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ComplyRight CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack (1032415)

  • 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.
More Details
$3.31 $3.99
OUT OF STOCK

Product#: 1032415

EXPIDITED SHIPPING - Estimated Delivery Mon 4/22

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: 100; Sheet Size: 8.5 x 11.

  • 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 Specification

Manufacturer ComplyRight
Categories ComplyRight Office SuppliesComplyRight Forms, Recordkeeping & Reference MaterialsComplyRight Forms
Manufacturer Stock No. 650657
MPN TFP1032415
Model# 1032415
UPC Code 015171105096
UNSPSC Code 0
Copy Types One-Part
Form Quantity 100
Form Size 8.5 x 11
Forms Per Page 1
Global Product Type Forms-Insurance
Layout One Form per Sheet
Paper Color(s) White
Post-Consumer Recycled Content Percent 0%
Pre-Consumer Recycled Content Percent 0%
Principal Heading(s) 1500 Health Insurance Claim Form
Print and Ruling Color(s) OCR Red
Sheet Size 8.5 x 11
Total Recycled Content Percent 0%
Assembly Required No assembly is required
Contains Recycled Materials N
Green Product N
Unit of Measure PK
Item Weight 1.065
Ships via UPS Y
Carton Pack Quantity 500 PK
Brand ComplyRight
Country of Origin US
UNSPSC Number 14111806

ComplyRight CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack (1032415) Reviews

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