CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 100 Forms Total-(TFP650657)
$6.99
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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
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