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  • Merck Access Program Enrollment Form Zinplava (bezlotoxumab). Patients And Prescribers Can Download

Get Merck Access Program Enrollment Form Zinplava (bezlotoxumab). Patients And Prescribers Can Download

The Merck Access Program ENROLLMENT FORM P: 8777094455 F: 8009771957 The Merck Access Program, PO Box 29067 Phoenix, AZ 85038 , TO GET STARTED, COMPLETE THE ENROLLMENT FORM AND FAX IT TO 8009771957.

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NDC 0006-3025-00 - Zinplavaâ„¢ (bezlotoxumab) Injection - 1,000 mg /40 mL - (25 mg/mL) For Intravenous Infusion Only - Requires dilution prior to administration.

Article Guidance Generic NameTrade NameHCPCS CodebelataceptNulojix®J0485bezlotoxumabZinplava™J0565eculizumabSoliris®J1300edaravoneRadicava™J130112 more rows

Merck Access Program for ZINPLAVAâ„¢ (bezlotoxumab) To receive benefits under the Co-pay Assistance Program, the patient must enroll in the Co-pay Assistance Program and be accepted as eligible. Patient may contact The Merck Access Program for current Program Product(s) subject to these Terms and Conditions.

The recommended dose of ZINPLAVA is a single dose of 10 mg/kg administered as an intravenous infusion over 60 minutes.

HCPCS Code for Injection, bezlotoxumab, 10 mg J0565.

Zinplava Generic Name & Formulations Bezlotoxumab 25mg/mL; soln for IV infusion after dilution; preservative-free.

The FDA approved ZINPLAVA based on evidence from two clinical trials of 1567 participants with CDI.

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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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