ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1)
$83.79
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Highlights
View all details
- 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
Final price is $83.79
1000/carton
Free Returns
Online. In store. Always free.
Learn More
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
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 $46.19
Unit of measure 50/Box Price per unit $0.92/Folder
Free Next-Day eligible by tomorrow
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $10.89
Unit of measure Dozen Price per unit $0.91/Highlighter
Next-Day Delivery by tomorrow
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $5.39
Unit of measure Dozen Price per unit $0.45/Pen
Next-Day Delivery by tomorrow
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $26.89
Unit of measure 10/Pack Price per unit $2.69/Correction Tape
Next-Day Delivery by tomorrow
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $11.09
Unit of measure 12/Pack Price per unit $0.92/Pad
Next-Day Delivery by tomorrow
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $9.99
Unit of measure 100/Box Price per unit $0.10/Fastener
Next-Day Delivery by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $13.19
Unit of measure Dozen Price per unit $1.10/Pad
Next-Day Delivery by tomorrow
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $22.49
Unit of measure 24/Pack Price per unit $0.01/Post-it® Note
Next-Day Delivery by tomorrow
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $9.99, Regular price was $13.69, You save 27%
Unit of measure Dozen Price per unit $0.83/Marker
Next-Day Delivery by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $9.99, Regular price was $12.69, You save 21%
Unit of measure Dozen Price per unit $0.83/Marker
Next-Day Delivery by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $17.89
Unit of measure 1000/Pack Price per unit $0.02/Paper Clip
Next-Day Delivery by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $16.99, Regular price was $20.59, You save 17%
Unit of measure 100/Box Price per unit $0.17/File Folder
Next-Day Delivery by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $15.69
Unit of measure Dozen Price per unit $0.01/Post-it® Note
Next-Day Delivery by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $6.99, Regular price was $8.69, You save 19%
Unit of measure 60/Pack Price per unit $0.12/Pen
Next-Day Delivery by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $15.99, Regular price was $19.49, You save 17%
Unit of measure 10/Pack Price per unit $1.60/Correction Tape
Next-Day Delivery by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $16.99, Regular price was $19.59, You save 13%
Unit of measure Dozen Price per unit $1.42/Pad
Next-Day Delivery by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $9.99
Unit of measure 1000/Pack Price per unit $0.01/Paper Clip
Next-Day Delivery by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $27.99, Regular price was $31.69, You save 11%
Unit of measure 250/Box Price per unit $0.11/File Folder
Next-Day Delivery by tomorrow
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $0.50, Regular price was $3.09, You save 83%
Unit of measure 8/Pack Price per unit $0.06/Pencil
Next-Day Delivery by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
Price is $6.99, Regular price was $8.19, You save 14%
Unit of measure 4/Pack Price per unit $1.75/Correction Tape
Next-Day Delivery by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
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) | ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500) | Cosco Privacy Sign-In Sheets, 3-Part, 125 Forms/Pack (074040) | ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 250 (CMS12LC250) |
|---|---|---|---|---|---|
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 $46.89 |  Price is $58.29 |  Price is $26.29 | |
| Reviews | |||||
| Delivery Information | Free Next-Day eligible by tomorrow | Next-Day Delivery by tomorrow | Free delivery by Fri, Jul 11 | Free delivery by Mon, Jul 14 | Delivery by Fri, Jul 11 |
| Available in my store | No | Yes | No | No | No |
| Medical Form Type | Health Insurance Claims | Health Insurance Claims | Health Insurance Claims | Privacy Sign-In Sheets | Health Insurance Claims |
| Medical Form Pack Size | 1000 | 100 | 500 | 125 | 250 |
| Length in Inches | 11 | 11 | 11 | 11.625 | 11 |
| Width in Inches | 8.5 | 8.5 | 8.5 | 8.5 | 8.5 |
| True Color | White / Red | White / Red | White / Red | Green | White / Red |
| Pack Qty | 1000 | 100 | 500 | 125 | 250 |
| Number of Parts | 1 | 1 | 1 | 3 | 1 |
| Print Type | Laser | Data not available | Laser | Digital | Laser |
| Acid Free | Acid Free | Data not available | Acid Free | Data not available | Acid Free |
| Next Day Delivery | Yes | Yes | Data not available | Data not available | Data not available |
| Add To Cart | Add To Cart | Add To Cart | Add To Cart |
Featured Products
Price is $49.99, Regular price was $79.99, You save 37%
Unit of measure 5000/Carton
Free Next-Day eligible by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $63.59
Unit of measure 25/Pack
Free delivery by Wed, Jul 09
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $21.95
Delivery by Mon, Jul 14
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $33.29
Delivery by Mon, Jul 14
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $57.29
Unit of measure 50/Pack
Free delivery by Wed, Jul 09
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $45.79
Unit of measure 100/Pack
Free delivery by Wed, Jul 09
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $21.69
Delivery by Mon, Jul 14
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $36.19
Unit of measure 50/Box
Free delivery by Mon, Jul 14
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $37.89
Unit of measure 50/Pack
Free delivery by Wed, Jul 09
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $21.19
Unit of measure 50/Pack
Delivery by Wed, Jul 09
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $20.19
Delivery by Mon, Jul 14
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $33.89
Delivery by Mon, Jul 14
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $45.79
Unit of measure 50/Pack
Free delivery by Wed, Jul 09
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $45.79
Unit of measure 100/Pack
Free delivery by Wed, Jul 09
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Price is $38.89
Unit of measure 50/Pack
Free delivery by Wed, Jul 09
1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30