Program Details
ACER THERAPEUTICS, INC.
OLPRUVA Navigator
Olpruva suspension
(sodium phenylbutyrate suspension)
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CONTACT
INFO |
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Address: |
, |
Phone: |
1-833-657-7882 |
Provider Phone: |
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Fax: |
1-855-624-2566 |
Website: |
Program Website |
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ELIGIBILITY
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Eligibility
Info: |
Eligibility is determined on case-by-case basis.
Patient must meet program incomde guidelines which are not disclosed.
Program offers co-pay assistance, patient support, and patient assistance programs for eligible patients. |
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Couple |
|
% FPL |
Income at or below: |
Not
Published |
Medical expenses
can be deducted from reported income: |
Not
Published |
Social security requested on form: |
Not
Published |
US citizenship/residency specified:
|
Not
Published |
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APPLICATION |
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Attachments
Required: |
Not Published
|
Physician
License #
Required: |
State
NPI
|
Prescriber
Signature
Allowed: |
Physician
|
Application
may be
faxed: |
Yes
|
Eligibility
determination
letter sent: |
Not Published
|
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MEDICATION |
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Receives: |
Medication
|
Shipped To: |
Not Published
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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: 12/15/2023
www.RxAssist.org
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