Manufacturer Printable Coupon
Antara Coupon Misc Information:
Antara® Retail Cost: Approximately $180 for thirty 130 mg capsules.
- Patients pays the first $15 per thirty capsule supply, Lupin pharmacauticals pays a subsidy towards the patient's normal copay (amount of subsidy limited to 14% of the pharmacy wholesale acquisition cost).
- Maximum value of Antara coupon is aproximately 14% of the wholesale cost of 30 units of medication.
- Antara coupon may be used once per month with a maximum of 12 coupon transactions per year or until the program expiration date, whichever comes first.
Antara Coupon Processing Credentials:
Bin: 610 020
Group ID: 9999 2049
ID#: Each card has a unique member ID number
Antara Coupon Submission Process:
- Submit claim to the patient's Primary Payer first, then submit the balance due to trialcard as a secondary Payer.
- Antara coupon adjudicated by TrialCARD, on behalf of Lupin Pharmaceuticals.
- Pharmacist help line is 1-877-343-1198; please have your NABP number handy when Antara coupon group number handy.
Below is an image Of an actual Antara Coupon downloaded October, 2011.
If you can cat afford Antara, even with the above coupon, or you do not qualify to use the Antara coupon, you may contact Lupin Pharmaceuticals to see if they have programs available for people with limited means.