HCFA-1500 Box 33 - Billing Provider Info & Phone No

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September 01, 2025

On the HCFA-1500 form, Box 33 is labeled “Billing Provider Info & Phone #” and is used to report the billing provider’s name, address, city, state, ZIP code, and telephone number. This box identifies the entity that is financially responsible for billing and receiving payment for the claim.

Tip: Always ensure that the billing provider’s address and phone number are current and match the information on file with the payer. Incorrect or outdated information may cause claim processing delays or rejections.

In our example below, the provider reported:

Billing Provider Name
123 Main Street
Anytown, NE 12345
415-555-0132

HCFA-1500 Box 33 - Billing Provider Info & Phone

In the X12 837P 5010 transaction, Box 33 maps to the 2010AA Billing Provider Loop. The data is reported as follows:

  • NM103 – Billing Provider Name (e.g., NM103 = Last/Organization Name)
  • N301 – Billing Provider Address Line
  • N401 – Billing Provider City Name
  • N402 – Billing Provider State Code
  • N403 – Billing Provider Postal Zone/ZIP Code
  • PER04 – Billing Provider Telephone Number

Sample 837P (5010) – Box 33 Mapping

> Billing Provider (2010AA) NM1*85*2*BILLING PROVIDER NAME*****XX*1234567893~ N3*123 MAIN STREET~ N4*ANYTOWN*NE*12345~ PER*IC*BILLING OFFICE*TE*4155550132~

Note: Box 33 establishes the official billing entity for the claim. Payers rely on this information to match payment to the correct provider. Be sure that the NPI, tax ID, and contact details align with payer records to prevent delays.

For additional information on the X12 837 standard, please refer to the official implementation guides published by X12.

HCFA-1500 Form Box Locations

Grab a sample of the HCFA-1500 claim form here - HCFA 02/12 Claim Form

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