1. MEMS 2.0 Illustration January 27, 2013

2. The Basics Reporting Start Date:January 1, 2013 Reporting End Date:June 30, 2013 Activity Title:Safe Prescribing Practices: ER/LA Opioids Publisher:The Academy of Safe Healthcare Practices Publication Date:February 4, 2013 Activity ID Catalog: Entry: URI http://www.example.org/opioidcourse Activity Location:Orlando, Florida Start Date and Time:February 4, 2013, 9:00 AM End Date and Time:March 4, 2013, 11:59 PM

3. Credit Information Jointly accredited:True Accrediting body:ACCME Activity Certification:AMA PRA Category 1 Credit type:CME Number of Credits:3 Accrediting body:AAFP Activity Certification:AAFP Prescribed Credit Type:CME Number of Credits:3 Commercial Support:Yes Commercial Supporter:REMS Program Companies

4. Regulatory Information Related to regulation:ER/LA Opioid REMS http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPati entsandProviders/UCM311290.pdf Instruction Addresses:Regulation: http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPati entsandProviders/UCM311290.pdf http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPati entsandProviders/UCM311290.pdf Component: I Title: Assessing Patients for Treatment with ER/LA Opioid Analgesic Therapy Assessment Addresses:Regulation: http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPati entsandProviders/UCM311290.pdf http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPati entsandProviders/UCM311290.pdf Component: I Title: Assessing Patients for Treatment with ER/LA Opioid Analgesic Therapy Audit Consent:True

5. Or for Courses Meeting all Requirements of REMS Compliant to regulation:ER/LA Opioid REMS http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPati entsandProviders/UCM311290.pdf Audit Consent:True

6. Participation Metrics Registered Participants:200 Number of Participants Receiving Credit: 150 Participants By Profession:Physician: 125 Advanced Practice Nurse: 25 Pharmacist: 50 Participants by Specialty:Family practice: 60 Geriatric medicine: 20 Internal medicine: 120 Participants By CategoryCategory: Prescribers Definition: http://www.medbiq.org/mems/definitions#prescriber http://www.medbiq.org/mems/definitions#prescriber Number: 143

7. Participation Metrics Participants By Practice type: (NEW) Primary Care: 175 Specialists: 25 Pain specialists: 15 Non-pain specialists: 10

8. Multiple Categories Profession:Physician Specialty:Internal medicine Practice Type:Primary Care Category:Name: Prescriber Definition: http://www.medbiq.org/mems/definitions#ER/ LA_opioid_prescriber http://www.medbiq.org/mems/definitions#ER/ LA_opioid_prescriber Number:99