Provider - Trawick International, Inc.

Provider Tax ID *

Date of Service *

Total Amount Claimed (Optional)

First Name of Patient *

Last Name of Patient *

Date of Birth of Patient *

With the exception of total amount, an entry for each input is required.
If all inputs have not been appropiately provided those missing/incorrect entries will be notated with red text.
If all inputs have been provided you will be redirected to the search results page after pressing the search button.
If you are unable to find the claim you are searching for, please contact us at trawickclaims@cbpinsure.com
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