Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR ink for scanning. For Laser Printers. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 500; Principal Heading(s): 1500 Health Insurance Claim Form.
Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8 1/2 x 11, 500 Forms/Pack
