Savings on prescriptions of OB Complete® Prenatal Dietary Supplements

Join the Savings Offers Program

Pay $0 on first fill*,

Pay first $10 on refills and we’ll pay the rest, up to $20.

* Up to a $60 savings on your first fill.

 

I agree to opt in to the Vertical Pharmaceuticals LLC. Savings Offers Program.

This card is valid for up to a total of 11 uses for each of these products: OB Complete® Petite,
OB Complete® One and OB Complete® Premier.

For a patient with an Eligible Third Party: Submit the claim to the primary Third Party Payer first, then
submit the balance due to Therapy First Plus as a Secondary Payer as a copay only billing using a valid
Other Coverage Code, (e.g. 8). On the first fill the offer is a $0 copay up to $60. On the remaining 10 refills
the patent is responsible for the first $10 and the card will cover up to $20 of their copay. Reimbursement
will be received from Therapy First Plus.

For Cash Paying Patients: Submit this claim to Therapy First Plus. A valid Other Coverage Code (e.g. 1)
is required. On the first fill the offer is a $0 copay up to $60. On the remaining 10 refills the patent is
responsible for the first $10 and the card will cover up to $20 of their copay. Reimbursement will be received
from Therapy First Plus.

Valid Other Coverage Code required. For any questions regarding Therapy First Plus online processing,
please call the help desk at 1-800-422-5604. Patients with questions should call 1-855-497-8460.

Program Rules— Eligibility, Terms & Conditions: This Instant Savings Card is not valid for prescriptions
reimbursed under a federally funded healthcare program, including Medicare or Medicaid or similar federal
or state assistance programs. Manufacturer reserves the right to rescind, revoke, or amend this offer without
notice. Card may not be copied or duplicated. No generic substitution with this offer.