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SSN : 
Date of Birth : 
Date of Injury : 

New providers must enter SSN, DOB and DOI to retrieve the claim number.

Search results include claims for dates of injury since 08/13/1999 or any date of injury with payments since 08/13/1999. Please contact (307) 777-7441 for additional assistance.

Claim No : 
Service Date From : 
Service Date To : 
Total Bill Amount : 
Provider Control Number : 
Payment Date From : 
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