 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
CMS-1500 Health Insurance Claim Form One-Part 1000 Pack CMS12LC1
- Item #:
- Category:
- Availability:
- Packaging:
- Platform:
- Condition:
- Brand:
- SBS-863722
- Medical Forms
- Item is in stock
- Retail Packaging
- N/A
- New
- TFP Data Systems
For Government/Education/Business pricing, please call 440.355.8008
Click to enlarge
Product Rating
(0 Ratings)
ComplyRight® CMS-1500 Health Insurance Claim Form
Meet billing requirements for Medicare Part B. Easy-to-read forms with crisp, clean text help ensure faster claims processing. Paper, layout and ink comply with CMS standards and requirements. Layout includes all 02/12 NUCC revisions and is a direct replacement for the previous 08/05 version. Printed in scannable, OCR "dropout" red ink. Form Type Details: CMS-1500; Dated/Undated: Undated; Forms Per Page: 1; Form Size: 8.5 x 11.
- Global Product Type: Insurance Forms
- Form Type Details: CMS-1500
- Dated/Undated: Undated
- Forms Per Page: 1
- Form Size: 8.5 x 11
- Sheet Size: 8.5 x 11
- Format Indicator: Unbound
- Form Quantity (Total): 1,000
- Copy Types: One-Part (No Copies)
- Principal Heading(s): 1500 Health Insurance Claim Form
- Paper Color(s): White
- Color Family: White
- Print and Ruling Color(s): OCR Red
- Product Biodegradability in Days: 0
- Pre-Consumer Recycled Content Percent: 0%
- Post-Consumer Recycled Content Percent: 0%
- Total Recycled Content Percent: 0%
 | WARNING: This product can expose you to chemicals including Di(2-ethylhexyl)phthalate (DEHP), which is known to the State of California to cause cancer and birth defects or other reproductive harm. For more information, go to www.P65Warnings.ca.gov. |
Be the first to review this product. Write a Review
Shipping Restrictions
- This item cannot be shipped to PO Boxes.
- This item can be shipped only within the U.S.
- UPC: 813859024444
- Mfr's Part #: CMS12LC1
