Xeomin – Merz

Maximum reimbursement of $5,000 per 12-month rolling period

o    No cap per injection

No provider signature needed

Patient enrolls, pays co-pay at TOS, submits EOB, gets reimbursement check in mail OR assign benefits to Dent

 Backdates up to 120 days

Click here to apply or call 1-888-4-XEOMIN