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New 2012 CMS-1500 Insurance Claim Form
CMS-1500 2 Part Form (02/12)
 
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Product Code: CMS-2PART-12
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Description Freight, Returns & Sales Tax Policies
 
New (02/12)CMS-1500 Form
9-1/2”W x 11”H for continuous printers 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
  • 9-1/2”W x 11”H

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