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Pfizer Bridge Program
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P.O. Box 220746
Charlotte, NC 28222
Phone
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800-645-1280
Fax:
800-479-2562
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Eligibility
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The patient must be uninsured or underinsured and meet income guidelines that are not disclosed. The medication must be used for a FDA-approved diagnosis.The patient must also be a US resident. |
Who Can Apply
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With the patient's permission, anyone concerned can call for an application. |
Required
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The doctor must complete and sign the Statement of Medical Necessity Form. The patient must complete and sign the application and the Patient Authorization Form. |
Supply
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Up to a 30-day supply |
Ship To
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Patient's home |
Note
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With the patient's permission, anyone concerned can call for an application. |
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Includes Support for This Drug NOTE: Linked drugs are available for Prescribers to Apply Online now. Click drug logo or drug name to start online application. |
Somavert injection |
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