UPS Shippable

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 1,000 Forms Total

SKU: TFPCMS12LC1 Categories: , , Brand:

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.


Unit of Measure: CT

Assembly Effort: None

Manufacturer Part Number: CMS12LC1

  • Quantity

  • Price

    $39.83

  • Subtotal

    $39.83

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