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EDI Report Request Tool

Updated: 02.07.19

NOTE: Electronic Remittance (835) Reports are only available for 45 days. Claim Response Reports are only available within 1 year of the current date.

Submitter Information

Submitter Name:
Contact First Name:
Contact Last Name:
Phone Number: - -
Email Address:
Provider NPI Number:
Submitter Number:

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


Please select the NUMBER of reports you are requesting.


Disclaimer: CGS' online tools and calculators are informational and educational tools only, designed to assist suppliers and providers in submitting claims correctly. CGS makes no guarantee that this resource will result in Medicare reimbursement for services provided. Although we've made every reasonable effort to provide effective resources, CGS is not responsible for the consequences of any decisions or actions taken in reliance upon or as a result of the information that these tools provide. CGS is not responsible for any human or mechanical errors or omissions.

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