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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