Dificid copay card

Please attach front and back of patient's insurance card (medical and prescription). COPAY CARD ENROLLMENT. ❑ Please check if enrolling in copay card Copay ID:.

$0 copay for members age 12-. 59 years at risk for preeclampsia DIFICID SUS (fidaxomicin). 2. DIFICID TAB 200MG (fidaxomicin). 2.

Copay assistance cards, also called copay

A copay card, also known as a copay assistance card, is a coupon offered by the drug manufacturer. Glyxambi -

Copay Card, Patient. Assistance. Copay Card, Patient. Assistance. Copay Card Zortress (everolimus) Novartis. Copay Card. Patient Assistance. Patient

A copay card, also known as a copay assistance card, is a coupon offered by the drug manufacturer. Victoza -

Vyvanse copay card. There's a savings card (copay card) available from the manufacturer of Vyvanse. You may be eligible for this coupon with

2. HealthWell Foundation Copay Program for DIFICID. If you are having trouble paying for your DIFICID medication due to unaffordable copays or deductibles, the HealthWell Foundation Copay Program may be able to assist you. To qualify for assistance for DIFICID you will need to meet the following criteria:

Page 1. COPAY CARD ENROLLMENT. Please check if enrolling in copay card. Copay ID: PRESCRIPTION INFORMATION. Prescriber's Signature