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CMS / HCFA 1500 Health Insurance Claim Forms, 25 Sheets, 02/12 Version

CMS / HCFA 1500 Health Insurance Claim Forms, 25 Sheets, 02/12 Version

$ 8.89

Availability: 62 in stock
  • Restocking Fee: 20%
  • Refund will be given as: Money Back
  • Return shipping will be paid by: Buyer
  • MPN: cm44
  • All returns accepted: Returns Accepted
  • Condition: New
  • Brand: Unbranded/Generic
  • Item must be returned within: 30 Days

    Description

    Claim form (version 02/12) replaces the current form (version 08/05)
    Printed on OCR "dropout" red soy-based ink on 20# paper per government regulations
    Available in laser and continuous format
    The most significant changes were the addition of eight diagnosis codes in field 21
    NEW The addition of the QR code at the top left of the form
    New CMS-1500 02/12 Claim Form (25 forms)