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Get Reimbursement Form

Ng Information. Completing the patient information form 1 Patient information It s essential that the patient s personal information is accurate. PATIENT INFORMATION FORM XIFAXAN 550 mg is indicated for reduction in risk of overt hepatic encephalopathy (HE) recurrence in patients 18 years of age. 2 Insurance coverage Phone: 1-866-XIFAXAN 1-866-943-2926 www.Xifaxan550helpline.com Please fax completed Form to: 800-387-5807 You can either fill out the insurance information OR check thi.

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