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

Part # TFPCMS12LC1

UPC 813859024444

$51.45

$38.59

Less than 10 available

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Product Details

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.

Additional Information

Part #: TFPCMS12LC1
MPN: CMS12LC1
UPC: 813859024444
UNSPC: 14111806

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.