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Coverage

Patient: John Doe

DIN	Drug name	Chemical name	Strength	Dosage	Quantity
02244016	REMICADE 100MG/VIAL INJ	INFLIXIMAB	100MG	INJ	4

Coverage amount (as of September 04, 2015 in Ontario)

Your plan covers

$0.00
You pay

$4,681.78

Prior authorization required

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Explanation of coverage for REMICADE 100MG/VIAL INJ

Plan design limits would result in no amount being payable

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To be eligible for reimbursement, the Massage Therapist must be registered and licensed to practice in the province in which treatment was provided. The Massage Therapist's professional designation and license number are required as part of the online claim submission. This information is usually provided on your receipt or is available from your Massage Therapist.

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