SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
CLEMENS PETER J IV

(Last) (First) (Middle)
211 COMMERCE STREET
SUITE 800

(Street)
NASHVILLE TN 37201

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CAREMARK RX INC [ CMX ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP-Finance & Treasurer
3. Date of Earliest Transaction (Month/Day/Year)
05/13/2004
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock, $.001 par value 05/13/2004 M 10,000 A $12 14,827.857 D
Common Stock, $.001 par value 05/13/2004 S 10,000 D $33.2 4,827.857 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option $32.03 05/10/2005(1) 05/10/2014 Common Stock, $.001 par value 40,000 40,000 D
Stock Option $12 05/13/2004 M 10,000 02/06/1995(2) 02/06/2005 Common Stock, $.001 par value 10,000 $0 0 D
Stock Option $16.625 07/24/1996(2) 07/24/2006 Common Stock, $.001 par value 4,750 4,750 D
Stock Option $3 09/21/1998(3) 09/21/2008 Common Stock, $.001 par value 16,000 16,000 D
Stock Option $3 09/21/1998(3) 09/21/2008 Common Stock, $.001 par value 19,250 19,250 D
Stock Option $3 09/21/1998(3) 09/21/2008 Common Stock, $.001 par value 1,000 1,000 D
Stock Option $4.1875 04/08/1999(3) 04/08/2009 Common Stock, $.001 par value 25,000 25,000 D
Stock Option $5.0625 10/13/1999(3) 10/13/2009 Common Stock, $.001 par value 50,000 50,000 D
Stock Option $12.25 01/12/2001(3) 01/12/2011 Common Stock, $.001 par value 50,000 50,000 D
Stock Option $13.21 11/07/2001(3) 11/07/2011 Common Stock, $.001 par value 50,000 50,000 D
Stock Option $18.15 03/31/2003(3) 03/31/2013 Common Stock, $.001 par value 20,000 20,000 D
Explanation of Responses:
1. Option vests in five equal annual installments beginning on the "Date Exercisable" above.
2. 20% of these options are exercisable on the grant date, and 20% are exercisable on each anniversary of the grant date.
3. 34% of these options are exercisable on the grant date, and 33% are exercisable on each of the 1st and 2nd anniversaries of the grant date.
/s/ Peter J. Clemens IV 05/17/2004
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.