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CMS-1500 Laser Pad Insurance Claim Form, Version 0212

Item#: Size:
Quantity 5 10 20 30 40
60152X  1-Part/Original $76.99 $97.99 $171.99 $256.99 $339.99
We recommend this quantity.
1.  Quantity

Benefits and Features

Speed third-party billing and manage your cash flow with this AMA and CMS approved claim formin a convenient laser pad format.
Includes all updates in the 02/12 version approved by the NUCC (National Uniform Claim Committee)

  • Convenient and easy to use! 1-part form on 20# white bond stock, printed in OCR red ink.
  • Accommodates NPI numbers as mandated by HIPAA.
  • Accepted by most health insurance companies.
  • Easy fill and tear single sheet format works with most laser printers.
  • Quantity: 100 insurance claim forms per pad.