CMS-1500 Rev. 08/05; 2-Part Pin-feed, White/Yellow, 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 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 :

WhiteYellow

Number of Parts :

2

Carbonless :

Yes

# Up Per Sheet/Page :

1

NCR Paper :

Yes

Numbered :

No

Holes Punched :

None

Personalization :

No

Security Features :

No

Miscellaneous

Brand :

Medical Arts Press

Country of Origin :

USA

Weight

Weight :

21.00 lbs. per Box