NUCC INSTRUCTIONS -The “Other Insured’s Policy or Group Number” identifies the policy or group number for coverage of the insured as indicated in Item Number 9.

Enter the policy or group number of the other insured.

Do not use a hyphen or space as a separator within the policy or group number.

MEDICARE INSTRUCTIONS - Enter the policy and/or group number of the Medigap insured preceded by MEDIGAP, MG, or MGAP.

NOTE: Item 9d must be completed, even when the provider enters a policy and/or group number in item 9a.