Office Supplies → Forms, Recordkeeping & Reference Materials → ComplyRight CMS12LC250 CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 250 Forms (TFP953639)

ComplyRight CMS12LC250 CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 250 Forms (TFP953639)

This Product is out of stock, a special order item,
or no longer available

If you need assistance with this item or finding a replacement product, please give us a call at 1-888-792-2166 or send an email to customer service.

Summary
  • 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.

Product Description

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. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 250; Sheet Size: 8.5 x 11.

Product Specs

Global Product TypeForms-Insurance
Form Size8.5 x 11
Forms Per Page1
Form Quantity250
Sheet Size8.5 x 11
Principal Heading(s)1500 Health Insurance Claim Form
LayoutOne Form per Sheet
Copy TypesOne-Part
Printer CompatibilityTypewriter/Handwrite Only
Paper Color(s)White
Print and Ruling Color(s)OCR Red
Pre-Consumer Recycled Content Percent0%
Post-Consumer Recycled Content Percent0%
Total Recycled Content Percent0%
Country of OriginUS
Carton Weight23 lbs.
Carton Pack Quantity2 PK
UNSPSC14111806

Shipping Weight & Item Dimensions

Weight22.837
Width9.652
Height9.214
Depth11.8

National Chemical Laboratories
Victory Innovations