CMS-1500 Health Insurance Claim Form, One-Part No Copies, 8.5 x 11, 1000PK
Mfr # CMS12LC1
Zoro # G615509063
product price:Â $49.75
/pk 1000, $0.05/eaKey Features
Form Size
8.5 in x 11 in
Forms per Page
1
Print and Ruling Color
Red
Copy Type
One-Part (No Copies)
Paper Color
White
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Specifications
Product Information
MFR #
CMS12LC1
Zoro #
G615509063
UPC #
-
Country of Origin
United States
Dimensions
Form Size
8.5 in x 11 in
Sheet Size
8.5 in x 11 in
Details
Item
Insurance Form
Forms per Page
1
Print and Ruling Color
Red
Copy Type
One-Part (No Copies)
Paper Color
White
Principal Heading
1500 Health Insurance Claim Form
Number of Forms
1000
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 indropoutin red ink.
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