•Eligible commercially insured patients pay just $0 per injection; $2,000 maximum benefit per calendar year
•Maximum program benefit per calendar year applies
•Before the calendar year ends, patients will receive information and eligibility requirements for continued participation in the program
•Offer may not be combined with any other coupon, discount, prescription savings card, free trial, or other offer
•Not valid for residents of MA, MN, or RI
•For any additional assistance please call at 8339484631, Monday – Friday, 8:00 AM – 11:00 PM ET
•Rebate Form can submit online or fax on 8335120495