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How to Receive Data from Samaritan Health Plans

Samaritan Health Plans requires this form to be used by external organizations seeking data and information from us.

The submission of this form does not guarantee data or information fulfillment. Data dissemination is at the discretion of Samaritan Health Plans guided by federal and state regulations.

The response to this request can take varying amounts of time to process depending on the complexity, sensitivity, and frequency of requested data and information.

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