ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1)
$83.79
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Highlights
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- Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
- Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
- Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1)
Item #: 116719Model #: CMS12LC1
$83.79
1000/carton
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About this product
Stay in compliance and process claims efficiently when submitting insurance claims with ComplyRight CMS-1500 Health Insurance Claim Forms.
Ensure all the necessary information for insurance claims is submitted by using these health insurance claim forms. The preprinted format allows for easy data entry, and the laser-cut sheets work with a wide range of printers for clear, precise printouts. These ComplyRight claim forms feature red OCR dropout ink to meet government regulations, ensuring better compliance and efficient document completion.
- Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
- Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
- Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
- Form features detailed information to help expedite payment for claims
- Form not available personalized
- Satisfy record-keeping requirements with these health insurance claim forms
- For use by all medical facilities
- Developed in conjunction with all the governing agencies
- 02/12 Version
- 8-1/2" x 11"
Frequently bought together
Price is $86.19
Unit of measure 500/Box
Free delivery by Tue, Sep 16
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Over 30
Price is $145.99
Delivery fees may apply
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Over 30
Price is $4.69
Unit of measure 100/Pack
Delivery by Thu, Sep 18
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Over 30
Price is $132.19
Unit of measure 100/Box
Free delivery by Wed, Sep 17
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Over 30
Price is $23.99
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Price is $19.49
Unit of measure 10/Pack Price per unit $1.95/Correction Tape
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Price is $22.19
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Over 30
Price is $12.59
Unit of measure 250/Pack
Delivery by Tue, Sep 16
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Price is $19.49
Delivery by Fri, Sep 19
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Over 30
Price is $3.49
Unit of measure 100/Pack
Delivery by Thu, Sep 18
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Over 30
Price is $67.09
Free delivery by Wed, Sep 24
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2026 AT-A-GLANCE 36" x 24" Yearly Dry Erase Wall Calendar, Reversible, White/Red (PM26-28-26)Â is New at Staples
Price is $32.99
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Over 30
Price is $177.09
Unit of measure 50/Box
Free delivery by Tue, Sep 16
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Over 30
Price is $112.79
Free delivery by Tue, Sep 30
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Over 30
Price is $74.99
Unit of measure Roll
Free delivery by Thu, Sep 18
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Over 30
Price is $62.69
Free delivery by Tue, Sep 16
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Over 30
Price is $79.99
Unit of measure Roll
Free delivery by Thu, Sep 18
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Over 30
Price is $143.79
Unit of measure 250/Pack
Free delivery by Tue, Sep 16
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Compare similar items
| Attributes | ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1) | Adams CMS-1500 Health Insurance Claims, 100/Pack (CMS1500L1V) | TOPS CMS-1500 Health Insurance Claims, 500/Pack (TOP 50126RV) | ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC) | TFP UB-04 CMS-1450 Health Insurance Claims, 2500/Carton (UB04LC) |
|---|---|---|---|---|---|
Your product ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1) Price is $83.79 |  Price is $24.79 |  Price is $50.59 |  Price is $89.59 |  Price is $89.29 | |
| Reviews | |||||
| Delivery Information | Free delivery by Tue, Sep 16 | Delivery by Tue, Sep 16 | Free delivery by Tue, Sep 16 | Free delivery by Tue, Sep 23 | Free delivery by Tue, Sep 23 |
| Available in my store | No | Yes | No | No | No |
| Medical Form Type | Health Insurance Claims | Health Insurance Claims | Health Insurance Claims | Health Insurance Claims | Health Insurance Claims |
| Medical Form Pack Size | 1000 | 100 | 500 | 2500 | 2500 |
| True Color | White / Red | White / Red | White / Red | White / Red | White / Red |
| Length in Inches | 11 | 11 | 11 | 11 | Data not available |
| Width in Inches | 8.5 | 8.5 | 8.5 | 8.5 | Data not available |
| Print Type | Laser | Data not available | Laser | Laser | Laser |
| Number of Parts | 1 | 1 | 1 | 1 | 1 |
| Acid Free | Acid Free | Data not available | Data not available | Acid Free | Data not available |
| Pack Qty | 1000 | 100 | 1 | 2500 | 250 |
| Next Day Delivery | Yes | Yes | Yes | Data not available | Data not available |
| Add To Cart | Add To Cart | Add To Cart | Add To Cart |
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Price is $17.39
Unit of measure 50/Pack
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