CMS 1500 Forms- Qty: 100

Availability: In Stock

$9.50

In stock

- +
Add to Wishlist
Add to Wishlist
Compare

This form was revised to align the paper form with some of the changes in the electronic health care claims: Professional (837), 005010X222 Technical Report Type 3 (5010) and 005010X222A1 Technical Report Type 3 (5010A1)

Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant
The most significant change was the addition of 8 diagnosis codes in field 21
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR “dropout” red ink on 20lb. paper (per government regulations)
Form not available personalized
Certified Chain of Custody; promotes sustainable forest management
Size: 8-1/2 x 11″

Reviews

There are no reviews yet.

Only logged in customers who have purchased this product may leave a review.

SKU: 100CMS12LC1 Category:
TO TOP
NEW!

Personal Shopping video or in person socially-distanced appointments offered for individuals or groups! 10% off if you keep your appt., additional 5% off anything ordered within 24 hours (15% total!)

X