loading
Search
Your Cart 0
  • Your shopping cart is currently empty.

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

Quick Find
: 7606379

Casepack
: 250

UOM
: PK

Model #
: CMS12LC250

SKU
: TFPCMS12LC250

$27.39
/ PK
This product qualifies for quantity discount pricing.
QuantityPer Item Price
1-5$27.39
6-10$26.78
11+$26.38

Product Description

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: No; Forms Per Page: 1; Form Size: 8.5 x 11.