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Item # 174-LR0192   Model # LR0192


$21.99
Each
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Per federal regulations, all healthcare providers must use the CMS-1500 Form for certain types of billing Lay template over CMS form to help alleviate confusion and errors, and helps increase reimbursements Assists with reporting of the National Provider Identifier, which must be used by all HIPAA-covered entities, including health plans, healthcare clearinghouses and healthcare providers

Product Information
Form Type :
Insurance
Format :
Template
Sheet Size :
8-1/2" x 11"
Lines :
No Lines
Form Size :
8-1/2" x 11"
Media Quantity :
1 Each
Binding Type :
Loose
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
Miscellaneous
Brand Name :
ComplyRight
Country of Origin :
USA
Weight
Weight :
1.00 lbs. per Each
Description Price Unit Take Action
CMS 1500 Laser Form; 1000/Box
CMS 1500 Laser Form; 1000/Box

174-14710

 $40.49
When you buy 25+ 		Box
Buy
CMS 1500 Laser Form; 500/Pack
CMS 1500 Laser Form; 500/Pack

174-CMSLC500

 $24.99
 		Pack
Buy
CMS-1500 Rev. 08/05; 1-Part Pin-feed
CMS-1500 Rev. 08/05; 1-Part Pin-feed

174-14711

 $37.99
When you buy 6+ 		Box
Buy
CMS-1500 2-Part Snapset
CMS-1500 2-Part Snapset

174-14716

 $50.79
When you buy 6+ 		Box
Buy
CMS-1500 Rev. 08/05; 1-Part Pads
CMS-1500 Rev. 08/05; 1-Part Pads

174-14718

 $5.99
When you buy 20+ 		Pad
Buy
Description Price Unit Take Action
Huge selection on filing supplies, forms and labels
Accessories
CMS 1500 Laser Form; 1000/Box
CMS 1500 Laser Form; 1000/Box See Others

$40.49
When you
buy 25+
Box Buy
CMS 1500 Laser Form; 500/Pack
CMS 1500 Laser Form; 500/Pack See Others

$24.99

Pack Buy
CMS-1500 Rev. 08/05; 1-Part Pin-feed
CMS-1500 Rev. 08/05; 1-Part Pin-feed See Others

$37.99
When you
buy 6+
Box Buy
CMS-1500 2-Part Snapset
CMS-1500 2-Part Snapset See Others

$50.79
When you
buy 6+
Box Buy
CMS-1500 Rev. 08/05; 1-Part Pads
CMS-1500 Rev. 08/05; 1-Part Pads See Others

$5.99
When you
buy 20+
Pad Buy
See All Products
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