a08505a6_Medical_billing__November_2010__Notes
[BlockNo.] 9 [Block Name] Other Insured’s Name [Block Code] A [Notes] 
If the patient has another health insurance secondary to the insurance named in Block 11, enter the last name, first name, and middle initial of the insured if it is different from the patient named in Block 2. If the patient and the insured are the same, enter the word SAME. If the patient has MA coverage only, leave the block blank.
CMS 1500 claim and UB 04 form- Medical billing: November 2010
Notes