2 Part Hand Written CMS 1500 Form. 500 per carton. 1 carton minimum. Ships in 24 hours.
NEW CMS 1500 forms for hand written claims. Want samples mailed to you?
Click Here.
2 part carbonless (NCR) paper.
Top sheet color: white
Bottom sheet color: yellow
OCR scanable paper.
Black and red ink.
100% compatible with UCCI requirements.
This is the
NEW CMS 1500 (08/05) form mandated by the U.S. Centers for Medicare and Medicaid Services (CMS) to be in use by
April 2, 2007, extended tentatively to July 1, adding the
split provider identifier fields for NPI numbers.
Minimum order is 500 CMS 1500 forms.
24 hour turnaround.
Shipping charge is $6.00/ctn to the continental US. Expedited shipping available.