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Web pulmonary arterial hypertension (pah) orals enrollment form fax referral to: Web after you work with your healthcare provider to complete and submit this form, we will determine your insurance coverage, needs,. Web learn how to enroll your patients in the uptravi program, a treatment for pulmonary arterial hypertension (pah). Web find helpful resources for enrollment, cost support, coverage, and more for uptravi, a prescription medicine for.