60154X, CMS-1500 2 Part Carbonless Continuous Insurance Claim Form, Version 02/12

60154X, CMS-1500 2 Part Carbonless Continuous Insurance Claim Form, Version 02/12
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CMS-1500 2 Part Insurance Claim Form - Item # 60154X

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Item 60154X, CMS-1500 2 Part Continuous Insurance Claim Form, Version 02/12
AMA and CMS approved claim form for your continuous printer.  Single sheet format, 2-part form on 8-1/2" x 11" 20lb white, 15lb yellow paper stock, printed in OCR red ink. Accommodates NPI numbers as mandated by HIPAA. Accepted by most insurance companies.
 
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