Description

Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR ink for scanning. For Laser Printers. Form Size: 8 1/2 x 11; Forms Per Page: 1; Form Quantity: 250; Principal Heading(s): 1500 Health Insurance Claim Form.

Additional information

Weight 0.00 oz
Dimensions 0.00 × 0.00 × 0.00 in

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