Product Description
TFP DATA SYSTEMS/COMPLYRIGHT CMS12LC1 - FORM,HLTH INSRNC,1000/CT - CMS-1500 HEALTH INSURANCE CLAIM FORM, ONE-PART (NO COPIES), 8.5 X 11, 1,000 FORMS TOTAL - MEET BILLING REQUIREMENTS FOR MEDICARE PART B. EASY-TO-READ FORMS WITH CRISP, CLEAN TEXT HELP ENSURE FASTER CLAIMS PROCESSING. PAPER, LAYOUT AND INK COMPLY WITH CMS STANDARDS AND REQUIREMENTS. LAYOUT INCLUDES ALL 02/12 NUCC REVISIONS AND IS A DIRECT REPLACEMENT FOR THE PREVIOUS 08/05 VERSION. PRINTED IN SCANNABLE, OCR "DROPOUT" RED INK. FORM TYPE DETAILS: CMS-1500; DATED/UNDATED: UNDATED; FORMS PER PAGE: 1; FORM SIZE: 8.5 X 11. - EQUAL TO TFPCMS12LC1
MANUFACTURER:
TFP DATA SYSTEMS/COMPLYRIGHT
MANUFACTURER PART NUMBER:
CMS12LC1
UNIT OF MEASURE:
CT
QTY PER UNIT OF MEASURE:
1000
COUNTRY OF ORIGIN:
UNITED STATES OF AMERICA
ORDER INCREMENT:
1
WEIGHT:
10.986
CONTRACTOR PART NUMBER:
2750372906
