ComplyRight CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 100 Forms Total

Meet billing requirements for Medicare Part B. Easy-to-read forms with crisp, clean text help ensure faster claims processing. Paper, layout and ink comply with CMS standards and requirements. Layout includes all 02/12 NUCC revisions and is a direct replacement for the previous 08/05 version. Printed in scannable, OCR "dropout" red ink.

Additional Information

• Part #: TFP650657
• MPN: 650657
• UPC: 015171105096
• UNSPC: 14111806

• Meet billing requirements for Medicare Part B.
• Easy-to-read forms for faster claims processing.
• Comply with CMS standards and requirements for paper, layout and ink.
• Printed in scannable, dropout OCR red ink.
• Include all 02/12 NUCC revisions, replacing the previous 08/05 version.