over-the-counter (otc) medications and products · choose from the list of covered medications and...
TRANSCRIPT
OVER-THE-COUNTER (OTC) MEDICATIONS AND PRODUCTS
Your 2018 catalog
INT_18_57481 09112017
ATTENTION If you speak English language assistance services free of charge are available to you Call 1-800-668-3813 (TTY 711) 8 am ndash 8 pm Monday ndash Friday and 8 am ndash 6 pm on Saturday ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-800-668-3813 注意如果您使用繁體中文您可以 免費獲得語言援助服務 請致電1-800-668-3813 (TTY 711) All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation including Cigna Health and Life Insurance Company Cigna HealthCare of South Carolina Inc Cigna HealthCare of North Carolina Inc Cigna HealthCare of Georgia Inc Cigna HealthCare of Arizona Inc HealthSpring Life amp Health Insurance Company Inc HealthSpring of Tennessee Inc HealthSpring of Alabama Inc HealthSpring of Florida Inc Bravo Health Mid Atlantic Inc and Bravo Health Pennsylvania Inc The Cigna name logos and other Cigna marks are owned by Cigna Intellectual Property Inc The benefit information provided is a brief summary not a complete description of benefits For more information contact the plan Limitations copayments and restrictions may apply Benefits formulary pharmacy network provider network premium andor copaymentscoinsurance may change on January 1 of each year Cigna-HealthSpring complies with applicable Federal civil rights laws and does not discriminate on the basis of race color national origin age disability or sex Cigna-HealthSpring cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza color nacionalidad edad discapacidad o sexo Cigna-HealthSpring is contracted with Medicare for PDP plans HMO and PPO plans in select states and with select State Medicaid programs Enrollment in Cigna-HealthSpring depends on contract renewal copy 2017 Cigna
YOUR OVER-THE-COUNTER (OTC) MEDICATIONS AND PRODUCTS
Choose from the list of covered medications and products in this catalog
Check your Cigna-HealthSpring Evidence of Coverage to see your monthly OTC allowance
2
1
Call to order 1-866-851-1579 (TTY 711) Monday ndash Friday 8 am ndash 9 pm EST
3
Ask us to double-check your mailing address We want to make sure you get your items 4
SAVE MONEY AND TIME You can get over-the-counter items sent right to your door ndash with FREE delivery
3
QAamp Common questions about
Q What can I order
A You can order from the list of covered items in this catalog Covered items may include
OTC medications bull Aspirin bull Acetaminophen bull Vitamins
bull Cold and flu medicine
Health-related products bull Nicotine patches bull Disposable underpads bull Compression socks
bull Nasal strips
Q How much is my quarterly allowance
A The dollar value of your quarterly allowance depends on your plan Check your Cigna-HealthSpring Evidence of Coverage to see your quarterly OTC allowance
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
your OTC benefit
Q When can I spend my quarterly allowance
A Your allowance goes into your account quarterly on January 1 April 1 July 1 and October 1 You can
bull Spend your full quarterly allowance as soon as it is in your account
bull Save up your allowances to order higher priced items later in the year
bull Order once a month up to 12 times a year
Unused balances roll forward each quarter However balances do not carry over to the next year
Q Who can get items through my OTC benefit
A You can order items that help you with a medical need every month you are a Cigna-HealthSpring customer Cigna-HealthSpring prohibits the purchase of OTC items for family members or friends
Q How do I get my order
A The cost of your order must be less than or equal to the account balance for items to ship OTC medications are only available for home delivery Covered items are sent to you free of delivery charge Please allow two weeks for home delivery
4
20
20
20
BRAND EQUIVALENT INDEX Please use the index below for ease in locating available OTC items
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
21st Century Glucosamine Chondroitin 3M Tape Tape Paper Surgical
- 1 in x 10 yd 3M Tape Tape Paper Surgical
- 2 in x 10 yd 3M Tape Tape Silk Surgical
- 1 in x 10 yd 3M Tape Tape Silk Surgical
- 2 in x 10 yd 3M Tape Tape Transparent
Surgical - 1 in x 10 yd 3M Tape Tape Transparent
Surgical - 2 in x 10 yd AampD A amp D Ointment Abreva Abreva Ace Ankle Support Ace Elastic Bandage - 2 in x 45 yd Ace Elastic Bandage - 3 in x 5 yd Ace Elastic Bandage - 4 in x 5 yd Ace Elastic Bandage - 6 in x 5 yd Advil Ibuprofen Afrin Nasal Decongestant
Spray - 12 Hour After Bite Relief After Bite Relief Aleve Naproxen AmLactin Ammonium Lactate Alka-Seltzer Effervescent Pain Reliever Anbesol Oral Pain Relief Antiseptic Towelettes
Antiseptic Towelettes
Arthritis Gloves Arthritis Gloves Small Arthritis Gloves Arthritis Gloves Medium Arthritis Gloves Arthritis Gloves Large Aspercreme Lidocaine Patch Attends Bladder Control Shaped
Pad Moderate Absorbency
10 Attends Bladder Control Shaped Pad18 Heavy Absorbency
Attends Bladder Control Shaped Pad 19 Maximum Absorbency
Attends Disposable Underwear 19 Medium
Attends Disposable Underwear 19 Large
Attends Disposable Underwear 19 X-Large
Attends Underpad Disposable 19 - 23rdquo x 24rdquo
Attends Underpad Disposable 19 - 23rdquo x 36rdquo
Attends Underpad Disposable15 - 30rdquo x 30rdquo 23 Bacitracin Bacitracin Ointment 17 Band-Aid Adhesive Bandages
17 Bath Mat Bath Mat Non-Skid Non-Skid
17 Bausch amp Lomb Eye Wash Solution 18 Bayer Aspirin 21 Bayer Aspirin Low Dose 12 Chewables
Benadryl Diphenhist (Antihistamine) 17 Benadryl Diphenhydramine HCL 22 (Antihistamine)
Benadryl Diphenhydramine HCL Zinc 22 Acetate Anti-itch Cream 13 Bengay Pain Relieving Muscle Rub 15 Benrsquos Insect Repellant Spray (Deet) 17 Biofreeze Fast Freeze Pain Relief Spray
23 Bonine Meclizine HCL Antiemetic
23 Braun Thermometer Digital Ear
23 Breathe Right Nasal Strips Small Medium
22 Breathe Right Nasal Strips Medium Large
20 Caltrate Calcium + Vitamin D Caltrate-D Calcium Carbonate Tablets
17
17
17
16
21
21
12
12
22
5
20
20
20
20
20
14
18 18 21 19 22 22 10 10
24
24
18 19
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Capzasin Capsaicin Carex Bath Tub Safety Rail Carex Cushion Foam Ring Carex Cushion Lumbar Carpal Tunnel Carpal Tunnel Brace Small Brace Carpal Tunnel Carpal Tunnel Brace Medium Brace Carpal Tunnel Carpal Tunnel Brace Large Brace Centrum Daily Multiple Vitamin
Tablets with Minerals Centrum SIlver Senior Multivitamin Cepacol Sore Throat Lozenges Cepacol Sore Throat Lozenges Cherry Chlor-Trimeton Chlorpheniramine Maleate
(Antihistamine) Chloraseptic Sore Throat Spray Cherry CholesTrak Home Access
Cholesterol Test Citrucel Methylcellulose Fiber Therapy Claritin Loratadine (Generic Claritin) Clean and Clear Acne Gel 10
Benzoyl Peroxide Colace Docusate Sodium
Stool Softener Colgate Rechargeable Toothbrush Colgate Toothbrush Colgate
Adult Soft Commit Nicotine Lozenges Compound W Wart Remover (liquid) Conair Water Jet Conair Water Jet Replacement Tips Coppertone Sunscreen Lotion SPF 30 Coricidin HBP Cough amp Cold for High
Blood Pressure Cortaid Hydrocortisone 1 Cream Cotton Balls Cotton Balls Curad Alcohol Pads
21 Curad Rib Belt - Female 17 (one size fits most)
17 17
Curad
Curad
Rib Belt - Male (one size fits most) First Aid Kit
23 DHEA DHEA
23 Depends Attends Discreet Menrsquos Guard Depends Attends Discreet Menrsquos Shield
23 Depends Attends Discreet Womenrsquos Maximum
10 Bladder Control Pad
11 Depends Attends Discreet
Womenrsquos Moderate 13 13
Depends Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
12 Depends Attends Discreet Womenrsquos Ultimate Bladder Control Pad
13 11
Depends Attends Discreet Womenrsquos Ultrathin Pad
Dr Scholls Callus Remover Pads 14 Dr Scholls Corn Remover Pads 12 Dr Scholls Diabetic Sock Black Medium 22 Dr Scholls Diabetic Sock Black Large
14 Dr Scholls Dr Scholls
Diabetic Sock White Medium Diabetic Sock White Large
15 Dramamine Dramamine Chewables 15
Dramamine Orange Driminate Antiemetic
23 Drive Medical Adjustable Transfer Bench 25 Drive Medical Cushion Gel Foam Seat 16 Drive Medical Quad Cane Small Base 16 Drive Medical Quad Cane Large Base 25 12
Dulcolax
Ecotrin
Bisacodyl Enteric Coated Laxative Aspirin Enteric Coated
14 Ecotrin Aspirin Low Dose 17 Efferdent Denture Cleaning Tablets 17 Essential Bath Bench with Back
20
20
20
19
19
16
16
16
16
21
21
17
17
6
20
20
20
20
18 18 14
21 21 15 17
25 19 25
13
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Essential Bath Bench without Back Excedrin Migraine Relief Feosol Ferrous Gluconate
(Iron Supplement) Feosol Ferrous Sulfate Fibercon Polycarbophil Fiber Tablets First Aid Only First Aid Kit 75 pieces Fixodent Fixodent Fleet Glycerin Suppository Fleet Hemorrhoidal Suppository Fruit of the Earth Aloe Vera Cream Futuro Back Support Elastic Futuro Back Support Elastic
with Lumbar Futuro Compression Knee High
Socks Womenrsquos Black Small Futuro Compression Knee
High Socks Womenrsquos Black Medium
Futuro Compression Knee High Socks Womenrsquos Black Large
Futuro Compression Knee High Socks Womenrsquos Nude Small
Futuro Compression Knee High Socks Womenrsquos Nude Medium
Futuro Compression Knee High Socks Womenrsquos Nude Large
Futuro Elbow Support Futuro Knee Support Elastic Small Futuro Knee Suppor t Elastic
Small with Stays Futuro Knee Suppor t
Elastic Medium Futuro Knee Suppor t Elastic
Medium with Stays Futuro Knee Support Elastic Large Futuro Knee Suppor t Elastic
Large with Stays Futuro Night Wrist Support
Smart Glove Futuro Wrist Splint
17 Futuro Wrist Support 22 Gold Bond Medicated Foot Powder 10 Gold Bond Moisturizing Body
Lotion with Aloe 10 14 18
Gyne-Lotrimin Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
15 HALLS Cough Drops Cherry 14 HealthSmart Finger Pulse Oximeter 19 Herpecin-L Herpecin-L Lip Balm 25 23 23
Hip Protector Hip Protector Hip Protector
Hip Protector Small Hip Protector Medium Hip Protector Large
23 Hip Protectorw Hip Protector X-Large
23 Hydrogen Peroxide Hydrogen Peroxide Hylandrsquos Ear Pain Relief Ear Drops
23 Hylandrsquos Leg Cramps Pain
Relief Caplets
23 Imodium A-D Loperamide HCL
Anti-Diarrheal
24 Isopropyl Isopropyl Alcohol
Wintergreen Lactaid Lactase Capsules 14
24 Lamisil AT Terbinafine HCL Antifungal Cream
15
24 24 24
24
24
Lantiseptic Lotrimin AF
Lotrimin AF
Ludens
Maalox
Barrier Cream Clotrimazole Antifungal Athletersquos Foot Cream Medicated Antifungal Foot Powder Spray Cough Drops Sugar Free Cherry Antacid Anti-Gas Liquid
20 14
15
12
13
24 Metamucil Natural Vegetable Laxative 24 Micatin Miconazole Nitrate 2
Antifungal Cream 24 Monistat 1 Tioconazole 1-Day Treatment
Vaginal Cream (with applicator) 25 Monistat 3 Micanozole 3-Day Treatment
12
11
15
24
24
24
24
18
16
10
7
14
18
14 15
13
13
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Murine Murine
Mucinex DM
NasalCrom
Ear Wax Removal Drops Ear Wax Removal System with Rubber Bulb Mucus Relief DM Expectorantamp Cough Suppressant Cromolyn Sodium(Allergy Nasal Spray)
16 16
12
12
Omron
One A Day
One A Day
Orajel
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo) One DailyMenrsquos Multivitamin One Daily Womenrsquos Multivitamin Orajel Pain Relief
11
11
11
15 Nature Made Nature Made Nature Made
Magnesium Oxide Niacin Stress Formula
10 11 11
Oral B Oral-B
Rechargeable Toothbrush Interdental Flossups 15
Tablets with Zinc Pepcid Famotidine Acid Reducer 13 Naturersquos Bounty Coenzyme Q-1 10 Pepsodent Toothpaste - Pepsodent 16 Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty
Folic Acid Iron Magnesium Melatonin
10 10 10 10
Pepto-Bismol Pepto-Bismol Phillipsrsquo
Bismatrol Chewable Tablets Pink Bismuth Milk of Magnesia
14 14 14
Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Neosporin Neosporin
Vitamin B-6 Vitamin D Fish Oil Tablets Neosporin Plus Triple Antibiotic Ointment
11 11 10 18 19
Povidone
Preparation H Prevail Prevail
Povidone Iodine Solution Antiseptic Hemorrhoidal Ointment Adult Briefs Medium Adult Briefs Large
18
19 19 20
Nexcare
Nexcare
Nicoderm
HotCold Pack1 small amp 1 large Thermometer Digital 60 seconds Nicotine Patch Step 1
18
19
23
Prevail Prilosec OTC ProCheck
Purell
Adult Briefs X-Large Omeprazole Acid Reducer Thermometer Flexible Tip Digital 10 seconds Hand Sanitizer
20 13 19
22 Nicoderm Nicoderm Nicorette Nix
Nicotine Patch Step 2 Nicotine Patch Step 3 Nicorelief Gum Permethrin Lice Treatment
23 23 23 22
Q-Tips Quick-Lock Reach
Cotton Tipped Swabs Raised Toilet Seat Reach Waxed Dental Floss Mint
16 18 15
Nova
Ocean Omron
Omron
Folding CaneErgonomic Handle Nasal Spray Saline Desktop Automatic Blood Pressure Monitor Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
18
13 11
11
Refresh PM Releev Renu MultipurposeSolution Reveal
Rid
Artificial Tears Ointment Releev Cold Sore Treatment Multi-Purpose Contact Lens Solution EZ Detect Colon Cancer Test Kit Lice Treatment Shampoo
16 15 16
11
22 Omron
Omron
Desktop Blood Pressure Monitor Replacement Cuff Wrist Blood Pressure Monitor
11
11
Robitussin Robitussin
Cough Syrup Expectorant Guaifenesin Cough Expectorant
12 12
8
12 16 16 10 10
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Robitussin Diabetic Tussin DM Salonpas Pain Relief Patches Senokot- S Senna Plus Stool
Softener Plus Laxative Shower Mat Shower Mat Non-Skid Sominex Sleep Tablets Sudafed PE Sudogest PE
(Nasal amp Sinus Decongestant) Sunbeam Heating Pad 12 in x 15 in Super Poligrip Polident Denture Cream Tek Pro Toothbrush Tek Pro
Straight Soft Therafirm Compression Knee High
Socks Menrsquos Black Medium Therafirm Compression Knee High
Socks Menrsquos Black Large Therafirm Compression Knee High
Socks Menrsquos White Medium Therafirm Compression Knee High
Socks Menrsquos White Large Thermacare Thermacare Knee amp Elbow Thermacare Thermacare Lower
Back amp Hip Thermacare Thermacare Menstrual Relief Thermometer Thermometer
Talking Ear and Forehead Tinactin Tolnaftate Antifungal Cream Toilet Safety Rails Toilet Safety Rails Tucks Pre-moist Hemorrhoid Pads Tums Antacid Chewables Tylenol Acetaminophen Tylenol Multi-Symptom Cold Formula Tylenol Arthritis Arthritis Pain Reliever Tylenol Extra Acetaminophen Strength Tylenol PM Pain Reliever
PM - Extra Strength Vicks Humidifier
Ultra-Sonic Cool Mist Vicks Personal Steam Inhaler
12 Vicks NyQuil All-Nite ColdFlu 22 Visine Artificial Tears Drops 14 Visine Redness Relief Eye Drops
18 22 13
Vitafusion Vitafusion Vitafusion Vitafusion
Biotin Gummy Calcium + Vitamin D Gummy Vitamin B-Complex Gummy Vitamin C Gummy
21 15
Vitafusion
Vitamin A
Vitafusion Fiber WeightManagement Vitamin A
16
23
Vitamin B-Complex Vitamin B-1
Vitamin B-Complex
Vitamin B-1
23 Vitamin B-6 Vitamin B-6 Vitamin B-12 Vitamin B-12
23 Vitamin C Vitamin C
23
22 22
Vitamin D Vitamin E Soft Gels Zantac Zantac
Vitamin D Vitamin E Soft Gels
Ranitidine Acid Reducer Simethicone
22 18 Zyrtec
Anti-Gas Chewables All-Day Allergy Tablets (Cetrizine HCL)
15 19 19 13 21 12 21 21
22
18
13
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
11
11
25
11
11
11
11
11
11
11
11
13
13
9
12
OTC MEDICATIONS AND PRODUCTS Before ordering any of the items below you should talk with your doctor
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Biotin Gummy 1820 Compare to Vitafusion Biotin Gummy Vitamins A registered trademark of Church amp Dwight Co Inc
$1200
Calcium + Vitamin D 1373 Compare to Caltratereg 600 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Calcium + Vitamin D Gummy
1823 Compare to Vitafusion Calcium + Vitamin D Gummy A registered trademark of Church amp Dwight Co Inc
$1400
Calcium Carbonate Tablets
1291 Compare to Caltrate-Dreg 600 + D Calcium Supplement 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$500
Coenzyme Q-10 1829 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
Daily Multiple Vitamin Tablets with Minerals
1385 Compare to Centrumreg 100 tablets per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Ferrous Gluconate (Iron Supplement)
1375 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$600
Ferrous Sulfate 1376 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$500
Fish Oil Tablets 1741 Compare to Naturersquos Bountyreg 1000 mg tablets 60 per bottleA registered trademark of Naturersquos Bounty Inc
$1100
Folic Acid 1850 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Glucosamine Chondroitin
1003 Compare to 21st Century Glucosamine amp Chondroitin Original Formula 250-200 mg capsules 60 per bottle A registered trademark of 21st Century HealthCare Inc
$1100
Iron 1417 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$900
Leg Cramps Pain Relief Caplets
1869 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1400
Magnesium 1418 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Magnesium Oxide 1377 Compare to Nature Madereg Strength 250mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$700
Melatonin 1879 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
10
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Niacin 1378 Compare to Nature Madereg Strength 100mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$500
One Daily Menrsquos Multi-Vitamin
1886 Compare to One A DayA registered trademark of Bayer AG
$1000
One Daily Womenrsquos Multi-Vitamin
1887 Compare to One A DayA registered trademark of Bayer AG
$1000
Senior Multivitamin 1392 Compare to Centrum SilverA registered trademark of Pfizer
$1000
Stress Formula Tablets with Zinc
1734 Compare to Nature Made Stress B Complex with Zinc A registered trademark of Pharmavite
$1400
Vitamin A 1379 Vitamin A 100 tablets per bottle $600 Vitamin B-Complex 1382 Vitamin B Complex 100 tablets per bottle $600 Vitamin B-Complex Gummy
1915 Compare to Vitafusion B-Complex Gummy VitaminsA registered trademark of Church amp Dwight Co Inc
$1200
Vitamin B-1 1016 Vitamin B-1 100 mg tablets 100 per bottle $600 Vitamin B-6 1380 Vitamin B-6 50 mg tablets 100 per bottle $600 Vitamin B-6 1388 Compare to Naturersquos Bounty A registered
trademark of Naturersquos Bounty Inc $800
Vitamin B-12 1381 Vitamin B-12 100 tablets per bottle $1000 Vitamin C 1017 Vitamin C 500 mg 100 tablets per bottle $600 Vitamin C Gummy 1916 Compare to Vitafusion Power C Gummy Vitamins
A registered trademark of Church amp Dwight Co Inc $1200
Vitamin D 1383 Vitamin D 100 tablets per bottle $500 Vitamin D 1390 Compare to Naturersquos Bounty
A registered trademark of Naturersquos Bounty Inc $1000
Vitamin E Soft Gels 1384 Vitamin E 100 tablets per bottle $800 In-Home Diagnostics
Desktop AutomaticBlood Pressure Monitor
1253 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$6000
Desktop Blood PressureMonitor Replacement Cuff
1504 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$1900
Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
1503 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$8000
EZ Detect Colon Cancer Test Kit
1416 Compare to Reveal Colon Disease Testreg A registered trademark of American Screening Corp
$1300
Finger Pulse Oximeter
1505 Compare to HealthSmartregA registered trademark of Briggs Healthcare
$5200
Home Access Cholesterol Test
1251 Compare to CholesTrakreg 1 pieceA registered trademark of AccuTech LLC
$3500
Wrist Blood Pressure Monitor
1501 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$4000
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo)
1502 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$5500
11
OTC MEDICATIONS AND PRODUCTS You can order the following items without having to talk with your doctor but we always recommend that you talk with your doctor before starting a new product regime
Category Product Item Brand EquivalentDescription Cost
Allergy All-Day Allergy TabletsCold Flu (Cetrizine HCL) Decongestant amp Sinus All-Nite ColdFlu
1090
1361
Compare to Zyrtecreg $700 10 mg tablets 14 per box A registered trademark of McNeil-PPC Inc Compare to Vicksreg NyQuilreg Cough $600 A registered trademark of Procter amp Gamble
ChlorpheniramineMaleate (Antihistamine)
1008 Compare to Chlor-Trimetonreg Allergy 4 mg tablets 100 per boxA registered trademark of Schering-Plough HealthCare Products Inc
$500
Cough amp Cold for High Blood Pressure
1166 Compare to Coricidin HBPA registered trademark of Bayer AG
$700
Cough Drops Cherry
1056 Compare to HALLSreg Quantity 30 lozenges A registered trademark of Mondelēz International
$600
Cough Drops Sugar Free Cherry
1182 Compare to Ludens Throat Drops Sugar Free Wild CherryA registered trademark of Prestige Brands
$600
Cough Syrup Expectorant
1054 Compare to Robitussinreg 4 oz per bottleA registered trademark of American Home Products Corporation
$500
Cromolyn Sodium(Allergy Nasal Spray)
1356 Compare to NasalCromreg 26 ml per bottleA registered trademark of McNeil-PPC Inc
$1400
Diabetic Tussin DM 1323 Compare to Robitussin DMA registered trademark of Pfizer
$1100
Diphenhist(Antihistamine)
1308 Compare to Benadrylreg 25 mg tablets 100 per box A registered trademark of Pfizer
$600
Diphenhydramine HCL (Antihistamine)
1009 Compare to Benadrylreg 25 mg 24 per packA registered trademark of Pfizer
$500
Guaifenesin Cough Expectorant
1180 Compare to Robitussinreg 200mg tablets 60 per bottle A registered trademark of American Home Products Corporation
$900
Loratadine (Generic Claritin)
1611 Compare to Claritinreg Allergy Relief 24hr 100 per bottle A registered trademark of Bayer
$2000
Mucus Relief DM Expectorant amp Cough Suppressant
1178 Compare to Mucinex DMA registered trademark of Reckitt Benckiser
$1200
Multi-Symptom Cold Formula
1357 Compare to Tylenolreg Cold Multi-Symptom 24 tablets per box A registered trademark of McNeil PPC Inc
$600
Nasal Decongestant Spray - 12 Hour
1091 Compare to Afrinreg 005 30 ml sprayA registered trademark of Schering-Plough HealthCare Products Inc
$500
12
Category Product Item Brand EquivalentDescription Cost
Allergy Cold Flu Decongestant amp Sinus (continued)
Nasal Spray Saline 1052 Compare to Oceanreg Premium Saline Nasal Spray 065 15 oz spray A registered trademark of Fleming Pharmaceuticals
$500
Personal Steam Inhaler 1792 Compare to Vicks Personal Steam InhalerA registered trademark of Procter amp Gamble
$5000
Sore Throat Lozenges 1360 Compare to Cepacolreg Quantity 16 lozengesA registered trademark of Reckitt Benckiser Group
$700
Sore Throat Lozenges Cherry
1176 Compare to CepacolA registered trademark of Reckitt Benckiser
$700
Sore Throat Spray Cherry 1904 Compare to Chloraseptic Sore Throat Spray - Cherry A registered trademark of Prestige Brands
$900
Sudogest PE (Nasal amp Sinus Decongestant)
1352 Compare to Sudafed PEreg 10mg 36 tablets per box A registered trademark of Johnson amp Johnson
$500
Antacids amp Acid Reducers
Antacid Anti-Gas Liquid 1006 Compare to Maaloxreg Regular Strength 12 oz per bottle A registered trademark of William H Rorer Inc
$600
Antacid Chewables 1346 Compare to Tumsreg 500 mg 150 tablets per bottle A registered trademark of SmithKline Beecham
$600
Effervescent Pain Reliever
1314 Compare to Alka-SeltzerA registered trademark of Bayer AG
$800
Famotidine Acid Reducer
1108 Compare to Pepcidreg 10 mg tablets 30 per box A registered trademark of Merck amp Co Inc
$600
Omeprazole Acid Reducer
1110 Compare to Prilosec OTCreg 20 mg tablets 28 per box A registered trademark of AstraZeneca
$2300
Ranitidine Acid Reducer 1900 Compare to ZantacA registered trademark of Sanofi
$800
Simethicone Anti-Gas Chewables
1800 Compare to ZantacA registered trademark of Sanofi
$1000
Anticandidal (yeast)
Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
1115 Compare to Gyne-Lotriminreg45 gm per tube A registered trademark of Schering-Plough HealthCare Products Inc
$800
Micanozole 3-Day Treatment
1117 Compare to Monistat 3reg 200 mg - 2 1 kitA registered trademark of McNeil-PPC Inc
$1400
Tioconazole 1-Day Treatment Vaginal Cream (with applicator)
1119 Compare to Monistat 1reg 65 1 tubeA registered trademark of McNeil-PPC Inc
$2000
13
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
ATTENTION If you speak English language assistance services free of charge are available to you Call 1-800-668-3813 (TTY 711) 8 am ndash 8 pm Monday ndash Friday and 8 am ndash 6 pm on Saturday ATENCIOacuteN Si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-800-668-3813 注意如果您使用繁體中文您可以 免費獲得語言援助服務 請致電1-800-668-3813 (TTY 711) All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation including Cigna Health and Life Insurance Company Cigna HealthCare of South Carolina Inc Cigna HealthCare of North Carolina Inc Cigna HealthCare of Georgia Inc Cigna HealthCare of Arizona Inc HealthSpring Life amp Health Insurance Company Inc HealthSpring of Tennessee Inc HealthSpring of Alabama Inc HealthSpring of Florida Inc Bravo Health Mid Atlantic Inc and Bravo Health Pennsylvania Inc The Cigna name logos and other Cigna marks are owned by Cigna Intellectual Property Inc The benefit information provided is a brief summary not a complete description of benefits For more information contact the plan Limitations copayments and restrictions may apply Benefits formulary pharmacy network provider network premium andor copaymentscoinsurance may change on January 1 of each year Cigna-HealthSpring complies with applicable Federal civil rights laws and does not discriminate on the basis of race color national origin age disability or sex Cigna-HealthSpring cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza color nacionalidad edad discapacidad o sexo Cigna-HealthSpring is contracted with Medicare for PDP plans HMO and PPO plans in select states and with select State Medicaid programs Enrollment in Cigna-HealthSpring depends on contract renewal copy 2017 Cigna
YOUR OVER-THE-COUNTER (OTC) MEDICATIONS AND PRODUCTS
Choose from the list of covered medications and products in this catalog
Check your Cigna-HealthSpring Evidence of Coverage to see your monthly OTC allowance
2
1
Call to order 1-866-851-1579 (TTY 711) Monday ndash Friday 8 am ndash 9 pm EST
3
Ask us to double-check your mailing address We want to make sure you get your items 4
SAVE MONEY AND TIME You can get over-the-counter items sent right to your door ndash with FREE delivery
3
QAamp Common questions about
Q What can I order
A You can order from the list of covered items in this catalog Covered items may include
OTC medications bull Aspirin bull Acetaminophen bull Vitamins
bull Cold and flu medicine
Health-related products bull Nicotine patches bull Disposable underpads bull Compression socks
bull Nasal strips
Q How much is my quarterly allowance
A The dollar value of your quarterly allowance depends on your plan Check your Cigna-HealthSpring Evidence of Coverage to see your quarterly OTC allowance
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
your OTC benefit
Q When can I spend my quarterly allowance
A Your allowance goes into your account quarterly on January 1 April 1 July 1 and October 1 You can
bull Spend your full quarterly allowance as soon as it is in your account
bull Save up your allowances to order higher priced items later in the year
bull Order once a month up to 12 times a year
Unused balances roll forward each quarter However balances do not carry over to the next year
Q Who can get items through my OTC benefit
A You can order items that help you with a medical need every month you are a Cigna-HealthSpring customer Cigna-HealthSpring prohibits the purchase of OTC items for family members or friends
Q How do I get my order
A The cost of your order must be less than or equal to the account balance for items to ship OTC medications are only available for home delivery Covered items are sent to you free of delivery charge Please allow two weeks for home delivery
4
20
20
20
BRAND EQUIVALENT INDEX Please use the index below for ease in locating available OTC items
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
21st Century Glucosamine Chondroitin 3M Tape Tape Paper Surgical
- 1 in x 10 yd 3M Tape Tape Paper Surgical
- 2 in x 10 yd 3M Tape Tape Silk Surgical
- 1 in x 10 yd 3M Tape Tape Silk Surgical
- 2 in x 10 yd 3M Tape Tape Transparent
Surgical - 1 in x 10 yd 3M Tape Tape Transparent
Surgical - 2 in x 10 yd AampD A amp D Ointment Abreva Abreva Ace Ankle Support Ace Elastic Bandage - 2 in x 45 yd Ace Elastic Bandage - 3 in x 5 yd Ace Elastic Bandage - 4 in x 5 yd Ace Elastic Bandage - 6 in x 5 yd Advil Ibuprofen Afrin Nasal Decongestant
Spray - 12 Hour After Bite Relief After Bite Relief Aleve Naproxen AmLactin Ammonium Lactate Alka-Seltzer Effervescent Pain Reliever Anbesol Oral Pain Relief Antiseptic Towelettes
Antiseptic Towelettes
Arthritis Gloves Arthritis Gloves Small Arthritis Gloves Arthritis Gloves Medium Arthritis Gloves Arthritis Gloves Large Aspercreme Lidocaine Patch Attends Bladder Control Shaped
Pad Moderate Absorbency
10 Attends Bladder Control Shaped Pad18 Heavy Absorbency
Attends Bladder Control Shaped Pad 19 Maximum Absorbency
Attends Disposable Underwear 19 Medium
Attends Disposable Underwear 19 Large
Attends Disposable Underwear 19 X-Large
Attends Underpad Disposable 19 - 23rdquo x 24rdquo
Attends Underpad Disposable 19 - 23rdquo x 36rdquo
Attends Underpad Disposable15 - 30rdquo x 30rdquo 23 Bacitracin Bacitracin Ointment 17 Band-Aid Adhesive Bandages
17 Bath Mat Bath Mat Non-Skid Non-Skid
17 Bausch amp Lomb Eye Wash Solution 18 Bayer Aspirin 21 Bayer Aspirin Low Dose 12 Chewables
Benadryl Diphenhist (Antihistamine) 17 Benadryl Diphenhydramine HCL 22 (Antihistamine)
Benadryl Diphenhydramine HCL Zinc 22 Acetate Anti-itch Cream 13 Bengay Pain Relieving Muscle Rub 15 Benrsquos Insect Repellant Spray (Deet) 17 Biofreeze Fast Freeze Pain Relief Spray
23 Bonine Meclizine HCL Antiemetic
23 Braun Thermometer Digital Ear
23 Breathe Right Nasal Strips Small Medium
22 Breathe Right Nasal Strips Medium Large
20 Caltrate Calcium + Vitamin D Caltrate-D Calcium Carbonate Tablets
17
17
17
16
21
21
12
12
22
5
20
20
20
20
20
14
18 18 21 19 22 22 10 10
24
24
18 19
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Capzasin Capsaicin Carex Bath Tub Safety Rail Carex Cushion Foam Ring Carex Cushion Lumbar Carpal Tunnel Carpal Tunnel Brace Small Brace Carpal Tunnel Carpal Tunnel Brace Medium Brace Carpal Tunnel Carpal Tunnel Brace Large Brace Centrum Daily Multiple Vitamin
Tablets with Minerals Centrum SIlver Senior Multivitamin Cepacol Sore Throat Lozenges Cepacol Sore Throat Lozenges Cherry Chlor-Trimeton Chlorpheniramine Maleate
(Antihistamine) Chloraseptic Sore Throat Spray Cherry CholesTrak Home Access
Cholesterol Test Citrucel Methylcellulose Fiber Therapy Claritin Loratadine (Generic Claritin) Clean and Clear Acne Gel 10
Benzoyl Peroxide Colace Docusate Sodium
Stool Softener Colgate Rechargeable Toothbrush Colgate Toothbrush Colgate
Adult Soft Commit Nicotine Lozenges Compound W Wart Remover (liquid) Conair Water Jet Conair Water Jet Replacement Tips Coppertone Sunscreen Lotion SPF 30 Coricidin HBP Cough amp Cold for High
Blood Pressure Cortaid Hydrocortisone 1 Cream Cotton Balls Cotton Balls Curad Alcohol Pads
21 Curad Rib Belt - Female 17 (one size fits most)
17 17
Curad
Curad
Rib Belt - Male (one size fits most) First Aid Kit
23 DHEA DHEA
23 Depends Attends Discreet Menrsquos Guard Depends Attends Discreet Menrsquos Shield
23 Depends Attends Discreet Womenrsquos Maximum
10 Bladder Control Pad
11 Depends Attends Discreet
Womenrsquos Moderate 13 13
Depends Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
12 Depends Attends Discreet Womenrsquos Ultimate Bladder Control Pad
13 11
Depends Attends Discreet Womenrsquos Ultrathin Pad
Dr Scholls Callus Remover Pads 14 Dr Scholls Corn Remover Pads 12 Dr Scholls Diabetic Sock Black Medium 22 Dr Scholls Diabetic Sock Black Large
14 Dr Scholls Dr Scholls
Diabetic Sock White Medium Diabetic Sock White Large
15 Dramamine Dramamine Chewables 15
Dramamine Orange Driminate Antiemetic
23 Drive Medical Adjustable Transfer Bench 25 Drive Medical Cushion Gel Foam Seat 16 Drive Medical Quad Cane Small Base 16 Drive Medical Quad Cane Large Base 25 12
Dulcolax
Ecotrin
Bisacodyl Enteric Coated Laxative Aspirin Enteric Coated
14 Ecotrin Aspirin Low Dose 17 Efferdent Denture Cleaning Tablets 17 Essential Bath Bench with Back
20
20
20
19
19
16
16
16
16
21
21
17
17
6
20
20
20
20
18 18 14
21 21 15 17
25 19 25
13
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Essential Bath Bench without Back Excedrin Migraine Relief Feosol Ferrous Gluconate
(Iron Supplement) Feosol Ferrous Sulfate Fibercon Polycarbophil Fiber Tablets First Aid Only First Aid Kit 75 pieces Fixodent Fixodent Fleet Glycerin Suppository Fleet Hemorrhoidal Suppository Fruit of the Earth Aloe Vera Cream Futuro Back Support Elastic Futuro Back Support Elastic
with Lumbar Futuro Compression Knee High
Socks Womenrsquos Black Small Futuro Compression Knee
High Socks Womenrsquos Black Medium
Futuro Compression Knee High Socks Womenrsquos Black Large
Futuro Compression Knee High Socks Womenrsquos Nude Small
Futuro Compression Knee High Socks Womenrsquos Nude Medium
Futuro Compression Knee High Socks Womenrsquos Nude Large
Futuro Elbow Support Futuro Knee Support Elastic Small Futuro Knee Suppor t Elastic
Small with Stays Futuro Knee Suppor t
Elastic Medium Futuro Knee Suppor t Elastic
Medium with Stays Futuro Knee Support Elastic Large Futuro Knee Suppor t Elastic
Large with Stays Futuro Night Wrist Support
Smart Glove Futuro Wrist Splint
17 Futuro Wrist Support 22 Gold Bond Medicated Foot Powder 10 Gold Bond Moisturizing Body
Lotion with Aloe 10 14 18
Gyne-Lotrimin Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
15 HALLS Cough Drops Cherry 14 HealthSmart Finger Pulse Oximeter 19 Herpecin-L Herpecin-L Lip Balm 25 23 23
Hip Protector Hip Protector Hip Protector
Hip Protector Small Hip Protector Medium Hip Protector Large
23 Hip Protectorw Hip Protector X-Large
23 Hydrogen Peroxide Hydrogen Peroxide Hylandrsquos Ear Pain Relief Ear Drops
23 Hylandrsquos Leg Cramps Pain
Relief Caplets
23 Imodium A-D Loperamide HCL
Anti-Diarrheal
24 Isopropyl Isopropyl Alcohol
Wintergreen Lactaid Lactase Capsules 14
24 Lamisil AT Terbinafine HCL Antifungal Cream
15
24 24 24
24
24
Lantiseptic Lotrimin AF
Lotrimin AF
Ludens
Maalox
Barrier Cream Clotrimazole Antifungal Athletersquos Foot Cream Medicated Antifungal Foot Powder Spray Cough Drops Sugar Free Cherry Antacid Anti-Gas Liquid
20 14
15
12
13
24 Metamucil Natural Vegetable Laxative 24 Micatin Miconazole Nitrate 2
Antifungal Cream 24 Monistat 1 Tioconazole 1-Day Treatment
Vaginal Cream (with applicator) 25 Monistat 3 Micanozole 3-Day Treatment
12
11
15
24
24
24
24
18
16
10
7
14
18
14 15
13
13
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Murine Murine
Mucinex DM
NasalCrom
Ear Wax Removal Drops Ear Wax Removal System with Rubber Bulb Mucus Relief DM Expectorantamp Cough Suppressant Cromolyn Sodium(Allergy Nasal Spray)
16 16
12
12
Omron
One A Day
One A Day
Orajel
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo) One DailyMenrsquos Multivitamin One Daily Womenrsquos Multivitamin Orajel Pain Relief
11
11
11
15 Nature Made Nature Made Nature Made
Magnesium Oxide Niacin Stress Formula
10 11 11
Oral B Oral-B
Rechargeable Toothbrush Interdental Flossups 15
Tablets with Zinc Pepcid Famotidine Acid Reducer 13 Naturersquos Bounty Coenzyme Q-1 10 Pepsodent Toothpaste - Pepsodent 16 Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty
Folic Acid Iron Magnesium Melatonin
10 10 10 10
Pepto-Bismol Pepto-Bismol Phillipsrsquo
Bismatrol Chewable Tablets Pink Bismuth Milk of Magnesia
14 14 14
Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Neosporin Neosporin
Vitamin B-6 Vitamin D Fish Oil Tablets Neosporin Plus Triple Antibiotic Ointment
11 11 10 18 19
Povidone
Preparation H Prevail Prevail
Povidone Iodine Solution Antiseptic Hemorrhoidal Ointment Adult Briefs Medium Adult Briefs Large
18
19 19 20
Nexcare
Nexcare
Nicoderm
HotCold Pack1 small amp 1 large Thermometer Digital 60 seconds Nicotine Patch Step 1
18
19
23
Prevail Prilosec OTC ProCheck
Purell
Adult Briefs X-Large Omeprazole Acid Reducer Thermometer Flexible Tip Digital 10 seconds Hand Sanitizer
20 13 19
22 Nicoderm Nicoderm Nicorette Nix
Nicotine Patch Step 2 Nicotine Patch Step 3 Nicorelief Gum Permethrin Lice Treatment
23 23 23 22
Q-Tips Quick-Lock Reach
Cotton Tipped Swabs Raised Toilet Seat Reach Waxed Dental Floss Mint
16 18 15
Nova
Ocean Omron
Omron
Folding CaneErgonomic Handle Nasal Spray Saline Desktop Automatic Blood Pressure Monitor Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
18
13 11
11
Refresh PM Releev Renu MultipurposeSolution Reveal
Rid
Artificial Tears Ointment Releev Cold Sore Treatment Multi-Purpose Contact Lens Solution EZ Detect Colon Cancer Test Kit Lice Treatment Shampoo
16 15 16
11
22 Omron
Omron
Desktop Blood Pressure Monitor Replacement Cuff Wrist Blood Pressure Monitor
11
11
Robitussin Robitussin
Cough Syrup Expectorant Guaifenesin Cough Expectorant
12 12
8
12 16 16 10 10
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Robitussin Diabetic Tussin DM Salonpas Pain Relief Patches Senokot- S Senna Plus Stool
Softener Plus Laxative Shower Mat Shower Mat Non-Skid Sominex Sleep Tablets Sudafed PE Sudogest PE
(Nasal amp Sinus Decongestant) Sunbeam Heating Pad 12 in x 15 in Super Poligrip Polident Denture Cream Tek Pro Toothbrush Tek Pro
Straight Soft Therafirm Compression Knee High
Socks Menrsquos Black Medium Therafirm Compression Knee High
Socks Menrsquos Black Large Therafirm Compression Knee High
Socks Menrsquos White Medium Therafirm Compression Knee High
Socks Menrsquos White Large Thermacare Thermacare Knee amp Elbow Thermacare Thermacare Lower
Back amp Hip Thermacare Thermacare Menstrual Relief Thermometer Thermometer
Talking Ear and Forehead Tinactin Tolnaftate Antifungal Cream Toilet Safety Rails Toilet Safety Rails Tucks Pre-moist Hemorrhoid Pads Tums Antacid Chewables Tylenol Acetaminophen Tylenol Multi-Symptom Cold Formula Tylenol Arthritis Arthritis Pain Reliever Tylenol Extra Acetaminophen Strength Tylenol PM Pain Reliever
PM - Extra Strength Vicks Humidifier
Ultra-Sonic Cool Mist Vicks Personal Steam Inhaler
12 Vicks NyQuil All-Nite ColdFlu 22 Visine Artificial Tears Drops 14 Visine Redness Relief Eye Drops
18 22 13
Vitafusion Vitafusion Vitafusion Vitafusion
Biotin Gummy Calcium + Vitamin D Gummy Vitamin B-Complex Gummy Vitamin C Gummy
21 15
Vitafusion
Vitamin A
Vitafusion Fiber WeightManagement Vitamin A
16
23
Vitamin B-Complex Vitamin B-1
Vitamin B-Complex
Vitamin B-1
23 Vitamin B-6 Vitamin B-6 Vitamin B-12 Vitamin B-12
23 Vitamin C Vitamin C
23
22 22
Vitamin D Vitamin E Soft Gels Zantac Zantac
Vitamin D Vitamin E Soft Gels
Ranitidine Acid Reducer Simethicone
22 18 Zyrtec
Anti-Gas Chewables All-Day Allergy Tablets (Cetrizine HCL)
15 19 19 13 21 12 21 21
22
18
13
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
11
11
25
11
11
11
11
11
11
11
11
13
13
9
12
OTC MEDICATIONS AND PRODUCTS Before ordering any of the items below you should talk with your doctor
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Biotin Gummy 1820 Compare to Vitafusion Biotin Gummy Vitamins A registered trademark of Church amp Dwight Co Inc
$1200
Calcium + Vitamin D 1373 Compare to Caltratereg 600 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Calcium + Vitamin D Gummy
1823 Compare to Vitafusion Calcium + Vitamin D Gummy A registered trademark of Church amp Dwight Co Inc
$1400
Calcium Carbonate Tablets
1291 Compare to Caltrate-Dreg 600 + D Calcium Supplement 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$500
Coenzyme Q-10 1829 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
Daily Multiple Vitamin Tablets with Minerals
1385 Compare to Centrumreg 100 tablets per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Ferrous Gluconate (Iron Supplement)
1375 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$600
Ferrous Sulfate 1376 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$500
Fish Oil Tablets 1741 Compare to Naturersquos Bountyreg 1000 mg tablets 60 per bottleA registered trademark of Naturersquos Bounty Inc
$1100
Folic Acid 1850 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Glucosamine Chondroitin
1003 Compare to 21st Century Glucosamine amp Chondroitin Original Formula 250-200 mg capsules 60 per bottle A registered trademark of 21st Century HealthCare Inc
$1100
Iron 1417 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$900
Leg Cramps Pain Relief Caplets
1869 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1400
Magnesium 1418 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Magnesium Oxide 1377 Compare to Nature Madereg Strength 250mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$700
Melatonin 1879 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
10
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Niacin 1378 Compare to Nature Madereg Strength 100mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$500
One Daily Menrsquos Multi-Vitamin
1886 Compare to One A DayA registered trademark of Bayer AG
$1000
One Daily Womenrsquos Multi-Vitamin
1887 Compare to One A DayA registered trademark of Bayer AG
$1000
Senior Multivitamin 1392 Compare to Centrum SilverA registered trademark of Pfizer
$1000
Stress Formula Tablets with Zinc
1734 Compare to Nature Made Stress B Complex with Zinc A registered trademark of Pharmavite
$1400
Vitamin A 1379 Vitamin A 100 tablets per bottle $600 Vitamin B-Complex 1382 Vitamin B Complex 100 tablets per bottle $600 Vitamin B-Complex Gummy
1915 Compare to Vitafusion B-Complex Gummy VitaminsA registered trademark of Church amp Dwight Co Inc
$1200
Vitamin B-1 1016 Vitamin B-1 100 mg tablets 100 per bottle $600 Vitamin B-6 1380 Vitamin B-6 50 mg tablets 100 per bottle $600 Vitamin B-6 1388 Compare to Naturersquos Bounty A registered
trademark of Naturersquos Bounty Inc $800
Vitamin B-12 1381 Vitamin B-12 100 tablets per bottle $1000 Vitamin C 1017 Vitamin C 500 mg 100 tablets per bottle $600 Vitamin C Gummy 1916 Compare to Vitafusion Power C Gummy Vitamins
A registered trademark of Church amp Dwight Co Inc $1200
Vitamin D 1383 Vitamin D 100 tablets per bottle $500 Vitamin D 1390 Compare to Naturersquos Bounty
A registered trademark of Naturersquos Bounty Inc $1000
Vitamin E Soft Gels 1384 Vitamin E 100 tablets per bottle $800 In-Home Diagnostics
Desktop AutomaticBlood Pressure Monitor
1253 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$6000
Desktop Blood PressureMonitor Replacement Cuff
1504 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$1900
Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
1503 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$8000
EZ Detect Colon Cancer Test Kit
1416 Compare to Reveal Colon Disease Testreg A registered trademark of American Screening Corp
$1300
Finger Pulse Oximeter
1505 Compare to HealthSmartregA registered trademark of Briggs Healthcare
$5200
Home Access Cholesterol Test
1251 Compare to CholesTrakreg 1 pieceA registered trademark of AccuTech LLC
$3500
Wrist Blood Pressure Monitor
1501 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$4000
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo)
1502 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$5500
11
OTC MEDICATIONS AND PRODUCTS You can order the following items without having to talk with your doctor but we always recommend that you talk with your doctor before starting a new product regime
Category Product Item Brand EquivalentDescription Cost
Allergy All-Day Allergy TabletsCold Flu (Cetrizine HCL) Decongestant amp Sinus All-Nite ColdFlu
1090
1361
Compare to Zyrtecreg $700 10 mg tablets 14 per box A registered trademark of McNeil-PPC Inc Compare to Vicksreg NyQuilreg Cough $600 A registered trademark of Procter amp Gamble
ChlorpheniramineMaleate (Antihistamine)
1008 Compare to Chlor-Trimetonreg Allergy 4 mg tablets 100 per boxA registered trademark of Schering-Plough HealthCare Products Inc
$500
Cough amp Cold for High Blood Pressure
1166 Compare to Coricidin HBPA registered trademark of Bayer AG
$700
Cough Drops Cherry
1056 Compare to HALLSreg Quantity 30 lozenges A registered trademark of Mondelēz International
$600
Cough Drops Sugar Free Cherry
1182 Compare to Ludens Throat Drops Sugar Free Wild CherryA registered trademark of Prestige Brands
$600
Cough Syrup Expectorant
1054 Compare to Robitussinreg 4 oz per bottleA registered trademark of American Home Products Corporation
$500
Cromolyn Sodium(Allergy Nasal Spray)
1356 Compare to NasalCromreg 26 ml per bottleA registered trademark of McNeil-PPC Inc
$1400
Diabetic Tussin DM 1323 Compare to Robitussin DMA registered trademark of Pfizer
$1100
Diphenhist(Antihistamine)
1308 Compare to Benadrylreg 25 mg tablets 100 per box A registered trademark of Pfizer
$600
Diphenhydramine HCL (Antihistamine)
1009 Compare to Benadrylreg 25 mg 24 per packA registered trademark of Pfizer
$500
Guaifenesin Cough Expectorant
1180 Compare to Robitussinreg 200mg tablets 60 per bottle A registered trademark of American Home Products Corporation
$900
Loratadine (Generic Claritin)
1611 Compare to Claritinreg Allergy Relief 24hr 100 per bottle A registered trademark of Bayer
$2000
Mucus Relief DM Expectorant amp Cough Suppressant
1178 Compare to Mucinex DMA registered trademark of Reckitt Benckiser
$1200
Multi-Symptom Cold Formula
1357 Compare to Tylenolreg Cold Multi-Symptom 24 tablets per box A registered trademark of McNeil PPC Inc
$600
Nasal Decongestant Spray - 12 Hour
1091 Compare to Afrinreg 005 30 ml sprayA registered trademark of Schering-Plough HealthCare Products Inc
$500
12
Category Product Item Brand EquivalentDescription Cost
Allergy Cold Flu Decongestant amp Sinus (continued)
Nasal Spray Saline 1052 Compare to Oceanreg Premium Saline Nasal Spray 065 15 oz spray A registered trademark of Fleming Pharmaceuticals
$500
Personal Steam Inhaler 1792 Compare to Vicks Personal Steam InhalerA registered trademark of Procter amp Gamble
$5000
Sore Throat Lozenges 1360 Compare to Cepacolreg Quantity 16 lozengesA registered trademark of Reckitt Benckiser Group
$700
Sore Throat Lozenges Cherry
1176 Compare to CepacolA registered trademark of Reckitt Benckiser
$700
Sore Throat Spray Cherry 1904 Compare to Chloraseptic Sore Throat Spray - Cherry A registered trademark of Prestige Brands
$900
Sudogest PE (Nasal amp Sinus Decongestant)
1352 Compare to Sudafed PEreg 10mg 36 tablets per box A registered trademark of Johnson amp Johnson
$500
Antacids amp Acid Reducers
Antacid Anti-Gas Liquid 1006 Compare to Maaloxreg Regular Strength 12 oz per bottle A registered trademark of William H Rorer Inc
$600
Antacid Chewables 1346 Compare to Tumsreg 500 mg 150 tablets per bottle A registered trademark of SmithKline Beecham
$600
Effervescent Pain Reliever
1314 Compare to Alka-SeltzerA registered trademark of Bayer AG
$800
Famotidine Acid Reducer
1108 Compare to Pepcidreg 10 mg tablets 30 per box A registered trademark of Merck amp Co Inc
$600
Omeprazole Acid Reducer
1110 Compare to Prilosec OTCreg 20 mg tablets 28 per box A registered trademark of AstraZeneca
$2300
Ranitidine Acid Reducer 1900 Compare to ZantacA registered trademark of Sanofi
$800
Simethicone Anti-Gas Chewables
1800 Compare to ZantacA registered trademark of Sanofi
$1000
Anticandidal (yeast)
Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
1115 Compare to Gyne-Lotriminreg45 gm per tube A registered trademark of Schering-Plough HealthCare Products Inc
$800
Micanozole 3-Day Treatment
1117 Compare to Monistat 3reg 200 mg - 2 1 kitA registered trademark of McNeil-PPC Inc
$1400
Tioconazole 1-Day Treatment Vaginal Cream (with applicator)
1119 Compare to Monistat 1reg 65 1 tubeA registered trademark of McNeil-PPC Inc
$2000
13
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
YOUR OVER-THE-COUNTER (OTC) MEDICATIONS AND PRODUCTS
Choose from the list of covered medications and products in this catalog
Check your Cigna-HealthSpring Evidence of Coverage to see your monthly OTC allowance
2
1
Call to order 1-866-851-1579 (TTY 711) Monday ndash Friday 8 am ndash 9 pm EST
3
Ask us to double-check your mailing address We want to make sure you get your items 4
SAVE MONEY AND TIME You can get over-the-counter items sent right to your door ndash with FREE delivery
3
QAamp Common questions about
Q What can I order
A You can order from the list of covered items in this catalog Covered items may include
OTC medications bull Aspirin bull Acetaminophen bull Vitamins
bull Cold and flu medicine
Health-related products bull Nicotine patches bull Disposable underpads bull Compression socks
bull Nasal strips
Q How much is my quarterly allowance
A The dollar value of your quarterly allowance depends on your plan Check your Cigna-HealthSpring Evidence of Coverage to see your quarterly OTC allowance
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
your OTC benefit
Q When can I spend my quarterly allowance
A Your allowance goes into your account quarterly on January 1 April 1 July 1 and October 1 You can
bull Spend your full quarterly allowance as soon as it is in your account
bull Save up your allowances to order higher priced items later in the year
bull Order once a month up to 12 times a year
Unused balances roll forward each quarter However balances do not carry over to the next year
Q Who can get items through my OTC benefit
A You can order items that help you with a medical need every month you are a Cigna-HealthSpring customer Cigna-HealthSpring prohibits the purchase of OTC items for family members or friends
Q How do I get my order
A The cost of your order must be less than or equal to the account balance for items to ship OTC medications are only available for home delivery Covered items are sent to you free of delivery charge Please allow two weeks for home delivery
4
20
20
20
BRAND EQUIVALENT INDEX Please use the index below for ease in locating available OTC items
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
21st Century Glucosamine Chondroitin 3M Tape Tape Paper Surgical
- 1 in x 10 yd 3M Tape Tape Paper Surgical
- 2 in x 10 yd 3M Tape Tape Silk Surgical
- 1 in x 10 yd 3M Tape Tape Silk Surgical
- 2 in x 10 yd 3M Tape Tape Transparent
Surgical - 1 in x 10 yd 3M Tape Tape Transparent
Surgical - 2 in x 10 yd AampD A amp D Ointment Abreva Abreva Ace Ankle Support Ace Elastic Bandage - 2 in x 45 yd Ace Elastic Bandage - 3 in x 5 yd Ace Elastic Bandage - 4 in x 5 yd Ace Elastic Bandage - 6 in x 5 yd Advil Ibuprofen Afrin Nasal Decongestant
Spray - 12 Hour After Bite Relief After Bite Relief Aleve Naproxen AmLactin Ammonium Lactate Alka-Seltzer Effervescent Pain Reliever Anbesol Oral Pain Relief Antiseptic Towelettes
Antiseptic Towelettes
Arthritis Gloves Arthritis Gloves Small Arthritis Gloves Arthritis Gloves Medium Arthritis Gloves Arthritis Gloves Large Aspercreme Lidocaine Patch Attends Bladder Control Shaped
Pad Moderate Absorbency
10 Attends Bladder Control Shaped Pad18 Heavy Absorbency
Attends Bladder Control Shaped Pad 19 Maximum Absorbency
Attends Disposable Underwear 19 Medium
Attends Disposable Underwear 19 Large
Attends Disposable Underwear 19 X-Large
Attends Underpad Disposable 19 - 23rdquo x 24rdquo
Attends Underpad Disposable 19 - 23rdquo x 36rdquo
Attends Underpad Disposable15 - 30rdquo x 30rdquo 23 Bacitracin Bacitracin Ointment 17 Band-Aid Adhesive Bandages
17 Bath Mat Bath Mat Non-Skid Non-Skid
17 Bausch amp Lomb Eye Wash Solution 18 Bayer Aspirin 21 Bayer Aspirin Low Dose 12 Chewables
Benadryl Diphenhist (Antihistamine) 17 Benadryl Diphenhydramine HCL 22 (Antihistamine)
Benadryl Diphenhydramine HCL Zinc 22 Acetate Anti-itch Cream 13 Bengay Pain Relieving Muscle Rub 15 Benrsquos Insect Repellant Spray (Deet) 17 Biofreeze Fast Freeze Pain Relief Spray
23 Bonine Meclizine HCL Antiemetic
23 Braun Thermometer Digital Ear
23 Breathe Right Nasal Strips Small Medium
22 Breathe Right Nasal Strips Medium Large
20 Caltrate Calcium + Vitamin D Caltrate-D Calcium Carbonate Tablets
17
17
17
16
21
21
12
12
22
5
20
20
20
20
20
14
18 18 21 19 22 22 10 10
24
24
18 19
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Capzasin Capsaicin Carex Bath Tub Safety Rail Carex Cushion Foam Ring Carex Cushion Lumbar Carpal Tunnel Carpal Tunnel Brace Small Brace Carpal Tunnel Carpal Tunnel Brace Medium Brace Carpal Tunnel Carpal Tunnel Brace Large Brace Centrum Daily Multiple Vitamin
Tablets with Minerals Centrum SIlver Senior Multivitamin Cepacol Sore Throat Lozenges Cepacol Sore Throat Lozenges Cherry Chlor-Trimeton Chlorpheniramine Maleate
(Antihistamine) Chloraseptic Sore Throat Spray Cherry CholesTrak Home Access
Cholesterol Test Citrucel Methylcellulose Fiber Therapy Claritin Loratadine (Generic Claritin) Clean and Clear Acne Gel 10
Benzoyl Peroxide Colace Docusate Sodium
Stool Softener Colgate Rechargeable Toothbrush Colgate Toothbrush Colgate
Adult Soft Commit Nicotine Lozenges Compound W Wart Remover (liquid) Conair Water Jet Conair Water Jet Replacement Tips Coppertone Sunscreen Lotion SPF 30 Coricidin HBP Cough amp Cold for High
Blood Pressure Cortaid Hydrocortisone 1 Cream Cotton Balls Cotton Balls Curad Alcohol Pads
21 Curad Rib Belt - Female 17 (one size fits most)
17 17
Curad
Curad
Rib Belt - Male (one size fits most) First Aid Kit
23 DHEA DHEA
23 Depends Attends Discreet Menrsquos Guard Depends Attends Discreet Menrsquos Shield
23 Depends Attends Discreet Womenrsquos Maximum
10 Bladder Control Pad
11 Depends Attends Discreet
Womenrsquos Moderate 13 13
Depends Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
12 Depends Attends Discreet Womenrsquos Ultimate Bladder Control Pad
13 11
Depends Attends Discreet Womenrsquos Ultrathin Pad
Dr Scholls Callus Remover Pads 14 Dr Scholls Corn Remover Pads 12 Dr Scholls Diabetic Sock Black Medium 22 Dr Scholls Diabetic Sock Black Large
14 Dr Scholls Dr Scholls
Diabetic Sock White Medium Diabetic Sock White Large
15 Dramamine Dramamine Chewables 15
Dramamine Orange Driminate Antiemetic
23 Drive Medical Adjustable Transfer Bench 25 Drive Medical Cushion Gel Foam Seat 16 Drive Medical Quad Cane Small Base 16 Drive Medical Quad Cane Large Base 25 12
Dulcolax
Ecotrin
Bisacodyl Enteric Coated Laxative Aspirin Enteric Coated
14 Ecotrin Aspirin Low Dose 17 Efferdent Denture Cleaning Tablets 17 Essential Bath Bench with Back
20
20
20
19
19
16
16
16
16
21
21
17
17
6
20
20
20
20
18 18 14
21 21 15 17
25 19 25
13
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Essential Bath Bench without Back Excedrin Migraine Relief Feosol Ferrous Gluconate
(Iron Supplement) Feosol Ferrous Sulfate Fibercon Polycarbophil Fiber Tablets First Aid Only First Aid Kit 75 pieces Fixodent Fixodent Fleet Glycerin Suppository Fleet Hemorrhoidal Suppository Fruit of the Earth Aloe Vera Cream Futuro Back Support Elastic Futuro Back Support Elastic
with Lumbar Futuro Compression Knee High
Socks Womenrsquos Black Small Futuro Compression Knee
High Socks Womenrsquos Black Medium
Futuro Compression Knee High Socks Womenrsquos Black Large
Futuro Compression Knee High Socks Womenrsquos Nude Small
Futuro Compression Knee High Socks Womenrsquos Nude Medium
Futuro Compression Knee High Socks Womenrsquos Nude Large
Futuro Elbow Support Futuro Knee Support Elastic Small Futuro Knee Suppor t Elastic
Small with Stays Futuro Knee Suppor t
Elastic Medium Futuro Knee Suppor t Elastic
Medium with Stays Futuro Knee Support Elastic Large Futuro Knee Suppor t Elastic
Large with Stays Futuro Night Wrist Support
Smart Glove Futuro Wrist Splint
17 Futuro Wrist Support 22 Gold Bond Medicated Foot Powder 10 Gold Bond Moisturizing Body
Lotion with Aloe 10 14 18
Gyne-Lotrimin Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
15 HALLS Cough Drops Cherry 14 HealthSmart Finger Pulse Oximeter 19 Herpecin-L Herpecin-L Lip Balm 25 23 23
Hip Protector Hip Protector Hip Protector
Hip Protector Small Hip Protector Medium Hip Protector Large
23 Hip Protectorw Hip Protector X-Large
23 Hydrogen Peroxide Hydrogen Peroxide Hylandrsquos Ear Pain Relief Ear Drops
23 Hylandrsquos Leg Cramps Pain
Relief Caplets
23 Imodium A-D Loperamide HCL
Anti-Diarrheal
24 Isopropyl Isopropyl Alcohol
Wintergreen Lactaid Lactase Capsules 14
24 Lamisil AT Terbinafine HCL Antifungal Cream
15
24 24 24
24
24
Lantiseptic Lotrimin AF
Lotrimin AF
Ludens
Maalox
Barrier Cream Clotrimazole Antifungal Athletersquos Foot Cream Medicated Antifungal Foot Powder Spray Cough Drops Sugar Free Cherry Antacid Anti-Gas Liquid
20 14
15
12
13
24 Metamucil Natural Vegetable Laxative 24 Micatin Miconazole Nitrate 2
Antifungal Cream 24 Monistat 1 Tioconazole 1-Day Treatment
Vaginal Cream (with applicator) 25 Monistat 3 Micanozole 3-Day Treatment
12
11
15
24
24
24
24
18
16
10
7
14
18
14 15
13
13
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Murine Murine
Mucinex DM
NasalCrom
Ear Wax Removal Drops Ear Wax Removal System with Rubber Bulb Mucus Relief DM Expectorantamp Cough Suppressant Cromolyn Sodium(Allergy Nasal Spray)
16 16
12
12
Omron
One A Day
One A Day
Orajel
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo) One DailyMenrsquos Multivitamin One Daily Womenrsquos Multivitamin Orajel Pain Relief
11
11
11
15 Nature Made Nature Made Nature Made
Magnesium Oxide Niacin Stress Formula
10 11 11
Oral B Oral-B
Rechargeable Toothbrush Interdental Flossups 15
Tablets with Zinc Pepcid Famotidine Acid Reducer 13 Naturersquos Bounty Coenzyme Q-1 10 Pepsodent Toothpaste - Pepsodent 16 Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty
Folic Acid Iron Magnesium Melatonin
10 10 10 10
Pepto-Bismol Pepto-Bismol Phillipsrsquo
Bismatrol Chewable Tablets Pink Bismuth Milk of Magnesia
14 14 14
Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Neosporin Neosporin
Vitamin B-6 Vitamin D Fish Oil Tablets Neosporin Plus Triple Antibiotic Ointment
11 11 10 18 19
Povidone
Preparation H Prevail Prevail
Povidone Iodine Solution Antiseptic Hemorrhoidal Ointment Adult Briefs Medium Adult Briefs Large
18
19 19 20
Nexcare
Nexcare
Nicoderm
HotCold Pack1 small amp 1 large Thermometer Digital 60 seconds Nicotine Patch Step 1
18
19
23
Prevail Prilosec OTC ProCheck
Purell
Adult Briefs X-Large Omeprazole Acid Reducer Thermometer Flexible Tip Digital 10 seconds Hand Sanitizer
20 13 19
22 Nicoderm Nicoderm Nicorette Nix
Nicotine Patch Step 2 Nicotine Patch Step 3 Nicorelief Gum Permethrin Lice Treatment
23 23 23 22
Q-Tips Quick-Lock Reach
Cotton Tipped Swabs Raised Toilet Seat Reach Waxed Dental Floss Mint
16 18 15
Nova
Ocean Omron
Omron
Folding CaneErgonomic Handle Nasal Spray Saline Desktop Automatic Blood Pressure Monitor Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
18
13 11
11
Refresh PM Releev Renu MultipurposeSolution Reveal
Rid
Artificial Tears Ointment Releev Cold Sore Treatment Multi-Purpose Contact Lens Solution EZ Detect Colon Cancer Test Kit Lice Treatment Shampoo
16 15 16
11
22 Omron
Omron
Desktop Blood Pressure Monitor Replacement Cuff Wrist Blood Pressure Monitor
11
11
Robitussin Robitussin
Cough Syrup Expectorant Guaifenesin Cough Expectorant
12 12
8
12 16 16 10 10
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Robitussin Diabetic Tussin DM Salonpas Pain Relief Patches Senokot- S Senna Plus Stool
Softener Plus Laxative Shower Mat Shower Mat Non-Skid Sominex Sleep Tablets Sudafed PE Sudogest PE
(Nasal amp Sinus Decongestant) Sunbeam Heating Pad 12 in x 15 in Super Poligrip Polident Denture Cream Tek Pro Toothbrush Tek Pro
Straight Soft Therafirm Compression Knee High
Socks Menrsquos Black Medium Therafirm Compression Knee High
Socks Menrsquos Black Large Therafirm Compression Knee High
Socks Menrsquos White Medium Therafirm Compression Knee High
Socks Menrsquos White Large Thermacare Thermacare Knee amp Elbow Thermacare Thermacare Lower
Back amp Hip Thermacare Thermacare Menstrual Relief Thermometer Thermometer
Talking Ear and Forehead Tinactin Tolnaftate Antifungal Cream Toilet Safety Rails Toilet Safety Rails Tucks Pre-moist Hemorrhoid Pads Tums Antacid Chewables Tylenol Acetaminophen Tylenol Multi-Symptom Cold Formula Tylenol Arthritis Arthritis Pain Reliever Tylenol Extra Acetaminophen Strength Tylenol PM Pain Reliever
PM - Extra Strength Vicks Humidifier
Ultra-Sonic Cool Mist Vicks Personal Steam Inhaler
12 Vicks NyQuil All-Nite ColdFlu 22 Visine Artificial Tears Drops 14 Visine Redness Relief Eye Drops
18 22 13
Vitafusion Vitafusion Vitafusion Vitafusion
Biotin Gummy Calcium + Vitamin D Gummy Vitamin B-Complex Gummy Vitamin C Gummy
21 15
Vitafusion
Vitamin A
Vitafusion Fiber WeightManagement Vitamin A
16
23
Vitamin B-Complex Vitamin B-1
Vitamin B-Complex
Vitamin B-1
23 Vitamin B-6 Vitamin B-6 Vitamin B-12 Vitamin B-12
23 Vitamin C Vitamin C
23
22 22
Vitamin D Vitamin E Soft Gels Zantac Zantac
Vitamin D Vitamin E Soft Gels
Ranitidine Acid Reducer Simethicone
22 18 Zyrtec
Anti-Gas Chewables All-Day Allergy Tablets (Cetrizine HCL)
15 19 19 13 21 12 21 21
22
18
13
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
11
11
25
11
11
11
11
11
11
11
11
13
13
9
12
OTC MEDICATIONS AND PRODUCTS Before ordering any of the items below you should talk with your doctor
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Biotin Gummy 1820 Compare to Vitafusion Biotin Gummy Vitamins A registered trademark of Church amp Dwight Co Inc
$1200
Calcium + Vitamin D 1373 Compare to Caltratereg 600 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Calcium + Vitamin D Gummy
1823 Compare to Vitafusion Calcium + Vitamin D Gummy A registered trademark of Church amp Dwight Co Inc
$1400
Calcium Carbonate Tablets
1291 Compare to Caltrate-Dreg 600 + D Calcium Supplement 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$500
Coenzyme Q-10 1829 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
Daily Multiple Vitamin Tablets with Minerals
1385 Compare to Centrumreg 100 tablets per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Ferrous Gluconate (Iron Supplement)
1375 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$600
Ferrous Sulfate 1376 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$500
Fish Oil Tablets 1741 Compare to Naturersquos Bountyreg 1000 mg tablets 60 per bottleA registered trademark of Naturersquos Bounty Inc
$1100
Folic Acid 1850 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Glucosamine Chondroitin
1003 Compare to 21st Century Glucosamine amp Chondroitin Original Formula 250-200 mg capsules 60 per bottle A registered trademark of 21st Century HealthCare Inc
$1100
Iron 1417 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$900
Leg Cramps Pain Relief Caplets
1869 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1400
Magnesium 1418 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Magnesium Oxide 1377 Compare to Nature Madereg Strength 250mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$700
Melatonin 1879 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
10
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Niacin 1378 Compare to Nature Madereg Strength 100mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$500
One Daily Menrsquos Multi-Vitamin
1886 Compare to One A DayA registered trademark of Bayer AG
$1000
One Daily Womenrsquos Multi-Vitamin
1887 Compare to One A DayA registered trademark of Bayer AG
$1000
Senior Multivitamin 1392 Compare to Centrum SilverA registered trademark of Pfizer
$1000
Stress Formula Tablets with Zinc
1734 Compare to Nature Made Stress B Complex with Zinc A registered trademark of Pharmavite
$1400
Vitamin A 1379 Vitamin A 100 tablets per bottle $600 Vitamin B-Complex 1382 Vitamin B Complex 100 tablets per bottle $600 Vitamin B-Complex Gummy
1915 Compare to Vitafusion B-Complex Gummy VitaminsA registered trademark of Church amp Dwight Co Inc
$1200
Vitamin B-1 1016 Vitamin B-1 100 mg tablets 100 per bottle $600 Vitamin B-6 1380 Vitamin B-6 50 mg tablets 100 per bottle $600 Vitamin B-6 1388 Compare to Naturersquos Bounty A registered
trademark of Naturersquos Bounty Inc $800
Vitamin B-12 1381 Vitamin B-12 100 tablets per bottle $1000 Vitamin C 1017 Vitamin C 500 mg 100 tablets per bottle $600 Vitamin C Gummy 1916 Compare to Vitafusion Power C Gummy Vitamins
A registered trademark of Church amp Dwight Co Inc $1200
Vitamin D 1383 Vitamin D 100 tablets per bottle $500 Vitamin D 1390 Compare to Naturersquos Bounty
A registered trademark of Naturersquos Bounty Inc $1000
Vitamin E Soft Gels 1384 Vitamin E 100 tablets per bottle $800 In-Home Diagnostics
Desktop AutomaticBlood Pressure Monitor
1253 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$6000
Desktop Blood PressureMonitor Replacement Cuff
1504 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$1900
Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
1503 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$8000
EZ Detect Colon Cancer Test Kit
1416 Compare to Reveal Colon Disease Testreg A registered trademark of American Screening Corp
$1300
Finger Pulse Oximeter
1505 Compare to HealthSmartregA registered trademark of Briggs Healthcare
$5200
Home Access Cholesterol Test
1251 Compare to CholesTrakreg 1 pieceA registered trademark of AccuTech LLC
$3500
Wrist Blood Pressure Monitor
1501 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$4000
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo)
1502 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$5500
11
OTC MEDICATIONS AND PRODUCTS You can order the following items without having to talk with your doctor but we always recommend that you talk with your doctor before starting a new product regime
Category Product Item Brand EquivalentDescription Cost
Allergy All-Day Allergy TabletsCold Flu (Cetrizine HCL) Decongestant amp Sinus All-Nite ColdFlu
1090
1361
Compare to Zyrtecreg $700 10 mg tablets 14 per box A registered trademark of McNeil-PPC Inc Compare to Vicksreg NyQuilreg Cough $600 A registered trademark of Procter amp Gamble
ChlorpheniramineMaleate (Antihistamine)
1008 Compare to Chlor-Trimetonreg Allergy 4 mg tablets 100 per boxA registered trademark of Schering-Plough HealthCare Products Inc
$500
Cough amp Cold for High Blood Pressure
1166 Compare to Coricidin HBPA registered trademark of Bayer AG
$700
Cough Drops Cherry
1056 Compare to HALLSreg Quantity 30 lozenges A registered trademark of Mondelēz International
$600
Cough Drops Sugar Free Cherry
1182 Compare to Ludens Throat Drops Sugar Free Wild CherryA registered trademark of Prestige Brands
$600
Cough Syrup Expectorant
1054 Compare to Robitussinreg 4 oz per bottleA registered trademark of American Home Products Corporation
$500
Cromolyn Sodium(Allergy Nasal Spray)
1356 Compare to NasalCromreg 26 ml per bottleA registered trademark of McNeil-PPC Inc
$1400
Diabetic Tussin DM 1323 Compare to Robitussin DMA registered trademark of Pfizer
$1100
Diphenhist(Antihistamine)
1308 Compare to Benadrylreg 25 mg tablets 100 per box A registered trademark of Pfizer
$600
Diphenhydramine HCL (Antihistamine)
1009 Compare to Benadrylreg 25 mg 24 per packA registered trademark of Pfizer
$500
Guaifenesin Cough Expectorant
1180 Compare to Robitussinreg 200mg tablets 60 per bottle A registered trademark of American Home Products Corporation
$900
Loratadine (Generic Claritin)
1611 Compare to Claritinreg Allergy Relief 24hr 100 per bottle A registered trademark of Bayer
$2000
Mucus Relief DM Expectorant amp Cough Suppressant
1178 Compare to Mucinex DMA registered trademark of Reckitt Benckiser
$1200
Multi-Symptom Cold Formula
1357 Compare to Tylenolreg Cold Multi-Symptom 24 tablets per box A registered trademark of McNeil PPC Inc
$600
Nasal Decongestant Spray - 12 Hour
1091 Compare to Afrinreg 005 30 ml sprayA registered trademark of Schering-Plough HealthCare Products Inc
$500
12
Category Product Item Brand EquivalentDescription Cost
Allergy Cold Flu Decongestant amp Sinus (continued)
Nasal Spray Saline 1052 Compare to Oceanreg Premium Saline Nasal Spray 065 15 oz spray A registered trademark of Fleming Pharmaceuticals
$500
Personal Steam Inhaler 1792 Compare to Vicks Personal Steam InhalerA registered trademark of Procter amp Gamble
$5000
Sore Throat Lozenges 1360 Compare to Cepacolreg Quantity 16 lozengesA registered trademark of Reckitt Benckiser Group
$700
Sore Throat Lozenges Cherry
1176 Compare to CepacolA registered trademark of Reckitt Benckiser
$700
Sore Throat Spray Cherry 1904 Compare to Chloraseptic Sore Throat Spray - Cherry A registered trademark of Prestige Brands
$900
Sudogest PE (Nasal amp Sinus Decongestant)
1352 Compare to Sudafed PEreg 10mg 36 tablets per box A registered trademark of Johnson amp Johnson
$500
Antacids amp Acid Reducers
Antacid Anti-Gas Liquid 1006 Compare to Maaloxreg Regular Strength 12 oz per bottle A registered trademark of William H Rorer Inc
$600
Antacid Chewables 1346 Compare to Tumsreg 500 mg 150 tablets per bottle A registered trademark of SmithKline Beecham
$600
Effervescent Pain Reliever
1314 Compare to Alka-SeltzerA registered trademark of Bayer AG
$800
Famotidine Acid Reducer
1108 Compare to Pepcidreg 10 mg tablets 30 per box A registered trademark of Merck amp Co Inc
$600
Omeprazole Acid Reducer
1110 Compare to Prilosec OTCreg 20 mg tablets 28 per box A registered trademark of AstraZeneca
$2300
Ranitidine Acid Reducer 1900 Compare to ZantacA registered trademark of Sanofi
$800
Simethicone Anti-Gas Chewables
1800 Compare to ZantacA registered trademark of Sanofi
$1000
Anticandidal (yeast)
Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
1115 Compare to Gyne-Lotriminreg45 gm per tube A registered trademark of Schering-Plough HealthCare Products Inc
$800
Micanozole 3-Day Treatment
1117 Compare to Monistat 3reg 200 mg - 2 1 kitA registered trademark of McNeil-PPC Inc
$1400
Tioconazole 1-Day Treatment Vaginal Cream (with applicator)
1119 Compare to Monistat 1reg 65 1 tubeA registered trademark of McNeil-PPC Inc
$2000
13
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
QAamp Common questions about
Q What can I order
A You can order from the list of covered items in this catalog Covered items may include
OTC medications bull Aspirin bull Acetaminophen bull Vitamins
bull Cold and flu medicine
Health-related products bull Nicotine patches bull Disposable underpads bull Compression socks
bull Nasal strips
Q How much is my quarterly allowance
A The dollar value of your quarterly allowance depends on your plan Check your Cigna-HealthSpring Evidence of Coverage to see your quarterly OTC allowance
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
your OTC benefit
Q When can I spend my quarterly allowance
A Your allowance goes into your account quarterly on January 1 April 1 July 1 and October 1 You can
bull Spend your full quarterly allowance as soon as it is in your account
bull Save up your allowances to order higher priced items later in the year
bull Order once a month up to 12 times a year
Unused balances roll forward each quarter However balances do not carry over to the next year
Q Who can get items through my OTC benefit
A You can order items that help you with a medical need every month you are a Cigna-HealthSpring customer Cigna-HealthSpring prohibits the purchase of OTC items for family members or friends
Q How do I get my order
A The cost of your order must be less than or equal to the account balance for items to ship OTC medications are only available for home delivery Covered items are sent to you free of delivery charge Please allow two weeks for home delivery
4
20
20
20
BRAND EQUIVALENT INDEX Please use the index below for ease in locating available OTC items
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
21st Century Glucosamine Chondroitin 3M Tape Tape Paper Surgical
- 1 in x 10 yd 3M Tape Tape Paper Surgical
- 2 in x 10 yd 3M Tape Tape Silk Surgical
- 1 in x 10 yd 3M Tape Tape Silk Surgical
- 2 in x 10 yd 3M Tape Tape Transparent
Surgical - 1 in x 10 yd 3M Tape Tape Transparent
Surgical - 2 in x 10 yd AampD A amp D Ointment Abreva Abreva Ace Ankle Support Ace Elastic Bandage - 2 in x 45 yd Ace Elastic Bandage - 3 in x 5 yd Ace Elastic Bandage - 4 in x 5 yd Ace Elastic Bandage - 6 in x 5 yd Advil Ibuprofen Afrin Nasal Decongestant
Spray - 12 Hour After Bite Relief After Bite Relief Aleve Naproxen AmLactin Ammonium Lactate Alka-Seltzer Effervescent Pain Reliever Anbesol Oral Pain Relief Antiseptic Towelettes
Antiseptic Towelettes
Arthritis Gloves Arthritis Gloves Small Arthritis Gloves Arthritis Gloves Medium Arthritis Gloves Arthritis Gloves Large Aspercreme Lidocaine Patch Attends Bladder Control Shaped
Pad Moderate Absorbency
10 Attends Bladder Control Shaped Pad18 Heavy Absorbency
Attends Bladder Control Shaped Pad 19 Maximum Absorbency
Attends Disposable Underwear 19 Medium
Attends Disposable Underwear 19 Large
Attends Disposable Underwear 19 X-Large
Attends Underpad Disposable 19 - 23rdquo x 24rdquo
Attends Underpad Disposable 19 - 23rdquo x 36rdquo
Attends Underpad Disposable15 - 30rdquo x 30rdquo 23 Bacitracin Bacitracin Ointment 17 Band-Aid Adhesive Bandages
17 Bath Mat Bath Mat Non-Skid Non-Skid
17 Bausch amp Lomb Eye Wash Solution 18 Bayer Aspirin 21 Bayer Aspirin Low Dose 12 Chewables
Benadryl Diphenhist (Antihistamine) 17 Benadryl Diphenhydramine HCL 22 (Antihistamine)
Benadryl Diphenhydramine HCL Zinc 22 Acetate Anti-itch Cream 13 Bengay Pain Relieving Muscle Rub 15 Benrsquos Insect Repellant Spray (Deet) 17 Biofreeze Fast Freeze Pain Relief Spray
23 Bonine Meclizine HCL Antiemetic
23 Braun Thermometer Digital Ear
23 Breathe Right Nasal Strips Small Medium
22 Breathe Right Nasal Strips Medium Large
20 Caltrate Calcium + Vitamin D Caltrate-D Calcium Carbonate Tablets
17
17
17
16
21
21
12
12
22
5
20
20
20
20
20
14
18 18 21 19 22 22 10 10
24
24
18 19
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Capzasin Capsaicin Carex Bath Tub Safety Rail Carex Cushion Foam Ring Carex Cushion Lumbar Carpal Tunnel Carpal Tunnel Brace Small Brace Carpal Tunnel Carpal Tunnel Brace Medium Brace Carpal Tunnel Carpal Tunnel Brace Large Brace Centrum Daily Multiple Vitamin
Tablets with Minerals Centrum SIlver Senior Multivitamin Cepacol Sore Throat Lozenges Cepacol Sore Throat Lozenges Cherry Chlor-Trimeton Chlorpheniramine Maleate
(Antihistamine) Chloraseptic Sore Throat Spray Cherry CholesTrak Home Access
Cholesterol Test Citrucel Methylcellulose Fiber Therapy Claritin Loratadine (Generic Claritin) Clean and Clear Acne Gel 10
Benzoyl Peroxide Colace Docusate Sodium
Stool Softener Colgate Rechargeable Toothbrush Colgate Toothbrush Colgate
Adult Soft Commit Nicotine Lozenges Compound W Wart Remover (liquid) Conair Water Jet Conair Water Jet Replacement Tips Coppertone Sunscreen Lotion SPF 30 Coricidin HBP Cough amp Cold for High
Blood Pressure Cortaid Hydrocortisone 1 Cream Cotton Balls Cotton Balls Curad Alcohol Pads
21 Curad Rib Belt - Female 17 (one size fits most)
17 17
Curad
Curad
Rib Belt - Male (one size fits most) First Aid Kit
23 DHEA DHEA
23 Depends Attends Discreet Menrsquos Guard Depends Attends Discreet Menrsquos Shield
23 Depends Attends Discreet Womenrsquos Maximum
10 Bladder Control Pad
11 Depends Attends Discreet
Womenrsquos Moderate 13 13
Depends Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
12 Depends Attends Discreet Womenrsquos Ultimate Bladder Control Pad
13 11
Depends Attends Discreet Womenrsquos Ultrathin Pad
Dr Scholls Callus Remover Pads 14 Dr Scholls Corn Remover Pads 12 Dr Scholls Diabetic Sock Black Medium 22 Dr Scholls Diabetic Sock Black Large
14 Dr Scholls Dr Scholls
Diabetic Sock White Medium Diabetic Sock White Large
15 Dramamine Dramamine Chewables 15
Dramamine Orange Driminate Antiemetic
23 Drive Medical Adjustable Transfer Bench 25 Drive Medical Cushion Gel Foam Seat 16 Drive Medical Quad Cane Small Base 16 Drive Medical Quad Cane Large Base 25 12
Dulcolax
Ecotrin
Bisacodyl Enteric Coated Laxative Aspirin Enteric Coated
14 Ecotrin Aspirin Low Dose 17 Efferdent Denture Cleaning Tablets 17 Essential Bath Bench with Back
20
20
20
19
19
16
16
16
16
21
21
17
17
6
20
20
20
20
18 18 14
21 21 15 17
25 19 25
13
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Essential Bath Bench without Back Excedrin Migraine Relief Feosol Ferrous Gluconate
(Iron Supplement) Feosol Ferrous Sulfate Fibercon Polycarbophil Fiber Tablets First Aid Only First Aid Kit 75 pieces Fixodent Fixodent Fleet Glycerin Suppository Fleet Hemorrhoidal Suppository Fruit of the Earth Aloe Vera Cream Futuro Back Support Elastic Futuro Back Support Elastic
with Lumbar Futuro Compression Knee High
Socks Womenrsquos Black Small Futuro Compression Knee
High Socks Womenrsquos Black Medium
Futuro Compression Knee High Socks Womenrsquos Black Large
Futuro Compression Knee High Socks Womenrsquos Nude Small
Futuro Compression Knee High Socks Womenrsquos Nude Medium
Futuro Compression Knee High Socks Womenrsquos Nude Large
Futuro Elbow Support Futuro Knee Support Elastic Small Futuro Knee Suppor t Elastic
Small with Stays Futuro Knee Suppor t
Elastic Medium Futuro Knee Suppor t Elastic
Medium with Stays Futuro Knee Support Elastic Large Futuro Knee Suppor t Elastic
Large with Stays Futuro Night Wrist Support
Smart Glove Futuro Wrist Splint
17 Futuro Wrist Support 22 Gold Bond Medicated Foot Powder 10 Gold Bond Moisturizing Body
Lotion with Aloe 10 14 18
Gyne-Lotrimin Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
15 HALLS Cough Drops Cherry 14 HealthSmart Finger Pulse Oximeter 19 Herpecin-L Herpecin-L Lip Balm 25 23 23
Hip Protector Hip Protector Hip Protector
Hip Protector Small Hip Protector Medium Hip Protector Large
23 Hip Protectorw Hip Protector X-Large
23 Hydrogen Peroxide Hydrogen Peroxide Hylandrsquos Ear Pain Relief Ear Drops
23 Hylandrsquos Leg Cramps Pain
Relief Caplets
23 Imodium A-D Loperamide HCL
Anti-Diarrheal
24 Isopropyl Isopropyl Alcohol
Wintergreen Lactaid Lactase Capsules 14
24 Lamisil AT Terbinafine HCL Antifungal Cream
15
24 24 24
24
24
Lantiseptic Lotrimin AF
Lotrimin AF
Ludens
Maalox
Barrier Cream Clotrimazole Antifungal Athletersquos Foot Cream Medicated Antifungal Foot Powder Spray Cough Drops Sugar Free Cherry Antacid Anti-Gas Liquid
20 14
15
12
13
24 Metamucil Natural Vegetable Laxative 24 Micatin Miconazole Nitrate 2
Antifungal Cream 24 Monistat 1 Tioconazole 1-Day Treatment
Vaginal Cream (with applicator) 25 Monistat 3 Micanozole 3-Day Treatment
12
11
15
24
24
24
24
18
16
10
7
14
18
14 15
13
13
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Murine Murine
Mucinex DM
NasalCrom
Ear Wax Removal Drops Ear Wax Removal System with Rubber Bulb Mucus Relief DM Expectorantamp Cough Suppressant Cromolyn Sodium(Allergy Nasal Spray)
16 16
12
12
Omron
One A Day
One A Day
Orajel
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo) One DailyMenrsquos Multivitamin One Daily Womenrsquos Multivitamin Orajel Pain Relief
11
11
11
15 Nature Made Nature Made Nature Made
Magnesium Oxide Niacin Stress Formula
10 11 11
Oral B Oral-B
Rechargeable Toothbrush Interdental Flossups 15
Tablets with Zinc Pepcid Famotidine Acid Reducer 13 Naturersquos Bounty Coenzyme Q-1 10 Pepsodent Toothpaste - Pepsodent 16 Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty
Folic Acid Iron Magnesium Melatonin
10 10 10 10
Pepto-Bismol Pepto-Bismol Phillipsrsquo
Bismatrol Chewable Tablets Pink Bismuth Milk of Magnesia
14 14 14
Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Neosporin Neosporin
Vitamin B-6 Vitamin D Fish Oil Tablets Neosporin Plus Triple Antibiotic Ointment
11 11 10 18 19
Povidone
Preparation H Prevail Prevail
Povidone Iodine Solution Antiseptic Hemorrhoidal Ointment Adult Briefs Medium Adult Briefs Large
18
19 19 20
Nexcare
Nexcare
Nicoderm
HotCold Pack1 small amp 1 large Thermometer Digital 60 seconds Nicotine Patch Step 1
18
19
23
Prevail Prilosec OTC ProCheck
Purell
Adult Briefs X-Large Omeprazole Acid Reducer Thermometer Flexible Tip Digital 10 seconds Hand Sanitizer
20 13 19
22 Nicoderm Nicoderm Nicorette Nix
Nicotine Patch Step 2 Nicotine Patch Step 3 Nicorelief Gum Permethrin Lice Treatment
23 23 23 22
Q-Tips Quick-Lock Reach
Cotton Tipped Swabs Raised Toilet Seat Reach Waxed Dental Floss Mint
16 18 15
Nova
Ocean Omron
Omron
Folding CaneErgonomic Handle Nasal Spray Saline Desktop Automatic Blood Pressure Monitor Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
18
13 11
11
Refresh PM Releev Renu MultipurposeSolution Reveal
Rid
Artificial Tears Ointment Releev Cold Sore Treatment Multi-Purpose Contact Lens Solution EZ Detect Colon Cancer Test Kit Lice Treatment Shampoo
16 15 16
11
22 Omron
Omron
Desktop Blood Pressure Monitor Replacement Cuff Wrist Blood Pressure Monitor
11
11
Robitussin Robitussin
Cough Syrup Expectorant Guaifenesin Cough Expectorant
12 12
8
12 16 16 10 10
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Robitussin Diabetic Tussin DM Salonpas Pain Relief Patches Senokot- S Senna Plus Stool
Softener Plus Laxative Shower Mat Shower Mat Non-Skid Sominex Sleep Tablets Sudafed PE Sudogest PE
(Nasal amp Sinus Decongestant) Sunbeam Heating Pad 12 in x 15 in Super Poligrip Polident Denture Cream Tek Pro Toothbrush Tek Pro
Straight Soft Therafirm Compression Knee High
Socks Menrsquos Black Medium Therafirm Compression Knee High
Socks Menrsquos Black Large Therafirm Compression Knee High
Socks Menrsquos White Medium Therafirm Compression Knee High
Socks Menrsquos White Large Thermacare Thermacare Knee amp Elbow Thermacare Thermacare Lower
Back amp Hip Thermacare Thermacare Menstrual Relief Thermometer Thermometer
Talking Ear and Forehead Tinactin Tolnaftate Antifungal Cream Toilet Safety Rails Toilet Safety Rails Tucks Pre-moist Hemorrhoid Pads Tums Antacid Chewables Tylenol Acetaminophen Tylenol Multi-Symptom Cold Formula Tylenol Arthritis Arthritis Pain Reliever Tylenol Extra Acetaminophen Strength Tylenol PM Pain Reliever
PM - Extra Strength Vicks Humidifier
Ultra-Sonic Cool Mist Vicks Personal Steam Inhaler
12 Vicks NyQuil All-Nite ColdFlu 22 Visine Artificial Tears Drops 14 Visine Redness Relief Eye Drops
18 22 13
Vitafusion Vitafusion Vitafusion Vitafusion
Biotin Gummy Calcium + Vitamin D Gummy Vitamin B-Complex Gummy Vitamin C Gummy
21 15
Vitafusion
Vitamin A
Vitafusion Fiber WeightManagement Vitamin A
16
23
Vitamin B-Complex Vitamin B-1
Vitamin B-Complex
Vitamin B-1
23 Vitamin B-6 Vitamin B-6 Vitamin B-12 Vitamin B-12
23 Vitamin C Vitamin C
23
22 22
Vitamin D Vitamin E Soft Gels Zantac Zantac
Vitamin D Vitamin E Soft Gels
Ranitidine Acid Reducer Simethicone
22 18 Zyrtec
Anti-Gas Chewables All-Day Allergy Tablets (Cetrizine HCL)
15 19 19 13 21 12 21 21
22
18
13
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
11
11
25
11
11
11
11
11
11
11
11
13
13
9
12
OTC MEDICATIONS AND PRODUCTS Before ordering any of the items below you should talk with your doctor
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Biotin Gummy 1820 Compare to Vitafusion Biotin Gummy Vitamins A registered trademark of Church amp Dwight Co Inc
$1200
Calcium + Vitamin D 1373 Compare to Caltratereg 600 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Calcium + Vitamin D Gummy
1823 Compare to Vitafusion Calcium + Vitamin D Gummy A registered trademark of Church amp Dwight Co Inc
$1400
Calcium Carbonate Tablets
1291 Compare to Caltrate-Dreg 600 + D Calcium Supplement 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$500
Coenzyme Q-10 1829 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
Daily Multiple Vitamin Tablets with Minerals
1385 Compare to Centrumreg 100 tablets per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Ferrous Gluconate (Iron Supplement)
1375 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$600
Ferrous Sulfate 1376 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$500
Fish Oil Tablets 1741 Compare to Naturersquos Bountyreg 1000 mg tablets 60 per bottleA registered trademark of Naturersquos Bounty Inc
$1100
Folic Acid 1850 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Glucosamine Chondroitin
1003 Compare to 21st Century Glucosamine amp Chondroitin Original Formula 250-200 mg capsules 60 per bottle A registered trademark of 21st Century HealthCare Inc
$1100
Iron 1417 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$900
Leg Cramps Pain Relief Caplets
1869 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1400
Magnesium 1418 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Magnesium Oxide 1377 Compare to Nature Madereg Strength 250mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$700
Melatonin 1879 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
10
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Niacin 1378 Compare to Nature Madereg Strength 100mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$500
One Daily Menrsquos Multi-Vitamin
1886 Compare to One A DayA registered trademark of Bayer AG
$1000
One Daily Womenrsquos Multi-Vitamin
1887 Compare to One A DayA registered trademark of Bayer AG
$1000
Senior Multivitamin 1392 Compare to Centrum SilverA registered trademark of Pfizer
$1000
Stress Formula Tablets with Zinc
1734 Compare to Nature Made Stress B Complex with Zinc A registered trademark of Pharmavite
$1400
Vitamin A 1379 Vitamin A 100 tablets per bottle $600 Vitamin B-Complex 1382 Vitamin B Complex 100 tablets per bottle $600 Vitamin B-Complex Gummy
1915 Compare to Vitafusion B-Complex Gummy VitaminsA registered trademark of Church amp Dwight Co Inc
$1200
Vitamin B-1 1016 Vitamin B-1 100 mg tablets 100 per bottle $600 Vitamin B-6 1380 Vitamin B-6 50 mg tablets 100 per bottle $600 Vitamin B-6 1388 Compare to Naturersquos Bounty A registered
trademark of Naturersquos Bounty Inc $800
Vitamin B-12 1381 Vitamin B-12 100 tablets per bottle $1000 Vitamin C 1017 Vitamin C 500 mg 100 tablets per bottle $600 Vitamin C Gummy 1916 Compare to Vitafusion Power C Gummy Vitamins
A registered trademark of Church amp Dwight Co Inc $1200
Vitamin D 1383 Vitamin D 100 tablets per bottle $500 Vitamin D 1390 Compare to Naturersquos Bounty
A registered trademark of Naturersquos Bounty Inc $1000
Vitamin E Soft Gels 1384 Vitamin E 100 tablets per bottle $800 In-Home Diagnostics
Desktop AutomaticBlood Pressure Monitor
1253 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$6000
Desktop Blood PressureMonitor Replacement Cuff
1504 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$1900
Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
1503 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$8000
EZ Detect Colon Cancer Test Kit
1416 Compare to Reveal Colon Disease Testreg A registered trademark of American Screening Corp
$1300
Finger Pulse Oximeter
1505 Compare to HealthSmartregA registered trademark of Briggs Healthcare
$5200
Home Access Cholesterol Test
1251 Compare to CholesTrakreg 1 pieceA registered trademark of AccuTech LLC
$3500
Wrist Blood Pressure Monitor
1501 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$4000
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo)
1502 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$5500
11
OTC MEDICATIONS AND PRODUCTS You can order the following items without having to talk with your doctor but we always recommend that you talk with your doctor before starting a new product regime
Category Product Item Brand EquivalentDescription Cost
Allergy All-Day Allergy TabletsCold Flu (Cetrizine HCL) Decongestant amp Sinus All-Nite ColdFlu
1090
1361
Compare to Zyrtecreg $700 10 mg tablets 14 per box A registered trademark of McNeil-PPC Inc Compare to Vicksreg NyQuilreg Cough $600 A registered trademark of Procter amp Gamble
ChlorpheniramineMaleate (Antihistamine)
1008 Compare to Chlor-Trimetonreg Allergy 4 mg tablets 100 per boxA registered trademark of Schering-Plough HealthCare Products Inc
$500
Cough amp Cold for High Blood Pressure
1166 Compare to Coricidin HBPA registered trademark of Bayer AG
$700
Cough Drops Cherry
1056 Compare to HALLSreg Quantity 30 lozenges A registered trademark of Mondelēz International
$600
Cough Drops Sugar Free Cherry
1182 Compare to Ludens Throat Drops Sugar Free Wild CherryA registered trademark of Prestige Brands
$600
Cough Syrup Expectorant
1054 Compare to Robitussinreg 4 oz per bottleA registered trademark of American Home Products Corporation
$500
Cromolyn Sodium(Allergy Nasal Spray)
1356 Compare to NasalCromreg 26 ml per bottleA registered trademark of McNeil-PPC Inc
$1400
Diabetic Tussin DM 1323 Compare to Robitussin DMA registered trademark of Pfizer
$1100
Diphenhist(Antihistamine)
1308 Compare to Benadrylreg 25 mg tablets 100 per box A registered trademark of Pfizer
$600
Diphenhydramine HCL (Antihistamine)
1009 Compare to Benadrylreg 25 mg 24 per packA registered trademark of Pfizer
$500
Guaifenesin Cough Expectorant
1180 Compare to Robitussinreg 200mg tablets 60 per bottle A registered trademark of American Home Products Corporation
$900
Loratadine (Generic Claritin)
1611 Compare to Claritinreg Allergy Relief 24hr 100 per bottle A registered trademark of Bayer
$2000
Mucus Relief DM Expectorant amp Cough Suppressant
1178 Compare to Mucinex DMA registered trademark of Reckitt Benckiser
$1200
Multi-Symptom Cold Formula
1357 Compare to Tylenolreg Cold Multi-Symptom 24 tablets per box A registered trademark of McNeil PPC Inc
$600
Nasal Decongestant Spray - 12 Hour
1091 Compare to Afrinreg 005 30 ml sprayA registered trademark of Schering-Plough HealthCare Products Inc
$500
12
Category Product Item Brand EquivalentDescription Cost
Allergy Cold Flu Decongestant amp Sinus (continued)
Nasal Spray Saline 1052 Compare to Oceanreg Premium Saline Nasal Spray 065 15 oz spray A registered trademark of Fleming Pharmaceuticals
$500
Personal Steam Inhaler 1792 Compare to Vicks Personal Steam InhalerA registered trademark of Procter amp Gamble
$5000
Sore Throat Lozenges 1360 Compare to Cepacolreg Quantity 16 lozengesA registered trademark of Reckitt Benckiser Group
$700
Sore Throat Lozenges Cherry
1176 Compare to CepacolA registered trademark of Reckitt Benckiser
$700
Sore Throat Spray Cherry 1904 Compare to Chloraseptic Sore Throat Spray - Cherry A registered trademark of Prestige Brands
$900
Sudogest PE (Nasal amp Sinus Decongestant)
1352 Compare to Sudafed PEreg 10mg 36 tablets per box A registered trademark of Johnson amp Johnson
$500
Antacids amp Acid Reducers
Antacid Anti-Gas Liquid 1006 Compare to Maaloxreg Regular Strength 12 oz per bottle A registered trademark of William H Rorer Inc
$600
Antacid Chewables 1346 Compare to Tumsreg 500 mg 150 tablets per bottle A registered trademark of SmithKline Beecham
$600
Effervescent Pain Reliever
1314 Compare to Alka-SeltzerA registered trademark of Bayer AG
$800
Famotidine Acid Reducer
1108 Compare to Pepcidreg 10 mg tablets 30 per box A registered trademark of Merck amp Co Inc
$600
Omeprazole Acid Reducer
1110 Compare to Prilosec OTCreg 20 mg tablets 28 per box A registered trademark of AstraZeneca
$2300
Ranitidine Acid Reducer 1900 Compare to ZantacA registered trademark of Sanofi
$800
Simethicone Anti-Gas Chewables
1800 Compare to ZantacA registered trademark of Sanofi
$1000
Anticandidal (yeast)
Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
1115 Compare to Gyne-Lotriminreg45 gm per tube A registered trademark of Schering-Plough HealthCare Products Inc
$800
Micanozole 3-Day Treatment
1117 Compare to Monistat 3reg 200 mg - 2 1 kitA registered trademark of McNeil-PPC Inc
$1400
Tioconazole 1-Day Treatment Vaginal Cream (with applicator)
1119 Compare to Monistat 1reg 65 1 tubeA registered trademark of McNeil-PPC Inc
$2000
13
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
20
20
20
BRAND EQUIVALENT INDEX Please use the index below for ease in locating available OTC items
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
21st Century Glucosamine Chondroitin 3M Tape Tape Paper Surgical
- 1 in x 10 yd 3M Tape Tape Paper Surgical
- 2 in x 10 yd 3M Tape Tape Silk Surgical
- 1 in x 10 yd 3M Tape Tape Silk Surgical
- 2 in x 10 yd 3M Tape Tape Transparent
Surgical - 1 in x 10 yd 3M Tape Tape Transparent
Surgical - 2 in x 10 yd AampD A amp D Ointment Abreva Abreva Ace Ankle Support Ace Elastic Bandage - 2 in x 45 yd Ace Elastic Bandage - 3 in x 5 yd Ace Elastic Bandage - 4 in x 5 yd Ace Elastic Bandage - 6 in x 5 yd Advil Ibuprofen Afrin Nasal Decongestant
Spray - 12 Hour After Bite Relief After Bite Relief Aleve Naproxen AmLactin Ammonium Lactate Alka-Seltzer Effervescent Pain Reliever Anbesol Oral Pain Relief Antiseptic Towelettes
Antiseptic Towelettes
Arthritis Gloves Arthritis Gloves Small Arthritis Gloves Arthritis Gloves Medium Arthritis Gloves Arthritis Gloves Large Aspercreme Lidocaine Patch Attends Bladder Control Shaped
Pad Moderate Absorbency
10 Attends Bladder Control Shaped Pad18 Heavy Absorbency
Attends Bladder Control Shaped Pad 19 Maximum Absorbency
Attends Disposable Underwear 19 Medium
Attends Disposable Underwear 19 Large
Attends Disposable Underwear 19 X-Large
Attends Underpad Disposable 19 - 23rdquo x 24rdquo
Attends Underpad Disposable 19 - 23rdquo x 36rdquo
Attends Underpad Disposable15 - 30rdquo x 30rdquo 23 Bacitracin Bacitracin Ointment 17 Band-Aid Adhesive Bandages
17 Bath Mat Bath Mat Non-Skid Non-Skid
17 Bausch amp Lomb Eye Wash Solution 18 Bayer Aspirin 21 Bayer Aspirin Low Dose 12 Chewables
Benadryl Diphenhist (Antihistamine) 17 Benadryl Diphenhydramine HCL 22 (Antihistamine)
Benadryl Diphenhydramine HCL Zinc 22 Acetate Anti-itch Cream 13 Bengay Pain Relieving Muscle Rub 15 Benrsquos Insect Repellant Spray (Deet) 17 Biofreeze Fast Freeze Pain Relief Spray
23 Bonine Meclizine HCL Antiemetic
23 Braun Thermometer Digital Ear
23 Breathe Right Nasal Strips Small Medium
22 Breathe Right Nasal Strips Medium Large
20 Caltrate Calcium + Vitamin D Caltrate-D Calcium Carbonate Tablets
17
17
17
16
21
21
12
12
22
5
20
20
20
20
20
14
18 18 21 19 22 22 10 10
24
24
18 19
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Capzasin Capsaicin Carex Bath Tub Safety Rail Carex Cushion Foam Ring Carex Cushion Lumbar Carpal Tunnel Carpal Tunnel Brace Small Brace Carpal Tunnel Carpal Tunnel Brace Medium Brace Carpal Tunnel Carpal Tunnel Brace Large Brace Centrum Daily Multiple Vitamin
Tablets with Minerals Centrum SIlver Senior Multivitamin Cepacol Sore Throat Lozenges Cepacol Sore Throat Lozenges Cherry Chlor-Trimeton Chlorpheniramine Maleate
(Antihistamine) Chloraseptic Sore Throat Spray Cherry CholesTrak Home Access
Cholesterol Test Citrucel Methylcellulose Fiber Therapy Claritin Loratadine (Generic Claritin) Clean and Clear Acne Gel 10
Benzoyl Peroxide Colace Docusate Sodium
Stool Softener Colgate Rechargeable Toothbrush Colgate Toothbrush Colgate
Adult Soft Commit Nicotine Lozenges Compound W Wart Remover (liquid) Conair Water Jet Conair Water Jet Replacement Tips Coppertone Sunscreen Lotion SPF 30 Coricidin HBP Cough amp Cold for High
Blood Pressure Cortaid Hydrocortisone 1 Cream Cotton Balls Cotton Balls Curad Alcohol Pads
21 Curad Rib Belt - Female 17 (one size fits most)
17 17
Curad
Curad
Rib Belt - Male (one size fits most) First Aid Kit
23 DHEA DHEA
23 Depends Attends Discreet Menrsquos Guard Depends Attends Discreet Menrsquos Shield
23 Depends Attends Discreet Womenrsquos Maximum
10 Bladder Control Pad
11 Depends Attends Discreet
Womenrsquos Moderate 13 13
Depends Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
12 Depends Attends Discreet Womenrsquos Ultimate Bladder Control Pad
13 11
Depends Attends Discreet Womenrsquos Ultrathin Pad
Dr Scholls Callus Remover Pads 14 Dr Scholls Corn Remover Pads 12 Dr Scholls Diabetic Sock Black Medium 22 Dr Scholls Diabetic Sock Black Large
14 Dr Scholls Dr Scholls
Diabetic Sock White Medium Diabetic Sock White Large
15 Dramamine Dramamine Chewables 15
Dramamine Orange Driminate Antiemetic
23 Drive Medical Adjustable Transfer Bench 25 Drive Medical Cushion Gel Foam Seat 16 Drive Medical Quad Cane Small Base 16 Drive Medical Quad Cane Large Base 25 12
Dulcolax
Ecotrin
Bisacodyl Enteric Coated Laxative Aspirin Enteric Coated
14 Ecotrin Aspirin Low Dose 17 Efferdent Denture Cleaning Tablets 17 Essential Bath Bench with Back
20
20
20
19
19
16
16
16
16
21
21
17
17
6
20
20
20
20
18 18 14
21 21 15 17
25 19 25
13
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Essential Bath Bench without Back Excedrin Migraine Relief Feosol Ferrous Gluconate
(Iron Supplement) Feosol Ferrous Sulfate Fibercon Polycarbophil Fiber Tablets First Aid Only First Aid Kit 75 pieces Fixodent Fixodent Fleet Glycerin Suppository Fleet Hemorrhoidal Suppository Fruit of the Earth Aloe Vera Cream Futuro Back Support Elastic Futuro Back Support Elastic
with Lumbar Futuro Compression Knee High
Socks Womenrsquos Black Small Futuro Compression Knee
High Socks Womenrsquos Black Medium
Futuro Compression Knee High Socks Womenrsquos Black Large
Futuro Compression Knee High Socks Womenrsquos Nude Small
Futuro Compression Knee High Socks Womenrsquos Nude Medium
Futuro Compression Knee High Socks Womenrsquos Nude Large
Futuro Elbow Support Futuro Knee Support Elastic Small Futuro Knee Suppor t Elastic
Small with Stays Futuro Knee Suppor t
Elastic Medium Futuro Knee Suppor t Elastic
Medium with Stays Futuro Knee Support Elastic Large Futuro Knee Suppor t Elastic
Large with Stays Futuro Night Wrist Support
Smart Glove Futuro Wrist Splint
17 Futuro Wrist Support 22 Gold Bond Medicated Foot Powder 10 Gold Bond Moisturizing Body
Lotion with Aloe 10 14 18
Gyne-Lotrimin Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
15 HALLS Cough Drops Cherry 14 HealthSmart Finger Pulse Oximeter 19 Herpecin-L Herpecin-L Lip Balm 25 23 23
Hip Protector Hip Protector Hip Protector
Hip Protector Small Hip Protector Medium Hip Protector Large
23 Hip Protectorw Hip Protector X-Large
23 Hydrogen Peroxide Hydrogen Peroxide Hylandrsquos Ear Pain Relief Ear Drops
23 Hylandrsquos Leg Cramps Pain
Relief Caplets
23 Imodium A-D Loperamide HCL
Anti-Diarrheal
24 Isopropyl Isopropyl Alcohol
Wintergreen Lactaid Lactase Capsules 14
24 Lamisil AT Terbinafine HCL Antifungal Cream
15
24 24 24
24
24
Lantiseptic Lotrimin AF
Lotrimin AF
Ludens
Maalox
Barrier Cream Clotrimazole Antifungal Athletersquos Foot Cream Medicated Antifungal Foot Powder Spray Cough Drops Sugar Free Cherry Antacid Anti-Gas Liquid
20 14
15
12
13
24 Metamucil Natural Vegetable Laxative 24 Micatin Miconazole Nitrate 2
Antifungal Cream 24 Monistat 1 Tioconazole 1-Day Treatment
Vaginal Cream (with applicator) 25 Monistat 3 Micanozole 3-Day Treatment
12
11
15
24
24
24
24
18
16
10
7
14
18
14 15
13
13
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Murine Murine
Mucinex DM
NasalCrom
Ear Wax Removal Drops Ear Wax Removal System with Rubber Bulb Mucus Relief DM Expectorantamp Cough Suppressant Cromolyn Sodium(Allergy Nasal Spray)
16 16
12
12
Omron
One A Day
One A Day
Orajel
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo) One DailyMenrsquos Multivitamin One Daily Womenrsquos Multivitamin Orajel Pain Relief
11
11
11
15 Nature Made Nature Made Nature Made
Magnesium Oxide Niacin Stress Formula
10 11 11
Oral B Oral-B
Rechargeable Toothbrush Interdental Flossups 15
Tablets with Zinc Pepcid Famotidine Acid Reducer 13 Naturersquos Bounty Coenzyme Q-1 10 Pepsodent Toothpaste - Pepsodent 16 Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty
Folic Acid Iron Magnesium Melatonin
10 10 10 10
Pepto-Bismol Pepto-Bismol Phillipsrsquo
Bismatrol Chewable Tablets Pink Bismuth Milk of Magnesia
14 14 14
Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Neosporin Neosporin
Vitamin B-6 Vitamin D Fish Oil Tablets Neosporin Plus Triple Antibiotic Ointment
11 11 10 18 19
Povidone
Preparation H Prevail Prevail
Povidone Iodine Solution Antiseptic Hemorrhoidal Ointment Adult Briefs Medium Adult Briefs Large
18
19 19 20
Nexcare
Nexcare
Nicoderm
HotCold Pack1 small amp 1 large Thermometer Digital 60 seconds Nicotine Patch Step 1
18
19
23
Prevail Prilosec OTC ProCheck
Purell
Adult Briefs X-Large Omeprazole Acid Reducer Thermometer Flexible Tip Digital 10 seconds Hand Sanitizer
20 13 19
22 Nicoderm Nicoderm Nicorette Nix
Nicotine Patch Step 2 Nicotine Patch Step 3 Nicorelief Gum Permethrin Lice Treatment
23 23 23 22
Q-Tips Quick-Lock Reach
Cotton Tipped Swabs Raised Toilet Seat Reach Waxed Dental Floss Mint
16 18 15
Nova
Ocean Omron
Omron
Folding CaneErgonomic Handle Nasal Spray Saline Desktop Automatic Blood Pressure Monitor Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
18
13 11
11
Refresh PM Releev Renu MultipurposeSolution Reveal
Rid
Artificial Tears Ointment Releev Cold Sore Treatment Multi-Purpose Contact Lens Solution EZ Detect Colon Cancer Test Kit Lice Treatment Shampoo
16 15 16
11
22 Omron
Omron
Desktop Blood Pressure Monitor Replacement Cuff Wrist Blood Pressure Monitor
11
11
Robitussin Robitussin
Cough Syrup Expectorant Guaifenesin Cough Expectorant
12 12
8
12 16 16 10 10
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Robitussin Diabetic Tussin DM Salonpas Pain Relief Patches Senokot- S Senna Plus Stool
Softener Plus Laxative Shower Mat Shower Mat Non-Skid Sominex Sleep Tablets Sudafed PE Sudogest PE
(Nasal amp Sinus Decongestant) Sunbeam Heating Pad 12 in x 15 in Super Poligrip Polident Denture Cream Tek Pro Toothbrush Tek Pro
Straight Soft Therafirm Compression Knee High
Socks Menrsquos Black Medium Therafirm Compression Knee High
Socks Menrsquos Black Large Therafirm Compression Knee High
Socks Menrsquos White Medium Therafirm Compression Knee High
Socks Menrsquos White Large Thermacare Thermacare Knee amp Elbow Thermacare Thermacare Lower
Back amp Hip Thermacare Thermacare Menstrual Relief Thermometer Thermometer
Talking Ear and Forehead Tinactin Tolnaftate Antifungal Cream Toilet Safety Rails Toilet Safety Rails Tucks Pre-moist Hemorrhoid Pads Tums Antacid Chewables Tylenol Acetaminophen Tylenol Multi-Symptom Cold Formula Tylenol Arthritis Arthritis Pain Reliever Tylenol Extra Acetaminophen Strength Tylenol PM Pain Reliever
PM - Extra Strength Vicks Humidifier
Ultra-Sonic Cool Mist Vicks Personal Steam Inhaler
12 Vicks NyQuil All-Nite ColdFlu 22 Visine Artificial Tears Drops 14 Visine Redness Relief Eye Drops
18 22 13
Vitafusion Vitafusion Vitafusion Vitafusion
Biotin Gummy Calcium + Vitamin D Gummy Vitamin B-Complex Gummy Vitamin C Gummy
21 15
Vitafusion
Vitamin A
Vitafusion Fiber WeightManagement Vitamin A
16
23
Vitamin B-Complex Vitamin B-1
Vitamin B-Complex
Vitamin B-1
23 Vitamin B-6 Vitamin B-6 Vitamin B-12 Vitamin B-12
23 Vitamin C Vitamin C
23
22 22
Vitamin D Vitamin E Soft Gels Zantac Zantac
Vitamin D Vitamin E Soft Gels
Ranitidine Acid Reducer Simethicone
22 18 Zyrtec
Anti-Gas Chewables All-Day Allergy Tablets (Cetrizine HCL)
15 19 19 13 21 12 21 21
22
18
13
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
11
11
25
11
11
11
11
11
11
11
11
13
13
9
12
OTC MEDICATIONS AND PRODUCTS Before ordering any of the items below you should talk with your doctor
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Biotin Gummy 1820 Compare to Vitafusion Biotin Gummy Vitamins A registered trademark of Church amp Dwight Co Inc
$1200
Calcium + Vitamin D 1373 Compare to Caltratereg 600 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Calcium + Vitamin D Gummy
1823 Compare to Vitafusion Calcium + Vitamin D Gummy A registered trademark of Church amp Dwight Co Inc
$1400
Calcium Carbonate Tablets
1291 Compare to Caltrate-Dreg 600 + D Calcium Supplement 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$500
Coenzyme Q-10 1829 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
Daily Multiple Vitamin Tablets with Minerals
1385 Compare to Centrumreg 100 tablets per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Ferrous Gluconate (Iron Supplement)
1375 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$600
Ferrous Sulfate 1376 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$500
Fish Oil Tablets 1741 Compare to Naturersquos Bountyreg 1000 mg tablets 60 per bottleA registered trademark of Naturersquos Bounty Inc
$1100
Folic Acid 1850 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Glucosamine Chondroitin
1003 Compare to 21st Century Glucosamine amp Chondroitin Original Formula 250-200 mg capsules 60 per bottle A registered trademark of 21st Century HealthCare Inc
$1100
Iron 1417 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$900
Leg Cramps Pain Relief Caplets
1869 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1400
Magnesium 1418 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Magnesium Oxide 1377 Compare to Nature Madereg Strength 250mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$700
Melatonin 1879 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
10
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Niacin 1378 Compare to Nature Madereg Strength 100mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$500
One Daily Menrsquos Multi-Vitamin
1886 Compare to One A DayA registered trademark of Bayer AG
$1000
One Daily Womenrsquos Multi-Vitamin
1887 Compare to One A DayA registered trademark of Bayer AG
$1000
Senior Multivitamin 1392 Compare to Centrum SilverA registered trademark of Pfizer
$1000
Stress Formula Tablets with Zinc
1734 Compare to Nature Made Stress B Complex with Zinc A registered trademark of Pharmavite
$1400
Vitamin A 1379 Vitamin A 100 tablets per bottle $600 Vitamin B-Complex 1382 Vitamin B Complex 100 tablets per bottle $600 Vitamin B-Complex Gummy
1915 Compare to Vitafusion B-Complex Gummy VitaminsA registered trademark of Church amp Dwight Co Inc
$1200
Vitamin B-1 1016 Vitamin B-1 100 mg tablets 100 per bottle $600 Vitamin B-6 1380 Vitamin B-6 50 mg tablets 100 per bottle $600 Vitamin B-6 1388 Compare to Naturersquos Bounty A registered
trademark of Naturersquos Bounty Inc $800
Vitamin B-12 1381 Vitamin B-12 100 tablets per bottle $1000 Vitamin C 1017 Vitamin C 500 mg 100 tablets per bottle $600 Vitamin C Gummy 1916 Compare to Vitafusion Power C Gummy Vitamins
A registered trademark of Church amp Dwight Co Inc $1200
Vitamin D 1383 Vitamin D 100 tablets per bottle $500 Vitamin D 1390 Compare to Naturersquos Bounty
A registered trademark of Naturersquos Bounty Inc $1000
Vitamin E Soft Gels 1384 Vitamin E 100 tablets per bottle $800 In-Home Diagnostics
Desktop AutomaticBlood Pressure Monitor
1253 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$6000
Desktop Blood PressureMonitor Replacement Cuff
1504 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$1900
Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
1503 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$8000
EZ Detect Colon Cancer Test Kit
1416 Compare to Reveal Colon Disease Testreg A registered trademark of American Screening Corp
$1300
Finger Pulse Oximeter
1505 Compare to HealthSmartregA registered trademark of Briggs Healthcare
$5200
Home Access Cholesterol Test
1251 Compare to CholesTrakreg 1 pieceA registered trademark of AccuTech LLC
$3500
Wrist Blood Pressure Monitor
1501 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$4000
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo)
1502 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$5500
11
OTC MEDICATIONS AND PRODUCTS You can order the following items without having to talk with your doctor but we always recommend that you talk with your doctor before starting a new product regime
Category Product Item Brand EquivalentDescription Cost
Allergy All-Day Allergy TabletsCold Flu (Cetrizine HCL) Decongestant amp Sinus All-Nite ColdFlu
1090
1361
Compare to Zyrtecreg $700 10 mg tablets 14 per box A registered trademark of McNeil-PPC Inc Compare to Vicksreg NyQuilreg Cough $600 A registered trademark of Procter amp Gamble
ChlorpheniramineMaleate (Antihistamine)
1008 Compare to Chlor-Trimetonreg Allergy 4 mg tablets 100 per boxA registered trademark of Schering-Plough HealthCare Products Inc
$500
Cough amp Cold for High Blood Pressure
1166 Compare to Coricidin HBPA registered trademark of Bayer AG
$700
Cough Drops Cherry
1056 Compare to HALLSreg Quantity 30 lozenges A registered trademark of Mondelēz International
$600
Cough Drops Sugar Free Cherry
1182 Compare to Ludens Throat Drops Sugar Free Wild CherryA registered trademark of Prestige Brands
$600
Cough Syrup Expectorant
1054 Compare to Robitussinreg 4 oz per bottleA registered trademark of American Home Products Corporation
$500
Cromolyn Sodium(Allergy Nasal Spray)
1356 Compare to NasalCromreg 26 ml per bottleA registered trademark of McNeil-PPC Inc
$1400
Diabetic Tussin DM 1323 Compare to Robitussin DMA registered trademark of Pfizer
$1100
Diphenhist(Antihistamine)
1308 Compare to Benadrylreg 25 mg tablets 100 per box A registered trademark of Pfizer
$600
Diphenhydramine HCL (Antihistamine)
1009 Compare to Benadrylreg 25 mg 24 per packA registered trademark of Pfizer
$500
Guaifenesin Cough Expectorant
1180 Compare to Robitussinreg 200mg tablets 60 per bottle A registered trademark of American Home Products Corporation
$900
Loratadine (Generic Claritin)
1611 Compare to Claritinreg Allergy Relief 24hr 100 per bottle A registered trademark of Bayer
$2000
Mucus Relief DM Expectorant amp Cough Suppressant
1178 Compare to Mucinex DMA registered trademark of Reckitt Benckiser
$1200
Multi-Symptom Cold Formula
1357 Compare to Tylenolreg Cold Multi-Symptom 24 tablets per box A registered trademark of McNeil PPC Inc
$600
Nasal Decongestant Spray - 12 Hour
1091 Compare to Afrinreg 005 30 ml sprayA registered trademark of Schering-Plough HealthCare Products Inc
$500
12
Category Product Item Brand EquivalentDescription Cost
Allergy Cold Flu Decongestant amp Sinus (continued)
Nasal Spray Saline 1052 Compare to Oceanreg Premium Saline Nasal Spray 065 15 oz spray A registered trademark of Fleming Pharmaceuticals
$500
Personal Steam Inhaler 1792 Compare to Vicks Personal Steam InhalerA registered trademark of Procter amp Gamble
$5000
Sore Throat Lozenges 1360 Compare to Cepacolreg Quantity 16 lozengesA registered trademark of Reckitt Benckiser Group
$700
Sore Throat Lozenges Cherry
1176 Compare to CepacolA registered trademark of Reckitt Benckiser
$700
Sore Throat Spray Cherry 1904 Compare to Chloraseptic Sore Throat Spray - Cherry A registered trademark of Prestige Brands
$900
Sudogest PE (Nasal amp Sinus Decongestant)
1352 Compare to Sudafed PEreg 10mg 36 tablets per box A registered trademark of Johnson amp Johnson
$500
Antacids amp Acid Reducers
Antacid Anti-Gas Liquid 1006 Compare to Maaloxreg Regular Strength 12 oz per bottle A registered trademark of William H Rorer Inc
$600
Antacid Chewables 1346 Compare to Tumsreg 500 mg 150 tablets per bottle A registered trademark of SmithKline Beecham
$600
Effervescent Pain Reliever
1314 Compare to Alka-SeltzerA registered trademark of Bayer AG
$800
Famotidine Acid Reducer
1108 Compare to Pepcidreg 10 mg tablets 30 per box A registered trademark of Merck amp Co Inc
$600
Omeprazole Acid Reducer
1110 Compare to Prilosec OTCreg 20 mg tablets 28 per box A registered trademark of AstraZeneca
$2300
Ranitidine Acid Reducer 1900 Compare to ZantacA registered trademark of Sanofi
$800
Simethicone Anti-Gas Chewables
1800 Compare to ZantacA registered trademark of Sanofi
$1000
Anticandidal (yeast)
Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
1115 Compare to Gyne-Lotriminreg45 gm per tube A registered trademark of Schering-Plough HealthCare Products Inc
$800
Micanozole 3-Day Treatment
1117 Compare to Monistat 3reg 200 mg - 2 1 kitA registered trademark of McNeil-PPC Inc
$1400
Tioconazole 1-Day Treatment Vaginal Cream (with applicator)
1119 Compare to Monistat 1reg 65 1 tubeA registered trademark of McNeil-PPC Inc
$2000
13
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
24
24
18 19
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Capzasin Capsaicin Carex Bath Tub Safety Rail Carex Cushion Foam Ring Carex Cushion Lumbar Carpal Tunnel Carpal Tunnel Brace Small Brace Carpal Tunnel Carpal Tunnel Brace Medium Brace Carpal Tunnel Carpal Tunnel Brace Large Brace Centrum Daily Multiple Vitamin
Tablets with Minerals Centrum SIlver Senior Multivitamin Cepacol Sore Throat Lozenges Cepacol Sore Throat Lozenges Cherry Chlor-Trimeton Chlorpheniramine Maleate
(Antihistamine) Chloraseptic Sore Throat Spray Cherry CholesTrak Home Access
Cholesterol Test Citrucel Methylcellulose Fiber Therapy Claritin Loratadine (Generic Claritin) Clean and Clear Acne Gel 10
Benzoyl Peroxide Colace Docusate Sodium
Stool Softener Colgate Rechargeable Toothbrush Colgate Toothbrush Colgate
Adult Soft Commit Nicotine Lozenges Compound W Wart Remover (liquid) Conair Water Jet Conair Water Jet Replacement Tips Coppertone Sunscreen Lotion SPF 30 Coricidin HBP Cough amp Cold for High
Blood Pressure Cortaid Hydrocortisone 1 Cream Cotton Balls Cotton Balls Curad Alcohol Pads
21 Curad Rib Belt - Female 17 (one size fits most)
17 17
Curad
Curad
Rib Belt - Male (one size fits most) First Aid Kit
23 DHEA DHEA
23 Depends Attends Discreet Menrsquos Guard Depends Attends Discreet Menrsquos Shield
23 Depends Attends Discreet Womenrsquos Maximum
10 Bladder Control Pad
11 Depends Attends Discreet
Womenrsquos Moderate 13 13
Depends Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
12 Depends Attends Discreet Womenrsquos Ultimate Bladder Control Pad
13 11
Depends Attends Discreet Womenrsquos Ultrathin Pad
Dr Scholls Callus Remover Pads 14 Dr Scholls Corn Remover Pads 12 Dr Scholls Diabetic Sock Black Medium 22 Dr Scholls Diabetic Sock Black Large
14 Dr Scholls Dr Scholls
Diabetic Sock White Medium Diabetic Sock White Large
15 Dramamine Dramamine Chewables 15
Dramamine Orange Driminate Antiemetic
23 Drive Medical Adjustable Transfer Bench 25 Drive Medical Cushion Gel Foam Seat 16 Drive Medical Quad Cane Small Base 16 Drive Medical Quad Cane Large Base 25 12
Dulcolax
Ecotrin
Bisacodyl Enteric Coated Laxative Aspirin Enteric Coated
14 Ecotrin Aspirin Low Dose 17 Efferdent Denture Cleaning Tablets 17 Essential Bath Bench with Back
20
20
20
19
19
16
16
16
16
21
21
17
17
6
20
20
20
20
18 18 14
21 21 15 17
25 19 25
13
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Essential Bath Bench without Back Excedrin Migraine Relief Feosol Ferrous Gluconate
(Iron Supplement) Feosol Ferrous Sulfate Fibercon Polycarbophil Fiber Tablets First Aid Only First Aid Kit 75 pieces Fixodent Fixodent Fleet Glycerin Suppository Fleet Hemorrhoidal Suppository Fruit of the Earth Aloe Vera Cream Futuro Back Support Elastic Futuro Back Support Elastic
with Lumbar Futuro Compression Knee High
Socks Womenrsquos Black Small Futuro Compression Knee
High Socks Womenrsquos Black Medium
Futuro Compression Knee High Socks Womenrsquos Black Large
Futuro Compression Knee High Socks Womenrsquos Nude Small
Futuro Compression Knee High Socks Womenrsquos Nude Medium
Futuro Compression Knee High Socks Womenrsquos Nude Large
Futuro Elbow Support Futuro Knee Support Elastic Small Futuro Knee Suppor t Elastic
Small with Stays Futuro Knee Suppor t
Elastic Medium Futuro Knee Suppor t Elastic
Medium with Stays Futuro Knee Support Elastic Large Futuro Knee Suppor t Elastic
Large with Stays Futuro Night Wrist Support
Smart Glove Futuro Wrist Splint
17 Futuro Wrist Support 22 Gold Bond Medicated Foot Powder 10 Gold Bond Moisturizing Body
Lotion with Aloe 10 14 18
Gyne-Lotrimin Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
15 HALLS Cough Drops Cherry 14 HealthSmart Finger Pulse Oximeter 19 Herpecin-L Herpecin-L Lip Balm 25 23 23
Hip Protector Hip Protector Hip Protector
Hip Protector Small Hip Protector Medium Hip Protector Large
23 Hip Protectorw Hip Protector X-Large
23 Hydrogen Peroxide Hydrogen Peroxide Hylandrsquos Ear Pain Relief Ear Drops
23 Hylandrsquos Leg Cramps Pain
Relief Caplets
23 Imodium A-D Loperamide HCL
Anti-Diarrheal
24 Isopropyl Isopropyl Alcohol
Wintergreen Lactaid Lactase Capsules 14
24 Lamisil AT Terbinafine HCL Antifungal Cream
15
24 24 24
24
24
Lantiseptic Lotrimin AF
Lotrimin AF
Ludens
Maalox
Barrier Cream Clotrimazole Antifungal Athletersquos Foot Cream Medicated Antifungal Foot Powder Spray Cough Drops Sugar Free Cherry Antacid Anti-Gas Liquid
20 14
15
12
13
24 Metamucil Natural Vegetable Laxative 24 Micatin Miconazole Nitrate 2
Antifungal Cream 24 Monistat 1 Tioconazole 1-Day Treatment
Vaginal Cream (with applicator) 25 Monistat 3 Micanozole 3-Day Treatment
12
11
15
24
24
24
24
18
16
10
7
14
18
14 15
13
13
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Murine Murine
Mucinex DM
NasalCrom
Ear Wax Removal Drops Ear Wax Removal System with Rubber Bulb Mucus Relief DM Expectorantamp Cough Suppressant Cromolyn Sodium(Allergy Nasal Spray)
16 16
12
12
Omron
One A Day
One A Day
Orajel
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo) One DailyMenrsquos Multivitamin One Daily Womenrsquos Multivitamin Orajel Pain Relief
11
11
11
15 Nature Made Nature Made Nature Made
Magnesium Oxide Niacin Stress Formula
10 11 11
Oral B Oral-B
Rechargeable Toothbrush Interdental Flossups 15
Tablets with Zinc Pepcid Famotidine Acid Reducer 13 Naturersquos Bounty Coenzyme Q-1 10 Pepsodent Toothpaste - Pepsodent 16 Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty
Folic Acid Iron Magnesium Melatonin
10 10 10 10
Pepto-Bismol Pepto-Bismol Phillipsrsquo
Bismatrol Chewable Tablets Pink Bismuth Milk of Magnesia
14 14 14
Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Neosporin Neosporin
Vitamin B-6 Vitamin D Fish Oil Tablets Neosporin Plus Triple Antibiotic Ointment
11 11 10 18 19
Povidone
Preparation H Prevail Prevail
Povidone Iodine Solution Antiseptic Hemorrhoidal Ointment Adult Briefs Medium Adult Briefs Large
18
19 19 20
Nexcare
Nexcare
Nicoderm
HotCold Pack1 small amp 1 large Thermometer Digital 60 seconds Nicotine Patch Step 1
18
19
23
Prevail Prilosec OTC ProCheck
Purell
Adult Briefs X-Large Omeprazole Acid Reducer Thermometer Flexible Tip Digital 10 seconds Hand Sanitizer
20 13 19
22 Nicoderm Nicoderm Nicorette Nix
Nicotine Patch Step 2 Nicotine Patch Step 3 Nicorelief Gum Permethrin Lice Treatment
23 23 23 22
Q-Tips Quick-Lock Reach
Cotton Tipped Swabs Raised Toilet Seat Reach Waxed Dental Floss Mint
16 18 15
Nova
Ocean Omron
Omron
Folding CaneErgonomic Handle Nasal Spray Saline Desktop Automatic Blood Pressure Monitor Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
18
13 11
11
Refresh PM Releev Renu MultipurposeSolution Reveal
Rid
Artificial Tears Ointment Releev Cold Sore Treatment Multi-Purpose Contact Lens Solution EZ Detect Colon Cancer Test Kit Lice Treatment Shampoo
16 15 16
11
22 Omron
Omron
Desktop Blood Pressure Monitor Replacement Cuff Wrist Blood Pressure Monitor
11
11
Robitussin Robitussin
Cough Syrup Expectorant Guaifenesin Cough Expectorant
12 12
8
12 16 16 10 10
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Robitussin Diabetic Tussin DM Salonpas Pain Relief Patches Senokot- S Senna Plus Stool
Softener Plus Laxative Shower Mat Shower Mat Non-Skid Sominex Sleep Tablets Sudafed PE Sudogest PE
(Nasal amp Sinus Decongestant) Sunbeam Heating Pad 12 in x 15 in Super Poligrip Polident Denture Cream Tek Pro Toothbrush Tek Pro
Straight Soft Therafirm Compression Knee High
Socks Menrsquos Black Medium Therafirm Compression Knee High
Socks Menrsquos Black Large Therafirm Compression Knee High
Socks Menrsquos White Medium Therafirm Compression Knee High
Socks Menrsquos White Large Thermacare Thermacare Knee amp Elbow Thermacare Thermacare Lower
Back amp Hip Thermacare Thermacare Menstrual Relief Thermometer Thermometer
Talking Ear and Forehead Tinactin Tolnaftate Antifungal Cream Toilet Safety Rails Toilet Safety Rails Tucks Pre-moist Hemorrhoid Pads Tums Antacid Chewables Tylenol Acetaminophen Tylenol Multi-Symptom Cold Formula Tylenol Arthritis Arthritis Pain Reliever Tylenol Extra Acetaminophen Strength Tylenol PM Pain Reliever
PM - Extra Strength Vicks Humidifier
Ultra-Sonic Cool Mist Vicks Personal Steam Inhaler
12 Vicks NyQuil All-Nite ColdFlu 22 Visine Artificial Tears Drops 14 Visine Redness Relief Eye Drops
18 22 13
Vitafusion Vitafusion Vitafusion Vitafusion
Biotin Gummy Calcium + Vitamin D Gummy Vitamin B-Complex Gummy Vitamin C Gummy
21 15
Vitafusion
Vitamin A
Vitafusion Fiber WeightManagement Vitamin A
16
23
Vitamin B-Complex Vitamin B-1
Vitamin B-Complex
Vitamin B-1
23 Vitamin B-6 Vitamin B-6 Vitamin B-12 Vitamin B-12
23 Vitamin C Vitamin C
23
22 22
Vitamin D Vitamin E Soft Gels Zantac Zantac
Vitamin D Vitamin E Soft Gels
Ranitidine Acid Reducer Simethicone
22 18 Zyrtec
Anti-Gas Chewables All-Day Allergy Tablets (Cetrizine HCL)
15 19 19 13 21 12 21 21
22
18
13
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
11
11
25
11
11
11
11
11
11
11
11
13
13
9
12
OTC MEDICATIONS AND PRODUCTS Before ordering any of the items below you should talk with your doctor
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Biotin Gummy 1820 Compare to Vitafusion Biotin Gummy Vitamins A registered trademark of Church amp Dwight Co Inc
$1200
Calcium + Vitamin D 1373 Compare to Caltratereg 600 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Calcium + Vitamin D Gummy
1823 Compare to Vitafusion Calcium + Vitamin D Gummy A registered trademark of Church amp Dwight Co Inc
$1400
Calcium Carbonate Tablets
1291 Compare to Caltrate-Dreg 600 + D Calcium Supplement 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$500
Coenzyme Q-10 1829 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
Daily Multiple Vitamin Tablets with Minerals
1385 Compare to Centrumreg 100 tablets per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Ferrous Gluconate (Iron Supplement)
1375 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$600
Ferrous Sulfate 1376 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$500
Fish Oil Tablets 1741 Compare to Naturersquos Bountyreg 1000 mg tablets 60 per bottleA registered trademark of Naturersquos Bounty Inc
$1100
Folic Acid 1850 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Glucosamine Chondroitin
1003 Compare to 21st Century Glucosamine amp Chondroitin Original Formula 250-200 mg capsules 60 per bottle A registered trademark of 21st Century HealthCare Inc
$1100
Iron 1417 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$900
Leg Cramps Pain Relief Caplets
1869 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1400
Magnesium 1418 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Magnesium Oxide 1377 Compare to Nature Madereg Strength 250mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$700
Melatonin 1879 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
10
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Niacin 1378 Compare to Nature Madereg Strength 100mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$500
One Daily Menrsquos Multi-Vitamin
1886 Compare to One A DayA registered trademark of Bayer AG
$1000
One Daily Womenrsquos Multi-Vitamin
1887 Compare to One A DayA registered trademark of Bayer AG
$1000
Senior Multivitamin 1392 Compare to Centrum SilverA registered trademark of Pfizer
$1000
Stress Formula Tablets with Zinc
1734 Compare to Nature Made Stress B Complex with Zinc A registered trademark of Pharmavite
$1400
Vitamin A 1379 Vitamin A 100 tablets per bottle $600 Vitamin B-Complex 1382 Vitamin B Complex 100 tablets per bottle $600 Vitamin B-Complex Gummy
1915 Compare to Vitafusion B-Complex Gummy VitaminsA registered trademark of Church amp Dwight Co Inc
$1200
Vitamin B-1 1016 Vitamin B-1 100 mg tablets 100 per bottle $600 Vitamin B-6 1380 Vitamin B-6 50 mg tablets 100 per bottle $600 Vitamin B-6 1388 Compare to Naturersquos Bounty A registered
trademark of Naturersquos Bounty Inc $800
Vitamin B-12 1381 Vitamin B-12 100 tablets per bottle $1000 Vitamin C 1017 Vitamin C 500 mg 100 tablets per bottle $600 Vitamin C Gummy 1916 Compare to Vitafusion Power C Gummy Vitamins
A registered trademark of Church amp Dwight Co Inc $1200
Vitamin D 1383 Vitamin D 100 tablets per bottle $500 Vitamin D 1390 Compare to Naturersquos Bounty
A registered trademark of Naturersquos Bounty Inc $1000
Vitamin E Soft Gels 1384 Vitamin E 100 tablets per bottle $800 In-Home Diagnostics
Desktop AutomaticBlood Pressure Monitor
1253 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$6000
Desktop Blood PressureMonitor Replacement Cuff
1504 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$1900
Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
1503 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$8000
EZ Detect Colon Cancer Test Kit
1416 Compare to Reveal Colon Disease Testreg A registered trademark of American Screening Corp
$1300
Finger Pulse Oximeter
1505 Compare to HealthSmartregA registered trademark of Briggs Healthcare
$5200
Home Access Cholesterol Test
1251 Compare to CholesTrakreg 1 pieceA registered trademark of AccuTech LLC
$3500
Wrist Blood Pressure Monitor
1501 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$4000
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo)
1502 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$5500
11
OTC MEDICATIONS AND PRODUCTS You can order the following items without having to talk with your doctor but we always recommend that you talk with your doctor before starting a new product regime
Category Product Item Brand EquivalentDescription Cost
Allergy All-Day Allergy TabletsCold Flu (Cetrizine HCL) Decongestant amp Sinus All-Nite ColdFlu
1090
1361
Compare to Zyrtecreg $700 10 mg tablets 14 per box A registered trademark of McNeil-PPC Inc Compare to Vicksreg NyQuilreg Cough $600 A registered trademark of Procter amp Gamble
ChlorpheniramineMaleate (Antihistamine)
1008 Compare to Chlor-Trimetonreg Allergy 4 mg tablets 100 per boxA registered trademark of Schering-Plough HealthCare Products Inc
$500
Cough amp Cold for High Blood Pressure
1166 Compare to Coricidin HBPA registered trademark of Bayer AG
$700
Cough Drops Cherry
1056 Compare to HALLSreg Quantity 30 lozenges A registered trademark of Mondelēz International
$600
Cough Drops Sugar Free Cherry
1182 Compare to Ludens Throat Drops Sugar Free Wild CherryA registered trademark of Prestige Brands
$600
Cough Syrup Expectorant
1054 Compare to Robitussinreg 4 oz per bottleA registered trademark of American Home Products Corporation
$500
Cromolyn Sodium(Allergy Nasal Spray)
1356 Compare to NasalCromreg 26 ml per bottleA registered trademark of McNeil-PPC Inc
$1400
Diabetic Tussin DM 1323 Compare to Robitussin DMA registered trademark of Pfizer
$1100
Diphenhist(Antihistamine)
1308 Compare to Benadrylreg 25 mg tablets 100 per box A registered trademark of Pfizer
$600
Diphenhydramine HCL (Antihistamine)
1009 Compare to Benadrylreg 25 mg 24 per packA registered trademark of Pfizer
$500
Guaifenesin Cough Expectorant
1180 Compare to Robitussinreg 200mg tablets 60 per bottle A registered trademark of American Home Products Corporation
$900
Loratadine (Generic Claritin)
1611 Compare to Claritinreg Allergy Relief 24hr 100 per bottle A registered trademark of Bayer
$2000
Mucus Relief DM Expectorant amp Cough Suppressant
1178 Compare to Mucinex DMA registered trademark of Reckitt Benckiser
$1200
Multi-Symptom Cold Formula
1357 Compare to Tylenolreg Cold Multi-Symptom 24 tablets per box A registered trademark of McNeil PPC Inc
$600
Nasal Decongestant Spray - 12 Hour
1091 Compare to Afrinreg 005 30 ml sprayA registered trademark of Schering-Plough HealthCare Products Inc
$500
12
Category Product Item Brand EquivalentDescription Cost
Allergy Cold Flu Decongestant amp Sinus (continued)
Nasal Spray Saline 1052 Compare to Oceanreg Premium Saline Nasal Spray 065 15 oz spray A registered trademark of Fleming Pharmaceuticals
$500
Personal Steam Inhaler 1792 Compare to Vicks Personal Steam InhalerA registered trademark of Procter amp Gamble
$5000
Sore Throat Lozenges 1360 Compare to Cepacolreg Quantity 16 lozengesA registered trademark of Reckitt Benckiser Group
$700
Sore Throat Lozenges Cherry
1176 Compare to CepacolA registered trademark of Reckitt Benckiser
$700
Sore Throat Spray Cherry 1904 Compare to Chloraseptic Sore Throat Spray - Cherry A registered trademark of Prestige Brands
$900
Sudogest PE (Nasal amp Sinus Decongestant)
1352 Compare to Sudafed PEreg 10mg 36 tablets per box A registered trademark of Johnson amp Johnson
$500
Antacids amp Acid Reducers
Antacid Anti-Gas Liquid 1006 Compare to Maaloxreg Regular Strength 12 oz per bottle A registered trademark of William H Rorer Inc
$600
Antacid Chewables 1346 Compare to Tumsreg 500 mg 150 tablets per bottle A registered trademark of SmithKline Beecham
$600
Effervescent Pain Reliever
1314 Compare to Alka-SeltzerA registered trademark of Bayer AG
$800
Famotidine Acid Reducer
1108 Compare to Pepcidreg 10 mg tablets 30 per box A registered trademark of Merck amp Co Inc
$600
Omeprazole Acid Reducer
1110 Compare to Prilosec OTCreg 20 mg tablets 28 per box A registered trademark of AstraZeneca
$2300
Ranitidine Acid Reducer 1900 Compare to ZantacA registered trademark of Sanofi
$800
Simethicone Anti-Gas Chewables
1800 Compare to ZantacA registered trademark of Sanofi
$1000
Anticandidal (yeast)
Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
1115 Compare to Gyne-Lotriminreg45 gm per tube A registered trademark of Schering-Plough HealthCare Products Inc
$800
Micanozole 3-Day Treatment
1117 Compare to Monistat 3reg 200 mg - 2 1 kitA registered trademark of McNeil-PPC Inc
$1400
Tioconazole 1-Day Treatment Vaginal Cream (with applicator)
1119 Compare to Monistat 1reg 65 1 tubeA registered trademark of McNeil-PPC Inc
$2000
13
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
25 19 25
13
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Essential Bath Bench without Back Excedrin Migraine Relief Feosol Ferrous Gluconate
(Iron Supplement) Feosol Ferrous Sulfate Fibercon Polycarbophil Fiber Tablets First Aid Only First Aid Kit 75 pieces Fixodent Fixodent Fleet Glycerin Suppository Fleet Hemorrhoidal Suppository Fruit of the Earth Aloe Vera Cream Futuro Back Support Elastic Futuro Back Support Elastic
with Lumbar Futuro Compression Knee High
Socks Womenrsquos Black Small Futuro Compression Knee
High Socks Womenrsquos Black Medium
Futuro Compression Knee High Socks Womenrsquos Black Large
Futuro Compression Knee High Socks Womenrsquos Nude Small
Futuro Compression Knee High Socks Womenrsquos Nude Medium
Futuro Compression Knee High Socks Womenrsquos Nude Large
Futuro Elbow Support Futuro Knee Support Elastic Small Futuro Knee Suppor t Elastic
Small with Stays Futuro Knee Suppor t
Elastic Medium Futuro Knee Suppor t Elastic
Medium with Stays Futuro Knee Support Elastic Large Futuro Knee Suppor t Elastic
Large with Stays Futuro Night Wrist Support
Smart Glove Futuro Wrist Splint
17 Futuro Wrist Support 22 Gold Bond Medicated Foot Powder 10 Gold Bond Moisturizing Body
Lotion with Aloe 10 14 18
Gyne-Lotrimin Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
15 HALLS Cough Drops Cherry 14 HealthSmart Finger Pulse Oximeter 19 Herpecin-L Herpecin-L Lip Balm 25 23 23
Hip Protector Hip Protector Hip Protector
Hip Protector Small Hip Protector Medium Hip Protector Large
23 Hip Protectorw Hip Protector X-Large
23 Hydrogen Peroxide Hydrogen Peroxide Hylandrsquos Ear Pain Relief Ear Drops
23 Hylandrsquos Leg Cramps Pain
Relief Caplets
23 Imodium A-D Loperamide HCL
Anti-Diarrheal
24 Isopropyl Isopropyl Alcohol
Wintergreen Lactaid Lactase Capsules 14
24 Lamisil AT Terbinafine HCL Antifungal Cream
15
24 24 24
24
24
Lantiseptic Lotrimin AF
Lotrimin AF
Ludens
Maalox
Barrier Cream Clotrimazole Antifungal Athletersquos Foot Cream Medicated Antifungal Foot Powder Spray Cough Drops Sugar Free Cherry Antacid Anti-Gas Liquid
20 14
15
12
13
24 Metamucil Natural Vegetable Laxative 24 Micatin Miconazole Nitrate 2
Antifungal Cream 24 Monistat 1 Tioconazole 1-Day Treatment
Vaginal Cream (with applicator) 25 Monistat 3 Micanozole 3-Day Treatment
12
11
15
24
24
24
24
18
16
10
7
14
18
14 15
13
13
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Murine Murine
Mucinex DM
NasalCrom
Ear Wax Removal Drops Ear Wax Removal System with Rubber Bulb Mucus Relief DM Expectorantamp Cough Suppressant Cromolyn Sodium(Allergy Nasal Spray)
16 16
12
12
Omron
One A Day
One A Day
Orajel
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo) One DailyMenrsquos Multivitamin One Daily Womenrsquos Multivitamin Orajel Pain Relief
11
11
11
15 Nature Made Nature Made Nature Made
Magnesium Oxide Niacin Stress Formula
10 11 11
Oral B Oral-B
Rechargeable Toothbrush Interdental Flossups 15
Tablets with Zinc Pepcid Famotidine Acid Reducer 13 Naturersquos Bounty Coenzyme Q-1 10 Pepsodent Toothpaste - Pepsodent 16 Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty
Folic Acid Iron Magnesium Melatonin
10 10 10 10
Pepto-Bismol Pepto-Bismol Phillipsrsquo
Bismatrol Chewable Tablets Pink Bismuth Milk of Magnesia
14 14 14
Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Neosporin Neosporin
Vitamin B-6 Vitamin D Fish Oil Tablets Neosporin Plus Triple Antibiotic Ointment
11 11 10 18 19
Povidone
Preparation H Prevail Prevail
Povidone Iodine Solution Antiseptic Hemorrhoidal Ointment Adult Briefs Medium Adult Briefs Large
18
19 19 20
Nexcare
Nexcare
Nicoderm
HotCold Pack1 small amp 1 large Thermometer Digital 60 seconds Nicotine Patch Step 1
18
19
23
Prevail Prilosec OTC ProCheck
Purell
Adult Briefs X-Large Omeprazole Acid Reducer Thermometer Flexible Tip Digital 10 seconds Hand Sanitizer
20 13 19
22 Nicoderm Nicoderm Nicorette Nix
Nicotine Patch Step 2 Nicotine Patch Step 3 Nicorelief Gum Permethrin Lice Treatment
23 23 23 22
Q-Tips Quick-Lock Reach
Cotton Tipped Swabs Raised Toilet Seat Reach Waxed Dental Floss Mint
16 18 15
Nova
Ocean Omron
Omron
Folding CaneErgonomic Handle Nasal Spray Saline Desktop Automatic Blood Pressure Monitor Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
18
13 11
11
Refresh PM Releev Renu MultipurposeSolution Reveal
Rid
Artificial Tears Ointment Releev Cold Sore Treatment Multi-Purpose Contact Lens Solution EZ Detect Colon Cancer Test Kit Lice Treatment Shampoo
16 15 16
11
22 Omron
Omron
Desktop Blood Pressure Monitor Replacement Cuff Wrist Blood Pressure Monitor
11
11
Robitussin Robitussin
Cough Syrup Expectorant Guaifenesin Cough Expectorant
12 12
8
12 16 16 10 10
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Robitussin Diabetic Tussin DM Salonpas Pain Relief Patches Senokot- S Senna Plus Stool
Softener Plus Laxative Shower Mat Shower Mat Non-Skid Sominex Sleep Tablets Sudafed PE Sudogest PE
(Nasal amp Sinus Decongestant) Sunbeam Heating Pad 12 in x 15 in Super Poligrip Polident Denture Cream Tek Pro Toothbrush Tek Pro
Straight Soft Therafirm Compression Knee High
Socks Menrsquos Black Medium Therafirm Compression Knee High
Socks Menrsquos Black Large Therafirm Compression Knee High
Socks Menrsquos White Medium Therafirm Compression Knee High
Socks Menrsquos White Large Thermacare Thermacare Knee amp Elbow Thermacare Thermacare Lower
Back amp Hip Thermacare Thermacare Menstrual Relief Thermometer Thermometer
Talking Ear and Forehead Tinactin Tolnaftate Antifungal Cream Toilet Safety Rails Toilet Safety Rails Tucks Pre-moist Hemorrhoid Pads Tums Antacid Chewables Tylenol Acetaminophen Tylenol Multi-Symptom Cold Formula Tylenol Arthritis Arthritis Pain Reliever Tylenol Extra Acetaminophen Strength Tylenol PM Pain Reliever
PM - Extra Strength Vicks Humidifier
Ultra-Sonic Cool Mist Vicks Personal Steam Inhaler
12 Vicks NyQuil All-Nite ColdFlu 22 Visine Artificial Tears Drops 14 Visine Redness Relief Eye Drops
18 22 13
Vitafusion Vitafusion Vitafusion Vitafusion
Biotin Gummy Calcium + Vitamin D Gummy Vitamin B-Complex Gummy Vitamin C Gummy
21 15
Vitafusion
Vitamin A
Vitafusion Fiber WeightManagement Vitamin A
16
23
Vitamin B-Complex Vitamin B-1
Vitamin B-Complex
Vitamin B-1
23 Vitamin B-6 Vitamin B-6 Vitamin B-12 Vitamin B-12
23 Vitamin C Vitamin C
23
22 22
Vitamin D Vitamin E Soft Gels Zantac Zantac
Vitamin D Vitamin E Soft Gels
Ranitidine Acid Reducer Simethicone
22 18 Zyrtec
Anti-Gas Chewables All-Day Allergy Tablets (Cetrizine HCL)
15 19 19 13 21 12 21 21
22
18
13
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
11
11
25
11
11
11
11
11
11
11
11
13
13
9
12
OTC MEDICATIONS AND PRODUCTS Before ordering any of the items below you should talk with your doctor
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Biotin Gummy 1820 Compare to Vitafusion Biotin Gummy Vitamins A registered trademark of Church amp Dwight Co Inc
$1200
Calcium + Vitamin D 1373 Compare to Caltratereg 600 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Calcium + Vitamin D Gummy
1823 Compare to Vitafusion Calcium + Vitamin D Gummy A registered trademark of Church amp Dwight Co Inc
$1400
Calcium Carbonate Tablets
1291 Compare to Caltrate-Dreg 600 + D Calcium Supplement 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$500
Coenzyme Q-10 1829 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
Daily Multiple Vitamin Tablets with Minerals
1385 Compare to Centrumreg 100 tablets per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Ferrous Gluconate (Iron Supplement)
1375 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$600
Ferrous Sulfate 1376 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$500
Fish Oil Tablets 1741 Compare to Naturersquos Bountyreg 1000 mg tablets 60 per bottleA registered trademark of Naturersquos Bounty Inc
$1100
Folic Acid 1850 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Glucosamine Chondroitin
1003 Compare to 21st Century Glucosamine amp Chondroitin Original Formula 250-200 mg capsules 60 per bottle A registered trademark of 21st Century HealthCare Inc
$1100
Iron 1417 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$900
Leg Cramps Pain Relief Caplets
1869 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1400
Magnesium 1418 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Magnesium Oxide 1377 Compare to Nature Madereg Strength 250mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$700
Melatonin 1879 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
10
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Niacin 1378 Compare to Nature Madereg Strength 100mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$500
One Daily Menrsquos Multi-Vitamin
1886 Compare to One A DayA registered trademark of Bayer AG
$1000
One Daily Womenrsquos Multi-Vitamin
1887 Compare to One A DayA registered trademark of Bayer AG
$1000
Senior Multivitamin 1392 Compare to Centrum SilverA registered trademark of Pfizer
$1000
Stress Formula Tablets with Zinc
1734 Compare to Nature Made Stress B Complex with Zinc A registered trademark of Pharmavite
$1400
Vitamin A 1379 Vitamin A 100 tablets per bottle $600 Vitamin B-Complex 1382 Vitamin B Complex 100 tablets per bottle $600 Vitamin B-Complex Gummy
1915 Compare to Vitafusion B-Complex Gummy VitaminsA registered trademark of Church amp Dwight Co Inc
$1200
Vitamin B-1 1016 Vitamin B-1 100 mg tablets 100 per bottle $600 Vitamin B-6 1380 Vitamin B-6 50 mg tablets 100 per bottle $600 Vitamin B-6 1388 Compare to Naturersquos Bounty A registered
trademark of Naturersquos Bounty Inc $800
Vitamin B-12 1381 Vitamin B-12 100 tablets per bottle $1000 Vitamin C 1017 Vitamin C 500 mg 100 tablets per bottle $600 Vitamin C Gummy 1916 Compare to Vitafusion Power C Gummy Vitamins
A registered trademark of Church amp Dwight Co Inc $1200
Vitamin D 1383 Vitamin D 100 tablets per bottle $500 Vitamin D 1390 Compare to Naturersquos Bounty
A registered trademark of Naturersquos Bounty Inc $1000
Vitamin E Soft Gels 1384 Vitamin E 100 tablets per bottle $800 In-Home Diagnostics
Desktop AutomaticBlood Pressure Monitor
1253 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$6000
Desktop Blood PressureMonitor Replacement Cuff
1504 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$1900
Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
1503 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$8000
EZ Detect Colon Cancer Test Kit
1416 Compare to Reveal Colon Disease Testreg A registered trademark of American Screening Corp
$1300
Finger Pulse Oximeter
1505 Compare to HealthSmartregA registered trademark of Briggs Healthcare
$5200
Home Access Cholesterol Test
1251 Compare to CholesTrakreg 1 pieceA registered trademark of AccuTech LLC
$3500
Wrist Blood Pressure Monitor
1501 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$4000
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo)
1502 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$5500
11
OTC MEDICATIONS AND PRODUCTS You can order the following items without having to talk with your doctor but we always recommend that you talk with your doctor before starting a new product regime
Category Product Item Brand EquivalentDescription Cost
Allergy All-Day Allergy TabletsCold Flu (Cetrizine HCL) Decongestant amp Sinus All-Nite ColdFlu
1090
1361
Compare to Zyrtecreg $700 10 mg tablets 14 per box A registered trademark of McNeil-PPC Inc Compare to Vicksreg NyQuilreg Cough $600 A registered trademark of Procter amp Gamble
ChlorpheniramineMaleate (Antihistamine)
1008 Compare to Chlor-Trimetonreg Allergy 4 mg tablets 100 per boxA registered trademark of Schering-Plough HealthCare Products Inc
$500
Cough amp Cold for High Blood Pressure
1166 Compare to Coricidin HBPA registered trademark of Bayer AG
$700
Cough Drops Cherry
1056 Compare to HALLSreg Quantity 30 lozenges A registered trademark of Mondelēz International
$600
Cough Drops Sugar Free Cherry
1182 Compare to Ludens Throat Drops Sugar Free Wild CherryA registered trademark of Prestige Brands
$600
Cough Syrup Expectorant
1054 Compare to Robitussinreg 4 oz per bottleA registered trademark of American Home Products Corporation
$500
Cromolyn Sodium(Allergy Nasal Spray)
1356 Compare to NasalCromreg 26 ml per bottleA registered trademark of McNeil-PPC Inc
$1400
Diabetic Tussin DM 1323 Compare to Robitussin DMA registered trademark of Pfizer
$1100
Diphenhist(Antihistamine)
1308 Compare to Benadrylreg 25 mg tablets 100 per box A registered trademark of Pfizer
$600
Diphenhydramine HCL (Antihistamine)
1009 Compare to Benadrylreg 25 mg 24 per packA registered trademark of Pfizer
$500
Guaifenesin Cough Expectorant
1180 Compare to Robitussinreg 200mg tablets 60 per bottle A registered trademark of American Home Products Corporation
$900
Loratadine (Generic Claritin)
1611 Compare to Claritinreg Allergy Relief 24hr 100 per bottle A registered trademark of Bayer
$2000
Mucus Relief DM Expectorant amp Cough Suppressant
1178 Compare to Mucinex DMA registered trademark of Reckitt Benckiser
$1200
Multi-Symptom Cold Formula
1357 Compare to Tylenolreg Cold Multi-Symptom 24 tablets per box A registered trademark of McNeil PPC Inc
$600
Nasal Decongestant Spray - 12 Hour
1091 Compare to Afrinreg 005 30 ml sprayA registered trademark of Schering-Plough HealthCare Products Inc
$500
12
Category Product Item Brand EquivalentDescription Cost
Allergy Cold Flu Decongestant amp Sinus (continued)
Nasal Spray Saline 1052 Compare to Oceanreg Premium Saline Nasal Spray 065 15 oz spray A registered trademark of Fleming Pharmaceuticals
$500
Personal Steam Inhaler 1792 Compare to Vicks Personal Steam InhalerA registered trademark of Procter amp Gamble
$5000
Sore Throat Lozenges 1360 Compare to Cepacolreg Quantity 16 lozengesA registered trademark of Reckitt Benckiser Group
$700
Sore Throat Lozenges Cherry
1176 Compare to CepacolA registered trademark of Reckitt Benckiser
$700
Sore Throat Spray Cherry 1904 Compare to Chloraseptic Sore Throat Spray - Cherry A registered trademark of Prestige Brands
$900
Sudogest PE (Nasal amp Sinus Decongestant)
1352 Compare to Sudafed PEreg 10mg 36 tablets per box A registered trademark of Johnson amp Johnson
$500
Antacids amp Acid Reducers
Antacid Anti-Gas Liquid 1006 Compare to Maaloxreg Regular Strength 12 oz per bottle A registered trademark of William H Rorer Inc
$600
Antacid Chewables 1346 Compare to Tumsreg 500 mg 150 tablets per bottle A registered trademark of SmithKline Beecham
$600
Effervescent Pain Reliever
1314 Compare to Alka-SeltzerA registered trademark of Bayer AG
$800
Famotidine Acid Reducer
1108 Compare to Pepcidreg 10 mg tablets 30 per box A registered trademark of Merck amp Co Inc
$600
Omeprazole Acid Reducer
1110 Compare to Prilosec OTCreg 20 mg tablets 28 per box A registered trademark of AstraZeneca
$2300
Ranitidine Acid Reducer 1900 Compare to ZantacA registered trademark of Sanofi
$800
Simethicone Anti-Gas Chewables
1800 Compare to ZantacA registered trademark of Sanofi
$1000
Anticandidal (yeast)
Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
1115 Compare to Gyne-Lotriminreg45 gm per tube A registered trademark of Schering-Plough HealthCare Products Inc
$800
Micanozole 3-Day Treatment
1117 Compare to Monistat 3reg 200 mg - 2 1 kitA registered trademark of McNeil-PPC Inc
$1400
Tioconazole 1-Day Treatment Vaginal Cream (with applicator)
1119 Compare to Monistat 1reg 65 1 tubeA registered trademark of McNeil-PPC Inc
$2000
13
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
BRAND EQUIVALENT INDEX
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Murine Murine
Mucinex DM
NasalCrom
Ear Wax Removal Drops Ear Wax Removal System with Rubber Bulb Mucus Relief DM Expectorantamp Cough Suppressant Cromolyn Sodium(Allergy Nasal Spray)
16 16
12
12
Omron
One A Day
One A Day
Orajel
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo) One DailyMenrsquos Multivitamin One Daily Womenrsquos Multivitamin Orajel Pain Relief
11
11
11
15 Nature Made Nature Made Nature Made
Magnesium Oxide Niacin Stress Formula
10 11 11
Oral B Oral-B
Rechargeable Toothbrush Interdental Flossups 15
Tablets with Zinc Pepcid Famotidine Acid Reducer 13 Naturersquos Bounty Coenzyme Q-1 10 Pepsodent Toothpaste - Pepsodent 16 Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty
Folic Acid Iron Magnesium Melatonin
10 10 10 10
Pepto-Bismol Pepto-Bismol Phillipsrsquo
Bismatrol Chewable Tablets Pink Bismuth Milk of Magnesia
14 14 14
Naturersquos Bounty Naturersquos Bounty Naturersquos Bounty Neosporin Neosporin
Vitamin B-6 Vitamin D Fish Oil Tablets Neosporin Plus Triple Antibiotic Ointment
11 11 10 18 19
Povidone
Preparation H Prevail Prevail
Povidone Iodine Solution Antiseptic Hemorrhoidal Ointment Adult Briefs Medium Adult Briefs Large
18
19 19 20
Nexcare
Nexcare
Nicoderm
HotCold Pack1 small amp 1 large Thermometer Digital 60 seconds Nicotine Patch Step 1
18
19
23
Prevail Prilosec OTC ProCheck
Purell
Adult Briefs X-Large Omeprazole Acid Reducer Thermometer Flexible Tip Digital 10 seconds Hand Sanitizer
20 13 19
22 Nicoderm Nicoderm Nicorette Nix
Nicotine Patch Step 2 Nicotine Patch Step 3 Nicorelief Gum Permethrin Lice Treatment
23 23 23 22
Q-Tips Quick-Lock Reach
Cotton Tipped Swabs Raised Toilet Seat Reach Waxed Dental Floss Mint
16 18 15
Nova
Ocean Omron
Omron
Folding CaneErgonomic Handle Nasal Spray Saline Desktop Automatic Blood Pressure Monitor Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
18
13 11
11
Refresh PM Releev Renu MultipurposeSolution Reveal
Rid
Artificial Tears Ointment Releev Cold Sore Treatment Multi-Purpose Contact Lens Solution EZ Detect Colon Cancer Test Kit Lice Treatment Shampoo
16 15 16
11
22 Omron
Omron
Desktop Blood Pressure Monitor Replacement Cuff Wrist Blood Pressure Monitor
11
11
Robitussin Robitussin
Cough Syrup Expectorant Guaifenesin Cough Expectorant
12 12
8
12 16 16 10 10
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Robitussin Diabetic Tussin DM Salonpas Pain Relief Patches Senokot- S Senna Plus Stool
Softener Plus Laxative Shower Mat Shower Mat Non-Skid Sominex Sleep Tablets Sudafed PE Sudogest PE
(Nasal amp Sinus Decongestant) Sunbeam Heating Pad 12 in x 15 in Super Poligrip Polident Denture Cream Tek Pro Toothbrush Tek Pro
Straight Soft Therafirm Compression Knee High
Socks Menrsquos Black Medium Therafirm Compression Knee High
Socks Menrsquos Black Large Therafirm Compression Knee High
Socks Menrsquos White Medium Therafirm Compression Knee High
Socks Menrsquos White Large Thermacare Thermacare Knee amp Elbow Thermacare Thermacare Lower
Back amp Hip Thermacare Thermacare Menstrual Relief Thermometer Thermometer
Talking Ear and Forehead Tinactin Tolnaftate Antifungal Cream Toilet Safety Rails Toilet Safety Rails Tucks Pre-moist Hemorrhoid Pads Tums Antacid Chewables Tylenol Acetaminophen Tylenol Multi-Symptom Cold Formula Tylenol Arthritis Arthritis Pain Reliever Tylenol Extra Acetaminophen Strength Tylenol PM Pain Reliever
PM - Extra Strength Vicks Humidifier
Ultra-Sonic Cool Mist Vicks Personal Steam Inhaler
12 Vicks NyQuil All-Nite ColdFlu 22 Visine Artificial Tears Drops 14 Visine Redness Relief Eye Drops
18 22 13
Vitafusion Vitafusion Vitafusion Vitafusion
Biotin Gummy Calcium + Vitamin D Gummy Vitamin B-Complex Gummy Vitamin C Gummy
21 15
Vitafusion
Vitamin A
Vitafusion Fiber WeightManagement Vitamin A
16
23
Vitamin B-Complex Vitamin B-1
Vitamin B-Complex
Vitamin B-1
23 Vitamin B-6 Vitamin B-6 Vitamin B-12 Vitamin B-12
23 Vitamin C Vitamin C
23
22 22
Vitamin D Vitamin E Soft Gels Zantac Zantac
Vitamin D Vitamin E Soft Gels
Ranitidine Acid Reducer Simethicone
22 18 Zyrtec
Anti-Gas Chewables All-Day Allergy Tablets (Cetrizine HCL)
15 19 19 13 21 12 21 21
22
18
13
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
11
11
25
11
11
11
11
11
11
11
11
13
13
9
12
OTC MEDICATIONS AND PRODUCTS Before ordering any of the items below you should talk with your doctor
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Biotin Gummy 1820 Compare to Vitafusion Biotin Gummy Vitamins A registered trademark of Church amp Dwight Co Inc
$1200
Calcium + Vitamin D 1373 Compare to Caltratereg 600 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Calcium + Vitamin D Gummy
1823 Compare to Vitafusion Calcium + Vitamin D Gummy A registered trademark of Church amp Dwight Co Inc
$1400
Calcium Carbonate Tablets
1291 Compare to Caltrate-Dreg 600 + D Calcium Supplement 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$500
Coenzyme Q-10 1829 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
Daily Multiple Vitamin Tablets with Minerals
1385 Compare to Centrumreg 100 tablets per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Ferrous Gluconate (Iron Supplement)
1375 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$600
Ferrous Sulfate 1376 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$500
Fish Oil Tablets 1741 Compare to Naturersquos Bountyreg 1000 mg tablets 60 per bottleA registered trademark of Naturersquos Bounty Inc
$1100
Folic Acid 1850 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Glucosamine Chondroitin
1003 Compare to 21st Century Glucosamine amp Chondroitin Original Formula 250-200 mg capsules 60 per bottle A registered trademark of 21st Century HealthCare Inc
$1100
Iron 1417 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$900
Leg Cramps Pain Relief Caplets
1869 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1400
Magnesium 1418 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Magnesium Oxide 1377 Compare to Nature Madereg Strength 250mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$700
Melatonin 1879 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
10
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Niacin 1378 Compare to Nature Madereg Strength 100mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$500
One Daily Menrsquos Multi-Vitamin
1886 Compare to One A DayA registered trademark of Bayer AG
$1000
One Daily Womenrsquos Multi-Vitamin
1887 Compare to One A DayA registered trademark of Bayer AG
$1000
Senior Multivitamin 1392 Compare to Centrum SilverA registered trademark of Pfizer
$1000
Stress Formula Tablets with Zinc
1734 Compare to Nature Made Stress B Complex with Zinc A registered trademark of Pharmavite
$1400
Vitamin A 1379 Vitamin A 100 tablets per bottle $600 Vitamin B-Complex 1382 Vitamin B Complex 100 tablets per bottle $600 Vitamin B-Complex Gummy
1915 Compare to Vitafusion B-Complex Gummy VitaminsA registered trademark of Church amp Dwight Co Inc
$1200
Vitamin B-1 1016 Vitamin B-1 100 mg tablets 100 per bottle $600 Vitamin B-6 1380 Vitamin B-6 50 mg tablets 100 per bottle $600 Vitamin B-6 1388 Compare to Naturersquos Bounty A registered
trademark of Naturersquos Bounty Inc $800
Vitamin B-12 1381 Vitamin B-12 100 tablets per bottle $1000 Vitamin C 1017 Vitamin C 500 mg 100 tablets per bottle $600 Vitamin C Gummy 1916 Compare to Vitafusion Power C Gummy Vitamins
A registered trademark of Church amp Dwight Co Inc $1200
Vitamin D 1383 Vitamin D 100 tablets per bottle $500 Vitamin D 1390 Compare to Naturersquos Bounty
A registered trademark of Naturersquos Bounty Inc $1000
Vitamin E Soft Gels 1384 Vitamin E 100 tablets per bottle $800 In-Home Diagnostics
Desktop AutomaticBlood Pressure Monitor
1253 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$6000
Desktop Blood PressureMonitor Replacement Cuff
1504 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$1900
Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
1503 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$8000
EZ Detect Colon Cancer Test Kit
1416 Compare to Reveal Colon Disease Testreg A registered trademark of American Screening Corp
$1300
Finger Pulse Oximeter
1505 Compare to HealthSmartregA registered trademark of Briggs Healthcare
$5200
Home Access Cholesterol Test
1251 Compare to CholesTrakreg 1 pieceA registered trademark of AccuTech LLC
$3500
Wrist Blood Pressure Monitor
1501 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$4000
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo)
1502 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$5500
11
OTC MEDICATIONS AND PRODUCTS You can order the following items without having to talk with your doctor but we always recommend that you talk with your doctor before starting a new product regime
Category Product Item Brand EquivalentDescription Cost
Allergy All-Day Allergy TabletsCold Flu (Cetrizine HCL) Decongestant amp Sinus All-Nite ColdFlu
1090
1361
Compare to Zyrtecreg $700 10 mg tablets 14 per box A registered trademark of McNeil-PPC Inc Compare to Vicksreg NyQuilreg Cough $600 A registered trademark of Procter amp Gamble
ChlorpheniramineMaleate (Antihistamine)
1008 Compare to Chlor-Trimetonreg Allergy 4 mg tablets 100 per boxA registered trademark of Schering-Plough HealthCare Products Inc
$500
Cough amp Cold for High Blood Pressure
1166 Compare to Coricidin HBPA registered trademark of Bayer AG
$700
Cough Drops Cherry
1056 Compare to HALLSreg Quantity 30 lozenges A registered trademark of Mondelēz International
$600
Cough Drops Sugar Free Cherry
1182 Compare to Ludens Throat Drops Sugar Free Wild CherryA registered trademark of Prestige Brands
$600
Cough Syrup Expectorant
1054 Compare to Robitussinreg 4 oz per bottleA registered trademark of American Home Products Corporation
$500
Cromolyn Sodium(Allergy Nasal Spray)
1356 Compare to NasalCromreg 26 ml per bottleA registered trademark of McNeil-PPC Inc
$1400
Diabetic Tussin DM 1323 Compare to Robitussin DMA registered trademark of Pfizer
$1100
Diphenhist(Antihistamine)
1308 Compare to Benadrylreg 25 mg tablets 100 per box A registered trademark of Pfizer
$600
Diphenhydramine HCL (Antihistamine)
1009 Compare to Benadrylreg 25 mg 24 per packA registered trademark of Pfizer
$500
Guaifenesin Cough Expectorant
1180 Compare to Robitussinreg 200mg tablets 60 per bottle A registered trademark of American Home Products Corporation
$900
Loratadine (Generic Claritin)
1611 Compare to Claritinreg Allergy Relief 24hr 100 per bottle A registered trademark of Bayer
$2000
Mucus Relief DM Expectorant amp Cough Suppressant
1178 Compare to Mucinex DMA registered trademark of Reckitt Benckiser
$1200
Multi-Symptom Cold Formula
1357 Compare to Tylenolreg Cold Multi-Symptom 24 tablets per box A registered trademark of McNeil PPC Inc
$600
Nasal Decongestant Spray - 12 Hour
1091 Compare to Afrinreg 005 30 ml sprayA registered trademark of Schering-Plough HealthCare Products Inc
$500
12
Category Product Item Brand EquivalentDescription Cost
Allergy Cold Flu Decongestant amp Sinus (continued)
Nasal Spray Saline 1052 Compare to Oceanreg Premium Saline Nasal Spray 065 15 oz spray A registered trademark of Fleming Pharmaceuticals
$500
Personal Steam Inhaler 1792 Compare to Vicks Personal Steam InhalerA registered trademark of Procter amp Gamble
$5000
Sore Throat Lozenges 1360 Compare to Cepacolreg Quantity 16 lozengesA registered trademark of Reckitt Benckiser Group
$700
Sore Throat Lozenges Cherry
1176 Compare to CepacolA registered trademark of Reckitt Benckiser
$700
Sore Throat Spray Cherry 1904 Compare to Chloraseptic Sore Throat Spray - Cherry A registered trademark of Prestige Brands
$900
Sudogest PE (Nasal amp Sinus Decongestant)
1352 Compare to Sudafed PEreg 10mg 36 tablets per box A registered trademark of Johnson amp Johnson
$500
Antacids amp Acid Reducers
Antacid Anti-Gas Liquid 1006 Compare to Maaloxreg Regular Strength 12 oz per bottle A registered trademark of William H Rorer Inc
$600
Antacid Chewables 1346 Compare to Tumsreg 500 mg 150 tablets per bottle A registered trademark of SmithKline Beecham
$600
Effervescent Pain Reliever
1314 Compare to Alka-SeltzerA registered trademark of Bayer AG
$800
Famotidine Acid Reducer
1108 Compare to Pepcidreg 10 mg tablets 30 per box A registered trademark of Merck amp Co Inc
$600
Omeprazole Acid Reducer
1110 Compare to Prilosec OTCreg 20 mg tablets 28 per box A registered trademark of AstraZeneca
$2300
Ranitidine Acid Reducer 1900 Compare to ZantacA registered trademark of Sanofi
$800
Simethicone Anti-Gas Chewables
1800 Compare to ZantacA registered trademark of Sanofi
$1000
Anticandidal (yeast)
Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
1115 Compare to Gyne-Lotriminreg45 gm per tube A registered trademark of Schering-Plough HealthCare Products Inc
$800
Micanozole 3-Day Treatment
1117 Compare to Monistat 3reg 200 mg - 2 1 kitA registered trademark of McNeil-PPC Inc
$1400
Tioconazole 1-Day Treatment Vaginal Cream (with applicator)
1119 Compare to Monistat 1reg 65 1 tubeA registered trademark of McNeil-PPC Inc
$2000
13
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
12 16 16 10 10
Brand Equivalent Catalog Item Page Brand
Equivalent Catalog Item Page
Robitussin Diabetic Tussin DM Salonpas Pain Relief Patches Senokot- S Senna Plus Stool
Softener Plus Laxative Shower Mat Shower Mat Non-Skid Sominex Sleep Tablets Sudafed PE Sudogest PE
(Nasal amp Sinus Decongestant) Sunbeam Heating Pad 12 in x 15 in Super Poligrip Polident Denture Cream Tek Pro Toothbrush Tek Pro
Straight Soft Therafirm Compression Knee High
Socks Menrsquos Black Medium Therafirm Compression Knee High
Socks Menrsquos Black Large Therafirm Compression Knee High
Socks Menrsquos White Medium Therafirm Compression Knee High
Socks Menrsquos White Large Thermacare Thermacare Knee amp Elbow Thermacare Thermacare Lower
Back amp Hip Thermacare Thermacare Menstrual Relief Thermometer Thermometer
Talking Ear and Forehead Tinactin Tolnaftate Antifungal Cream Toilet Safety Rails Toilet Safety Rails Tucks Pre-moist Hemorrhoid Pads Tums Antacid Chewables Tylenol Acetaminophen Tylenol Multi-Symptom Cold Formula Tylenol Arthritis Arthritis Pain Reliever Tylenol Extra Acetaminophen Strength Tylenol PM Pain Reliever
PM - Extra Strength Vicks Humidifier
Ultra-Sonic Cool Mist Vicks Personal Steam Inhaler
12 Vicks NyQuil All-Nite ColdFlu 22 Visine Artificial Tears Drops 14 Visine Redness Relief Eye Drops
18 22 13
Vitafusion Vitafusion Vitafusion Vitafusion
Biotin Gummy Calcium + Vitamin D Gummy Vitamin B-Complex Gummy Vitamin C Gummy
21 15
Vitafusion
Vitamin A
Vitafusion Fiber WeightManagement Vitamin A
16
23
Vitamin B-Complex Vitamin B-1
Vitamin B-Complex
Vitamin B-1
23 Vitamin B-6 Vitamin B-6 Vitamin B-12 Vitamin B-12
23 Vitamin C Vitamin C
23
22 22
Vitamin D Vitamin E Soft Gels Zantac Zantac
Vitamin D Vitamin E Soft Gels
Ranitidine Acid Reducer Simethicone
22 18 Zyrtec
Anti-Gas Chewables All-Day Allergy Tablets (Cetrizine HCL)
15 19 19 13 21 12 21 21
22
18
13
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
11
11
25
11
11
11
11
11
11
11
11
13
13
9
12
OTC MEDICATIONS AND PRODUCTS Before ordering any of the items below you should talk with your doctor
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Biotin Gummy 1820 Compare to Vitafusion Biotin Gummy Vitamins A registered trademark of Church amp Dwight Co Inc
$1200
Calcium + Vitamin D 1373 Compare to Caltratereg 600 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Calcium + Vitamin D Gummy
1823 Compare to Vitafusion Calcium + Vitamin D Gummy A registered trademark of Church amp Dwight Co Inc
$1400
Calcium Carbonate Tablets
1291 Compare to Caltrate-Dreg 600 + D Calcium Supplement 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$500
Coenzyme Q-10 1829 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
Daily Multiple Vitamin Tablets with Minerals
1385 Compare to Centrumreg 100 tablets per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Ferrous Gluconate (Iron Supplement)
1375 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$600
Ferrous Sulfate 1376 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$500
Fish Oil Tablets 1741 Compare to Naturersquos Bountyreg 1000 mg tablets 60 per bottleA registered trademark of Naturersquos Bounty Inc
$1100
Folic Acid 1850 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Glucosamine Chondroitin
1003 Compare to 21st Century Glucosamine amp Chondroitin Original Formula 250-200 mg capsules 60 per bottle A registered trademark of 21st Century HealthCare Inc
$1100
Iron 1417 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$900
Leg Cramps Pain Relief Caplets
1869 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1400
Magnesium 1418 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Magnesium Oxide 1377 Compare to Nature Madereg Strength 250mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$700
Melatonin 1879 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
10
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Niacin 1378 Compare to Nature Madereg Strength 100mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$500
One Daily Menrsquos Multi-Vitamin
1886 Compare to One A DayA registered trademark of Bayer AG
$1000
One Daily Womenrsquos Multi-Vitamin
1887 Compare to One A DayA registered trademark of Bayer AG
$1000
Senior Multivitamin 1392 Compare to Centrum SilverA registered trademark of Pfizer
$1000
Stress Formula Tablets with Zinc
1734 Compare to Nature Made Stress B Complex with Zinc A registered trademark of Pharmavite
$1400
Vitamin A 1379 Vitamin A 100 tablets per bottle $600 Vitamin B-Complex 1382 Vitamin B Complex 100 tablets per bottle $600 Vitamin B-Complex Gummy
1915 Compare to Vitafusion B-Complex Gummy VitaminsA registered trademark of Church amp Dwight Co Inc
$1200
Vitamin B-1 1016 Vitamin B-1 100 mg tablets 100 per bottle $600 Vitamin B-6 1380 Vitamin B-6 50 mg tablets 100 per bottle $600 Vitamin B-6 1388 Compare to Naturersquos Bounty A registered
trademark of Naturersquos Bounty Inc $800
Vitamin B-12 1381 Vitamin B-12 100 tablets per bottle $1000 Vitamin C 1017 Vitamin C 500 mg 100 tablets per bottle $600 Vitamin C Gummy 1916 Compare to Vitafusion Power C Gummy Vitamins
A registered trademark of Church amp Dwight Co Inc $1200
Vitamin D 1383 Vitamin D 100 tablets per bottle $500 Vitamin D 1390 Compare to Naturersquos Bounty
A registered trademark of Naturersquos Bounty Inc $1000
Vitamin E Soft Gels 1384 Vitamin E 100 tablets per bottle $800 In-Home Diagnostics
Desktop AutomaticBlood Pressure Monitor
1253 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$6000
Desktop Blood PressureMonitor Replacement Cuff
1504 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$1900
Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
1503 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$8000
EZ Detect Colon Cancer Test Kit
1416 Compare to Reveal Colon Disease Testreg A registered trademark of American Screening Corp
$1300
Finger Pulse Oximeter
1505 Compare to HealthSmartregA registered trademark of Briggs Healthcare
$5200
Home Access Cholesterol Test
1251 Compare to CholesTrakreg 1 pieceA registered trademark of AccuTech LLC
$3500
Wrist Blood Pressure Monitor
1501 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$4000
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo)
1502 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$5500
11
OTC MEDICATIONS AND PRODUCTS You can order the following items without having to talk with your doctor but we always recommend that you talk with your doctor before starting a new product regime
Category Product Item Brand EquivalentDescription Cost
Allergy All-Day Allergy TabletsCold Flu (Cetrizine HCL) Decongestant amp Sinus All-Nite ColdFlu
1090
1361
Compare to Zyrtecreg $700 10 mg tablets 14 per box A registered trademark of McNeil-PPC Inc Compare to Vicksreg NyQuilreg Cough $600 A registered trademark of Procter amp Gamble
ChlorpheniramineMaleate (Antihistamine)
1008 Compare to Chlor-Trimetonreg Allergy 4 mg tablets 100 per boxA registered trademark of Schering-Plough HealthCare Products Inc
$500
Cough amp Cold for High Blood Pressure
1166 Compare to Coricidin HBPA registered trademark of Bayer AG
$700
Cough Drops Cherry
1056 Compare to HALLSreg Quantity 30 lozenges A registered trademark of Mondelēz International
$600
Cough Drops Sugar Free Cherry
1182 Compare to Ludens Throat Drops Sugar Free Wild CherryA registered trademark of Prestige Brands
$600
Cough Syrup Expectorant
1054 Compare to Robitussinreg 4 oz per bottleA registered trademark of American Home Products Corporation
$500
Cromolyn Sodium(Allergy Nasal Spray)
1356 Compare to NasalCromreg 26 ml per bottleA registered trademark of McNeil-PPC Inc
$1400
Diabetic Tussin DM 1323 Compare to Robitussin DMA registered trademark of Pfizer
$1100
Diphenhist(Antihistamine)
1308 Compare to Benadrylreg 25 mg tablets 100 per box A registered trademark of Pfizer
$600
Diphenhydramine HCL (Antihistamine)
1009 Compare to Benadrylreg 25 mg 24 per packA registered trademark of Pfizer
$500
Guaifenesin Cough Expectorant
1180 Compare to Robitussinreg 200mg tablets 60 per bottle A registered trademark of American Home Products Corporation
$900
Loratadine (Generic Claritin)
1611 Compare to Claritinreg Allergy Relief 24hr 100 per bottle A registered trademark of Bayer
$2000
Mucus Relief DM Expectorant amp Cough Suppressant
1178 Compare to Mucinex DMA registered trademark of Reckitt Benckiser
$1200
Multi-Symptom Cold Formula
1357 Compare to Tylenolreg Cold Multi-Symptom 24 tablets per box A registered trademark of McNeil PPC Inc
$600
Nasal Decongestant Spray - 12 Hour
1091 Compare to Afrinreg 005 30 ml sprayA registered trademark of Schering-Plough HealthCare Products Inc
$500
12
Category Product Item Brand EquivalentDescription Cost
Allergy Cold Flu Decongestant amp Sinus (continued)
Nasal Spray Saline 1052 Compare to Oceanreg Premium Saline Nasal Spray 065 15 oz spray A registered trademark of Fleming Pharmaceuticals
$500
Personal Steam Inhaler 1792 Compare to Vicks Personal Steam InhalerA registered trademark of Procter amp Gamble
$5000
Sore Throat Lozenges 1360 Compare to Cepacolreg Quantity 16 lozengesA registered trademark of Reckitt Benckiser Group
$700
Sore Throat Lozenges Cherry
1176 Compare to CepacolA registered trademark of Reckitt Benckiser
$700
Sore Throat Spray Cherry 1904 Compare to Chloraseptic Sore Throat Spray - Cherry A registered trademark of Prestige Brands
$900
Sudogest PE (Nasal amp Sinus Decongestant)
1352 Compare to Sudafed PEreg 10mg 36 tablets per box A registered trademark of Johnson amp Johnson
$500
Antacids amp Acid Reducers
Antacid Anti-Gas Liquid 1006 Compare to Maaloxreg Regular Strength 12 oz per bottle A registered trademark of William H Rorer Inc
$600
Antacid Chewables 1346 Compare to Tumsreg 500 mg 150 tablets per bottle A registered trademark of SmithKline Beecham
$600
Effervescent Pain Reliever
1314 Compare to Alka-SeltzerA registered trademark of Bayer AG
$800
Famotidine Acid Reducer
1108 Compare to Pepcidreg 10 mg tablets 30 per box A registered trademark of Merck amp Co Inc
$600
Omeprazole Acid Reducer
1110 Compare to Prilosec OTCreg 20 mg tablets 28 per box A registered trademark of AstraZeneca
$2300
Ranitidine Acid Reducer 1900 Compare to ZantacA registered trademark of Sanofi
$800
Simethicone Anti-Gas Chewables
1800 Compare to ZantacA registered trademark of Sanofi
$1000
Anticandidal (yeast)
Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
1115 Compare to Gyne-Lotriminreg45 gm per tube A registered trademark of Schering-Plough HealthCare Products Inc
$800
Micanozole 3-Day Treatment
1117 Compare to Monistat 3reg 200 mg - 2 1 kitA registered trademark of McNeil-PPC Inc
$1400
Tioconazole 1-Day Treatment Vaginal Cream (with applicator)
1119 Compare to Monistat 1reg 65 1 tubeA registered trademark of McNeil-PPC Inc
$2000
13
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
OTC MEDICATIONS AND PRODUCTS Before ordering any of the items below you should talk with your doctor
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Biotin Gummy 1820 Compare to Vitafusion Biotin Gummy Vitamins A registered trademark of Church amp Dwight Co Inc
$1200
Calcium + Vitamin D 1373 Compare to Caltratereg 600 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Calcium + Vitamin D Gummy
1823 Compare to Vitafusion Calcium + Vitamin D Gummy A registered trademark of Church amp Dwight Co Inc
$1400
Calcium Carbonate Tablets
1291 Compare to Caltrate-Dreg 600 + D Calcium Supplement 600 mg tablets 60 per bottle A registered trademark of Pfizer Consumer Healthcare
$500
Coenzyme Q-10 1829 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
Daily Multiple Vitamin Tablets with Minerals
1385 Compare to Centrumreg 100 tablets per bottle A registered trademark of Pfizer Consumer Healthcare
$700
Ferrous Gluconate (Iron Supplement)
1375 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$600
Ferrous Sulfate 1376 Compare to Feosolreg 325 mg tablets 100 per bottle A registered trademark of Meda Consumer Healthcare Inc
$500
Fish Oil Tablets 1741 Compare to Naturersquos Bountyreg 1000 mg tablets 60 per bottleA registered trademark of Naturersquos Bounty Inc
$1100
Folic Acid 1850 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Glucosamine Chondroitin
1003 Compare to 21st Century Glucosamine amp Chondroitin Original Formula 250-200 mg capsules 60 per bottle A registered trademark of 21st Century HealthCare Inc
$1100
Iron 1417 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$900
Leg Cramps Pain Relief Caplets
1869 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1400
Magnesium 1418 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$800
Magnesium Oxide 1377 Compare to Nature Madereg Strength 250mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$700
Melatonin 1879 Compare to Naturersquos BountyA registered trademark of Naturersquos Bounty Inc
$1200
10
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Niacin 1378 Compare to Nature Madereg Strength 100mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$500
One Daily Menrsquos Multi-Vitamin
1886 Compare to One A DayA registered trademark of Bayer AG
$1000
One Daily Womenrsquos Multi-Vitamin
1887 Compare to One A DayA registered trademark of Bayer AG
$1000
Senior Multivitamin 1392 Compare to Centrum SilverA registered trademark of Pfizer
$1000
Stress Formula Tablets with Zinc
1734 Compare to Nature Made Stress B Complex with Zinc A registered trademark of Pharmavite
$1400
Vitamin A 1379 Vitamin A 100 tablets per bottle $600 Vitamin B-Complex 1382 Vitamin B Complex 100 tablets per bottle $600 Vitamin B-Complex Gummy
1915 Compare to Vitafusion B-Complex Gummy VitaminsA registered trademark of Church amp Dwight Co Inc
$1200
Vitamin B-1 1016 Vitamin B-1 100 mg tablets 100 per bottle $600 Vitamin B-6 1380 Vitamin B-6 50 mg tablets 100 per bottle $600 Vitamin B-6 1388 Compare to Naturersquos Bounty A registered
trademark of Naturersquos Bounty Inc $800
Vitamin B-12 1381 Vitamin B-12 100 tablets per bottle $1000 Vitamin C 1017 Vitamin C 500 mg 100 tablets per bottle $600 Vitamin C Gummy 1916 Compare to Vitafusion Power C Gummy Vitamins
A registered trademark of Church amp Dwight Co Inc $1200
Vitamin D 1383 Vitamin D 100 tablets per bottle $500 Vitamin D 1390 Compare to Naturersquos Bounty
A registered trademark of Naturersquos Bounty Inc $1000
Vitamin E Soft Gels 1384 Vitamin E 100 tablets per bottle $800 In-Home Diagnostics
Desktop AutomaticBlood Pressure Monitor
1253 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$6000
Desktop Blood PressureMonitor Replacement Cuff
1504 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$1900
Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
1503 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$8000
EZ Detect Colon Cancer Test Kit
1416 Compare to Reveal Colon Disease Testreg A registered trademark of American Screening Corp
$1300
Finger Pulse Oximeter
1505 Compare to HealthSmartregA registered trademark of Briggs Healthcare
$5200
Home Access Cholesterol Test
1251 Compare to CholesTrakreg 1 pieceA registered trademark of AccuTech LLC
$3500
Wrist Blood Pressure Monitor
1501 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$4000
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo)
1502 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$5500
11
OTC MEDICATIONS AND PRODUCTS You can order the following items without having to talk with your doctor but we always recommend that you talk with your doctor before starting a new product regime
Category Product Item Brand EquivalentDescription Cost
Allergy All-Day Allergy TabletsCold Flu (Cetrizine HCL) Decongestant amp Sinus All-Nite ColdFlu
1090
1361
Compare to Zyrtecreg $700 10 mg tablets 14 per box A registered trademark of McNeil-PPC Inc Compare to Vicksreg NyQuilreg Cough $600 A registered trademark of Procter amp Gamble
ChlorpheniramineMaleate (Antihistamine)
1008 Compare to Chlor-Trimetonreg Allergy 4 mg tablets 100 per boxA registered trademark of Schering-Plough HealthCare Products Inc
$500
Cough amp Cold for High Blood Pressure
1166 Compare to Coricidin HBPA registered trademark of Bayer AG
$700
Cough Drops Cherry
1056 Compare to HALLSreg Quantity 30 lozenges A registered trademark of Mondelēz International
$600
Cough Drops Sugar Free Cherry
1182 Compare to Ludens Throat Drops Sugar Free Wild CherryA registered trademark of Prestige Brands
$600
Cough Syrup Expectorant
1054 Compare to Robitussinreg 4 oz per bottleA registered trademark of American Home Products Corporation
$500
Cromolyn Sodium(Allergy Nasal Spray)
1356 Compare to NasalCromreg 26 ml per bottleA registered trademark of McNeil-PPC Inc
$1400
Diabetic Tussin DM 1323 Compare to Robitussin DMA registered trademark of Pfizer
$1100
Diphenhist(Antihistamine)
1308 Compare to Benadrylreg 25 mg tablets 100 per box A registered trademark of Pfizer
$600
Diphenhydramine HCL (Antihistamine)
1009 Compare to Benadrylreg 25 mg 24 per packA registered trademark of Pfizer
$500
Guaifenesin Cough Expectorant
1180 Compare to Robitussinreg 200mg tablets 60 per bottle A registered trademark of American Home Products Corporation
$900
Loratadine (Generic Claritin)
1611 Compare to Claritinreg Allergy Relief 24hr 100 per bottle A registered trademark of Bayer
$2000
Mucus Relief DM Expectorant amp Cough Suppressant
1178 Compare to Mucinex DMA registered trademark of Reckitt Benckiser
$1200
Multi-Symptom Cold Formula
1357 Compare to Tylenolreg Cold Multi-Symptom 24 tablets per box A registered trademark of McNeil PPC Inc
$600
Nasal Decongestant Spray - 12 Hour
1091 Compare to Afrinreg 005 30 ml sprayA registered trademark of Schering-Plough HealthCare Products Inc
$500
12
Category Product Item Brand EquivalentDescription Cost
Allergy Cold Flu Decongestant amp Sinus (continued)
Nasal Spray Saline 1052 Compare to Oceanreg Premium Saline Nasal Spray 065 15 oz spray A registered trademark of Fleming Pharmaceuticals
$500
Personal Steam Inhaler 1792 Compare to Vicks Personal Steam InhalerA registered trademark of Procter amp Gamble
$5000
Sore Throat Lozenges 1360 Compare to Cepacolreg Quantity 16 lozengesA registered trademark of Reckitt Benckiser Group
$700
Sore Throat Lozenges Cherry
1176 Compare to CepacolA registered trademark of Reckitt Benckiser
$700
Sore Throat Spray Cherry 1904 Compare to Chloraseptic Sore Throat Spray - Cherry A registered trademark of Prestige Brands
$900
Sudogest PE (Nasal amp Sinus Decongestant)
1352 Compare to Sudafed PEreg 10mg 36 tablets per box A registered trademark of Johnson amp Johnson
$500
Antacids amp Acid Reducers
Antacid Anti-Gas Liquid 1006 Compare to Maaloxreg Regular Strength 12 oz per bottle A registered trademark of William H Rorer Inc
$600
Antacid Chewables 1346 Compare to Tumsreg 500 mg 150 tablets per bottle A registered trademark of SmithKline Beecham
$600
Effervescent Pain Reliever
1314 Compare to Alka-SeltzerA registered trademark of Bayer AG
$800
Famotidine Acid Reducer
1108 Compare to Pepcidreg 10 mg tablets 30 per box A registered trademark of Merck amp Co Inc
$600
Omeprazole Acid Reducer
1110 Compare to Prilosec OTCreg 20 mg tablets 28 per box A registered trademark of AstraZeneca
$2300
Ranitidine Acid Reducer 1900 Compare to ZantacA registered trademark of Sanofi
$800
Simethicone Anti-Gas Chewables
1800 Compare to ZantacA registered trademark of Sanofi
$1000
Anticandidal (yeast)
Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
1115 Compare to Gyne-Lotriminreg45 gm per tube A registered trademark of Schering-Plough HealthCare Products Inc
$800
Micanozole 3-Day Treatment
1117 Compare to Monistat 3reg 200 mg - 2 1 kitA registered trademark of McNeil-PPC Inc
$1400
Tioconazole 1-Day Treatment Vaginal Cream (with applicator)
1119 Compare to Monistat 1reg 65 1 tubeA registered trademark of McNeil-PPC Inc
$2000
13
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
Category Product Item Brand EquivalentDescription Cost
Vitamins amp Minerals
Niacin 1378 Compare to Nature Madereg Strength 100mgQuantity 100 tabs A registered trademark of Nature Made Nutritional Products
$500
One Daily Menrsquos Multi-Vitamin
1886 Compare to One A DayA registered trademark of Bayer AG
$1000
One Daily Womenrsquos Multi-Vitamin
1887 Compare to One A DayA registered trademark of Bayer AG
$1000
Senior Multivitamin 1392 Compare to Centrum SilverA registered trademark of Pfizer
$1000
Stress Formula Tablets with Zinc
1734 Compare to Nature Made Stress B Complex with Zinc A registered trademark of Pharmavite
$1400
Vitamin A 1379 Vitamin A 100 tablets per bottle $600 Vitamin B-Complex 1382 Vitamin B Complex 100 tablets per bottle $600 Vitamin B-Complex Gummy
1915 Compare to Vitafusion B-Complex Gummy VitaminsA registered trademark of Church amp Dwight Co Inc
$1200
Vitamin B-1 1016 Vitamin B-1 100 mg tablets 100 per bottle $600 Vitamin B-6 1380 Vitamin B-6 50 mg tablets 100 per bottle $600 Vitamin B-6 1388 Compare to Naturersquos Bounty A registered
trademark of Naturersquos Bounty Inc $800
Vitamin B-12 1381 Vitamin B-12 100 tablets per bottle $1000 Vitamin C 1017 Vitamin C 500 mg 100 tablets per bottle $600 Vitamin C Gummy 1916 Compare to Vitafusion Power C Gummy Vitamins
A registered trademark of Church amp Dwight Co Inc $1200
Vitamin D 1383 Vitamin D 100 tablets per bottle $500 Vitamin D 1390 Compare to Naturersquos Bounty
A registered trademark of Naturersquos Bounty Inc $1000
Vitamin E Soft Gels 1384 Vitamin E 100 tablets per bottle $800 In-Home Diagnostics
Desktop AutomaticBlood Pressure Monitor
1253 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$6000
Desktop Blood PressureMonitor Replacement Cuff
1504 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$1900
Desktop Talking Blood Pressure Monitor (87rdquo to 134rdquo)
1503 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$8000
EZ Detect Colon Cancer Test Kit
1416 Compare to Reveal Colon Disease Testreg A registered trademark of American Screening Corp
$1300
Finger Pulse Oximeter
1505 Compare to HealthSmartregA registered trademark of Briggs Healthcare
$5200
Home Access Cholesterol Test
1251 Compare to CholesTrakreg 1 pieceA registered trademark of AccuTech LLC
$3500
Wrist Blood Pressure Monitor
1501 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$4000
Wrist Talking Blood Pressure Monitor (9rdquo to 146rdquo)
1502 Compare to Omronreg A registered trademark of Omron Healthcare Inc
$5500
11
OTC MEDICATIONS AND PRODUCTS You can order the following items without having to talk with your doctor but we always recommend that you talk with your doctor before starting a new product regime
Category Product Item Brand EquivalentDescription Cost
Allergy All-Day Allergy TabletsCold Flu (Cetrizine HCL) Decongestant amp Sinus All-Nite ColdFlu
1090
1361
Compare to Zyrtecreg $700 10 mg tablets 14 per box A registered trademark of McNeil-PPC Inc Compare to Vicksreg NyQuilreg Cough $600 A registered trademark of Procter amp Gamble
ChlorpheniramineMaleate (Antihistamine)
1008 Compare to Chlor-Trimetonreg Allergy 4 mg tablets 100 per boxA registered trademark of Schering-Plough HealthCare Products Inc
$500
Cough amp Cold for High Blood Pressure
1166 Compare to Coricidin HBPA registered trademark of Bayer AG
$700
Cough Drops Cherry
1056 Compare to HALLSreg Quantity 30 lozenges A registered trademark of Mondelēz International
$600
Cough Drops Sugar Free Cherry
1182 Compare to Ludens Throat Drops Sugar Free Wild CherryA registered trademark of Prestige Brands
$600
Cough Syrup Expectorant
1054 Compare to Robitussinreg 4 oz per bottleA registered trademark of American Home Products Corporation
$500
Cromolyn Sodium(Allergy Nasal Spray)
1356 Compare to NasalCromreg 26 ml per bottleA registered trademark of McNeil-PPC Inc
$1400
Diabetic Tussin DM 1323 Compare to Robitussin DMA registered trademark of Pfizer
$1100
Diphenhist(Antihistamine)
1308 Compare to Benadrylreg 25 mg tablets 100 per box A registered trademark of Pfizer
$600
Diphenhydramine HCL (Antihistamine)
1009 Compare to Benadrylreg 25 mg 24 per packA registered trademark of Pfizer
$500
Guaifenesin Cough Expectorant
1180 Compare to Robitussinreg 200mg tablets 60 per bottle A registered trademark of American Home Products Corporation
$900
Loratadine (Generic Claritin)
1611 Compare to Claritinreg Allergy Relief 24hr 100 per bottle A registered trademark of Bayer
$2000
Mucus Relief DM Expectorant amp Cough Suppressant
1178 Compare to Mucinex DMA registered trademark of Reckitt Benckiser
$1200
Multi-Symptom Cold Formula
1357 Compare to Tylenolreg Cold Multi-Symptom 24 tablets per box A registered trademark of McNeil PPC Inc
$600
Nasal Decongestant Spray - 12 Hour
1091 Compare to Afrinreg 005 30 ml sprayA registered trademark of Schering-Plough HealthCare Products Inc
$500
12
Category Product Item Brand EquivalentDescription Cost
Allergy Cold Flu Decongestant amp Sinus (continued)
Nasal Spray Saline 1052 Compare to Oceanreg Premium Saline Nasal Spray 065 15 oz spray A registered trademark of Fleming Pharmaceuticals
$500
Personal Steam Inhaler 1792 Compare to Vicks Personal Steam InhalerA registered trademark of Procter amp Gamble
$5000
Sore Throat Lozenges 1360 Compare to Cepacolreg Quantity 16 lozengesA registered trademark of Reckitt Benckiser Group
$700
Sore Throat Lozenges Cherry
1176 Compare to CepacolA registered trademark of Reckitt Benckiser
$700
Sore Throat Spray Cherry 1904 Compare to Chloraseptic Sore Throat Spray - Cherry A registered trademark of Prestige Brands
$900
Sudogest PE (Nasal amp Sinus Decongestant)
1352 Compare to Sudafed PEreg 10mg 36 tablets per box A registered trademark of Johnson amp Johnson
$500
Antacids amp Acid Reducers
Antacid Anti-Gas Liquid 1006 Compare to Maaloxreg Regular Strength 12 oz per bottle A registered trademark of William H Rorer Inc
$600
Antacid Chewables 1346 Compare to Tumsreg 500 mg 150 tablets per bottle A registered trademark of SmithKline Beecham
$600
Effervescent Pain Reliever
1314 Compare to Alka-SeltzerA registered trademark of Bayer AG
$800
Famotidine Acid Reducer
1108 Compare to Pepcidreg 10 mg tablets 30 per box A registered trademark of Merck amp Co Inc
$600
Omeprazole Acid Reducer
1110 Compare to Prilosec OTCreg 20 mg tablets 28 per box A registered trademark of AstraZeneca
$2300
Ranitidine Acid Reducer 1900 Compare to ZantacA registered trademark of Sanofi
$800
Simethicone Anti-Gas Chewables
1800 Compare to ZantacA registered trademark of Sanofi
$1000
Anticandidal (yeast)
Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
1115 Compare to Gyne-Lotriminreg45 gm per tube A registered trademark of Schering-Plough HealthCare Products Inc
$800
Micanozole 3-Day Treatment
1117 Compare to Monistat 3reg 200 mg - 2 1 kitA registered trademark of McNeil-PPC Inc
$1400
Tioconazole 1-Day Treatment Vaginal Cream (with applicator)
1119 Compare to Monistat 1reg 65 1 tubeA registered trademark of McNeil-PPC Inc
$2000
13
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
OTC MEDICATIONS AND PRODUCTS You can order the following items without having to talk with your doctor but we always recommend that you talk with your doctor before starting a new product regime
Category Product Item Brand EquivalentDescription Cost
Allergy All-Day Allergy TabletsCold Flu (Cetrizine HCL) Decongestant amp Sinus All-Nite ColdFlu
1090
1361
Compare to Zyrtecreg $700 10 mg tablets 14 per box A registered trademark of McNeil-PPC Inc Compare to Vicksreg NyQuilreg Cough $600 A registered trademark of Procter amp Gamble
ChlorpheniramineMaleate (Antihistamine)
1008 Compare to Chlor-Trimetonreg Allergy 4 mg tablets 100 per boxA registered trademark of Schering-Plough HealthCare Products Inc
$500
Cough amp Cold for High Blood Pressure
1166 Compare to Coricidin HBPA registered trademark of Bayer AG
$700
Cough Drops Cherry
1056 Compare to HALLSreg Quantity 30 lozenges A registered trademark of Mondelēz International
$600
Cough Drops Sugar Free Cherry
1182 Compare to Ludens Throat Drops Sugar Free Wild CherryA registered trademark of Prestige Brands
$600
Cough Syrup Expectorant
1054 Compare to Robitussinreg 4 oz per bottleA registered trademark of American Home Products Corporation
$500
Cromolyn Sodium(Allergy Nasal Spray)
1356 Compare to NasalCromreg 26 ml per bottleA registered trademark of McNeil-PPC Inc
$1400
Diabetic Tussin DM 1323 Compare to Robitussin DMA registered trademark of Pfizer
$1100
Diphenhist(Antihistamine)
1308 Compare to Benadrylreg 25 mg tablets 100 per box A registered trademark of Pfizer
$600
Diphenhydramine HCL (Antihistamine)
1009 Compare to Benadrylreg 25 mg 24 per packA registered trademark of Pfizer
$500
Guaifenesin Cough Expectorant
1180 Compare to Robitussinreg 200mg tablets 60 per bottle A registered trademark of American Home Products Corporation
$900
Loratadine (Generic Claritin)
1611 Compare to Claritinreg Allergy Relief 24hr 100 per bottle A registered trademark of Bayer
$2000
Mucus Relief DM Expectorant amp Cough Suppressant
1178 Compare to Mucinex DMA registered trademark of Reckitt Benckiser
$1200
Multi-Symptom Cold Formula
1357 Compare to Tylenolreg Cold Multi-Symptom 24 tablets per box A registered trademark of McNeil PPC Inc
$600
Nasal Decongestant Spray - 12 Hour
1091 Compare to Afrinreg 005 30 ml sprayA registered trademark of Schering-Plough HealthCare Products Inc
$500
12
Category Product Item Brand EquivalentDescription Cost
Allergy Cold Flu Decongestant amp Sinus (continued)
Nasal Spray Saline 1052 Compare to Oceanreg Premium Saline Nasal Spray 065 15 oz spray A registered trademark of Fleming Pharmaceuticals
$500
Personal Steam Inhaler 1792 Compare to Vicks Personal Steam InhalerA registered trademark of Procter amp Gamble
$5000
Sore Throat Lozenges 1360 Compare to Cepacolreg Quantity 16 lozengesA registered trademark of Reckitt Benckiser Group
$700
Sore Throat Lozenges Cherry
1176 Compare to CepacolA registered trademark of Reckitt Benckiser
$700
Sore Throat Spray Cherry 1904 Compare to Chloraseptic Sore Throat Spray - Cherry A registered trademark of Prestige Brands
$900
Sudogest PE (Nasal amp Sinus Decongestant)
1352 Compare to Sudafed PEreg 10mg 36 tablets per box A registered trademark of Johnson amp Johnson
$500
Antacids amp Acid Reducers
Antacid Anti-Gas Liquid 1006 Compare to Maaloxreg Regular Strength 12 oz per bottle A registered trademark of William H Rorer Inc
$600
Antacid Chewables 1346 Compare to Tumsreg 500 mg 150 tablets per bottle A registered trademark of SmithKline Beecham
$600
Effervescent Pain Reliever
1314 Compare to Alka-SeltzerA registered trademark of Bayer AG
$800
Famotidine Acid Reducer
1108 Compare to Pepcidreg 10 mg tablets 30 per box A registered trademark of Merck amp Co Inc
$600
Omeprazole Acid Reducer
1110 Compare to Prilosec OTCreg 20 mg tablets 28 per box A registered trademark of AstraZeneca
$2300
Ranitidine Acid Reducer 1900 Compare to ZantacA registered trademark of Sanofi
$800
Simethicone Anti-Gas Chewables
1800 Compare to ZantacA registered trademark of Sanofi
$1000
Anticandidal (yeast)
Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
1115 Compare to Gyne-Lotriminreg45 gm per tube A registered trademark of Schering-Plough HealthCare Products Inc
$800
Micanozole 3-Day Treatment
1117 Compare to Monistat 3reg 200 mg - 2 1 kitA registered trademark of McNeil-PPC Inc
$1400
Tioconazole 1-Day Treatment Vaginal Cream (with applicator)
1119 Compare to Monistat 1reg 65 1 tubeA registered trademark of McNeil-PPC Inc
$2000
13
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
Category Product Item Brand EquivalentDescription Cost
Allergy Cold Flu Decongestant amp Sinus (continued)
Nasal Spray Saline 1052 Compare to Oceanreg Premium Saline Nasal Spray 065 15 oz spray A registered trademark of Fleming Pharmaceuticals
$500
Personal Steam Inhaler 1792 Compare to Vicks Personal Steam InhalerA registered trademark of Procter amp Gamble
$5000
Sore Throat Lozenges 1360 Compare to Cepacolreg Quantity 16 lozengesA registered trademark of Reckitt Benckiser Group
$700
Sore Throat Lozenges Cherry
1176 Compare to CepacolA registered trademark of Reckitt Benckiser
$700
Sore Throat Spray Cherry 1904 Compare to Chloraseptic Sore Throat Spray - Cherry A registered trademark of Prestige Brands
$900
Sudogest PE (Nasal amp Sinus Decongestant)
1352 Compare to Sudafed PEreg 10mg 36 tablets per box A registered trademark of Johnson amp Johnson
$500
Antacids amp Acid Reducers
Antacid Anti-Gas Liquid 1006 Compare to Maaloxreg Regular Strength 12 oz per bottle A registered trademark of William H Rorer Inc
$600
Antacid Chewables 1346 Compare to Tumsreg 500 mg 150 tablets per bottle A registered trademark of SmithKline Beecham
$600
Effervescent Pain Reliever
1314 Compare to Alka-SeltzerA registered trademark of Bayer AG
$800
Famotidine Acid Reducer
1108 Compare to Pepcidreg 10 mg tablets 30 per box A registered trademark of Merck amp Co Inc
$600
Omeprazole Acid Reducer
1110 Compare to Prilosec OTCreg 20 mg tablets 28 per box A registered trademark of AstraZeneca
$2300
Ranitidine Acid Reducer 1900 Compare to ZantacA registered trademark of Sanofi
$800
Simethicone Anti-Gas Chewables
1800 Compare to ZantacA registered trademark of Sanofi
$1000
Anticandidal (yeast)
Clotrimazole 7-DayTreatment Vaginal Cream (with applicator)
1115 Compare to Gyne-Lotriminreg45 gm per tube A registered trademark of Schering-Plough HealthCare Products Inc
$800
Micanozole 3-Day Treatment
1117 Compare to Monistat 3reg 200 mg - 2 1 kitA registered trademark of McNeil-PPC Inc
$1400
Tioconazole 1-Day Treatment Vaginal Cream (with applicator)
1119 Compare to Monistat 1reg 65 1 tubeA registered trademark of McNeil-PPC Inc
$2000
13
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
OTC MEDICATIONS AND PRODUCTS
14
Category Product Item Brand EquivalentDescription Cost
Anti-diarrheal Laxatives amp Digestive Health
Bisacodyl EntericCoated Laxative
1128 Compare to Dulcolaxreg 5mg tabs 100 tabs per pack A registered trademark of Boehringer Ingelheim International GmbH
$600
Bismatrol Chewable Tablets
1045 Compare to Chewable Pepto-Bismolreg 262 mg 30 chewable tablets per boxA registered trademark of Proctor amp Gamble
$600
Docusate Sodium Stool Softener
1126 Compare to Colacereg 100 mg capsules 100 per bottleA registered trademark of Purdue Products
$600
Glycerin Suppository 1125 Compare to Fleetreg Glycerin Suppositories 25 suppositories per bottle A registered trademark of CB Fleet Co Inc
$500
Lactase Capsules 1067 Compare to Lactaidreg 9000 ICC 60 tabletsA registered trademark of McNeil Nutritionals LLC
$1000
Loperamide HCL Anti-Diarrheal
1133 Compare to Imodium A-Dreg2 mg tablets 12 per boxA registered trademark of McNeil-PPC Inc
$500
Methylcellulose Fiber Therapy
1354 Compare to Citrucelreg 16 oz per bottleA registered trademark of GlaxoSmithKline
$1200
Milk of Magnesia 1011 Compare to Phillipsrsquoreg Milk of Magnesia 400 mg 12 oz bottle A registered trademark of Bayer HealthCare LLC
$600
Natural VegetableLaxative
1340 Compare to Metamucilreg 13 oz powder per bottleA registered trademark of Procter amp Gamble
$1000
Pink Bismuth 1318 Compare to Pepto-Bismolreg 262 mg 8 oz per bottle A registered trademark of Procter amp Gamble
$600
PolycarbophilFiber Tablets
1012 Compare to Fiberconreg 625 mg tablets 90 per bottle A registered trademark of Whitehall-Robins Healthcare
$1000
Senna Plus Stool Softener Plus Laxative
1130 Compare to Senokot- Sreg 86 - 50 mg 60 tablets per bottle A registered trademark of Purdue Products
$600
Anti-fungal amp Anti-itch
Clotrimazole Antifungal Athletersquos Foot Cream
1047 Compare to Lotrimin AFreg Strength 1 Quantity 1 oz A registered trademark of MSD Consumer Care Inc
$600
DiphenhydramineHCL Zinc Acetate Anti-itch Cream
1140 Compare to Benadrylreg Itch Stopping Quantity 1 oz A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Hydrocortisone1 Cream
1074 Compare to Cortaidreg Maximum Strength Cream 1 1 oz per tubeA registered trademark of Johnson amp Johnson Corporation
$600
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
15
Category Product Item Brand EquivalentDescription Cost
Anti-fungal amp Anti-itch (continued)
Medicated Antifungal Foot Powder Spray
1874 Compare to Lotrimin AFA registered trademark of Bayer AG
$1000
Miconazole Nitrate 2 Antifungal Cream
1135 Compare to MicatinA registered trademark of WellSpring
$800
Terbinafine HCL Antifungal Cream
1046 Compare to Lamisil ATreg Strength 1 Quantity 05 oz A registered trademark of Novartis Consumer Health Inc
$1200
Tolnaftate Antifungal Cream
1064 Compare to Tinactinreg Strength 1Quantity 05 oz A registered trademark of MSD Consumer Care Inc
$500
Cold Sore amp Medicated Lip Products
Abreva 1152 Compare to Abrevareg 10 2 gm per tubeA registered trademark of GlaxoSmithKline
$2600
Herpecin-L Lip Balm 1153 Compare to Herpecin-Lreg Lip Balm 1 01 oz A registered trademark of Chattem Inc
$800
Releev Cold Sore Treatment
1359 Releevreg Cold Sore Treatment Strength013 Quantity 6 ml A registered trademark of Merix Pharmaceutical Corporation
$2500
Dental amp Denture Care
Denture Cleaning Tablets
1032 Compare to Efferdentreg Anti-Bacterial Denture Cleanser 40 tablets per boxA registered trademark of Warner-Lambert Consumer Healthcare
$700
Fixodent 1187 Compare to Fixodentreg 075 oz per tubeA registered trademark of Procter amp Gamble
$700
Interdental Flossups 1751 Compare to Oral-Breg Complete Floss Picks 90 ct A registered trademark of Procter amp Gamble
$700
Orajel Pain Relief 1454 Compare to Orajelreg 7 gm tube A registered trademark of Church amp Dwight Co Inc
$1100
Oral Pain Relief 1286 Compare to Anbesolreg Strength 20 Quantity 15 ml A registered trademark of Pfizer labs
$600
Polident Denture Cream 1324 Compare to Super PoligripA registered trademark of GlaxoSmithKline
$800
Reach Waxed Dental Floss Mint
1455 Compare to Reachreg Dental Floss 55 Yards Quantity 1 A registered trademark of Johnson amp Johnson Consumer Products Co
$500
Rechargeable Toothbrush
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
Toothbrush Colgate Adult Soft
1413 Compare to Colgatereg ToothbrushA registered trademark of Procter amp Gamble
$500
Toothbrush Rechargeable
1450 Compare to Oral Breg VitalityA registered trademark of Procter amp Gamble
$4000
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Dental amp Denture Care (continued)
Water Jet 1744 Compare to Conair Water JetA registered trademark of Conair
$3900
Water Jet Replacement Tips
1743 Compare to Conair Replacement TipsA registered trademark of Conair
$1800
Toothbrush Tek Pro Straight Soft
1412 Compare to Tek Proreg ToothbrushA registered trademark of Dr Fresh
$400
Toothpaste - Pepsodent 1414 Compare to Pepsodentreg Complete CareFluoride Toothpaste Quantity 6 oz A registered trademark of Church amp Dwight Co
$600
Diabetes Diabetic Sock Black Medium
1491 Compare to Dr Schollsreg Black Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock Black Large
1492 Compare to Dr Schollsreg Black Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Medium
1489 Compare to Dr Schollsreg White Size Medium Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Diabetic Sock White Large
1490 Compare to Dr Schollsreg White Size Large Quantity 1 pair A registered trademark of MSD Consumer Care Inc
$800
Ear Care Cotton Tipped Swabs 1742 Compare to Q-Tipsreg Cotton Swabs 300 ct A registered trademark of Unilever
$700
Ear Pain Relief Ear Drops 1841 Compare to Hylandrsquos Ear ReliefA registered trademark of Hylandrsquos
$1300
Ear Wax Removal Drops
1190 Compare to Murinereg Ear Drops 15 ml per bottle A registered trademark of Prestige Brands International Inc
$500
Ear Wax Removal System with Rubber Bulb
1363 Compare to Murinereg Ear Wax Removal System 15 ml per bottle with syringeA registered trademark of Prestige Brands International Inc
$700
Eye Care Artificial Tears Drops
1192 Compare to Visinereg Tears Eye Drops Quantity 05oz A registered trademark of Johnson amp Johnson Healthcare Products
$600
Artificial Tears Ointment
1194 Compare to lsquoRefresh PMrsquo 35 gm per tubeA registered trademark of Allergan Inc
$600
Eye Wash Solution 1196 Compare to Bausch amp LombA registered trademark of Bausch amp Lomb
$800
Multi-Purpose Contact Lens Solution
1468 Compare to Renu MultipurposeSolutionreg Quantity 120 mlA registered trademark of Bausch amp Lomb
$600
Redness Relief Eye Drops
1061 Compare to Visinereg Original15 ml per bottle A registered trademark of Johnson amp Johnson Healthcare Products
$500
16
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
Category Product Item Brand EquivalentDescription Cost
First Aid amp Medical Supplies
Adhesive Bandages
AdjustableTransfer Bench
After Bite Relief
Alcohol Pads
Antiseptic Towelettes
1344
1764
1803
1200
1201
Compare to Band-Aidreg Sheer Box of 60 per box A registered trademark of McNeil-PPC Inc Compare to Drive Medical Adjustable Transfer Bench A registered trademark of Medical Depot Inc Compare to After Bite Relief 5 ozA registered trademark of Tender Corporation Compare to Curadreg Alcohol Swabs 100 per box A registered trademark of Beiersdorf Inc Antiseptic Towelettes Quantity 100
$700
$8000
$900
$600
$700
Bacitracin Ointment 1020 Compare to Bacitracin 1 oz per tube $600
Bath Bench with Back
Bath Bench without Back
Bath Mat Non-Skid
1728
1727
1459
Compare to Essentialreg Shower Bench with back A registered trademark of Essential Medical Supply Compare to Essentialreg Shower BenchA registered trademark of Essential Medical Supply Bath Mat Non-Skid
$6500
$5500
$1700
Bath Tub Safety Rail 1730 Compare to Carexreg Bathrub Rail with chrome finish A registered trademark of Carex Health Brands
$3700
Cotton Balls 1763 Cotton Balls Quantity 200 $700
Cushion Foam Ring 1732 Compare to Carexreg FoamCushion A registered trademark of Carex Health Brands
$2100
Cushion Gel Foam Seat
Cushion Lumbar
1466
1731
Compare to Drive MedicalregA registered trademark of Drive Medical Design and Manufacturing Compare to Carexreg Lumbar SupportCushion A registered trademark of Carex Health Brands
$4200
$2700
Elastic Bandage- 2 in x 45 yd
1207 Compare to Acereg Elastic Bandage 2rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 3 in x 5 yd
1209 Compare to Acereg Elastic Bandage 3rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$400
Elastic Bandage- 4 in x 5 yd
1211 Compare to Acereg Elastic Bandage 4rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare
$500
17
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
First Aid amp Elastic BandageMedical Supplies - 6 in x 5 yd (continued)
Fast Freeze Pain Relief Spray
1213
1846
Compare to Acereg Elastic Bandage $500 6rdquo x 5 yd 1 per pack A registered trademark of BD Consumer Healthcare Compare to Biofreeze Pain Relief $1400 Spray A registered trademark of Hygenic Corporation
First Aid Kit 1738 Compare to Curadreg First Aid Kit 175 pieces A registered trademark of Medline Industries
$1700
First Aid Kit 75 Pieces
1215 Compare to First Aid Onlyreg FAO-120 75 pieces A registered trademark of First Aid Only
$1000
Folding CaneErgonomic Handle
1726 Compare to Novareg Folding CanesA registered trademark of NOVA Medical Products
$2000
HotCold Pack1 small amp 1 large
1062 Compare to Nexcarereg 2 per packA registered trademark of 3M
$700
Humidifier Ultra-Sonic Cool Mist
1795 Compare to Vicks Ultrasonic HumidifierA registered trademark of Procter amp Gamble
$6000
Hydrogen Peroxide 1228 Hydrogen Peroxide 3 8 oz $500
Isopropyl Alcohol Wintergreen
1229 Isopropyl Alcohol Wintergreen 16 oz $600
Insect Repellant Spray (Deet)
1796 Compare to Benrsquosreg Spray Pump Insect Repellent - 30 Percent DEET 4 ozA registered trademark of Ariens Specialty Brands LLC
$1200
Neosporin Plus 1326 Compare to Neosporin Antibiotic and Pain Relieving Cream A registered trademark of Johnson amp Johnson
$1100
Povidone Iodine Solution Antiseptic
1203 Povidone Iodine Solution Antiseptic 4 oz $800
Quad Cane Large Base 1776 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$3000
Quad Cane Small Base 1777 Compare to Drive Medical Quad CaneA registered trademark of Medical Depot Inc
$2500
Raised Toilet Seat 1729 Compare to Quick-Lockreg Raised Toilet Seat A registered trademark of Carex Health Brands
$3500
Shower Mat Non-Skid 1460 Shower Mat Non-Skid $1400
Talking Ear and Forehead Thermometer
1925 Thermometer Talking Ear and Forehead $4500
Tape Paper Surgical - 1 in x 10 yd
1217 Compare to 3M TapeA registered trademark of 3M
$600
18
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
Category Product Item Brand EquivalentDescription Cost
First Aid amp Tape Paper Surgical Medical Supplies - 2 in x 10 yd (continued) Tape Silk Surgical
- 1 in x 10 yd
1218
1219
Compare to 3M Tape $800 A registered trademark of 3M Compare to 3M Tape $600 A registered trademark of 3M
Tape Silk Surgical - 2 in x 10 yd Tape Transparent Surgical - 1 in x 10 yd Tape Transparent Surgical - 2 in x 10 yd Thermometer Digital 60 seconds Thermometer Flexible Tip Digital 10 seconds Thermometer Digital Ear
Toilet Safety Rails
1220
1221
1222
1063
1697
1285
1779
Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to 3M TapeA registered trademark of 3M Compare to Nexcarereg A registered trademark of 3M Consumer Health Compare to ProCheckreg A registered trademark of Microlife Corporation Compare to Braunreg ThermoScanCompact Ear Thermometer 1 per packA registered trademark of Procter amp Gamble Toilet Safety Rails
$800
$600
$800
$500
$1200
$2400
$5000
Triple Antibiotic Ointment
1014 Compare to Neosporinreg 1 oz per tubeA registered trademark of Pfizer
$700
Foot Care Callus Remover Pads 1238 Compare to Dr Schollsreg 6 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Corn Remover Pads 1236 Compare to Dr Schollsreg 9 per packA registered trademark of Schering-Plough Healthcare Products Inc
$700
Medicated Foot Powder 1240 Compare to Gold Bond Foot PowderA registered trademark of Chattem Inc
$700
Hemorrhoidal Preparations
Hemorrhoidal Ointment
1066 Compare to Preparation Hreg Hemorrhoidal Ointment 2 oz per tube A registered trademark of Pfizer Consumer Healthcare
$700
Hemorrhoidal Suppository
1247 Compare to FleetA registered trademark of CB Fleet Company
$700
Pre-moist Hemorrhoid Pads
1364 Compare to Tucksreg 100 per boxA registered trademark of Warner-Lambert Consumer Healthcare
$800
DHEA 1737 DHEA Quantity 50 $1200 Hormone Replacement Incontinence A amp D Ointment 1300 Compare to A amp D Ointment $800
A registered trademark of Schering-Plough Healthcare Products Inc
Supplies
Adult Briefs 1303 Compare to Prevailreg 12 per bag $1000 Medium - 32rdquo to 44rdquo A registered trademark of First Quality
Enterprises Inc
19
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Incontinence Supplies (continued)
Adult Briefs Large - 45rdquo to 58rdquo
Adult Briefs X-Large - 59rdquo to 64rdquo
Attends Discreet Menrsquos Guard
1304
1305
1811
Compare to Prevailreg 12 per bagA registered trademark of First Quality Enterprises Inc Compare to Prevailreg 10 per bagA registered trademark of First Quality Enterprises Inc Compare to DependsA registered trademark of Kimberly-Clark
$1200
$1200
$1600
Attends Discreet Menrsquos Shield
1810 Compare to DependsA registered trademark of Kimberly-Clark
$1500
Attends Discreet Womenrsquos Maximum Bladder Control Pad Attends Discreet Womenrsquos Moderate Bladder Control Pad Attends Discreet Womenrsquos Panty Liner
1812
1813
1815
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1800
$1400
Attends Discreet Womenrsquos Ultimate Bladder Control Pad Attends Discreet Womenrsquos Ultrathin Pad
1814
1816
Compare to DependsA registered trademark of Kimberly-Clark
Compare to DependsA registered trademark of Kimberly-Clark
$2000
$1400
Barrier Cream 1302 Compare to Lantiseptic Barrier CreamA registered trademark of Santus
$1000
Bladder Control Shaped Pad Moderate Absorbency
1478 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1700
Bladder Control Shaped Pad Heavy Absorbency
1479 Compare to Attendsreg 24 per packA registered trademark of Attends Healthcare Products Inc
$1900
Bladder Control Shaped Pad Maximum Absorbency
1480 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Medium - 34rdquo to 44rdquo
1021 Compare to Attendsreg 20 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear Large - 44rdquo to 58rdquo
1026 Compare to Attendsreg 18 per packA registered trademark of Attends Healthcare Products Inc
$1600
Disposable Underwear X-Large - 58rdquo to 68rdquo
1027 Compare to Attendsreg 14 per packA registered trademark of Attends Healthcare Products Inc
$1600
20
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
Category Product Item Brand EquivalentDescription Cost
Incontinence Underpad Supplies Disposable - 23rdquo x 24rdquo (continued)
Underpad Disposable - 23rdquo x 36rdquo
1476
1299
Compare to Attendsreg 50 per pack $1500 A registered trademark of Attends Healthcare Products Inc Compare to Attendsreg 25per pack $1000 A registered trademark of Attends Healthcare Products Inc
Underpad 1477 Compare to Attendsreg 10 per pack $800 Disposable - 30rdquo x 30rdquo A registered trademark of Attends
Healthcare Products Inc Motion Sickness Dramamine Chewables
Orange 1264 Compare to Dramaminereg 50 mg tablets
8 chewable tablets per pack A registered trademark of GD Searle amp Co Corporation
$700
Driminate Antiemetic 1263 Compare to Dramaminereg 50 mg tablets 12 per pack A registered trademark of GD Searle amp Co Corporation
$500
Meclizine HCL Antiemetic
1366 Compare to Boninereg 125 mg 100 tabletsA registered trademark of Pfizer
$800
Pain Relievers amp Fever Reducers
Acetaminophen 1001 Compare to Tylenolreg 325 mg tablets 100 per bottle A registered trademark of McNeil-PPC Inc
$600
Acetaminophen 1600 Compare to Tylenol Extra StrengthA registered trademark of Johnson amp Johnson
$1000
Arthritis Pain Reliever
1311 Compare to Tylenol Arthritisreg 650 mg tablets 100 per bottleA registered trademark of McNeil-PPC Inc
$1200
Aspirin 1095 Compare to Bayerreg Genuine Aspirin325 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$500
AspirinEnteric Coated
1096 Compare to Ecotrinreg Regular Strength325 mg tablets 100 per bottle A registered trademark of Prestige Brands Inc
$500
AspirinLow Dose
1002 Compare to Ecotrinreg Low Strength 81mg tablets 120 per bottle A registered trademark of Prestige Brands Inc
$600
Aspirin Low Dose Chewables
1802 Compare to Bayer Aspirin Chewable wLow Dose A registered trademark of Bayer AG
$500
Capsaicin 1367 Compare to Capzasinreg 2 oz per tubeA registered trademark of Chattem Inc
$1000
Heating Pad 12 in X 15 in
1861 Compare to Sunbeam Heating PadA registered trademark of Newell Brands
$2600
Ibuprofen 1004 Compare to Advilreg 200 mg tablets 100 per bottle A registered trademark of Pfizer Consumer Healthcare
$700
21
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Pain Relievers amp Fever Reducers
Lidocaine Patch 1871 Compare to AspercremeA registered trademark of Chattem Inc
$1700
(continued) Migraine Relief 1365 Compare to Excedrinreg Migraine 250mg Acetaminophen 250mg Aspirin 65mgCaffeine tablets 100 per bottle A registered trademark of Bristol-Myers Company
$600
Naproxen 1097 Compare to Alevereg 220 mg tablets 100 per bottle A registered trademark of Bayer HealthCare LLC
$1100
Pain Relief Patches 1739 Compare to Salonpasreg Pain Relief Patch 5 per box A registered trademark of Hisamitsu America Inc
$1400
Pain Reliever PM - Extra Strength
1332 Compare to Tylenol PM A registered trademark of Johnson amp Johnson
$1000
Pain Relieving Muscle Rub
1475 Compare to Bengayreg 2 oz bottleA registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Thermacare Knee amp Elbow
1911 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Lower Back amp Hip
1912 Compare to ThermacareA registered trademark of Pfizer
$1500
Thermacare Menstrual Relief
1913 Compare to ThermacareA registered trademark of Pfizer
$1500
Pediculicide (lice treatment)
Lice Treatment Shampoo
1271 Compare to Ridreg 240 ml per bottleA registered trademark of Pfizer
$900
Permethrin Lice Treatment
1269 Compare to Nixreg 1 59 ml per bottleA registered trademark of Insight Pharmaceuticals Corporation
$1400
Personal Care Acne Gel 10 Benzoyl Peroxide
1076 Compare to Clean and Clearreg 10 15oz tube A registered trademark of Johnson amp Johnson Consumer Companies Inc
$600
Ammonium Lactate 1368 Compare to AmLactinreg 8 oz A registered trademark of Upsher-Smith Laboratories Inc
$900
Hand Sanitizer 1065 Compare to Purellreg 62 8 oz per bottleA registered trademark of Basell NV Corporation
$600
Sleep Aids Nasal Strips Small Medium
1724 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Nasal Strips Medium Large
1725 Compare to Breathe Rightreg 30 per boxA registered trademark of CNS Inc
$1200
Sleep Tablets 1276 Compare to Sominexreg Nighttime Sleep-Aid 25 mg 50 tabs per box A registered trademark of Prestige Brands Inc
$600
22
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
Category Product Item Brand EquivalentDescription Cost
Smoking Nicotine Lozenges 1281 Compare to Commitreg 4 mg 72 per box $4700 A registered trademark of GlaxoSmithKline Cessation
Nicorelief Gum Before orderingany of these items you should talk Nicotine Patch with your doctor Step 1
1372
1369
Compare to Nicorettereg 4 mg 50 per box $2500 A registered trademark of GlaxoSmithKline Compare to Nicodermreg CQreg $4500 21mg24hr 14 per box A registered trademark of Hoechst Marion Roussel Inc
Nicotine Patch 1370 Compare to Nicodermreg CQreg $4500 Step 2 14mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Nicotine Patch 1371 Compare to Nicodermreg CQreg $4500 Step 3 7mg24hr 14 per box A registered
trademark of Hoechst Marion Roussel Inc Supportive Items
Ankle Support 1225 Compare to Acereg Ankle Brace 1 per pack A registered trademark of BD Consumer Healthcare
$800
Arthritis Gloves Small 1767 Arthritis Gloves Small 1 pair $2500 Arthritis Gloves Medium 1766 Arthritis Gloves Medium 1 pair $2500 Arthritis Gloves Large 1765 Arthritis Gloves Large 1 pair $2500 Back SupportElastic - 24rdquo to 46rdquo
1487 Compare to FuturoregA registered trademark of 3M
$2500
Back SupportElastic with Lumbar
1488 Compare to FuturoregA registered trademark of 3M
$2900
Carpal Tunnel Brace Small
1770 Carpal Tunnel Brace Small Quantity 1 $2500
Carpal Tunnel Brace Medium
1769 Carpal Tunnel Brace Medium Quantity 1 $2500
Carpal Tunnel Brace Large
1768 Carpal Tunnel Brace Large Quantity 1 $2500
Compression Knee HighSocks Menrsquos Black Medium (Shoe Size 8 - 10)
1398 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos Black Large(Shoe Size 105 - 12)
1399 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Medium (Shoe Size 8 - 10)
1400 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee HighSocks Menrsquos White Large(Shoe Size 105 - 12)
1401 Compare to TherafirmregA registered trademark of Knit-Rite Inc
$1700
Compression Knee High Socks Womenrsquos Black Small (Shoe Size 4-5)
1409 Compare to FuturoregA registered trademark of 3M
$1200
23
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
24
OTC MEDICATIONS AND PRODUCTS
Category Product Item Brand EquivalentDescription Cost
Supportive Items (continued)
Compression Knee High Socks Womenrsquos Black Medium (ShoeSize 55 - 75)
1410 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Black Large (Shoe Size 8 - 105)
1411 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Small (Shoe Size 4 - 5)
1406 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Medium (Shoe Size 55 - 75)
1407 Compare to FuturoregA registered trademark of 3M
$1200
Compression Knee High Socks Womenrsquos Nude Large (Shoe Size 8 - 105)
1408 Compare to FuturoregA registered trademark of 3M
$1200
Elbow Support 1224 Compare to Futuro Elbow SupportA registered trademark of 3M
$1500
Hip Protector Small 1864 Hip Protector Small Quantity 1 $4500
Hip Protector Medium 1863 Hip Protector Medium Quantity 1 $4500
Hip Protector Large 1862 Hip Protector Large Quantity 1 $4500
Hip Protector X-Large 1865 Hip Protector X-Large Quantity 1 $4500
Knee Support ElasticSmall
1481 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticSmall with Stays
1484 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticMedium
1482 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticMedium with Stays
1485 Compare to FuturoregA registered trademark of 3M
$1600
Knee Support ElasticLarge
1483 Compare to FuturoregA registered trademark of 3M
$1000
Knee Support ElasticLarge with Stays
1486 Compare to FuturoregA registered trademark of 3M
$1600
Night Wrist Support Smart Glove
1463 Compare to Futuro Night Wrist SupportA registered trademark of 3M
$2800
Rib Belt - Female (one size fits most)
1457 Compare to Curad Rib BeltA registered trademark of Medline Industries
$2100
Rib Belt - Male (one size fits most)
1456 Compare to Curad Rib Belt A registered trademark of Medline Industries
$2100
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
Category Product Item Brand EquivalentDescription Cost
Wrist Splint 1230 Compare to Futuro Wrist Splint A registered trademark of 3M
$1900
Wrist Support 1227 Compare to Futuro Wrist SupportA registered trademark of 3M
$1500
Supportive Items (continued)
Therapeutic Skin amp Sun Care
Aloe Vera Cream 1070 Compare to Fruit of the Earthreg 240ml per tube A registered trademark of Fruit of the Earth Inc
$600
Moisturizing BodyLotion with Aloe
1893 Compare to Gold Bond Skin Therapy LotionA registered trademark of Chattem Inc
$800
Sunscreen Lotion SPF 30
1284 Compare to Coppertonereg 35 oz per bottleA registered trademark of Schering-Plough HealthCare Products Inc
$600
Wart Remover Wart Remover (Liquid)
1075 Compare to Compound Wreg Wart RemoverStrength 17 Quantity 9 ml A registered trademark of Medtech Products Inc
$900
Weight Loss Vitafusion Fiber 1735 Compare to Vitafusion Fiber Well Fit $1600 Weight Management A registered trademark of Church
amp Dwight Co Inc
1-866-851-1579 (TTY 711) You can place your OTC order Monday ndash Friday 8 am ndash 9 pm EST
Residents of nursing facilities should check to determine which OTC products may be shipped to their facility before ordering Product ordering policies may vary by facility PLEASE NOTE The items covered by the benefit are limited to items that are consistent with CMS guidance in the most recent version of chapter 4 of the Medicare Managed Care Manual Each item in the following alphabetized list is either a medicine ointment or spray or a condition which is addressed by a medicine ointment or spray acid acne allergy analgesics (which reduce pain inflammation) anti-arthritics antibiotics anti-diarrheas anti-fungals anti-gas antishyhistamines anti-inflammatory anti-insect anti-itch anti-parasitic antipyretics (fever reducing) antiradicals antiseptics arthritis asthma blood clotting bruises burns calluses colds cold sores corns cough decongestants dermatitis diabetes digestive aids ear drops eczema expectorants (mucus) eye drops flu gastrointestinal hay fever headaches hemorrhoidal incontinence influenza lactose intolerance products laxatives (medicated) lice (medicated) lip products menopausal menstrual motion sickness nasal osteoporosis pain pediculicide psoriasis rash respiratory scars sinus sleep smoking snoring sore throat steroids stomach sunscreen thrush travel sickness wart worms wounds etc The following are not eligible for purchase through the OTC and will not be covered by Cigna-HealthSpring Baby medicines contraceptives dehydration drink dry skin lotions (eg eucerin aquaphor) hair-loss products lactaid milk (because it is a food not a medicine) and shampoos to fight dandruff Certain smoking cessation may be Part B Certain diabetic supplies may be Part B or Part D Please contact Customer Service for more information Antiperspirants chap stick deodorants facial cleansers feminine products grooming devices hair conditioners hair removal hair bleaches moisturizers perfumes shampoos shaving and menrsquos grooming and soaps are also not eligible
25
KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
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KEEP TRACK OF YOUR ORDERS BELOW
Date Item
26
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
00000
English ndash ATTENTION If you speak English language assistance services free of charge are available to you Call 1-877-653-0327 (TTY 711)
Spanish ndash ATENCIOacuteN si habla espantildeol tiene a su disposicioacuten servicios gratuitos de asistencia linguumliacutestica Llame al 1-877-653-0327 (TTY 711)
Chinese ndash注意如果您使用繁體中文您可以免費獲得語言援助服務請致電 1-877-653-0327 (TTY 711)
Tiếng Việt (Vietnamese) ndash CHUacute Yacute Nếu bạn noacutei Tiếng Việt coacute caacutec dịch vụ hỗ trợ ngocircn ngữ miễn phiacute dagravenh cho bạn Gọi số 1-877-653-0327 (TTY 711)
Korean ndash 주의 한국어를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니다 1-877-653-0327 (TTY 711) 번으로 전화해 주십시오
Tagalog ndash PAUNAWA Kung nagsasalita ka ng Tagalog maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad Tumawag sa 1-877-653-0327 (TTY 711)
Russian ndash ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги перевода Звоните 1-877-653-0327 (телетайп 711)
0327Arabic-653-877-1اتصل برقم تتحدث اذكر اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجانإذا كنت ملحوظة (711كم والبم الصم هاتف رق
French ndash ATTENTION Si vous parlez franccedilais des services daide linguistique vous sont proposeacutes gratuitement Appelez le 1-877-653-0327 (ATS 711)
Polish ndash UWAGA Jeżeli moacutewisz po polsku możesz skorzystać z bezpłatnej pomocy językowej Zadzwoń pod numer 1-877-653-0327 (TTY 711)
Italian ndash ATTENZIONE In caso la lingua parlata sia litaliano sono disponibili servizi di assistenza linguistica gratuiti Chiamare il numero 1-877-653-0327 (TTY 711)
German ndash ACHTUNG Wenn Sie Deutsch sprechen stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfuumlgung Rufnummer 1-877-653-0327 (TTY 711)
Japanese ndash注意事項日本語を話される場合無料の言語支援をご利用いただけます 1-877-653-0327 )TTY 711(までお電話にてご連絡ください
(
Farsi
ກບຫບ
Hindi ndash धयान द अगर आप ह िदी बोलत तो आपक ललए भाषा स ायता सवाएि ननशलक उपलबध 1-877-653-0327 (TTY 711) पर कॉल कर
Gujarati ndash સચના જો તમ ગજરાતી બોલતા હો તો નનશલક ભાષા સહાય સવાઓ તમારા માટ ઉપલબધ છ ફોન કરો 1-877-653-0327 (TTY 711)
Urdu ل کا ںيہياب تدسں يمفت ممات خدد کی ن کی مدکو زبا آپ تو ںيہتے بولردو ار آپ گار داخبر1-877-653-0327 (711 TTT) ک
Lao ndash ເອາໃຈໃ ສ ຖາທານເວາພາສາລາວ ານ ລການໃ ຫຄວາມຊວຍ ເຫອດານພາສາຈະໃ ລການຟຣແ ທານໂທ 1-877-653-0327 (TTY 711)
Greek ndash ΠΡΟΣΟΧΗ Αν μιλάτε ελληνικά στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης οι οποίες παρέχονται δωρεάν Καλέστε 1-877-653-0327 (TTY 711)
دباشی مم اهفرا می شرابن گايراصورت بی نزبايالت هست نيدکی مگو تفگی ارسفن ه زبابر گا هوجتد يريگبتماس (TTY 711) 0327-653-877-1ا ب
27
CignaHealthSpringcom
CignaHealthSpringcom