CLM-Provider EOB
Unique EOB Key
Provider Portal
*All Fields Below Are Required
Provider Tax Id
Please Enter Patient Details Below
Policy Number
First Name
Last Name
Date of Birth
Last 4 digits of Social Security Number
Do Not Have Social Security Number
Zip Code
Select Date of Service
Start:
End:
*Explanation of Benefits prior to 7/10/2019 12:00 AM are not viewable online
