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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 $65.99 $100.99 $173.99 $248.99 $386.99
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.