NEW CMS 1500 Claim Forms - 500 Sheets (02/12 Version) for Laser or Inkjet Printers

NEW CMS 1500 Claim Forms - 500 Sheets (02/12 Version) for Laser or Inkjet Printers

Product ID: B00FS0GBFU Condition: New

$ 185
includes Duties & VAT
Delivery: 10-20 working days
Ships from USA warehouse.
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Product Description

NEW CMS 1500 Claim Forms - 500 Sheets (02/12 Version) for Laser or Inkjet Printers

  • APPROVED OMB-0938-1197 (Version 02/12)
  • 1-Part Laser Form CMS-1500 printed in red ink
  • For Laser and Inkjet Printers
  • Size: 8-1/2" X 11"; Weight: 24# Paper
  • Pack of 500 Sheets

Item Number 1500NC This form accommodates the reporting of the National Provider Identifier (NPI). Printed in red ink on special bond paper in strict compliance with NUCC and CMS regulations and specifications. These claim forms (formerly HCFA-1500) are used to submit health insurance claims for services provided by health care professionals to Medicare and Medicaid, insurance companies or clearinghouses for processing. Printed in red ink on special bond paper in strict compliance with government regulations and specifications. Available in both laser and pin-fed continuous formats Size: 8 1/2 x 11 Red Ink Most recent update (02/12)

Technical Specifications

Country
USA
Brand
Jaxplaza
Manufacturer
Jaxplaza
PartNumber
CMS1500
Model
DNT-14457