Vitaminas/Minerales

$20 LIMIT PER ORDER PER MONTH
LIMITE DE $20 POR PEDIDO POR MES
IF YOUR ORDER EXCEEDS THE $20 LIMIT ITEMS WILL BE REMOVED
IN ORDER TO FALL WITHIN THE $20 LIMIT.
SI SU PEDIDO ES SUPERIOR AL LIMITE DE $20, SE QUITARA
PRODUCTOS PARA QUE LA ORDEN SEA MENOS DE $20
NAME (NOMBRE) ___________________________________________________________________________________________________________________
ADDRESS (DIRECCIÓN) _______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
MEMBER ID ( NUMERO DE MEMBRESIA) _____________________________________ PHONE (TELEFONO) ________________________________________________
Vitamins / Minerals
Qty
Brand
(Vitaminas/Minerales)
(Marca)
B3
PV VITAMIN E OIL
2 oz
V1
B-COMPLEX VITAMIN 100% RDA
100 ct
V8
ECHINACEA 400 mg
60 ct
V9
GINGKO BILOBA 400 mg
50 ct
V10 GLUCOSAMIN/CHONDROITIN 50 ct
V11
CALCIUM 500 mg +D
75 ct
V14
A 10,000 IU NATURAL
100 ct
V16
VITAMIN E 400IU
100 ct
V17
FOLIC ACID 800 mg
100 ct
V18
IRON
100 ct
V19
OMEGA-3 FISH OIL 1000 mg
100 ct
V2
VITAMIN C 500 mg
100 ct
V20
SOYA LECITHIN 1200
100 ct
V21
URINOZINC
60 ct
V22
COLLAGEN 500 mg
100 ct
V24
GARLIC ODORLESS 2000
100 ct
V26
VITAMIN D 400 IU
100 ct
V3
CALCIUM CARBONATE + D
60 ct CALTRATE
V5
CO-ENZYME Q-`0 10 mg
30 ct
V6
DAILY MULTI VITAMIN
100 ct ONE-A-DAY
V7
COMPLETE SENIOR VITAMINS
100 ct CENTRUM SILVER
Pain Relievers (Analgésicos)
P1
IBUPROFEN TABS 200 mg
50 ct ADVIL
P11
NON_ASPIRIN CHEW 80 mg
30 ct TYLENOL
P13
NON-ASPIRIN SUSPENSION CHERRY
4 oz TYLENOL
P14
HOT AND COLD PATCHES
5 ct ICY HOT
P17 MIGRAINE RELIEF CAPLETS 100 ct EXCEDRIN MGRN
P2
ASPIRIN 325 mg
100 ct BAYER
P3
ENTERIC ASPIRIN 325 mg
100 ct ECOTRIN
P4
LOW-DOSE ASPIRIN ENTERIC COATED 81mg
120 ct ECOTRIN
P6 ACETAMINOPHEN 500 mg TABLETS 100 ct TYLENOL
P8
CHEWABLE ASPIRIN 81 mg
36 ct BAYER
P44
THERAPEUTIC BLUE GEL
4oz MINERAL ICE
V29
AZO DINE URINARY
32 ct AZO STANDARD
Antacids / Digestion / Laxatives (Antiácidos / Digestión / Laxantes)
Price
(Precio)
5.99
3.99
6.99
5.99
9.99
4.99
3.19
8.99
2.99
4.99
6.49
4.99
6.49
14.99
7.99
4.99
2.99
3.99
4.99
4.29
7.79
A1 EFFERVESCENT PAIN RELIEF
A4 CALCIUM ANTACID TABLETS
A7
RANITIDINE 75 mg
A8
ANTACID TABLETS
D1
ANTI-DIARRHEAL TABLETS
D3
PINK BISMUTH TABLETS CHEWABLE
D4
GAS RELIEF E/S
L1
BISACODYL TABS
L2
STOOL SOFTENER
L9
IMODIUM CAPSULES
L4 NATURAL VEGETABLE LAXATIVE
L5
CASCARA SAGRADA
L6 GLYCERIN SUPPOSITORIES ADULT
L7
FIBER CAPSULES
Anti-Hemorrhoidals (Contra Hemorroides)
3.99
3.99
7.99
5.99
4.99
3.99
4.99
7.99
7.99
5.59
9.99
4.99
2.99
9.99
H2
HEMORROIDAL SUPPOSITORIES
H3
HEMORROIDAL OINTMENT
Anti-Fungals (Antimicóticos)
O1
CLOTRIMAZOLE
O2
TOLNAFTATE
M25
CLOTRIMAZOLE VAG.
36 ct
96 ct
30 ct
100 ct
18 ct
30 ct
30 ct
100 ct
60 ct
6 ct
100 ct
90 ct
25 ct
160 ct
ALKA-SELTZER
TUMS
ZANTAC
MYLANTA
IMODIUM
PEPT0-BISMOL
GAS-X
DULCOLAX
COLACE
NBE ITEM
SENOKOT
FLEET
METAMUCIL
2.99
3.99
2.99
5.19
5.99
2.99
4.99
3.99
5.99
4.99
3.19
4.99
12 ct PREPARATION-H
2 oz PREPARATION-H
3.99
4.99
1 oz LOTIMIN
1 oz TINACTIN
30 gr MONISTAT
8.99
4.99
5.99
YOU WILL RECEIVE THE GENERIC EQUIVALENT OF ALL ITEMS.
USTED RECIBIRA EL GENERICO DE TODOS LOS PRODUCTOS.
First Aid (Primeros Auxilios)
Price
(Precio)
3"
2.99
4 oz
3.99
1 oz
2.99
4 oz
3.99
4 oz
3.99
1 ct
4.99
4 oz
1.99
1 oz
2.99
.5 oz
3.99
30 ct
1.99
1 oz NO EQUIVALENT 1.99
Each
J&J
4.99
.5"X5 yd CORTAID
1.99
Qty
Brand
(Marca)
ACE
DESITIN
BENADRYL
BEN-GAY
BENADRYL
CALADRYL
CORTAID
CORTAID
CORTAID
F1
BANDAGE SELF-ADHERANT
F10
DIAPER RASH OINTMENT
F11
ANTI-ITCH CREAM
F2
MUSCLE RUB
F29
ANTI-ITCH GEL
HOT/COLD THERAPY - MULTI-COMPRESS
F34
F4
CALAMINE LOTION
F5
HYDROCORTISONE CREAM 1%
F7
TRIPLE ANTIBIOTIC OINTMENT
F9
CLEAR PLASTIC BANDAGES
F21
PV IODINE
F24
PV FIRST-AID KIT
F62
FIRST AID TAPE
Dental (Dental)
B2
DENTURE TABS
40 ct EFFERDENT
B6
DENTURE ADHESIVE REGULAR
2.5 oz FIXODENT
M2
TOOTH BRUSH
30 ct
M17
PV DENTAL FLOSSERS
J&J
100yd
M35
DENTAL FLOSS WAXED
J&J
Eye / Ear Care (Cuidado de la Vista y Oido)
E1
ARTIFICIAL TEARS
.5 oz TEARS NATURALE
E2
EYE DROPS
.5 oz VISINE
B16
EAR WAX DROP
.5 oz MURINE
E3
EARACHE DROPS
.4 oz SIMILISAN
Cough / Cold / Allergy ( Tos / Catarros / Alergia)
C1
NASAL SPRAY REGULAR 1 oz AFRIN
C10
LORATIDINE 10 mg
10 ct CLARITIN
C11 SORE THROAT LOZENGES 18 ct CLORASEPTIC
C12
TUSSIN EXPECTORANT
4 oz ROBITUSSIN
C13
TUSSIN DM
4 oz ROBITUSSIN DM
C14
NON-ASPIRIN COLD
24 ct TYLENOL COLD
NASAL DECONGESTANT PSEUDO FREE
C16
18 ct SUDAFED
C19 CHEST CONGESTANT RELIEF 400MG 50 ct MUCINEX
C2
ALLERGY CAPSULES
24 ct BENADRYL
C23 IBUPROFEN COLD AND SINUS 20 ct ADVIL COLD/SINUS
C24
DAYTIME PE SOFTGELS
12 ct DAYQUIL
SINUS AND ALLERGY TABS PSEUDO FREE
C30
24 ct SUDAFED
C7
MEDICATED CHEST RUB
4 oz VICK'S VAPORUB
C53
CETIRIZINE 10 mg TABLETS
14 ct ZRYTEC
SINUS CONGESTION & PAIN NIGHTTIME (PSUEDO FREE)
C54
24 ct TYLENOL
C52
SALINE NASAL SPRAY
1.5 oz OCEAN
Miscellaneous • Sunscreen Lotion / Teeth-related items / Dentures / Mouth Care
C8
THERMOMETER DIGITAL
B1
PV MOTION SICKNESS
20 ct
B4
FACIAL TISSUE
8 pk KLEENEX
B8
PV LATEX GLOVES
10 pk
B10
PV GLASS DROPPERS
2 ct
B13 PV CREW SOCK-WHITE MENS 2 pk
B14 PV CREW SOCK-BLACK WOMENS 2 pk
B71
PV LANCETS
100ct
B72
BLOOD PRESSURE MONITOR
M1
SUNBLOCK SPF 30
4 oz COPPERTONE
F35
MEDICATED CALLOUS REMOVER
6 ct DR SCHOLL
M3
LIP BALM
.5 oz CHAP STICK
M5
SUGAR SUBSTITUTE
50 ct EQUALL
M6
SLEEP AID
16 ct SOMINEX
M11
BABY POWDER
4 oz
J&J
M12
BABY WIPES
20 ct
J&J
M14
PV DEODORANT
2.7oz
M36 FINGER NAIL CLIPPER W/FILE 1 pk
M23
HAND SANITIZER
2 oz PUREL
M15
POCKET COMB
1 pk
B18
PV VITAMIN E CREAM
4 oz NO EQUIVALENT
4.99
4.39
.99
1.99
1.99
3.99
2.99
2.99
6.99
3.99
6.99
2.99
3.99
3.99
3.99
3.99
7.99
2.99
3.99
3.49
3.99
3.99
8.99
3.99
2.99
4.99
2.99
1.49
1.29
1.99
3.99
3.99
3.99
14.99
3.99
2.99
1.19
1.99
3.99
1.49
1.49
2.79
1.99
1.29
.99
3.99
HOW TO ORDER BY MAIL:
1. Clearly write your name, address, telephone number and member ID
in the space at the top of the form. Your shipping address must be the same
as the address in your member record. We cannot fill your order if your
address is not the same.
2. Check (√) items you want on the order form that add up to $20 or less.
Your benefit limit is $20 every month. If you order more than $20, you
will receive the first $20 of items on your order.
3. Place a first class postage stamp on the address side (out-side) of the form.
Fold, seal and mail.
ORDER BY FAX:
Fax the completed order form to 1-866-682-6733 any time.
For customer service, please call your Tango Plan Care Manager.
COMO ORDENAR POR CORREO:
1. Escriba claramente su nombre, dirección, numero de teléfono y numero
de miembrecia en el espacio indicado. Su dirección de envio debe coin
cidir con la dirección que tenemos en su archivo de afiliación. No se
completarán las solicitudes en los casos en que no coincidan las
direcciónes.
2 Seleccione artículos que sumen hasta $20 o menos. Su beneficio tiene
un limite de $20 cada mes. Si excede este limite, recibirá
automáticamente sólo aquellos artículos que sumen un total de
$20 o menos.
3. Doble, coloque una estampilla en el formulario y envielo a la
direccion de abajo.
POR FAX:
Envie su forma por fax al 1-866-682-6733 a cualquier hora.
Para servicio al cliente, por favor llamar a su administrador(a) de cuidado
con el plan Tango.
Name: _______________________________________________
Address: _____________________________________________
City: _____________________ State: __________ Zip: ________
Navarro Discount Pharmacies
9400 NW 104 Street
Medley, FL 33178
PLACE
STAMP
HERE