Box 11b - Other Claim ID

Box Definition

Box 11b on the CMS-1500 claim form is used to display the claim casualty number and qualifiers for worker's compensation claims.

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In AveaOffice

This field is not currently editable in AveaOffice.

EDI Loop/Segment

Loop 2010BA, Segment REF01 (Y4 Qualifier) / REF02 (Claim Casualty Number)

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