CMS 1500 form Field 9d

Field 9 d - Insurance Plan Name or Program Name


The “Insurance Plan Name or Program Name” identifies the name of the plan or program of the other insured as indicated in Item Number 9.

NUCC INSTRUCTIONS: Enter the other insured’s insurance plan or program name.

MEDICARE INSTRUCTIONS - Enter the Coordination of Benefits Agreement (COBA) Medigap-based Identifier (ID). 


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