MISCELLANEOUS • Misceláneo OTC $45
2
SOLIS Health Plans is an HMO with a Medicare contract and a contract with the Florida Medicaid Program. Enrollment in SOLIS Health Plans, Inc. (HMO) depends on contract renewal. Atención: Si usted habla español, servicios de asistencia en español, de forma gratuita, están disponible para usted. Llame al 1 (844) 447-6547 (TTY 711). Name/Nombre: Phone/Teléfono: Member ID/No de Membresía: Address/Dirección: Order Month/Mes de Orden: OTC $45 SPF 001 (HMO) Miami-Dade County Plan: DISCLAIMER: H0982_100OTC452019_M H0982_100OTC452019_M B R A N D N A M E S I Z E C O S T Nombre de Marca Dosis Tamaño Precio 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 S T R E N G T H Q T Y . G E N E R I C N A M E Cantidad Nombre Genérico PROBIOTIC WITH VEGGIE CAP Probiotic 40 $13.00 Pepto-Bismol 8oz $5.00 LOPERAMIDE SOLUTION Imodium Solution 1mg/7.5ml 4oz $7.00 ANTI-DIARRHEALS • Antidiarréicos LOPERAMIDE TABLETS Imodium AD 2mg 12 $7.00 GAS RELIEF Gas-X 80mg 36 $8.00 RANITIDINE Zantac 75mg 30 $10.00 OMEPRAZOLE Prilosec OTC 20mg 14 $12.00 MINERAL OIL Mineral Oil 16oz $7.00 EFFERVESCENT PAIN RELIEF Alka Seltzer 36 $6.00 CIMETIDINE TABLETS Tagamet HB 200 200mg 30 $10.00 CALCIUM ANTACID TABLETS Tums EX Assorted 750mg 96 $6.00 ANTACID LIQUID/ANTIGAS Mylanta / Maalox 12oz $6.00 ANTACIDS • Antiácido ACID GONE CHEWABLE Gaviscon Chewable 160-105mg 100 $10.00 ACETAMINOPHEN ARTHRITIS Tylenol Arthritis 650mg 100 $10.00 MINERAL ICE Mineral Ice 4oz $8.00 HEADACHE RELIEF Excedrin Migraine 250-250-65mg 100 $10.00 IBUPROFEN Advil / Motrin 200mg 50 $5.00 ICY HOT MEDICATED PATCHES Icy Hot 5 $8.00 BABY ASPIRIN CHEWABLE Bayer Baby Aspirin 81mg 36 $4.00 ASPIRIN TABLETS (COATED) Ecotrin 325mg 100 $4.00 PAIN RELIEVERS • Analgésicos ACETAMINOPHEN Tylenol Extra 500mg 100 $8.00 GNP BISMUTH SUBSALICYLATE 200 $4.00 201 $5.00 202 $7.00 203 $2.00 204 $4.00 205 $6.00 206 $10.00 207 $11.00 208 $4.00 209 $5.00 210 $6.00 211 $35.00 212 $10.00 213 $11.00 214 $11.00 215 $12.00 216 $10.00 217 $8.00 218 $3.00 219 $6.00 220 $13.00 221 $7.00 222 $3.00 223 $11.00 224 $6.00 225 $6.00 226 $14.00 227 $5.00 228 $40.00 229 $40.00 230 $40.00 231 $40.00 232 $40.00 233 $40.00 234 $40.00 STEP 1: NICOTINE 4MG LOZENGE #72 Step 1: Nicotine 4MG Lozenge #72 4mg 72 STEP 2: NICOTINE 2MG LOZENGE #72 Step 2: Nicotine 2MG Lozenge #72 2mg 72 STEP 3: NICOTINE 7MG/24 HR PATCH #7 Step 3: Nicotine 7MG/24 HR Patch #7 7mg/24hr 7 STEP 1: NICOTINE 4MG MINT GUM GUM #110 Step 1: Nicotine 4MG Mint Gum Gum #110 4mg 110 STEP 2: NICOTINE 2MG MINT GUM GUM #110 Step 2: Nicotine 2MG Mint Gum Gum #110 2mg 110 SMOKING CESSATION PRODUCTS • Productos para dejar de fumar STEP 1: NICOTINE 21MG/24 HR PATCH #7 Step 1: Nicotine 21MG/24 HR Patch #7 21mg/24hr 7 STEP 2: NICOTINE 14MG/24 HR PATCH #7 Step 2: Nicotine 14MG/24 HR Patch #7 14mg/24hr 7 COTTON SWABS Q-Tips 300 DIMENHYDRINATE Dramamine 50mg 12 MISCELLANEOUS • Misceláneo TOOTHBRUSH Toothbrush 1 FIXODENT ADHESIVE CREAM Fixodent Adhesive Cream 2.4oz MOISTURIZER LOTION Skin Moisturizer 10oz PETROLEUM JELLY LIP BALM Vaseline Lip Balm .35oz CAVITY PROTECTION TOOTHPASTE PLAIN Cavity Protection Toothpaste 6.4oz TOTAL WHITENING TOOTHPASTE Total Whitening Toothpaste 6oz URINARY PAIN RELEIF Azo Standard 95mg 30 SALICYLIC ACID Compound W liquid 17% .31oz SUNSCREEN LOTION SPF 30 Sunscreen Lotion SPF 30 7.3oz Vitamin E Oil 2.5oz DENTURE CLEANSER Denture Cleanser 40 FULLY AUTOMATIC BP MONITOR Blood Pressure Monitor 1 VITAMIN E OIL 2oz HEMORRHOIDAL SUPPOSITORIES Preparation H Suppository 12 CLOTRIMAZOLE CREAM Lotrimin Cream 1% 1oz TOLNAFTATE Tinactin 1% .5oz 16oz SF NATURAL FIBER POWDER Metamucil SF Powder 10oz Diabetes Trio 60 GUAIFENESIN SF Diabetic Tussin SF 100mg/5ml 4oz GLUCOSE TABLETS Glucose Tablets 4GRM 10 TUSSIN DM SF Robitussin DM Sugar Free 4oz CALCIUM ANTACID EXTRA STRENGTH Tums Extra Strength SF 80 CHROMIUM PICOLINATE DIABETES TRIO IROFOL Iron Supplement ISOPROPYL ALCOHOL Isopropyl Alcohol ALCOHOL SWABS Alcohol Swabs 100 Chromium Picolinate (Blood Sugar Aid) 100 HEMORRHOIDAL OINTMENT Preparation H Ointment 100mg/EI 4oz ANTI-FUNGAL CREAMS • Cremas para Hongos ANTI-HEMORRHOIDALS • Antihemorroidal DIABETIC SECTION • Sección de Diabéticos
Transcript of MISCELLANEOUS • Misceláneo OTC $45
SOLIS Health Plans is an HMO with a Medicare contract and a contract with the Florida Medicaid Program. Enrollment in SOLIS Health Plans, Inc. (HMO) depends on contract renewal.
Atención: Si usted habla español, servicios de asistencia en español, de forma gratuita, están disponible para usted. Llame al 1 (844) 447-6547 (TTY 711).
Name/Nombre: Phone/Teléfono:
Lorem ipsumMember ID/No de Membresía:
Address/Dirección: Order Month/Mes de Orden:
OTC $45SPF 001 (HMO) Miami-Dade County
Plan:
DISCLAIMER:
H0982_100OTC452019_MH0982_100OTC452019_M
BRAND NAME SIZE COSTNombre de Marca Dosis Tamaño Precio
101102103104105106107108
109110111112113114115116117
118119120121
STRENGTHQTY. GENERIC NAMECantidad Nombre Genérico
PROBIOTIC WITH VEGGIE CAP Probiotic 40 $13.00Pepto-Bismol 8oz $5.00
LOPERAMIDE SOLUTION Imodium Solution 1mg/7.5ml 4oz $7.00
ANTI-DIARRHEALS • Antidiarréicos
LOPERAMIDE TABLETS Imodium AD 2mg 12 $7.00
GAS RELIEF Gas-X 80mg 36 $8.00RANITIDINE Zantac 75mg 30 $10.00OMEPRAZOLE Prilosec OTC 20mg 14 $12.00MINERAL OIL Mineral Oil 16oz $7.00EFFERVESCENT PAIN RELIEF Alka Seltzer 36 $6.00CIMETIDINE TABLETS Tagamet HB 200 200mg 30 $10.00CALCIUM ANTACID TABLETS Tums EX Assorted 750mg 96 $6.00ANTACID LIQUID/ANTIGAS Mylanta / Maalox 12oz $6.00
ANTACIDS • Antiácido
ACID GONE CHEWABLE Gaviscon Chewable 160-105mg 100 $10.00
ACETAMINOPHEN ARTHRITIS Tylenol Arthritis 650mg 100 $10.00MINERAL ICE Mineral Ice 4oz $8.00HEADACHE RELIEF Excedrin Migraine 250-250-65mg 100 $10.00IBUPROFEN Advil / Motrin 200mg 50 $5.00ICY HOT MEDICATED PATCHES Icy Hot 5 $8.00BABY ASPIRIN CHEWABLE Bayer Baby Aspirin 81mg 36 $4.00ASPIRIN TABLETS (COATED) Ecotrin 325mg 100 $4.00
PAIN RELIEVERS • AnalgésicosACETAMINOPHEN Tylenol Extra 500mg 100 $8.00
GNP BISMUTH SUBSALICYLATE
200 $4.00201 $5.00202 $7.00203 $2.00204 $4.00205 $6.00206 $10.00207 $11.00208 $4.00209 $5.00210 $6.00211 $35.00212 $10.00213 $11.00
214 $11.00215 $12.00
216 $10.00217 $8.00
218 $3.00219 $6.00
220 $13.00221 $7.00222 $3.00223 $11.00224 $6.00225 $6.00226 $14.00227 $5.00
228 $40.00229 $40.00230 $40.00231 $40.00232 $40.00233 $40.00234 $40.00
STEP 1: NICOTINE 4MG LOZENGE #72 Step 1: Nicotine 4MG Lozenge #72
4mg 72STEP 2: NICOTINE 2MG LOZENGE #72 Step 2: Nicotine 2MG Lozenge
#722mg 72
STEP 3: NICOTINE 7MG/24 HR PATCH #7 Step 3: Nicotine 7MG/24 HR Patch #7
7mg/24hr 7STEP 1: NICOTINE 4MG MINT GUMGUM #110
Step 1: Nicotine 4MG Mint Gum Gum #110
4mg 110STEP 2: NICOTINE 2MG MINT GUMGUM #110
Step 2: Nicotine 2MG Mint Gum Gum #110
2mg 110
SMOKING CESSATION PRODUCTS • Productos para dejar de fumarSTEP 1: NICOTINE 21MG/24 HR PATCH #7 Step 1: Nicotine 21MG/24 HR
Patch #721mg/24hr 7
STEP 2: NICOTINE 14MG/24 HR PATCH #7 Step 2: Nicotine 14MG/24 HR Patch #7
14mg/24hr 7
COTTON SWABS Q-Tips 300DIMENHYDRINATE Dramamine 50mg 12
MISCELLANEOUS • Misceláneo
TOOTHBRUSH Toothbrush 1FIXODENT ADHESIVE CREAM Fixodent Adhesive Cream 2.4oz
MOISTURIZER LOTION Skin Moisturizer 10ozPETROLEUM JELLY LIP BALM Vaseline Lip Balm .35oz
CAVITY PROTECTION TOOTHPASTE PLAIN Cavity Protection Toothpaste 6.4ozTOTAL WHITENING TOOTHPASTE Total Whitening Toothpaste 6oz
URINARY PAIN RELEIF Azo Standard 95mg 30SALICYLIC ACID Compound W liquid 17% .31oz
SUNSCREEN LOTION SPF 30 Sunscreen Lotion SPF 30 7.3ozVitamin E Oil 2.5oz
DENTURE CLEANSER Denture Cleanser 40FULLY AUTOMATIC BP MONITOR Blood Pressure Monitor 1
VITAMIN E OIL
2ozHEMORRHOIDAL SUPPOSITORIES Preparation H Suppository 12
CLOTRIMAZOLE CREAM Lotrimin Cream 1% 1ozTOLNAFTATE Tinactin 1% .5oz
16ozSF NATURAL FIBER POWDER Metamucil SF Powder 10oz
Diabetes Trio 60GUAIFENESIN SF Diabetic Tussin SF 100mg/5ml 4oz
GLUCOSE TABLETS Glucose Tablets 4GRM 10
TUSSIN DM SF Robitussin DM Sugar Free 4ozCALCIUM ANTACID EXTRA STRENGTH Tums Extra Strength SF 80
CHROMIUM PICOLINATE
DIABETES TRIO
IROFOL Iron Supplement
ISOPROPYL ALCOHOL Isopropyl Alcohol
ALCOHOL SWABS Alcohol Swabs 100Chromium Picolinate (Blood Sugar Aid)
100
HEMORRHOIDAL OINTMENT Preparation H Ointment
100mg/EI 4oz
ANTI-FUNGAL CREAMS • Cremas para Hongos
ANTI-HEMORRHOIDALS • Antihemorroidal
DIABETIC SECTION • Sección de Diabéticos
161 $12.00162 $13.00163 $14.00164 $17.00
165 $6.00166 $12.00167 $4.00168 $12.00169 $11.00
170 $7.00171 $6.00172 $6.00173 $21.00174 $5.00175 $9.00176 $17.00177 $4.00178 $13.00179 $8.00180 $8.00181 $4.00182 $7.00183 $3.00184 $6.00185 $6.00186 $9.00187 $6.00188 $4.00189 $8.00190 $7.00191 $15.00192 New Pharma $17.00193 $5.00194 New Pharma $15.00
195 $6.00196 $15.00197 $7.00198 $7.00199 $16.00
ALMEBEX PLUS B12 New PharmaVENIPHLEX
EPAMAX
MERITENE POWDER New Pharma Meritene Powder 16oz
LECITHIN 1200MG Mason Lecithin 1200mg 1200mg 100EMERGEN-C Emergen-C 3.3oz 10
ZINC SULFATE Zinc Sulfate 50mg 100SERENITAS (SLEEP AID) New Pharma Serenitas (Sleep Aid) 3mg 30
GINKGO BILOBA Mason Ginkgo Biloba 500mg 60Epamax (Vegetarian EPA & DHA Omega)
60
Almebex plus B12 8ozVeniphlex (Leg Vein Health) 60
B 12 SUBLINGUAL Mason B 12 Sublingual 1000mcg 100Mason Acidophilus with Pectin 100
Vit D - 1000 IU Mason Vit D 1000 IU 1000IU 60FOLIC ACID Mason Folic Acid 800mcg 100
MELATONIN AND B6 Mason Melatonin and B6 5mg/1mg 60Vit D - 2000 IU Mason Vit D 2000 IU 2000IU 60
VITAMIN C 500 MG Mason Vitamin C (Ascorbic Acid) 500mg 100VITAMIN E 400 IU Mason Vitamin E 400IU 100
VITAMIN A 10,000 IU Mason Vitamin A 10,000IU 100VITAMIN B COMPLEX Mason Mega B Complex 100
SAW-PALMETTO Mason Saw-Palmetto 500mg 60VITA TRUM Mason Centrum Silver 100
IRON Mason Feosol 100PROSTATE THERAPY Mason Urinozinc 60
FISH OIL (OMEGA 3) Mason Fish Oil (Omega 3) 1000mg 120 Mason Glucosamine 1500/1200 100
CO-ENZYME Q-10 Mason CoQ10 200mg 30DAILY MULTI VITAMINS Mason One A Day Essentials 100
Mason Caltrate + D3 60CALCIUM CITRATE + D3 Mason Citracal+D3 60
SENNA TABS (Natural Laxative) Senokot 8.6mg 100VITAMINS/MINERALS/HERBS • Vitaminas/Minerales/Hierbas
Mason Oscal 500mg 100
GLYCERIN SUPPOSITORIES (Adult) Fleet Suppositories 25NATURAL FIBER POWDER Metamucil 13oz
LAXATIVES • Laxantes
BISACODYL TABLETS Dulcolax 5mg 25DOCUSATE SODIUM 250mg 100
MICONAZOLE VAGINAL CREAM Monistat Vaginal Cream 100mg 1.5ozTIOCONAZOLE 1 Tioconazole 7% .16oz
CLOTRIMAZOLE VAGINAL Gyne-Lotrimin 1% 1.5ozMICONAZOLE 7 VAGINAL SUPPOSITORIES Monistat Vaginal 100mg 7
FEMININE HYGIENE • Higiene Femenina
H0982_100OTC452019_M H0982_100OTC452019_M
CALCIUM 500 (OYSTER SHELL) CALCIUM CARBONATE + D3
GLUCOSAMINE / CHONDROITIN
ACIDOPHILUS WITH PECTIN
122 Mucinex $13.00123 Benadryl Capsules $5.00124 Robitussin $6.00125 Robitussin DM $7.00126 Claritin / Alavert $15.00127 Vicks Vaporub $7.00128 Afrin $7.00129 Tylenol Cold $8.00130 Ocean $5.00131 Chloraseptic $6.00132 Oral Thermometer $7.00133 Allegra $14.00134 Claritin Syrup $10.00
$25.00135136 Zyrtec $16.00137 $1.00
138 $7.00139 $6.00140 $14.00141 $14.00142 $13.00
143 $18.00144 $18.00145 $18.00146 $18.00
147 $6.00148 $4.00149 $6.00150 $13.00151 $7.00152 $14.00153 $6.00154 $6.00155 $7.00156 $7.00157 $7.00158 $2.00159 $5.00160 $2.00
Hydrogen PeroxideHYDROGEN PEROXIDE
4ozGUAIFENESIN
FLONASE 120 MD 50mcg
COTTON BALLS Cotton Balls 100
16ozIODINE Iodine 1oz
MUSCLE RUB Ben-Gay 3ozTRIPLE ANTIBIOTIC OINTMENT Neosporin 1oz
HYDROCORTISONE OINTMENT Cortaid Ointment 1.0% 1ozMEDICATED CALLUS REMOVER Dr Scholl’s Callus Rem. 6
HOT & COLD THERAPY COMPRESS Hot & Cold Therapy Compress
1HYDROCORTISONE CREAM Cortaid Cream 0.50% 1oz
CAPSAICIN CREAM (ARTHRITIS PAIN RELIEF RUB) Zostrix 2ozELASTIC BANDAGE (2 OR 3 INCHES) Ace Bandage 1
BANDAGE STRIPS Band-Aids 60CALAMINE LOTION Caladryl 6oz
INCONTINENCE UNDERWEAR UNISEX (XLARGE) Depend Underwear Unisex XLARGE 20
FIRST AID • Primeros Auxilios
ANTI ITCH CREAM Benadryl Cream 1oz
INCONTINENCE UNDERWEAR UNISEX (MEDIUM) Depend Underwear Unisex MEDIUM 20INCONTINENCE UNDERWEAR UNISEX (LARGE) Depend Underwear Unisex LARGE 20
SYSTANE ULTRA Systane Ultra .3oz
INCONTINENCE • Incontinencia
INCONTINENCE UNDERWEAR UNISEX (SMALL) Depend Underwear Unisex SMALL 20
Lutein Plus Tablets
60GENTEAL TEARS TWIN PACK Genteal Tears .5oz
EYE / EAR CARE • Cuidado de la Vista / Oído
EAR WAX DROPS Debrox .5ozEYE DROPS Visine Redness Relief .5ozLUTEIN PLUS WITH ZEAXANTHIN Mason
CERTIZINE HCLFlonase 120 MD
10mg 30TRAVEL THROAT SIZE LOZENGE HALLS Stick Honey Lemon 9
LORATADINE SYRUP 5mg 4oz
ORAL THERMOMETER 1FEXOFENADINE HCL 180mg 15
SEA SOFT NASAL MIST 1.5ozSORE THROAT SPRAY 6oz
NASAL SPRAY 1ozACETAMINOPHEN COLD 24
LORATADINE 10mg 30MEDICATED CHEST RUB 3.5oz
GUAIFENESIN/DEXTROMETHORPHAN 4oz
MUCUS RELIEF 400mg 60DIPHENHYDRAMINE CAPSULES 25mg 24
COUGH / COLD / ALLERGY • Tos / Resfriado / Alergia
Extra Strength Stool Softner
