1500 Form Box 33
Android 2019 - 1500 Form Box 33, Instructions for completing the cms 1500 claim form, Instructions for completing the cms 1500 claim form the center of medicaid and medicare services (cms) form 1500 must be used to bill sfhp for. Cms 1500 (02/12) claim form instructions, Pr0029 v1.5 01/24/2018 . cms 1500 (02/12) claim form instructions . field numbe r field name instructions 1 a . insured’s id number. Sfmhp provider manual - hcfa 1500, Other insurance information (blocks 9-9d) - this section is completed if the patient has other insurance. required box 9 - other insured's name..