Program Details
FRESENIUS KABI
KabiCare - Stimufend
Stimufend
(pegfilgrastim-fpgk)
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CONTACT
INFO |
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Address: |
, |
Phone: |
1-833-522-4227 |
Provider Phone: |
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Fax: |
1-833-302-1420 |
Website: |
Program Website |
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ELIGIBILITY
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Eligibility
Info: |
If your patient does not have insurance and/or cannot afford their medication, they may be eligible for additional assistance through the Patient Assistance Program or through independent nonprofit patient assistance programs.
Patients must not be eligible for commercial copay assistance or Bridge to Therapy support if the prescription is eligible to be reimbursed, in whole or in part, by any state or federal healthcare program. |
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Couple |
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% FPL |
Income at or below: |
Not
Published |
Medical expenses
can be deducted from reported income: |
Not
Published |
Social security requested on form: |
No |
US citizenship/residency specified:
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Yes |
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APPLICATION |
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Attachments
Required: |
Financial
|
Physician
License #
Required: |
NPI
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Prescriber
Signature
Allowed: |
Physician
|
Application
may be
faxed: |
Yes
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Eligibility
determination
letter sent: |
Not Published
|
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MEDICATION |
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Receives: |
Medication
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Shipped To: |
Provider
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Quantity in
Shipment: |
Not Published
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Delivery Time: |
Not Published
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Re-application
Policy: |
Not Published |
Refill Policy: |
Not Published
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Other Information: |
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Last Updated: 02/15/2024
www.RxAssist.org
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