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Medicaid Claim Form Laser 1 Part

From: $35.00

  • Size: 8.5 x 11
  • Paper: 1 part carbonless snap-apart format
  • Form is printed in red ink
  • Prints with your company information in black ink
  • Check our FAQ for current production times.
SKU: CMS-1500-1 Tag:
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Medicaid Claim Form CMS-1500 – 1 Part

Claim Form CMS-1500 or HCFA-1500 is a 1-part form; it has already been authorized by Medicare and Medicaid Services to meet all insurance claim requirements. Customize this form with the name and address of your medical office.

Call us at 1-800-370-5591 in the event that you have any questions.

Weight N/A
Dimensions 1 × 2 × 3 in

250, 500, 1000

Paper Type

1 part (white only)