Medicaid Claim Form 2 Part
- Size: 8.5 x 11
- Paper: 2 part carbonless snap-apart format
- Form printed in red ink
- Prints with your company information in black ink.
- Check our FAQ for current production times.
Medicaid Claim Form CMS-1500 – 2 Part Carbonless
This Medicaid Claim Form is available in a 2-part carbonless snap-apart format. This form has been already approved by Medicare and Medicaid for insurance claims. Customize this form with the name and address of your medical office.
If you have any questions, feel free to call us. We are available at 1-800-370-5591.
|Dimensions||1 × 2 × 3 in|
250, 500, 1000
2 part (white-yellow)