TREMFYA®

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Medication Guide

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XARELTO®

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Insurance Coverage

Prior Authorizations, Exceptions & Appeals

Medicare

Medicaid

Reimbursement

ICD-10 Codes

Coding & Billing

Affordability

Helping Patients Afford Ustekinumab

Treatment Support

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Benefits Investigation Support

Helping Patients Afford RYBREVANT®

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Initiate Patient on VELETRI®

Overview

Complete the Prescription Process

Insurance Verification

Specialty Pharmacies

Helping Patients Afford VELETRI®

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Helping Patients Afford DARZALEX®

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 Zytiga®

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Patient Information

ZYTIGA®

Trial Offer

TREMFYA withMe Trial Offer

TREMFYA® Medically Unlikely Edits (MUE) Appeal Process

TREMFYA withMe Access Program for UC/CD

TREMFYA withMe Delay and Denial Support for PsO/PsA

Helping Patients Afford TREMFYA®

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OPSUMIT®

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ERLEADA® (apalutamide)

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ERLEADA®

Helping Patients Afford INVOKAMET® XR

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Invega Sustenna

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INVEGA SUSTENNA®

<section className={isiClass}><div className="sticky-isi-content"><div className={`isi-back-btn ${showIsiBack}`}><rce-button className="btn bs-btn" onClick={isiMobBackHandler}>Back</rce-button></div><div className="isi-level-first"><div className="isi-heading-group d-flex flex-row text-white"><div className="left-side"><h4 className="panel-title d-lg-inline-block">Important Safety Information For</h4><div>{isiTabs}</div></div><div className="right-side"><ul className="isi-options d-flex flex-row"><li className={isiMinimizeClass} onClick={isiMinimize}><span className="text-default">Minimize</span><span className="text-short">Min</span><span className="minimize-icon"></span></li><li className={isiExpandClass} onClick={isiExpand}>Expand<span className="expand-icon"></span></li><li className={isiFullScreenClass} onClick={isiFullScreen}><span className="text-default">Full Screen</span><span className="text-short">Full</span><span className="fullscreen-icon"></span></li><li className={isiReturnClass} onClick={isiReturnWebsite}>Return to Website<span className="return-icon"></span></li></ul></div></div><div className="isi-heading-product d-flex flex-row text-white"><div className="left-side"><h4 className="panel-title d-lg-inline-block py-2">IMPORTANT SAFETY INFORMATION</h4></div><div className="right-side"><h4 className="panel-title d-lg-inline-block py-2">INDICATION</h4><ul className="isi-options d-inline-flex flex-row"><li className={isiMinimizeClass} onClick={isiMinimize}><span className="text-default">Minimize</span><span className="text-short">Min</span><span className="minimize-icon"></span></li><li className={isiExpandClass} onClick={isiExpand}>Expand<span className="expand-icon"></span></li><li className={`d-md-block ${isiFullScreenClass}`} onClick={isiFullScreen}><span className="text-default">Full Screen</span><span className="text-short">Full</span><span className="fullscreen-icon"></span></li><li className={isiReturnClass} onClick={isiReturnWebsite}><span className="text-default">Return to Website</span><span className="text-short">Return</span><span className="return-icon"></span></li></ul></div></div></div><div className="isi-level-second">{isiContent}</div></div></section>

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UPTRAVI®

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<div className="custom-foot xarelto-jcp-resources d-none"><p className="text-one"><strong>XARELTO® is licensed from Bayer HealthCare AG, 51368 Leverkusen, Germany.</strong></p><p className="text-second">© Johnson &amp; Johnson Health Care Systems Inc. 2024 <span className="ex-sp ps-2">12/24</span> <span className="ex-sp ps-2">cp-412172v3</span></p><div className="image-jnj"><div className="media media--type-image media--view-mode-media-library media--view-mode-default">                    <img src="/system/files/2024-12-27/04-33-26/JNJ_Logo_SingleLine_Red_RGB.svg" alt="Johnson &amp; Johnson Red Icon" className="img-fluid">        </div></div></div><footer className="text-white footer" id="global-footer"><div className="wrapper"><div className="region region-footer mx-0"><div className="block block-panels-mini clearfix px-0"><div className="row bs-row top-row region-row"><div className="col bs-col col-sm-12 region-col"><div className="footer-disclaimer"><div className="panel-content"><div className="field-type-text-with-summary"><div className="field-items"><div className="field-item even"><p className="general-only">Information about your patient’s insurance coverage, cost support options, and treatment support is given by service providers for <span className="text-nowrap">J&amp;J withMe</span>. The information you get does not require you or your patient to use any <span className="text-nowrap">J&amp;J</span> product. Because the information we give you comes from outside sources, <span className="text-nowrap">J&amp;J withMe</span> cannot promise the information will be complete.</p><p className="stelara-only">Information about your patient’s insurance coverage, cost support options, and treatment support is given by service providers for <span className="text-nowrap">STELARA withMe</span> cost support. The information you get does not require you or your patient to use any <span className="text-nowrap">J&amp;J</span> product. Because the information we give you comes from outside sources, <span className="text-nowrap">STELARA withMe</span> cannot promise the information will be complete.</p><p className="tremfya-only">Information about your patient’s insurance coverage, cost support options, and treatment support is given by service providers for <span className="text-nowrap">TREMFYA withMe</span>. The information you get does not require you or your patient to use any <span className="text-nowrap">J&amp;J</span> product. Because the information we give you comes from outside sources, <span className="text-nowrap">TREMFYA withMe</span> cannot promise the information will be complete.</p></div></div></div></div></div></div></div><div className="row bs-row main-row region-row"><div className="left-col col-12 bs-col col-sm-4 col-lg-4 px-0"><div className="footer-logo"><div className="pane-content"><div className="field-type-text-with-summary"><div className="field-item even"><div className="media media-element-container media-default"><div className="file file-image"><div className="content non-withme-footer-logo"><a href="https://www.jnjwithme.com/"><div className="media media--type-image media--view-mode-media-library media--view-mode-default">                    <img src="/system/files/2023-10-16/19-08-12/logo-footer-2.svg" alt="Home" loading="lazy" className="img-fluid">        </div></a></div><div className="content withme-footer-logo"><a href="https://www.jnjwithme.com/"><div className="media 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className="panel-pane pane-block"><div className="pane-content"><div className="node node-callout clearfix" id="node-1254"><div className="field field-name-body field-type-text-with-summary field-label-hidden"><div className="field-items"><div className="field-item even"><div className="last-updated-desktop"><p>Last updated on<br>May 5, 2025.</p><p className="stelara-only">Last updated on<br>February 28, 2025.</p><p className="tremfya-only">Last updated on<br>February 28, 2025.</p></div><div><div className="callout-block"><div className="node node-callout clearfix" id="node"></div></div></div></div></div></div></div></div></div></div><div className="main-col region-col col-sm-4 col-12 col-lg-6"><div className="panel-pane pane-block footer-copyright"><div className="pane-content"><div className="node node-callout clearfix" id="node-1259"><div className="field field-name-body field-type-text-with-summary field-label-hidden"><div className="field-items"><div className="field-item even"><div className="bs-grid container-fluid copyright-wrapper"><div className="row row-1 row-first mx-0"><div className="col col-first col-last col-md-12 px-0"><div className="content">{commonFooterContent}</div></div></div><div className="row row-2 row-last row-footnote mx-0"><div className="col col-first col-md-6 px-0"><div className="content"><p>Last updated on<br>May 5, 2025.</p><p className="stelara-only">Last updated on<br>February 28, 2025.</p><p className="tremfya-only">Last updated on<br>February 28, 2025.</p></div></div><div className="col col-last col-md-6 px-0"><div className="content"><p></p><div className="link-mobile"><div className="node node-callout clearfix" id="node-453"><div className="field field-name-body field-type-text-with-summary field-label-hidden"><div className="field-items"><div className="field-item even"><p><a href="/hcp/contact-us">Contact 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INVOKAMET® XR

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Helping Patients Afford ERLEADA®

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Helping Patients Afford TECVAYLI®

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Formulary Coverage

Helping Patients Afford INVOKANA®

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Helping Patients Afford YONDELIS®

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TALVEY® (talquetamab-tgvs)

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TALVEY®

Delay and Denial Support

Helping Patients Afford SIMPONI®

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IMAAVY withMe Access Program

Helping Patients Afford IMAAVY™

Help Your Patients Start and Stay on IMAAVY™

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Ustekinumab

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Initiate Patient on TRACLEER®

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opsynvi

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OPSYNVI®

RYBREVANT® (amivantamab-vmjw)

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RYBREVANT®

INVEGA TRINZA®

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<div className="product-section"><div className="product-white-area product-welcome-banner"><section className="product-welcome"><h1 className="product-header">Medicaid</h1><nav aria-label="breadcrumb"><ol className="breadcrumb"><li className="breadcrumb-item"><a href="/">Janssen CarePath</a></li><li className="breadcrumb-item" aria-current="page"><a href="/hcp/xarelto">XARELTO<sup>®</sup></a></li><li className="breadcrumb-item" aria-current="page"><a href="/hcp/xarelto/insurance-coverage/medicaid">Insurance Coverage</a></li></ol></nav></section></div><section className="mt-5 mb-5 inner-links product-page-right"><div className="row medicaid-right-thm-row"><div className="col col-first col-12 col-lg-8 left-area"><div className="row product-template-innerlinks"><div className="container col-first col-md-12 px-0"><div className="subsection-wrapper"><p>Medicaid provides free or low-cost health coverage to Americans with limited income and resources. Low-income adults, children, pregnant women, elderly adults, and people with disabilities may be eligible. Medicaid is run by each state. The program is funded jointly by the states and the federal government. Coverage for XARELTO® may depend on the indication, along with other factors. Since information varies by state, we recommend contacting the state directly or reviewing its website.</p><p>Visit your state’s Medicaid page for more coverage information. You can use the menu below to find contact details for your state.</p><div>{findContactDetails}</div><div data-entity-type="node" data-entity-uuid="95a96a53-430d-41a9-8cdf-3de68abed49d" data-embed-button="node" data-entity-embed-display="view_mode:node.block_content" data-langcode="en" data-entity-embed-display-settings="[]" className="embedded-entity">            <div className="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><rec-searchable-dropdown options={stateOptions} label="label" id="value" placeholder="Type or select your state"></rec-searchable-dropdown><div className="stateoptionhiden"><div className="medicaid-list-group"><ul ref={stateListRef}><li data-value="AL" contact-page="https://medicaid.alabama.gov/content/10.0_Contact/10.1_Medicaid_Contacts.aspx" visit-page="https://medicaid.alabama.gov/" contact-number="334-242-5000">Alabama</li><li data-value="AK" contact-page="https://www.medicaidalaska.com/portals/wps/portal/ContactUS" visit-page="https://dhss.alaska.gov/pages/default.aspx" contact-number="800-770-5650">Alaska</li><li data-value="AZ" contact-page="https://azahcccs.gov/shared/AHCCCScontacts.html" visit-page="https://azahcccs.gov" contact-number>Arizona</li><li data-value="AR" contact-page="https://humanservices.arkansas.gov/divisions-shared-services/medical-services/contact-dms-2" visit-page="https://humanservices.arkansas.gov/divisions-shared-services/medical-services/helpful-information-for-providers/manuals/pharmacy-prov" contact-number="501-682-8292">Arkansas</li><li data-value="CA" contact-page="https://www.dhcs.ca.gov/Pages/dhcs_contact.aspx" visit-page="https://mcweb.apps.prd.cammis.medi-cal.ca.gov" contact-number>California</li><li data-value="CO" contact-page="https://hcpf.colorado.gov/contact-hcpf" visit-page="https://hcpf.colorado.gov" contact-number>Colorado</li><li data-value="CT" contact-page="https://portal.ct.gov/HUSKY/How-to-Contact-Us" visit-page="https://www.ctdssmap.com/CTPortal/Home" contact-number="877-CT-HUSKY (877-284-8759)" husky-telephone="1-877-284-8759">Connecticut</li><li data-value="DE" contact-page="https://www.dhss.delaware.gov/dhss/dmma/contact.html" visit-page="https://medicaid.dhss.delaware.gov" contact-number>Delaware</li><li data-value="DC" contact-page="https://dc.gov/agency/department-human-services" visit-page="https://dhcf.dc.gov" contact-number="202-671-4200">District of Columbia</li><li data-value="FL" contact-page="https://ahca.myflorida.com/contact-ahca" visit-page="https://ahca.myflorida.com" contact-number="888-419-3456">Florida</li><li data-value="GA" contact-page="https://dch.georgia.gov/about-us/contact-us" visit-page="https://dch.georgia.gov" contact-number="404-656-4507">Georgia</li><li data-value="HI" contact-page="https://medquest.hawaii.gov/en/contact-us.html" visit-page="https://medquest.hawaii.gov/en.html" contact-number>Hawaii</li><li data-value="ID" contact-page="https://healthandwelfare.idaho.gov/contact-us" visit-page="https://healthandwelfare.idaho.gov" contact-number>Idaho</li><li data-value="IL" contact-page="https://hfs.illinois.gov/about/phonedirectory.html" visit-page="https://hfs.illinois.gov" contact-number>Illinois</li><li data-value="IN" contact-page="https://www.in.gov/fssa/contact-us" visit-page="https://www.in.gov/medicaid" contact-number>Indiana</li><li data-value="IA" contact-page="https://hhs.iowa.gov/contact-hhs" visit-page="https://hhs.iowa.gov" contact-number="800-972-2017">Iowa</li><li data-value="KS" contact-page="https://www.dcf.ks.gov/DCFContacts/Pages/default.aspx" visit-page="https://www.kdhe.ks.gov" contact-number>Kansas</li><li data-value="KY" contact-page="https://www.chfs.ky.gov/Pages/contact.aspx" visit-page="https://www.chfs.ky.gov/agencies/dms/Pages/default.aspx" contact-number="800-372-2973">Kentucky</li><li data-value="LA" contact-page="https://www.myplan.healthy.la.gov/en/contact-us" visit-page="https://www.lamedicaid.com/provweb1/default.htm" contact-number="855-229-6848">Louisiana</li><li data-value="ME" contact-page="https://www.maine.gov/dhhs/about/contact" visit-page="https://www.maine.gov/dhhs" contact-number>Maine</li><li data-value="MD" contact-page="https://health.maryland.gov/Pages/contactus.aspx" visit-page="https://health.maryland.gov/Pages/Home.aspx" contact-number="877-463-3464">Maryland</li><li data-value="MA" contact-page="https://www.mass.gov/info-details/contact-masshealth-information-for-members#masshealth-member-customer-service-center-" visit-page="https://www.mass.gov/orgs/executive-office-of-health-and-human-services" contact-number="800-841-2900">Massachusetts</li><li data-value="MI" contact-page="https://www.michigan.gov/mdhhs/assistance-programs/medicaid/portalhome/medicaid-providers/champs-a/champs/accordion/resources/contact-provider-support" visit-page="https://www.michigan.gov/mdhhs/assistance-programs/medicaid/portalhome/medicaid-providers" contact-number="800-292-2550">Michigan</li><li data-value="MN" contact-page="https://mn.gov/dhs/general-public/about-dhs/contact-us" visit-page="https://www.health.state.mn.us" contact-number="651-431-2000">Minnesota</li><li data-value="MS" contact-page="https://medicaid.ms.gov/contact" visit-page="https://medicaid.ms.gov" contact-number="800-421-2408">Mississippi</li><li data-value="MO" contact-page="https://dss.mo.gov/contactdss.htm" visit-page="https://dss.mo.gov" contact-number>Missouri</li><li data-value="MT" contact-page="https://dphhs.mt.gov/contact" visit-page="https://dphhs.mt.gov" contact-number>Montana</li><li data-value="NE" contact-page="https://dhhs.ne.gov/Pages/Contact-DHHS.aspx" visit-page="https://dhhs.ne.gov/Pages/default.aspx" contact-number="402-471-3121">Nebraska</li><li data-value="NV" contact-page="https://dhhs.nv.gov/Customer_Service/Customer_Service" visit-page="https://dhhs.nv.gov" contact-number="775-684-4000">Nevada</li><li data-value="NH" contact-page="https://www.dhhs.nh.gov/medicaid-contact-directory" visit-page="https://www.dhhs.nh.gov" contact-number="866-291-1674">New Hampshire</li><li data-value="NJ" contact-page="https://www.state.nj.us/humanservices/dmahs/staff/info" visit-page="https://www.state.nj.us/humanservices/dmahs/home/index.html" contact-number>New Jersey</li><li data-value="NM" contact-page="https://www.hsd.state.nm.us/lookingforassistance/contact-us" visit-page="https://www.hsd.state.nm.us" contact-number="800-283-4465">New Mexico</li><li data-value="NY" contact-page="https://www.health.ny.gov/health_care/medicaid/program/contact.htm" visit-page="https://www.health.ny.gov" contact-number>New York</li><li data-value="NC" contact-page="https://medicaid.ncdhhs.gov/contacts" visit-page="https://medicaid.ncdhhs.gov" contact-number="888-245-0179">North Carolina</li><li data-value="ND" contact-page="https://www.hhs.nd.gov/contact" visit-page="https://www.hhs.nd.gov" contact-number="701-328-2310">North Dakota</li><li data-value="OH" contact-page="https://medicaid.ohio.gov/home/contact-us/contact-us" visit-page="https://medicaid.ohio.gov" contact-number>Ohio</li><li data-value="OK" contact-page="https://oklahoma.gov/ohca/contact-us.html" visit-page="https://oklahoma.gov/ohca.html" contact-number>Oklahoma</li><li data-value="OR" contact-page="https://healthcare.oregon.gov/marketplace/Pages/contact.aspx" visit-page="https://www.oregon.gov/oha/Pages/index.aspx" contact-number>Oregon</li><li data-value="PA" contact-page="https://www.dhs.pa.gov/contact/Pages/Helpful%20Phone%20Numbers.aspx" visit-page="https://www.dhs.pa.gov/Pages/default.aspx" contact-number="800-692-7462">Pennsylvania</li><li data-value="RI" contact-page="https://eohhs.ri.gov/about-eohhs/contact" visit-page="https://eohhs.ri.gov" contact-number="401-462-5274">Rhode Island</li><li data-value="SC" contact-page="https://www.scdhhs.gov/contact" visit-page="https://www.scdhhs.gov" contact-number>South Carolina</li><li data-value="SD" contact-page="https://doh.sd.gov/contact" visit-page="https://doh.sd.gov" contact-number="605-773-3361">South Dakota</li><li data-value="TN" contact-page="https://www.tn.gov/tenncare/contact-us.html" visit-page="https://www.tn.gov/tenncare.html" contact-number="800-342-3145">Tennessee</li><li data-value="TX" contact-page="https://www.hhs.texas.gov/about/contact-us" visit-page="https://www.hhs.texas.gov" contact-number="512-424-6500">Texas</li><li data-value="UT" contact-page="https://medicaid.utah.gov/contact" visit-page="https://medicaid.utah.gov" contact-number>Utah</li><li data-value="VT" contact-page="http://dvha.vermont.gov/contact" visit-page="https://dvha.vermont.gov" contact-number="802-879-5900">Vermont</li><li data-value="VA" contact-page="https://www.dmas.virginia.gov/about-us/contact" visit-page="https://www.dmas.virginia.gov" contact-number>Virginia</li><li data-value="WA" contact-page="https://www.hca.wa.gov/about-hca/contact-hca" visit-page="https://www.hca.wa.gov" contact-number>Washington</li><li data-value="WV" contact-page="https://dhhr.wv.gov/contacts/HN/Pages/default.aspx" visit-page="https://dhhr.wv.gov/Pages/default.aspx" contact-number="304-558-1700">West Virginia</li><li data-value="WI" contact-page="https://www.dhs.wisconsin.gov/contacts.htm" visit-page="https://www.dhs.wisconsin.gov" contact-number="608-266-1865">Wisconsin</li><li data-value="WY" contact-page="https://health.wyo.gov/contact" visit-page="https://health.wyo.gov" contact-number="866-571-0944">Wyoming</li></ul></div></div></div>      </div></div></div></div></div><div className="col col-last col-12 col-lg-4 right-area"><div data-entity-type="node" data-entity-uuid="a0ec8845-0865-4b5d-8b32-80b8c617f070" data-embed-button="node" data-entity-embed-display="view_mode:node.block_content" data-langcode="en" data-entity-embed-display-settings="[]" className="embedded-entity">            <div className="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><div className="product-template-innerlinks"><div className="pdf-image"><a href="/system/files/2024-07-08/15-55-28/know-your-state.pdf" target="_blank" title="Know Your State Interactive Tool" data-entity-type="media" data-entity-uuid="9144bb9a-cd5c-4b65-84c9-c020e4520f6a" data-entity-substitution="media"><div className="media media--type-image media--view-mode-media-library media--view-mode-default">                    <img src="/system/files/styles/large/private/2024-07-08/11-13-36/know-your-state.png?itok=ArbUTrCJ" width="362" height="271" alt="Know Your State Interactive Tool" title="Know Your State Interactive Tool" loading="lazy" className="img-fluid image-style-large">        </div></a></div><div className="pdf-link"><a href="/system/files/2024-07-08/15-55-28/know-your-state.pdf" data-entity-type="media" data-entity-uuid="9144bb9a-cd5c-4b65-84c9-c020e4520f6a" data-entity-substitution="media" target="_blank" title="Know Your State Interactive Tool">Know Your State Interactive Tool</a></div><div className="pdf-description">Learn about access and affordability options for patients in your state.</div></div></div>      </div></div></div></section></div>

Xarelto - Insurance Coverage - Medicaid

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<div className="banner-notice"><rce-container className="container bs-container"><rce-row className="row bs-row"><rce-col className="col bs-col"><div className="withme-banner" id="withmeBanner"><p><span className="no-break"><strong>Janssen CarePath</strong></span><strong> is becoming J&amp;J withMe. </strong>Our name may be changing, but our commitment to patients stays the same. <button className="learnmore" type="button" data-bs-toggle="modal" data-bs-target="#withmemodal">                                                                                  Learn More                                                                                </button> <button className="close-banner">X</button></p></div></rce-col></rce-row></rce-container></div><div className="modal fade" id="withmemodal" tabindex="-1" aria-labelledby="withmeModalLabel" aria-hidden="true"><div className="modal-dialog"><div className="modal-content"><p><button className="btn-close" type="button" data-bs-dismiss="modal" aria-label="Close">X</button></p><div className="modal-body"><div className="popup-logo"><div className="media media--type-image media--view-mode-media-library media--view-mode-default">                    <img src="/system/files/styles/large/private/2024-07-11/16-54-37/jnj-withme-logo.png?itok=IMrN78Gl" width="480" height="214" alt="J&amp;J withMe Logo" title="J&amp;J withMe Logo" loading="lazy" className="img-fluid image-style-large">        </div></div><p className="withme-popup-h">Janssen CarePath is becoming J&amp;J withMe. During this transition, you may see both program names in use.</p><p><strong>At Johnson &amp; Johnson, we are committed to helping people live fuller lives.</strong> Our J&amp;J withMe program is here at every step to provide personalized support to help patients start and stay on their J&amp;J medicines.</p></div></div></div></div><div className="modal fade" id="withmemodalonco" tabindex="-1" aria-labelledby="withmeModalLabelonco" aria-hidden="true"><div className="modal-dialog"><div className="modal-content"><p><button className="btn-close" type="button" data-bs-dismiss="modal" aria-label="Close">X</button></p><div className="modal-body"><div className="popup-logo"><div className="media media--type-image media--view-mode-media-library media--view-mode-default">                    <img src="/system/files/styles/large/private/2024-07-11/16-54-37/jnj-withme-logo.png?itok=IMrN78Gl" width="480" height="214" alt="J&amp;J withMe Logo" title="J&amp;J withMe Logo" loading="lazy" className="img-fluid image-style-large">        </div></div><p className="withme-popup-h">Janssen CarePath is becoming J&amp;J withMe. During this transition, you may see both program names in use.</p><p><strong>At Johnson &amp; Johnson, we are committed to helping people live fuller lives.</strong> Our J&amp;J withMe program is here at every step to provide personalized support to help patients start and stay on their J&amp;J medicines.</p></div></div></div></div>

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<div className="container bs-gray-400" ref={guidePopupContainerRef}><div className="row"><div className="col-12 col-lg-5 pdflist-view"><div className="overflow-auto pdf-lists"><ul><li className="li-file docx"><a href="/system/files/2024-02-27/14-34-43/xarelto-sample-exception-letter.docx" data-entity-type="media" data-entity-uuid="25b7e7e2-b860-4062-83b5-a4e1bfa87851" data-entity-substitution="media" onMouseOver={showPdfHandler} data-pdf-id="1" target="_blank" title="Letter of Exception">Letter of Exception</a></li><li className="li-file docx"><a href="/system/files/2024-02-27/14-37-11/xarelto-sample-letter-of-medical-necessity.docx" data-entity-type="media" data-entity-uuid="2f7c7c93-395f-45a2-9721-72d1e70b6531" data-entity-substitution="media" onMouseOver={showPdfHandler} data-pdf-id="2" target="_blank" title="Letter of Medical Necessity">Letter of Medical Necessity</a></li><li className="li-file pdf"><a href="/system/files/2024-12-12/02-18-16/xarelto-patient-affordability-chart.pdf" data-entity-type="media" data-entity-uuid="8f02e05f-057a-49e0-b186-64853d50bb07" data-entity-substitution="media" onMouseOver={showPdfHandler} data-pdf-id="3" target="_blank" title="Patient Affordability Options">Patient Affordability Options</a></li><li className="li-file pdf"><a href="/system/files/2024-12-12/02-10-22/xarelto-savings-program-overview.pdf" data-entity-type="media" data-entity-uuid="9494b356-e034-4b35-ad37-6ff187d97e4b" data-entity-substitution="media" onMouseOver={showPdfHandler} data-pdf-id="4" target="_blank" title="Savings Program Overview">Savings Program Overview</a></li><li className="li-file pdf"><a href="/system/files/2025-01-06/12-59-12/xarelto-rebate-form.pdf" data-entity-type="media" data-entity-uuid="7bcf8ffe-1564-4fc4-8226-0a0fc8e85760" data-entity-substitution="media" onMouseOver={showPdfHandler} data-pdf-id="5" target="_blank" title="Savings Program Rebate Form">Savings Program Rebate Form</a></li></ul></div></div><div className="col col-lg-7 d-sm-none d-lg-block right-section invokametxr-right-section"><div className="container"><div className="close-preview d-none d-lg-block" onClick={hideFormsModal}></div><div className="row pdf-preview default-preview"><div className="logo-preview"><div className="media media--type-image media--view-mode-media-library media--view-mode-default">                    <img src="/system/files/styles/large/private/2024-04-29/13-41-25/logo.png?itok=tKOq0dN8" width="200" height="78" alt="Home" title="Home" loading="lazy" className="img-fluid image-style-large">        </div></div><div className="hov-inst hov-inst-less">Hover on a document on the left for a quick document preview</div></div><div className="row d-none pdf-preview pdf-1"><div className="col col-lg-5 col-xl-6 d-md-none d-lg-block pdf-image"><a href="/system/files/2024-02-27/14-34-43/xarelto-sample-exception-letter.docx" target="_blank" data-entity-type="media" data-entity-uuid="25b7e7e2-b860-4062-83b5-a4e1bfa87851" data-entity-substitution="media" title="Letter of Exception"><div className="pdf-preview-canvas media media--type-image media--view-mode-media-library media--view-mode-default">                    <img src="/system/files/styles/large/private/2024-02-27/14-49-56/xarelto-sample-exception-letter.png?itok=PriaMxUm" width="386" height="480" alt="Letter of Exception" title="Letter of Exception" loading="lazy" className="img-fluid image-style-large">        </div></a></div><div className="col col-lg-5 col-xl-6 d-md-none d-lg-block pdf-description"><div className="row title"><div className="col"><h3 className="pdf-header"><a href="/system/files/2024-02-27/14-34-43/xarelto-sample-exception-letter.docx" data-entity-type="media" data-entity-uuid="25b7e7e2-b860-4062-83b5-a4e1bfa87851" data-entity-substitution="media" target="_blank" title="Letter of Exception">Letter of Exception</a></h3></div></div><div className="row desc"><div className="col"><p className="pdf-text">A template that you can fill out and submit to a patient’s health insurance provider asking them to cover a medication that is not on formulary.</p></div></div></div></div><div className="row d-none pdf-preview pdf-2"><div className="col col-lg-5 col-xl-6 d-md-none d-lg-block pdf-image"><a href="/system/files/2024-02-27/14-37-11/xarelto-sample-letter-of-medical-necessity.docx" target="_blank" data-entity-type="media" data-entity-uuid="2f7c7c93-395f-45a2-9721-72d1e70b6531" data-entity-substitution="media" title="Letter of Medical Necessity"><div className="pdf-preview-canvas media media--type-image media--view-mode-media-library media--view-mode-default">                    <img src="/system/files/styles/large/private/2024-02-27/14-52-33/xarelto-sample-letter-of-medical-necessity.png?itok=2B5PnZZQ" width="388" height="480" alt="Letter of Medical Necessity" title="Letter of Medical Necessity" loading="lazy" className="img-fluid image-style-large">        </div></a></div><div className="col col-lg-5 col-xl-6 d-md-none d-lg-block pdf-description"><div className="row title"><div className="col"><h3 className="pdf-header"><a href="/system/files/2024-02-27/14-37-11/xarelto-sample-letter-of-medical-necessity.docx" data-entity-type="media" data-entity-uuid="2f7c7c93-395f-45a2-9721-72d1e70b6531" data-entity-substitution="media" target="_blank" title="Letter of Medical Necessity">Letter of Medical Necessity</a></h3></div></div><div className="row desc"><div className="col"><p className="pdf-text">A template that you can fill out and submit to a patient’s health insurance provider. You may use it to explain why <span className="text-nowrap">XARELTO®</span> is medically necessary for your patient.</p></div></div></div></div><div className="row d-none pdf-preview pdf-3"><div className="col col-lg-5 col-xl-6 d-md-none d-lg-block pdf-image"></div><div className="col col-lg-5 col-xl-6 d-md-none d-lg-block pdf-description"><div className="row title"><div className="col"><h3 className="pdf-header"><a href="/system/files/2024-12-12/02-18-16/xarelto-patient-affordability-chart.pdf" data-entity-type="media" data-entity-uuid="8f02e05f-057a-49e0-b186-64853d50bb07" data-entity-substitution="media" target="_blank" title="Patient Affordability Options">Patient Affordability Options</a></h3></div></div><div className="row desc"><div className="col"><p className="pdf-text">Discover options that can make <span className="text-nowrap">XARELTO®</span> more affordable for your patients.</p></div></div></div></div><div className="row d-none pdf-preview pdf-4"><div className="col col-lg-5 col-xl-6 d-md-none d-lg-block pdf-image"></div><div className="col col-lg-5 col-xl-6 d-md-none d-lg-block pdf-description"><div className="row title"><div className="col"><h3 className="pdf-header"><a href="/system/files/2024-12-12/02-10-22/xarelto-savings-program-overview.pdf" data-entity-type="media" data-entity-uuid="9494b356-e034-4b35-ad37-6ff187d97e4b" data-entity-substitution="media" target="_blank" title="Savings Program Overview">Savings Program Overview</a></h3></div></div><div className="row desc"><div className="col"><p className="pdf-text">Eligible patients using commercial or private insurance can save on out-of-pocket costs for <span className="text-nowrap">XARELTO®</span>.</p></div></div></div></div><div className="row d-none pdf-preview pdf-5"><div className="col col-lg-5 col-xl-6 d-md-none d-lg-block pdf-image"><a href="/system/files/2025-01-06/12-59-12/xarelto-rebate-form.pdf" target="_blank" data-entity-type="media" data-entity-uuid="7bcf8ffe-1564-4fc4-8226-0a0fc8e85760" data-entity-substitution="media" title="Savings Program Rebate Form"><div className="pdf-preview-canvas media media--type-image media--view-mode-media-library media--view-mode-default">                    <img src="/system/files/styles/large/private/2025-01-04/03-21-34/xarelto-rebate-form-preview.png?itok=jXYAB0AP" width="375" height="480" alt="Savings Program Rebate Form" title="Savings Program Rebate Form" loading="lazy" className="img-fluid image-style-large">        </div></a></div><div className="col col-lg-5 col-xl-6 d-md-none d-lg-block pdf-description"><div className="row title"><div className="col"><h3 className="pdf-header"><a href="/system/files/2025-01-06/12-59-12/xarelto-rebate-form.pdf" data-entity-type="media" data-entity-uuid="7bcf8ffe-1564-4fc4-8226-0a0fc8e85760" data-entity-substitution="media" target="_blank" title="Savings Program Rebate Form">Savings Program Rebate Form</a></h3></div></div><div className="row desc"><div className="col"><p className="pdf-text">A form the patient can submit if the pharmacy isn’t able to process the <span className="text-nowrap">Janssen CarePath</span> Savings Program card.</p></div></div></div></div></div></div></div></div>

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<rce-modal className="modal bs-modal jcp-common-video-popup" id="my-experience-brightcove" show={showBCPopup} onHide={onBCPopupHidden}><rce-modal-header className="modal-header bs-modal-header" closeButton={true}></rce-modal-header><rce-modal-body className="modal-body bs-modal-body"><rce-brightcove-video className="brightcove-player react-brightcove-player" accountId="4317630935001" videoId="6314734494112"></rce-brightcove-video><div className="portal-links d-flex py-3"><a className="portal-signup text-center" href="https://www.janssencarepathportal.com/s/login/SelfRegister" target="_blank">Sign up for Provider Portal</a><a className="portal-login text-center" href="https://www.janssencarepathportal.com/s/login/" target="_blank">Log In</a></div></rce-modal-body></rce-modal>

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LAZCLUZE™

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<p className="blue-text">Treatment and Cost Support Are Now Provided by <em>SPRAVATO withMe</em></p><div className="media-embed spravatowithmelogo-wrapper"><div className="media media-element-container media-default img-spravato-withme"><div className="file file-image file-image-svgxml" id="file-374"><div className="content"><div className="media media--type-image media--view-mode-media-library media--view-mode-default">                    <img src="/system/files/2024-03-29/12-29-15/spr_wme_rgb_fc_pos.svg" alt loading="lazy" className="img-fluid">        </div></div></div></div><div className="media media-element-container media-default img-spravato"><div className="file file-image file-image-svgxml" id="file-375"><div className="content"><div className="media media--type-image media--view-mode-media-library media--view-mode-default">                    <img src="/system/files/2024-03-29/12-31-07/spravato_logo_28mg.svg" alt="SPRAVATO®" title="SPRAVATO®" loading="lazy" className="img-fluid">        </div></div></div></div></div><p className="sparvato-anchor"><a href="https://www.spravatohcp.com/spravato-with-me" id="redirect-spravato" target="_BLANK"><strong>Click here</strong></a> to learn more about <em>SPRAVATO withMe</em>.</p>

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IMAAVY™ (nipocalimab-aahu)

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