-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, LDukr4V31phHJDWmK+vbYajg6OlYBgy41fzgQCKuSRo6VAHr9TH3Cy+3juNN90YY bZFL8f+mvMU25qsy0YDNgw== 0001209191-05-021198.txt : 20050419 0001209191-05-021198.hdr.sgml : 20050419 20050419163234 ACCESSION NUMBER: 0001209191-05-021198 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050415 FILED AS OF DATE: 20050419 DATE AS OF CHANGE: 20050419 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PROVINCE HEALTHCARE CO CENTRAL INDEX KEY: 0001044942 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-GENERAL MEDICAL & SURGICAL HOSPITALS, NEC [8062] IRS NUMBER: 621710772 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 105 WESTPARK DR STREET 2: STE 400 CITY: BRENTWOOD STATE: TN ZIP: 37027 BUSINESS PHONE: 6153701377 MAIL ADDRESS: STREET 1: 105 WESTPARK DR STREET 2: SUITE 180 CITY: BRENTWOOD STATE: TN ZIP: 37207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MOODY SAM CENTRAL INDEX KEY: 0001181781 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 333-34421 FILM NUMBER: 05759597 BUSINESS ADDRESS: STREET 1: 105 WESTWOOD PLACE SUITE 400 CITY: BRENTWOOD STATE: TN ZIP: 37027 MAIL ADDRESS: STREET 1: 105 WESTWOOD PLACE STE 400 CITY: BRENTWOOD STATE: TN ZIP: 37027 4 1 bna94295_bna03moody.xml MAIN DOCUMENT DESCRIPTION X0202 4 2005-04-15 1 0001044942 PROVINCE HEALTHCARE CO PRV 0001181781 MOODY SAM 105 WESTWOOD PLACE STE 400 BRENTWOOD TN 37027 0 1 0 0 Sr. VP of Operations Common Stock 2005-04-15 4 D 0 30337 D 0 D Stock Option 18.20 2005-04-15 4 D 0 43168 6.16 D 2012-08-21 Common Stock 43168 0 D Stock Option 16.40 2005-04-15 4 D 0 21940 7.96 D 2011-05-15 Common Stock 21940 0 D Stock Option 16.709 2005-04-15 4 D 0 32875 7.651 D 2011-02-22 Common Stock 32875 0 D Stock Option 11.50 2005-04-15 4 D 0 23908 12.86 D 2011-05-03 Common Stock 23908 0 D Stock Option 8.945 2005-04-15 4 D 0 1 15.415 D 2011-03-01 Common Stock 1 0 D Stock Option 7.167 2005-04-15 4 D 0 36000 17.193 D 2009-06-25 Common Stock 36000 0 D Stock Option 23.50 2005-04-15 4 D 0 27985 .86 D 2012-05-22 Common Stock 27985 0 D Stock Option 7.71 2005-04-15 4 D 0 41000 16.65 D 2013-03-11 Common Stock 41000 0 D Stock Option 15.75 2005-04-15 4 D 0 40000 8.61 D 2014-03-10 Common Stock 40000 0 D Stock Option 21.08 2005-04-15 4 D 0 9328 3.28 D 2012-03-13 Common Stock 9328 0 D Disposed of pursuant to the Agreement and Plan of Merger between issuer and LifePoint Hospitals, Inc. ("LifePoint") in exchange for cash in the amount of $345,083 plus 8,849 shares of LifePoint. This option was canceled in the merger in exchange for a cash payment equal to the product of (i) the number of shares of the issuer's common stock subject to the award; and (ii) the excess, if any, of the per share merger consideration over the exercise price per share of the award. /s/ Sam Moody 2005-04-18 -----END PRIVACY-ENHANCED MESSAGE-----