select count(*) AS CN,Account, Client, DealerNam, MSEG, Tier INTO #T FROM TABLE
GROUP BY Account, Client, DealerNam, MSEG, Tier
DELETE FROM #T WHERE CN < 2
SELECT * FROM TABLE T LEFT JOIN #T ON T.Account = #T.Account AND T.Client = #T.Client AND T.DealerNam = #T.DealerNam AND T.MSEG = #T.MSEG...