Formsandchecks CMS-1500 Version 02/12 Claim Forms
$39.89
Brand: Formsandchecks
Model: 07106
Color: white
Features
- 1-Part Laser Form CMS-1500 printed in red ink
- New Version 02/12 (APPROVED OMB-0938-1197)
- Medicare will begin accepting this Version 02/12 on 1/06/14. Starting 04/04/14 Medicare will accept this Version 02/12 only.
- Size: 8-1/2" X 11"; Weight: 24# Paper
- For Laser and Inkjet Printers
Details
Formsandchecks CMS-1500 laser claim forms feature the New Version 02/12 format, printed in red ink for insurance claim processing. The 1-part forms are designed for use with laser and inkjet printers and are identified by model 07106 and part number 6509.
UPC: 090146171061