NY Opioid Assessment Report

Reporter

Reporter DEA Number PP0000000
Reporter NY Controlled Substance License 0900100
Transaction Year 2018
NY Gross Opioid Receipts US$ 23,000,000
NY Gross Assessable Opioid Receipts US$ 19,000,000
NY Total MMEs 22500
NY Total Assessable MMEs 13800
Billing Contact Name John Doe
Billing Contact Phone 518-555-5555 Ext 2233
Billing Contact Email guesswho@nowhere.com
SFS Customer Id 01231312
Reporting Contact Name Jane Doe
Reporting Contact Phone 5186665555
Reporting Contact Email guesswho@everywhere.com

Reporter Address

Billing Address

ACME PHARMACEUTICAL
ONE BEAR HILL ROAD
CHESTNUT FALLING, NY 10999
NY County: Albany
ACME PHARMACEUTICAL
TWO LAMB RIDGE ROAD
SUITE 001
CHESTNUT VILLAGE, PA 13999
NY County: Not NY

NY Total Distributed Opioid Drug List

NDC Number Package Size NY Total Packages NY Total NDC MME NY Total Assessable Packages NY Total Assessable NDC MME
498120136** 1 5 15000 3 9000
60760037792 120 10 6000 8 4800
00406833062 100 0.5 1500 0 0

NY Exempt Opioid Drug List

NDC Number
00406833062

NY Receiving-Associate DEA List

Receiver DEA Number Receiver NY Controlled Substance License Receiver Status
PX0000000 0309999 Reportable
AZ9999999 MentalHygiene32Exempt
AX0000000 PublicHealth40Exempt
BX9999996 Reportable
BX9999998 FinalPOSNonNYExempt
BX9999997 VeterinarianExempt
BX9999993 FederalVAExempt
BX9999995 OtherGovFedExempt
BX9999994 IndianReservationExempt

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