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

Item#: Size:
Quantity 500 1000 2000 3000 5000
60150X  1-Part/Original $72.99 $110.99 $191.99 $273.99 $425.99
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 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.