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2012 CMS-1500 Insurance Claim Form
CMS-1500 Snap Apart 2 Part Form (02/12)


 
List Price: $175.00
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Unit Qty: 1000
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Product Code: CMSS-1500-12
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Description Freight, Returns & Sales Tax Policies
 
CMS-1500 Form
8-1/2”W x 11”H snap apart form and is a two part form.
Printed in red, OCR scannable ink in compliance with government standards

The new CMS-1500 (02/12) Health Insurance Claim Form accommodates the reporting of the National Provider Identifier. This new version replaces the old CMS-1500 (08/05) version.

Barcoding is no longer a part of this form.
Colors & Features
  • 8-1/2”W x 11”H




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Average Customer Review: Average Customer Review: 4.5 of 5 4.5 of 5 Total Reviews: 2 Write a review.

  0 of 0 people found the following review helpful:
 
4 of 5 September 11, 2018
Reviewer: Anonymous Person from Mayaguez, Puerto Rico  
Good price, good product, expensive shipping... Took a lot from ordering to receiving it!

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  0 of 0 people found the following review helpful:
 
5 of 5 Excellent Company July 13, 2017
Reviewer: Anonymous Person from Bonner Springs, KS United States  
Efficient, professional and user friendly.

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