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        <EIN>611846373</EIN>
        <PrimaryActivitiesTxt>CALIFORNIA OPERATIONS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>CA</LegalDomicileStateCd>
        <TotalIncomeAmt>283490</TotalIncomeAmt>
        <EndOfYearAssetsAmt>292770</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>SURPLUS RX</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
