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Prescribing Information Medication Guide keytrudahcp.com
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PRODUCT INFORMATION

Physician Prescribing Information
Medication Guide
Guide for KEYTRUDA
Additional Guide for KEYTRUDA

COVERAGE AND REIMBURSEMENT SUPPORT

Prior Authorization Checklist
Appeal Checklist
Sample Prior Authorization Letter
Sample Appeal Letter
Prior Authorization Checklist
Sample Prior Authorization Letter
Appeal Checklist
Sample Appeal Letter

BILLING CODES

Coding & Billing Information
Sample CMS-1500 Form
Sample UB-04 Form
 

PATIENT RESOURCES

FOUNDATIONAL SUPPORT

WHAT IF MY PATIENT ISN’T ELIGIBLE FOR THE MERCK CO-PAY ASSISTANCE PROGRAM?

Your patient may be able to get help from an independent co-pay assistance foundation. A representative can provide you with information about independent foundations that may be able to provide financial support to patients who do not qualify for the Merck Co-pay Assistance Program. Each independent foundation has its own eligibility criteria and application process.

Available Independent Foundation Support

PRODUCT
DISTRIBUTION

  • AUTHORIZED
    DISTRIBUTOR
  • PHONE
    NUMBER
  • ORDER ITEM #
    FOR KEYTRUDA
  • ORDER ITEM #
    FOR KEYTRUDA
 
 
Carton of one 100 mg/4 mL
(25 mg/mL), single-use vial
Carton of two 100 mg/4 mL
(25 mg/mL), single-use vials
ASD Healthcare
800-746-6273
10248338
10246707
Besse Medical
800-543-2111
10254504
10251288
Cardinal Health Specialty Distribution
877-453-3972
5058029
5555008
CuraScript Specialty Distribution
877-599-7748
260622
386235
McKesson Plasma and Biologics
877-625-2566
3425493
3979275
McKesson Specialty Care Distribution
800-482-6700
5005010
5009280
M&D Specialty Distribution
800-710-6100
015090
015025
Oncology Supply
800-633-7555
10239747
10242461
AUTHORIZED DISTRIBUTOR
  • Phone Number800-746-6273
  • Order Item # for KEYTRUDA Carton of one 100 mg/4 mL
    (25 mg/mL), single-use vial    10248338
  • Order Item # for KEYTRUDA Carton of two 100 mg/4 mL
    (25 mg/mL), single-use vials    10246707
  • Phone Number800-543-2111
  • Order Item # for KEYTRUDA Carton of one 100 mg/4 mL
    (25 mg/mL), single-use vial    10254504
  • Order Item # for KEYTRUDA Carton of two 100 mg/4 mL
    (25 mg/mL), single-use vials    10251288
  • Phone Number877-453-3972
  • Order Item # for KEYTRUDA Carton of one 100 mg/4 mL
    (25 mg/mL), single-use vial    5058029
  • Order Item # for KEYTRUDA Carton of two 100 mg/4 mL
    (25 mg/mL), single-use vials    5555008
  • Phone Number877-599-7748
  • Order Item # for KEYTRUDA Carton of one 100 mg/4 mL
    (25 mg/mL), single-use vial    260622
  • Order Item # for KEYTRUDA Carton of two 100 mg/4 mL
    (25 mg/mL), single-use vials    386235
  • Phone Number877-625-2566
  • Order Item # for KEYTRUDA Carton of one 100 mg/4 mL
    (25 mg/mL), single-use vial    3425493
  • Order Item # for KEYTRUDA Carton of two 100 mg/4 mL
    (25 mg/mL), single-use vials    3979275
  • Phone Number800-482-6700
  • Order Item # for KEYTRUDA Carton of one 100 mg/4 mL
    (25 mg/mL), single-use vial    5005010
  • Order Item # for KEYTRUDA Carton of two 100 mg/4 mL
    (25 mg/mL), single-use vials    5009280
  • Phone Number800-710-6100
  • Order Item # for KEYTRUDA Carton of one 100 mg/4 mL
    (25 mg/mL), single-use vial    015090
  • Order Item # for KEYTRUDA Carton of two 100 mg/4 mL
    (25 mg/mL), single-use vials    015025
  • Phone Number800-633-7555
  • Order Item # for KEYTRUDA Carton of one 100 mg/4 mL
    (25 mg/mL), single-use vial    10239747
  • Order Item # for KEYTRUDA Carton of two 100 mg/4 mL
    (25 mg/mL), single-use vials    10242461

Merck does not recommend the use of one authorized distributor over another.

Merck does not make any warranty as to the services offered by any particular authorized distributor.

Vial may not be shown at actual size.

The information available here is compiled from sources believed to be accurate, but Merck makes no representation that it is accurate. This information is subject to change. Payer coding requirements may vary or change over time, so it is important to regularly check with each payer as to payer-specific requirements.

The information available here is not intended to be definitive or exhaustive, and is not intended to replace the guidance of a qualified professional advisor. Merck and its agents make no warranties or guarantees, expressed or implied, concerning the accuracy or appropriateness of this information for your particular use given the frequent changes in public and private payer billing. The use of this information does not guarantee payment or that any payment received will cover your costs.

You are solely responsible for determining the appropriate codes and for any action you take in billing. Information about HCPCS codes is based on guidance issued by the Centers for Medicare & Medicaid Services applicable to Medicare Part B and may not apply to other public or private payers. Consult the relevant manual and/or other guidelines for a description of each code to determine the appropriateness of a particular code and for information on additional codes. Diagnosis codes should be selected only by a healthcare professional.