X0206 3 2016-09-28 0 0001651561 Tabula Rasa HealthCare, Inc. TRHC 0001384604 ORIGINATE GROWTH FUND 1A LP 205 WEBSTER STREET BETHLEHEM PA 18015 0 0 1 0 0000902959 BRESSNER GLEN R 205 WEBSTER STREET BETHLEHEM PA 18015 1 0 1 0 Common Stock 37658 D Series A Preferred Stock Common Stock 472560 D Series A-1 Preferred Stock Common Stock 302659 D Series B Preferred Stock Common Stock 53912 D All series of Preferred Stock will automatically convert into Tabula Rasa HealthCare, Inc. (the "Issuer") common stock immediately prior to the closing of the initial public offering and have no expiration date. This report is filed jointly by Originate Growth Fund #1A, L.P. ("Originate #1A"), Originate Growth GP, LLC ("Originate GP"), Glen Bressner ("Bressner"), Eric Arnson ("Arnson"), and Michael Gausling ("Gausling"). Originate #1A is the record holder of 916,766 shares of Series A Preferred Stock, which will automatically convert into 472,560 shares of common stock upon the closing of the Issuer's initial public offering. Originate #1A is the record holder of 587,158 shares of Series A-1 Preferred Stock, which will automatically convert into 302,659 shares of common stock upon the closing of the Issuer's initial public offering. Originate #1A is the record holder of 104,589 shares of Series B Preferred Stock, which will automatically convert into 53,912 shares of common stock upon the closing of the Issuer's initial public offering. The shares are held by Originate #1A. The general partner of Originate #1A is Originate GP, a limited liability company. The members of Originate GP are Bressner, Arnson, and Gausling. The members of Originate GP share voting and dispositive power over the shares held by Originate #1A. Each of these individuals disclaims beneficial ownership of such shares, except to the extent of his pecuniary interest. Originate Growth Fund #1A, L.P. By: Originate Growth GP, LLC By: /s/ Glen Bressner, Managing Partner 2016-09-28 Originate Growth GP, LLC By: /s/ Glen Bressner, Managing Partner 2016-09-28 /s/ Glen Bressner 2016-09-28 /s/ Eric Arnson 2016-09-28 /s/ Michael J. Gausling 2016-09-28