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ComplyRight CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 100 Forms Total

Product Number: TFP650657
  • Meet billing requirements for Medicare Part B.
  • Easy-to-read forms for faster claims processing.
  • Comply with CMS standards and requirements for paper, layout and ink.
  • Printed in scannable, dropout OCR red ink.
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$7.04
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Delivered by Mon 4/29 Tue 4/30 - This is an estimated delivery timeline

Product Description

ComplyRight CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 100 Forms Total - Meet billing requirements for Medicare Part B. Easy-to-read forms with crisp, clean text help ensure faster claims processing. Paper, layout and ink comply with CMS standards and requirements. Layout includes all 02/12 NUCC revisions and is a direct replacement for the previous 08/05 version. Printed in scannable, OCR "dropout" red ink.

  • Meet billing requirements for Medicare Part B.
  • Easy-to-read forms for faster claims processing.
  • Comply with CMS standards and requirements for paper, layout and ink.
  • Printed in scannable, dropout OCR red ink.
  • Include all 02/12 NUCC revisions, replacing the previous 08/05 version.
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Product Specifications

  • Assembly Required
    No
  • Brand Name
    ComplyRight
  • Copy Types
    One-Part (No Copies)
  • Country of Origin
    United States
  • Dated/Undated
    Undated
  • Form Size
    8.5 x 11 8.5 x 11
  • Forms Per Page
    1
  • Global Product Type
    Insurance Forms
  • Paper Color(s)
    White
  • Post-Consumer Recycled Content Percent
    0%
  • Pre-Consumer Recycled Content Percent
    0%
  • Principal Heading(s)
    1500 Health Insurance Claim Form
  • Print and Ruling Color(s)
    OCR Red
  • Recycled
    No
  • Sheet Size
    8.5 x 11
  • Total Recycled Content Percent
    0%

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