CMS-1500 Rev. 08/05; 1-Part Pin-feed, 1,500/Box

Accommodates reporting of the National Provider Identifier (NPI) number Approved by the National Uniform Claim Committee (NUCC) Better aligned with the electronic HIPAA ASC X12N 837 Non-institutional Transaction Standard Printed on recycled 20-lb. bond paper Two-part self-duplicating (carbonless) forms are also available 1500 per box Certified Chain of Custody; Promoting Sustainable Forest Management Size: 8-1/2x11"

Product Information

Form Type :

Insurance

Format :

Health Insurance Claim Form

Sheet Size :

9-1/2" x 11"

Form Size :

8-1/2" x 11"

Media Quantity :

1500

Binding Type :

Continuous

Paper Color :

White

Number of Parts :

1

Carbonless :

No

# Up Per Sheet/Page :

1

NCR Paper :

No

Numbered :

No

Holes Punched :

None

Personalization :

No

Security Features :

No

Environmental Information

Certifications & Standards :

SFI Sustainable Forestry Iniative

Miscellaneous

Brand :

Medical Arts Press

Country of Origin :

USA

Weight

Weight :

12.00 lbs. per Box