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

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

Item # TFPCMS12LC250

  • Meet billing requirements for Medicare Part B.
  • Easy-to-read forms for faster claims processing.
  • Comply with CMS standards and requirements for paper, layout and ink.
  • Printed in scannable, dropout OCR red ink.
  • Include all 02/12 NUCC revisions, replacing the previous 08/05 version.
Alternate #CMS12LC250
Your Price:
$31.22/PK
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/Undated: Undated; Forms Per Page: 1; Form Size: 8.5 x 11.
Specifications
  • 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%
  • Country of Origin US
  • Carton Pack Quantity 2
  • Pack Quantity 250
  • UPC 758399422254
  • UNSPSC 14111806
Recently Viewed Items