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Offer not valid for any individual for whom any part of InnoPran XL^® prescription is or will be covered by Medicaid, Medicare (including Medicare Advantage or Part D Prescription Plans), any state prescription drug programs, or any other public payer program.

• This program cannot be combined with any other coupon certificate, voucher or similar offer.
• Offer applies to out-of-pocket (OOP) expenses for InnoPran XL^®. Out-of-pocket expenses greater than $0 will be covered up to a maximum of $300 per prescription of actual out-of-pocket expenses (a) per 30-day supply for each of up to twelve (12) prescription fills, (b) per 60-day supply for each of up to six (6) prescription fills, or (c) per 90-day supply for each of up to four (4) prescription fills.
• Offer good only in the USA and Puerto Rico at participating retail pharmacies and cannot be redeemed at government-subsidized clinics.
• ANI Pharmaceuticals, Inc. reserves the right to rescind, revoke or amend this offer without notice.
• Participation in this program must comply with all applicable state laws and contractual or other obligations as a pharmacy provider.
• This is not an insurance program.

• Participating patients and pharmacists understand and agree to comply with the terms and conditions of this offer as set forth herein.
• Offer not extended for prescriptions for:
  • No claims paid by Government-sponsored insurance plans
    • Medicare, Medicaid, Federal, State, Patient Pharmaceutical Assistance
  • No Pharmacies in states that prohibit the offering of co-pay assistance at the point of dispensing
  • Patients 17 years of age and younger are excluded
  • No cash claims

To find a participating eVoucherRx™ pharmacy visit: www.evoucherrx.relayhealth.com/storelookup.

For questions about the copay card program or if you have problems processing the copay card please call 1-888-846-0234.