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 regulationsAvailable in laser and continuous formatThe most significant changes were the addition of eight diagnosis codes in field 21NEW The addition of the QR code at the top left of the formNew CMS-1500 02/12 Claim Form (25 forms)
Price: 18.04 USD
Location: Meridian, Georgia
End Time: 2025-01-06T14:00:47.000Z
Shipping Cost: 0 USD
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Item Specifics
Restocking Fee: 20%
Return shipping will be paid by: Buyer
All returns accepted: Returns Accepted
Item must be returned within: 30 Days
Refund will be given as: Money Back
MPN: cm44
Country/Region of Manufacture: United States
Model: HCFA 1500
Brand: Unbranded/Generic
Type: Health Insurance Claim Forms
