The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete.
The reader should not assume that the information is accurate and complete.

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 13F

FORM 13F INFORMATION TABLE
OMB APPROVAL
OMB Number: 3235-0006
Estimated average burden
hours per response: 23.8
COLUMN 1 COLUMN 2 COLUMN 3 COLUMN 4 COLUMN 5 COLUMN 6 COLUMN 7 COLUMN 8
VALUE SHRS OR SH/ PUT/ INVESTMENT OTHER VOTING AUTHORITY
NAME OF ISSUER TITLE OF CLASS CUSIP (x$1000) PRN AMT PRN CALL DISCRETION MANAGER SOLE SHARED NONE
10X GENOMICS INC CL A COM 88025U109 5,777 92,700 SH   SOLE   0 0 92,700
89BIO INC COM 282559103 101,112 4,004,442 SH   SOLE   4,004,442 0 0
ABBVIE INC COM 00287Y109 17,448 229,000 SH   DFND 1 32,100 0 196,900
ACADIA HEALTHCARE COMPANY IN COM 00404A109 25,326 1,380,160 SH   DFND 1 164,500 0 1,215,660
ACCELERON PHARMA INC COM 00434H108 23,146 257,549 SH   DFND 1 18,500 0 239,049
ADAPTIMMUNE THERAPEUTICS PLC SPONDS ADR 00653A107 6,870 2,525,654 SH   SOLE   2,525,654 0 0
ADVERUM BIOTECHNOLOGIES INC COM 00773U108 33,713 3,450,644 SH   DFND 1 371,397 0 3,079,247
AEGLEA BIOTHERAPEUTICS INC COM 00773J103 13,353 2,865,524 SH   SOLE   2,865,524 0 0
AERPIO PHARMACEUTICALS INC COM 00810B105 2,856 5,193,946 SH   SOLE   5,193,946 0 0
AGILE THERAPEUTICS INC COM 00847L100 2,232 1,200,000 SH   DFND 1 400,000 0 800,000
AGIOS PHARMACEUTICALS INC COM 00847X104 58,638 1,652,696 SH   DFND 1 191,400 0 1,461,296
AGIOS PHARMACEUTICALS INC COM 00847X104 8,870 250,000 SH Call DFND 1 79,500 0 170,500
ALCON INC ORD SHS H01301128 17,946 351,380 SH   DFND 1 125,800 0 225,580
ALECTOR INC COM 014442107 200,947 8,327,691 SH   SOLE   8,327,691 0 0
ALEXION PHARMACEUTICALS INC COM 015351109 185,990 2,071,385 SH   DFND 1 336,100 0 1,735,285
ALPINE IMMUNE SCIENCES INC COM 02083G100 10,572 3,670,955 SH   SOLE   3,670,955 0 0
AMGEN INC COM 031162100 21,327 105,200 SH   SOLE   0 0 105,200
ANAPTYSBIO INC COM 032724106 5,310 375,800 SH   DFND 1 35,200 0 340,600
APELLIS PHARMACEUTICALS INC COM 03753U106 1,352 50,485 SH   SOLE   0 0 50,485
APPLIED THERAPEUTICS INC COM 03828A101 43,147 1,319,877 SH   DFND 1 60,832 0 1,259,045
APTINYX INC COM 03836N103 2,510 1,162,108 SH   DFND 1 170,100 0 992,008
APTOSE BIOSCIENCES INC COM NEW 03835T200 3,914 659,000 SH   DFND 1 104,100 0 554,900
ARCUTIS BIOTHERAPEUTICS INC COM 03969K108 139,281 4,673,850 SH   DFND 1 4,067,564 0 606,286
ARENA PHARMACEUTICALS INC COM NEW 040047607 5,603 133,400 SH   SOLE   0 0 133,400
ARGENX SE SPONSORED ADR 04016X101 3,766 28,591 SH   SOLE   0 0 28,591
ARROWHEAD PHARMACEUTICALS IN COM 04280A100 1,959 68,100 SH   SOLE   0 0 68,100
ARVINAS INC COM 04335A105 40,099 995,000 SH   DFND 1 560,000 0 435,000
ASCENDIS PHARMA A S SPONSORED ADR 04351P101 370,194 3,287,400 SH   DFND 1 3,011,900 0 275,500
ATHENEX INC COM 04685N103 31,032 4,009,346 SH   DFND 1 229,000 0 3,780,346
ATRICURE INC COM 04963C209 31,178 928,189 SH   DFND 1 143,500 0 784,689
AURINIA PHARMACEUTICALS INC COM 05156V102 19,393 1,336,547 SH   SOLE   0 0 1,336,547
AVROBIO INC COM 05455M100 10,319 663,174 SH   DFND 1 64,000 0 599,174
BAUSCH HEALTH COS INC COM 071734107 37,198 2,399,880 SH   DFND 1 361,200 0 2,038,680
BELLUS HEALTH INC NEW COM NEW 07987C204 69,370 7,025,832 SH   DFND 1 4,943,416 0 2,082,416
BENEFYTT TECHNOLOGIES INC COM CL A 08182C106 21,559 962,900 SH   DFND 1 160,400 0 802,500
BIOGEN INC COM 09062X103 151,989 480,400 SH   DFND 1 55,700 0 424,700
BIOLINERX LTD SPONSORED ADS 09071M205 92 69,240 SH   SOLE   69,240 0 0
BIOMARIN PHARMACEUTICAL INC COM 09061G101 45,672 540,500 SH   DFND 1 45,000 0 495,500
BIOMX INC COM 09090D103 16,194 2,313,489 SH   SOLE   2,313,489 0 0
BIOXCEL THERAPEUTICS INC COM 09075P105 2,398 107,300 SH   DFND 1 19,000 0 88,300
BOSTON SCIENTIFIC CORP COM 101137107 158,167 4,847,300 SH   DFND 1 939,400 0 3,907,900
BRISTOL-MYERS SQUIBB CO COM 110122108 137,945 2,474,800 SH   DFND 1 428,700 0 2,046,100
BRISTOL-MYERS SQUIBB CO RIGHT 99/99/9999 110122157 1,330 350,000 SH   DFND 1 120,140 0 229,860
CARA THERAPEUTICS INC COM 140755109 7,831 592,800 SH   DFND 1 77,200 0 515,600
CASSAVA SCIENCES INC COM 14817C107 1,530 250,000 SH Call DFND 1 97,500 0 152,500
CATABASIS PHARMACEUTICALS IN COM NEW 14875P206 184 44,398 SH   SOLE   44,398 0 0
CENTENE CORP DEL COM 15135B101 79,354 1,335,700 SH   DFND 1 179,300 0 1,156,400
CIGNA CORP NEW COM 125523100 77,906 439,700 SH   DFND 1 84,900 0 354,800
CORVUS PHARMACEUTICALS INC COM 221015100 14,280 6,767,584 SH   SOLE   6,767,584 0 0
CRINETICS PHARMACEUTICALS IN COM 22663K107 29,977 2,039,282 SH   SOLE   2,039,282 0 0
CRISPR THERAPEUTICS AG NAMEN AKT H17182108 23,376 551,200 SH   DFND 1 37,400 0 513,800
CTI BIOPHARMA CORP COM 12648L601 8,759 9,520,600 SH   SOLE   9,520,600 0 0
CURIS INC COM NEW 231269200 956 1,358,363 SH   DFND 1 116,869 0 1,241,494
DECIPHERA PHARMACEUTICALS IN COM 24344T101 47,658 1,157,600 SH   DFND 1 190,100 0 967,500
DEXCOM INC COM 252131107 91,013 338,000 SH   DFND 1 50,000 0 288,000
EDWARDS LIFESCIENCES CORP COM 28176E108 33,348 176,800 SH   DFND 1 27,800 0 149,000
EHEALTH INC COM 28238P109 89,922 638,558 SH   DFND 1 86,021 0 552,537
ESSA PHARMA INC COM NEW 29668H708 5,887 1,471,853 SH   SOLE   1,471,853 0 0
EXELIXIS INC COM 30161Q104 54,761 3,180,100 SH   DFND 1 391,400 0 2,788,700
FLEXION THERAPEUTICS INC COM 33938J106 1,047 133,000 SH   SOLE   0 0 133,000
GILEAD SCIENCES INC COM 375558103 109,979 1,471,100 SH   DFND 1 128,600 0 1,342,500
GLAUKOS CORP COM 377322102 47,760 1,547,646 SH   SOLE   1,547,646 0 0
HARPOON THERAPEUTICS INC COM 41358P106 28,329 2,446,409 SH   DFND 1 1,360,704 0 1,085,705
HCA HEALTHCARE INC COM 40412C101 63,776 709,800 SH   DFND 1 121,000 0 588,800
HEALTH CATALYST INC COM 42225T107 4,696 179,598 SH   SOLE   179,598 0 0
HERON THERAPEUTICS INC COM 427746102 6,309 537,420 SH   SOLE   0 0 537,420
HORIZON THERAPEUTICS PUB LTD SHS G46188101 69,361 2,341,700 SH   DFND 1 324,500 0 2,017,200
HUMANA INC COM 444859102 88,020 280,300 SH   DFND 1 42,300 0 238,000
IGM BIOSCIENCES INC COM 449585108 4,535 80,760 SH   DFND 1 7,460 0 73,300
IMARA INC COM 45249V107 43,600 2,719,902 SH   DFND 1 2,532,402 0 187,500
IMMUNOVANT INC COM 45258J102 2,794 179,500 SH   DFND 1 34,500 0 145,000
INFLARX NV COM N44821101 4,078 1,067,600 SH   DFND 1 403,800 0 663,800
INSPIRE MED SYS INC COM 457730109 20,917 347,000 SH   SOLE   347,000 0 0
INTELLIA THERAPEUTICS INC COM 45826J105 3,205 262,100 SH   SOLE   262,100 0 0
INTERSECT ENT INC COM 46071F103 812 68,553 SH   DFND 1 6,600 0 61,953
INTUITIVE SURGICAL INC COM NEW 46120E602 83,740 169,100 SH   DFND 1 27,700 0 141,400
IOVANCE BIOTHERAPEUTICS INC COM 462260100 166,089 5,548,326 SH   DFND 1 1,337,800 0 4,210,526
IQVIA HLDGS INC COM 46266C105 18,876 175,000 SH   SOLE   0 0 175,000
IVERIC BIO INC COM 46583P102 2,580 750,000 SH   SOLE   0 0 750,000
KALA PHARMACEUTICALS INC COM 483119103 47,490 5,402,730 SH   DFND 1 4,651,895 0 750,835
KALVISTA PHARMACEUTICALS INC COM 483497103 3,218 420,641 SH   DFND 1 46,500 0 374,141
KITOV PHARMA LTD SPONSORED ADS 49803V107 1,058 3,461,983 SH   SOLE   3,461,983 0 0
LOGICBIO THERAPEUTICS INC COM 54142F102 31,946 6,466,783 SH   SOLE   6,466,783 0 0
MEIRAGTX HOLDINGS PLC COM G59665102 48,146 3,582,320 SH   DFND 1 133,500 0 3,448,820
MENLO THERAPEUTICS INC COM 586858102 4,693 1,751,295 SH   SOLE   0 0 1,751,295
MERCK & CO. INC COM 58933Y105 199,205 2,589,100 SH   DFND 1 382,100 0 2,207,000
MERSANA THERAPEUTICS INC COM 59045L106 7,851 1,346,721 SH   SOLE   0 0 1,346,721
MIRATI THERAPEUTICS INC COM 60468T105 109,409 1,423,300 SH   DFND 1 197,700 0 1,225,600
MUSTANG BIO INC COM 62818Q104 675 251,685 SH   SOLE   251,685 0 0
NABRIVA THERAPEUTICS PLC SHS G63637105 2,671 4,644,600 SH   SOLE   4,644,600 0 0
NANOSTRING TECHNOLOGIES INC COM 63009R109 28,677 1,192,400 SH   DFND 1 156,400 0 1,036,000
NATERA INC COM 632307104 99,941 3,347,000 SH   DFND 1 989,200 0 2,357,800
NEOLEUKIN THERAPEUTICS INC COM 64049K104 10,490 921,800 SH   DFND 1 159,000 0 762,800
NEUBASE THERAPEUTICS INC COM 64132K102 2,642 371,114 SH   DFND 1 37,000 0 334,114
NEUROCRINE BIOSCIENCES INC COM 64125C109 99,967 1,155,015 SH   DFND 1 137,470 0 1,017,545
NEXTCURE INC COM 65343E108 100,497 2,711,013 SH   SOLE   2,711,013 0 0
NOVO-NORDISK A S ADR 670100205 19,866 330,000 SH   SOLE   0 0 330,000
NOVUS THERAPEUTICS INC COM 67011N105 1,241 3,183,314 SH   SOLE   3,183,314 0 0
OBSEVA SA COM H5861P103 6,279 2,605,531 SH   SOLE   2,605,531 0 0
OTONOMY INC COM 68906L105 142 71,994 SH   SOLE   71,994 0 0
PASSAGE BIO INC COM 702712100 109,666 6,962,899 SH   DFND 1 5,947,323 0 1,015,576
PFENEX INC COM 717071104 11,510 1,305,034 SH   DFND 1 131,668 0 1,173,366
PFIZER INC COM 717081103 98,315 3,012,100 SH   DFND 1 521,900 0 2,490,200
PFIZER INC COM 717081103 16,320 500,000 SH Call DFND 1 159,000 0 341,000
PREVAIL THERAPEUTICS INC COM 74140Y101 168,496 13,822,463 SH   SOLE   13,822,463 0 0
PROTAGONIST THERAPEUTICS INC COM 74366E102 472 66,909 SH   SOLE   0 0 66,909
PROTHENA CORP PLC SHS G72800108 31,054 2,902,239 SH   DFND 1 613,800 0 2,288,439
PTC THERAPEUTICS INC COM 69366J200 51,245 1,148,723 SH   DFND 1 184,300 0 964,423
REGENERON PHARMACEUTICALS COM 75886F107 8,399 17,200 SH   SOLE   0 0 17,200
REGENXBIO INC COM 75901B107 8,668 267,700 SH   DFND 1 33,200 0 234,500
RESTORBIO INC COM 76133L103 4,975 4,830,387 SH   SOLE   4,830,387 0 0
REVOLUTION MEDICINES INC COM 76155X100 6,573 300,000 SH   DFND 1 36,500 0 263,500
SAREPTA THERAPEUTICS INC COM 803607100 88,278 902,449 SH   DFND 1 148,300 0 754,149
SCPHARMACEUTICALS INC COM 810648105 25,233 3,409,865 SH   SOLE   3,409,865 0 0
SELECT SECTOR SPDR TR SBI HEALTHCARE 81369Y209 10,027 113,200 SH   SOLE   113,200 0 0
SELECTA BIOSCIENCES INC COM 816212104 6,251 2,593,869 SH   SOLE   2,593,869 0 0
SI BONE INC COM 825704109 16,507 1,381,300 SH   DFND 1 76,000 0 1,305,300
SIERRA ONCOLOGY INC COM NEW 82640U404 14,507 1,477,320 SH   DFND 1 1,306,860 0 170,460
SINOVAC BIOTECH LTD SHS P8696W104 17,151 2,839,500 SH   SOLE   0 0 2,839,500
SPDR S&P 500 ETF TR TR UNIT 78462F103 15,774 50,000 SH Put DFND 1 15,500 0 34,500
SPDR SER TR S&P BIOTECH 78464A870 9,850 127,200 SH   SOLE   127,200 0 0
SPRINGWORKS THERAPEUTICS INC COM 85205L107 199,970 7,406,307 SH   SOLE   7,406,307 0 0
STRYKER CORP COM 863667101 61,784 371,100 SH   DFND 1 63,000 0 308,100
SUTRO BIOPHARMA INC COM 869367102 1,069 104,800 SH   SOLE   104,800 0 0
SYNDAX PHARMACEUTICALS INC COM 87164F105 3,181 290,000 SH   DFND 1 212,000 0 78,000
SYNLOGIC INC COM 87166L100 3,492 2,029,996 SH   SOLE   2,029,996 0 0
TELA BIO INC COM 872381108 23,675 3,027,542 SH   SOLE   3,027,542 0 0
THERAVANCE BIOPHARMA INC COM G8807B106 4,889 211,545 SH   SOLE   0 0 211,545
THERMO FISHER SCIENTIFIC INC COM 883556102 31,281 110,300 SH   DFND 1 16,800 0 93,500
TRICIDA INC COM 89610F101 211,514 9,614,280 SH   SOLE   9,614,280 0 0
TRILLIUM THERAPEUTICS INC COM NEW 89620X506 3,236 801,000 SH   DFND 1 391,800 0 409,200
TURNING POINT THERAPEUTICS I COM 90041T108 122,606 2,745,327 SH   DFND 1 2,027,550 0 717,777
UNIQURE NV SHS N90064101 46,690 983,979 SH   DFND 1 153,000 0 830,979
VERONA PHARMA PLC SPONSORED ADS 925050106 5,152 1,250,396 SH   SOLE   1,250,396 0 0
VERRICA PHARMACEUTICALS INC COM 92511W108 16,173 1,479,733 SH   SOLE   1,479,733 0 0
VERTEX PHARMACEUTICALS INC COM 92532F100 175,464 737,400 SH   DFND 1 113,100 0 624,300
X4 PHARMACEUTICALS INC COM 98420X103 10,865 1,086,493 SH   SOLE   1,086,493 0 0
XENON PHARMACEUTICALS INC COM 98420N105 18,856 1,662,812 SH   DFND 1 732,512 0 930,300
XTANT MED HLDGS INC COM NEW 98420P308 6,169 9,207,012 SH   SOLE   9,207,012 0 0
ZAFGEN INC COM 98885E103 852 1,106,529 SH   SOLE   1,106,529 0 0
ZAI LAB LTD ADR 98887Q104 13,076 254,000 SH   SOLE   254,000 0 0
ZYMEWORKS INC COM 98985W102 20,654 582,302 SH   DFND 1 15,300 0 567,002