RxBIN: 610524
RxPCN: Loyalty
RxGRP: 50775438
ISSUER: (80840)
ID:

To the Patient:

You must present this coupon to the pharmacist along with your valid, signed prescription to receive this benefit. If you have any questions regarding your eligibility or benefits, call the Elestrin Savings Coupon program at 877-264-2440 (8:00 AM—8:00 PM ET, Monday—Friday). You are not eligible if prescriptions are paid by any state or other federally funded programs, including, but not limited to Medicare or Medicaid, Medigap, VA or DOD or TriCare, or where prohibited by law; and you will otherwise comply with the terms of this offer.

If your pharmacy does not accept your Elestrin Savings Coupon, please follow the below steps in order to receive reimbursement (if eligible):

To the Pharmacist:

When you use this coupon, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state or other governmental programs for this prescription.

What is the most important information I should know about Elestrin (an Estrogen Hormone)?

Please see full Prescribing Information, including Boxed Warning and Patient Information Sheet at Elestin.com.

Call your doctor for medical advice about any side effects. You may report side effects to the FDA at 1-800-FDA-1088 or to Meda Pharmaceuticals Inc. at 1-877-999-8401.

RxBIN: 610524
RxPCN: Loyalty
RxGRP: 50775438
ID:
Offer Expires: 12/31/2013

logo

Distributed by: Meda Pharmaceuticals
265 Davidson Avenue
Somerset, NJ 08873
www.elestrin.com

© 2014 Meda Pharmaceuticals Inc. All rights reserved.