Part B Claims
Novitas Solutions Attn: Part B Claims PO Box XXXX (replace the Xs with the PO Box number from the table below) Mechanicsburg, PA 17055-XXXX (fill in the +4 from the table below)
| Part B Claims CMS 1500 Claim Form (08/05) | PO Box | Zip +4 |
|---|---|---|
| Arkansas | P.O. Box 3098 | 17055-1816 |
| Colorado | P.O. Box 3107 | 17055-1823 |
| DCMA | P.O. Box 3396 | 17055-1841 |
| Delaware | P.O. Box 3397 | 17055-1842 |
| Indian Health Services | P.O. Box 3111 | 17055-1857 |
| Influenza/Flu Claims/Roster Billings | P.O. Box 3112 | 17055-1827 |
| Louisiana | P.O. Box 3097 | 17055-1815 |
| Maryland | P.O. Box 3398 | 17055-1843 |
| Mississippi | P.O. Box 3129 | 17055-1834 |
| New Jersey | P.O. Box 3030 | 17055-1802 |
| New Mexico | P.O. Box 3107 | 17055-1823 |
| Oklahoma | P.O. Box 3107 | 17055-1823 |
| Pennsylvania | P.O. Box 3418 | 17055-1854 |
| Texas | P.O. Box 3108 | 17055-1824 |