Daliresp
Daliresp™ Coupon; Save $20 Of The Cost Of Your Next Prescription For Daliresp (roflumilast); Doctor Distributed
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Name of Offer:
Daliresp Copay Assistance Program
Description:
Launch Coupon; Doctor Distributed Reusable Coupon Card
Details: Daliresp is a new medication for COPD. Daliresp coupons are part of a comprehensive program designed to increase the likeliehood of a positive outcome regarding Daliresp (roflumilast) therapy.
Pharmaceutical sales representatives are distributing these coupons in large quantities to doctors that treat COPD patients.
If your doctor does not have a supply of these cards, he needs to contact Forest Laboratories.
Not all doctors qualify to participate in this program.
Other Misc:
- Patient pays the first $20.
- Maximum value of Daliresp coupon is $20 per prescription ($240 per year).
- Daliresp coupon patient help line is 1-866-271-5502.
- Daliresp coupon expiration date is 11/30/2012.
- Daliresp coupon may be used once every 25 days with a maximum of 12 coupon transactions per year or until the program expiration date, whichever comes first.
- Limit 1 card per patient for the lifetime of the program.
- Patient pays the first $20.
- Maximum value of Daliresp coupon is $20 per prescription ($240 per year).
- Daliresp coupon patient help line is 1-866-271-5502.
- Daliresp coupon expiration date is 11/30/2012.
- Daliresp coupon may be used once every 25 days with a maximum of 12 coupon transactions per year or until the program expiration date, whichever comes first.
- Limit 1 card per patient for the lifetime of the program.
Daliresp Coupon Processing Credentials:
Bin: 004 682
RxPCN: CN
Group ID: EC 4800 3001
ID#: Each card has a unique ID number
Daliresp Coupon Submission Process:
Submit claim to the patient's Primary Payer first, then submit the balance due to Therapy Plus as a secondary Payer as a copay only billing using a valid Other Coverage Code (EG 8).
- Daliresp coupon adjudicated by PSKW, LLC on behalf of Forest Laboratories.
Pharmacist help line is 1-800-422-5604; please have your NABP number handy when Daliresp coupon group number handy.
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Internet Drug Coupons
Buying Group Coupon Savings Card
- Name: ________________________________
- RxMBR: 10 Digit Phone Number
- RxBin: 610709
- RxPCN: 7777
- RxGRP: EDRUGCOUPON
- Program: UNA RX CARD - UNITED NETWORKS OF AMERICA
Directions:
Print up this page and cut out the coupon. Present the coupon to the pharmacist along with your signed prescription BEFORE your prescription is filled. The pharmacist will put the coupon codes into his computer and tell you if you have a discount coming and how much you are saving compared to the normal retail price.
Important Information; Please Read:
This is a InternetDrugCoupon.com Membership Card & Reuseable Coupon. It is like a discount prescription card, only better. It is 100% free.
There are no membership fees, no registration forms, no paperwork, nothing to buy associated with this program. It never expires! It is already activated. You can photocopy it as many times as you want and give it to your friends.
Carrying this coupon means that you are part of our medicine group. It's similar to when you present your AAA card to a motel to get a discount.
Most of the big chains will grant you a discount ranging from 10% to 75% on most drugs but NOT ALL DRUGS when you use this coupon as long as you are a cash paying customer. Also, most privately owned drugstores accept this coupon.
Each drugstore decides what products they will discount and how much they will discount it.
If you want to maximize your savings with this reusable coupon, the first few times you use it, take it to 2 or 3 drugstores and get a price quote on your various medicines.
This way you can get a feel for which drugstores offer the biggest discounts to our group on particular medicines. You might wind up using the coupon for drug "A" at one store and drug "B" at a different store.