CMS 1500 claim form billing instruction Part 1
BLOCK 1
Show the type of health insurance coverage applicable to this claim by checking the appropriate box, e.g., if a Medicare claim is being filed, check the Medicare box.Completion of this field is required for all claims.
BLOCK 1A INSURED'S I.D. NUMBER (For Program in Block 1)
Enter the patient's Medicare Health Insurance Claim Number (HICN) whether Medicare is the primary or secondary payer.Completion of this field is required for all claims.
BLOCK 2 PATIENT'S NAME
Enter the patient's last name, first name, and middle initial, if any, exactly as shown on the patient's Medicare card.Completion of this field is required for all claims.
