DROPS101™ WEB TOOL
MOXEZA® (moxifloxacin HCI ophthalmic solution) 0.5% as base
MOXEZA® (moxifloxacin HCI ophthalmic solution) 0.5% as base
STEP-BY-STEP GUIDE Close
  • STEP 1: Before getting started, wash your hands with soap and water.

  • STEP 2: If your child's eye is crusted, use a warm, wet washcloth to remove any debris. Remember to wipe gently.

  • STEP 3: Ask your child to lie back on a flat surface like a couch. Or place your child's head on your lap if this is comfortable for you.

  • STEP 4: Invert the closed bottle and remove the cap with the bottle still in the inverted position.

  • STEP 5: Tilt your child's head and tell him/her to look away from the bottle. Gently pull down your child's lower lid to make a pocket.

  • STEP 6: Place the tip of the bottle near the eye so the drop with fall into the pocket. The tip of the bottle should not touch the fingers, the eye or any other surfaces. Squeeze the inverted bottle to instill one drop into the affected eye.

  • STEP 7: Ask your child to close his/her eyes. When you are finished, you may want to remove any extra liquid with a clean tissue, wiping from the nose outward. Make sure to wash your hands when you are through to prevent the spread of infection.

    References: Includes materials adapted from: How to give eye medicines. Children’s Healthcare of Atlanta. http://www.choa.org/Menus/Documents/Wellness/teachingsheets/eyemed.pdf . Updated April 2009. Accessed September 21, 2012.

TERMS AND CONDITIONS Close

Terms and Conditions: Offer applies only to prescriptions (1) that are subject to a private insurance copay requirement of greater than $25, or (2) for which the patient has no insurance. Offer not valid for patients who are enrolled in a federal or state program that provides prescription drug benefits through retail or mail-order pharmacists, including Medicare Part D and Medicaid. In addition, offer is not valid for patients who are Massachusetts residents.

Program managed by PSKW, LLC on behalf of Alcon. Offer limited to one card per patient and six uses per card. No other purchase is necessary. This card may not be combined with any other rebate, discount, free trial, or other similar offer for the same prescription. Card is not transferable. Card will be accepted only at participating pharmacies. Card is not health insurance. Alcon reserves the right to rescind, revoke or amend this offer without notice at any time. Use of this card is subject to applicable state and federal law.

Patient Instructions: In order to redeem this card you must have a valid prescription for MOXEZA® Solution or VIGAMOX® Solution with the prescriber ID# identified on the prescription. Present this card to your pharmacist along with your valid prescription. By using this card, you agree that you will not submit a claim for prescription reimbursement to any federal or state prescription benefit program. In addition, you agree that you will disclose this offer to your private insurer, if any. If you have questions, please call 1-866-391-9859.

Pharmacist Instructions for a patient paying 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) The patient is responsible for $25.00 copay and reimbursement will be received from Therapy First Plus

Pharmacist Instructions for a cash paying patient: Submit this claim to Therapy First Plus. A valid Other Coverage Code (e.g., 1) is required. The patient is responsible for $25.00 and reimbursement will be received Therapy First Plus. For any questions regarding Therapy First Plus online processing, please call the Help Desk at 1-800-422-5604.

Close Check Your Email

Share all the great features of DROPS101 Web Tool from your mobile device, including instant savings information, dosing instructions, and games.

Close
MOXEZA® SOLUTION REBATE

Check Your Email

Your printable rebate is on its way.


SCROLL OR TOUCH FOR 
IMPORTANT SAFETY INFORMATION