CMS-1500 Laser Printer Medical Claims Form - 2500 Sheets, Revised 02/12

Item Number 1500NC 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. 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. Available in both laser and pin-fed continuous formats Size: 8 1/2 x 11 Red Ink Most recent update (02/12)