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View Prescription Drug Assistance Program Details
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| Nationwide: |
Yes |
| Program Name: |
Aciphex Patient Assistance Program |
| Program Type: |
Pharmaceutical Company |
| Drugs Covered: |
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| Eligibility: |
You must meet financial and insurance requirements. You can't be eligible for public or private reimbursement that covers this medication. |
| Applicant: |
Patient and Physician / Licensed Practitioner |
| Company Name: |
Janssen Pharmaceutica |
| Address: |
P.O. Box 220458 |
| City: |
Charlotte |
| State: |
NC |
| Zip Code: |
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| Telephone: |
8005235870 |
| Telephone: |
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| E-Mail: |
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| Web Site: |
http://www.janssen.com/
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| Service Hours: |
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| Couple Income Limit: |
99999 |
| Single Income Limit: |
99999 |
| Enrollment Fee: |
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| Note: |
Physician must certify medical need. Income and insurance (indicating no prescription coverage) documentation must accompany application. |
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