1. No category

YOUR PERSONAL HEALTH AND WELLNESS SHOP
NAME (NOMBRE) ______________________________________________________________
ADDRESS (DIRECCIÓN) ________________________________________________________
_____________________________________________________________________________
MEMBER ID ( NUMERO DE MEMBRESIA) __________________________________________
PHONE (TELEFONO) ___________________________________________________________
YOU WILL RECEIVE THE GENERIC EQUIVALENT OF to
ALL ITEMS.
Price
Item Antacids / Digestion / Laxatives Qty Similar
Similar a Precio
A4
A7
A8
A13
A14
A15
L1
L11
L13
L2
L4
L6
L7
Q1
Q3
Q4
(Antiácidos / Digestión / Laxantes)
ANTACID CALCIUM ES TABLETS 96CT
TUMS
RANITIDINE 75 MG
30CT ZANTAC
ANTACID TABS
100CT MYLANTA
ANTACID/ANTI GAS CHEWABLE TABS 90 CT MAALOX
HEARTBURN RELIEF TABS 30 CT PEPCID ACID
DRAMAMINE TABLETS
20 CT DRAMAMINE
LAXATIVE TABS (BISACODYL) 100CT DULCOLAX
COLON CLEANSER
120 CT
ENEMA SINGLE
1CT
FLEET
STOOL SOFTENER
60CT COLACE
LAXATIVE (NATURAL VEGETABLE)
100CT SENOKOT
GLYCERIN SUPPOSITORIES 25CT FLEET
FIBER CAPSULES
160CT METAMUCIL
ANTI -DIARRHEAL TABS
18CT IMODIUM
PINK BISMUTH CHEWABLE TABS 30CT PEPTOBISMOL
GAS RELIEF TABS E/S
30CT GAS X
Pain Relief (Analgésicos)
A1 EFFERVESCENT PAIN RELIEF 36CT ALKA-SELTZER
F2
MUSCLE RUB
4OZ BENGAY
F34 HOT/COLD PATCHES (REUSABLE) 1CT ICY HOT
M46
AZO URINARY RELIEF
12TABS AZO STANDARD
M6
SLEEP AID
16CT SOMINEX
P1 IBUPROFEN PAIN RELIEF 200 MG 50CT
ADVIL
P2
ASPIRIN 325 MG
100CT ECOTRIN
P3
ASPRIN (ENTERIC) 325 MG 100CT ECOTRIN
P4 ASPIRIN LOW DOSE (COATED ) 120CT BAYER
P6
ACETAMINOPHEN 500 MG 100CT TYLENOL
P8 ASPIRIN 81 MG (CHEWABLE ) 36CT BAYER
P9
ASPRIN (COATED)
100CT BAYER
P11
NON-ASPIRIN (CHEWABLE) 80MG
30CT TYLENOL
P13 NON-ASPIRIN SUSPENSION
4OZ TYLENOL
P14
HOT/COLD PATCHES
5CT ICY HOT
P17
MIGRAINE RELIEF
100CT EXEDRIN
P19
NAPROXEN 220MG
100CT ALEVE
P44 MUSCLE THERAPEUTIC BLUE GEL 4OZ MINERAL ICE
P45 ACETAMINOPHIN PAIN RELIEVER 24 CT TYLENOL PM
Cough / Cold / Allergy (Tos / Catarros / Alergia)
C1
NASAL SPRAY REGULAR
1OZ
AFRIN
C2 ALLERGY DIPHENHYDRAMINE CAPSULES 24CT BENADRYL
C7
CHEST RUB-MEDICATED
3.5OZ VICK'S VAPORUB
C10 ALLERGY LORATIDINE 10 MG 10CT CLARITIN
C11 SORE THROAT LOZENGES
18CT CHLORASEPTIC
C12 TUSSIN EXPECTORANT-LIQUID 4OZ ROBITUSSEN
C13 TUSSIN DM COUGH-LIQUID
4OZ ROBITUSSEN DM
C14 COLD MULTI -SYMPTOM MAPAP 24CT TYLENOL COLD
C16 NASAL DECONGESTANT TABS 18CT SUDAFED PE
C19 CHEST DECONGESTANT 400 MG 50CT MUCINEX
C24
COLD GELS PE DAYTIME
12CT VICK'S DAYQUIL
C35 COUGH SYRUP (SUGAR FREE) 4OZ SUGER FREE TUSSIN
C52
NASAL SALINE SPRAY
1.5OZ
OCEAN
C53 ALLERGY CETIRIZINE 10 MG TABS 14CT
ZYRTEC
C54 SINUS CONGESTION NIGHTTIME 12CT VICK'S NYQUIL
C55 ALLERGY DIPHENHYDRAMINE (LIQUID) 4 OZ BENADRYL
C56
SINUS ACETAMENOPHIN
24 CT TYLENOL SINUS
C57
SORE THROAT SPRAY
6 OZ CHLORASEPTIC
$3.99
$7.99
$6.49
$4.99
$6.99
$3.99
$8.99
$7.99
$1.99
$6.99
$10.99
$3.49
$10.99
$5.49
$3.99
$4.49
$4.49
$5.49
$4.99
$4.99
$3.99
$4.49
$2.49
$5.49
$5.49
$6.99
$3.99
$1.99
$4.49
$3.49
$6.99
$7.49
$7.99
$3.99
$3.99
$4.49
$3.49
$4.99
$7.99
$3.49
$4.49
$4.49
$3.99
$4.49
$9.49
$4.49
$4.49
$3.49
$9.99
$4.49
$4.49
$4.99
$3.99
YOU WILL RECEIVE THE GENERIC EQUIVALENT OF ALL ITEMS.
USTED RECIBIRA EL GENERICO DE TODOS LOS PRODUCTOS.
First Aid
Qty Similar to
Item
Primeros Auxilios
Similar a
F4
CALAMINE LOTION
6OZ CALADRYL
F5 HYDROCORTISONE CREAM 1% 1OZ CORTAID
F10
SKIN RASH OINTMENT
2OZ DESITIN
F11
ANTI -ITCH CREAM
1OZ BENADRYL
F29
ANTI- ITCH GEL
4OZ BENADRYL
F1 SELF-ADHERENT BANDAGES
3”
ACE
F7 TRIPLE ANTIBIOTIC OINTMENT 0.5OZ NEOSPORIN
F9
CLEAR PLASTIC BANDAGE
30CT BAND AID
F21
IODINE
1OZ DR. SANA
F24
FIRST AID KIT
1CT
J&J
F61 TRIPLE ANTIBIOTIC OINTMENT PLUS
1OZ NEOSPORIN PLUS
F62
FIRST AID TAPE
5YD
J&J
M45
ALCOHOL PREP PADS
100CT
M52 BENZOCAINE TOPICAL (COLD SORES) 1 OZ ANBESOL GEL
M53
GAUZE
2"
J&J
P20 GLUCOSE CHEWABLE TABS 10CT
DEX 4
Dental Teeth Related (Dental)
M35
DENTAL FLOSS WAXED
100 YD
J&J
X2
DENTURE TABS
40CT EFFERDENT
X6 DENTURE ADHESIVE REGULAR 2.5OZ FIXODENT
M2
TOOTHBRUSH
1CT ORAL-B
Anti-Hemorrhoidals (Contra Hemorroides)
H2
H3
E3
X16
E1
E2
Price
Precio
$2.49
$4.99
$3.99
$3.49
$4.99
$3.49
$4.49
$2.49
$1.99
$6.99
$6.99
$1.99
$3.99
$5.99
$1.89
$2.49
$1.99
$5.49
$4.99
$0.99
HEMORRHOIDAL SUPPOSITORIES
12 CT PREPARATION $4.99
HEMORRHOIDAL OINTMENT 2OZ PREPARATION H $6.49
Ear and Eye Care (Cuidado de la vista y Oido)
EAR DROPS
0.4OZ SIMILISAN $7.99
EAR WAX DROPS
0.5OZ MURINE $4.49
ARTIFICIAL TEARS
0.5OZ TEARS NATURALE $4.49
EYE DROPS ORIGINAL
0.5OZ VISINE $3.49
Miscellaneous (Misceláneo)
M11
SKIN POWDER
M12
BABY WIPES
F35 MEDICATED CALLUS REMOVER
M23
HAND SANITIZER
M43
SQUARE TWEEZERS
M44
NAIL CLIPPER
M50
LUBRICATING JELLY
M51
7 DAY PILL BOX
M30
MICONAZOLE NITRATE
X80
MAXI REGULAR
X82
TAMPON PLASTIC
X71 *BLOOD PRESURE MONITOR SEMI DIGITAL
X72 *BLOOD PRESSURE MONITOR
C8
THERMOMETER DIGITAL
4OZ
J&J
20CT
J&J
1CT DR. SCHOLLS
2OZ
PUREL
1CT
1CT
4OZ
K-Y
EACH
APEX
1 APL MONISTAT 7
24CT ALWAYS
20CT TAMPAX PEARL
1CT
1CT OMRON
1CT
APEX
USTED RECIBIRA EL GENERICO DE TODOS LOS PRODUCTOS.
*Please limit to one per order. / *Por favor, limite a uno por orden.
$1.99
$1.99
$3.49
$1.49
$0.99
$1.99
$4.49
$1.99
$6.99
$3.49
$3.99
$24.99
$17.99
$4.99
Vitamins / Minerals (Vitaminas / Minerales)
V1
VITAMIN B-COMPLEX 100%
100CT B-COMPLEX $4.49
V17
FOLIC ACID 800 MCG
V3
CALCIUM CARBONATE 600 MG +D
60CT
V19
OMEGA 3 FISH OIL 1000 MG
V6
MULTIVITAMINS (TABLET)
V26
VITAMIN D 400 MG IU
100CT NATURE MADE $2.99
VITAMIN B 12
100CT NATURE MADE $8.49
V2
V5
VITAMIN C 500 MG
CO- Q10 10 MG
100CT NATURE MADE $5.99
CALTRATE
$4.49
100CT ONE A DAY
$4.99
30CT NATURE'S BOUNTY $5.49
V7 VITAMINS (COMPLETE SENIOR) 100CT CENTRUM SILVER $9.99
V10 GLUCOSAMINE/CHONDROITIN (TABLETS) 50CT NATURE'S BOUNTY $10.99
V11 CALCIUM 500 MG + VITAMIN D 75CT
CITRACAL
$5.49
V14 VITAMIN A 10,000 IU NATURAL 100CT NATURE'S BOUNTY $4.49
V15 MULTIVITAMINS (CHEWABLE ) 100CT FLINTSTONES $6.99
V16
VITAMIN E 400 MG IU
100CT NATURE MADE $11.99
V18
V21
IRON SUPPLEMENT
URINOZINC
V32
VITAMIN D 1000 MG IU
V35
MAGNESIUM 500 MG
V38
CO- Q10 30 MG
V33
100CT FOLIC ACID $2.99
100CT
100CT
60CT
$7.49
$14.99
100CT NATURE MADE $3.49
100CT NATURE'S BOUNTY $3.99
V36 ZINC GLUCONATE 50 MG CHELATED 100CT
FDC
$4.49
V40
FDC
$4.49
SELENIUM 50 MG
V44
PROSIGHT VITAMIN
90CT NATURE'S BOUNTY $9.99
100CT
60 CT
Must consult with Primary Care Physician prior to ordering a dual-purpose item.
Debe consultar con su médico de cabecera antes de ordenar un producto de doble propósito.
Over-the-Counter Drug Catalog Program
$75 Quarterly Benefit
MERCY CARE ADVANTAGE
PURITAN
$5.49
OCUVITE
$6.99
Programa de Catálogo de Medicamentos sin Receta
Beneficio de $75 Trimestral
MERCY CARE ADVANTAGE
MERCY CARE ADVANTAGE is pleased to provide its members the Your
Personal Health and Wellness Shop. This is a convenient way to get generic
non-prescription medicine and personal health and wellness products by
mail through you MERCY CARE ADVANTAGE OTC Benefit.
HOW TO ORDER BY MAIL:
1. Clearly write your name, address, telephone number and member
ID in the space at the top of the form. Your shipping address must be
the same as the address in your member record. We cannot fill your
order if your address is not the same.
2. Check (√) items you want on the order form that add up to $75
or less. Your benefit limit is $75 every quarter. If you order more than
$75, you will receive the first $75 of items on your order.
3. Fold and seal the form with tape.
MERCY CARE ADVANTAGE se complace en proveer a sus miembros el Catálogo
de Medicamentos Sin Receta. Esta es una forma conveniente de recibir por
correo sus medicamentos y suministros sin receta medica a través de su
beneficio de MERCY CARE ADVANTAGE
COMO ORDENAR POR CORREO:
1. Escriba claramente su nombre, dirección, numero de teléfono y numero
de socio en el espacio indicado. Su dirección de envio debe coincidir
con la dirección que tenemos en su archivo de afiliación. No se
completarán las solicitudes en los casos en que no coincidan las
direcciónes.
2 Seleccione artículos que sumen hasta $75 o menos. Su beneficio tiene
un limite de $75 cada trimestre. Si excede este limite, recibirá
automáticamente sólo los primeros artículos que sumen un total de $75.
3. Doble y selle el formulario con cinta adhesiva.
4. Place a first class postage stamp on the address side (out-side) of
the form and mail.
4. Coloque una estampilla de Primera Clase en la parte de afuera de este
formulario.
ORDER BY PHONE:
To place your order by phone, call 1-888-628-2770 from 9 a.m. to 5 p.m.
E.S.T. Monday through Friday.
POR TELEFONO:
Para colocar su orden llame al 1-888-628-2770 de 9 a.m. a 5 p.m.,
Hora del Este Lunes a Viernes.
ORDER BY FAX:
Fax the completed order form to 1-866-682-6733 any time.
POR FAX:
Envie su forma por fax al 1-866-682-6733 a cualquier hora.
ORDER ONLINE: mercycaremca.otchs.com
POR INTERNET: mercycaremca.otchs.com
OTC Health Solutions
9400 NW 104 Street
Medley, FL 33178
City: _____________________ State: __________ Zip: ________
Address: _____________________________________________
Name: _______________________________________________
Place
Stamp
Here