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Send completed form to: Service Benefit Plan Prior Approval P.O. Box 52080 MC 139 PRIOR APPROVAL REQUEST Phoenix, AZ 85072-2080 Additional information is required to process your claim for prescription
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What is dimethyl fumarate?
Dimethyl fumarate is an oral medication used for the treatment of multiple sclerosis.
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Dimethyl fumarate is used to reduce relapses and delay disability progression in patients with multiple sclerosis.
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