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Knowledgebase: How to Fill Out The CMS-1500 Form > The CMS-1500 Form - Fields 1–13: Patient and Insured Information
Field 2 - Patient's Name
Posted by Dan Perrine, Last modified by Dan Perrine on 28 March 2018 05:33 AM

Field 2 on the CMS 1500 claim form is for the Patient's Name.

The “Patient’s Name” is the name of the person who received the treatment or supplies.

INSTRUCTIONS: Enter the patient’s full last name, first name, and middle initial. If the patient uses a last name suffix (e.g., Jr, Sr), enter it after the last name and before the first name. Titles (e.g., Sister, Capt, Dr) and professional suffixes (e.g., PhD, MD, Esq) should not be included with the name.


Use commas to separate the last name, first name, and middle initial. A hyphen can be used for hyphenated names. Do not use periods within the name.


If the patient’s name is the same as the insured’s name (i.e., the patient is the insured), then it is not necessary to report the patient’s name.

MEDICARE - Enter the patient's last name, first name, and middle initial, if any, as shown on the patient's Medicare card. This is a required field.
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