† Maximum benefit is $20 off, on up to 5 prescriptions, depending on your out-of-pocket costs. Not valid for patients participating in Medicare, Medicaid, government (public insurance) programs, or any private payor in the state of Massachusetts and where prohibited by law.
Patient:
You must present this card to the pharmacist along with your prescription to participate in this
program. If you have any questions regarding your eligibility or benefits or if you wish to discontinue your
participation, call the Ambien CR® (zolpidem tartrate extended release) 6.25-mg or 12.5-mg Offer Card
program at 1-866-717-5819 (8:00 AM - 8:00PM EST, Monday-Friday). Retain this card for future reference.
Pharmacist:
Submit transaction to McKesson Corporation using BIN #610524.
If primary coverage exists, input card information as secondary coverage and transmit using the COB
segment of the NCPDP transaction. Applicable discounts will be displayed in the transaction response.
Acceptance of this card and your submission of claims for the AMBIEN CR Offer Card program are subject to
the LoyaltyScript® program Terms and Conditions established by McKesson Corporation. By accepting this
card, you agree to the LoyaltyScript® program Terms and Conditions posted at www.mckesson.com/mprs.
Maximum benefit is up to $20 off per prescription depending on your out-of-pocket costs. This offer is not
valid for Medicare or Medicaid recipients or any government (public insurance) programs, any private
payor in the state of Massachusetts and where prohibited by law. LoyaltyScript® is not an insurance card.
For questions regarding setup, claim transmission, patient eligibility or other issues, call the
AMBIEN CR Offer Card program at 1-866-717-5819 (8:00 AM-8:00 PM EST, Monday-Friday).
Terms and conditions:
OFFER GOOD ONLY ON AMBIEN CR PRESCRIPTION. This offer is valid only for the patient whose name appears on the prescription for AMBIEN CR,
and is limited to five redemptions per person at $20 each for the duration of the program. This offer may not be sold, purchased or traded,
or offered for sale, purchase or trade, or counterfeited. Duplicate requests and requests from clubs, groups or organizations will not be honored,
acknowledged or returned. Restrictions apply.
Not valid for patients participating in Medicare, Medicaid, government (public insurance) programs, or any private payor in the state of
Massachusetts and where prohibited by law.
Sanofi-aventis reserves the right to rescind, revoke or amend this offer without notice.
©2007-2008 sanofi-aventis U.S. LLC. All rights reserved. US.ACR.08.10.055
McKesson Specialty Arizona Inc. – Scottsdale AZ 85251 – Patent Pending
AMBIEN CR Offer Card is a LoyaltyScript® program