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Web Find REMICADE 174 support for owner patients by Janssen CarePath infusion help the more See full Product amp Product Information including Boxed Warning Web STEP 1 Complete the information on the next page Sign the form STEP 2 Include a copy of the pharmacy receipt Valid receipt will include your name medication date and
Web if a pharmacy provides REMICADE 174 or Infliximab to my treatment provider and can accept REMICADE and Infliximab Mastercard the rebate for REMICADE 174 or Web account If you would like to receive a rebate check payable to you by mail you must complete a Rebate Request Form and provide proof of medication payment At your
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Web Find REMICADE 174 support for your patients through Janssen CarePath infusion support and view Seeing full Product amp Safety Information including Boxed Warnings Web Benefits Investigation Form Complete and fax this form to 866 489 5955 For assistance call 877 CarePath 877 227 3728 Monday Friday 8 00 am 8 00 pm ET UPDATE
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Web Medical Benefit Rebate Form Complete this side of the form only if you are submitting an Explanation of Benefits EOB for a rebate check to be sent directly to the patient
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