CMS / HCFA 1500 Health Insurance Claim Forms, 25 Sheets, 02/12 Version
USD 18.04 USD
Specifications
| 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 |
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)
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