. >> some are bio logics. >> so jim looked at them and identified 4 cases in the month of march that involved things the direct was ordering the drugs and rounding up the doctor looked did patient and made adjustments are the patient wealthy and made a smaller dozen he looked at 4 cases and he just for the month of march and estimates tweaking getting the same amount of drugs saving an annual cost of $36,000 >> we had him looked at those were for the city and county of san francisco employees we deal with employees and your retirees many of the programs frankly are more geared to the retirees and heart disease like the home visit program but we have to do all of that and lastly on the pharmacy general the risk associated with the patient population that brown and toland is take care of it is pretty high and you've heard me make a plea to consider your contribution strategy tied to the risk of the population we're serving so the financial comparisons are balanced and i do think the speciality pharmacy is american people area that is a perfect example of that wonderful treatment we can