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Field 11 a - Insured's Date of Birth, Sex
Posted by Dan Perrine, Last modified by Dan Perrine on 28 March 2018 06:51 AM

Field 11a of the CMS 1500 claim form, the “Insured’s Date of Birth, Sex” is the birth date and gender of the insured as indicated in Item Number 1a.

INSTRUCTIONS: Enter the 8-digit date of birth (MM│DD│YYYY) of the insured and an X to indicate the sex (gender) of the insured. Only one box can be marked. If gender is unknown, leave blank.

MEDICARE - Enter the insured's 8-digit birth date (MM | DD | CCYY) and sex if different from item 3.


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