CMS-1500 (02/12) Claim Forms (100 single-sided forms)

CMS-1500 (02/12) Claim Forms (100 single-sided forms)

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CMS-1500 Health Insurance Claim Form (02/12); 100 Sheets

Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant

  • Designed for filing medical claims to government payers and commercial insurance companies
  • Includes the newest NUCC revisions
  • Printed in red, scannable, OCR ink
  • Guaranteed to comply with all government standards for paper, ink and layout.
  • 8-1/2" x 11"
  • For laser or inkjet printers
  • 100 sheets
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