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1. #Tivicay copay card phone number full#
2. #Tivicay copay card phone number code#
3. #Tivicay copay card phone number trial#

#Tivicay copay card phone number full#

Please click here for full prescribing information for Rhopressa ®. Most corneal verticillata resolved upon discontinuation of treatment. This reaction did not result in any apparent visual functional changes. The corneal verticillata seen in Rhopressa ®- treated patients were first noted at 4 weeks of daily dosing. Instillation site erythema, corneal staining, blurred vision, increased lacrimation, erythema of eyelid, and reduced visual acuity were reported in 5-10% of patients. Other common (approximately 20%) adverse reactions were: corneal verticillata, instillation site pain, and conjunctival hemorrhage. Six percent of patients discontinued therapy due to conjunctival hyperemia. The most common ocular adverse reaction observed in controlled clinical studies with Rhopressa ® dosed once daily was conjunctival hyperemia, reported in 53% of patients. reserves the right to rescind, revoke or amend this offer without notice at any time.īY USING THIS CARD, YOU AND YOUR PHARMACIST UNDERSTAND AND AGREE TO COMPLY WITH THESE ELIGIBILITY REQUIREMENTS AND TERMS OF USE. Program managed by ConnectiveRx on behalf of Aerie Pharmaceuticals, Inc. It is illegal to (or offer to) sell, purchase, trade, reproduce or counterfeit this offer. Offer not valid for patients under 18 years of age. By using this offer, the patient certifies that he or she will comply with any terms of his or her health insurance contract requiring notification to his or her payor of the existence and/or value of this offer.

#Tivicay copay card phone number trial#

Offer may not be combined with any savings, discount card, trial or similar offer for the same prescription. Offer not valid for prescriptions reimbursed under Medicare, a Medicaid drug benefit plan, TRICARE, CHAMPUS or other federal or state health programs. territories including, but not limited to, Puerto Rico. Restrictions: This offer is valid for eligible residents of the United States only. For eligible commercial patients when the product is not covered, submit BIN and OCC 03.įor any questions regarding CHANGE HEALTHCARE online processing, please call the Help Desk at 1-80. For eligible commercial patients, submit BIN and OCC 08.

#Tivicay copay card phone number code#

Pharmacist instructions: Submit the claim to the primary commercial insurance company first, then submit the balance due to CHANGE HEALTHCARE as a Secondary Payer COB with patient responsibility amount and a valid Other Coverage Code (OCC). Offer valid up to 12-month qualifying prescriptions.

Maximum savings limit applies patient out-of-pocket expense may vary. Patient pay amount may vary dependent upon commercial insurance coverage for ROCKLATAN ® or RHOPRESSA ®. Patients with questions about the ROCKLATAN ® or RHOPRESSA ® Savings offer should call 1-84.Įligible commercially insured patients may pay as little as $25 per 30-day, 60-day, or 90-day supply. Patients who are enrolled in a state or federally funded prescription insurance program, such as Medicare or Medicaid, are excluded. By using this offer, you are certifying that you meet the eligibility criteria and will comply with the terms and conditions described in the Restrictions section below. Patient Instructions: In order to redeem this offer you must have a valid prescription for ROCKLATAN ® or RHOPRESSA ®.