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Web complete the otezla start form or the sp enrollment form. Send with copies of the medical and prescription benefit card to. 1 patient information (complete or include demographic sheet) Filling out the start form and. Web enrollment form for otezla® (apremilast) f2 street city state zip rrx v05 feb 2024 po box 19149, lenexa, s 66285 phone 1.

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Web Enrollment Form For Otezla® (Apremilast) F2 Street City State Zip Rrx V05 Feb 2024 Po Box 19149, Lenexa, S 66285 Phone 1.

Please complete this form if you’d like an sp to provide prior. Send with copies of the medical and prescription benefit card to. Web otezla® specialty pharmacy (sp) start form. 1 patient information (complete or include demographic sheet)

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