Specialty Pharmacy Network for NEXPLANON: Organon does not recommend the use of one authorized pharmacy over another. Organon does not make any warranty as to the services offered by any particular authorized pharmacy. Accredo Health Group Inc. 866-844-0148 AllianceRx Walgreens Prime 888-380-6188 CVS Specialty Pharmacy 800-237-2767 Magellan Rx Pharmacy 866-554-2673 ASPN Pharmacies, LLC 888-970-0195 CenterWell Specialty Pharmacy 800-486-2668 Specialty Pharmacy Network for NEXPLANON *Ple a se no te t he CSCN Enr o ll m ent F or m ser v e s a s th e p ati e nt s pre s cription . NEXPLANON is available through a limited specialty pharmacy network as a pharmacy benefit. Through the assignment of benefit (AOB) process, NEXPLANON is paid for by the insurance plan. The specialty pharmacy will ship NEXPLANON to a health care provider's office for the procedure, and there is no out-of-pocket cost to the health care provider. The CSCN can conduct a benefits investigation, and if NEXPLANON is provided as a ph a rmac y be ne f it , a n d i f re q u e st e d , the CSCN will forward the patient s prescription* to the specialty pharmacy of your choice (or as required by the patient s insurance plan).
Specialty Pharmacy Network for NEXPLANON: Organon does not recommend the use of one authorized pharmacy over another. Organon does not make any warranty as to the services offered by any particular authorized pharmacy. ASPN Pharmacies, LLC 888-970-0195 CVS Specialty Pharmacy 800-237-2767 Accredo Health Group Inc. 866-844-0148 CenterWell Specialty Pharmacy 800-486-2668 Magellan Rx Pharmacy 866-554-2673 AllianceRx Walgreens Prime 888-380-6188 *Please note the CSCN Enrollment Form serves as the patient’s prescription. Specialty Pharmacy Network for NEXPLANON NEXPLANON is available through a limited specialty pharmacy network as a pharmacy benefit. Through the assignment of benefit (AOB) process, NEXPLANON is paid for by the insurance plan. The specialty pharmacy will ship NEXPLANON to a health care provider’s office for the procedure, and there is no out-of-pocket cost to the health care provider. The CSCN can conduct a benefits investigation, and if NEXPLANON is provided as a pharmacy benefit, and if requested, the CSCN will forward the patient s prescription* to the specialty pharmacy of your choice (or as required by the patient s insurance plan).

2 WAYS TO ENROLL

Fill out and submit using an online portal

Download, print, complete, and fax the form

Contact the CSCN:     844-NEX-4321 (844-639-4321) OR 844-232-2618

This site is intended only for residents of the United States.

© 2023 Organon group of companies. All rights reserved. ORGANON and the ORGANON Logo are trademarks of the Organon group of companies. US-XPL-116863 08/23

© 2023 Organon group of companies. All rights reserved. ORGANON and the ORGANON Logo are trademarks of the Organon group of companies. US-XPL-116863 08/23