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