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CMS-1500 Health Insurance Claim Form, Two-Part Carbonless, 8.5 x 11, 250 Forms Total-(TFPCMS12LC250)
CMS-1500 Health Insurance Claim Form, Two-Part Carbonless, 8.5 x 11, 250 Forms Total-(TFPCMS12LC250)
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- 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