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PATIENT ENROLLMENT Prescription only valid if faxed FAX COMPLETED FORM TO: 18773298484 TOUCHPOINTS PHONE: 18008484876 PLEASE COMPLETE ALL FIELDS TO AVOID PROCESSING DELAYS TP ID# (TOUCHPOINTS USE.

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Medicare typically covers when administered in a hospital outpatient setting through Part B. If the patient has a managed Medicare/Medicare Advantage (Part C) plan, the plan usually covers as a medical benefit.

Co-pay Savings Program: Eligible commercially insured and cash-paying patients may save up to $500 per month on co-pays; for additional information contact the program at 800-848-4876.

About The lowest GoodRx price for the most common version of is around $1,377.07, 31% off the average retail price of $2,003.48.

Health plans typically cover as either a medical or pharmacy benefit. The Vivitrol2gether team can look into your patient's health plan coverage and communicate insurer requirements. How healthcare providers obtain usually depends on how it is covered by the patient's health plan.

No. There is currently no therapeutically equivalent version of available in the United States. Note: Fraudulent online pharmacies may attempt to sell an illegal generic version of . These medications may be counterfeit and potentially unsafe.

Health plans typically cover as either a medical or pharmacy benefit. The Vivitrol2gether team can look into your patient's health plan coverage and communicate insurer requirements. How healthcare providers obtain usually depends on how it is covered by the patient's health plan.

must be prepared and administered by a healthcare professional. The recommended dose of is 380 mg delivered intramuscularly every 4 weeks or once a month.

The lowest GoodRx price for the most common version of is around $22.23, 77% off the average retail price of $100.60.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232