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Eligibility Rules

Patient Instructions: Redeem this coupon ONLY when accompanied by a valid prescription for TRIANEX® 0.05% (Triamcinolone Acetonide Ointment, USP). Commercially insured patients pay $0 for their prescription. Maximum reimbursement limits apply. This card may be presented at the time of fill for instant savings. Offer is good for commercially insured patients only. This coupon is good for up to 12 uses and is not transferable.
Pharmacist instructions for a patient with an Eligible Third Party: Submit the claim to the primary Third Party Payer first, then submit the balance due to Change Healthcare as a Secondary Payer COB [coordination of benefits] with patient responsibility amount and a valid Other Coverage Code (eg, 08). Maximum reimbursement limits apply. Reimbursement will be received from Change Healthcare.
For patients whose insurance plan does not cover product: Submit the claim from the primary Third Party Payer to Change Healthcare as a secondary payer COB with patient responsibility amount and process using Other Coverage Code (eg, 03). Maximum reimbursement limits apply. Reimbursement will be received from Change Healthcare.
Valid Other Coverage Code required: For any questions regarding Change Healthcare online processing, please call the Help Desk at 1-800-422-5604. For offer details and patients with questions about this offer, please call 1-844-492-9829.
Please consult Full Prescribing Information for TRIANEX® 0.05% (Triamcinolone Acetonide Ointment, USP). Not valid for cash-paying patients or patients reimbursed by federal healthcare programs, including Medicare, Medicaid, TriCare, the Department of Veterans Affairs, state maternal and child health block grant programs under 42 U.S.C. 701 et. seq. state social service block grant programs under 42 U.S.C. section 1397 et. seq. or any other similar federal or state healthcare program. Void where prohibited by law, taxed or restricted. Void outside the United States. Patient is responsible for reporting receipt of card program rewards to any private insurer that pays for or reimburses any part of the prescriptions filled with this card. Void if reproduced. It is illegal for any person to sell, purchase, or trade, or offer to sell, purchase or trade, or to counterfeit this card. Offer expires 12 months after initial use. Promius Pharma reserves the right to rescind, revoke or amend this offer at any time without notice.
INDICATION AND IMPORTANT SAFETY INFORMATION
The most common adverse events with TRIANEX Ointment include burning, itching, irritation, dryness, and folliculitis. TRIANEX Ointment is contraindicated in patients who are hypersensitive to any of the ingredients of this product. As with all topical corticosteroids, systemic absorption can produce reversible HPA-axis suppression.
IMPORTANT PATIENT SAFETY INFORMATION
  • Do not bandage or wrap the treated area unless directed by your physician.
  • Use the least amount of TRIANEX Ointment necessary for the shortest period of time as directed by your physician.
  • Do not use TRIANEX Ointment if you are allergic to any of the ingredients in TRIANEX Ointment.
  • Do not use TRIANEX Ointment if you are pregnant or plan to become pregnant. It is not known if TRIANEX Ointment will harm your unborn baby.
  • Do not use TRIANEX Ointment if you are breastfeeding or plan to breastfeed as it is not known if TRIANEX Ointment passes into breast milk.