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New CMS-1500 02/12 Claim Form (25 forms)

5.0 (5) Write Review
Free shipping on orders over $29.99

$14.44

$ 6 .99 $6.99

In Stock
  • 25 Forms - - 02/12 Version
  • All forms are government approved CMS-1500 to serve federal programs and private insurers as a universal claim form
  • Approved OMB-0938-1197 (02/12).


1 Part Laser (25 Single Sheets - for Laser/Inkjet Printers). 02/12 Version.......... Both CMS and the NUCC have issued their transition timelines, affecting providers that accept government and private insurance. Please check with your Payer / Insurance Companies


Jenna Romito
Reviewed in the United States on August 19, 2017
Great form!
Amanda
Reviewed in the United States on July 27, 2017
Exactly what I needed to file for insurance
Ruth E Taylor
Reviewed in the United States on May 21, 2015
Met my expectations. Was what I needed.
Cody
Reviewed in the United States on October 29, 2015
Simple buy from this seller. Very easy.
Moge
Reviewed in the United States on December 7, 2013
Looks great! and works well with (1500cms.com) 02/12 Printable Template. Form is clear and and prints without jamming, good quality.