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Posted by Patria Henriques on Friday, April 26, 2024

Florida - Roster Billing Information

First Coast Service Options, Inc.

Immunization Roster Billing:
http://medicare.fcso.com/Preventive_resources/172751.asp

Forms:
http://medicare.fcso.com/Forms/

Sample CMS Form with Pneumococcal Vaccine Fields Noted:
http://medicare.fcso.com/Forms/138527.pdf

Pneumococcal Vaccine Roster Form:
http://medicare.fcso.com/Forms/138380.pdf

Sample CMS Form with Influenza Vaccine Fields Noted:
http://medicare.fcso.com/Forms/137488.pdf

Influenza Vaccine Roster Form:
http://medicare.fcso.com/Forms/137489.pdf

Medicare Enrollment Information:
http://medicare.fcso.com/PECOS_News/191943.asp

Electronic Data Interchange (EDI) Information:
https://medicare.fcso.com/Landing/192388.asp

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