ComplyRight CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

Part # TFPCMS12LC250

UPC 758399422254

$33.25

$24.99

Less than 10 available

OUT OF STOCK

Enter your email address to be notified when this item is back in stock.

Qty:

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 #: TFPCMS12LC250
MPN: CMS12LC250
UPC: 758399422254
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.