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CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms

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Your Price: $31.40

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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): 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