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Get Anthem CMS 1500 2009-2021

Not required 1a Required 2 Required 3 Required 4 Required 5 Required 6 Required 7 Required 8 Not required 9 Required if applicable 9a Required if applicable Required if applicable Required for Federal Employee Program (FEP) if applicable Required for FEP if applicable 9b 9c 9d Field Description Type of Health Insurance Coverage applicable to Claim Patient’s type of coverage. Insured’s ID Number Identification or certificate number assigned to the insured/subscriber. Pl.

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