{"id":24302,"date":"2023-12-22T18:09:04","date_gmt":"2023-12-22T18:09:04","guid":{"rendered":"https:\/\/ameripharmaspecialty.com\/?page_id=24302"},"modified":"2024-09-12T15:25:55","modified_gmt":"2024-09-12T22:25:55","slug":"fulphila-copay-assistance","status":"publish","type":"page","link":"https:\/\/ameripharmaspecialty.com\/zh\/fulphila-copay-assistance\/","title":{"rendered":"Fulphila \u5171\u4ed8\u989d\u63f4\u52a9"},"content":{"rendered":"<style>\n\t@media screen and (min-width: 1023px) {\n\t\t.copayHeroBanner-image {\n\t\t\tposition: absolute;\n\t\t\ttop: 0;\n\t\t\tleft: 0;\n\t\t\twidth: 100%;\n\t\t\theight: 100%;\n\t\t\tz-index: -1;\n\t\t}\n\n\t\t.copayHeroBanner-image img {\n\t\t\tobject-fit: cover;\n\t\t\theight: 100%;\n\t\t\twidth: 100%;\n\t\t}\n\t}\n<\/style>\n\n<div  id=\"copay-hero-banner-0a20c83728e7c740f9ebe0fa3af74916\" style=\"\" class=\"copayHeroBanner\">\n\t<div class=\"container\">\n\t\t<div class=\"banner-wrap \">\n\t\t\t<div class=\"content\">\n\t\t\t\t<p id=\"breadcrumbs\"><span><span><a href=\"https:\/\/ameripharmaspecialty.com\/zh\/\">Home<\/a><\/span><\/span><\/p>\t\t\t\t<h2 class=\"title\">Get Financial Relief Now<\/h2>\n\t\t\t\t<p class=\"text\">Apply for Fulphila Copay Assistance<\/p>\n\n\t\t\t\t<div class=\"list\">\n\t\t\t\t\t<ul>\n<li>Free service matches you with top copay assistance programs<\/li>\n<li>Specialists assist you throughout the application process<\/li>\n<li>Get automated updates on your funding status<\/li>\n<li>Over $55 million secured for our patients to date<\/li>\n<\/ul>\n\t\t\t\t<\/div>\n\n\t\t\t\t\n\t\t\t\t\t<div class=\"button-wrap\">\n\t\t\t\t\t\t<a class=\"button\" href=\"#form\" target=\"_self\">Talk To A Specialist<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\t<picture class=\"copayHeroBanner-image\">\n\t\t\t\t<source media=\"(min-width:1023px)\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/copay-banner-desktop-scaled.jpeg\">\n\t\t<img decoding=\"async\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/copay-banner-mbile-no-gradient.jpeg\" alt=\"\">\n\t<\/picture>\n<\/div>\n\n\n<div  id=\"copay-how-it-works-dcbe2585156c490683cdaf67e612fd1c\" style=\"\" class=\"copayAssistanceWork\">\n\t<div class=\"container\">\n\t\t<div class=\"copayAssistanceWork-wrapper\">\n\t\t\t<div class=\"top-section\">\n\t\t\t\t<h2 class=\"title\">How Assistance Works<\/h2>\n\t\t\t\t<p class=\"subtext\">Streamlining our patient\u2019s specialty pharmacy experience with unmatched full-service convenience<\/p>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<ul class=\"bottom-section\">\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step1.png\" class=\"attachment-full size-full\" alt=\"Coverage Verification Code\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">1. Check Your Coverage\/Benefits Verification<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">Our team of expert billers finds the best avenues of coverage that minimize out-of-pocket costs.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step2.png\" class=\"attachment-full size-full\" alt=\"Transfer Prescription to AmeriPharma - Image\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">2. Transfer Prescription to AmeriPharma\u00ae<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">We process your prescription by working with your previous pharmacy or prescriber, making the transition quick and easy.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step3.png\" class=\"attachment-full size-full\" alt=\"Icon - Eligard copay assistance process\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">3. Prior Authorization<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">Our team of specialists obtains approval from your insurance companies within 24 to 72 hours.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step4.png\" class=\"attachment-full size-full\" alt=\"Eligard Copay Financial Assistance Icon\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">4. Copay Assistance &#038; Financial Aid<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">We secure financial aid and decrease copays, out-of-pocket expenses, and high deductibles. To date, AmeriPharma\u00ae Specialty Care has secured $55 million in financial assistance for our patients.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step5.png\" class=\"attachment-full size-full\" alt=\"Nursing Care Logo\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">5. Nursing Care Coordination If Needed<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">AmeriPharma\u00ae puts your schedule and home environment first when scheduling and coordinating one of our specialized nurses for your in-home infusions.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step6.png\" class=\"attachment-full size-full\" alt=\"Delivery Coordination - Image\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">6. Delivery Coordination<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">Medications are always delivered in strict compliance with the specific requirements for shipping. Next-day and overnight cold-chain deliveries are coordinated around your schedule.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"image-30-text-70-896aa67f1798e395df73e80bcd3ecf5a\" style=\"\" class=\"img30text70 white\">\n\t<div class=\"container\">\n\t\t<div class=\"block-wrap right\">\n\t\t\t<div class=\"block-column image\">\n\t\t\t\t<picture class=\"image-30\">\n\t\t\t\t\t\t\t\t\t\t<source loading=\"lazy\" media=\"(min-width:768px)\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/pharmacist.jpg\">\n\t\t\t\t\t<img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/block_image_mobile.jpg\" alt=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/pharmacist.jpg\" style=\"width:auto;\">\n\t\t\t\t<\/picture>\n\t\t\t<\/div>\n\t\t\t<div class=\"block-column\">\n\t\t\t\t<div class=\"text\">\n\t\t\t\t\t<h2>What Is Fulphila?<\/h2>\n<p>Pegfilgrastim, which is also known by the brand name,\u00a0Neulasta, is a\u00a0hematopoietic agent\u00a0that is used to treat neutropenia. Neulasta was the first medication produced based on the active element pegfilgrastim. Pegfilgrastim is not a hazardous drug, nor is it a form of chemotherapy.<\/p>\n<p>Based on Neulasta, several different biosimilars have been produced, one of which is called Fulphila. Fulphila is similar to Neulasta in its mechanism of action, administration route, strength, and dosage.<\/p>\n<hr \/>\n<h4>Mechanism of Action<\/h4>\n<p>Pegfilgrastim is a blood cell colony-stimulating agent (CSA) and has been used successfully by cancer patients to stimulate the growth of white blood cells, more specifically neutrophils. It does this by stimulating the production of neutrophils directly from the bone marrow.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"image-30-text-70-9f690421abcfb09f46c86187807c60f4\" style=\"\" class=\"img30text70 light_gray\">\n\t<div class=\"container\">\n\t\t<div class=\"block-wrap left\">\n\t\t\t<div class=\"block-column image\">\n\t\t\t\t<picture class=\"image-30\">\n\t\t\t\t\t\t\t\t\t\t<source loading=\"lazy\" media=\"(min-width:768px)\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/block_image_1.jpg\">\n\t\t\t\t\t<img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/block-image-2.jpeg\" alt=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/block_image_1.jpg\" style=\"width:auto;\">\n\t\t\t\t<\/picture>\n\t\t\t<\/div>\n\t\t\t<div class=\"block-column\">\n\t\t\t\t<div class=\"text\">\n\t\t\t\t\t<h2>How Is Fulphila Use<b>d?<\/b><\/h2>\n<p>Fulphila has been approved by the Food and Drug Administration (FDA) for the treatment and prevention of (febrile) neutropenia caused by chemotherapy or radiation.<\/p>\n<hr \/>\n<h4>Available Formulations<\/h4>\n<p>Fulphila is only available as a subcutaneous (under the skin) injection. The injection is available as a single-use prefilled syringe for subcutaneous injection at a dose of 6 mg\/0.6 mL.<\/p>\n<p>The injection sites can include upper areas of the buttocks, front of the thighs, lower abdomen area (2 inches away from the navel), or the upper outer arms. Do not inject into areas where the skin is tender, bruised, red, scaly, or hard, and avoid areas with scars or stretch marks. After injection, do not rub the injection site. Do not handle the prefilled syringe if you are allergic to latex, and do not save unused medication in the prefilled syringe for later use. You should not attempt to give yourself a subcutaneous injection until you have received the appropriate training from your healthcare provider.<\/p>\n<hr \/>\n<h4>Missed Dose<\/h4>\n<p>If you miss a dose, contact your physician immediately to reschedule.<\/p>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"copay-assistance-1d7dd16377401571539aae07acfc2c3c\" style=\"\" class=\"copayAssistance\">\n\t<div class=\"container\">\n\t\t<div class=\"copayAssistanceWrap\">\n\t\t\t<h2 class=\"title\">Copay and Financial Assistance<\/h2>\n\t\t\t<p class=\"text\">AmeriPharma\u00ae Specialty Pharmacy alleviates financial burdens for patients and their families<\/p>\n\t\t\t\t\t\t\t<ul class=\"list\">\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<div class=\"icon\">\n\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"75\" height=\"75\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/icon1-1.png\" class=\"attachment-full size-full\" alt=\"Advanced software Icon\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<p class=\"sub-text\">Advanced software locates funding sources to match you with top-dollar foundation programs<\/p>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<div class=\"icon\">\n\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"67\" height=\"66\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/icon2.png\" class=\"attachment-full size-full\" alt=\"Copay and Financial Assistance\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<p class=\"sub-text\">One of our copay assistance specialists will assist with the application process<\/p>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<div class=\"icon\">\n\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"75\" height=\"75\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/icon3.png\" class=\"attachment-full size-full\" alt=\"Funding Icon\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<p class=\"sub-text\">Automatic updates will be sent to you and your physician on the status of the funding<\/p>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<div  id=\"image-30-text-70-79ceac86ae9795b051ee8577b5c1ba46\" style=\"\" class=\"img30text70 white\">\n\t<div class=\"container\">\n\t\t<div class=\"block-wrap right\">\n\t\t\t<div class=\"block-column image\">\n\t\t\t\t<picture class=\"image-30\">\n\t\t\t\t\t\t\t\t\t\t<source loading=\"lazy\" media=\"(min-width:768px)\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/05\/doctor-patient.jpg\">\n\t\t\t\t\t<img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/05\/doctor-patient-sm.jpg\" alt=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/05\/doctor-patient.jpg\" style=\"width:auto;\">\n\t\t\t\t<\/picture>\n\t\t\t<\/div>\n\t\t\t<div class=\"block-column\">\n\t\t\t\t<div class=\"text\">\n\t\t\t\t\t<h2>Precautions<\/h2>\n<p>Unless approved by your physician, pegfilgrastim is generally not recommended for:<\/p>\n<ul>\n<li aria-level=\"1\"><b>Patients who have an allergy to human granulocyte colony-stimulating factors (CFS) such as\u00a0<a href=\"https:\/\/ameripharmaspecialty.com\/other-health-conditions\/filgrastim-zarxio\/\">filgrastim<\/a>\u00a0or pegfilgrastim products.<\/b>\u00a0The needle cap on the prefilled syringe contains natural rubber (derived from latex). Do not handle the prefilled syringe if allergic to latex. Allergic reactions can cause a rash over the whole body, shortness of breath, wheezing, dizziness, swelling around your mouth or eyes, fast heart rate, and sweating. If you have any of these symptoms, stop using Fulphila and call your doctor or get emergency help right away.<\/li>\n<li aria-level=\"1\"><b>Patients with sickle cell disorder.\u00a0<\/b>Using Fulphila can lead to a condition called sickle cell crisis, which may be life-threatening and require discontinuation of Fulphila.<\/li>\n<li><b>Patients receiving radiation therapy.\u00a0<\/b>Fulphila may increase the risk of developing a precancerous condition called myelodysplastic syndrome (MDS) or a type of blood cancer called <a href=\"https:\/\/medlineplus.gov\/acutemyeloidleukemia.html\">acute\u00a0myeloid leukemia<\/a>\u00a0(AML).<\/li>\n<\/ul>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"copay-side-effect-list-fce3dd9d6d317b5d1bc2f7cfb5570b6f\" style=\"\" class=\"copaySideEffectList\">\n\t<div class=\"container\">\n\t\t<h2 class=\"title\">Fulphila Side Effects<\/h2>\n\t\t<div class=\"content  sideEffectList\" id=\"sideEffectList\">\n\t\t\t<div class=\"vc_row wpb_row vc_inner vc_row-fluid\">\n<div class=\"wpb_column vc_column_container vc_col-sm-6\">\n<div class=\"vc_column-inner\">\n<div class=\"wpb_wrapper\">\n<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<h5><strong>Serious side effects include:<\/strong><\/h5>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"vc_row wpb_row vc_inner vc_row-fluid\">\n<div class=\"wpb_column vc_column_container vc_col-sm-6\">\n<div class=\"vc_column-inner\">\n<div class=\"wpb_wrapper\">\n<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<ul>\n<li aria-level=\"1\">Injection-site pain<\/li>\n<li aria-level=\"1\">Bone and muscle aches<\/li>\n<li aria-level=\"1\">Thrombocytopenia, leukocytosis<\/li>\n<li aria-level=\"1\">Lung problem called acute respiratory distress syndrome (ARDS)<\/li>\n<li aria-level=\"1\">Kidney injury<\/li>\n<li aria-level=\"1\">Capillary leak syndrome (CLS)<\/li>\n<li aria-level=\"1\">Inflammation of blood vessels<\/li>\n<li aria-level=\"1\">Rupture of the spleen<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"wpb_column vc_column_container vc_col-sm-6\">\n<div class=\"vc_column-inner\">\n<div class=\"wpb_wrapper\">\n<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<h5><strong>Less severe side effects include:<\/strong><\/h5>\n<\/div>\n<\/div>\n<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<ul>\n<li aria-level=\"1\">Sweating<\/li>\n<li aria-level=\"1\">Dark urine<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"copay-insurance-companies-b917494ae02507224940bb830e3cc060\" style=\"\" class=\"copayInsuranceCompanies\">\n\t<div class=\"container\">\n\t\t<h3 class=\"title\">Insurances Accepted<\/h3>\n\t\t<p class=\"text\">We accept Medicare, multi-state Medicaid, Medi-Cal, Blue Shield, and most private insurances. Call us to find out more about your coverage.<\/p>\n\t\t\t\t\t<ul class=\"list\">\n\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"218\" height=\"34\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/01\/medicare-footer-logo.png\" class=\"attachment-full size-full\" alt=\"Medicare logo displayed in the website footer.\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/01\/medicare-footer-logo.png 218w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/01\/medicare-footer-logo-86x13.png 86w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/01\/medicare-footer-logo-167x26.png 167w\" sizes=\"auto, (max-width: 218px) 100vw, 218px\" \/>\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"270\" height=\"58\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/07\/medicaid-gov-logo.png\" class=\"attachment-full size-full\" alt=\"Medicaid logo\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/07\/medicaid-gov-logo.png 270w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/07\/medicaid-gov-logo-86x18.png 86w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/07\/medicaid-gov-logo-167x36.png 167w\" sizes=\"auto, (max-width: 270px) 100vw, 270px\" \/>\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"104\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/Image-137.png\" class=\"attachment-full size-full\" alt=\"Blue Cross Blue Shield Logo\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/Image-137.png 200w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/Image-137-86x45.png 86w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/Image-137-167x87.png 167w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/>\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t<\/ul>\n\t\t\t<\/div>\n<\/div>\n\n\n\n<div id=\"form\">\n\t<div  id=\"copay-form-1d5ac268bf816572fb8c28c3aa06192e\" style=\"\" class=\"copayForm\">\n\t\t<div class=\"container\">\n\t\t\t<div class=\"copayForm-wrapper\">\n\t\t\t\t<div class=\"content\">\n\n\t\t\t\t\t\t\t\t\t\t\t<h2 class=\"title\">Get Started in Minutes<\/h2>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"text\">Fill out your information and one of our specialists will call you ASAP.<\/p>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"question\">How Much Can You Save?<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"answer\">Complete this form to save up to 100%!<\/p>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<!--<a class=\"contact-button\" href=\"tel:8777780318\">(877) 778-0318<\/a>-->\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"form\">\n\t\t\t\t\t<div id=\"iframe-container\"><\/div>\n\t\t\t\t\t<script>     \n                        window.addEventListener('DOMContentLoaded', () => {\n                            function buildForm(posthogID) {\n                                let formId = 'Lac86iCjiIyfdFLJylVF';\n                                let formHeight = '400px';\n                                function getURLParameter(e){return decodeURIComponent((RegExp(e+\"=(.+?)(&|$)\").exec(location.search)||[,null])[1])}   \n                                let utmParams = ['utm_source','utm_medium','utm_campaign','utm_campaignid','utm_adgroup','utm_term','utm_keyword','keyword','device','match','loc','utm_network','gclid','extensionid', 'sitelink']; 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