CMS-1500 Laser Pad Insurance Claim Form, Version 0212

Item#: 60152X Size: 8 1/2 x 11"
Quantity 5 10 20 30 40
60152X  1-Part/Original $116.99 $148.99 $259.99 $387.99 $511.99
We recommend this 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.