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MAP CUSTOM ORDER

product listing
as of
December 4, 2012
*Please note that the Custom Order inventory changes on a daily basis, and therefore some of
the items shown below may not be available at the exact time you place your order.
For a more current status of available inventory, please contact our Customer Service team
directly at 912-280-6627 before placing your order.

Generic #

Item #

Description

&

Unit Size

UM Exp Date

Service
Qty
SubFee In
Ordered Totals
U.S. $

BOOKS
00001-03566-00D
00001-03566-01P

Lets Build Our Lives 1


Construyamos Nuestras Vidas (Spanish Edition Let's Build Our Lives) 1
PHARMACEUTIALS

BK
BK

N/A
N/A

1.00
1.50

0.00
0.00
0.00

10 00037-04401-01R
00093-04175-74D
00093-08675-78D
00378-02200-01R
00378-04490-93R
00378-01700-01R
00093-00784-10D
00378-06990-52R
00597-00183-90R
00093-00752-01D
00093-00752-10D
00093-00318-01D
00172-04280-70D
00093-07364-98D
00378-04042-77R
00378-04043-77R
00378-01418-93R
00378-01419-77R
00378-01420-93R
00172-05032-60D
00172-05033-60D
00172-03759-80D
00172-03760-80D
00172-03757-60D
00172-03761-70D
00093-00928-10D
00093-00576-06D
00093-07202-10D
00093-07154-10D
00093-07155-10D
00093-07155-98D
00172-04365-60D
00597-00031-34R
00597-00032-34R
00093-05126-01D
00378-06166-77R
00378-06167-77R
00093-07436-01D
00378-03015-01R
68180-00384-06D
68180-00118-07D
68180-00117-07D
00093-07219-06D
00093-07540-06D
00093-04444-01D
00378-07028-01R
00093-00293-05D
63807-00102-01D
00172-02083-60D
00093-02080-01D
00093-02080-10D
00031-02092-26D

Penicillamine 250mg, Depen, treatment of Wilson's Disease 100cap


Cephalexin 125mg/5ml For Oral Suspension 200ml
Amoxicillin 600m per 5ml/Clavulanate Potassium 42.9mg/5ml 75ml
Acyclovir 200mg 100cap
Famciclovir 125mg 30tab
Nitrofurantoin (Macrocrystals) 100mg 100cap
Tamoxifen Citrate 10mg 1,000tab
Albuterol Sulfate Inhalation Solution 0.083%, Unit Dose Vials 25 x 3ml
Pramipexole Dihydrochloride 0.125mg, Mirapex 90tab
Atenolol 50mg 100tab
Atenolol 50mg 1,000tab
Diltiazem Hydrochloride 30mg 100tab
Verapamil Hydrochloride 240mg, Extended-Release 500tab
Losartan Potassium 25mg 90ea
Losartan Potassium 50mg 90ea
Losartan Potassium 100mg 90ea
Losartan Potassium 50mg & Hydrochlorothiazide 12.5mg 30tab
Losartan Potassium 100mg & Hydrochlorothiazide 12.5mg 90tab
Losartan Potassium 100mg & Hydrochlorothiazide 25mg 30tab
Lisinopril 20mg/Hydrochlorothiazide 25mg 100tab
Lisinopril 10mg/Hydrochlorothiazide 12.5mg 100tab
Lisinopril 10mg 1,000tab
Lisinopril 20mg 1,000tab
Lisinopril 2.5mg 100tab
Lisinopril 40mg 500tab
Lovastatin 40mg 1,000tab
Lovastatin 20mg 60tab
Pravastatin Sodium 40mg 1,000tab
Simvastatin 20mg 1,000tab
Simvastatin 40mg 1,000tab
Simvastatin 40mg 90tab
Labetalol Hydrochloride 200mg 100tab
Clonidine Transdermal System 0.1mg/day, 4 Systems and 4 covers 1ea
Clonidine Transdermal System 0.125mg, 4 Systems and 4 covers 1pk
Benazepril HCL 20mg 100tab
Amlodipine Besylate 5mg/Atorvastatin Calcium 40mg 90tab
Amlodipine Besylate 5mg/Atorvastatin Calcium 80mg 90tab
Ramipril 2.5mg 100cap
Nabumetone 500mg 100tab
Tramadol 200mg 30tab
Levetiracetam 750mg 60tab
Levetiracetam 500mg 60tab
Topiramate 100mg 60tab
Topiramate 50mg 60tab
Gabapentin 800mg 100cap
Promethazine Hydrochloride 12.5mg 100tab
Carbidopa25mg/Levodopa 100mg 500tab
Sodium Chloride Injection 0.9% 10ml Flush Syringe ZR 100ea
Hydrochlorothiazide 25mg 100tab
Hydrochlorothiazide 12.5mg 100tab
Hydrochlorothiazide 12.5mg 1,000tab
Robitussin Cough + Chest / Robitussin Multi-Night Time 2 x 118ml

BT
BT
BT
BT
BT
BT
BT
BX
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
PK
PK
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BT
BX
BT
BT
BT
PK

3/31/2013
9/30/2013
6/30/2013
6/30/2013
7/31/2013
6/30/2013
9/30/2013
7/31/2013
9/30/2013
9/30/2013
9/30/2013
9/30/2013
6/30/2013
8/31/2013
7/31/2013
7/31/2013
7/31/2013
6/30/2013
6/30/2013
8/31/2013
9/30/2013
8/31/2013
7/31/2013
7/31/2013
8/31/2013
7/31/2013
9/30/2013
5/31/2013
6/30/2013
8/31/2013
8/31/2013
8/31/2013
9/30/2013
5/31/2013
9/30/2013
7/31/2013
7/31/2013
8/31/2013
8/31/2013
8/31/2013
7/31/2013
9/30/2013
7/31/2013
9/30/2013
8/31/2013
6/30/2013
7/31/2013
5/1/2013
8/31/2013
6/30/2013
6/30/2013
6/30/2013

1.50
2.98
0.52
3.44
1.60
1.35
14.25
0.55
0.45
0.62
3.24
1.65
3.15
0.75
1.20
1.42
0.65
1.15
0.70
1.25
1.55
6.00
7.00
3.00
5.00
12.00
1.25
3.08
4.00
4.95
0.52
1.24
0.25
0.14
1.31
0.93
1.05
1.25
1.62
2.25
0.88
0.95
0.45
0.35
1.35
1.23
12.25
0.56
0.95
0.55
5.45
0.92

0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

998008
P20062

081308
081342
81801
81803
83603
100015
121212
121230
240420
240420
240435
240445
240480
240481
240483
240530
240531
240531
240491
240492
240494
240503
240504
240511
240603
240604
240611
240616
240619
240619
240811
240855
240860
240861
242812
242814
243204
280902
280921
281204
281231
281225
281235
281234
282487
289210
401226
402806
402816
402816
480842

MAP CUSTOM ORDER

1 of 4

Generic #

Item #

480842
562210
564019
564034
682004
682012
682025
840451
840452
840468
840470
840475
840605
840633
840830
842419
861204
P40002
P40003
P40009
P40016
P40041
P40063
P40067
P40073
P40078
P40082
P40086
P40093
P40099
P40101
P40102
P40104
P40109
P40110
P40111
P40112
P40114

00031-02092-27D
00093-00233-33D
00093-07351-56D
00093-07350-56D
68382-00028-10D
68382-00030-10D
00172-03649-60D
12547-23722-00D
00081-00730-87D
12547-00237-79D
00093-01010-42D
42192-00308-60D
00093-00264-15D
08137-01050-37D
74300-93940-00D
42546-00100-20D
00023-03513-60D
00143-09938-01P
00143-98880-80P
00904-07822-31P
61971-00115-05P
00904-07915-80P
62756-00293-13P
00143-21120-05P
16571-00412-10P
68180-01240-01P
00904-02009-40P
00603-38560-32P
53746-02530-05P
51672-12980-10P
00904-01982-80P
00904-01985-00P
64679-00936-02P
00093-02267-01P
00904-00734-31P
00093-08204-01P
64679-00903-01P
00904-07704-70P

P40018
P40035
P40049
P40055

10267-09454-00P
09040-05318-00P
49348-00106-10P
09045-31360-00P

P10001
P10002
P10025
P10028
P40001
930021
930021
930022
930022
930094
940071
952000
952000
952003
952010
952019
952019
952020
952020
952021

00001-09380-00P
00001-92630-10P
00001-08235-00P
00001-08236-00P
00001-40001-01P
08137-04484-00D
51135-81503-00D
08137-01050-54D
51131-00640-68D
51131-20740-60D
08290-04867-47D
31280-03054-87D
31280-03056-35D
31280-03053-43D
08881-03054-60D
08290-03055-77D
31280-03050-53D
31280-03056-01D
31280-03056-02D
31280-03054-88D

MAP CUSTOM ORDER

Description

&

Unit Size

Robitussin Multi-Symptom / Robitussin Multi Night Time 2 x 118ml


Ondansetron HCL 4mg 3tab
Lansoprazole 30mg 30cap
Lansoprazole 15mg, Delayed Release 30cap
Metformin Hydrochloride 500mg 1,000tab
Metformin Hydrochloride 1000mg 1,000tab
Glipizide 5mg, 100tabs
Neosporin Neo to Go First Aid Antiseptic & Pain Relieving Spray 6x7.7ml
Polymyxin B Sulfate, Bacitracin, Neomycin 3.5mg, Neosporin 28.3gm
Pramoxine HCI 10mg, Neomycin 3.5mg, Neosporin + Pain 28.3gm
Mupirocin 2% Topical Ointment 22gm
Nicotinamide 750mg, Zinc Oxide, Cupric Oxide, Folic Acid 500mcg 60tab
Fluocinonide 0.05% Ointment 15gm
Hydrocortisone 1%, Cortaid Anti-Itch Cream 28g
Bengay Zero Degrees Menthol Pain Relieving Gel Vanishing Scent 85gm
CEM-Urea Pre-filled Applicator 45% Urea 20ml
Trospium Chloride 20mg 60tab
Amoxicillin 250mg 100cap
Amoxicillin Powder for Oral Suspension 125mg/5ml 80ml
Clotrimazole 1% Anti-Fungal Cream 28.35gram
Sulfamethoxazole 400mg & Trimethoprim 80mg 500tab
Ibuprofen 200mg 1,000tab
Cephalexin 250mg 500cap
Doxycycline Hyclate 100mg 500tab
Ciprofloxacin 500mg 100tab
Cephalexin For Oral Suspension 250mg/5ml 100ml
Aspirin 325mg 500tab
Hydrochlorothiazide 25mg 1,000tab
Ranitidine 150mg 500tab
Ketoconazole Cream 2% 15gm
Acetaminophen 325mg, Mapap 1,000tab
Acetaminophen 160mg/5ml, MAPAP Childrens 118ml
Famotidine 20mg 100tab
Amoxicillin 125mg, Chewable 100tab
Neomycin/Bacitracin 3.5mg Ointment 28gram
Cimetidine 400mg 100tab
Captopril 25mg 100tab
Aspirin 81mg, Major Brand, Enteric Coated 81mg 250tab
VITAMINS
Multi-Vitamins 1,000ea
Multi-Vitamins + Iron 1000ea
Multi-Vitamins, Children's Chewable, Orange Flavor 500tab
Prenatal Vitamins 100tab
SUPPLIES
Sphygmomanometer, Aneroid Adult with Nylon Cuff 1
Stethoscope, Sprague Rappaport-Type, Black 1
Vinyl Exam Gloves, Powder-Free, Synthetic, Size Medium 100ea
Vinyl Exam Gloves, Powder-Free, Synthetic, Size Large 100ea
Oral Rehydration Salts 100 scht
Band-Aid, (10) 3/4" and (15) 5/8", Dora the Explorer 25ea
Bandages, Nexcare Soft 'n Flex, Latex Free, Assorted Sizes 35ea
Band-Aid Dryfit Flexible Fabric, 7/8" x 2-3/4", Sterile 17ea
Bandages, Nexcare Active Extra Cushion Spots 60ea
Elastic Bandage 2" x 4.2' unstreached, Self-Adhering 1
Tape, TruFit Sports Black 48rolls
Collector Sharps 1.5qt, Guardian One-Piece 1
Collector Sharps 1qt, Red 1
Collector Sharps 8qts 1
Collector Sharps 8.0qts, Nestable Sharps Collector 1
Collector Sharps 5gallon 1
Collector Sharps 5gallon, Recykeen 1
Collector Sharps 9 gal, Clear 1
Collector Sharps 9 gal, Extra Large 1
Collector Sharps 3.3qt, small disposable 1

UM Exp Date

Service
Qty
SubFee In
Ordered Totals
U.S. $

PK
PK
BT
BT
BT
BT
BT
BX
TB
TB
TB
BT
TB
TB
PK
TB
BT
BT
BT
TB
BT
BT
BT
BT
BT
BT
BT
BT
BT
TB
BT
BT
BT
BT
TB
BT
BT
BT

7/31/2013
7/31/2013
6/30/2013
8/31/2013
11/30/2013
10/31/2013
5/31/2013
8/1/2013
5/31/2013
8/25/2013
6/30/2013
5/31/2013
7/31/2013
6/30/2013
8/1/2013
6/30/2013
6/30/2013
1/31/2014
11/30/2014
9/30/2014
4/30/2015
5/31/2015
1/31/2014
11/30/2014
4/30/2016
5/31/2015
3/31/2014
4/30/2014
6/30/2014
11/30/2013
10/31/2015
10/31/2014
2/28/2015
1/31/2014
3/31/2014
4/30/2015
5/31/2015
1/31/2014

0.92
0.15
0.63
0.95
8.50
11.00
0.82
0.85
0.45
0.33
0.95
0.15
0.65
0.25
0.30
0.55
0.85
12.40
2.92
1.93
39.96
17.18
39.94
31.23
22.39
6.88
8.96
10.89
13.84
7.65
7.02
1.38
5.17
22.12
3.24
7.50
2.74
2.59

BT
BT
BT
BT

4/30/2015
1/31/2014
10/31/2013
9/30/2014

13.77
19.02
6.44
3.93

EA
EA
BX
BX
EA
BX
BX
BX
BX
RL
CS
EA
EA
EA
EA
EA
EA
EA
EA
EA

N/A
N/A
N/A
N/A
12/31/2014
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A

24.69
12.01
4.75
4.75
15.00
0.28
0.39
0.19
0.67
0.21
4.40
1.34
1.34
1.34
1.34
1.34
1.34
1.34
1.34
1.34

0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
2 of 4

Generic #
952027
952027
952029
952029
952030
952032
952032
952032
952032
952032
952032
952033
952117
952122
960002
960018
960019
960027
960063
960095
960101
960101
960102
960116
960116
960132
960135
960138
960141
960141
960170
960172
960205
960208
960208
960208
960223
960228
960262
961009
961010
961010
980017
980019
980019
980022
980022
980022
980022
980022
980022
980022
980022
980022
980022
980023
980023
980023
980023
980023
980023
980023
980023
980023

Item #

Description

31280-03056-10D
31280-03056-14D
31280-03051-60D
31280-03054-57D
31280-03054-64D
31280-03050-57D
31280-03054-27D
31280-03054-44D
31280-03055-17D
31280-03055-43D
31280-03055-51D
31280-03054-90D
31280-03056-13D
31280-03050-54D
31280-03052-10D
31280-03096-26D
31280-03095-78D
11917-00048-13D
08290-03284-38D
31280-03016-25D
31280-03050-60D
31280-03096-57D
31280-03010-35D
31280-03059-30D
31280-03284-11D
31280-03016-04D
31280-03096-20D
31280-03095-72D
31280-03050-62D
31280-03096-46D
31280-03059-50D
31280-03055-40D
31280-03059-15D
31280-03051-80D
31280-03051-96D
31280-03057-66D
31280-03051-27D
31280-03059-00D
31280-03201-19D
08290-03284-66D
08290-03284-65D
31280-03059-32D
08290-04830-54D
08290-04860-41D
08290-04860-42D
08290-04860-85D
08290-04860-89D
08290-04861-08D
08290-04861-74D
08290-04861-76D
08290-04884-07D
51131-19000-00D
51131-19784-00D
51131-19785-00D
51131-19822-00D
08225-04202-00D
08225-04203-00D
08225-04205-00D
08290-02075-24D
08290-04836-37D
51131-19811-00D
51131-19812-00D
51131-20330-00D
63323-14203-00D

MAP CUSTOM ORDER

&

Unit Size

Collector Sharps 17gal, Nestable Sharps Collector 1


Collector Sharps 17gal, Sharps Collector 1
Collector Sharps 6.0gal, Multi-Use 1
Collector Sharps 6.0gal, Guardian Nestable/Carry Handle 1
Collector Sharps 14.0qt, Nestable 1
Collector Sharps 5.4qt. Recykleen 1
Collector Sharps 5.4qt, Point-Of-Use 1
Collector Sharps 5.4qt, Guardian Side Entry 1
Collector Sharps 5.4qt, Patient Room 1
Sharps Collector Horizontal, Nestable, 5.4qts 1
Collector Sharps 5.4qts, Patient Room 1
Collector Sharps 8.2qt, Guardian One-Piece 1
Collector Sharps 19gal, Nestable 1
Collector Sharps Patient Room, 3.0gal 1
Syringe Oral Dispensing 3ml, amber with tip cap, non-sterile 100ea
Syringe 1cc 25g x 5/8, Luer Lok, Precision Glide 100ea
Syringe 3cc Luer-Lok, 20g x 1" Precision Glide 100ea
Syringe 1cc Insulin, 31g x 5/16" 100 ea.
Syringe Insulin, 3/10cc 31g x 5/16" , Sterile 100ea
Syringe 20cc Slip Tip, sterile 40ea
Syringe 3ml, 18g x 1 1/2" 100ea
Syringe 3ml, Luer Lok 200ea
Syringe 60cc Luer-Lok, bulk non-sterile 125ea
Safety Glide Insulin Syringe 1ml w/29g x 1/2" 100ea
Syringe Insulin 1cc, 30g x 1/2, Sterile 100ea
Syringe 10cc Slip-Tip, sterile single use 100ea
Syringe 2oz, Catheter Tip, Latex-free 40ea
Syringe 3cc Luer-lok, 22g x 1" Precision Glide needle 100ea
Syringe 5ml, 18g x 1 1/2" w/Luer-lok and Blunt Fill Needle, Sterile, 100ea
Syringe 5ml, Luer Lok Tip 125ea
Allergy Tray, Syringe 1ml syringe 27g x 1/2" 25ea
Allergy Tray, Syringe 1cc 27g x 1/2" Regular Bevel Needle 25ea
Needle 21g x 1", SafetyGlide Shielding IM, sterile 50ea
Needle 18g x 1 1/2", Blunt Fill, Sterile 100ea
Needle 18g x 1 1/2", Precision Glide 100ea
Needle 18g x 1 1/2", sterile 100ea
Needle 25g x 1 1/2" sterile 100ea
Needle 22g x 1 1/2", Shielding IM, sterile 50ea
Pen Needles, 31g x 3/16", B-D Ultra Fine III 100ea
Syringe 1/2cc 30g x 1/2", U-100 Ultra-Fine Needle 100ea
Syringe 1/2cc U-100 Insulin, 28g x 1/2" 100ea
Syringe 1/2cc 29g x 1/2" SafetyGlide Insulin Syringe 100ea
Hinged Knee Brace, Medium, Coolmax Lining, Premium Protection 1ea
Elbow Support, Trufit Neoprene, Size: Medium 1
Elbow Support, Trufit Neoprene, Size: Large 1
Knee Support, TruFit Neoprene Closed Knee, Small 1ea
Knee Support, TruFit Neoprene Closed Knee, Extra-Large 1ea
Knee Support, TruFit Open Patella, Standard Support, Medium 1ea
Knee Support, TruFit Open Patella, Advanced Protection, Medium 1ea
Knee Support, TruFit Open Patella, Moderate Support, X-Large 1ea
Knee Support Size Small, elastoprene 1
Knee Support, Futuro, Power Stretch-RX, Open Patella, X-Lrge 1ea
Knee Support, ACE Moisture Control, Moderate, Small 1ea
Knee Support, ACE Moisture Control, Moderate, Medium 1ea
Knee Support, ACE, Mild, Extra-Large 1ea
Elbow Support, Futuro, Mild, Size Small 1ea
Elbow Support, Futuro, Mild, Size Medium 1
Elbow Support, Futuro, Mild Support, Size Large 1
Elbow Support, Ace Elasto-Preene, Moderate, Large/X-Large 1ea
Tennis Elbow Brace, w/Gel Cushion, Antimicrobial, Large/X-Large 1ea
Elbow Support, ACE, Moderate, Medium, Left or Right 1ea
Elbow Support, ACE, Moderate, Large, Left or Right 1ea
Elbow Support,Futuro Comfort Lift, Small 1ea
Elbow Support, Futuro, Power Knit Material, Size Medium 1ea

UM Exp Date
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
EA
BX
BX
BX
BX
BX
BX
BX
BX
CS
BX
BX
BX
BX
BX
CS
BX
TR
TR
BX
BX
BX
BX
BX
BX
BX
BX
BX
BX
PK
EA
EA
PK
PK
PK
PK
PK
EA
BX
BX
BX
BX
BX
BX
BX
BX
PK
BX
BX
BX
BX

N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
3/31/2017
N/A
N/A
N/A
5/31/2017
N/A
N/A
2/28/2017
N/A
N/A
N/A
11/30/2016
N/A
1/31/2017
5/31/2017
N/A
4/30/2017
N/A
12/31/2016
N/A
N/A
N/A
3/31/2017
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A

Service
Qty
SubFee In
Ordered Totals
U.S. $
1.34
1.34
1.34
1.34
1.34
1.34
1.34
1.34
1.34
1.34
1.34
1.34
1.34
1.34
1.05
1.89
1.89
1.89
1.89
1.12
0.84
2.10
3.50
1.89
1.89
1.82
0.31
1.89
2.24
2.36
0.47
0.19
0.42
0.84
0.84
0.84
0.84
0.42
0.77
1.89
1.89
1.89
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50

0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

3 of 4

Generic #
980023
980027
980027
980027
980027
980030
980030
980030
980033
980035
980035
980035
980035
980035
980035
980044
980044
980044
980044
980044
980044
980095
980095
980095
980114
980126
980126
980126
980126
980129
985002
985009
985070
985085
985097
985097
985097
985097
985179
985179
985183
985207
991001
991001
991001
991003
991003

Item #

Description

63323-14205-00D
08290-02077-36D
51131-01190-51D
51131-19045-00D
51131-92183-00D
08290-02072-77D
51131-19826-00D
51131-19832-00D
72140-47876-00D
08290-02077-42D
49022-42824-00D
49022-42825-00D
51131-02072-49D
51131-84599-00D
51131-92185-00D
08225-05223-00D
08290-02077-38D
08290-02077-40D
08290-04836-33D
51131-19829-00D
51131-92204-00D
49022-43331-00D
49022-43332-00D
82902-06975-00D
08290-02039-65D
08290-04880-04D
08290-04880-05D
08290-04880-06D
08290-04880-07D
08290-04834-51D
70501-37340-00D
08290-04867-67D
70501-02024-00D
12547-94747-00D
08290-02010-70D
08290-02011-61D
08290-02022-62D
08290-04880-84D
00052-10415-60D
00052-70293-00D
00052-37108-00D
12547-00521-25D
08881-01365-00D
08881-13765-40D
08881-9113A-00D
31280-04060-81D
31280-04060-91D

&

Unit Size

Elbow Support, Futuro, Size Large 1ea


Ankle Brace, Ace Tek Zone Antimicrobial, Gel cushion, One Size 1ea
Ankle StabilizerTruFit Dial System, Large/Extra-Large 1ea
Ankle Stabilizer, TruFit Dial System, Small/Medium 1ea
Ankle Brace, Nexcare, Elastic, Slip-on, Medium, Light Support 1ea
Wrist Stabilizer, Ace Antimicrobial, Firm, Large/X-Large, Left 1ea
Wrist Support, Ace Wrap Around, Moderate Support, One Size 1ea
Wrist Stabilizer, Ace Deluxe, Firm, Large/Extra-Large 1ea
Ankle Support, Futuro Wrap Around, Adjustable, Large 1ea
Elbow Brace, Small/Medium, Adjustable Gel Strap, Left or Right 1ea
Elbow Brace, Adjustable Gel Strap, Small/Medium 1ea
Elbow Brace, Antimicrobial, Adjustable Gel Strap, Large/X-Large 1ea
Elbow Brace, Neoprene, One Size Fits All 1ea
Elbow Brace, Nexcare, Breathable, Adjustable 1ea
Elbow Brace w/Pad, Nexcare, Breathable, Adjustable 1ea
Wrist Brace, Moderate Support, Right or Left Hand, Adjustable 1ea
Wrist Brace, Antimicrobial Gel Cushion, Small/Medium 1ea
Wrist Brace, Antimicrobial Gel Cushion, Small/Medium, Right 1ea
Wrist Brace, w/Gel Cushion, Antimicrobial Small/Medium, Right 1ea
Wrist Brace, Ace Right Hand, Moderate Support, Small/Medium 1ea
Wrist Brace, Nexcare. Adjustable, Breathable, Left or Right Hand 1 ea
Thumb Stabilizer, Ace Antimicrobial, Left or Right, Small/Medium 1ea
Thumb Immobilizer, Ace Antimicrobial, Left or Right, Large 1ea
Thumb Immobilizer, Firm Support Left/Right, Regular Size 1ea
Shin/Calf Support, Ace, Moderate, One Size, Left or Right 1ea
Protective Cup and Brief, Teen. Small/Medium, Shatterproof 1ea
Protective Cup and Brief, Teen. X-Large,, Shatterproof 1ea
Protective Cup and Brief, Small/Medium, Shatterproof 1ea
Protective Cup and Brief, Large/Extra-Large, Shatterproof 1ea
Knee Pads, TruFit, One Size, Adjustible 1pr
Salicylic Acid 2%, Neutrogena Acne Wash Foaming Scrub 124ml w/bonus 14ml
Cold Compress, TruFit Instant, Single Use 2ea
Moisturizer, Neutrogena Men, Oil-Free,Sensitive skin, SPF 30 50ml
Neosporin Eczema Daily Moisturizing Cream Colloidal oatmeal 170g
Athletic Supporter, Suspensory with Leg Straps, Small Pouch 1ea
Athletic Supporter, Suspensory with Leg Straps, Small Pouch 1ea
Athletic Supporter, Suspensory with Leg Straps, Medium Pouch 1ea
Athletic Supporter, TruFit , Adult Large 1
Denture Cup, Allegiance Red Shatter-Resistant 250ea
Denture Cup, Aqua, Single Use 250ea
Soap Dish, Snap On Style, Ivory 500ea
Listerine Antiseptic Soft Mint 500ml
Single Shot Epidural Tray, Sterile 1ea
Single Dose Epidural Tray, Sterile 1ea
Sterile Epidural Anesthesia Tray 1ea
BD Single Shot Epidural Tray, 17g x 3.5", 5ml Syringe 1
BD Single Shot Epidural Tray, 18g x 3.5", 5ml Syringe 1

UM Exp Date
BX
BX
PK
PK
PK
BX
BX
BX
BX
BX
BX
BX
BX
PK
PK
BX
BX
BX
PK
BX
PK
PK
PK
BX
BX
PK
PK
PK
PK
EA
PK
PK
BT
TB
EA
EA
EA
EA
CS
CS
CS
BT
TR
TR
TR
TR
TR

N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
6/28/2013
N/A
5/9/2013
7/1/2013
N/A
N/A
N/A
N/A
N/A
N/A
N/A
3/31/2014
8/1/2013
9/18/2013
4/1/2014
6/30/2013
9/30/2013

Service
Qty
SubFee In
Ordered Totals
U.S. $
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.50
0.29
0.15
0.11
0.29
0.50
0.50
0.50
0.50
0.53
0.53
1.05
1.05
0.95
1.17
0.81
0.81
0.95
Grand Total

0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
$0.00

After entering the quantities you need, please print and fax your order to 912-280-6638, along with the additional application forms and order
form found by clicking on the following weblink, or copying and pasting it into your browser:
www.map.org/tp-forms
Or, email all of the required forms as attachments to:
custsrvc@map.org
MAP's Customer Service team can also be reached by phone at 912-280-6627; Monday thru Friday - 8am to 5pm (Eastern Time)

Thank you for your order!

MAP CUSTOM ORDER

4 of 4

MAP Custom Order Form


Return Form To: MAP International, 4700 Glynco Parkway, Brunswick, GA 31525
Phone: 1-912-280-6627 Fax: 912-280-6638 Email: custsrvc@map.org
ACCOUNT NAME AND ADDRESS
SHIPPING ADDRESS
MAP
Please complete this section
with the address to which the packs will be shipped.

NAME

MAP ACCOUNT # (if known)

STREET (UPS CAN NOT DELIVER TO A P.O. BOX)

STREET / PO BOX

CITY / STATE / ZIP

CITY / STATE / ZIP

TELEPHONE NUMBER

TELEPHONE NUMBER

FAX NUMBER

FAX NUMBER

USE

Account #

NAME

Order #

Please use the Account Name registered with MAP International,


or the name on your Partner Profile application.
Please complete this section to receive an invoice.

E-MAIL ADDRESS

REFERRED BY:

Ship Date:

Name on Card _________________________________________

Offer #

CHECK (If faxing order, include copy of check)


MASTERCARD
VISA
AMERICAN EXPRESS DISCOVER

ETA:

COUNTRY INFORMATION
All Customs documents are attached to the cartons.
PACKS ARE FOR HAND-CARRY OR AIR FREIGHT ONLY.
PACKS MAY NOT BE SHIPPED BY CONTAINER.
(NO delivery to US sanctioned countries without proper US
government licensing and prior MAP approval)

TT:

PAYMENT AND RECEIPTING INFORMATION


Payment must accompany your order and may be made using
CREDIT CARD or CHECK.
When mailing a check, please include account name on check.
Travel Packs may not be returned for a refund.
The pre-paid service fee is tax deductible.

MEDICINE DESTINATION: COUNTRY

MEDICINE DESTINATION: HOSPITAL / CLINIC

Company Name ________________________________________


CC#__________________________________________________
Exp. Date __________________

ADDRESS

Security Code ____________

Address for tax receipt if different from Account address:

DEPARTURE DATE

RETURN DATE

______________________________________________________
______________________________________________________

The CUSTOM ORDER

service fee is determined by the items and quantities selected.


($100 minimum order required). Shipping is additional. Please allow 3-4 weeks for delivery.

Any additional donation to help support MAPs medicine programs is much appreciated.
If you wish to contribute, please indicate the extra amount here: $________________ Thank You!

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