For eligible patients, this voucher is good for one

To the Patient:

Please present this voucher to your pharmacist, along with a completed and signed prescription from your doctor for Jardiance® (empagliflozin) tablets.

JARDIANCE is a prescription medication. Only your health care provider can decide whether JARDIANCE is right for you.

Voucher Terms and Conditions

Eligible patients 18 years or older may receive one 14-day free supply of Jardiance® (empagliflozin) tablets by presenting this voucher and a valid prescription at participating outpatient or retail pharmacies on or before December 31, 2021. In Massachusetts and California, the validity of this voucher and its use are subject to state law. Other state restrictions may apply. This offer is limited to one use per patient per lifetime and cannot be combined with any other free trial offer. Voucher is not health insurance, not transferable and no substitutions are allowed. Only valid for patients in the 50 United States, DC, and Puerto Rico. Voucher not valid for patients receiving Medicare Part A covered care in a facility (including, but not limited to, a hospital, skilled nursing facility, nursing home, and hospice). Void where prohibited by law. Offer may change at any time, without notice.

For questions, please call 1-800-657-7613 (8:00 AM-8:00 PM EST, Monday-Friday, Saturday 9:30 AM-6:00 PM EST).

To the Pharmacist:

Submit claim to McKesson Corporation using BIN #610524.

For questions, please call 1-800-657-7613 (8:00 AM-8:00 PM EST, Monday-Friday, Saturday 9:30 AM-6:00 PM EST). No claim for reimbursement for product dispensed pursuant to this voucher may be submitted to any third party payer, whether private or government payer (like Medicare Part D, Medicaid, VA, DOD or TRICARE), where prohibited by law or submitted to count toward a patient's True Out of Pocket (TrOOP) cost. Not valid for patients receiving Medicare Part A covered care in a facility (including, but not limited to, a hospital, skilled nursing facility, nursing home, and hospice). Offer not valid if reproduced or submitted to any other payer. It is illegal for any person to sell, purchase or trade, or offer to sell, purchase or trade, or to counterfeit this voucher.

Prescriber ID # required on prescription. McKesson retains the right to review all records and documentation relating to the filling/dispensing of product.
 
  • BIN: 610524
  • PCN: 1016
  • GROUP #: 40027307
  • Expiration Date: 12/31/21
  • ISSUER: (80840)
  • ID #: 1176153742



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PC-US-118290 (01/21)