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ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250)

ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250)
- Sold as 250/Pack
- This form was revised to align the paper form with some of the changes in the electronic healthcare claims: Professional (837), 005010X222 Technical Report Type 3 (5010) and 005010X222A1 Technical Report Type 3 (5010A1)
- Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
- The most significant change was the addition of 8 diagnosis codes in field 21

Country	USA
Brand	ComplyRight
Manufacturer	TFP DATA SYSTEMS
Binding	Office Product
ItemPartNumber	CMS12LC250
Model	CMS12LC250
Warranty	Contact Manufacturer
Color	White
ReleaseDate	2023-04-04
UPCs	758399422254
EANs	0758399422254

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