CONTACT
INFO |
|
Address: |
, |
Phone: |
1-844-722-6672 |
Provider Phone: |
|
Fax: |
1-844-482-4482 |
Website: |
Program Website |
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ELIGIBILITY
|
|
Eligibility
Info: |
Patients who do not have health insurance and cannot afford treatment, Pfizer enCompass can provide information on the patient's state Medicaid program if the patient is interested in applying.
Program also offers co-pay assistance. |
|
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:
|
Yes |
|
APPLICATION |
|
Attachments
Required: |
Not Published
|
Physician
License #
Required: |
NPI
|
Prescriber
Signature
Allowed: |
Physician
|
Application
may be
faxed: |
Yes
|
Eligibility
determination
letter sent: |
Not Published
|
|
MEDICATION |
|
Receives: |
Not Published
|
Shipped To: |
Not Published
|
Quantity in
Shipment: |
Not Published
|
Delivery Time: |
Not Published
|
Re-application
Policy: |
Not Published |
Refill Policy: |
Not Published
|
Other Information: |
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