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CMS-1500 Two-Part Carbonless Insurance Claim Form 0212

Item#: Size:
Quantity 1 2 3 4 5
60151X  2-Parts/Duplicate $73.99 $143.99 $209.99 $258.99 $291.99
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.
Includes all updates in the 02/12 version approved by the NUCC (National Uniform Claim Committee)

  • Convenient and easy to use!

    2-part carbonless forms on 20#/15# self-duplicating stock, printed in OCR red ink.
  • Accommodates NPI numbers

    as mandated by HIPAA.
  • Accepted by most

    health insurance companies.
  • Quantity:

    Comes in packs of 250.