CMS-1500 Two-Part Carbonless Insurance Claim Form 0212

Item#: 60151X Size: 8 1/2 x 11"
Quantity 1 2 3 4 5
60151X  2-Parts/Duplicate $81.99 $158.99 $230.99 $284.99 $321.99
We recommend this quantity.

Benefits and Features

Speed third-party billing and manage your cash flow with this AMA and CMS approved claim form.
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.