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EDI Report Request Tool

NOTE: Reports are only available for 56 days.

Provider Information

Practice Name:
Contact First Name:
Contact Last Name:
State:
Phone Number:	. .
Email Address:
Provider NPI Number:
Submitter Number:
Stratus ID:

Please select the TYPE of Report. You may only select one report type.

Acknowledgement Report (997)
Electronic Receipt Listing
Electronic Remittance Notice

Please select the NUMBER of reports you are requesting.

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