Form 480.6A -- "Informativa de Ingreso"

First Coast, as a MAC, is only responsible for withholding monies and/or taxes established by the United States federal government. Therefore, First Coast will not be providing the "Informativa de Ingreso 480.6A" or an equivalent document disclosing the provider's annual reimbursement from the MAC to providers in Puerto Rico or the U.S. Virgin Islands. 

First Coast offers information on dollars paid through option four (4) of the interactive voice response (IVR) system. This information is also available through SPOT.