New CMS-1500 02/12 Claim Form (25 forms)
Price:
$5.07
- 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
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New CMS-1500 02/12 Claim Form (100 forms)
NEW CMS 1500 Claim Forms - HCFA (Version 02/12) (250 Sheets)
NEW CMS 1500 Claim Forms - 25 Sheets (02/12 Version) for Laser or Inkjet Printers
NEW CMS 1500 Claim Forms - 500 Sheets (02/12 Version) for Laser or Inkjet Printers
