CMS-1500 Health Insurance Laser Printer Claim Form

This form accommodates the reporting of the National Provider Identifier (NPI). Printed in red ink on special bond paper in strict compliance with NUCC and CMS regulations and specifications. 8 1/2 x 11 These claim forms (formerly HCFA-1500) are used to submit health insurance claims for services provided by health care professionals to Medicare and Medicaid, insurance companies or clearinghouses for processing. Printed in red ink on special bond paper in strict compliance with government regulations and specifications. Form is non Bar Code format Quantity discounts built into pricing Call office for large quantity orders

• Pricing is for 100 forms
• Call office for large quantity discounts
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