BOTOX^® Complete Savings Program Terms and Conditions

1. Offer good only with a valid prescription for BOTOX^® (onabotulinumtoxinA). 2. Based on insurance coverage, reimbursement may be up to $1,400 for the first treatment in a year and $1,000 for each subsequent treatment with a maximum savings limit of $4,000 per year; patient out-of-pocket expense may vary. 3. Offer not valid for (a) patients enrolled in Medicare, Medicaid, TRICARE or any other government-reimbursed healthcare program (including any state pharmaceutical assistance programs), or private indemnity or HMO insurance plans that reimburse for the entire cost of prescription drugs; (b) patients who are Medicare-eligible and enrolled in an employer-sponsored health plan or prescription drug benefit program for retirees; (c) cash-paying patients. 4. Offer valid for up to 5 treatments over a 12-month period. 5. Offer Valid only for BOTOX and BOTOX treatment related costs not covered by insurance; this only includes co-pay, co-insurance, deductible, and excludes Out of Network and/or Not Covered Cost. For residents of Massachusetts and Rhode Island, offer applies to cost of BOTOX and not to any related medical service(s). 6. Claims must be submitted within 180 days of treatment date and must include a copy of (a) an Explanation of Benefits (EOB) for the BOTOX treatment, (b) a Specialty Pharmacy (SP) receipt for BOTOX, or (c) other writing showing payment of out-of-pocket BOTOX and BOTOX treatment related costs not covered by insurance; this only includes co-pay, co-insurance, deductible, and excludes Out of Network and/or Not Covered cost. 7. A BOTOX^® Complete Savings Program check will be issued to the patient upon approval of a claim. 8. AbbVie reserves the right to rescind, revoke, or amend this offer without notice. 9. Offer good only in the USA, including Puerto Rico, at participating retail locations. 10. Void where prohibited by law, taxed, or restricted. 11. Offer does not constitute health insurance. 12. By participating in the BOTOX^® Complete Savings Program, you acknowledge and agree to the terms and conditions of this program. 13. Subject to all other terms and conditions, the maximum annual benefit that may be available solely for the patient’s benefit under the co-pay assistance program is $4,000 per calendar year. The actual application and use of the benefit available under the co-pay assistance program may vary on a monthly, quarterly, and/or annual basis depending on each individual patient’s plan of insurance and other prescription drug costs. 14. To learn about AbbVie’s privacy practices and your privacy choices, visit https://abbv.ie/corpprivacy.

For questions about the program, please call 1-800-44-BOTOX (1-800-442-6869).