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Insurance Claim Forms

NEW CMS 1500 Claim Forms - 500 Sheets (02/12 Version) for Laser or Inkjet Printers

R 1,540

or 4 x payments of R385.00 with Payflex

Payflex

Availability: Currently in Stock

Delivery: 10-20 working days

NEW CMS 1500 Claim Forms - 500 Sheets (02/12 Version) for Laser or Inkjet Printers
- APPROVED OMB-0938-1197 (Version 02/12)
- 1-Part Laser Form CMS-1500 printed in red ink
- For Laser and Inkjet Printers
- Size: 8-1/2" X 11"; Weight: 24# Paper
- Pack of 500 Sheets
Item Number 1500NC This form accommodates the reporting of the National Provider Identifier (NPI). Printed in red ink on special bond paper in strict compliance with NUCC and CMS regulations and specifications. These claim forms (formerly HCFA-1500) are used to submit health insurance claims for services provided by health care professionals to Medicare and Medicaid, insurance companies or clearinghouses for processing. Printed in red ink on special bond paper in strict compliance with government regulations and specifications. Available in both laser and pin-fed continuous formats Size: 8 1/2 x 11 Red Ink Most recent update (02/12)
Country USA
Manufacturer Jaxplaza
Binding Office Product
ItemPartNumber CMS1500
Model DNT-14457
ReleaseDate 0000-00-00

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