with a copy to: Alphatec Spine, Inc. 2051 Palomar Airport Road, Suite 100 Carlsbad, California 92011 Telephone: 760-431-9286 Facsimile: 760-431-9083 Attention: Ebun S. Gamer, Esq., General Counsel

If to Distributor:

International Imports, It~~ .. _ ~ . ,,._ c~' ·~ t--'0 '2!03 ? S°..W. ~,.,.....~'. .:::> l,') ~ l. t.---( ....

'9A '{2';.6 0 ~ ,~ ~111!1...'°'I , • - 3I1''l

Pt-t- 'H. ~11.., --s/'' Any notice to be given or to be served upon any party to this Agreement will be deemed

to be given and received when delivered (if the notice is delivered on a day other than a business day or after 5 p.m. (local time where received) on a business day, then delivery shall be deemed to have taken place on the first business day thereafter) to the address of each party set forth in this Section via courier or other means of personal service including, but not limited to, messenger service, FedEx, DHL or United Parcel Service, or if sent by facsimile (telecopier), when received as long as the full text of any such notice is (i) readable and (ii) is received in full prior to 5:00 p.m. (local time where received) on a business day which receipt is confirmed. If the full readable text is received following 5:00 p.m., then the notice will be deemed received at 10:00 a.m. (local time where received) on the next succeeding business day. The telecopier number for each party is set forth in this Section. The notice information in this Section may be changed by giving written notice of such change to the other party as provided in this Section for giving notice. However, unless and until such written notice of change is actually received, the last address or telecopier number as stated by written notice or as provided in this Agreement, if no written notice of change has been sent or received, will be deemed to continue in effect for all purposes.

29. Injunctive Relief. The parties intend that certain obligations and provisions of this Agreement, including without limitation those governing: intellectual property rights, confidentiality, non-competition, exclusivity of distribution rights, the termination of rights upon the termination or expiration of this Agreement, and the obligation to return Consigned Inventory upon termination or expiration of the Agreement shall be enforceable by specific performance and other equitable relief (collectively the "Specific Performance Provisions"). The parties

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acknowledge that a party seeking to enforce the Specific Performance Provisions will not have an adequate remedy at law for the breach of the Specific Performance Provisions, damages alone will not be adequate for a breach of the Specific Performance Provisions, and such party will suffer irreparable harm as a result of such breach. Such party shall have the right to attempt to enforce the Specific Performance Provisions through application for specific enforcement and all equitable remedies, including, but not limited to, mandatory and prohibitory injunctions.

30. Scope and Modification. This Agreement represents the entire understanding between the parties relating to the subject matter hereof, and supersedes all prior agreements between the parties. There are not terms or representations other than those stated herein. No modification or waiver of this Agreement shall be valid unless in writing and signed by the party against whom it is asserted.

31. Waiver. The waiver by either party of any right hereunder or of a failure to perform or a breach by the other party shall not be deemed a waiver of any other right or of any other failure or breach by that other party, whether of a similar nature or otherwise.

32. Severability. In case one or more provisions of this Agreement are invalid, the validity of the remaining provisions shall not be affected thereby.

33. Counterparts. The Agreement may be signed in any nwnber of counterparts, and by the different parties hereto on separate counterparts, each of which shall be deemed an original and all of which shall constitute one and the same instrument, and in pleading or providing any provisions thereof it shall not be necessary to produce more than one such counterpart. The Agreement shall become binding when one or more counterparts hereof, individually or taken together, shall bear the signatures of all of the parties reflected thereon as the signatories.

34. Survival. Notwithstanding the expiration or termination of this Agreement for any reason, rights and obligations which by the nature should survive will remain in full force and effect. In particular, and without limitation, the following sections shall survive the expiration or termination of this Agreement: Section 9, Section 10, Section 11, Section 17, Section 19, Section 20, Section 21, Section 23, Section 25, Section 28, Section 29, Section 34 and Section 35. The following sections shall survive the expiration or termination of this Agreement through the Sell-Off Period: Section 7, Section 12, and Section 18.

35. Governing Law and Jurisdiction. This Agreement shall be governed by, and construed and interpreted in accordance with, the laws of the State of California as a contract made between two parties made in California to be performed and consummated in California. The sole and exclusive venue for any action brought under this Agreement shall be in a federal or state court in San Diego County, California, and the parties agree that such courts shall have jurisdiction.

[Signature Page Follows]

12

ATEC0000021


IN WITNESS WHEREOF, the parties have executed this Agreement as of the date and year first set forth above.

ALPHATEC SPINE, INC.

By:~-=~~~~~~~~ Dirk Kuyper President and Chi

ATEC0000022


EXHIBIT A

PRODUCTS AND PRICES

2

ATEC0000023


Part#

69011-014 69011-016 69011-018 69011-020 69011-022 69011-024 69011-026 69012-028 69012-031 69012-034 69012-037 69012-040 69012-043 69012-046 69013-045 69013-048 69013-051 69013-054 69013-057 69013-060 69013-063 69013-066 69013-069 69014-060 69014-064 69014-068 69014-072 69014-076 69014-080 69014-084 69040-010 69040-012 69040-014 69040-016 69040-018 69040-110 69040-112 69040-114 69040-115 69040-116 69040-117 69040-118 69041-010 69041-012 69041-014 69041-016 69041-018 69045-010 69045-012 69045-014 69045-016 69045-018 69045-110 69045-112 69045-114 69045-116 69045-118 69046-010 69046-012 69046-014 69046-016 69046-018

69101 69105 69107 69110 69115 69121 69130

Description

. .. ,, !!!':

REVEAL -1-LEVEL CERVICAL PLATE -14MM REVEAL -1-LEVEL CERVICAL PLATE -16MM REVEAL-1-LEVEL CERVICAL PLATE -18MM REVEAL -1-LEVEL CERVICAL PLATE - 20MM REVEAL - 1-LEVEL CERVICAL PLATE - 22MM REVEAL - 1-LEVEL CERVICAL PLATE - 24MM REVEAL - 1-LEVEL CERVICAL PLATE - 26MM REVEAL - 2-LEVEL CERVICAL PLATE - 28MM REVEAL - 2-LEVEL CERVICAL PLATE -31 MM REVEAL - 2-LEVEL CERVICAL PLATE - 34MM REVEAL - 2-LEVEL CERVICAL PLATE - 37MM REVEAL - 2-LEVEL CERVICAL PLATE - 40MM REVEAL - 2-LEVEL CERVICAL PLATE - 43MM REVEAL - 2-LEVEL CERVICAL PLATE - 46MM REVEAL - 3-LEVEL CERVICAL PLATE - 45MM REVEAL - 3-LEVEL CERVICAL PLATE - 48MM REVEAL - 3-LEVEL CERVICAL PLATE -51MM REVEAL - 3-LEVEL CERVICAL PLATE - 54MM REVEAL - 3-LEVEL CERVICAL PLATE - 57MM REVEAL - 3-LEVEL CERVICAL PLATE - 60MM REVEAL - 3-LEVEL CERVICAL PLATE - 63MM REVEAL - 3-LEVEL CERVICAL PLATE - 66MM REVEAL - 3-LEVEL CERVICAL PLATE - 69MM REVEAL - 4-LEVEL CERVICAL PLATE - 60MM REVEAL - 4-LEVEL CERVICAL PLATE - 64MM REVEAL - 4-LEVEL CERVICAL PLATE - 68MM REVEAL - 4-LEVEL CERVICAL PLATE - 72MM REVEAL - 4-LEVEL CERVICAL PLATE - 76MM REVEAL - 4-LEVEL CERVICAL PLATE - 80MM REVEAL - 4-LEVEL CERVICAL PLATE - 84MM REVEAL -VARIABLE ANGLE SCREW - 4.0MMX10MM REVEAL - VARIABLE ANGLE SCREW - 4.0MMX12MM REVEAL -VARIABLE ANGLE SCREW-4.0MMX14MM REVEAL - VARIABLE ANGLE SCREW - 4.0MMX16MM REVEAL -VARIABLE ANGLE SCREW-4.0MMX18MM REVEAL - SELF-DRILLING SCREW - 4.0MMX1 OMM REVEAL - SELF-DRILLING SCREW - 4.0MMX12MM REVEAL - SELF-DRILLING SCREW - 4.0MMX14MM REVEAL - SELF-DRILLING SCREW - 4.0MMX15MM REVEAL - SELF-DRILLING SCREW -4.0MMX16MM REVEAL -SELF-DRILLING SCREW - 4.0MMX17MM REVEAL - SELF-DRILLING SCREW - 4.0MMX1BMM REVEAL- FIXED ANGLE SCREW -4.0MMX10MM REVEAL - FIXED ANGLE SCREW - 4.0MMX12MM REVEAL - FIXED ANGLE SCREW - 4.0MMX14MM REVEAL - FIXED ANGLE SCREW - 4.0MMX16MM REVEAL - FIXED ANGLE SCREW - 4.0MMX18MM REVEAL -VARIABLE ANGLE SCREW - 4.5MMX10MM REVEAL-VARIABLE ANGLE SCREW-4.5MMX12MM REVEAL -VARIABLE ANGLE SCREW- 4.5MMX14MM REVEAL -VARIABLE ANGLE SCREW - 4.5MMX16MM REVEAL -VARIABLE ANGLE SCREW-4.5MMX18MM REVEAL - SELF-DRILLING SCREW - 4.5MMX1 OMM REVEAL - SELF-DRILLING SCREW -4.5MMX12MM REVEAL - SELF-DRILLING SCREW - 4.5MMX14MM REVEAL-SELF-DRILLING SCREW-4.5MMX16MM REVEAL -SELF-DRILLING SCREW -4.5MMX18MM REVEAL - FIXED ANGLE SCREW - 4.5MMX10MM REVEAL - FIXED ANGLE SCREW - 4.5MMX12MM REVEAL - FIXED ANGLE SCREW - 4.5MMX14MM REVEAL- FIXED ANGLE SCREW-4.5MMX16MM REVEAL - FIXED ANGLE SCREW - 4.5MMX18MM

. " ' REVEAL -ANTERIOR PLATE HOLDER REVEAL - TEMPORARY FIXATION PIN REVEAL - PIN INSERTER/EXTRACTOR DELATALOC - FIXED ANGLE DRILL GUIDE DELTALOC - VARIABLE ANGLE DRILL GUIDE REVEAL -ANTERIOR CERVICAL PLATE BENDING PLIERS DELTALOC - QUICK CONNECT HANDLE

"CONFIDENTIAL INFORMATION" Alphate<: Spine, Inc.

2008 Price List 1of17

¥ .. $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

$ $ $ .. $ $ $ $ $ $ $

2008 List Discount Price

Price

" ~'";] . l! ,,

'· 1 925 $ 855.00 1 925 $ 855.00 1 925 $ 855.00 1 925 $ 855.00 1 925 $ 855.00 1 925 $ 855.00 1 925 $ 855.00 2188 $ 855.00 2188 $ 855.00 2188 $ 855.00 2188 $ 855.00 2 188 $ 855.00 2188 $ 855.00 2188 $ 855.00 2456 $ 960.00 2 456 $ 960.00 2,456 $ 960.00 2 456 $ 960.00 2456 $ 960.00 2456 $ 960.00 2456 $ 960.00 2456 $ 960.00 2456 $ 960.00 2 719 $ 1 062.00 2 719 $ 1 062.00 2 719 $ 1 062.00 2 719 $ 1 062.00 2 719 $ 1 062.00 2 719 $ 1 062.00 2 719 $ 1 062.00

394 $ 142.50 394 $ 142.50 394 $ 142.50 394 $ 142.50 394 $ 142.50 438 $ 142.50 438 $ 142.50 438 $ 142.50 438 $ 142.50 438 $ 142.50 438 $ 142.50 438 $ 142.50 350 $ 142.50 350 $ 142.50 350 $ 142.50 350 $ 142.50 350 $ 142.50 494 $ 142.50 494 $ 142.50 494 $ 142.50 494 $ 142.50 494 $ 142.50 438 $ 142.50 438 $ 142.50 438 $ 142.50 438 $ 142.50 438 $ 142.50 481 $ 142.50 481 $ 142.50 481 $ 142.50 481 $ 142.50 481 $ 142.50

931 $ 192.96 363 $ 37.14

1344 $ 75.88 2 269 $ 93.58 2 269 $ 110.99 1 263 $ 837 35

388 $ 170.94

ATEC0000024


Part II

69150 69161 69171 69172 69140-010 69140-012 69140-014 69140-016 69140-018 69170 69191

63001-120 63001-240 63002-500 63005 63003-26 63003-37 63003-60 63008 63009 63010 63011 63014 63015 63012 63013 63035-08 63035-10 63035-12 63035-14 63035-16 63035-18 63035-20 63035-22 63035-24 63035-26 63035-28 63035-30 63035-32 63035-34 63035-36 63035-38 63035-40 63035-42 63035-44 63035-46 63035-48 63035-50 63035-52 63035-54 63035-56 63035-58 63035-60 63040-08 63040-10 63040-12 63040-14 63040-16 63040-18 63040-20 63040-22 63040-24 63040-26 63040-28 63040-30 63040-32 63040-34 63040-36 63040-38 63040-40 63040-42 63040-44 63040-46 63040-48 63040-50 63040-52

Description

REVEAL-TAP REVEAL - TAPERED HEX DRIVER REVEAL - UNLOCKING TOOL REVEAL - SINGLE USE LOCKING TOOL REVEAL - DRILL - 4.0MMX10MM REVEAL - DRILL - 4.0MMX12MM REVEAL - DRILL - 4.0MMX14MM REVEAL -DRILL- 4.0MMX16MM REVEAL - DRILL - 4.0MMX18MM REVEAL - LOCKING TOOL REVEAL- CERVICAL Pl.ATE STERILIZATION CASE

' 'M•.\!''"'.''"Qt<'Al<il;l'f\' '. -SOLANAS -Tl CERVICAL ROD - 3.3MMX120MM SOLANAS - Tl CERVICAL ROD - 3.3MMX240MM SOLANAS - Tl 3.3MM - 5.5MM TRANSITIONAL ROD - 500MM SOLANAS - SET SCREW SOLANAS - Tl 3.3MM LARGE ADJUSTABLE BRIDGE - 26MM SOLANA$ - Tl 3.3MM LARGE ADJUSTABLE BRIDGE - 37MM SOLANAS - Tl 3.3MM LARGE ADJUSTABLE BRIDGE - 60MM SOLANAS - 3.3MM-5.5MM AXIAL ROD CONNECTOR SOLANAS - 3.3MM-5.5MM PARALLEL ROD CONNECTOR SOLANAS - 3.3MM-3.3MM PARALLEL ROD CONNECTOR SOLANAS - 3.3MM-3.3MM AXIAL ROD CONNECTOR SOLANAS - CLOSED 3.3MM LATERAL CONNECTOR SOLANAS -OPEN 3.3MM LATERAL CONNECTOR SOLANAS - CERVICAL HOOK - 6MM SOLANAS - CERVICAL HOOK - 5MM SOLANA$ - Tl POLY AXIAL PEDICLE SCREW - 3.5MMX8MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 3.5MMX1 OMM SOLANA$ - Tl POLY AXIAL PEDICLE SCREW - 3.5MMX12MM SOLANAS-TI POLYAXIAL PEDICLE SCREW-3.5MMX14MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 3.5MMX1 BMM SOLANAS -Tl POLYAXIAL PEDICLE SCREW-3.5MMX18MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 3.5MMX20MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 3.5MMX22MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 3.5MMX24MM SOLANAS-TI POLYAXIAL PEDICLE SCREW-3.5MMX26MM SOLANA$ - Tl POLY AXIAL PEDICLE SCREW - 3.5MMX28MM SOLANA$- Tl POLYAXIAL PEDICLE SCREW- 3.5MMX30MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 3.5MMX32MM SOLANA$ - Tl POLY AXIAL PED I CLE SCREW - 3.5MMX34MM SOLANAS - Tl POLY AXIAL PE DI CLE SCREW - 3.5MMX36MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 3.5MMX38MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 3.5MMX40MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 3.5MMX42MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 3.5MMX44MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 3.5MMX46MM SOLANA$ - Tl POLY AXIAL PED I CLE SCREW - 3.5MMX48MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 3.5MMX50MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 3.5MMX52MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 3.5MMX54MM SOLANA$ - Tl POLY AXIAL PED I CLE SCREW - 3.5MMX56MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 3.5MMX58MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 3.5MMX60MM SOLANAS-TI POLYAXIAL PEDICLE SCREW-4.0MMX8MM SOLANAS - Tl POLYAXIAL PEDICLE SCREW- 4.0MMX10MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 4.0MMX12MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 4.0MMX 14MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 4.0MMX16MM SOLANAS -Tl POLYAXIAL PEDICLE SCREW-4.0MMX18MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 4.0MMX20MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX22MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX24MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX26MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 4 OMMX28MM SOLANAS - Tl POLY AXIAL PE DI CLE SCREW - 4.0MMX30MM SOLAN AS - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX32MM SOLANAS - Tl POLY AXIAL PE DI CLE SCREW - 4.0MMX34MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX36MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX38MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 4.0MMX40MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW· 4.0MMX42MM SOLANAS - Tl POL YAXIAL PEOICLE SCREW - 4.0MMX44MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 4.0MMX46MM SOLANA$ - Tl POLY AXIAL PED I CLE SCREW - 4.0MMX48MM SOLANA$ - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX50MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 4.0MMX52MM

"CONFIDENTIAL INFORMATION" Alphatec Spine, Inc.

2008 Price List 2 Of 17

, -- '<-'I: . ~;·

··""'"'


Price

$ 294 $ 56.52 $ 1 288 $ 86.93 $ 319 $ 23.68 $ 163 $ 18.66 $ 394 $ 51.36 $ 394 $ 83.83 $ 394 $ 86.70 $ 394 $ 100.69 $ 394 $ 118.87 $ 319 $ 124.48 $ 1 800 $ 1 435.69

•'

$ 290 $ 113.00 $ 469 $ 183.00 $ 950 $ 371.00 $ 213 $ 83.00 $ 1,540 $ 800.00 $ 1,540 $ 800.00 $ 1,540 $ 800.00 $ 1 200 $ 468.00 $ 1 200 $ 468.00 $ 1 200 $ 468.00 $ 1 200 $ 468.00 $ 740 $ 289.00 $ 740 $ 289.00 $ 938 $ 366.00 $ 938 $ 366.00 $ 1 456 $ 568.00 $ 1 456 $ 568.00 $ 1 456 $ 568.00 $ 1 456 $ 568.00 $ 1 456 $ 568.00 $ 1 456 $ 568.00 $ 1 456 $ 568.00 $ 1 456 $ 568.00 $ 1,456 $ 568.00 $ 1 456 $ 568.00 $ 1 456 $ 568.00 $ 1 456 $ 568.00 $ 1456 $ 568.00 $ 1456 $ 568.00 $ 1456 $ 568.00 $ 1 456 $ 568.00 $ 1 456 $ 568.00 $ 1,513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00

1 513 $ 590.00 1 513 $ 590.00 1 513 $ 590.00 1 513 $ 590.00 1 513 $ 590.00

$ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00

ATEC0000025


Part#

63040-54 63040-56 63040-58 63040-60 63043-20 63043-24 63043-28 63043-32 63043-36 63043-40 63043-44 63043-48 63043-50 63135-20 63135-22 63135-24 63135-26 63135-28 63135-30 63135-32 63135-34 63135-36 63135-38 63135-40 63135-42 63135-44 63135-46 63135-48 63135-50

10603 63901 63903 63905 63907-35 63907-40 63909 63910 63911 63912 63913 63914 63916 63917 63918 63919-01 63919-02 63920 63924-15 63925 63928-10 63928-12 63928-14 63928-16 63928-18 63931 63932 63933 63934 63941 63942 63943 63944 63945 63947 63948 63949 63950 63951 63998 63997 63926 63927 63907-30 63907-43 63928-08 63946-35

Description

SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX54MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 4.0MMX56MM SOLANAS - Tl POLYAXIAL PEDICLE SCREW-4.0MMX58MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX60MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 4.35MMX20MM SOLANAS -Tl POLYAXIAL PEDICLE SCREW-4.35MMX24MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 4.35MMX28MM SOLANAS - Tl POLY AXIAL PED I CLE SCREW - 4.35MMX32MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 4.35MMX36MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 4.35MMX40MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 4.35MMX44MM SOLANAS - Tl POLYAXIAL PEDICLE SCREW - 4.35MMX48MM SOLANAS - Tl POLY AXIAL PEDICLE SCREW - 4.35MMX50MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PED I CLE SCREW - 3.5MMX20MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PEDICLE SCREW - 3.5MMX22MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PED I CLE SCREW - 3.5MMX24MM SOLANAS - Tl POLYAXIAL SMOOTH SHANK PEDICLE SCREW - 3.5MMX26MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PEDICLE SCREW - 3.5MMX28MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PED I CLE SCREW - 3.5MMX30MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PED I CLE SCREW - 3.5MMX32MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PED I CLE SCREW - 3.5MMX34MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PEDICLE SCREW - 3.5MMX36MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PEDICLE SCREW - 3.5MMX38MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PEDICLE SCREW - 3.5MMX40MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PEDICLE SCREW - 3.5MMX42MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PEDICLE SCREW - 3 5MMX44MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PEDICLE SCREW - 3.5MMX46MM SOLANA$ - Tl POLY AXIAL SMOOTH SHANK PED I CLE SCREW - 3.5MMX48MM SOLANAS - Tl POLY AXIAL SMOOTH SHANK PEDICLE SCREW - 3.5MMX50MM

!'(H.0 ..• Jt!O .. ~ SOLANAS - SMALL DEPTH GAUGE SOLANAS - POL YAXIAL SCREWDRIVER SOLANAS - SET SCREW INSERTER SOLANAS ·DRILL GUIDE SOLANAS -TAP -3.5MM SOLANAS - TAP - 4.0MM SOLANAS • HOOK TRIAL SOLANAS - HOOK HOLDER SOLANAS - ROD HOLDER - 3.3MM SOLANAS - ROD BENDER - 3.3MM SOLANAS - SCREW HEAD POSITIONER SOLANAS - SCREW BONE AWL SOLANAS - ROD CUTIER - 3.3MM SOLANAS - COMPRESSOR SOLANAS - DISTRACTOR SOLANAS - IN SITU BENDER - LEFT SOLANAS - IN SITU BENDER - RIGHT SOLANAS - KERRISON ROD PERSUADER SOLANAS-3.0MM ROD TEMPLATE 15CM SOLANAS - BALL TIP PROBE SOLANAS-FIXED DEPTH DRILL-2.1MM X 10MM SOLANAS -FIXED DEPTH DRILL-2.1MM X 12MM SOLANAS - FIXED DEPTH DRILL-2.1MM X 14MM SOLANAS - FIXED DEPTH DRILL - 2.MM1 X 16MM SOLANAS - FIXED DEPTH DRILL - 2.1MM X 18MM SOLANAS - UNIVERSAL HANDLE SOLANAS - ROD PUSHER SOLANAS - HOOK IMPACTOR SOLANAS - UNIVERSAL T-HANDLE SOLANAS -ADJUSTABLE BRIDGE DRIVER SOLANAS -ADJUSTABLE BRIDGE HOLDER SOLANAS - TORQUE LIMITING HANDLE - 10 IN-LB SOLANAS - TORQUE LIMITING HANDLE - 25 IN-LB SOLANAS - ADJUSTABLE BRIDGE COUNTER TORQUE SOLANAS - ADJUSTABLE DRILL STOP SOLANAS - TORQUE LIMITING T-HANDLE - 40 IN-LB SOLANAS - SET SCREW TORQUE SHAFT SOLANAS - DOMINO HEX DRIVER SOLANAS - COUNTER TORQUE SOLANAS - CERVICAL/THORACIC INSTRUMENT TRAY SOLANAS - CERVICAL/THORACIC IMPLANT TRAY SOLANAS - PEDICLE PROBE SOLANAS - OFFSET CONNECTOR COUNTER TORQUE SOLANAS - TAP - 3.0MM SOLANAS - TAP - 4.3MM SOLANAS - FIXED DEPTH DRILL-2.1MM X BMM SOLANAS -ADJUSTABLE DRILL - 3.SMM X 20-50MM


2008 Price List 3Of17


Price

$ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1 513 $ 590.00 $ 1513 $ 590.00 .. '>'<-

" .. $ 993 $ 450.59 $ 2188 $ 523.47 $ 1363 $ 259.13 $ 463 $ 273.93 $ 531 $ 114.57 $ 531 $ 108.81 $ 1188 $ 204.14 $ 1 225 $ 344.09 $ 925 $ 230.81 $ 925 $ 612.49 $ 988 $ 155.40 $ 2019 $ 268.96 $ 1 981 $ 628.68 $ 825 $ 1 061.73 $ 994 $ 514.30 $ 931 $ 144.01 $ 931 $ 160.83 $ 2 788 $ 892.17 $ 200 $ 70.21 $ 531 $ 97.15 $ 331 $ 77.72 $ 331 $ 45.79 $ 331 $ 74.77 $ 331 $ 68.72 $ 331 $ 129.25 $ 1 656 $ 446.19 $ 988 $ 276.19 $ 1 988 $ 385.01 $ 750 $ 476.34 $ 375 $ 136.29 $ 1 000 $ 400.00 $ 1875 $ 454.97 $ 1 875 $ 454.97 $ 1188 $ 475.00 $ 500 $ 419.53 $ 1 875 $ 626.45 $ 375 $ 77.36 $ 375 $ 131.03 $ 1188 $ 483.77 $ 2 500 $ 726.70 $ 2 500 $ 1 327.04 $ 750 $ 337.22 $ 1188 $ 438.06 $ 531 $ 112.29 $ 531 $ 106.78 $ 331 $ 143.13 $ 494 $ 46.21

ATEC0000026


Part#

61001-012 61001-014 61001-016 61001-018 61001-020 61001-022 61001-024 61001-026 61002-024 61002-026 61002-028 61002-030 61002-032 61002-034 61002-037 61002-040 61002-043 61002-046 61003-039 61003-042 61003-045 61003-048 61003-051 61003-054 61003-057 61003-060 61003-063 61003-066 61003-069 61004-060 61004-064 61004-068 61004-072 61004-076 61004-080 61004-084 61005-085 61005-090 61005-095 61005-100 61240-010 61240-011 61240-012 61240-013 61240-014 61240-015 61240-016 61240-017 61240-018 61240-019 61240-020 61340-010 61340-012 61340-014 61340-016 61340-018 61345-010 61345-012 61345-014 61345-016 61345-018 61440-010 61440-012 61440-014 61440-016 61440-018 61540-010 61540-012 61540-014 61540-016 61540-018 61545-010 61545-012 61545-014 61545-016 61545-018

Description

. , ' ' ' TRESTLE - 1-LEVEL ANTERIOR CERVICAL PLATE - 12MM TRESTLE - 1-LEVEL ANTERIOR CERVICAL PLATE - 14MM TRESTLE - 1-LEVEL ANTERIOR CERVICAL PLATE -16MM TRESTLE -1-LEVEL ANTERIOR CERVICAL PLATE -18MM TRESTLE -1-LEVEL ANTERIOR CERVICAL PLATE -20MM TRESTLE - 1-LEVEL ANTERIOR CERVICAL PLATE - 22MM TRESTLE - 1-LEVEL ANTERIOR CERVICAL PLATE - 24MM TRESTLE - 1-LEVEL ANTERIOR CERVICAL PLATE - 26MM TRESTLE - 2-LEVEL ANTERIOR CERVICAL PLATE - 24MM TRESTLE - 2-LEVEL ANTERIOR CERVICAL PLATE - 26MM TRESTLE - 2-LEVEL ANTERIOR CERVICAL PLATE - 28MM TRESTLE - 2-LEVEL ANTERIOR CERVICAL PLATE - 30MM TRESTLE - 2-LEVEL ANTERIOR CERVICAL PLATE - 32MM TRESTLE - 2-LEVEL ANTERIOR CERVICAL PLATE - 34MM TRESTLE - 2-LEVEL ANTERIOR CERVICAL PLATE - 37MM TRESTLE - 2-LEVEL ANTERIOR CERVICAL PLATE - 40MM TRESTLE - 2-LEVEL ANTERIOR CERVICAL PLATE - 43MM TRESTLE - 2-LEVEL ANTERIOR CERVICAL PLATE - 46MM TRESTLE - 3-LEVEL ANTERIOR CERVICAL PLATE - 39MM TRESTLE - 3-LEVEL ANTERIOR CERVICAL PLATE - 42MM TRESTLE - 3-LEVEL ANTERIOR CERVICAL PLATE - 45MM TRESTLE - 3-LEVEL ANTERIOR CERVICAL PLATE -48MM TRESTLE - 3-LEVEL ANTERIOR CERVICAL PLATE -51MM TRESTLE - 3-LEVEL ANTERIOR CERVICAL PLATE - 54MM TRESTLE - 3-LEVEL ANTERIOR CERVICAL PLATE - 57MM TRESTLE - 3-LEVEL ANTERIOR CERVICAL PLATE - 60MM TRESTLE - 3-LEVEL ANTERIOR CERVICAL PLATE - 63MM TRESTLE - 3-LEVEL ANTERIOR CERVICAL PLATE - 66MM TRESTLE - 3-LEVEL ANTERIOR CERVICAL PLATE - 69MM TRESTLE - 4-LEVEL ANTERIOR CERVICAL PLATE - 60MM TRESTLE - 4-LEVEL ANTERIOR CERVICAL PLATE - 64MM TRESTLE - 4-LEVEL ANTERIOR CERVICAL PLATE - 68MM TRESTLE - 4-LEVEL ANTERIOR CERVICAL PLATE - 72MM TRESTLE - 4-LEVEL ANTERIOR CERVICAL PLATE - 76MM TRESTLE - 4-LEVEL ANTERIOR CERVICAL PLATE - 80MM TRESTLE - 4-LEVEL ANTERIOR CERVICAL PLATE - 84MM TRESTLE - 5-LEVEL ANTERIOR CERVICAL PLATE - 85MM TRESTLE - 5-LEVEL ANTERIOR CERVICAL PLATE - 90MM TRESTLE - 5-LEVEL ANTERIOR CERVICAL PLATE - 95MM TRESTLE - 5-LEVEL ANTERIOR CERVICAL PLATE - 100MM TRESTLE -VARIABLE ANGLE SELF-DRILLING SCREW-4.0MMX10MM TRESTLE -VARIABLE ANGLE SELF-DRILLING SCREW - 4.0MMX11MM TRESTLE - VARIABLE ANGLE SELF-DRILLING SCREW - 4.0MMX12MM TRESTLE - VARIABLE ANGLE SELF-DRILLING SCREW -4.0MMX13MM TRESTLE - VARIABLE ANGLE SELF-DRILLING SCREW - 4.0MMX14MM TRESTLE - VARIABLE ANGLE SELF-DRILLING SCREW - 4.0MMX15MM TRESTLE - VARIABLE ANGLE SELF-DRILLING SCREW - 4.0MMX16MM TRESTLE -VARIABLE ANGLE SELF-DRILLING SCREW - 4.0MMX17MM TRESTLE - VARIABLE ANGLE SELF-DRILLING SCREW - 4.0MMX18MM TRESTLE - VARIABLE ANGLE SELF-DRILLING SCREW - 4.0MMX19MM TRESTLE - VARIABLE ANGLE SELF-DRILLING SCREW - 4.0MMX20MM TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW - 4.0MMX10MM TRESTLE -VARIABLE ANGLE SELF-TAPPING SCREW -4.0MMX12MM TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW - 4.0MMX14MM TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW -4.0MMX16MM TRESTLE -VARIABLE ANGLE SELF-TAPPING SCREW-4.0MMX18MM TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW - 4.5MMX10MM TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW - 4.5MMX12MM TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW -4.5MMX14MM TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW - 4.5MMX16MM TRESTLE -VARIABLE ANGLE SELF-TAPPING SCREW - 4.5MMX18MM TRESTLE - FIXED ANGLE SELF-DRILLING SCREW - 4.0MMX10MM TRESTLE - FIXED ANGLE SELF-DRILLING SCREW-4 OMMX12MM TRESTLE - FIXED ANGLE SELF-DRILLING SCREW - 4 OMMX14MM TRESTLE - FIXED ANGLE SELF-DRILLING SCREW - 4.0MMX16MM TRESTLE - FIXED ANGLE SELF-DRILLING SCREW - 4.0MMX18MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW -4.0MMX10MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW -4.0MMX12MM TRESTLE- FIXED ANGLE SELF-TAPPING SCREW-4.0MMX14MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW - 4.0MMX16MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW-4.0MMX18MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW -4.5MMX10MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW-4.5MMX12MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW-4.5MMX14MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW - 4.5MMX16MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW - 4.5MMX18MM


2008 Price List 4 of 17


Price

$ 2 238 $ 873.00 $ 2 238 $ 873.00 $ 2238 $ 873.00 $ 2,238 $ 873.00 $ 2 238 $ 873.00 $ 2 238 $ 873.00 $ 2 238 $ 873.00 $ 2 238 $ 873.00 $ 2 600 $ 1 014.00 $ 2 600 $ 1 014.00 $ 2600 $ 1 014.00 $ 2 600 $ 1 014.00 $ 2 600 $ 1 014.00 $ 2 600 $ 1 014.00 $ 2 600 $ 1 014.00 $ 2600 $ 1 014.00 $ 2 600 $ 1 014.00 $ 2 600 $ 1 014.00 $ 2 913 $ 1136.00 $ 2 913 $ 1136.00 $ 2 913 $ 1136.00 $ 2 913 $ 1 136.00 $ 2 913 $ 1136.00 $ 2 913 $ 1136.00 $ 2 913 $ 1136.00 $ 2913 $ 1136.00 $ 2 913 $ 1136.00 $ 2913 $ 1,136.00 $ 2913 $ 1136.00 $ 4 225 $ 1 648.00 $ 4 225 $ 1 648.00 $ 4 225 $ 1 648.00 $ 4 225 $ 1 648.00 $ 4 225 $ 1 648.00 $ 4 225 $ 1 648.00 $ 4225 $ 1 648.00 $ 4 563 $ 1 780.00 $ 4,563 $ 1 780.00 $ 4 563 $ 1 780.00 $ 4 563 $ 1 780.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00

ATEC0000027


Part#

61340-011 61340-013 61340-015 61340-017 61340-019 61340-020 61345-011 61345-013 61345-015 61345-017 61345-019 61345-020 61440-011 61440-013 61440-015 61440-017 61440-019 61440-020 61540-011 61540-013 61540-015 61540-017 61540-019 61540-020 61545-011 61545-013 61545-015 61545-017 61545-019 61545-020

61700 61706 61707 61708 61709 61710 61711 61713-010 61713-011 61713-012 61713-013 61713-014 61713-015 61713-016 61713-017 61713-018 61713-019 61713-020 61715 61717 61718 61719 61720 61721

~

11-2028 11-2037 11-2042 11-2053 11-2075 62005 62005-85 62001-04 62001-05 62001-06 62001-07 62001-08 62001-09 62001-10 62001-11 62001-12 62001-13 62001-15 62001-17 62001-20 62001-25

Description

TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW - 4.0MMX11 MM TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW- 4.0MMX13MM TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW -4.0MMX15MM TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW -4.0MMX17MM TRESTLE -VARIABLE ANGLE SELF-TAPPING SCREW-4.0MMX19MM TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW - 4.0MMX20MM TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW - 4.5MMX11MM TRESTLE -VARIABLE ANGLE SELF-TAPPING SCREW-4.5MMX13MM TRESTLE - VARIABLE ANGLE SELF-TAPPING SCREW - 4.5MMX15MM TRESTLE -VARIABLE ANGLE SELF-TAPPING SCREW-4.5MMX17MM TRESTLE -VARIABLE ANGLE SELF-TAPPING SCREW-4.5MMX19MM TRESTLE -VARIABLE ANGLE SELF-TAPPING SCREW - 4.5MMX20MM TRESTLE - FIXED ANGLE SELF-DRILLING SCREW - 4.0MMX11MM TRESTLE - FIXED ANGLE SELF-DRILLING SCREW - 4.0MMX13MM TRESTLE - FIXED ANGLE SELF-DRILLING SCREW - 4.0MMX15MM TRESTLE- FIXED ANGLE SELF-DRILLING SCREW-4.0MMX17MM TRESTLE - FIXED ANGLE SELF-DRILLING SCREW - 4.0MMX19MM TRESTLE - FIXED ANGLE SELF-DRILLING SCREW - 4.0MMX20MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW-4.0MMX11MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW -4.0MMX13MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW - 4.0MMX15MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW - 4.0MMX1 ?MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW - 4.0MMX19MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW - 4.0MMX20MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW - 4.5MMX11 MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW - 4.5MMX13MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW - 4.5MMX15MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW- 4.5MMX17MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW -4.5MMX19MM TRESTLE - FIXED ANGLE SELF-TAPPING SCREW - 4.5MMX20MM ,_,, :t .. ~.o-.... v.e~ .......... ,.l',!GicS,,Y><;r, .. .....iNS TRESTLE -ANTERIOR CERVICAL PLATE STERILIZATION SET TRESTLE - TEMPORARY PIN TRESTLE -AWL 8MM WITH STOP TRESTLE - AWL FOR DRILL GUIDE TRESTLE - HANDLE AWL TRESTLE - VARIABLE ANGLE DRILL GUIDE TRESTLE - FIXED ANGLE DRILL GUIDE TRESTLE - SS FIXED 2.3MM DRILL BIT -10MM TRESTLE - SS FIXED 2.3MM DRILL BIT - 11 MM TRESTLE - SS FIXED 2.3MM DRILL BIT - 12MM TRESTLE - SS FIXED 2.3MM DRILL BIT - 13MM TRESTLE - SS FIXED 2.3MM DRILL BIT - 14MM TRESTLE - SS FIXED 2.3MM DRILL BIT - 15MM TRESTLE - SS FIXED 2.3MM DRILL BIT - 16MM TRESTLE - SS FIXED 2.3MM DRILL BIT - 17MM TRESTLE - SS FIXED 2.3MM DRILL BIT- 18MM TRESTLE - SS FIXED 2.3MM DRILL BIT - 19MM TRESTLE - SS FIXED 2.3MM DRILL BIT - 20MM TRESTLE - 4.0MM TAP 1 OMM TRESTLE - SELF RETAINING SCREWDRIVER TRESTLE - QUICK CONNECT HANDLE TRESTLE- CERVICAL PLATE REMOVAL TOOL TRESTLE - PLATE BENDER CERVICAL PLATE I Rco;:, 1 LE - ::iLIUER ALIG,.ru•EN I I " L

.. a·,.·· . lxATfbl'JlitH<i>T,EM ZODIAC - Tl 5.5MM ADJUSTABLE BRIDGE - XX-SMALL ZODIAC - Tl 5.5MM ADJUSTABLE BRIDGE - X-SMALL ZODIAC - Tl 5.5MM ADJUSTABLE BRIDGE - SMALL ZODIAC - Tl 5.5MM ADJUSTABLE BRIDGE - MEDIUM ZODIAC - Tl 5.5MM ADJUSTABLE BRIDGE - LARGE ZODIAC - Tl STANDARD SET SCREW ZODIAC - Tl SET SCREW - 8.5MM ZODIAC - Tl ALLOY BROACHED ROD - 5.5MMX40MM ZODIAC - Tl ALLOY BROACHED ROD - 5.5MMX50MM ZODIAC - Tl ALLOY BROACHED ROD· 5.5MMX60MM ZODIAC - Tl ALLOY BROACHED ROD - 5.5MMX70MM ZODIAC - Tl ALLOY BROACHED ROD - 5.5MMX80MM ZODIAC - Tl ALLOY BROACHED ROD - 5.5MMX90MM ZODIAC ·Tl ALLOY BROACHED ROD - 5.5MMX1 OOMM ZODIAC - Tl ALLOY BROACHED ROD - 5.5MMX110MM ZODIAC-Tl ALLOY BROACHED ROD -5.5MMX120MM ZODIAC -Tl ALLOY BROACHED ROD -5.5MMX130MM ZODIAC -Tl ALLOY BROACHED ROD -5.5MMX150MM ZODIAC -Tl ALLOY BROACHED ROD -5.5MMX170MM ZODIAC - Tl ALLOY BROACHED ROD - 5.5MMX200MM ZODIAC - Tl ALLOY BROACHED ROD - 5.5MMX250MM

"CONFIDENTIAL INFORMATION" Alphatec Spine. Inc.

2008 Price Ust s of 17


Price

$ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 494 $ 193.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 456 $ 178.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00 $ 519 $ 202.00

$i(:u.' ,,~J~~' : ~~:,~~~tf!l

$ 1 869 $ 934.38 $ 200 $ 78.00 $ 413 $ 74.10

413 $ 69.94 ! 456 $ 297.78 ~ 850 $ 394.49 ~ 850 $ 399.29 $ 350 $ 137.00 $ 350 $ 137.00 $ 350 $ 137.00 $ 350 $ 137.00 $ 350 $ 137.00 $ 350 $ 137.00 $ 350 $ 137.00 $ 350 $ 137.00 $ 350 $ 137.00 $ 350 $ 137.00 $ 350 $ 137.00 $ 350 $ 82.54 $ 725 $ 124.78 $ 675 $ 290.24 $ 1 313 $ 869.61 $ 1 500 $ 658.13 $ 488 $ 139.58 ,. I~~, ;.\ : »'ii<'"''.' : ~'.W·• •

',.,., : "'1'

$ 1 988 $ 775.00 $ 1 988 $ 775.00 $ 1 988 $ 775.00 $ 1 988 $ 775.00 $ 1 988 $ 775.00 $ 288 $ 95.00 $ 288 $ 95.00 $ 531 $ 118.75 $ 531 $ 118.75 $ 531 $ 118.75 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50

ATEC0000028


Part#

62001-50 62002-04 62002-05 62002-06 62002-07 62002-08 62002-09 62002-10 62002-11 62002-12 62002-13 62002-15 62002-17 62002-20 62002-25 62002-30 62002-45 62002-50 62003-04 62003-05 62003-06 62003-07 62003-08 62003-09 62003-10 62003-11 62003-12 62003-13 62003-15 62003-17 62003-20 62004-04 62004-05 62004-06 62004-07 62004-08 62004-09 62004-10 62004-11 62004-12 62004-13 62004-15 62004-17 62004-20 62004-03 62004-035 62004-045 62004-055 62004-065 62004-075 62014-03 62014-04 62014-05 62014-06 62014-07 62014-08 62014-09 62014-10 62014-11 62014-12 62014-13 62014-35 62040-20 62040-25 62040-30 62040-35 62040-40 62040-45 62045-25 62045-30 62045-35 62045-40 62045-45 62045-50 62045-55 62055-25 62055-30

Description

ZODIAC - Tl ALLOY BROACHED ROD - 5.5MMX500MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX40MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX50MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX60MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX70MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX80MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX90MM ZODIAC- CP Tl BROACHED ROD - 5.5MMX100MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX110MM ZODIAC -CP Tl BROACHED ROD -5.5MMX120MM ZODIAC-GP Tl BROACHED ROD -5.5MMX130MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX150MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX170MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX200MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX250MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX300MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX450MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX500MM ZODIAC - Tl ALLOY PRE CONTOURED BROACHED ROD - 5.5MMX40MM ZODIAC - Tl ALLOY PRE CONTOURED BROACHED ROD - 5.5MMX50MM ZODIAC - Tl ALLOY PRECONTOURED BROACHED ROD - 5.5MMX60MM ZODIAC - Tl ALLOY PRE CONTOURED BROACHED ROD - 5.5MMX70MM ZODIAC - Tl ALLOY PRECONTOURED BROACHED ROD - 5.5MMX80MM ZODIAC - Tl ALLOY PRECONTOURED BROACHED ROD - 5.5MMX90MM ZODIAC - Tl ALLOY PRECONTOURED BROACHED ROD - 5.5MMX100MM ZODIAC - Tl ALLOY PRECONTOURED BROACHED ROD - 5.5MMX110MM ZODIAC - Tl ALLOY PRECONTOURED BROACHED ROD - 5.5MMX120MM ZODIAC - Tl ALLOY PRE CONTOURED BROACHED ROD - 5.5MMX130MM ZODIAC - Tl ALLOY PRECONTOURED BROACHED ROD - 5.5MMX150MM ZODIAC- Tl ALLOY PRECONTOURED BROACHED ROD - 5.5MMX170MM ZODIAC - Tl ALLOY PRECONTOURED BROACHED ROD - 5.5MMX200MM ZODIAC - CP Tl PRE CONTOURED ROD - 5.5MMX40MM ZODIAC - CP Tl PRECONTOURED ROD - 5.5MMX50MM ZODIAC· CP Tl PRECONTOURED ROD - 5.5MMX60MM ZODIAC - CP Tl PRE CONTOURED ROD· 5.5MMX70MM ZODIAC - CP Tl PRECONTOURED ROD - 5.5MMX80MM ZODIAC - CP Tl PRECONTOURED ROD - 5.5MMX90MM ZODIAC - CP Tl PRECONTOURED ROD - 5.5MMX100MM ZODIAC - CP Tl PRECONTOURED ROD - 5.5MMX110MM ZODIAC - CP Tl PRECONTOURED ROD - 5.5MMX120MM ZODIAC- CP Tl PRECONTOURED ROD - 5.5MMX130MM ZODIAC- CP Tl PRECONTOURED ROD - 5.5MMX150MM ZODIAC - CP Tl PRECONTOURED ROD - 5.5MMX170MM ZODIAC - CP Tl PRECONTOURED ROD - 5.5MMX200MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX30MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX35MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX45MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX55MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX65MM ZODIAC - CP Tl BROACHED ROD - 5.5MMX75MM ZODIAC - CP Tl PRECONTOURED NON-BROACHED ROD - 5.5MMX30MM ZODIAC - CP Tl PRECONTOURED NON-BROACHED ROD - 5.5MMX40MM ZODIAC - CP Tl PRECONTOURED NON-BROACHED ROD - 5.5MMX50MM ZODIAC - CP Tl PRECONTOURED NON-BROACHED ROD • 5.5MMX60MM ZODIAC - CP Tl PRECONTOURED NON-BROACHED ROD - 5.5MMX70MM ZODIAC - CP Tl PRECONTOURED NON-BROACHED ROD - 5.5MMX80MM ZODIAC - CP Tl PRECONTOURED NON-BROACHED ROD - 5.5MMX90MM ZODIAC - CP Tl PRECONTOURED NON-BROACHED ROD - 5.5MMX100MM ZODIAC - CP Tl PRECONTOURED NON-BROACHED ROD - 5.5MMX11 OMM ZODIAC - CP Tl PRECONTOURED NON-BROACHED ROD - 5.5MMX120MM ZODIAC - CP Tl PRECONTOURED NON-BROACHED ROD - 5.5MMX130MM ZODIAC - CP Tl PRECONTOURED NON-BROACHED ROD - 5.5MMX3.50MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX20MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX25MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX30MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX35MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX40MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 4.0MMX45MM ZODIAC - Tl POLYAXIAL PEDICLE SCREW - 4.5MMX25MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 4.5MMX30MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 4.5MMX35MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 4.5MMX40MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW· 4.5MMX45MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 4.5MMX50MM ZODIAC - Tl POL YAXIAL PEDICLE SCREW - 4.5MMX55MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 5.5MMX25MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 5.5MMX30MM


2008 Pnce Lisi Bof 17


Price

$ 531 $ 142.50 $ 531 $ 118.75 $ 531 $ 118.75 $ 531 $ 118.75 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 118.75 $ 531 $ 118.75 $ 531 $ 118.75 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 531 $ 142.50 $ 631 $ 118.75 $ 631 $ 118.75 $ 631 $ 118.75 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 118.75 $ 631 $ 118.75 $ 631 $ 118.75 $ 631 $ 118.75 $ 631 $ 118.75 $ 631 $ 142.50 $ 631 $ 118.75 $ 631 $ 118.75 $ 631 $ 118.75 $ 631 $ 118.75 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 631 $ 142.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50 $ 1 719 $ 712.50

ATEC0000029


Part#

62055-35 62055-40 62055-45 62055-50 62055-55 62055-60 62065-25 62065-30 62065-35 62065-40 62065-45 62065-50 62065-55 62065-60 62075-25 62075-30 62075-35 62075-40 62075-45 62075-50 62075-55 62075-60 62075-65 62075-70 62075-75 62075-80 62085-25 62085-30 62085-35 62085-40 62085-45 62085-50 62085-55 62085-60 62085-65 62085-70 62085-75 62085-80 62145-25 62145-30 62145-35 62145-40 62145-45 62155-25 62155-30 62155-35 62155-40 62155-45 62155-50 62155-55 62165-25 62165-30 62165-35 62165-40 62165-45 62165-50 62165-55 62165-60 62175-25 62175-30 62175-35 62175-40 62175-45 62175-50 62175-55 62175-60 62345-50 62365-30 62365-35 62365-40 62365-45 62365-50 62365-55 62375-30 62375-35 62375-40 62375-45

Description

ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 5.5MMX35MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 5.5MMX40MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 5.5MMX45MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 5.5MMX50MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 5.5MMX55MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 5.5MMX60MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 6.5MMX25MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 6.5MMX30MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 6.5MMX35MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 6.5MMX40MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 6.5MMX45MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 6.5MMX50MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 6.5MMX55MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 6.5MMX60MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 7.5MMX25MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 7.5MMX30MM ZODIAC -Tl POLYAXIAL PEDICLE SCREW- 7.5MMX35MM ZODIAC-Tl POLYAXIAL PEDICLE SCREW- 7.5MMX40MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 7.5MMX45MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 7.5MMX50MM ZODIAC - Tl POLY AXIAL PED IC LE SCREW - 7.5MMX55MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 7.5MMX60MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 7.5MMX65MM ZODIAC - Tl POLY AXIAL PED IC LE SCREW - 7.5MMX70MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 7.5MMX75MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 7.5MMX80MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 8.5MMX25MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 8.5MMX30MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 8.5MMX35MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 8.5MMX40MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 8.5MMX45MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 8.5MMX50MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 8.5MMX55MM ZODIAC - Tl POLY AXIAL PEDICLE SCREW - 8.5MMX60MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 8.5MMX65MM ZODIAC - Tl POLY AXIAL PED I CLE SCREW - 8.5MMX70MM ZODIAC - Tl POL YAXIAL PEDICLE SCREW - 8.5MMX75MM ZODIAC-Tl POLYAXIAL PEDICLE SCREW- 8.5MMX80MM ZODIAC - Tl HIGH-TOP POLY AXIAL PEDICLE SCREW - 4.5MMX25MM ZODIAC - Tl HIGH-TOP POLY AXIAL PEDICLE SCREW - 4.5MMX30MM ZODIAC - Tl HIGH-TOP POLY AXIAL PEDICLE SCREW - 4.5MMX35MM ZODIAC - Tl HIGH-TOP POLY AXIAL PEDICLE SCREW - 4.5MMX40MM ZODIAC - Tl HIGH-TOP POLYAXIAL PEDICLE SCREW - 4.5MMX45MM ZODIAC - Tl HIGH-TOP POLY AXIAL PEDICLE SCREW - 5.5MMX25MM ZODIAC - Tl HIGH-TOP POLY AXIAL PEDICLE SCREW - 5.5MMX30MM ZODIAC - Tl HIGH-TOP POLY AXIAL PEDICLE SCREW - 5.5MMX35MM ZODIAC - Tl HIGH-TOP POLY AXIAL PED I CLE SCREW - 5.5MMX40MM ZODIAC - Tl HIGH-TOP POLY AXIAL PEDICLE SCREW - 5.5MMX45MM ZODIAC - Tl HIGH-TOP POLY AXIAL PED I CLE SCREW - 5.5MMX50MM ZODIAC - Tl HIGH-TOP POLY AXIAL PED I CLE SCREW - 5.5MMX55MM ZODIAC - Tl HIGH-TOP POLY AXIAL PED I CLE SCREW - 6.5MMX25MM ZODIAC - Tl HIGH-TOP POLYAXIAL PEDICLE SCREW - 6.5MMX30MM ZODIAC -Tl HIGH-TOP POLYAXIAL PEDICLE SCREW-6.5MMX35MM ZODIAC - Tl HIGH-TOP POLY AXIAL PED I CLE SCREW - 6.5MMX40MM ZODIAC-Tl HIGH-TOP POLYAXIAL PEDICLE SCREW-6.5MMX45MM ZODIAC - Tl HIGH-TOP POLY AXIAL PEDICLE SCREW· 6.5MMX50MM ZODIAC - Tl HIGH-TOP POLY AXIAL PED I CLE SCREW - 6.5MMX55MM ZODIAC-Tl HIGH-TOP POLYAXIAL PEDICLE SCREW-6.5MMX60MM ZODIAC-Tl HIGH-TOP POLYAXIAL PEDICLE SCREW-7.5MMX25MM ZODIAC - Tl HIGH-TOP POLY AXIAL PEDICLE SCREW - 7.5MMX30MM ZODIAC-Tl HIGH-TOP POLYAXIAL PEDICLE SCREW- 7.5MMX35MM ZODIAC -Tl HIGH-TOP POLYAXIAL PEDICLE SCREW- 7.5MMX40MM ZODIAC-Tl HIGH-TOP POLYAXIAL PEDICLE SCREW- 7.5MMX45MM ZODIAC -Tl HIGH-TOP POLYAXIAL PEDICLE SCREW- 7.5MMX50MM ZODIAC - Tl HIGH-TOP POLY AXIAL PED I CLE SCREW - 7.5MMX55MM ZODIAC-Tl HIGH-TOP POLYAXIAL PEDICLE SCREW-7.5MMX60MM ZODIAC - Tl SACRAL POLY AXIAL PED I CLE SCREW - 4.5MMX50MM ZODIAC - Tl SACRAL POLY AXIAL PEDICLE SCREW - 6.5MMX30MM ZODIAC - Tl SACRAL POLY AXIAL PEDICLE SCREW - 6.5MMX35MM ZODIAC - Tl SACRAL POLY AXIAL PEDICLE SCREW - 6.5MMX40MM ZODIAC - Tl SACRAL POLY AXIAL PEDICLE SCREW - 6.5MMX45MM ZODIAC - Tl SACRAL POLY AXIAL PEDICLE SCREW - 6.5MMX50MM ZODIAC - Tl SACRAL POLY AXIAL PED I CLE SCREW - 6.5MMX55MM ZODIAC - Tl SACRAL POLYAXIAL PEDICLE SCREW - 7.5MMX30MM ZODIAC -Tl SACRAL POLYAXIAL PEDICLE SCREW - 7.5MMX35MM ZODIAC - Tl SACRAL POLY AXIAL PEDICLE SCREW - 7.5MMX40MM ZODIAC - Tl SACRAL POLY AXIAL PED I CLE SCREW - 7.5MMX45MM

"CONFIDENTIAL INFORMATION" Alphalec Spine, Inc.

2008 Price Lisi 7of17

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Price

1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1719 $ 712.50 1 719 $ 712.50 1719 $ 712.50 1 719 $ 712.50 1,719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 719 $ 712.50 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 1 981 $ 773.00 2119 $ 826.00 2119 $ 826.00 2119 $ 826.00 2119 $ 826.00 2119 $ 826.00 2 119 $ 826.00 2 119 $ 826.00 2119 $ 826.00 2119 $ 826.00 2 119 $ 826.00 2,119 $ 826.00

ATEC0000030


Part#

62375-50 62375-55 62375-60

62901 62902 62903 62904 62910-45 62910-55 62910-65 62910-75 62914 62915 62916 62917 62918 62919 62921 62922 62923 62926 62927 62979 62928 62929 62931 62932 62933 62935 62936 62938 62940 62941 62942 62943 62944 62945 62948 62951 62952 62953 62954 62956 62957 62958 62959 62963 62989 65458 66426 66446 62911-L55 62911-L65 62911-L75 62911-R55 62911-R65 62911-R75 62930-15 62930-45 62912 62946 62947 62913 62910-85 62924-15 62934 62996 62997 62998 62999 92901 92902 92903-02 92904 92905 92906

Description

ZODIAC ·Tl SACRAL POLY AXIAL PEDICLE SCREW· 7.5MMX50MM ZODIAC ·Tl SACRAL POLY AXIAL PED I CLE SCREW· 7.5MMX55MM ZODIAC -Tl SACRAL POLYAXIAL PEOICLE SCREW· 7.5MMX60MM

'· ;$' ZODIAC· STOPPED BONE AWL ZODIAC· ICE PICK ZODIAC· CURVED BONE PROBE ZODIAC ·STRAIGHT BONE PROBE ZODIAC-POLYAXIAL SOLID TAPER TAP 4.5 ZODIAC -POLYAXIAL SOLID TAPER TAP 5.5 ZODIAC -POLYAXIAL SOLID TAPER TAP 6.5 ZODIAC· POLYAXIAL SOLID TAPER TAP 7.5 ZODIAC· POLY AXIAL HEAD POSITIONER ZODIAC· POLY AXIAL ROD PUSHER ZODIAC· POLYAXIAL ROD INSERTER ZODIAC· LARGE ROD HOLDING FORCEPS ZODIAC· POLYAXIAL ROD ROTATING WRENCH ZODIAC ·POLY AXIAL INSITU ROD BENDER ZODIAC· ROD ROCKER ZODIAC· POLYAXIAL CANNULATED ANITOROUE ZODIAC. REDUCER ZODIAC· T-HANDLE RATCHET/ QUICK COUPLE ZODIAC - CROSSLINK HEX DRIVER ZODIAC - ADJUSTABLE BRIDGE DRIVER ZODIAC· POLY AXIAL COMPRESSOR ZODIAC· POLYAXIAL DISTRACTOR ZODIAC - POLY AXIAL SET SCREW INSERTER ZODIAC - BONE MARKER INSERTER ZODIAC - BRIDGE GAUGE ZODIAC· MODULAR RATCHETING AXIAL HANDLE ZODIAC - SCREW MEASUREMENT BLOCK ZODIAC· SET SCREW REMOVER ZODIAC • HIGH TOP SCREW BREAKER ZODIAC • POLY AXIAL SCREW REMOVER ZODIAC ·BRIDGE TORQUE ADAPTER ZODIAC - ZODIAC MODULAR TORQUE WRENCH· 40 IN/LB AXIAL HANDLE ZODIAC - HIGH TOP SCREW INSERTER ZODIAC - TABLE TOP ROD CUTTER COLLAPSIBLE HANDLE BLACK ZODIAC • MONOAXIAL SCREWDRIVER ZODIAC· HOOK PUSHER ZODIAC - HOOK IMPACTOR ZODIAC • PEDICLE TRIAL ZODIAC· LAMINA FINDER ZODIAC· CURVED HOOK HOLDER ZODIAC - MODULAR TORQUE WRENCH· 100 IN/LB 'T' HANDLE ZODIAC· POINTED THORACIC PEDICLE PROBE ZODIAC ·BLUNT THRACIC PEDICLE PROBE ZODIAC - HOOK IMPACTOR DRIVER ASSM ZODIAC. 8.5 CANNULATED ANTITORQUE MIRAGE ·BALL TIP PROBE STRAIGHT MIRAGE ·TT BRIDGE/CLAMP HOLDER MIRAGE ·FRENCH ROD BENDER ZODIAC - DRILLING BONE MARKER LEFT 5.5MM ZODIAC - DRILLING BONE MARKER LEFT 6.5MM ZODIAC- DRILLING BONE MARKER LEFT 7.5MM ZODIAC. DRILLING BONE MARKER RIGHT 5.5MM ZODIAC • DRILLING BONE MARKER RIGHT 6.5MM ZODIAC. DRILLING BONE MARKER RIGHT 7.5MM ZODIAC-ROD TEMPLATE 15cm LENGTH 5mm DIA ZODIAC • ROD TEMPLATE 45cm LENGTH 5mm DIA ZODIAC - POLY AXIAL SCREW INSERTER ZODIAC ·HIGH TOP POLY AXIAL SCREWDRIVER ZODIAC • MONOAXIAL SCREWDRIVER ZODIAC ·POLY AXIAL SCREWDRIVER ZODIAC - POLYAXIAL SOLID TAPER TAP 8.5 ZODIAC - 3.0MM ROD TEMPLATE ZODIAC. T-HANDLE TORQUE WRENCH ZODIAC· ADJUSTABLE BRIDGE CADDY ZODIAC - DEFORMITY CASE ZODIAC -IMPLANT TRAY ZODIAC - INSTRUMENT TRAY ZODIAC - POLY AXIAL SCREW HEAD POSITIONER ZODIAC· LARGE ROD HOLDER ZODIAC. IN SITU ROD BENDER· RIGHT ZODIAC • EXTENDED ROD ROCKER ZODIAC. PERSUADER-KERRISON STYLE ZODIAC • PARALLEL COMPRESSOR

'CONFIDENTIAL INFORMATION' Alphatec Spine, Inc.



Price

$ 2119 $ 826.00 $ 2119 $ 826.00 $ 2119 $ 826.00

':• .. . $ 813 $ 95.72 $ 813 $ 178.83 $ 750 $ 245.63 $ 750 $ 168.39 $ 860 $ 75.80 $ 860 $ 54.83 $ 860 $ 50.74 $ 860 $ 61.88 $ 750 $ 91.85 $ 688 $ 192.63 $ 688 $ 340.72 $ 875 $ 380.75 $ 688 $ 223.04 $ 625 $ 225.96 $ 750 $ 295.88 $ 813 $ 272.19 $ 5 688 $ 1131.77 $ 1125 $ 536.31 $ 563 $ 85.39 $ 1 325 $ 213.38 $ 1 000 $ 452.20 $ 1 000 $ 460.98 $ 563 $ 127.96 $ 750 $ 190.47 $ 250 $ 19.42 $ 1148 $ 509.80 $ 313 $ 10.38 $ 438 $ 91.69 $ 438 $ 212.03 $ 500 $ 90.99 $ 250 $ 43.75 $ 938 $ 676.62 $ 1 000 $ 266.19 $ 2000 $ 1 929.57 $ 813 $ 215.09 $ 563 $ 298.72 $ 813 $ 1 012.17 $ 563 $ 221.25 $ 563 $ 503.36 $ 1 063 $ 222.74 $ 875 $ 669.81 $ 750 $ 288.56 $ 750 $ 156.80 $ 1 063 $ 451.72 $ 563 $ 489.23 $ 388 $ 35.60 $ 563 $ 331.59 $ 1 375 $ 316.15 $ 500 $ 34.20 $ 500 $ 28.15 $ 500 $ 30.23 $ 500 $ 32.90 $ 500 $ 26.94 $ 500 $ 27.30 $ 250 $ 44.64 $ 250 $ 40.75 $ 1 094 $ 189.91 $ 750 $ 444.78 $ 813 $ 533.51 $ 875 $ 331.66 $ 860 $ 66.17 $ 400 $ 45.49 $ 2 000 $ 67491 $ 1 081 $ 540.63 $ 2 938 $ 1 098.90 $ 2 938 $ 897.22 $ 2688 $ 796.38 $ 88 $ 291.58 $ 688 $ 507.22 $ 313 $ 335.79 $ 594 $ 437.61 $ 1 719 $ 1 347.09 $ 1 875 $ 1 290.41

ATEC0000031


Part# Description 2008 List

Discount Price Price

92907 ZODIAC - PARALLEL DISTRACTOR $ 1 875 $ 1 292.77 92908 ZODIAC - SET SCREW INSERTER $ 1163 $ 182.85 92909 ZODIAC - FRENCH ROD BENDER $ 1 063 $ 702.46 92912 ZODIAC- DEGENERATIVE IMPLANT STERILIZATION CASE $ 1 094 $ 756.51 92920 ZODIAC - HOOK HOLDER SIDE HOLDING $ 1 844 $ 450.58 92922 ZODIAC - TABLE TOP ROD CUITER $ 1 531 $ 1 099.89 92910-40 ZODIAC-4.0MM SOLID TAPERED POLYAXIAL TAP $ 860 $ 168.47 92910-45 ZODIAC-4.5MM SOLID TAPERED POLYAXIAL TAP $ 860 $ 286.92 92910-55 ZODIAC - 5.5MM SOLi D TAPER ED POLY AXIAL TAP $ 860 $ 273.83 92910-65 ZODIAC-6.5MM SOLID TAPERED POLYAXIAL TAP $ 860 $ 259.88 92910-75 ZODIAC - 7.5MM SOLID TAPERED POLYAXIAL TAP $ 860 $ 274.52 92910-85 ZODIAC-8.5MM SOLID TAPERED POLYAXIAL TAP $ 860 $ 263.58 92913 ZODIAC - DEGENERATIVE INSTRUMENT STERILIZATION CASE 1 $ 1144 $ 1 473.55 92914 ZODIAC - LONGER STRAIGHT HOOK HOLDER SS $ 1144 $ 234.67 92915 ZODIAC - LONGER ANGLED HOOK HOLDER SS $ 294 $ 106.98 92916 ZODIAC - 4.0MM BLUNT BONE PROBE $ 519 $ 205.98 92917 ZODIAC - 4.0MM POINTED BONE PROBE $ 519 $ 6.00 92918 ZODIAC - TRANSVERSE PROCESS HOOK STARTER SS $ 581 $ 418.74 92919 ZODIAC - HOOK IMPACTOR $ 731 $ 531.67 92921-01 ZODIAC - CORONAL ROD BENDER -LEFT $ 1 269 $ 921.11 92921-02 ZODIAC - CORONAL BENDER-RIGHT $ 1 269 $ 728.97 92923 ZODIAC - ROD CUTTER $ 975 $ 706.80 92925 ZODIAC - DEFORMITY INSTRUMENT STERILIZATION CASE $ 1134 $ 827.00 92927 ZODIAC - ROD PUSHER $ 263 $ 241.48 92933 ZODIAC - DEGENERATIVE INSTRUMENT STERILIZATION CASE 2 $ 1138 $ 1 072.03 92938 ZODIAC - SET SCREW DRIVER $ 638 $ 143.33 92943 ZODIAC -T-HANDLE TORQUE WRENCH $ 1172 $ 585.94 92953 ZODIAC - PEDICLE HOOK STARTER $ 238 $ 439.70 92954 ZODIAC - LAMINA HOOK STARTER $ 519 $ 432.69 92958 ZODIAC - POINTED THORACIC PEDICLE PROBE $ 425 $ 211.94 92959 ZODIAC - BLUNT THORACIC PEDICLE PROBE $ 675 $ 301.61 92981 ZODIAC - STOPPED BONE AWL $ 131 $ 255.39 92983 ZODIAC - CURVED BONE PROBE $ 319 $ 214.22 92984 ZODIAC - STRAIGHT BONE PROBE $ 313 $ 209.59 !1i1ir~~·J:·!f.~l·~1£1fR'l&1t~•1;;.;t~~~rolZJi~~-~-11-.;g'al'i"1!1·al!m:m111:1t;fi~~ 64113-008 64113-010 64113-012 64113-014 64113-108 64113-110 64113-112 64113-114 64114-008 64114-010 64114-012 64114-014 64114-108 64114-110 64114-112 64114-114 64115-008 64115-010 64115-012 64115-014 64115-108 64115-110 64115-112 64115-114 64116-008 64116-010 64116-012 64116-014 64116-108 64116-110 64116-112 64116-114

64005 64060 64061 64065 64073 64074 64091 64092 64093

NOVEL-LCC - PEEK MEDIUM SPACER - 10MMX20MMX8MM NOVEL-LCC - PEEK MEDIUM SPACER - 10MMX20MMX10MM NOVEL-LCC -PEEK MEDIUM SPACER - 10MMX20MMX12MM NOVEL-LCC - PEEK MEDIUM SPACER - 10MMX20MMX14MM NOVEL-LCC - PEEK 5 DEGREES MEDIUM SPACER - 10MMX20MMX8MM NOVEL-LCC - PEEK 5 DEGREES MEDIUM SPACER - 10MMX20MMX10MM NOVEL-LCC- PEEK 5 DEGREES MEDIUM SPACER - 10MMX20MMX12MM NOVEL-LCC- PEEK 5 DEGREES MEDIUM SPACER - 10MMX20MMX14MM NOVEL-LCC - PEEK LARGE SPACER - 12MMX20MMX8MM NOVEL-LCC - PEEK LARGE SPACER - 12MMX20MMX8MM NOVEL-LCC - PEEK LARGE SPACER - 12MMX20MMX8MM NOVEL-LCC - PEEK LARGE SPACER - 12MMX20MMX8MM NOVEL-LCC -PEEK 5 DEGREES LARGE SPACER- 12MMX20MMX8MM NOVEL-Lee - PEEK 5 DEGREES LARGE SPACER- 12MMX20MMX10MM NOVEL-LCC - PEEK 5 DEGREES LARGE SPACER- 12MMX20MMX12MM NOVEL-LCC- PEEK 5 DEGREES LARGE SPACER- 12MMX20MMX14MM NOVEL-LCC- PEEK MEDIUM SPACER - 10MMX25MMX8MM NOVEL-LCC - PEEK MEDIUM SPACER - 10MMX25MMX10MM NOVEL-LCC -PEEK MEDIUM SPACER - 10MMX25MMX12MM NOVEL-Lee - PEEK MEDIUM SPACER - 10MMX25MMX14MM NOVEL-LCC - PEEK 5 DEGREES MEDIUM SPACER - 10MMX25MMX8MM NOVEL-LCC - PEEK 5 DEGREES MEDIUM SPACER - 10MMX25MMX10MM NOVEL-LCC-PEEK 5 DEGREES MEDIUM SPACER - 10MMX25MMX12MM NOVEL-LCC - PEEK 5 DEGREES MEDIUM SPACER - 10MMX25MMX14MM NOVEL-LCC - PEEK LARGE SPACER - 12MMX25MMX8MM NOVEL-LCC - PEEK LARGE SPACER - 12MMX25MMX10MM NOVEL-LCC - PEEK LARGE SPACER- 12MMX25MMX12MM NOVEL-LCC - PEEK LARGE SPACER - 12MMX25MMX14MM NOVEL-LCC - PEEK 5 DEGREES LARGE SPACER - 12MMX25MMX8MM NOVEL-LCC -PEEK 5 DEGREES LARGE SPACER - 12MMX25MMX10MM NOVEL-LCC - PEEK 5 DEGREES LARGE SPACER- 12MMX25MMX12MM NOVEL-LCC -PEEK 5 DEGREES LARGE SPACER - 12MMX25MMX14MM

NOVEL - INSERTER ADP - LONG KERRISON ADP - STRAIGHT PITUITARY RONGEUR ADP - DOWN ANGLED PITUITARY RONGEUR NOVEL - STRAIGHT ENDPLATE RASP NOVEL-ANGLED ENDPLATE RASP NOVEL - STRAIGHT ADJUSTER NOVEL - THREADED REMOVER NOVEL - STRAIGHT IMPACTOR


2008 Plice List 9of 17

$ 4 369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4 369 $ 1 704.00 s 4 369 $ 1 704.00 $ 4369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4369 $ 1 704.00 $ 4 369 $ 1,704.00 $ 4369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4369 $ 1 704.00 $ 4369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4369 $ 1 704.00 $ 4369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4 369 $ 1 704.00 $ 4 369 $ 1 704.00

$ 1 263 $ 996.93 $ 2 900 $ 646.87 $ 2 650 $ 574.09 $ 2650 $ 575.00 $ 731 $ 181.71 $ 731 $ 241.65 $ 731 $ 256.01 $ 863 $ 229.53 $ 663 $ 184.74

ATEC0000032


Part#

85890 85911 64010-005 64010-006 64010-007 64010-008 64010-009 64010-010 64010-011 64010-012 64010-013 64010-014 64010-015 64030-003 64030-004 64030-005 64030-006 64030-007 64030-008 64030-009 64030-010 64030-011 64030-012 64030-013 64030-014 64030-015 64043-008 64043-010 64043-012 64043-014 64100-01 64100-02 64100-03 64100-04 64193-108 64193-110 64193-112 64193-114 64195-108 64195-110 64195-112 64195-114 64100

64813-006 64613-009 64813-010 64813-011 64613-012 64813-013 64613-014 64815-008 64815-009 64815-010 64815-011 64815-012 64815-013 64615-014 64817-008 64817-009 64817-010 64817-011 64817-012 64817-013 64617-014 64835-009 64835-010 64835-011 64835-012 64835-013 64635-014 64835-015 64837-009 64837-010 64837-011 64837-012 64837-013

Description

NOVEL-TL - SLAP HAMMER NOVEL-TL· T-HANOLE NOVEL - ROTATING DISTRACTOR - SIZE 5 NOVEL - ROTATING DISTRACTOR - SIZE 6 NOVEL - ROTATING DISTRACTOR -SIZE 7 NOVEL - ROTATING OISTRACTOR - SIZE 8 NOVEL- ROTATING OISTRACTOR- SIZE 9 NOVEL- ROTATING DISTRACTOR -SIZE 10 NOVEL -ROTATING DISTRACTOR -SIZE 11 NOVEL- ROTATING OISTRACTOR -SIZE 12 NOVEL - ROTATING OISTRACTOR -SIZE 13 NOVEL - ROTATING OISTRACTOR - SIZE 14 NOVEL - ROTATING OISTRACTOR -SIZE 15 NOVEL - ROTATING SHAVER - SIZE 3 NOVEL- ROTATING SHAVER - SIZE 4 NOVEL-ROTATING SHAVER-SIZE 5 NOVEL-ROTATING SHAVER-SIZE 6 NOVEL - ROTATING SHAVER - SIZE 7 NOVEL- ROTATING SHAVER-SIZE 8 NOVEL - ROTATING SHAVER- SIZE 9 NOVEL-ROTATING SHAVER -SIZE 10 NOVEL - ROTATING SHAVER - SIZE 11 NOVEL- ROTATING SHAVER-SIZE 12 NOVEL- ROTATING SHAVER - SIZE 13 NOVEL - ROTATING SHAVER - SIZE 14 NOVEL - ROTATING SHAVER - SIZE 15 NOVEL-BOX CHISEL-10MMX8MM NOVEL· BOX CHISEL - 10MMX10MM NOVEL - BOX CHISEL -10MMX12MM NOVEL - BOX CHISEL - 10MMX14MM NOVEL-LCC - CADDY NOVEL-LCC - CADDY LID NOVEL-LCC - TRIAL CADDY NOVEL-LCC - TRIAL CADDY-LID NOVEL-LCC - MEDIUM 5 DEGREES TRIAL - 6MM NOVEL-LCC ·MEDIUM 5 DEGREES TRIAL - 110MM NOVEL-LCC-MEDIUM 5 DEGREES TRIAL-12MM NOVEL-LCC - MEDIUM 5 DEGREES TRIAL-14MM NOVEL-LCC - MEDIUM 5 DEGREES TRIAL - 6MM NOVEL-LCC - MEDIUM 5 DEGREES TRIAL -10MM NOVEL-LCC - MEDIUM 5 DEGREES TRIAL - 12MM NOVEL-LCC - MEDIUM 5 DEGREES TRIAL - 14MM NOVEL-LCC- STERILIZATION CASE

,£ -NOVEL-SD - PEEK SMALL SPACER - 9MMX22MMX8MM NOVEL-SO - PEEK SMALL SPACER· 9MMX22MMX9MM NOVEL-SO - PEEK SMALL SPACER - 9MMX22MMX1 OMM NOVEL-SD - PEEK SMALL SPACER - 9MMX22MMX11 MM NOVEL-SD - PEEK SMALL SPACER - 9MMX22MMX12MM NOVEL-SD - PEEK SMALL SPACER - 9MMX22MMX13MM NOVEL-SD - PEEK SMALL SPACER - 9MMX22MMX14MM NOVEL-SD - PEEK MEDIUM SPACER - 9MMX25MMX8MM NOVEL-SD - PEEK MEDIUM SPACER - 9MMX25MMX9MM NOVEL-SD - PEEK MEDIUM SPACER - 9MMX25MMX1 OMM NOVEL-SD ·PEEK MEDIUM SPACER· 9MMX25MMX11 MM NOVEL-SD-PEEK MEDIUM SPACER-9MMX25MMX12MM NOVEL-SD - PEEK MEDIUM SPACER - 9MMX25MMX13MM NOVEL-SD - PEEK MEDIUM SPACER- 9MMX25MMX14MM NOVEL-SO - PEEK LARGE SPACER - 9MMX28MMX8MM NOVEL-SD - PEEK LARGE SPACER - 9MMX28MMX9MM NOVEL-SD - PEEK LARGE SPACER -9MMX28MMX10MM NOVEL-SD- PEEK LARGE SPACER -9MMX28MMX11MM NOVEL-SD - PEEK LARGE SPACER - 9MMX28MMX12MM NOVEL-SD - PEEK LARGE SPACER -9MMX28MMX13MM NOVEL-SD - PEEK LARGE SPACER - 9MMX28MMX14MM NOVEL-SD - PEEK MEDIUM WIDE SPACER - 9MMX25MMX9MM NOVEL-SD - PEEK MEDIUM WIDE SPACER - 9MMX25MMX10MM NOVEL-SD - PEEK MEDIUM WIDE SPACER· 9MMX25MMX11MM NOVEL-SD· PEEK MEDIUM WIDE SPACER· 9MMX25MMX12MM NOVEL-SD - PEEK MEDIUM WIDE SPACER - 9MMX25MMX13MM NOVEL-SD - PEEK MEDIUM WIDE SPACER - 9MMX25MMX14MM NOVEL-SD - PEEK MEDIUM WIDE SPACER - 9MMX25MMX15MM NOVEL-SD - PEEK LARGE WIDE SPACER - 9MMX28MMX9MM NOVEL-SD - PEEK LARGE WIDE SPACER -9MMX28MMX10MM NOVEL-SO - PEEK LARGE WI DE SPACER - 9MMX28MMX11 MM NOVEL-SD - PEEK LARGE WIDE SPACER- 9MMX26MMX12MM NOVEL-SD - PEEK LARGE WIDE SPACER - 9MMX28MMX13MM


2008 Price LISI 10 of 17


Price

$ 531 $ 287.43 $ 1 094 $ 304.81 $ 781 $ 150.29 $ 781 $ 170.38 $ 781 $ 117.69 $ 781 $ 138.55 $ 781 $ 146.85 $ 781 $ 116.56 $ 781 $ 116.45 $ 781 $ 115.42 $ 781 $ 135.65 $ 781 $ 130.75 $ 781 $ 107.10 $ 913 $ 187.80 $ 913 $ 145.38 $ 913 $ 149.15 $ 913 $ 185.10 $ 913 $ 111.85 $ 913 $ 126.47 $ 913 $ 113.72 $ 913 $ 136.78 $ 913 $ 155.57 $ 913 $ 112.46 $ 913 $ 146.48 $ 913 $ 121.73 $ 913 $ 116.55 $ 913 $ 445.21 $ 913 $ 409.55 $ 913 $ 373.74 $ 913 $ 438.23 $ 531 $ 370.57 $ 138 $ 55.54 $ 531 $ 277.22 $ 138 $ 43.45 $ 275 $ 45.60 $ 275 $ 57.56 $ 275 $ 52.99 $ 275 $ 57.75 $ 275 $ 54.05 $ 275 $ 64.55 $ 275 $ 63.90 $ 275 $ 59.37 $ 2100 $ 1117.16

$ 4 369 $ 1 520.00 $ 4369 $ 1 520.00 $ 4 369 $ 1 520.00 $ 4 369 $ 1 520.00 $ 4 369 $ 1 520.00 $ 4 369 $ 1 520.00 $ 4 369 $ 1 520.00 $ 4 369 $ 1 520.00 $ 4 369 $ 1 520.00 $ 4369 $ 1 520.00 $ 4 369 $ 1 520.00 $ 4 369 $ 1 520.00 $ 4,369 $ 1 520.00 $ 4 369 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5994 $ 1 520.00 $ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00

ATEC0000033


Part#

64837-014 64837-015

64005 64073 64074 64091 64092 64093 85890 85911 64010-005 64010-006 64010-007 64010-008 64010-009 64010-010 64010-011 64010-012 64010-013 64010-014 64010-015 64030-003 64030-004 64030-005 64030-006 64030-007 64030-008 64030-009 64030-010 64030-011 64030-012 64030-013 64030-014 64030-015 64043-008 64043-010 64043-012 64043-014 64800-01 64800-02 64895-008 64895-009 64895-010 64895-011 64895-012 6489~13

6489~14

64612-007 64612-008 64612-009 64612-010 64612-011 64612-012 64612-013 64612-014 64612-107 64612-108 64612-109 64612-110 64612-111 64612-112 64612-113 64612-114 64614-007 64614-008 64614-009 64614-010 64614-011 64614-012 64614-013 64614-014 64614-015 64614-016 64614-017 64614-107

Description

NOVEL-SD - PEEK LARGE WIDE SPACER -9MMX28MMX14MM NOVEL-SD - PEEK LARGE WIDE SPACER - 9MMX28MMX15MM

NOVEL - INSERTER NOVEL - STRAIGHT ENDPLATE RASP NOVEL -ANGLED ENDPLATE RASP NOVEL - STRAIGHT ADJUSTER NOVEL - THREADED REMOVER NOVEL - STRAIGHT IMPACTOR NOVEL-TL - SLAP HAMMER NOVEL-TL - T-HANDLE NOVEL - ROTATING DISTRACTOR - SIZE 5 NOVEL - ROTATING DISTRACTOR - SIZE 6 NOVEL - ROTATING DISTRACTOR - SIZE 7 NOVEL - ROTATING DISTRACTOR - SIZE 8 NOVEL - ROTATING DISTRACTOR - SIZE 9 NOVEL - ROTATING DISTRACTOR - SIZE 10 NOVEL - ROTATING DISTRACTOR - SIZE 11 NOVEL - ROTATING DISTRACTOR - SIZE 12 NOVEL - ROTATING DISTRACTOR - SIZE 13 NOVEL- ROTATING DISTRACTOR - SIZE 14 NOVEL- ROTATING DISTRACTOR-SIZE 15 NOVEL- ROTATING SHAVER - SIZE 3 NOVEL - ROTATING SHAVER - SIZE 4 NOVEL - ROTATING SHAVER - SIZE 5 NOVEL- ROTATING SHAVER - SIZE 6 NOVEL - ROTATING SHAVER - SIZE 7 NOVEL - ROTATING SHAVER - SIZE 8 NOVEL - ROTATING SHAVER - SIZE 9 NOVEL - ROTATING SHAVER -SIZE 10 NOVEL-ROTATING SHAVER-SIZE 11 NOVEL- ROTATING SHAVER -SIZE 12 NOVEL - ROTATING SHAVER - SIZE 13 NOVEL - ROTATING SHAVER - SIZE 14 NOVEL-ROTATING SHAVER-SIZE 15 NOVEL - BOX CHISEL - 10MMX8MM NOVEL - BOX CHISEL-10MMX10MM NOVEL - BOX CHISEL -10MMX12MM NOVEL - BOX CHISEL - 10MMX14MM NOVEL-SD - CADDY MEDIUM NOVEL-SD - CADDY LID NO:VEL-SD - MEDIUM TRIAL - 8MM NOVEL-SD - MEDIUM TRIAL - 9MM NOVEL-SD - MEDIUM TRIAL - 10MM NOVEL-SD - MEDIUM TRIAL - 11MM NOVEL-SD - MEDIUM TRIAL - 12MM NOVEL-SD - MEDIUM TRIAL· 13MM NOVEL-SD· MEDIUM TRIAL· 14MM

NOVEL-TL - PEEK SMALL SPACER - 22MMX1 OMMX7MM NOVEL-TL - PEEK SMALL SPACER - 22MMX10MMXBMM NOVEL-TL - PEEK SMALL SPACER - 22MMX10MMX9MM NOVEL-TL - PEEK SMALL SPACER - 22MMX10MMX10MM NOVEL-TL- PEEK SMALL SPACER-22MMX10MMX11MM NOVEL-TL - PEEK SMALL SPACER -22MMX10MMX12MM NOVEL-TL- PEEK SMALL SPACER-22MMX10MMX13MM NOVEL-TL- PEEK SMALL SPACER - 22MMX10MMX14MM NOVEL-TL - PEEK 5 DEGREES SMALL SPACER - 22MMX10MMX7MM NOVEL-TL - PEEK 5 DEGREES SMALL SPACER - 22MMX10MMX8MM NOVEL-TL - PEEK 5 DEGREES SMALL SPACER - 22MMX10MMX9MM NOVEL-TL - PEEK 5 DEGREES SMALL SPACER - 22MMX10MMX1 OMM NOVEL-TL - PEEK 5 DEGREES SMALL SPACER - 22MMX10MMX11MM NOVEL-TL - PEEK 5 DEGREES SMALL SPACER - 22MMX10MMX12MM NOVEL-TL- PEEK 5 DEGREES SMALL SPACER - 22MMX10MMX13MM NOVEL-TL - PEEK 5 DEGREES SMALL SPACER - 22MMX10MMX14MM NOVEL-TL - PEEK MEDIUM SPACER - 24MMX10MMX7MM NOVEL-TL - PEEK MEDIUM SPACER- 24MMX10MMX8MM NOVEL-TL - PEEK MEDIUM SPACER - 24MMX10MMX9MM NOVEL-TL- PEEK MEDIUM SPACER - 24MMX10MMX10MM NOVEL-TL - PEEK MEDIUM SPACER - 24MMX10MMX11 MM NOVEL-TL. PEEK MEDIUM SPACER - 24MMX10MMX12MM NOVEL-TL - PEEK MEDIUM SPACER - 24MMX10MMX13MM NOVEL-TL - PEEK MEDIUM SPACER - 24MMX10MMX14MM NOVEL-TL - PEEK MEDIUM SPACER - 24MMX10MMX15MM NOVEL-TL - PEEK MEDIUM SPACER - 24MMX10MMX16MM NOVEL-TL - PEEK MEDIUM SPACER - 24MMX10MMX17MM NOVEL-TL - PEEK 5 DEGREES MEDIUM SPACER -24MMX10MMX7MM


2008 Price List 11of17

~

'.

'


Price

$ 5 994 $ 1 520.00 $ 5 994 $ 1 520.00

. .,l><

$ 1 263 $ 996.93 $ 731 $ 181.71 $ 731 $ 241.65 $ 731 $ 256.01 $ 863 $ 229.53 $ 663 $ 184.74 $ 531 $ 287.43 $ 1 094 $ 304.81 $ 781 $ 150.29 $ 781 $ 170.38 $ 781 $ 117.69 $ 781 $ 138.55 $ 781 $ 146.85 $ 781 $ 116.56 $ 781 $ 116.45 $ 781 $ 115.42 $ 781 $ 135.65 $ 781 $ 130.75 $ 781 $ 107.10 $ 913 $ 187.80 $ 913 $ 145.38 $ 913 $ 149.15 $ 913 $ 185.10 $ 913 $ 111.85 $ 913 $ 126.47 $ 913 $ 113.72 $ 913 $ 136.78 $ 913 $ 155.57 $ 913 $ 112.46 $ 913 $ 146.48 $ 913 $ 121.73 $ 913 $ 116.55 $ 913 $ 445.21 $ 913 $ 409.55 $ 913 $ 373.74 $ 913 $ 438.23 $ 800 $ 375.97 $ 200 $ 60.72 $ 269 $ 77.49 $ 269 $ 69.60 $ 269 $ 82.79 $ 269 $ 71.13 $ 269 $ 80.08 $ 269 $ 69.52 $ 269 $ 98.34

$ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 794 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00

ATEC0000034


Part#

64614-108 64614-109 64614-110 64614-111 64614-112 64614-113 64614-114 64614-115 64614-116 64614-117 64616-007 64616-008 64616-009 64616-010 64616-011 64616-012 64616-013 64616-014 64616-015 64616-016 64616-017 64616-107 64616-108 64616-109 64616-110 64616-111 64616-112 64616-113 64616-114 64616-115 64616-116 64616-117 64618-007 64618-008 64618-009 64618-010 64618-011 64618-012 64618-013 64618-014 64618-015 64618-016 64618-017 64618-018 64618-019 64618-020 64618-107 64618-108 64618-109 64618-110 64618-111 64618-112 64618-113 64618-114 64618-115 64618-116 64618-117 64618-118 64618-119 64618-120

64010-005 64010-006 64010-007 64010-008 64010-009 64010-010 64010-011 64010-012 64010-013 64010-014 64010-015 64620-03 64620-04 64620-05 64620-06 64620-07

Description

NOVEL-TL- PEEK 5 DEGREES MEDIUM SPACER - 24MMX10MMX8MM NOVEL-TL - PEEK 5 DEGREES MEDIUM SPACER - 24MMX10MMX9MM NOVEL-TL - PEEK 5 DEGREES MEDIUM SPACER - 24MMX10MMX10MM NOVEL-TL - PEEK 5 DEGREES MEDIUM SPACER - 24MMX10MMX11MM NOVEL-TL - PEEK 5 DEGREES MEDIUM SPACER -24MMX10MMX12MM NOVEL-TL- PEEK 5 DEGREES MEDIUM SPACER - 24MMX10MMX13MM NOVEL-TL - PEEK 5 DEGREES MEDIUM SPACER - 24MMX1OMMX14MM NOVEL-TL - PEEK 5 DEGREES MEDIUM SPACER - 24MMX10MMX15MM NOVEL-TL- PEEK 5 DEGREES MEDIUM SPACER - 24MMX10MMX16MM NOVEL-TL - PEEK 5 DEGREES MEDIUM SPACER - 24MMX10MMX17MM NOVEL-TL - PEEK LARGE SPACER - 28MMX10MMX7MM NOVEL-TL - PEEK LARGE SPACER - 28MMX10MMX8MM NOVEL-TL - PEEK LARGE SPACER - 28MMX10MMX9MM NOVEL-TL - PEEK LARGE SPACER - 28MMX10MMX10MM NOVEL-TL - PEEK LARGE SPACER - 28MMX10MMX11 MM NOVEL-TL - PEEK LARGE SPACER - 28MMX10MMX12MM NOVEL-TL - PEEK LARGE SPACER - 28MMX10MMX13MM NOVEL-TL - PEEK LARGE SPACER - 28MMX10MMX14MM NOVEL-TL - PEEK LARGE SPACER - 28MMX10MMX15MM NOVEL-Tl - PEEK LARGE SPACER - 28MMX10MMX16MM NOVEL-Tl -PEEK LARGE SPACER - 28MMX10MMX17MM NOVEL-TL - PEEK 5 DEGREES LARGE SPACER - 28MMX10MMX7MM NOVEL-TL- PEEK 5 DEGREES LARGE SPACER - 28MMX10MMX8MM NOVEL-TL - PEEK 5 DEGREES LARGE SPACER - 28MMX10MMX9MM NOVEL-TL - PEEK 5 DEGREES LARGE SPACER - 28MMX10MMX10MM NOVEL-Tl-PEEK 5 DEGREES LARGE SPACER -28MMX10MMX11MM NOVEL-Tl - PEEK 5 DEGREES LARGE SPACER -28MMX10MMX12MM NOVEL-TL - PEEK 5 DEGREES LARGE SPACER· 28MMX10MMX13MM NOVEL-TL- PEEK 5 DEGREES LARGE SPACER - 28MMX10MMX14MM NOVEL-TL - PEEK 5 DEGREES LARGE SPACER - 28MMX10MMX15MM NOVEL-TL- PEEK 5 DEGREES LARGE SPACER - 28MMX10MMX16MM NOVEL-TL -PEEK 5 DEGREES LARGE SPACER -28MMX10MMX17MM NOVEL-TL - PEEK X-l.ARGE SPACER- 30MMX10MMX7MM NOVEL-TL- PEEK X-LARGE SPACER - 30MMX10MMX8MM NOVEL-TL - PEEK X-LARGE SPACER - 30MMX10MMX9MM NOVEL-TL - PEEK X-LARGE SPACER - 30MMX10MMX1 OMM NOVEL-TL - PEEK X-LARGE SPACER - 30MMX10MMX11MM NOVEL-TL -PEEK X-LARGE SPACER - 30MMX10MMX12MM NOVEL-TL - PEEK X-LARGE SPACER -30MMX10MMX13MM NOVEL-Tl - PEEK X-LARGE SPACER -30MMX10MMX14MM NOVEL-TL- PEEK X-LARGE SPACER - 30MMX1DMMX15MM NOVEL-Tl - PEEK X-LARGE SPACER - 30MMX10MMX16MM NOVEL-Tl - PEEK X-LARGE SPACER - 30MMX10MMX17MM NOVEL-TL - PEEK X-LARGE SPACER - 30MMX10MMX18MM NOVEL-TL - PEEK X-LARGE SPACER - 30MMX10MMX19MM NOVEL-Tl-PEEK X-LARGE SPACER - 30MMX10MMX20MM NOVEL-Tl - PEEK 5 DEGREES X-LARGE SPACER - 30MMX10MMX7MM NOVEL-Tl- PEEK 5 DEGREES X-LARGE SPACER - 30MMX10MMX8MM NOVEL-Tl-PEEK 5 DEGREES X-LARGE SPACER - 30MMX10MMX9MM NOVEL-Tl- PEEK 5 DEGREES X-LARGE SPACER - 30MMX10MMX10MM NOVEL-TL - PEEK 5 DEGREES X-LARGE SPACER - 30MMX1 OMMX11 MM NOVEL-TL - PEEK 5 DEGREES X-LARGE SPACER - 30MMX10MMX12MM NOVEL-TL- PEEK 5 DEGREES X-LARGE SPACER-30MMX10MMX13MM NOVEL-Tl - PEEK 5 DEGREES X-LARGE SPACER - 30MMX10MMX14MM NOVEL-TL - PEEK 5 DEGREES X-LARGE SPACER - 30MMX10MMX15MM NOVEL-TL - PEEK 5 DEGREES X-LARGE SPACER - 30MMX10MMX16MM NOVEL-TL - PEEK 5 DEGREES X-LARGE SPACER -30MMX10MMX17MM NOVEL-TL - PEEK 5 DEGREES X-LARGE SPACER - 30MMX10MMX18MM NOVEL-TL - PEEK 5 DEGREES X-LARGE SPACER - 30MMX10MMX19MM NOVEL-TL - PEEK 5 DEGREES X-LARGE SPACER - 30MMX10MMX20MM

NOVEL - ROTATING DISTRACTOR - SIZE 5 NOVEL- ROTATING DISTRACTOR - SIZE 6 NOVEL - ROTATING DISTRACTOR - SIZE 7 NOVEL - ROTATING DISTRACTOR - SIZE 8 NOVEL - ROTATING DISTRACTOR - SIZE 9 NOVEL - ROTATING DISTRACTOR - SIZE 10 NOVEL-ROTATING DISTRACTOR-SIZE 11 NOVEL- ROTATING DISTRACTOR - SIZE 12 NOVEL- ROTATING DISTRACTOR- SIZE 13 NOVEL- ROTATING DISTRACTOR - SIZE 14 NOVEL- ROTATING DISTRACTOR - SIZE 15 NOVEL-TL - DISC SHAVER - 3MM NOVEL-TL - DISC SHAVER - 4MM NOVEL-TL - DISC SHAVER - 5MM NOVEL-Tl - DISC SHAVER - 6MM NOVEL-TL - DISC SHAVER - 7MM

.'.A'e


2008 Price Lisi 12Of17


Price

$ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 856 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 900 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00 $ 6 956 $ 1 520.00

'. -$ 781 $ 150.29 $ 781 $ 170.38 $ 781 $ 117.69 $ 781 $ 138.55 $ 781 $ 146.85 $ 781 $ 116.56 $ 781 $ 116.45 $ 781 $ 115.42 $ 781 $ 135.65 $ 781 $ 130.75 $ 781 $ 107.10 $ 610 $ 153.00 $ 610 $ 153.00 $ 610 $ 153.00 $ 610 $ 153.00 $ 610 $ 153.00

ATEC0000035


Part# Description 2008 List

Discount Price Price

64620-08 NOVEL-TL - DISC SHAVER - 8MM $ 610 $ 153.00 64620-09 NOVEL-TL - DISC SHAVER - 9MM $ 610 $ 153.00 64620-10 NOVEL-TL - DISC SHAVER -10MM $ 610 $ 153.00 64620-11 NOVEL-TL - DISC SHAVER- 11MM $ 610 $ 153.00 64620-12 NOVEL-TL - DISC SHAVER - 12MM $ 610 $ 153.00 64620-13 NOVEL-TL - DISC SHAVER - 13MM $ 610 $ 153.00 64620-14 NOVEL-TL - DISC SHAVER - 14MM $ 610 $ 153.00 64620-15 NOVEL-TL - DISC SHAVER - 15MM $ 610 $ 153.00 64620-16 NOVEL-TL - DISC SHAVER -16MM $ 763 $ 153.00 64620-17 NOVEL-TL - DISC SHAVER - 17MM $ 763 $ 153.00 64621 NOVEL-TL - STRAIGHT ENDPLATE RASP $ 785 $ 217.15 64622-01 NOVEL-TL - LEFT CURVED RASP $ 925 $ 217.77 64622-02 NOVEL-TL - RIGHT CURVED RASP $ 925 $ 219.12 64630-01 NOVEL-TL - STRAIGHT TAMP $ 585 $ 448.92 64630-02 NOVEL-TL - CURVED TAMP $ 585 $ 525.69 64634-02 NOVEL-TL - 30 DEGREEES INSERTER $ 1 600 $ 986.86 64634-01 NOVEL-TL - STRAIGHT INSERTER $ 1 600 $ 811.04 64639 NOVEL-TL - BONE GRAFT PACKING BLOCK $ 425 $ 223.11 64640-01 NOVEL-TL - SMALL BONE GRAFT TAMP $ 510 $ 165.64 64640-02 NOVEL-TL - MEDIUM BONE GRAFT TAMP $ 510 $ 189.50 64641 NOVEL-TL - IMPLANT RETRIEVER $ 1 250 $ 475.00 64630-03 NOVEL-TL - BAYONETED TAMP $ 731 $ 500.73 64640-03 NOVEL-TL - LARGE BONE GRAFT TAMP $ 638 $ 214.70 64640-04 NOVEL-TL - XLARGE BONE GRAFT TAMP $ 638 $ 200.86 64600 NOVEL-TL -STERILIZATION CASE $ 2250 $ 1125.00 85889 NOVEL-TL - IMPACT HAMMER $ 385 $ 476.83 85890 NOVEL-TL - SLAP HAMMER $ 531 $ 287.43 85901 NOVEL-TL - MEDIUM QUICK CONNECT HANDLE $ 900 $ 405.30 85911 NOVEL-TL -T-HANDLE $ 1 094 $ 304.81 85912 NOVEL-TL - LARGE QUICK CONNECT HANDLE $ 900 $ 390.87

r~zf ~~~~~1~~~r:1f~~~m.~~~!~~~~"!.~~}~~~~~:-~.:-~-~1t::~~'l?l:~~ 64311-008 64311-010 64311-012 64311-014 64311-016 64311-018 64311-108 64311-110 64311-112 64311-114 64311-116 64311-118 64313-008 64313-010 64313-012 64313-014 64313-016 64313-018 64313-108 64313-110 64313-112 64313-114 64313-116 64313-118 64313-244 64313-246 64313-248 64313-250 64315-008 64315-010 64315-012 64315-014 64315-016 64315-018 64315-108 64315-110 64315-112 64315-114 64315-116 64315-118

64005 64073 64074 64091 64092

NOVEL-VC - PEEK SMALL SPACER - 26MMX16MMX8MM NOVEL-VC - PEEK SMALL SPACER -26MMX16MMX10MM NOVEL-VC - PEEK SMALL SPACER - 26MMX16MMX12MM NOVEL-VC - PEEK SMALL SPACER - 26MMX16MMX14MM NOVEL-VC - PEEK SMALL SPACER - 26MMX16MMX16MM NOVEL-VC - PEEK SMALL SPACER -26MMX16MMX18MM NOVEL-VC - PEEK 5 DEGREES SMALL SPACER - 26MMX16MMX8MM NOVEL-VC -PEEK 5 DEGREES SMALL SPACER - 26MMX16MMX10MM NOVEL-VC - PEEK 5 DEGREES SMALL SPACER - 26MMX16MMX12MM NOVEL-VC- PEEK 5 DEGREES SMALL SPACER- 26MMX16MMX14MM NOVEL-VC -PEEK 5 DEGREES SMALL SPACER- 26MMX16MMX16MM NOVEL-VC- PEEK 5 DEGREES SMALL SPACER - 26MMX16MMX18MM NOVEL-VC - PEEK MEDIUM SPACER - 32MMX20MMX8MM NOVEL-VC - PEEK MEDIUM SPACER - 32MMX20MMX10MM NOVEL-VC - PEEK MEDIUM SPACER - 32MMX20MMX12MM NOVEL-VC - PEEK MEDIUM SPACER -32MMX20MMX14MM NOVEL-VC - PEEK MEDIUM SPACER - 32MMX20MMX16MM NOVEL-VG - PEEK MEDIUM SPACER - 32MMX20MMX18MM NOVEL-VC - PEEK 5 DEGREES MEDIUM SPACER - 32MMX20MMX8MM NOVEL-VC - PEEK 5 DEGREES MEDIUM SPACER - 32MMX20MMX10MM NOVEL-VC -PEEK 5 DEGREES MEDIUM SPACER- 32MMX20MMX12MM NOVEL-VG - PEEK 5 DEGREES MEDIUM SPACER - 32MMX20MMX14MM NOVEL-VG -PEEK 5 DEGREES MEDIUM SPACER - 32MMX20MMX16MM NOVEL-VC - PEEK 5 DEGREES MEDIUM SPACER - 32MMX20MMX18MM NOVEL-VC - PEEK 8 DEGREES MEDIUM SPACER - 32MMX20MMX44MM NOVEL-VC - PEEK 8 DEGREES MEDIUM SPACER - 32MMX20MMX46MM NOVEL-VG - PEEK 8 DEGREES MEDIUM SPACER - 32MMX20MMX448MM NOVEL-VC - PEEK B DEGREES MEDIUM SPACER - 32MMX20MMX50MM NOVEL-VC - PEEK LARGE SPACER - 3BMMX24MMX8MM NOVEL-VC - PEEK LARGE SPACER - 38MMX24MMX10MM NOVEL-VC - PEEK LARGE SPACER - 38MMX24MMX12MM NOVEL-VG - PEEK LARGE SPACER - 38MMX24MMX14MM NOVEL-VC - PEEK LARGE SPACER - 38MMX24MMX16MM NOVEL-VC - PEEK LARGE SPACER - 38MMX24MMX18MM NOVEL-VC - PEEK 5 DEGREES LARGE SPACER - 38MMX24MMX8MM NOVEL-VC - PEEK 5 DEGREES LARGE SPACER - 38MMX24MMX10MM NOVEL-VC - PEEK 5 DEGREES LARGE SPACER - 38MMX24MMX12MM NOVEL-VC - PEEK 5 DEGREES LARGE SPACER- 38MMX24MMX14MM NOVEL-VC - PEEK 5 DEGREES LARGE SPACER - 3BMMX24MMX16MM NOVEL-VC - PEEK 5 DEGREES LARGE SPACER - 38MMX24MMX18MM

:ve· NOVEL - INSERTER NOVEL - STRAIGHT ENDPLATE RASP NOVEL -ANGLED ENDPLATE RASP NOVEL - STRAIGHT ADJUSTER NOVEL - THREADED REMOVER

, . , _R_,.,,,w.n . N.S'

"CONFIDENTIAL INFORMATION" A!phatec Spine, Inc.


c,;:,,~ ' ~-:~'. •_,,Y • ~' ,··-"

$ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00 $ 7 281 $ 2 500.00

r'~_":'.J/ '';.:f< ~~ ..

$ 1 263 $ 996.93 $ 731 $ 181.71 $ 731 $ 241.65 $ 731 $ 256.01 $ 863 $ 229.53

ATEC0000036


Part#

64093 64098 85890 85911 64010--005 64010--006 64010--007 64010--008 64010-009 64010--010 64010--011 64010-012 64010--013 64010--014 64010--015 64025--008 64025--010 64025--012 64025--014 64027--008 64027--010 64027-012 64027--014 64029--008 64029--010 64029--012 64029--014 64030-003 64030--004 64030--005 64030--006 64030-007 64030-008 64030-009 64030--010 64030--011 64030--012 64030--013 64030-014 64030--015 64098-101 64098-102 64098-301 64098-302 64098-501 64098-502 64300--01 64300-02 64300--03 64300-04 64391-108 64391-110 64391-112 64391-114 64393-108 64393-110 64393-112 64393-114 64395-108 64395-110 64395-112 64395-114 64300

64703-104 64703-105 64713-004 64713--005 64713-006 64713--007 64713--008 64713--009 64713-104 64713-105 64713-106 64713-107 64713-108

Description

NOVEL ·STRAIGHT IMPACTOR NOVEL-VG - MODULAR SPINE DISTRACTOR NOVEL-TL - SLAP HAMMER NOVEL-TL - T-HANDLE NOVEL· ROTATING DISTRACTOR - SIZE 5 NOVEL - ROTATING DISTRACTOR - SIZE 6 NOVEL· ROTATING DISTRACTOR - SIZE 7 NOVEL - ROTATING DISTRACTOR - SIZE 8 NOVEL - ROTATING DISTRACTOR - SIZE 9 NOVEL· ROTATING DISTRACTOR - SIZE 10 NOVEL· ROTATING DISTRACTOR - SIZE 11 NOVEL· ROTATING DISTRACTOR ·SIZE 12 NOVEL - ROTATING DISTRACTOR - SIZE 13 NOVEL - ROTATING DISTRACTOR ·SIZE 14 NOVEL· ROTATING DISTRACTOR ·SIZE 15 NOVEL - MODULAR CHISEL - 26mmX8MM NOVEL- MODULAR CHISEL· 26mmX10MM NOVEL - MODULAR CHISEL· 26mmX12MM NOVEL· MODULAR CHISEL· 26mmX14\MM NOVEL - MODULAR CHISEL - 32MMX8MM NOVEL - MODULAR CHISEL· 32MMX10MM NOVEL - MODULAR CHISEL - 32MMX12MM NOVEL - MODULAR CHISEL - 32MMX14MM NOVEL - MODULAR CHISEL - 38MMX8MM NOVEL - MODULAR CHISEL - 38MMX10MM NOVEL- MODULAR CHISEL -38MMX12MM NOVEL - MODULAR CHISEL - 38MMX14MM NOVEL- ROTATING SHAVER-SIZE 3 NOVEL - ROTATING SHAVER - SIZE 4 NOVEL - ROTATING SHAVER- SIZE 5 NOVEL - ROTATING SHAVER - SIZE 6 NOVEL - ROTATING SHAVER - SIZE 7 NOVEL- ROTATING SHAVER -SIZE 8 NOVEL- ROTATING SHAVER -SIZE 9 NOVEL-ROTATING SHAVER-SIZE 10 NOVEL - ROTATING SHAVER - SIZE 11 NOVEL- ROTATING SHAVER-SIZE 12 NOVEL- ROTATING SHAVER - SIZE 13 NOVEL- ROTATING SHAVER-SIZE 14 NOVEL - ROTATING SHAVER-SIZE 15 NOVEL-VC - SMALL RIGHT MODULAR DISTRACTOR TIP NOVEL-VC - SMALL LEFT MODULAR DISTRACTOR TIP NOVEL-VC - MEDIUM RIGHT MODULAR DISTRACTOR TIP NOVEL-VC - MEDIUM LEFT MODULAR DISTRACTOR TIP NOVEL-Ve -LARGE RIGHT MODULAR DISTRACTOR TIP NOVEL-VC - LARGE LEFT MODULAR DISTRACTOR TIP NOVEL-VC - CADDY NOVEL-VC - CADDY LID NOVEL-LCC - TRIAL CADDY NOVEL-VC - TRIAL CADDY LID NOVEL-VC - SMALL 5 DEGREES TRIAL - 8MM NOVEL-VC - SMALL 5 DEGREES TRIAL - 10MM NOVEL-VC-SMALL 5 DEGREES TRIAL-12MM NOVEL-VC - SMALL 5 DEGREES TRIAL - 14MM NOVEL-VC - MEDIUM 5 DEGREES TRIAL - 8MM NOVEL-VC - MEDIUM 5 DEGREES TRIAL -10MM NOVEL-VG-MEDIUM 5 DEGREES TRIAL-12MM NOVEL-VC - MEDIUM 5 DEGREES TRIAL - 14MM NOVEL-VC - LARGE 5 DEGREES TRIAL - 8MM NOVEL-VC - LARGE 5 DEGREES TRIAL - 1 OMM NOVEL-VC - LARGE 5 DEGREES TRIAL - 12MM NOVEL-VC - LARGE 5 DEGREES TRIAL - 14MM NOVEL-VC - STERILIZATION CASE

•i' .21 '. {RE T>S' NOVEL-XS - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX4MM NOVEL-XS - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX5MM NOVEL-XS- PEEK SMALL SPACER - 14MMX12MMX4MM NOVEL-XS - PEEK SMALL SPACER - 14MMX12MMX5MM NOVEL-XS - PEEK SMALL SPACER -14MMX12MMX6MM NOVEL-XS - PEEK SMALL SPACER - 14MMX12MMX7MM NOVEL-XS - PEEK SMALL SPACER -14MMX12MMX8MM NOVEL-XS - PEEK SMALL SPACER - 14MMX12MMX9MM NOVEL-XS -PEEK 5 DEGREES SMALL SPACER -14MMX12MMX4MM NOVEL-XS - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX5MM NOVEL-XS • PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX6MM NOVEL-XS - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX7MM NOVEL-XS - PEEK 5 DEGREES SMALL SPACER-14MMX12MMX8MM

"CONFIDENTIAL INFORMATION" AJphatec Spine, Inc.


"


Price

$ 663 $ 184.74 $ 3 844 $ 1 404.97 $ 531 $ 287.43 $ 1 094 $ 304.81 $ 781 $ 150.29 $ 781 $ 170.38 $ 781 $ 117.69 $ 781 $ 138.55 $ 781 $ 146.85 $ 781 $ 116.56 $ 781 $ 116.45 $ 781 $ 115.42 $ 781 $ 135.65 $ 781 $ 130.75 $ 781 $ 107.10 $ 913 $ 167.58 $ 913 $ 209.50 $ 913 $ 128.02 $ 913 $ 119.63 $ 913 $ 226.80 $ 913 $ 118.71 $ 913 $ 132.38 $ 913 $ 154.73 $ 913 $ 103.0B $ 913 $ 130.98 $ 913 $ 167.48 $ 913 $ 151.08 $ 913 $ 187.80 $ 913 $ 145.38 $ 913 $ 149.15 $ 913 $ 185.10 $ 913 $ 111.85 $ 913 $ 126.47 $ 913 $ 113.72 $ 913 $ 136.78 $ 913 $ 155.57 $ 913 $ 112.46 $ 913 $ 146.48 $ 913 $ 121.73 $ 913 $ 116.55 $ 531 $ 128.54 $ 531 $ 134.34 $ 531 $ 160.79 $ 531 $ 190.62 $ 531 $ 134.98 $ 531 $ 167.66 $ 531 $ 617.76 $ 200 $ 184.47 $ 400 $ 403.72 $ 200 $ 45.70 $ 269 $ 104.92 $ 269 $ 75.47 $ 269 $ 81.38 $ 269 $ 90.00 $ 269 $ 230.75 $ 269 $ 79.28 $ 269 $ 82.09 $ 269 $ 111.63 $ 269 $ 73.93 $ 269 $ 88.17 $ 269 $ 79.83 $ 269 $ 102.07 $ 2100 $ 966.57

' :Jt' .,~

" $ 2644 $ 1,140.00 $ 2 644 $ 1140.00 $ 2644 $ 1140.00 $ 2644 $ 1140.00 $ 2 644 $ 1140.00 $ 2644 $ 1140.00 $ 2644 $ 1140.00 $ 2644 $ 1140.00 $ 2644 $ 1140.00 $ 2644 $ 1140.00 $ 2644 $ 1140.00 $ 2644 $ 1140.00 $ 2 644 $ 1,140.00

ATEC0000037


Part#

64713-109 64715--004 64715-005 64715--006 64715--007 64715--008 64715--009 64715-104 64715-105 64715-106 64715-107 64715-108 64715-109 64717-004 64717-005 64717-006 64717--007 64717--008 64717--009 64717-104 64717-105 64717-106 64717-107 64717-108 64717-109

64713-110 64713-112 64713-114 64713-111 64713-113 64713-115 64713-116 64713-117 64713-118 64713-119 64713-120 64713-121 64713-122 64713-123 64733-124 64733-125 64733-126 64733-127 64733-128 64733-129 64733-130 64733-131 64733-132 64733-133 64733-134 64733-135 64733-136 64733-137 64733-138 64733-139 64753-140 64753-141 64753-142 64753-143 64753-144 64753-145 64753-146 64753-147 64753-148 64753-149 64753-150

64715-110 64715-112 64715-114 64715-111 64715-113 64715-115 64715-116 64715-117 64715-118

Description

NOVEL-XS - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX9MM NOVEL-XS-PEEK MEDIUM SPACER-14MMX12MMX4MM NOVEL-XS -PEEK MEDIUM SPACER-14MMX12MMX5MM NOVEL-XS - PEEK MEDIUM SPACER - 14MMX12MMX6MM NOVEL-XS - PEEK MEDIUM SPACER - 14MMX12MMX7MM NOVEL-XS - PEEK MEDIUM SPACER - 14MMX12MMX8MM NOVEL-XS - PEEK MEDIUM SPACER - 14MMX12MMX9MM NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER -14MMX12MMX4MM NOVEL-XS-PEEK 5 DEGREES MEDIUM SPACER - 14MMX12MMX5MM NOVEL-XS- PEEK 5 DEGREES MEDIUM SPACER - 14MMX12MMX6MM NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER - 14MMX12MMX7MM NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER -14MMX12MMX8MM NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER -14MMX12MMX9MM NOVEL-XS- PEEK LARGE SPACER -20MMX18MMX4MM NOVEL-XS - PEEK LARGE SPACER - 20MMX18MMX5MM NOVEL-XS - PEEK LARGE SPACER - 20MMX18MMX6MM NOVEL-XS - PEEK LARGE SPACER - 20MMX18MMX7MM NOVEL-XS - PEEK LARGE SPACER - 20MMX 1 BMMXBMM NOVEL-XS - PEEK LARGE SPACER - 20MMX18MMX9MM NOVEL-XS - PEEK 5 DEGREES LARGE SPACER - 20MMX18MMX4MM NOVEL-XS - PEEK 5 DEGREES LARGE SPACER - 20MMX18MMX5MM NOVEL-XS - PEEK 5 DEGREES LARGE SPACER - 20MMX18MMX6MM NOVEL-XS - PEEK 5 DEGREES LARGE SPACER - 20MMX18MMX7MM NOVEL-XS - PEEK 5 DEGREES LARGE SPACER - 20MMX1 BMMX8MM NOVEL-XS - PEEK 5 DEGREES LARGE SPACER - 20MMX18MMX9MM

l\CER!Ml~P.; '

NOVEL-CP-PEEK 5 DEGREES SMALL SPACER-14MMX12MMX10MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX12MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX14MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX11MM NOVEL-GP-PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX13MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX15MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX16MM NOVEL-CP -PEEK 5 DEGREES SMALL SPACER -14MMX12MMX17MM NOVEL-CP -PEEK 5 DEGREES SMALL SPACER -14MMX12MMX18MM NOVEL-CP -PEEK 5 DEGREES SMALL SPACER -14MMX12MMX19MM NOVEL-CP -PEEK 5 DEGREES SMALL SPACER -14MMX12MMX20MM NOVEL-CP -PEEK 5 DEGREES SMALL SPACER -14MMX12MMX21MM NOVEL-GP- PEEK 5 DEGREES SMALL SPACER-14MMX12MMX22MM NOVEL-GP- PEEK 5 DEGREES SMALL SPACER -14MMX12MMX23MM NOVEL-GP- PEEK 5 DEGREES SMALL SPACER -14MMX12MMX24MM NOVEL-GP -PEEK 5 DEGREES SMALL SPACER -14MMX12MMX25MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX26MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX27MM NOVEL-CP-PEEK 5 DEGREES SMALL SPACER -14MMX12MMX28MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX29MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX30MM NOVEL-GP - PEEK 5 DEGREES SMALL SPACER-14MMX12MMX31MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER-14MMX12MMX32MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX33MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX34MM NOVEL-GP - PEEK 5 DEGREES SMALL SPACER-14MMX12MMX35MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX36MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX37MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX38MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX39MM NOVEL-GP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX40MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX41MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX42MM NOVEL-GP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX43MM NOVEL-GP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX44MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX45MM NOVEL-CP -PEEK 5 DEGREES SMALL SPACER -14MMX12MMX46MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX47MM NOVEL-GP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX48MM NOVEL-CP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX49MM NOVEL-GP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX50MM

' .. ~ ER . M.'.,,.,Pf:i ..... ~ IS'M · NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER- 14MMX12MMX10MM NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER-14MMX12MMX12MM NOVEL-XS -PEEK 5 DEGREES MEDIUM SPACER -14MMX12MMX14MM NOVEL-XS -PEEK 5 DEGREES MEDIUM SPACER-14MMX12MMX11MM NOVEL-XS -PEEK 5 DEGREES MEDIUM SPACER - 14MMX12MMX13MM NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER - 14MMX12MMX15MM NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER-14MMX12MMX16MM NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER - 14MMX12MMX17MM NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER -14MMX12MMX18MM

"CONFIDENTIAL INFORMATION" Alphatec Spina, Inc.

2008 Price List 15 of 17

* ' . ,,.. . ~ ,\f:i-~~~;t:

..


Price

$ 2 644 $ 1 140.00 $ 2 644 $ 1 140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1 140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2644 $ 1140.00 $ 2 644 $ 1 140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1 140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00 $ 2 644 $ 1140.00

.·· ~;: $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 10 197 $ 3 977.00 $ 10 197 $ 3 977.00 $ 10 197 $ 3 977.00 $ 10 197 $ 3 977.00 $ 10 197 $ 3,977.00 $ 10 197 $ 3 977.00 $ 10 197 $ 3 977.00 $ 10 197 $ 3 977.00 $ 10 197 $ 3 977.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4379.00

,.

$ 9 840 s 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00

ATEC0000038


Part#

64715-119 64715-120 64715-121 64715-122 64715-123 64735-124 64735-125 64735-126 64735-127 64735-128 64735-129 64735-130 64735-131 64735-132 64735-133 64735-134 64735-135 64735-136 64735-137 64735-138 64735-139 64755-140 64755-141 64755-142 64755-143 64755-144 64755-145 64755-146 64755-147 64755-148 64755-149 64755-150

64006 64007 64096 64097-01 64097-02 64700-07 64700-08 64793-104 64793-105 64793-106 64793-107 64793-108 64793-109 64795-104 64795-105 64795-106 64795-107 64795-108 64795-109 64797-104 64797-105 64797-106 64797-107 64797-108 64797-109

64060 64061 64065 64063 64080-001 64080-002 64085 64087 64051-002 64051-004 64052-002 64052-004 64053-002 64053-004 64054-002 64054-004 64055-002 64055-004

Description

NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER-14MMX12MMX19MM NOVEL-XS -PEEK 5 DEGREES MEDIUM SPACER -14MMX12MMX20MM NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER - 14MMX12MMX21MM NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER - 14MMX12MMX22MM NOVEL-XS -PEEK 5 DEGREES MEDIUM SPACER-14MMX12MMX23MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX24MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX25MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX26MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX27MM NOVEL-GP- PEEK 5 DEGREES MEDIUM SPACER -17MMX15MMX28MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER -17MMX15MMX29MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX30MM NOVEL-GP -PEEK 5 DEGREES MEDIUM SPACER-17MMX15MMX31MM NOVEL-GP-PEEK 5 DEGREES MEDIUM SPACER -17MMX15MMX32MM NOVEL-GP- PEEK 5 DEGREES MEDIUM SPACER-17MMX15MMX33MM NOVEL-GP- PEEK 5 DEGREES MEDIUM SPACER- 17MMX15MMX34MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX35MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX36MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX37MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER- 17MMX15MMX38MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER- 17MMX15MMX39MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX40MM NOVEL-GP -PEEK 5 DEGREES MEDIUM SPACER -17MMX15MMX41MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX42MM NOVEL-GP -PEEK 5 DEGREES MEDIUM SPACER -17MMX15MMX43MM NOVEL-GP -PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX44MM NOVEL-GP -PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX45MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX46MM NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX47MM NOVEL-GP -PEEK 5 DEGREES MEDIUM SPACER -17MMX15MMX48MM NOVEL-GP -PEEK 5 DEGREES MEDIUM SPACER -17MMX15MMX49MM NOVEL-GP -PEEK 5 DEGREES MEDIUM SPACER-17MMX15MMX50MM

'X NOVEL-XS - SMALL THREAD INSERTER NOVEL-XS - LARGE THREAD INSERTER NOVEL-XS - BONE GRAFT PACKING BLOCK NOVEL-XS - MEDIUM/LARGE BONE TAMP NOVEL-XS - SMALL BONE TAMP NOVEL-XS - CADDY NOVEL-XS - CADDY LID NOVEL-XS - SMALL 5 DEGREES TRIAL - 4MM NOVEL-XS - SMALL 5 DEGREES TRIAL - 5MM NOVEL-XS - SMALL 5 DEGREES TRIAL - 6MM NOVEL-XS - SMALL 5 DEGREES TRIAL - ?MM NOVEL-XS - SMALL 5 DEGREES TRIAL - 8MM NOVEL-XS - SMALL 5 DEGREES TRIAL - 9MM NOVEL-XS - MEDIUM 5 DEGREES TRIAL - 4MM NOVEL-XS - MEDIUM 5 DEGREES TRIAL - 5MM NOVEL-XS - MEDIUM 5 DEGREES TRIAL - 6MM NOVEL-XS - MEDIUM 5 DEGREES TRIAL - 7MM NOVEL-XS - MEDIUM 5 DEGREES TRIAL - 8MM NOVEL-XS - MEDIUM 5 DEGREES TRIAL - 9MM NOVEL-XS - LARGE 5 DEGREES TRIAL - 4MM NOVEL-XS - LARGE 5 DEGREES TRIAL - 5MM NOVEL-XS - LARGE 5 DEGREES TRIAL - 6MM NOVEL-XS - LARGE 5 DEGREES TRIAL - ?MM NOVEL-XS - LARGE 5 DEGREES TRIAL - 8MM NOVEL-XS - LARGE 5 DEGREES TRIAL - 9MM

,,,,r. IN - i¢,;·~~*

ADP - LONG KERRISON ADP - STRAIGHT PITUITARY RONGEUR ADP- DOWN ANGLED PITUITARY RONGEUR ADP - UP ANGLED PITUITARY RONGEUR ADP - NERVE ROOT RETRATOR - 1MM ADP-NERVE ROOT RETRATOR -2MM ADP - STRAIGHT OSTEOTOME ADP - CURVED OSTEOTOME ADP - STRAIGHT CU RETIE - 2MM ADP - STRAIGHT CU RETIE - 4MM ADP -ANGLED CURETTE - 2MM ADP -ANGLED CURETTE - 4MM ADP - RIGHT ANGLED CURETTE - 2MM ADP - RIGHT ANGLED CU RETIE - 4MM ADP - LEFT ANGLED CURETIE - 2MM ADP - LEFT ANGLED CU RETIE - 4MM ADP - STRAIGHT RING CURETTE - 2MM ADP - STRAIGHT RING CURETTE - 4MM

"CONFIDENTIAL INFORMATION" Alphalec Spine, Inc.


; '\{\~~~¥~;:.


Price

$ 9 S40 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 9 840 $ 3 838.00 $ 10 197 $ 3 977.00 $ 10,197 $ 3 977.00 $ 10 197 $ 3 977.00 $ 10 197 $ 3977.00 $ 10 197 $ 3977.00 $ 10 197 $ 3 977.00 $ 10 197 $ 3 977.00 $ 10 197 $ 3 977.00 $ 10 197 $ 3 977.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00 $ 11 227 $ 4 379.00

$ 1 010 $ 381.22 $ 1 010 $ 292.81 $ 265 $ 119.11 $ 425 $ 169.27 $ 425 $ 193.12 $ 320 $ 488.23 $ 160 $ 67.16 $ 530 $ 261.00 $ 530 $ 259.72 $ 530 $ 208.62 $ 530 $ 294.24 $ 530 $ 223.69 $ 530 $ 249.95 $ 530 $ 172.18 $ 530 $ 238.00 $ 530 $ 223.93 $ 530 $ 226.61 $ 530 $ 235.93 $ 530 $ 261.30 $ 530 $ 202.61 $ 530 $ 255.16 $ 530 $ 247.27 $ 530 $ 186.43 $ 530 $ 269.89 $ 530 $ 216.65

-~ ,, ~ ., $ 2 900 $ 646.87 $ 2 650 $ 574.09 $ 2 650 $ 575.00 $ 2 650 $ 573.90 $ 519 $ 156.41 $ 538 $ 188.48 $ 794 $ 263.43 $ 794 $ 305.71 $ 813 $ 290.57 $ 813 $ 291.89 $ 813 $ 293.90 $ 813 $ 293.66 $ 813 $ 292.07 $ 813 $ 257.95 $ 813 $ 295.49 $ 813 $ 297.90 $ 813 $ 290.54 $ 813 $ 288.35

ATEC0000039


Part#

64056-002 64056-004 64057-002 64057-004 64058-004 64900

ADP - ANGLED RING CURETTE - 2MM ADP -ANGLED RING CURETTE - 4MM ADP - LATERAL ANGLED RING CURETTE - 2MM ADP - LATERAL ANGLED RING CURETTE -4MM ADP - TOOTHED CURETTE - 4MM ADP - STERILIZATION CASE

Description


2008 Price Lisi 17 of 17


Price

$ 813 $ 295.15 $ 813 $ 294.93 $ 813 $ 293.93 $ 813 $ 295.44 $ 850 $ 353.47 $ 1 394 $ 730.15

ATEC0000040


EXHIBIT B

TERRITORY

As of the Effective Date, the Territory shall be as follows:

Pacific Hospital of Long Beach in Long Beach, CA Tustin Hospital* Tri-Cities Hawaiian Gardens* Southcoast Hospital*

* The parties agree that the Distributor shall have non-exclusive rights to distribute the Products in the hospitals marked with an asterik.

The parties agree that this Exhibit B may only be amended upon the written agreement of the parties.

3

ATEC0000041


EXHIBITC

FORM OF PURCHASE ORDER

Purchase Order Number -------To: Alphatec Spine, Inc. From: International Implants, LLC Date: Re: Purchase Order

Part Name Part Number Size Quantity Per Unit Total Cost Cost (including

discounts)

Total Cost: -----

Submitted by International Implants, LLC

By: ________ _

Name: ---------Title: ----------

ATEC0000042


AMENDMENT TO DISTRIBUTION AGREEMENT

This Amendment to the Distribution Agreement (this "Amendment") is made as of October~\ , 2008 between International Implants, LLC, (the "Distributor") and Alphatec Spine, Inc. (the "Company"). Capitalized terms undefined herein shall have the meaning ascribed them in the Agreement.

RECITALS

Reference is made to that certain Distribution Agreement dated July 10, 2008 (the "Effective Date"), between the parties to this Amendment (the "Agreement").

The Parties desire to amend the Agreement as set forth herein.

Now, therefore, in consideration of the mutual promises set forth herein and for other good and valuable consideration, the receipt and sufficiency of which is acknowledged by the Parties hereto, the Parties hereto agree as follows:

1. AMENDMENTS

1.1 Amendment to Exhibit A - Products and Prices. Exhibit A of the Agreement is hereby amended to include the following:

"As of the Effective Date, the Products listed below shall be subject to the prices indicated in this Amendment.

Part No. Description Price

64100-01 NOVEL-LCC - CADDY No Charge

64100-02 NOVEL-LCC - CADDY LID No Charge 64100-03 NOVEL-LCC - TRIAL CADDY No Charge 64100-04 NOVEL-LCC - TRIAL CADDY-LID No Charge 64113-008 NOVEL-LCC - PEEK MEDIUM SP ACER - 1 OMMX20MMX8MM $ 1,250.00 64113-010 NOVEL-LCC - PEEK MEDIUM SPACER - 10MMX20MMX10MM $ 1,250.00 64113-012 NOVEL-LCC - PEEK MEDIUM SPACER - 10MMX20MMX12MM $ 1,250.00 64113-014 NOVEL-LCC - PEEK MEDIUM SPACER- 10MMX20MMX14MM $ 1,250.00 64193-008 NOVEL LCC TRIAL 20M, 8MM NON LORDOTIC No Charge 64193-010 NOVEL LCC TRIAL 20M, lOMM NON LORDOTIC No Charge 64193-012 NOVEL LCC TRIAL 20M, 12MM NON LORDOTIC No Charge 64193-014 NOVEL LCC TRIAL 20M, 14MM NON LORDOTIC No Charge 64100-01 NOVEL-LCC - CADDY No Charge 64100-02 NOVEL-LCC - CADDY LID No Charge 64100-03 NOVEL-LCC - TRIAL CADDY No Charge 64100-04 NOVEL-LCC - TRIAL CADDY-LID No Charge 64115-008 NOVEL-LCC - PEEK MEDIUM SPACER - 10MMX25MMX8MM $ 1,250.00

ATEC0000043



64115-010 NOVEL-LCC - PEEK MEDIUM SPACER - 10MMX25MMXIOMM $ 1,250.00 64115-012 NOVEL-LCC - PEEK MEDIUM SP ACER - 10MMX25MMX12MM $ 1,250.00 64115-014 NOVEL-LCC - PEEK MEDIUM SPACER - 10MMX25MMX14MM $ 1,250.00

64195-008 NOVEL LCC TRIAL 25M, 8MM NON LORDOTIC No Charge 64195-010 NOVEL LCC TRIAL 25M-5, lOMM NON LORDOTIC No Charge

64195-012 NOVEL LCC TRIAL 25M-5, 12MM NON LORDOTIC No Charge 64195-014 NOVEL LCC TRIAL 25M-5, 14MM NON LORDOTIC No Charge

64100-01 NOVEL-LCC - CADDY No Charge 64100-02 NOVEL-LCC - CADDY LID No Charge 64100-03 NOVEL-LCC - TRIAL CADDY No Charge 64100-04 NOVEL-LCC - TRIAL CADDY-LID No Charge 64113-108 NOVEL-LCC - PEEK 5 DEGREES MEDIUM SPACER - 10MMX20MMX8MM $ 1,250.00

64113-110 NOVEL-LCC - PEEK 5 DEGREES MEDIUM SP ACER - 10MMX20MMXIOMM $ 1,250.00 64113-112 NOVEL-LCC - PEEK 5 DEGREES MEDIUM SPACER - 10MMX20MMX12MM $ 1,250.00

64113-114 NOVEL-LCC - PEEK 5 DEGREES MEDIUM SP ACER - 10MMX20MMX14MM $ 1,250.00

64193-108 NOVEL-LCC - MEDIUM 5 DEGREES TRIAL - 8MM No Charge

64193-110 NOVEL-LCC - MEDIUM 5 DEGREES TRIAL - l lOMM No Charge 64193-112 NOVEL-LCC - MEDIUM 5 DEGREES TRIAL - 12MM No Charge

64193-114 NOVEL-LCC - MEDIUM 5 DEGREES TRIAL- 14MM No Charge 64100-01 NOVEL-LCC - CADDY No Charge

64100-02 NOVEL-LCC - CADDY LID No Charge 64100-03 NOVEL-LCC - TRIAL CADDY No Charge

64100-04 NOVEL-LCC - TRIAL CADDY-LID No Charge

64115-108 NOVEL-LCC - PEEK 5 DEGREES MEDIUM SPACER - 10MMX25MMX8MM $ 1,250.00

64115-110 NOVEL-LCC - PEEK 5 DEGREES MEDIUM SPACER - 10MMX25MMXIOMM $ 1,250.00




64195-110 NOVEL-LCC - MEDIUM 5 DEGREES TRIAL - lOMM No Charge



64800-01 NOVEL-SD - CADDY MEDIUM No Charge

64800-02 NOVEL-SD - CADDY LID No Charge

64813-008 NOVEL-SD - PEEK SMALL SP ACER - 9MMX22MMX8MM $ 1,250.00

64813-009 NOVEL-SD - PEEK SMALL SPACER - 9MMX22MMX9MM $ 1,250.00

64813-010 NOVEL-SD - PEEK SMALL SPACER- 9MMX22MMXIOMM $ 1,250.00

64813-011 NOVEL-SD - PEEK SMALL SP ACER - 9MMX22MMX1 IMM $ 1,250.00

64813-012 NOVEL-SD - PEEK SMALL SPACER- 9MMX22MMX12MM $ 1,250.00

64813-013 NOVEL-SD - PEEK SMALL SP ACER - 9MMX22MMX13MM $ 1,250.00

64813-014 NOVEL-SD - PEEK SMALL SPACER - 9MMX22MMX14MM $ 1,250.00

64893-008 SD CAGE TRIAL, SMALL, 8MM No Charge


64893-010 SD CAGE TRIAL, SMALL, 1 OMM No Charge

64893-011 SD CAGE TRIAL, SMALL, I IMM No Charge



2

ATEC0000044




64800-01 NOVEL-SD - CADDY MEDIUM No Charge 64800-02 NOVEL-SD - CADDY LID No Charge 64815-008 NOVEL-SD - PEEK MEDIUM SP ACER - 9MMX25MMX8MM $ 1,250.00 64815-009 NOVEL-SD - PEEK MEDIUM SP ACER - 9MMX25MMX9MM $ 1,250.00 64815-010 NOVEL-SD - PEEK MEDIUM SPACER - 9MMX25MMX10MM $ 1,250.00 64815-011 NOVEL-SD - PEEK MEDIUM SP ACER - 9MMX25MMX11MM $ 1,250.00 64815-012 NOVEL-SD - PEEK MEDIUM SPACER - 9MMX25MMX12MM $ 1,250.00 64815-013 NOVEL-SD - PEEK MEDIUM SP ACER - 9MMX25MMX13MM $ 1,250.00 64815-014 NOVEL-SD - PEEK MEDIUM SPACER - 9MMX25MMX14MM $ 1,250.00 64895-008 NOVEL-SD - MEDIUM TRIAL - 8MM No Charge 64895-009 NOVEL-SD - MEDIUM TRIAL - 9MM No Charge 64895-010 NOVEL-SD - MEDIUM TRIAL - lOMM No Charge 64895-011 NOVEL-SD - MEDIUM TRIAL - 1 lMM No Charge 64895-012 NOVEL-SD - MEDIUM TRIAL - 12MM No Charge

64895-013 NOVEL-SD - MEDIUM TRIAL - 13MM No Charge

64895-014 NOVEL-SD - MEDIUM TRIAL - 14MM No Charge

64614-007 NOVEL-TL - PEEK MEDIUM SPACER - 24MMX10MMX7MM $ 1,250.00


64614-009 NOVEL-TL - PEEK MEDIUM SP ACER - 24MMX1 OMMX9MM $ 1,250.00



64614-012 NOVEL-TL- PEEK MEDIUM SPACER- 24MMX10MMX12MM $ 1,250.00

64614-013 NOVEL-TL- PEEK MEDIUM SPACER- 24MMX10MMX13MM $ 1,250.00

64614-014 NOVEL-TL- PEEK MEDIUM SPACER- 24MMX10MMX14MM $ 1,250.00 64601-01- NOVEL TL MEDIUM NON LORDOTIC IMPLANTS, CADDY ASSY 03 No Charge

64636-007 TRIAL 7MM MEDIUM NON-LORDOTIC No Charge

64636-008 TRIAL 8MM MEDIUM NON-LORDOTIC No Charge

64636-009 TRIAL 9MM MEDIUM-NON-LORDOTIC No Charge

64636-010 TRIAL lOMM MEDIUM-NON-LORDOTIC No Charge

64636-011 TRIAL 1 lMM MEDIUM-NON-LORDOTIC No Charge




64614-107 NOVEL-TL - PEEK 5 DEGREES MEDIUM SPACER- 24MMX10MMX7MM $ 1,250.00



64614-110 NOVEL-TL - PEEK 5 DEGREES MEDIUM SPACER- 24MMX10MMXIOMM $ 1,250.00

64614-111 NOVEL-TL - PEEK 5 DEGREES MEDIUM SPACER - 24MMX1 OMMXl lMM $ 1,250.00

64614-112 NOVEL-TL - PEEK 5 DEGREES MEDIUM SPACER - 24MMXIOMMX12MM $ 1,250.00

64614-113 NOVEL-TL - PEEK 5 DEGREES MEDIUM SPACER - 24MMXIOMMX13MM $ 1,250.00

64614-114 NOVEL-TL- PEEK 5 DEGREES MEDIUM SPACER- 24MMXIOMMX14MM $ 1,250.00

64601-01- NOVEL TL MEDIUM-5 IMPLANTS, CADDY ASSY 04 No Charge

64636-107 TRIAL 7MM MEDIUM-5 No Charge


3

ATEC0000045




64636-110 TRIAL lOMM MEDIUM-5 No Charge 64636-111 TRIAL 1 lMM MEDIUM-5 No Charge 64636-112 TRIAL 12MM MEDIUM-5 No Charge 64636-113 TRIAL 13MM MEDIUM-5 No Charge

64636-114 TRIAL l 4MM MEDIUM-5 No Charge 64700-07 NOVEL-XS - CADDY No Charge

64700-08 NOVEL-XS - CADDY LID No Charge 64713-104 NOVEL-XS - PEEK 5 DEGREES SMALL SPACER- 14MMX12MMX4MM $ 875.00 64713-105 NOVEL-XS - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX5MM $ 875.00 64713-106 NOVEL-XS - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX6MM $ 875.00 64713-107 NOVEL-XS - PEEK 5 DEGREES SMALL SPACER- 14MMX12MMX7MM $ 875.00

64713-108 NOVEL-XS -PEEK 5 DEGREES SMALL SPACER-14MMX12MMX8MM $ 875.00 64713-109 NOVEL-XS - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX9MM $ 875.00 64715-104 NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER - 14MMX12MMX4MM $ 875.00 64715-105 NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER- 14MMX12MMX5MM $ 875.00 64715-106 NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER- 14MMX12MMX6MM $ 875.00 64715-107 NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER- 14MMX12MMX7MM $ 875.00 64715-108 NOVEL-XS - PEEK 5 DEGREES MEDIUM SPACER- 14MMX12MMX8MM $ 875.00

64715-109 NOVEL-XS -PEEK 5 DEGREES MEDIUM SPACER-14MMX12MMX9MM $ 875.00 64717-104 NOVEL-XS - PEEK 5 DEGREES LARGE SPACER- 20MMX18MMX4MM $ 875.00 64717-105 NOVEL-XS - PEEK 5 DEGREES LARGE SPACER- 20MMX18MMX5MM $ 875.00

64717-106 NOVEL-XS - PEEK 5 DEGREES LARGE SPACER- 20MMX18MMX6MM $ 875.00 64717-107 NOVEL-XS - PEEK 5 DEGREES LARGE SPACER- 20MMX18MMX7MM $ 875.00 64717-108 NOVEL-XS - PEEK 5 DEGREES LARGE SPACER - 20MMX18MMX8MM $ 875.00 64717-109 NOVEL-XS - PEEK 5 DEGREES LARGE SPACER - 20MMX18MMX9MM $ 875.00 64006 NOVEL-XS- SMALL THREAD INSERTER No Charge

64007 NOVEL-XS- LARGE THREAD INSERTER No Charge

64096 NOVEL-XS - BONE GRAFT PACKING BLOCK No Charge

64097-01 NOVEL-XS - MEDIUM/LARGE BONE TAMP No Charge

64097-02 NOVEL-XS - SMALL BONE TAMP No Charge

64793-104 NOVEL-XS - SMALL 5 DEGREES TRIAL - 4MM No Charge 64793-105 NOVEL-XS - SMALL 5 DEGREES TRIAL - 5MM No Charge

64793-106 NOVEL-XS - SMALL 5 DEGREES TRIAL - 6MM No Charge




64795-104 NOVEL-XS-MEDIUM 5 DEGREES TRIAL-4MM No Charge

64795-105 NOVEL-XS - MEDIUM 5 DEGREES TRIAL - 5MM No Charge

64795-106 NOVEL-XS - MEDIUM 5 DEGREES TRIAL - 6MM No Charge 64795-107 NOVEL-XS - MEDIUM 5 DEGREES TRIAL - 7MM No Charge

64795-108 NOVEL-XS - MEDIUM 5 DEGREES TRIAL - 8MM No Charge 64795-109 NOVEL-XS - MEDIUM 5 DEGREES TRIAL - 9MM No Charge 64797-104 NOVEL-XS - LARGE 5 DEGREES TRIAL - 4MM No Charge 64797-105 NOVEL-XS - LARGE 5 DEGREES TRIAL - 5MM No Charge 64797-106 NOVEL-XS - LARGE 5 DEGREES TRIAL - 6MM No Charge

4

ATEC0000046



64797-107 NOVEL-XS - LARGE 5 DEGREES TRIAL - 7MM No charge

64797-108 NOVEL-XS - LARGE 5 DEGREES TRIAL - 8MM No charge 64797-109 NOVEL-XS - LARGE 5 DEGREES TRIAL - 9MM No charge

64700 NOVEL XS STERILIZATION CASE No charge

64623 STRAIGHT, OSTEOTOME No Charge

64624 CURVED, OSTEOTOME No Charge 64642-01 PITUITARY STRAIGHT, POSTERIOR, NARROW No Charge

64642-02 PITUITARY UP BITE, POSTERIOR, NARROW No Charge

64642-03 PITUITARY DOWN BITE, POSTERIOR, NARROW No Charge

64642-04 PITUITARY CURVED, POSTERIOR, NARROW No Charge

64625-02 PUSH DOWN STRAIGHT, CURETTE, SIZE 2 No Charge

64625-04 PUSH DOWN STRAIGHT, CURETTE, SIZE 4 No Charge

64643-02 CURETTE, OFFSET DOWN PUSHING, SIZE 2 No Charge

64643-04 CURETTE, OFFSET DOWN PUSHING, SIZE 4 No Charge

64626-02 STRAIGHT, RING CURETTE, "TEARDROP SHAPE", SIZE 2 No Charge

64626-04 STRAIGHT, RING CURETTE, "TEARDROP SHAPE", SIZE 4 No Charge

64627-02 CURETTE, ANGLED RING "TEARDROP", SIZE 2 No Charge

64627-04 CURETTE, ANGLED RING "TEARDROP", SIZE 4 No Charge

64644-02 CURETTE, STRAIGHT CUP, SIZE 2 No Charge

64644-04 CURETTE, STRAIGHT CUP, SIZE 4 No Charge

64651-02 CURETTE, RIGHT ANGLED, SIZE 2 (ASSEMBLY) No Charge

64651-04 CURETTE, RIGHT ANGLED, SIZE 4 (ASSEMBLY) No Charge

64652-02 CURETTE, LEFT ANGLED, SIZE 2 (ASSEMBLY) No Charge

64652-04 CURETTE, LEFT ANGLED, SIZE 4 (ASSEMBLY) No Charge

64645-01 NERVE RETRACTOR, 45° SHORT, ASSEMBLY No Charge

64645-02 NERVE RETRACTOR, 45° LONG, ASSEMBLY No Charge

64645-03 NERVE RETRACTOR, 90° SHORT, ASSEMBLY No Charge

64650-01 TAMP, STRAIGHT, BONE GRAFT (ASSEMBLY) No Charge

64650-02 TAMP, WIDE TIP, BONE GRAFT (ASSEMBLY) No Charge

64602 STERILIZATION CASE, NOVEL PDP No Charge

64647 DISTRACTOR, LAMINA No Charge

64648 DISTRACTOR, ENDPLATE No Charge

64620-03 NOVEL-TL - DISC SHA VER - 3MM No Charge







64620-10 NOVEL-TL-DISC SHAVER- lOMM No Charge

64620-11 NOVEL-TL- DISC SHA VER - 1 lMM No Charge

64620-12 NOVEL-TL- DISC SHA VER - 12MM No Charge


64620-14 NOVEL-TL-DISC SHAVER-14MM No Charge

64620-15 NOVEL-TL-DISC SHAVER-15MM No Charge

64621 NOVEL-TL - STRAIGHT ENDPLATE RASP No Charge

5

ATEC0000047



64622-01 NOVEL-TL - LEFT CURVED RASP No Charge

64622-02 NOVEL-TL - RIGHT CURVED RASP No Charge

85911 NOVEL-TL-T-HANDLE No Charge 85901 NOVEL-TL - MEDIUM QUICK CONNECT HANDLE No Charge

85912 NOVEL-TL - LARGE QUICK CONNECT HANDLE No Charge

64634-02 NOVEL-TL - 30 DEGREEES INSERTER No Charge

64634-01 NOVEL-TL - STRAIGHT INSERTER No Charge

64630-01 NOVEL-TL- STRAIGHT TAMP No Charge

64630-02 NOVEL-TL- CURVED TAMP No Charge

64630-03 NOVEL-TL - BAYONETED TAMP No Charge

85890 NOVEL-TL - SLAP HAMMER No Charge

85889 NOVEL-TL - IMPACT HAMMER No Charge

64639 NOVEL-TL - BONE GRAFT PACKING BLOCK No Charge

64640-01 NOVEL-TL - SMALL BONE GRAFT TAMP No Charge

64640-02 NOVEL-TL - MEDIUM BONE GRAFT TAMP No Charge

64640-03 NOVEL-TL - LARGE BONE GRAFT TAMP No Charge

64640-04 NOVEL-TL - XLARGE BONE GRAFT TAMP No Charge

64092 NOVEL - THREADED REMOVER No Charge

64641 NOVEL-TL - IMPLANT RETRIEVER No Charge

64600-01 STERILIZATION CASE, NOVEL TL, DISC PREP TRAY No Charge

64600-02 STERILIZATION CASE, NOVEL TL, IMPLANT TRAY No Charge

64600-03 STERILIZATION CASE, NOVEL TL, LID No Charge

64600-04 STERILIZATION CASE, NOVEL TL, INSTRUMENT CASE No Charge

64616-007 NOVEL-TL - PEEK LARGE SPACER - 28MMX10MMX7MM $ 1,250.00








64601-01- NOVEL TL LARGE IMPLANTS, CADDY ASSY NON LORDOTIC 01 No Charge

64637-007 TRIAL 7MM LARGE NON-LORDOTIC No Charge



64637-010 TRIAL lOMM LARGE NON-LORDOTIC No Charge

64637-011 TRIAL 1 lMM LARGE NON-LORDOTIC No Charge




64616-107 NOVEL-TL - PEEK 5 DEGREES LARGE SPACER- 28MMX10MMX7MM $ 1,250.00




64616-111 NOVEL-TL - PEEK 5 DEGREES LARGE SP ACER - 28MMX1 OMMXl lMM $ 1,250.00


6

ATEC0000048




64616-114 NOVEL-TL- PEEK 5 DEGREES LARGE SPACER- 28MMX10MMX14MM $ 1,250.00 64601-01- NOVEL TL LARGE IMPLANTS, CADDY ASSY LORDOTIC 02 No Charge

64637-107 TRIAL 7MM LARGE LORDOTIC No Charge


64637-109 TRIAL 9MM LARGE LORDOTIC No Charge 64637-110 TRIAL lOMM LARGE LORDOTIC No Charge

64637-111 TRIAL 1 lMM LARGE LORDOTIC No Charge




.xPart Nri: . ··. i;n~s<mi6,tion (NOVEL ~c ;e:EEl(;IMPLAN'l'S~,.;f ·· ... . /J:''./~1 };,; : .. PriCe't• ~1

64311-208 SM - 8MM - 8 DEG $ 1,900.00 64311-210 SM - lOMM - 8 DEG $ 1,900.00 64311-212 SM - 12MM - 8 DEG $ 1,900.00 64311-214 SM-14MM- 8 DEG $ 1,900.00 64311-216 SM - 14MM - 8 DEG $ 1,900.00 64311-218 SM-14MM- 8 DEG $ 1,900.00 64313-208 MD - 8MM - 8 DEG $ 1,900.00 64313-210 MD - lOMM - 8 DEG $ 1,900.00 64313-212 MD - 12MM - 8 DEG $ 1,900.00 64313-214 MD-14MM- 8 DEG $ 1,900.00 64313-216 MD - 16MM - 8 DEG $ 1,900.00 64313-218 MD- 18MM- 8 DEG $ 1,900.00 64315-208 LG - 8MM - 8 DEG $ 1,900.00 64315-210 LG - lOMM - 8 DEG $ 1,900.00 64315-212 LG - 12MM - 8 DEG $ 1,900.00 64315-214 LG-14MM- 8 DEG $ 1,900.00 64315-216 LG-16MM- 8 DEG $ 1,900.00 64315-218 LG - 18MM - 8 DEG $ 1,900.00

Part No~ . DE:SQRIPTION<NOVtL+YC PEEK I~L~$1 . ····\:fW'0 I :; ..

···l?d~•c ~·, 64311-408 SM-8MM-12DEG $ 1,900.00 64311-410 SM- lOMM- 12 DEG $ 1,900.00 64311-412 SM - 12MM - 12 DEG $ 1,900.00 64311-414 SM-14MM- 12 DEG $ 1,900.00 64311-416 SM-14MM- 12 DEG $ 1,900.00 64311-418 SM- 14MM-12 DEG $ 1,900.00 64313-408 MD - 8MM - 12 DEG $ 1,900.00 64313-410 MD-8MM-12 DEG $ 1,900.00 64313-412 MD-8MM-12 DEG $ 1,900.00 64313-414 MD - 8MM - 12 DEG $ 1,900.00 64313-416 MD - 8MM - 12 DEG $ 1,900.00 64313-418 MD - 8MM - 12 DEG $ 1,900.00 64315-408 LG - 8MM - 12 DEG $ 1,900.00 64315-410 LG - lOMM - 12 DEG $ 1,900.00 64315-412 LG - 12MM - 12 DEG $ 1,900.00 64315-414 LG-14MM-12 DEG $ 1,900.00

7

ATEC0000049


LG- 18MM- 12 DEG

Other than as set forth in this amended price list, all other products and pricing provided in the Agreement shall remain in full force and effect."

1.2 Amendment to Section 5.3. Section 5.3 of the Agreement is hereby amended and restated in its entirety as follows:

"5.3 Consigned Inventory and No-Charge Inventory.

5.3.1 Consigned Inventory. From time to time, the Company may consign certain Products or related instrumentation to the Distributor. The Company will retain all right, title and interest in and to such Products and instrumentation (the "Consigned Inventory"). The Distributor will hold said Consigned Inventory in a fiduciary capacity. If any Consigned Inventory is lost, missing, stolen, or damaged beyond usability, then the Company shall invoice Distributor for the price set forth on Exhibit A for such Consigned Inventory. If a price for such Consigned Inventory is not set forth on Exhibit A, then the Company shall invoice the Distributor 100% of the Company's then-current list price for such Consigned Inventory. Upon the termination or expiration of this Agreement, or upon the request of the Company, the Distributor shall immediately, and at its own expense, return all Consigned Inventory in its possession or control to the Company. The Company shall be entitled to access the Distributor's facilities at least once per month to audit the Consigned Inventory following at least five business days' notice. Distributor shall make payment in accordance with Section 6.2 for any inventory that is deemed to be lost, damaged or missing as a result of such audit. The Distributor agrees and acknowledges that all Consignment Inventory designated by the Company in its sole discretion to be loaner inventory shall be subject to the Company's thencurrent Loaner Inventory Policy.

5.3.2 No Charge Inventory. Both Distributor and Company agree that certain of the Products listed on Exhibit A do not have a purchase price (the "NoCharge Inventory"). Such No-Charge Inventory shall not be included within the Consigned Inventory. Upon the termination or expiration of this Agreement, the Distributor shall immediately, and at its own expense, return all No-Charge Inventory in its possession or control to the Company. The Company shall be entitled to access the Distributor's facilities at least once per month to audit the No-Charge Inventory following at least five business days' notice."

1.3 Amendment to Section 5.5. The following language shall be added to the end of Section 5.5:

8

ATEC0000050


"All purchases shall be submitted on the Company's then-current form of purchase order. The party's further agree that any modification to the terms and conditions on such purchase order shall be of no force or effect unless such modification is agreed to in writing by the parties."

1.4 Addition of Section 5.6. The following language shall be added to the Agreement as Section 5.6:

"As of October 31, 2008, Distributor shall have the right, once every fiscal quarter during the term of this Agreement, to request that the Company allow Distributor to exchange Products the Company with a total value of up to fifteen percent ( 15%) of the Products paid for by the Distributor during the prior 90-day period for Products of the same type (i.e., polyaxial lumbar screws for poly axial lumbar screws, cervical plates for cervical plates); and the Company shall use commercially reasonable efforts (which shall be determined in the company's sole discretion) to accommodate such exchange request. Each request for an exchange of Products must be made not less than 45 days before the end of a fiscal quarter. Custom implants or implants that are not a part of the Company's regular price list shall not be subject exchange pursuant to this Section 5.6"

2. MISCELLANEOUS

In the event of any conflict between the provisions of this Amendment and the Agreement, the provisions of this Amendment shall prevail. Capitalized terms not defined in this Amendment shall have the meaning ascribed to such terms in the Agreement. Other than as set forth in this Amendment, the remainder of the Agreement shall remain in full force and effect.


9

ATEC0000051


IN WITNESS WHEREOF, the parties have executed this Amendment to the Agreement on the date set forth above.


Dirk Kuyper President and Chie xecutive Officer

INTERNATIONAL IMPLANTS, LLC

-Name: Title:

10

ATEC0000052


SECOND AMENDMENT TO DISTRIBUTION AGREEMENT

This Second Amendment to. the Distribution Agreement (this "Second Amendmenf') is made as of February 3. 2009, between Intemational Implants, LLC) (the "Distributor") and Alphatec Spine, Inc. (the "Company"), Capitalized terms undefined herein shall have the meaning ascribed them in the Agreement.

RECITALS

Reference is made to that certain Distribution Agreement dated July 10, 2008, as amended, (the ~'Effective Date"). ·between the parties to this Second Amendment (the "Agreement'').


Now, therefore, in consideration of the mutual promises set forth herein and for other good and valuable consideration, the receipt and sufficiency of which is acknowledged by the Parties hereto, the Parties hereto agree as follows:·

1. AMENDMENTS


"As of the Effective Date, the Ptoducts listed below shall be subject to the prices indicated in this Second Amendment.

64713-110 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX10MM 64713-112 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER-14MMX12MMX12MM 64713-114 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER - 14MMXi2MMX14MM 64713-116 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX16MM 64713-118 NOVEL-GP- PEEK 5 DEGREES SMALL SPACER -14MMX12MMX18MM 64713-120 NOVEL-GP- PEEK 5 DEGREES SMALL SPACER-14MMX12MMX20MM 64713-122 NOV!=L-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX22MM

NOVEL-GP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX24MM 64733-126 NOVEL-CP - PEEK'5 DEGREES SMALL SPACER-14MMX12MMX26MM 64733-128 NOVEL-CP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX28MM 64733-130 NOVEL-CP- PEEK 6 DEGREES SMALL SPACER M 14MMX12MMX30MM 64733-132 NOVEL-CP" PEEK 5 DEGREES SMALL SPACER -14MMX12MMX32MM 64733-134 NOVEL-CP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX34MM 64733-136 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX36MM 64733·138 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER-14MMX12MMX38MM 64753-140 NOVEL-CP - PEE.K 6 DEGREES SMALL SPACER-14MMX12MMX40MM 64763-142 NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX42MM 64753-144 NOVEL-CP- PEEK 5 DEGREES SMALL SPACER-14MMX12MMX44MM 64753-~46 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER - i4MMX12MMX46MM 64753-148 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX48MM

3,000.00 3,000.00 3 000.00 3000.00 e 000.00

$ 3 000.00 $ 3 000.0D $ 3,000,00 $ 3 000.00 $ 3,000.00 $ 3,000.00 $ 3,000.00 $ 3,000.00 $ 3,000.00 $ 3000,00 $ 3,000,00 $ 3,000.00 $ 3,000.00 $ 3,000.00 $ 3,000.00

ATEC0000053


~ ~ ..... ™-~~- ~- ~¥;~.~-- -- -· - , .. s~~~~"'"'5i.=±--as.-~-:=..:~~~~; '·llE c:~·: . - ..... . -64753-150 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER~ 14MMX12MMX50MM $ 3,000.00 64701-01-01. Novel-GP, Srna\I Implant Caddv 64701-01-02 Novel-GP Small Lordotlc Implant Caddy Lid 64713-111 NOVEL-GP- PEEK 5 DEGREES SMALL SPACER-14MMX12MMX11MM $ 3,000.00 64713-113 NOVEL-GP· PEEK 5 DEGREES SMALL SPACER- 14MMX12MMX13MM $ 3 000.00 64713-115 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER· 14MMX12MMX15MM $ 3 000.00 64713-117 NOVEL-GP - PEEK 5 DEGREES SMALLSPACER-14MMX12MMX17MM $ 3000.00 64713-119 NOVEL-GP-PEEK 5 DEGREES SMALL SPACER· 14MMX12MMX19MM $ 3,000.00 64713-121 NOVEL-GP -PEEK 5 DEGREES SMALL SPACER -14MMX12MMX21MM $ 3,000.00 64713-123 NOVEL-CP- PEEK 5 DEGREES SMALL SPACER-14MMX12MMX23MM $ 3,000.00 64733-125 NOVEL-CP - PEEK 5 DEGREES SMALL SPACER-14MMX12MMX25MM $ 3,000.00 64733-127 NOVEL-CP- PEEK 5 DEGREES SMALL SPACER-14MMX12MMX27MM $ 3,000.00 64733-129 NOVEL-CP- Pl?:EK 5 DEGREES SMALLSPACER-14MMX12MMX29MM $ 3000,00 64733-131 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX31 MM $ 3,000,00 64733-133 NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX33MM $ 3,000.00 64733-135 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER -14MMX12MMX35MM $ 3000.00 64733-137 NOVEL-CP - PEEK 5 DEGREES SMALL SPACER - 14MMX12MMX37MM $ 3. 000.00 64733-139 NOVEL-GP - PEEK5 DEGREES SMALL SPACER-14MMX12MMX39MM $ 3 000,00 64753-141 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER- 14MMX12MMX41MM $ 3 000.00 64753-143 NOVEG-CP - PEEK 5 DEGREES SMALL SPACER· 14MMX12MMX43MM $ 3,000.00 64753-145 NOVEL-CP - PEEK 5 DEGREES SMALL SPACER-14MMX12MMX45MM $ 3,000.00 64753-147 NOVEL-OP· PEEK 5 DEGREES SMALL SPACER-14MMX12MMX47MM $ 3,000.00 647"53-149 NOVEL-GP - PEEK 5 DEGREES SMALL SPACER~ 14MMX12MMX49MM $ 3,000.00 64701·03 NOVEL-CP, SMALL 11 MM-49MM IMPLANT, CADDY (ASSEMBLY) INS-022 NOVEL-GP, PACKAGE. INSERT 64715-110 NOVEL-CP - PEEK 5 DEGREES MEDIUM SPACER - 14MMX12MMX1 OMM $ 3 000.0() 64715-112 NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 14MMX12MMX12MM $ 3000.00 64715-114 NOVEL-GP- PEEK 6 DEGREES MEDIUM SPACER-14MMX12MMX14MM '$ 3,000.00 64715-116 NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER-14MMX12MMX16MM $ 3,000.00 64715-118 NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER • 14MMX12MMX1 BMM $ 3,000.00 64715-120 NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER -14MMX12MMX20MM $ 3,000,00 64715-122 NOVEL-CP - PEEK 5 DEGREES MEDIUM SPACER-14MMX12MMX22MM $ 3,000.00' 64735-124 NOVEL-CP - PEEK 5 DEGREES MEDIUM SPACER· 17MMX15MMX24MM $ 3,000.00 64735-126 NOVEL-GP· PEEK 5 DEGREES ME:DIUM SPACER -17MMX15MMX26MM $• 3000.00 64735-128 NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER -17MMX15MMX28MM $ 3 000.00 64735-130 NOVEL-CP ·PEEK 5 DEGREES MEDIUM SPACER -17MMX15MMX30MM $ 3 000.00 64735-132 NOVEL-CP ·PEEK 5 DEGREES MEDIUM .SPACER -17MMX15MMX32MM $ 3 000.00 64735-134 NOVEL-GP- PEEK 5 DEGREES MEDIUM SPACER-17MMX15MMX34MM $ 3 000.00 64735-136 NOVEt-CP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX36MM $ 3,000.00 64735-138 NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER -17MMX15MMX38MM $ 3000.00 64755-140 NOVEL-CP - PEEK 5 DEGREES MEDIUM SPACER-17MMX15MMX40MM $ 3,ooo-.oo 64755-142 NOVEL-GP- PEEK 5 DEGREES MEDlUM SPACER· 17MMX15MMX42MM $ 3,000.00 64755-144 NOVEL-GP-PEEK 5 DEGREES MEDIUM SPAGER-17MMX15MMX44MM $ 3,000.00 64755-146 NOVEL-GP~ PEEK 5 DEGREES MEDIUM SPACER -17MMX15MMX46MM $ 3,000.00 64755-148 NOVEL-CP - PEEK 5 DEGREES MEDIUM SPACER-17MMX15MMX4ElMM $ 3 000.00 64755-150 NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX50MM $ 3,000.00 64701-02-01 NOVEL-CP, MEDIUM, IMPLANT CADDY 64701-02-02 NOVEL-GP, MEDIUM LORDOTIC IMPLANT CADDY LID 64715-111 NOVEL~CP - PEEK 5 DEGREES MEDIUM SPACER - 14MMX12MMX11 MM $ 3,000,00 64715-113 NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 14MMX12MMX13MM $ 3000.00 64715-115 NOVEL-GP- PEEK 5 OEGREES MEDIUM SPACER - 14MMX12MMX15MM $ 3,000.00 64715-117 NOVEL-GP· PEEK5 DEGREES MEDIUM SPACER-14MMX12MMX17MM $ 3,000.00

2

ATEC0000054


::~-- ~: - . ~~~~ .... ~~~=-~;,;;·;nc-=~--- """mm~~~~~~:~,--~~w~.~~ · =. ~ ;~~ ~·~ =-= -~r . ·:-~..:.-~=.;-

64715-119 NOVEL-CP - PEEK 5 DEGREES MEDIUM SPACER-14MMX12MMX19MM $ 3,000.00 64715-121 NOVEL..CP- PEEK 5 DEGREES MEDIUM SPACER-14MMX12MMX21MM $ 3 000.00 64715-123 NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER· 14MMX12MMX23MM $ 3000.00 64735-125 NOVEL-GP- PEEK 5 DEGREES MEDIUM SPACER- 17MMX15MMX25MM $ 3000.00 '64736-127 NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER -17MMX15MMX27MM $ 3 000.00 64735-129 NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER-17MMX15MMX29MM $ 3,000.00 64735-131 NOVEL-GP- PEEK 5 DEGREES MEDIUM SPACER-17MMX15MMX31MM $ 3,000.00 64735-133 NOVEL-GP· PEEK 5 DEGREES MEDIUM SPACER-17MMX15MMX33MM $ 3,000.00 64735-135 NOVEL-OP· PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX35MM $ 3,000.00 64735-137 NOVEL-OP. PE'.EK 5 DEGREES MEDIUM SPACER -17MMX15MMX37MM $ 3,000.00 64735-139 NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX39MM $ 3",000.00 64755-141 NOVEL·CP-PEEK 5 DEGREES MEDIUM SPACER· 17MMX15MMX41MM $ 3 000,00 64755-143 NOVEL-GP- PEEK 5 DEGREES MEDIUM SPACER-17MMX15MMX43MM $ 3,000.00 64755·145 NOVEL·CP- PEEK 5 DEGREES MEDIUM SPACER-17MMX15MMX45MM $ 3 000.00 64755-147 NOVEL-GP - PEEK 5 DEGREES MEDIUM SPACER - 17MMX15MMX47MM $ 3000,00 64755-149 NOVEL·CP - PEEK 5 DEGREES MEDIUM SPACER-17MMX15MMX49MM $ 3,000.00 64701-04 NOVEL-GP MEDIUM 11MM-49MM IMPLANT CADDY (ASSEMBLY) 1NS-022 NOVEL-GP PACKAGE INSERT 64904-01 NOVEL CP INSERTER (ASSEMBLY) 64001-01 NOVEL CERVICAL RASP SMALL 7 DEGREE LORDOTIC 64902-01 NOVEL GP TAMP, SMALL (ASSEMBLY) 64902-02 NOVEL CPTAMP, MEDIUM (ASSEMBLY) 64908 NOVEL CP CALIPER (ASSEMBLY) 64712 NOVEL CP STERILIZATION TRAY INS-022 NOVEL CP PACKAGE INSERT

Other than as set forth in this amended price list, all other products and pricing provided in the Agreement shall remain in full force and effect. 'i

2. MISCELLANEOUS

In the event of any conflict between the provisions of this Second Amendment and the Agreement, the provisions of this Second Amendment shall prevail. Capitalized terms not defined in this Second Amendment shall have the meaning ascribed to such terms i11 the Agreement. Other than as set forth in this Second Amendment, the remainder of the Agreement shall remain in full force and effect.


3

/

ATEC0000055


IN WITNESS WHEREOF, the parties have executed this Second Amendment to the Agreement on the date set forth above.


President and · Executive Officer


4

ATECoonnn~R


THIRD AMENDMENT TO ~~~~~~~~~~~~~DIB~RIBBTI0N~AG-RE-EM-EN~~~~·~-~-~-~-~-~··~-~-~--~-~--~--~-~---~-~-~-~~~

This Third Amendment to the Distribution Agreement (this "Third Amendment'') is made as of February 4, 2010, between International Implants, LLC, (the "Distributor") and Alphatec Spine, Inc. (the "Company"). Capitalized terms undefined herein shall have the meaning ascribed them in the Agreement.

RECITALS

Reference is made to that certain Distribution Agreement dated July 10, 2008, as amended, (the "Effective Date"), between the parties to this Third Amendment (the "Agreement").


Now, therefore, in consideration of the mutual promises set forth herein and for other good and valuable consideration, the receipt and sufficiency of which is acknowledged by the Parties hereto, the Parties hereto agree as follows:

1. AMENDMENTS


"As of the Effective Date, the Products listed below shall be subject to the prices indicated in this Third Amendment.

r-_'. ,'·:---~------~ _____ y ____ -~1- -. ~g3~ir i¥~~ -~if¥-~-~~,:u -;Ii :.fill-:-_--:- ---- --.-- -r-:c- ---~ ~~ --'~j ,_ ~- ~- __ _ _ ... Jl!!L~ _ ~ M~t ___ _ __ _ _ ___ __ ~ ,, _ @ :ji ~ _ _ _ Xii: ht _ J§ _ _ _ _ __ __ _ • ~i- _ 22015 SETSCREW $ 95.00

73845-30 CANNULATED POLYAXIAL SCREW 4.5MM X 30MM $ 800.00




73845-50 CANNULATED POLYAXlAL SCREW 4.5MM X 50MM $ 800.00


73845-60 CANNULA TED POL YAXIAL SCREW 4.5MM X 60MM $ 800.00







73855-60 CANNULA TED POLY AXIAL SCREW 5.5MM X 60MM $ 800.00

73865-30 CANNULA TED POLY AXIAL SCREW 6.5MM X 30MM $ 800.00

ATEC0000057


·-~~· .... " ... ~.-:~':···:·.(·t:~~~fv .,~ ·.· ····-·f.1'~·!ef@J11;R~ ::i·~i.:, · ,.ti,~f'--.·--·. -.-~,·-;~--·::l·----iillJ --~;··--.-~· 1 i ___ ,_ _ ... _,, _ .. J!H~, §L_ r11m~l:11~ r~,.,. " _. f -~·-rt. -~_ .. Jl~L ~--C- ___ • ,_ ·- __ Jlli __ ._ j

··--·-·· -· -·-··--·· ~Cfl\t'J t'J tlLAIEl'.'.i=F>OL:YAXffl\LSCREW=6"'.'5rv'IKi!A'3"5rvlrvl $ a-tro""'.'"oo-- ----· --- -----· 13860-35- -













73955-30 SACRAL CANNULATED POLYAXIAL SCREW 5.5MM X 30MM $ 800.00


73955-40 SACRAL CANNULATED POL YAXIAL SCREW 5.5MM X 40MM $ 800.00

73955-45 SACRAL CANNULATED POL YAXIAL SCREW 5.5MM X 45MM $ 800.00



73965-35 SACRAL CAN NU LATED POLYAXIAL SCREW 6.5MM X 35MM $ 800.00

73965-40 SACRAL CAN NU LATED POLYAXIAL SCREW 6.5MM X 40MM $ 800.00


73965-50 SACRAL CANNULATED POLYAXIAL SCREW6.5MM X 50MM $ 800.00





73975-50 SACRAL CANNULA TED POLY AXIAL SCREW 8.5MM X 50MM $ 800.00

73600-030 PRE-CONTOURED I GP Tl ROD 5.5MM X 3CM $ 142.50

73600-035 PRE-CONTOURED I CP Tl ROD 5.5MM X 3.5CM $ 142.50

73600-040 PRE-CONTOURED I CP Tl ROD 5.5MM X 4CM $ 142.50


73600-050 PRE-CONTOURED I GP Tl ROD 5.5MM X 5CM $ 142.50









73601-030 STRAIGHT CP Tl ROD - 5.5MM X 30MM $ 142.50




2

ATEC0000058


~nB01';;0-70~ ~s-"fRAIB~"f=ep~-wRe>B - !Y.5MMA-70MM

73601-080 STRAIGHT CP Tl ROD - 5.5MM X BOMM $ 73601-090 STRAIGHT CP Tl ROD - 5.5MM X 90MM $ 73601-100 STRAIGHT CP Tl ROD- 5.5MM X 100MM $ 142.50 73601-110 STRAIGHT CP Tl ROD- 5.5MM X 110MM $ 142.50 73601-120 STRAIGHT CP Tl ROD - 5.5MM X 120MM $ 142.50 73601-130 STRAIGHT GP Tl ROD - 5.5MM X 130MM $ 142.50 73601-140 STRAIGHT GP Tl ROD - 5.5MM X 140MM $ 142.50 73601-150 STRAIGHT GP Tl ROD - 5.5MM X 150MM $ 142.50 73601-160 STRAIGHT GP Tl ROD - 5.5MM X 160MM $ 142.50 73601-170 STRAIGHT GP Tl ROD - 5.5MM X 170MM $ 142.50 73601-180 STRAIGHT GP Tl ROD - 5.5MM X 180MM $ 142.50 73601-190 STRAIGHT GP Tl ROD - 5.5MM X 190MM $ 142.50 73601-200 STRAIGHT GP Tl ROD - 5.5MM X 200MM $ 142.50 73601-210 STRAIGHT GP Tl ROD- 5.5MM X 210MM $ 142.50 73601-220 STRAIGHT GP Tl ROD - 5.5MM X 220MM $ 142.50 73601-230 STRAIGHT GP Tl ROD - 5.5MM X 230MM $ 142.50 73601-240 STRAIGHT CP Tl ROD - 5.5MM X 240MM $ 142.50 73601-250 STRAIGHT CP Tl ROD - 5.5MM X 250MM $ 142.50

73601-260 STRAIGHT CP Tl ROD - 5.5MM X 260MM $ 142.50 73601-270 STRAIGHT CP Tl ROD - 5.5MM X 270MM $ 142.50 73601-280 STRAIGHT CP Tl ROD - 5.5MM X 280MM $ 142.50 73601-290 STRAIGHT GP Tl ROD - 5.5MM X 290MM $ 142.50 73601-300 STRAIGHT CP Tl ROD - 5.5MM X 300MM $ 142.50

Other than as set forth in this amended price list, all other products and pricing provided in the Agreement shall remain in full force and effect."

2. MISCELLANEOUS

In the event of any conflict between the provisions of this Third Amendment and the Agreement, the provisions of this Third Amendment shall prevail. Capitalized terms not defined in this Third Amendment shall have the meaning ascribed to such terms in the Agreement. Other than as set forth in this Third Amendment, the remainder of the Agreement shall remain in full force and effect.

** Signature Page Follows **

3

- ·-·- --- -

ATEC0000059


IN WITNESS WHEREOF, the parties have executed this Third Amendment to the Agreement on the date set forth above.



4

ATEC0000060

0.0

EXHIBIT 1-C




----·--- r:· -- -· -·-- --- ·-·- _____ _ ..S.CIE_RE.CD_..Q_T.E_ Ql.0 __ 6.KSCA~a 'PACIFIC HOSPITAL OF L.B . ; DEPT LA 22597 PASADENA CA 91185- 25

...... __ ·-- ---·---·-- · ........... ~-- -· - -· -·-· -··-· -· - -· .-~ ·-· -··-· . - -· -·-· --

•t• s:A~· 1~ .. e _ ............ -..-. ..;-·-·- -·--·--·---·--·---·--·------------- -------- - - ----- -- - - ------' 02 7 B GRAFTON FLEX 027~ GRAFTON PASTE 0271 INTERNATIONAL IMPLANT

"

ti

" " I 11:

.. i I

11~

"l n~

t.& Sl:iN. L~l'I'$

l 1944.00 3 5193 . 60 l 90282~00

'" 1::

1:1

Ill

1!i

ui

1;+

11!

11!


SCIF RECD DTE ~010 BKSCAN 8 -2010 08:59 AM 046896 10 2

Itemized Statement qevenue COde 278 Only

Service Date

Charge Code

40531222 40531218 40599999

PACIFIC HOSPITAL OF LONG BEACH 2776 PACIFIC AVENUE

Qnt. 1 3 1

LONG BEACH,CA 90806 (562) 595-1911

Charge Detail

Description

Totals For Rev Code 278

GRAFTON FLEX MEDIUM GRAFTON PASTE 10ML INTERNATIONAL IMPLANTS - SUPPLY/IMPLANTS

Code 278

Charge Summary Revenue Code Description SUPPLY/IMPLANTS

TOTAL CHARGES

Amount 1944.00 5193.60

90282.00 97419.60

97419.60

97419.60

Cas

e 8:

13-c

v-00

956-

AG

-CW

D

ocum

ent 2

81-4

F

iled

11/1

7/14

P

age

4 of

5

Pag

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Purchase Order Listing ---.. - ·. ..

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PO Nunil1<'r· PHLB-65086

(Please ~rto this PO Number on al correspondence)

• =NATIONAL -- --- - ---

Aux 1l1<1ry PO t-..;ur1b~r

-:ACIFICHC

RECEMNG 203n SN ACACIA SUITE 110 2778 PACIFIC AVE NEWPORT BEACH. CA 92650 ?HONE:949-871).38b2 FAX:949-B70-3688

lllli\IWY Date: ~10

LONG BEACH. CA 90806 .

FOB: PO Slatua: TRANSMITTED Terma: W60

6207~ 7.&X40 POLY IMPlANT 7 (2)

64815-012 12MMSO PEEK

1 (2)

9 X 26 X 14 SO MED PEE1<

SETSCREW menll: I LOT'62T.! 7 (1) 627949 (3> 628 (2)

2 EA/t 620()41-07 70MM ROD -CURVED LOTl6261 -4 (1) 619503 (1) EA/1 11-2053 MEDIUM CROSS LINK

LOTll6262

Comments:

Aulhartucl l!ly:

() PACIFIC HOSPITAL LONG BEACH

2776 PACIFIC AVE

Phonv: 562-997-2556 Fax: 562·981-6371

SURGERY

7'4200SURG SURGERY

74200SURG SURGERY

7'4200SURG SURGERY 7<4200SURG SURGERY

7-4200SURG SURGERY

7.t4200SURG SURGERY

Page 1af1

l\pprv,•rt

-2 E PACIFIC HOSPITAL LONG BEACH ~ RECEIVING 'Si 2776 PACIFIC AVE ~ LONG BEACH, CA 90006 J . ':"i ·

~ VII:

I 01. 1420.a1 oo

I 01 . 7420.31 oo

I 01 . 7420.31 DO

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•l2 ( international i implants, lie

20377 Acacia Street Suite 110 Newport Beach, CA 92660

Invoice Date Invoice #

Bin To

Pacific Hospital Of Long Beach Materials Maoagement 2776 Pacific Avenue Long Beach. CA 90806

P.O. Number Tenns

PHLB-05086 Net 90days

Quantity Item Code

4 62065-45

2 62075-40

2 64815-012

Z 64SIS-014

6 22015 2 62004-07

l 11-2053

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Phone: (949) 87°"3602 m>-o10 10530 Fu: (949~ 879-3888

Ship To

Pacific Hospital Of L.ong Beach Materials Management 2776 Pacific Avenue Loos Beach, CA 90806

Patient Name Patient Number

Description Price Each Amount

TI STANDARD POLY AXIAL SCREW ASSY, 6.SMM x 2,364.00 9,456.00 45MM TI STANDARD POLY AXIAL SCREW ASSY, 7.5.MM x 2,364.00 4,728.00 40MM NOVEL-SD- PEEK MEDIUM SPACER- 6,009.00 12,018.00 9MMX25MMX12MM NOVEL-SD - PEEK MEDIUM SPACER - 6,009.00 12,018.00 9MMX25MMX14MM TI STANDARD SCREW SET 396.00 2,376.00 CP 11 PRE.CONTOURED ROD 5.5 DIA X 7CM FEMALE 868.00 1,736.00 HEX TI ADJUSTABLE BRIDGE, 5.5 ROD 2,734.00 2.734.00

freight 75.00 75.00

For product information: (562) 997-2425 Total $45,141.00

0.0

EXHIBIT 1-D




SCIF Rec ~009 FRSCAN 211 ~009 0 PACIFIC HOSPITAL ~ 111111111111111 DEPT LA 22597 PASADENf\ CA 91185-259

• -3 l 11 01

• :.II .. .. • 5844 23 1

111 SFFR

-9 .,9 004 NEI .._ 04 - TRD

STATE COMPENSATION INS. P.O.BOX 65005 PINEDALE CA 93650 - 5005

0278 GRAFTON FLEX 0278 GRAFI'ON MATRIX 0278 INTERNATIONAL IMPLANT

0001 1 1

STATE COMPENSATION INS.

06000061608

72210 9

72210

3492 73395

72210

8108 ~98051 ~97779

8162 -098451 -98915 STATE COMPENSATION

INS. P.O.BOX 65005 PINEDALB, CA. 93650 - 5005

80 0

y y

0460

2 5284.00 1 3471.0u l 83980.00

92735.00 11111111

0460

.... _., __ _


SCIF Rec -~009 FRSCAN 211~009 09:42 AM 015844 23 2

Itemized Statement Revenue Code 278 Only ~009

Service Date

Charge

PACIFIC HOSPITAL OF LONG BEACH 2776 PACIFIC AVENUE LONG BEACH,CA 90806

(562) 595-1911

Charge Detail

Qnt. Description 2 GRAFTON FLEX 1

Code 40531211 40531212 40599999 l

Totals For Rev Code 278

GRAFTON MATRIX INTERNATIONAL IMPLANTS - SUPPLY/IMPLANTS

Code 278

Charge Summary Revenue Code Description SUPPLY/IMPLANTS

TOTAL CHARGES

Amount 5284.00 3471.00

83980.00 92735.00

92735.00

92735.00


SC:[ F Rec - 2009 FRSCAN 2 11 009 09:42 AM 015844 23 3

·~

Caller's Name:

From: unknown Page: 4111 Date111f009 9:15:48 AM

12 J intemallonal I implantt, Ile

20377 Southwest Acacia StreetSUite 120 Newport Beach, CA 92660

BILL ONLY

.__ _______ Phone :

0,

Hospita l Name : A.wK<r llo.yi. Shlppl ng: 811llng:

&-t~L4?2

1 urgeiy Date: Doctor:

/,, rt') C> 0" t- Circle One . 0 Purchase Order . ....__~(J.11v~ __ v..._. ___ I.__ ____ Replenishment Requ Ired? Yes . ~

*Preserve

FD FZ

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SCIF Rec ~009 FRSCAN 211 ~009 09:42 AM 015844 23 6

From: unknown Page: 5/11 Date:.009 9:15:48 AM

.. l2, ( ·internatiortal. ! implani~, lie ' .

suR~~~v RE·qu1-s~r10.N FORM. 20377 SW Acacia Street, Suite l,10

NfW'p<ll't Beach, CA '92260 .

~G:Z'6·c: . hbr2 .. HOSPITAL NAME

PATI

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PURCHASE O~EA.: .__ __ (9 __ .D_oo_2f_· .. ~··} : · T~JA1TtOUnt: 'Iii ut((J

SUP.GER.V DATI!: 0 BHI On;y f!/J.: esXICk

SURGEON NA~E:

PROCEDIJRE: &¥-~J

Submitted Bv: ------~t~:

Clerk.al :

Logged and Processd 19y'""; -----.,--.-~--'----"-Date:

~evJewed Prices 0 F11xed to 12 D ~mtn.iment Repalr ·

0 Logged Report D Jncident P.ep~ . 0 Ottter .

Internal Ur

Thi& t.ix was received by GFI FAXmaker fax sel\'el'. For more information, visit http://www"gfi.com

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Case 8:13-cv-00956-A

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Page 1ot2

A11x1 l1 .ir·1 PU Nu111IJl'' Appro\icr -- ~ACIFIC HOSPITAL LONG BEACH - ~ACIFIC HOSPITAL LONG BEACH ~

RECEIVING RECEIVING ~ SUITE 110 2778 PACIRC AVE 2776 PACIFIC AVE I' NEWPORT BEACH. CA 92980 LONG BEACH. CA 90806. LONG BEACH. CA 90806 ~ PAONE:!Ms:s70.:.-:w>2 FAX:949-87().3688 -:-;

Dell'l9syDllta: _. FOB: Via: ! PO Statu.: TRANSMITTED TenM: Nl80 'Cii

Ill&:

1 EA /1 rrents: LOT#621

2 EA/1 62066-40 ·162<15f;o (1) 620647 (1)

11-2053 ·--*ot

5.5X40 IMPLANT SCREW

B.5X'40 POLY IMPLANT SCREW

MEDIUM CROSS LINK

10XX20X10 LCC PEEK CAGE

NEXUS IC DBM PUTIY 10CC

S\J.R.GERY

74200SURG S\JRGERY

74200SURG SURGERY

74200SURG SUROERY

7'4200SURG SURGERY 742WSURG SURGERY

7.rax>SURG SURGERY

01.7420.3100 I $360.0000

01.7420.3100 I $2, 149.0000

01.7420.3100 I $2, 149.0000

01. 7420.3100 I $2, 149.0000

01. 7420.3100 I $2,485.0000

01.7420.3100 I $5,-482.0000

01. 74.20.3100 I $960.0000

01.7420.3100 I

0 PACIFIC HOSPITAL LONG BEACH

2n6 PACIFIC AVE I::-' ~ POi--- I Phone: 582-997-2566 Fax: 562-981~71

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$1,578.0000 j .5

$2,160.0000 ~ E

$6,447.0000 & ~

$2,149.0000 3 ~

$4,298.0000 j nl

$2,485.0000 ~ u. u::

$21 .~.0000 " >-

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$9!0.0000 i ~ Ill

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WV L11:si.:e 600l/61./t :&lea i. i.t~ :aBl!c! UMOU)fun :wOJ::!

s £l vvs~~o ~~ l v=6o 600l~~l N~Js~~ 600l~~a~_ ~IJS

0.0

EXHIBIT 2



Billing Entity ‐ Hospital Billing Entity ‐ Surgeon Surgeon Beg Date of Service End Date of ServiceAmount Paid to Hospital by

State FundAmount Paid to Surgeon by

State FundPACIFIC HOSPITAL OF LONG BEACH KHALID B AHMED MD A PROFESSION Ahmed, Khalid 11/15/2008 11/18/2008 $51,116 $7,064

PACIFIC HOSP OF LONG BEACH AHMED, KHALID B Ahmed, Khalid 10/18/2008 10/22/2008 $70,001 $6,957

PACIFIC HOSPITAL OF LONG BEACH JACK H AKMAKJIAN MD INC Akmakjian, Jack 9/13/2010 9/17/2010 $131,646 $9,007

PACIFIC HOSPITAL OF LONG BEACHAKMAKJIAN SPINE & GENERAL ORTHOPAEDICS C Akmakjian, Jack 10/12/2012 10/16/2012 $170,510 $6,979

PACIFIC HOSPITAL OF LONG BEACH FULLERTON ORTHOPAEDIC SURGERY Alexander, Gerald 12/19/2012 12/23/2012 $108,382 $24,217

PACIFIC HOSPITAL OF LONG BEACH HAIDER SPINE CENTER MEDICAL GR Alexander, Gerald 3/31/2011 4/4/2011 $67,142 $10,910

PACIFIC HOSPITAL OF LONG BEACH IAN I T ARMSTRONG MD INC Armstrong, Ian 1/9/2012 1/13/2012 $119,754 $8,943

PACIFIC HOSPITAL OF LONG BEACH IAN ARMSTRONG MD Armstrong, Ian 5/9/2011 5/13/2011 $90,916 $7,277

PACIFIC HOSPITAL OF LONG BEACH DANIEL A CAPEN MD Capen, Daniel 3/24/2012 3/27/2012 $70,979 $9,377

HEALTHSMART PACIFIC INC DANIEL CAPEN MD Capen, Daniel 5/19/2011 5/23/2011 $97,313 $13,797

PACIFC HOSP LONG BEACH MITCHELL G COHEN M D Cohen, Mitchell 9/14/2011 10/6/2011 $111,779 $7,088

PACIFIC HOSP LONG BEACH MITCHELL G COHEN MD INC Cohen, Mitchell 2/15/2010 2/20/2010 $141,533 $12,192

PACIFIC HOSPITAL OF LONG BEACH ISRAEL P CHAMBI Chambi, Israel 2/11/2011 2/13/2011 $61,437 $9,779

PACIFIC HOSPITAL OF LONG BEACH ISRAEL P CHAMBI Chambi, Israel 3/2/2011 3/5/2011 $45,484 $10,172

PACIFIC HOSPITAL OF LONG BEACH CATALINO D DUREZA MD Dureza, Catalino 1/15/2009 1/20/2009 $90,587 $9,902

PACIFIC HOSPITAL OF LONG BEACHMMG CATALINO DUREZA/CATALINO D DUREZA MD Dureza, Catalino 4/15/2009 4/21/2009 $119,410 $17,795

PACIFIC HOSPITAL OF LONG BEACH HAIDER SPINE CENTER MEDICAL GR Haider, Thomas 5/6/2010 5/11/2010 $164,903 $19,782

PACIFIC HOSPITAL OF LONG BEACH HAIDER SPINE CENTER MEDICAL GR Haider, Thomas 5/27/2010 5/31/2010 $74,247 $10,371

PACIFIC HOSPITAL OF LONG BEACH JOHN LARSEN MD Larsen, John 3/8/2011 3/13/2011 $77,135 $7,029

PACIFIC HOSPITAL OF LONG BEACH JOHN M LARSEN/JOHN LARSEN MD Larsen, John 10/23/2008 10/27/2008 $99,108 $15,927

PACIFIC HOSPITAL OF LONG BEACH NELSON SPINE INSTITUTE Nelson, Russell 1/9/2007 1/13/2007 $85,924 $9,050

PACIFIC HOSPITAL OF LONG BEACH NELSON SPINE INSTITUTE Nelson, Russell 10/3/2006 10/11/2006 $97,041 $27,907

PACIFIC HOSPITAL OF LONG BEACHA MICHAEL MOHEIMANI MD IN/COAST SPINE AND SPORTS MEDICINE Moheimani, Assad 2/28/2011 3/4/2011 $86,966 $8,837

PACIFIC HOSPITAL OF LONG BEACH COAST SPINE AND SPORT MEDICINE Moheimani, Assad 10/1/2011 10/6/2011 $179,686 $11,788

PACIFIC HOSPITAL OF LONG BEACH RICHARD L MULVANIA INC Mulvania, Richard 1/19/2010 1/23/2010 $100,287 $15,358

PACIFIC HOSPITAL OF LONG BEACH RICHARD MULVANIA MD Mulvania, Richard 11/3/2009 11/6/2009 $100,640 $19,612

HEALTHSMART PACIFIC INC JARMINSKI, ANDREW R Jarminski, Andrew (Asst) 5/22/2010 5/25/2010 $47,507 $2,051

PACIFIC HOSPITAL OF LONG BEACH ANDREW JARMINSKI Jarminski, Andrew (Asst) 9/1/2010 9/9/2010 $115,976 $3,127

HEALTHSMART PACIFIC INC SERGE OBUKHOFF MD PH D INC/ Obukhoff, Serge 5/2/2011 5/6/2011 $93,737 $12,565

PACIFIC HOSPITAL OF LONG BEACH SERGE OBUKHOFF Obukhoff, Serge 4/22/2011 5/5/2011 $77,944 $8,858

PACIFIC HOSP LONG BEACH DAVID PAYNE Payne, David 1/21/2009 1/24/2009 $82,726 $14,672

PACIFIC HOSPITAL OF LONG BEACH PAYNE, DAVID H Payne, David 11/4/2009 11/7/2009 $66,132 $6,935

PACIFIC HOSPITAL OF LONG BEACHCOASTAL NEUROSURGERY & SPINE ASSOCIATES Tantuwaya, Lokesh 4/4/2012 4/4/2012 $73,215 $8,549

PACIFIC HOSPITAL OF LONG BEACHCOASTAL NEUROSURGERY & SPINE ASSOCIATES Tantuwaya, Lokesh 3/13/2012 3/19/2012 $103,057 $11,970

PACIFIC HOSPITAL OF LONG BEACH ORTHOPAEDIC MEDICAL GROUP OF R Uppal, Gurvinder 10/6/2012 10/11/2012 $136,985 $16,777

PACIFIC HOSPITAL OF LONG BEACH ORTHOPAEDIC MEDICAL GROUP OF R Uppal, Gurvinder 12/21/2012 12/25/2012 $132,090 $16,934


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