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Sunovion Support Prescription Assistance Program (Aptiom)
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PO Box 220285
Charlotte, NC 28222
Phone
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(877)850-0819
Fax:
877-850-0821
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Eligibility
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Patients must have no prescription coverage for the needed medication, be at or below 300% of the Federal Poverty Level, must reside in the US, Puerto Rico or USVI and must provide a diagnosis code. |
Who Can Apply
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Patients or healthcare providers can call to have an application mailed or it can be downloaded. |
Required
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Doctors must complete a section of the application and sign. Patients must also complete a section of the application, sign and attach proof of income. |
Supply
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30 day supply |
Ship To
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Pharmacy |
Note
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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. |
Aptiom tablet |
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