Question

What information is entered into Block 4 on the CMS-1500 claim for a workers' compensation case?

Answer 1

Enter the insured's address and telephone number. If Block 4 is completed, this field should be completed. The first line is for the street address; the second line is for the city and state; the third line is for the zip code and phone number.

Step-by-step explanation:

Answer 2

Enter the insured's address and telephone number. If Block 4 is completed, this field should be completed. The first line is for the street address; the second line is for the city and state; the third line is for the zip code and phone number.