CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 100 Forms Total
CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 100 Forms Total
$6.43
/ PK
SKU
#TFP650657
Ships in 2-3 days
- 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.
| Specification(s) | |
|---|---|
| Form Type Details | CMS-1500 |
| Global Product Type | Forms-Insurance |
| 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) | 100 |
| 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 |
| Pre-Consumer Recycled Content Percent | 0% |
| Post-Consumer Recycled Content Percent | 0% |
| Total Recycled Content Percent | 0% |
| Shipping Quantity | 500 |
| Brand | ComplyRight® |
| UPC Code | 15171105096 |
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.