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STEP THERAPY FORM ER RxCore Unless otherwise indicated below, authorization quantities are limited to the manufacturer recommended dosageComplete online at www.selecthealth.org/pa or fax back to:

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4. Start filling out the form or providing the necessary clarifications by entering the requested information accurately.
5. Use clear and concise language while providing explanations or clarifications to avoid any confusion.
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8. Submit the filled form or clarification as per the instructions provided.
9. Keep a copy of the filled form or clarification for your records.
10. Note: If you have any doubts or concerns while filling out the form or providing clarifications, seek assistance from the relevant authority or person.

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What is the purpose of for questions or clarifications?

The purpose of filing for questions or clarifications is to obtain necessary information or clarity on specific issues to ensure compliance with regulations or to make informed decisions.

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