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* if you have commercial insurance and if you receive your prescriptions through mail order. Commercially insured patients: Eligible patients can save on out-of-pocket costs that exceed $54 (up to a $225 savings limit) on each 90-day supply, up to 4 refills* Cash-paying patients: Eligible patients can save up to $225 off each 90-day supply, up to 4 refills* Follow these simple steps Fill a prescription through your mail-order pharmacy for a 90-day supply of . Fill out and sign the form o.

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