CMS-1500 Laser Sheet Insurance Claim Form, Version 02/12

Item#: 60150X Size: 8 1/2 x 11"
Quantity 500 1000 2000 3000 5000
60150X  1-Part/Original $86.99 $131.99 $228.99 $325.99 $505.99
We recommend this quantity.

Benefits and Features

Speed third-party billing and manage your cash flow with this AMA and CMS approved claim form for your laser printer.
Includes all updates to 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.
  • Single sheet format

    works with most laser printers.
  • Quantity:

    Comes in packs of 500.