CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms
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.
- Form Type Details: CMS-1500
- Global Product Type: Insurance Forms
- 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): 250
- 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%
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Shipping Restrictions
- This item cannot be shipped to PO Boxes.
- This item can be shipped only within the U.S.
- UPC: 758399422254
- Mfr's Part #: CMS12LC250