certified pharmacy fitter seminar

Presenter Info.

Optimizing Disease State Management Optimizing Disease State Management with with

Measuring, Fitting and Recommending Measuring, Fitting and Recommending Graduated Compression GarmentsGraduated Compression Garments

ObjectivesObjectives Introduce SIGVARIS and Value Added Services Assess SIGVARIS graduated compression garments Evaluate appropriate techniques for measuring, fitting,

sizing, and donning compression garments Demonstrate donning and doffing SIGVARIS graduated

compression garments Discuss compression therapy clinical pearls Assess the graduated compression garment payment

model

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Who is SIGVARIS?Who is SIGVARIS?

Dr. Karl SiggDr. Karl Sigg Tortuous Tortuous VeinVein

== SIGVARISSIGVARIS

Who is SIGVARIS? Who is SIGVARIS? Ganzoni Manufacturing established 1864

─ 5th generation family owners

1950’s collaboration with Dr Karl Sigg designs first two-way stretch stocking - SIGVARIS 503─ The only physician founded compression stocking company

The largest manufacturer of The largest manufacturer of medical ready-to-wear medical ready-to-wear compression stockings in the worldcompression stockings in the world

Supported more than 120 scientific Supported more than 120 scientific publicationspublications

Commitment to investment in Commitment to investment in research and developmentresearch and development

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SIGVARIS INCSIGVARIS INCPeachtree City, GAPeachtree City, GAUSAUSA

SIGVARIS CORPSIGVARIS CORP Montréal, QCMontréal, QC CanadaCanada

SIGVARIS BRASILSIGVARIS BRASILSão PauloSão PauloBrasilBrasil

GANZONI SAGANZONI SASt-Louis, FranceSt-Louis, France

GANZONI SAGANZONI SASt-Just, FranceSt-Just, France

GANZONI GmbHGANZONI GmbHMemmingen, DeutschlandMemmingen, Deutschland

SIGVARIS GmbHSIGVARIS GmbH Wien, ÖsterreichWien, Österreich

GANZONI & CIE AGGANZONI & CIE AGSt. Gallen, SchweizSt. Gallen, Schweiz

SIGVARIS BRITAIN LTD.SIGVARIS BRITAIN LTD.Winchester, EnglandWinchester, England

GANZONI &CIEGANZONI &CIEWWHQWWHQWinterthur, SchweizWinterthur, Schweiz

SIGVARIS TODAYSIGVARIS TODAY

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SIGVARIS US Headquarters SIGVARIS US Headquarters Peachtree City, GeorgiaPeachtree City, Georgia

Since 1997: Manufacturing, Distribution, R & DSince 1997: Manufacturing, Distribution, R & D

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SIGVARIS QualitySIGVARIS Quality

ISO 13485 (Rev 2008) Certified─ Meets the requirements of ISO 9001─ Meets the requirements of FDA for Class II Medical

Devices─ Ensures quality product and service throughout

SIGVARIS─ Employee empowerment─ Undergoes recertification process every year

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SIGVARIS Manufacturing ProcessSIGVARIS Manufacturing Process

1. Yarn curing / wrapping

2. Knitting

3. Hand sewing

4. Boarding / shaping

5. Dyeing / ironing

6. Inspection & packaging

7. Testing, QA, R&D

Three ReasonsThree ReasonsTo Sell SIGVARISTo Sell SIGVARIS

1: The Company!1: The Company!

Only medical compression stocking company founded by a physician

Driving medical studies proving efficacy

Compression is ALL that we do!

2. Double Covered Yarns2. Double Covered Yarns

QualityQuality

DurabilityDurability

ComfortComfort

Covered spandex

2nd covering(S-twist)

1st covering(Z-twist)

3. Precise Fit Sizing3. Precise Fit Sizing²² System System

Fit 98% of the population

Less need for custom Ensures medically

correct compression dosage as stated on the box

Comfort is the Key toComfort is the Key toRepeat SalesRepeat Sales

Precise Fit Sizing² ™ (PFS²) are the basis for:

Comfort + fit + Correct Compression + Patient Compliance = Comfort + fit + Correct Compression + Patient Compliance =

Therapeutic ResultsTherapeutic Results

Comfort and fit and correct compression leads to compliance & therapeutic results

Compliance means the product is worn and must be replaced

Our Value Added ServicesOur Value Added Services

Market Your Pharmacy and Market Your Pharmacy and Your Compression BusinessYour Compression Business

Know the physicians within your community, especially vein centers and wound care clinics

Email, fax, mail, and call your local physicians to let them know you are in the stocking business!─ Send them an introduction letter with local TMs contact

information─ Pharmacy branded patient education materials─ Customized SIGVARIS Prescription Pads

Hold an open house for local physicians Co-market with your local TM Generate co-op dollars to use

Market Your Pharmacy and Market Your Pharmacy and Your Compression BusinessYour Compression Business

Educate and generate awareness in the community by targeting specific patient populations─ Manufacturing plants, casinos, school teachers,

firefighters, police, nursing homes, etc. Hold awareness day programs and Healthy Leg Days for

patients Roll-out consumer rebates and promotions

Grow Our Product Line,Grow Our Product Line,and Your Bottom Lineand Your Bottom Line

Attractive packaging Attractive retail displays

─ Powerwings─ Table tops─ Wall displays─ Spinner racks

Attractive signage─ Shelf talkers─ Window stickers─ Header cards

Attractive products with all appropriate measuring tools and accessories

Customizable Marketing ResourcesCustomizable Marketing Resources SIGVARIS Prescription Pads Patient Reminder Postcards Newspaper Advertisements Email graphics for E-blasts Patient brochures

Pharmacy Education ToolsPharmacy Education Tools Pharmacy In-services Certified Pharmacy Fitter Seminar

with Continuing Education Credits

Online training modules Information disease state programs Robert Stemmer Library

─ Over 1,000 clinical studies/papers─ Online: www.stemmerlibrary.com

http://www.stemmerlibrary.com/

Patient Education ToolsPatient Education Tools Brochures Posters DVDs Shelf talkers Online donning tips and tricks

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Service, Service, ServiceService, Service, ServiceDELIVERY ALL orders received before 5pm will be shipped the same day

ORDERING 4 Easy Ways to Order: Phone, E-Mail, B2B, Fax

PRODUCT AVAILABILITY Peachtree City, GA warehouse

CATEGORY EXPERTS The ONLY sales force DEDICATED to selling graduated

compression stockings/socks

PRODUCT DEPTH Compression stockings/sock for ALL medical/consumers needs

SIGVARIS ProductsSIGVARIS ProductsSIGVARIS Medical

SIGVARIS Well Being

SIGVARIS Sports

Accessories

SIGVARIS Medical

Diabetic Compression Sock(602)

18-25mmHg Drirelease™ fabric with

Freshguard─ Breathable

─ Wicks moisture

─ Odor control

Flat seem over toe Padded sole and heel Slight release in top band Measured sizing, including

extra large

APMAAPMA

Seal of Seal of AcceptanceAcceptance

APMAAPMA

Seal of Seal of AcceptanceAcceptance

Medical TherapyMedical Therapy

Color coordinated box stripe, color/fabric swatch and catalog page information─ Easy identification─ Inventory management

SIGVARIS Compression StockingsSIGVARIS Compression Stockings

Medical Therapy (Rx)─ Therapeutic benefit and specific indication─ Needs prescription by qualified medical professional─ Needs to be fitted by SIGVARIS Certified Fitter─ Compression levels:

─ 15-20mmHg─ 20-30mmHg─ 30-40mmHg─ 40-50mmHg─ 50-60mmHg

Medical Therapy Medical Therapy

Cotton Series (230)─ 20-30 and 30-40mmHg─ Natural fiber content 25% Supima®

Cotton─ 100% cotton contact with the skin─ Minimizes heat and moisture build up─ Easy to apply and remove─ Best suited for patients with skin

allergies or sensitive skin─ Available in open-toe


Cushioned Cotton (360)─ 20-30mmHg─ Especially designed for those who stand

for prolonged periods of time.─ Extra padded sole, heel and toe absorbs

impact and protects feet─ 64% Supima® Cotton─ Naturally breathable, soft and hypo-

allergenic─ Flat, low-friction toe seam─ Diabetic friendly*

* For diabetics without arterial insufficiency and neuropathy


Truly Transparent (770) ~ Women Only─ 20-30mmHg; 30-40mmHg─ Sheer, yet durable Medical Therapy product─ Ideal for fashion conscious woman─ Beaded silicone grip-top with lace on thigh

style─ Often prescribed for women post-vein

procedure─ Available in open toe


EverSheer (780) ~ Women Only─ SHEEREST Medical Therapy product

─ 15-20mmHg─ 20-30mmHg─ 30-40mmHg

─ Patented Sensinnov band for thigh-high─ Ideal for fashion conscious woman─ Ideal for post-procedure─ Available in open toe


SOFT OPAQUE (840) ~ Women Only─ 15-20mmHg─ 20-30mmHg─ 30-40mmHg

─ Fashionable Opaque hosiery─ Professional or casual wear

─ Soft to the skin─ Excellent moisture management─ Patented Sensinnov band for thigh-hi


Select Comfort Series (860)─ Perhaps our easiest to don and remove!─ Designed for women and men

─ Men’s product has a slight ribbed design

─ Wide range of styles─ Calf (open or closed toe)

─ Thigh with grip top (open or closed toe)

─ Pantyhose

─ Maternity Pantyhose

─ Thigh with waist attachment (open toe)


Natural Rubber Series (500)─ 30-40mmHg, 40-50mmHg, 50-60mmHg─ Designed with low fatigue rate to sustain

compression throughout the day─ Ideal for patients with more serious

symptoms or long-term therapy─ Available in compression levels of 30-40

mmHg, 40-50 mmHg, and 50-60 mmHg─ Up to 18” ankle circumference.

─ Great alternative to custom made garments─ Open toe only─ Unique sizing chart

Please note that this product is not latex-free and is the only SIGVARIS product that contains natural latex.Please note that this product is not latex-free and is the only SIGVARIS product that contains natural latex.

SIGVARIS WELL BEING

Cotton Blends

Casual Cotton (186/146)Casual Cotton (186/146)

─ 66% Supima® cotton for extra comfort and durability

─ Highest quality natural cotton provides extraordinary softness

─ Non-constricting top band and toe zone

─ Available in an array of colors

Cushioned Cotton (182/142)Cushioned Cotton (182/142)

─ 68% Supima® cotton─ Naturally breathable, soft and hypo-

allergenic─ Ideal for sensitive skin

─ Soft, cushioned sole, heel and toe; best suited for those prolonged standing professions and industries such as healthcare workers, factory workers, etc.

─ Flat, low-friction toe seams─ Diabetic friendly features*

* For diabetics without arterial insufficiency and neuropathy

Nylon Blends

Classic Dress (145) Classic Dress (145) Women onlyWomen only

─ A dress sock with contemporary ribbed design

─ Ideal for everyday wear both at the office and on the town

─ Reinforced heel─ Extra room in the toe to prevent

constriction─ Available in many fashionable

colors

Business Casual (189)Men only

Wide band with two way stretch for easy donning

Stretchable toe fabric and a wide heel design to create comfort and durability

Stripped pattern for professional look

Classic Ribbed (180)Classic Ribbed (180) Men OnlyMen Only

─ A dress sock with a subtle ribbed design─ Ideal for everyday wear ─ Calf support panel for better distribution

of compression across the leg─ Extra room in the toe to prevent

constriction

Sheer Fashion (120)Sheer Fashion (120) Women OnlyWomen Only

─ 15-20mmHg─ Jersey knit construction for incredible

sheerness and optimum comfort─ Available in wide range of fashionable

colors─ Styles include;

─ Knee-hi─ Thigh-hi ─ Pantyhose ─ Maternity

Sheer Fashion SizingSheer Fashion Sizing

Pantyhose and maternity sizing grid (see catalog): Pantyhose and maternity sizing grid (see catalog):

By Height and Weight*By Height and Weight* *Pre-pregnancy weight for maternity*Pre-pregnancy weight for maternity

Pantyhose and maternity sizing grid (see catalog): Pantyhose and maternity sizing grid (see catalog):

By Height and Weight*By Height and Weight* *Pre-pregnancy weight for maternity*Pre-pregnancy weight for maternity

SIGVARIS SPORTS


ACTIVE WEAR (Over the Counter) Athletic Recovery

─ Designed to help flush out the lactic acid built up in the leg during exercise, relieving tired, aching legs and exercise-induced muscle soreness.

─ Measured by:─ Ankle Circumference and Shoe size

─ 15-20 mmHg

Active Wear Sizing ChartActive Wear Sizing Chart


ACTIVE WEAR (Over the Counter) Performance Sock

─ Designed for weekend warriors to top competitors and athletes of all kind

─ Measured by:─ Ankle and Calf Circumference/Shoe size

─ 20-30mmHg

Performance Sock Sizing ChartPerformance Sock Sizing Chart

Sports Sleeve Features and Benefits

─ Stabilizes & diminishes vibrations of active muscles for faster regeneration

─ Latex-free high-tech fibers provide odor and thermal control; sleeve stays incredibly dry

─ Extra-wide comfort top band keeps sleeve comfortably in place

─ Less aching and cramping to optimize performance potential

─ True graduated compression

(20-30mmHg)

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SIGVARIS Donning AccessoriesSIGVARIS Donning Accessories

Latex Free GlovesLatex Free GlovesLatex Gloves Latex Gloves

Need pictureNeed picture

GlovesGloves

SIGVARIS Donning AccessoriesSIGVARIS Donning AccessoriesEasy Slides

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SIGVARIS Donning AccessoriesSIGVARIS Donning AccessoriesDonning Devices

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Care InstructionsCare Instructions

Machine wash on gentle cycle and lukewarm water using lingerie bag

SIGVARIS Washing Solution─ Do not use detergents, stain removers,

fabric softeners or bleach─ Travel-friendly 2 oz size available

Rinse well

Care InstructionsCare Instructions

Air dry only ─ DO NOT use clothes dryer or expose to

direct sunlight.

Removing body oils from silicone beads and strips─ Use clean cloth with rubbing alcohol

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2

3

Ankle Circumference

Calf Circumference

Calf Length

Measuring for Calf Length StylesMeasuring for Calf Length Styles

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Thigh Circumference

Measuring for Thigh and Pantyhose StylesMeasuring for Thigh and Pantyhose Styles

Leg Length

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PFSPFS System ChartSystem Chart²²

9”9”9”9”

16.5”16.5”16.5”16.5”

16”16”16”16”

How to Order – Well BeingHow to Order – Well Being

CC BB 9999189189

Product SeriesProduct Series189 Men’s189 Men’sBusiness CasualBusiness Casual

Product StyleProduct StyleCalfCalf

Size Size B = Shoe SizeB = Shoe Size9 – 11 and Ankle9 – 11 and AnkleCircumference 10 ½”Circumference 10 ½”

ColorColorBlackBlack

How to Order – Medical Therapy - PFSHow to Order – Medical Therapy - PFS²²

CC MLML WW8484 22 9999

Product SeriesProduct SeriesSoft OpaqueSoft Opaque

Pressure DesignationPressure Designation20 – 30 mmHg20 – 30 mmHg

Product StyleProduct StyleCalfCalf

Size Size Medium LongMedium Long

GenderGenderWomanWoman

ColorColorBlackBlack

What is the SIGVARIS Product Code?What is the SIGVARIS Product Code?

Physician’s Rx Woman patient wanting sheer hosiery

─ Pantyhose─ 20-30 mmHg ─ Black ─ Ankle circumference= 9.5”─ Calf circumference = 16”─ Thigh circumference = 25”─ Length = 27.5”

The Product Code is:The Product Code is:

782PMSW99782PMSW99or or

772PMSW99772PMSW99

What is the What is the SIGVARIS Product Code?SIGVARIS Product Code?

Physician’s Rx Male patient wants beige closed toe calf-length Needs 30-40 mmHg The patient has some arthritis and a limited range of

motion Measurements are:

─ Ankle = 25.5 cm─ Calf = 45 cm─ Calf Length = 42.25 cm

Measuring for “OTC” Compression TherapyMeasuring for “OTC” Compression TherapyRead the Box to Identify Appropriate Measuring SystemRead the Box to Identify Appropriate Measuring System

Exercise #1Exercise #1OTC MeasuringOTC Measuring

PART A:

Utilize a patient record card to record the following measurements for yourself:Ankle circumferenceShoe Size

PART B:

Determine your size in the following products:WOMEN: Sheer Fashion knee-high (120)MEN: Business Casual sock (189)

Measuring for Medical Compression Therapy: Measuring for Medical Compression Therapy: Calf Length StylesCalf Length Styles

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22

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1. Ankle Circumference1. Ankle Circumference

2. Calf Circumference2. Calf Circumference

3. Calf Length3. Calf Length

Three main circumference measurements of both legs Measure ankle circumference just above the ankle bone Measure calf circumference at the widest part of each calf Measure calf length from the fold of the knee to heal, without

patients’ shoes

Measuring for Medical Compression Therapy: Measuring for Medical Compression Therapy: Thigh and Pantyhose Styles Thigh and Pantyhose Styles

5. Thigh Length5. Thigh Length

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4. Thigh Circumference4. Thigh Circumference

Additional circumference measurements Measure thigh circumference around the widest part of the top of

thigh Measure thigh length from gluteal fold to heal, with patient shoes

removed

Exercise #2Exercise #2Medical MeasuringMedical Measuring

PART A:

Measure your RIGHT LEG for a calf length sock. Utilize a patient record card to record the measurements for your RIGHT LEG.

PART B:

Measure your neighbor’s LEFT LEG for a calf length sock. Utilize a patient record card to record the measurements for your neighbor’s LEFT LEG.

PART C:

Utilize the PFS2 sizing chart to determine your compression size. Tell your SIGVARIS representative your size to retrieve a pair of socks to don and doff.

Exercise #2Exercise #2Medical MeasuringMedical Measuring

PART C:

Utilize the PFS2 sizing chart to determine your compression size. Tell your SIGVARIS representative your size to retrieve a pair of socks to don and doff.

Donning Hints, Tips, and TricksDonning Hints, Tips, and Tricks

Golden Rules to Donning StockingsGolden Rules to Donning Stockings Identify the appropriate glove size for yourself

and the patient…put them on Discuss the importance of gloves in donning and

doffing Do NOT bunch the garment like ordinary socks. Fitter applies the 1st stocking Patient applies to 2nd leg COACH, COACH, COACH…REPEAT UNTIL THE

PATIENT IS COMFORTABLE WITH TECHNIQUE

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Golden Rules to Doffing StockingsGolden Rules to Doffing Stockings Peel off garment like a banana Fitter removes stocking from the 1st leg Patient removes stocking from 2nd leg Observe

─ Behaviors towards garment and level of compression

─ Dexterity─ Location of venous complication on leg

Offer donning aids - Easy Slide/Off/Caron/Lever

Offer lighter compression with double layers COACH THEM7373

Donning Methods: Pull-on MethodDonning Methods: Pull-on Method

1.1. Grasp the stockings at both Grasp the stockings at both sides of the top band – DO NOT sides of the top band – DO NOT BUNCH STOCKINGSBUNCH STOCKINGS

2.2. Pull onto the foot and up the Pull onto the foot and up the leg as far as possibleleg as far as possible

3.3. Select a position on the leg to Select a position on the leg to grasp and pull up again as far as grasp and pull up again as far as possible OR Fold excess fabric possible OR Fold excess fabric down onto the leg (DO NOT down onto the leg (DO NOT BUNCH) and grasp and pull-upBUNCH) and grasp and pull-up

4.4. Repeat until heal is in place and Repeat until heal is in place and stocking is smooth on legstocking is smooth on leg

Donning Methods: Sock-Puppet MethodDonning Methods: Sock-Puppet Method

Heel Pocket-out MethodHeel Pocket-out Method1.1. Turn stockings inside out by placing hand inside the foot, grasp Turn stockings inside out by placing hand inside the foot, grasp

the heel, and pull the stocking inside outthe heel, and pull the stocking inside out2.2. Slide foot into the stocking until toe and heel are correctly Slide foot into the stocking until toe and heel are correctly

positionedpositioned3.3. Grasp top of stocking and pull over ankle, up calf, and into placeGrasp top of stocking and pull over ankle, up calf, and into place

Proper Fit. Comfort. ComplianceProper Fit. Comfort. Compliance

Calf length garments should fit 2 finger lengths

below bend on knee Thigh high garments should fit at the fattest

part of thigh Open toe garments should peak the toe and

rest comfortable across toe PIPS

Comfort = Compliance

Compliance = Wear & Achievement of Clinical Outcomes

Clinical Outcomes = Repeat Sales!

Compression Care Counseling PointsCompression Care Counseling PointsMeasuring Measure both legs and size based upon the

lower/smallest measurements Measure the patient at the earliest part of their day Calf length garments should fit 2-finger lengths below

the bend of the knee for proper fit

Compression Care Counseling PointsCompression Care Counseling PointsWear and Care Hand wash or machine wash daily on gentle cycle using

lukewarm water Wash garments alone or in a device to protect the garment

(i.e., a lingerie bag) Use a mild detergent or manufacturer provided washing

solution Encourage patients to purchase 2-pair

1 pair to WASH 1 pair to WEAR

Air dry garments and avoid tumble drying Removing body oils from silicone beads and strips with

rubbing alcohol

Tools of the TradeTools of the Trade Fitting Room - clean and clutter free Product - can’t sell what you don’t have Gloves - a must (they really work)! Tape Measure Catalog with measuring charts Easy Slides + Off’s / Easy Slide Caron / Easy Lever SIGVARIS Washing Solution Gown or Shorts A mat for feet Chair or bench Powder

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Check Out Those LegsCheck Out Those LegsSubjectively Assess Legs and Ask…Subjectively Assess Legs and Ask… What does the skin look like? Does it look “normal” Is it discolored? Is it dry and flaky? Is tight and shiny? Is it weeping? Is one leg larger than the other? Does anyone in your family have problems with their legs? If female, ask if they have had any children? Did you have problems with your legs during pregnancy?

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Your PatientsYour Patients Market research indicates that the target compression segment is

─ Females,

─ Aged 40-65,

─ Working with access to group health benefits/flexible spending Probe and Educate

─ Inquire about ADLs, disease and medication history

─ Educate about DVT and other venous disorders

─ Request a prescription from patient and physician

─ What healthcare benefits and flexible spending account does the patient have?

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Show Your Value &Show Your Value &Let the Fitting Begin...Let the Fitting Begin...

Take the person into the fitting room/area Ask about and record co-morbid conditions

─ Consider contraindications and precautions for compression therapy

Inquire of compression history, if any Explain venous disease and compression therapy in laymen

terms Discuss the need for compliance and expected outcomes with

daily wear and care Measure the patient and record data on Patient Record Card Let the patient take charge in garment selection Practice donning and doffing

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Compression Payment ModelCompression Payment Model

Healthcare Common Procedure CodesHealthcare Common Procedure CodesGRADIENT COMPRESSION STOCKING, BELOW KNEE, 18-30 MMHG, EACH Compression stocking BK18-30 A6530

GRADIENT COMPRESSION STOCKING, BELOW KNEE, 30-40 MMHG, EACH Compression stocking BK30-40 A6531

GRADIENT COMPRESSION STOCKING, BELOW KNEE, 40-50 MMHG, EACH Compression stocking BK40-50 A6532

GRADIENT COMPRESSION STOCKING, THIGH LENGTH, 18-30 MMHG, EACH Gc stocking thighlngth 18-30 A6533



GRADIENT COMPRESSION STOCKING, FULL LENGTH/CHAP STYLE, 18-30 MMHG, EACH Gc stocking full lngth 18-30 A6536



GRADIENT COMPRESSION STOCKING, WAIST LENGTH, 18-30 MMHG, EACH Gc stocking waistlngth 18-30 A6539



GRADIENT COMPRESSION STOCKING, CUSTOM MADE Gc stocking custom made A6542

GRADIENT COMPRESSION STOCKING, LYMPHEDEMA Gc stocking lymphedema A6543

GRADIENT COMPRESSION STOCKING, GARTER BELT Gc stocking garter belt A6544

GRADIENT COMPRESSION STOCKING, NOT OTHERWISE SPECIFIED G compression stocking NOS A6549

The BEST The BEST compression garment compression garment

is the one that is the one that YOUR PATIENT WEARSYOUR PATIENT WEARS

Thank you for Thank you for attending!attending!

certified pharmacy fitter seminar

Technology

sigvaris compres

sigvaris manufacturing

sigvaris quality iso

efficacy compression

sigvaris sports accessories

donning compression

correct compression

diabetic compression