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  • Ask your pharmacist to manually input the codes from your mobile device
  • Make sure your pharmacy fills your prescription exactly as written

*Click here for Terms and Conditions

  • Ask your pharmacist to manually input the codes from your mobile device
  • Make sure your pharmacy fills your prescription exactly as written

*Tap here for Terms and Conditions

RxBIN: 610524
RxPCN: Loyalty
RxGRP: 50777290
ISSUER: (80840)
ID#:


Offer Expires: 3/31/17

Eligible patients will pay no more than $25 for a prescription. Maximum benefit per bottle is $75.

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*Terms and Conditions:Valid only for those with commercial insurance.Offer not valid under Medicare, Medicaid, or any other federal or state program, for cash-paying patients, or where plan reimburses you for the entire cost of your prescription drug. Eligible commercially insured patients may pay as little as $25 in out-of-pocket expenses for each 3 mL bottle of VIGAMOX® (moxifloxacin hydrochloride ophthalmic solution) 0.5% as base with a maximum benefit per bottle of $75. Offer good for up to three (3) 3 mL bottles of VIGAMOX® Solution for a single patient. Patient must be one (1) year or older to be eligible for VIGAMOX® Solution. No other purchase is necessary. If insured patient reaches maximum benefit per bottle, patient will be responsible for the difference. Offer is not valid where prohibited by law. Valid only in the US, USVI, Guam and Puerto Rico. This program is not health insurance. Offer may not be combined with any other rebate, coupon, or offer. Novartis reserves the right to rescind, revoke, or amend the program without notice. Patient certifies responsibility for complying with applicable limitations, if any, of any commercial insurance and reporting receipt of program rewards, if necessary, to any commercial insurer.This offer expires on 3/31/17.

Patient Instructions: : Ensure this co-pay offer, your insurance information and a valid prescription for VIGAMOX® Solution is provided to your participating pharmacist. The prescriber ID# must be identified on the prescription. If you have any questions, please call 1-844-236-8027 (8:00 am to 8:00 pm ET, Monday-Friday).This offer expires on 3/31/17.

When you use this offer, you are certifying that you understand the program rules, regulations, and terms and conditions and that you will comply with them. You may not use this offer if prohibited by your insurer. You are not eligible if you are a cash payer or if prescriptions are paid by any federal or state program, or where prohibited by law; and you will otherwise comply with the terms and conditions above. You are responsible for any reporting of the use of this offer required by your insurer.

Pharmacist Instructions:When you use this offer, you are certifying that you have not submitted and will not submit a claim for reimbursement under any federal, state, or other government programs for this prescription. Pharmacist will comply with his/her obligations when processing the prescription for payment. By using this offer, you agree to the terms and conditions of this program. Co-pay offers must be accompanied by a prescription for VIGAMOX® Solution. If primary coverage exists, input offer as secondary coverage and transmit using the COB segment of the NCPDP transaction. Submit transaction to McKesson Corporation using BIN #610524. Acceptable discounts will be displayed in the transaction response. Acceptance of this offer and your submission of claims are also subject to the Terms and Conditions posted at www.mckesson.com/mprstnc.

If you have any questions, please call McKesson Help Desk at 1-844-236-8027 (8:00 am to 8:00 pm ET, Monday-Friday).

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