CMS 1500 form Field 2

Field 2 - Patient's Name

Field 2 on the CMS 1500 claim form is for the Patient's Name.

The “Patient’s Name” is the name of the person who received the treatment or supplies.

NUCC INSTRUCTIONS: Enter the patient’s full last name, first name, and middle initial. If the patient uses a last name suffix (e.g., Jr, Sr), enter it after the last name and before the first name. Titles (e.g., Sister, Capt, Dr) and professional suffixes (e.g., PhD, MD, Esq) should not be included with the name.

Use commas to separate the last name, first name, and middle initial. A hyphen can be used for hyphenated names. Do not use periods within the name.

If the patient’s name is the same as the insured’s name (i.e., the patient is the insured), then it is not necessary to report the patient’s name.

MEDICARE INSTRUCTIONS- Enter the patient's last name, first name, and middle initial, if any, as shown on the patient's Medicare card.
This is a required field.



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