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CBR On-Demand Web Request Form

For Medicare Administrative Contractors (MACs) only

Please contact the CBR Producer at 530-896-7080 or CBR.Support@hp.com for any questions regarding your request.
Currently, the CBR Producer is only able to furnish CBR's that have been previously released and approved by CMS.

CBR Services Overview
Interactive Map for State and National Averages
FAQs
Inquiry Form
Recommended Links
Events Calendar
CBR Samples
CBR On-Demand Request Form
Medicare Administrative Contractors (MACs) Only
Survey

Contact Us

: If you would like to submit a question, please fill out the CBR Support Inquiry Form. You may also contact our help desk by calling 530-896-7080 or write to:
CBR Services
402 Otterson Drive
Suite 120
Chico, CA 95928.; For comments, please send an email to the CBR Services Mailbox.
Address Change: If you have problems or require an address change, please visit the CBR Disseminator site.

Note: All Fields Are Required
Name:
Title:
Phone Number:
Fax Number:
Email Address:
Contractor Number:
Region/Jurisdiction:
CBR Topic Number:
NPI(s):	characters remaining
Reason for Request:	characters remaining