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CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250)
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R 1,489
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Description
- 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
Technical Specifications
Manufacturer
TFP DATA SYSTEMS
Model
CMS12LC250
Color
White
Height
3.3 cm
Length
28.5 cm
Width
22.1 cm
Weight
1.13 kg
Release date
4 April 2023
Shipping & Delivery
Your order is shipped from the USA and delivered to your door in South Africa in 10–20 working days. All items are fully tracked.
Returns & Exchanges
We offer a 30-day return window. If something isn't right, contact our support team and we'll make it right.