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Carnitor Drug Assistance Program
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Carnitor Drug Assistance Program
C/O NORD Danbury, CT 06813-1968
Phone
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855-653-3220
Fax:
203-349-3279
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Eligibility
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The patient must have no prescription coverage for the requested medication and meet income guidelines that are not disclosed. The patient must be diagnosed with Carnitene Definciency, be a US resident and have a prescription from a US doctor. |
Who Can Apply
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The doctor, patient, social worker or patient advocate must call for a prescreening. |
Required
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The doctor must fill out a section, sign the application and attach a prescription.The patient must fill out a section, sign the application and attach proof of income and any insurance information. |
Supply
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Up to a 90-day supply |
Ship To
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Patient's home |
Note
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Assistance may be give from 25-100% for up to 1 year. Negative decision may be appealed. |
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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. |
Carnitor (levocarnitine) |
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