ComplyRight CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack (650657)
ComplyRight CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack (650657)

$5.67

Part #: 650657

ComplyRight CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack (650657)

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. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 100; Sheet Size: 8.5 x 11.

Features

  • 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.

$5.67

Part #: 650657

Product Specs

  • Copy Types

    One-Part Carbonless

  • Form Quantity

    100

  • Form Size

    8.5 x 11

  • Forms Per Page

    1

  • Global Product Type

    Forms-Insurance

  • Layout

    One Form per Sheet

  • Manufacturer Stock No.

    650657

  • 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

  • Sheet Size

    8.5 x 11

  • Total Recycled Content Percent

    0%

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