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CMS-1500 Laser Sheet Insurance Claim Forms (1 Part)
Item # FPQFE-XNRDQ
Speed third-party billing and manage your cash flow with this AMA and CMS approved claim form for your laser printer. Includes all updates to the 02/12 Version approved by the NUCC (National Uniform Claim Committee). Convenient and easy to use! 1-Part form on 20# White bond stock, printed in OCR red ink. Accommodates NPI numbers as mandated by HIPAA. Accepted by most health insurance companies. Single sheet format works with most laser printers. 8 1/2" W x 11" H
White/Red
Production Time: 6 to 9 working days
Packaging: Bulk
60018 (Illinois, United States)| Quantity | Your Price (each) |
|---|---|
| 500 | $0.12 |
| 1,000 | $0.09 |
| 1,500 | $0.08 |
| 2,000 | $0.08 |
| 2,500 | $0.08 |
| 5,000 | $0.08 |
| Quantity: | 500 | 1,000 | 1,500 | 2,000 | 2,500 | 5,000 |
|---|---|---|---|---|---|---|
| Your Price (each): | $0.12 | $0.09 | $0.08 | $0.08 | $0.08 | $0.08 |
White/Red
Medical, Office
Decoration not included in price.
Production Time: 6 to 9 working days
Packaging: Bulk
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