The efficacy of any formulation is directly related to its preparation, which is why

1. “Just what the Doctor ordered”…. The efficacy of any formulation is directly related to its preparation, which is why THE SELECTION OF YOUR COMPOUNDING PHARMACY IS CRITICAL

2. www.royalpalmma.com

3. Mission… Provide the highest quality custom prescriptions, unique services and education to meet each patient's healthcare needs and improve quality of life.

4. About Royal Palm Specialty Pharmacy • Combined compounding experience over 40 years • Licensed in every state • Dedicated to caring for patients as individuals • Specializes in the formulation of drugs that are not commercially available • Pharmacists use state-of-the-art technology with approved ingredients so the finished medication meets the doctor's exact specifications • Has over 5,000+ doctors writing and have treated 100,000+ patients

5. Our Compounding Professionals Can Prepare…. • Unique dosage forms containing the best dose of medication for each individual. • Medications in dosage forms that are not commercially available, such as transdermal gels, troches, "chewies", and lollipops. • Medications free of problem-causing excipients such as dyes, sugar, lactose, or alcohol. • Combinations of various compatible medications into a single dosage form for easier administration and improved compliance.

6. Members of PCCA (Professional Compounding Centers of America) • Ensures that your patients’ prescriptions will be compounded with the highest quality and purity of ingredients • Unparalleled quality control and quality assurance for all products ensuring safety and effectiveness • PCCA is registered with and inspected by the FDA and DEA • Purity of dry powders is insuredas they come with a certificate of analysis - We order the BEST of the best ingredients. • Follows USP 795 and 797 guidelines that govern safe compounding practices for non-sterile and sterile products

7. Insurance Coverage • Covered by most major insurance providers including: Medicare Part D, Express Scripts, Medco, Tricare, Aetna, Cigna, Blue Cross-Blue Shield, and many more • Contracted with over 500 insurance companies • Good Neighbor Program prescription savings club

8. Insurance Coverage Continued… • Royal Palm formulations are in compliance with Medicare Part D Guidelines of Lower Active Dosage and derived from tablets. Formula #74585 covered by MOST Medicare plans • Tricare coverage for both active duty and non-active duty military members **Please note: Medicaid and Humana do NOT pay well in North Carolina

9. Good Neighbor Program? (What’s that!) For those without insurance or not covered by insurance $11.95 per year for membership Low affordable cost per gram! Minimum of 30 grams We can’t control patients coverage or copays but we can guarantee that every patient you send to us will leave with control for their pain

10. Patient Dedication • Focused on meeting the needs of each individual patient and improving their quality of life • Prescriptions mailed to patients free of charge within 24 hours of patient contact • Outbound calls for Rx refill reminders by Royal Palm made at day 25, typically - coincides with MD/Prescriber directions.

11. Example of script pad provided by Royal Palm. Per NC law, Ketamine can NOT be listed on script, however please know it IS available Doctor can add, delete, change percentage of any ingredient on this pad. Mix, match, make your own. Total percentage needs to be = or < 38% . This script simply serves as a helpful tool. Custom script pads available

12. You need to fill in your (the doctor’s) name, phone, address and DEA# on the first script only • Check the compound requested • Fill in patient name and phone • Circle refills, sign and date • Fax to the pharmacy • The patient will be contacted and insurance verified • If verified before 3EST, most likely it ships that day • We can overnight for speedy delivery and all of our shipping is free to patients

13. Life Just Got Easier! CUSTOM made script pads available to those doctors who support the usage of Royal Palm. Call Royal Palm or your local Representative to order

14. Writing a Prescription for a Compounded Medication with your own prescription pad

15. Royal Palm uses the best calibrated pump dispensers on the market - EXACT dose dispenser 1 push of the pump = 1 gram

16. Life File e-Prescribing and Workflow Tool • Life File is an innovative Web application that connects pharmacies, physicians and patients • Royal Palm’s complete offering of compounded medications is available through Life File • Data is retrieved directly from our pharmacy database in real-time • Life File provides physicians and providers access to all patients and medications ever sent to Royal Palm Specialty Pharmacy

17. Easy access to Life-File through the Royal Palm website or Smartphone app This service is provided FREE! Ask for set-up form!

18. Example of Setup Form

19. Patient Benefits of Life-File Prescription Refills • Patient Information: Patients and caregivers can maintain detailed personal records including insurances for themselves, family members, and those in their care. Contact information can be updated thus providing both providers and pharmacies with the latest data. • Medication History: Patients may view their medication histories. Even if the original prescriptions were not sent via electronic means, a one year history of all medications complete with the original provider’s instructions, remaining refills, and pricing are available. Current and previous medications are displayed with the actual drug image thus greatly improving safety. • Refill Management: Patients may order refills for active prescriptions by simply clicking a button and confirming their order. • Dosage Scheduling: Patients may set up automatic reminders for any current medications and be notified as described previously including text messages. • Secure Mail and Quick Messaging: Patients may use the same encrypted secure mail system as providers and pharmacies. Quick messaging allows a patient to send short questions to both pharmacies and providers (if a provider allows this option). • Refill Management: Patients may order refills for active prescriptions by simply clicking a button and confirming their order • Dosage Scheduling: Patients may set up automatic reminders for any current medications and be notified as described previously including text messages.

20. Misc. • Royal Palm can align with Electronic Interfaces and Coordinate EMR/Electronic RX on a case by case basis • Copay program rolling out soon…

21. Frequently Asked Questions…

22. Can my child (or my elderly parent) take compounded medication? Yes. Children and the elderly are often the types of patients who benefit most from compounding. Often, parents have a tough time getting their children to take medicine because of the taste. A compounding pharmacist can work directly with the physician and the patient to select a flavoring agent, such as vanilla butternut or tutti frutti, which provides both an appropriate match for the medication's properties and the patient's taste preferences. Compounding pharmacists also have helped patients who are experiencing chronic pain. For example, some arthritic patients cannot take certain medications due to gastrointestinal side effects. Working with their physician's prescription, a compounding pharmacist can provide them with a topical preparation with the anti-inflammatory or analgesic their doctor has prescribed for them. Compounded prescriptions often are used for pain management in hospice care.

23. What kinds of prescriptions can be compounded? Almost any kind. Compounded prescriptions are ideal for any patient requiring unique dosages and/or delivery devices, which can take the form of solutions, suppositories, sprays, oral rinses, lollipops and even as transdermal sticks. Compounding applications can include: Bio-identical Hormone Replacement Therapy, Veterinary, Hospice, Pediatric, Ophthalmic, Dental, Otic (for the ear), Dermatology, Medication Flavoring, Chronic Pain Management, Neuropathies, Sports Medicine, Infertility, Wound Therapy, Podiatry and Gastroenterology.

24. Will patient insurance cover compounded medications? Because compounded medications are exempt by law from having the National Drug Code ID numbers that manufactured products carry, some insurance companies will not directly reimburse the compounding pharmacy. However, almost every insurance plan allows for the patient to be reimbursed by sending in claims forms. While a patient may pay a pharmacy directly for a compounded prescription, most insurance plans should cover the final cost.

25. Please visit www.RoyalPalmMA.com for more information, studies, testimonials, additional answers to questions, etc

26. Contact Royal Palm Royal Palm Specialty Pharmacy118 Main Street.Webster, MA 01570 Phone: 508-461-4045 Fax: 508-943-0496 info@royalpalmma.com

27. Your Local Royal Palm Rep

28. for giving us the opportunity to fulfill your compounding needs!