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CMS-1500 Health Insurance Claim Forms with QR Code Identifier, One-Part (No Copies), 8.5 x 11, 500 F

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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.

SKU: C003-09959

Brand part number: 12LC500

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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: 500; Sheet Size: 8.5 x 11.

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Manufacturer	COSCO

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CMS-1500 Health Insurance Claim Forms with QR Code Identifier, One-Part (No Copies), 8.5 x 11, 500 F

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