Image of ComplyRight® CMS12LC1 CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 1,000 Forms Total
Image of ComplyRight® CMS12LC1 CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 1,000 Forms Total
Image of ComplyRight® CMS12LC1 CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 1,000 Forms Total
Image of ComplyRight® CMS12LC1 CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 1,000 Forms Total
Image of ComplyRight® CMS12LC1 CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 1,000 Forms Total

ComplyRight® CMS12LC1 CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 1,000 Forms Total

SKU: TFPCMS12LC1

Regular priceYour Price: $37.25
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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

  • Meet billing requirements for Medicare Part B.
  • Easy-to-read forms for faster claims processing.
  • Comply with CMS standards and requirements for paper, layout and ink.
  • Printed in scannable, dropout OCR red ink.
  • Include all 02/12 NUCC revisions, replacing the previous 08/05 version.


Product Details

SKU: TFPCMS12LC1
Manufacturer: TFP DATA SYSTEMS
Mfr. Part Number: CMS12LC1
Brand Name: ComplyRight ®
Assembly Required: No
Alternate Part Numbers: TFPCMS12LC1, TFP-CMS12LC1, CMS12LC1, 00813859024444 (GTIN), 00813859024444 (GTIN), 813859024444 (UPC), 00813859024444 (GTIN), 813859024444 (UPC), 00813859024444 (GTIN), 813859024444 (UPC)
Country of Origin: US (UNITED STATES)
TAA Compliant: Yes
UNSPSC Code: 0014111806
Unit of Measure: CT (Carton of 1,000)
UPS Shippable: Yes
Air Shippable: Yes
Item Dimensions: 11.41 in. D x 9.10 in. W x 4.89 in. H
Shipped Dimensions: 11.41 in. D x 9.10 in.W x 4.89 in. H
Weight: 11.0000 lb.
Expiration Date: No

Environmental Properties

Energy Star: No
Green Indicator: No
Recycled: No

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