ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC)
$91.89
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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 Claims, 2500/Pack (CMS12LC)
Item #: 125557Model #: CMS12LC
Final price is $91.89
2500/pack
Free Returns
Online. In store. Always free.
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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 $146.69
Free delivery by Tue, Oct 14
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Over 30
Price is $91.59
Unit of measure 2500/Carton
Free delivery by Tue, Oct 14
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Over 30
Price is $88.39
Unit of measure 500/Box
Free delivery by Tue, Oct 07
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Over 30
Price is $18.99
Unit of measure 1000/Pack Price per unit $0.02/Paper Clip
Delivery by Tue, Oct 07
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Over 30
Price is $10.99
Unit of measure 250/Box
Delivery by Tue, Oct 14
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Over 30
Price is $73.99
Free delivery by Tue, Oct 07
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Over 30
Price is $56.89
Unit of measure 300/Pack Price per unit $0.19/Cup
Free delivery by Tue, Oct 07
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Over 30
Price is $28.49
Unit of measure 500/Pack
Delivery by Tue, Oct 14
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Over 30
Price is $50.99
Free delivery by Thu, Oct 09
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Over 30
Price is $49.79
Unit of measure 20/Pack
Free delivery by Tue, Oct 07
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Over 30
Price is $58.69
Unit of measure 100/Box
Free delivery by Tue, Oct 07
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Over 30
Price is $29.29
Delivery by Tue, Oct 07
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2026 AT-A-GLANCE 32" x 48" Yearly Dry Erase Wall Calendar, Reversible, White/Green (PM310-28-26)Â is New at Staples
Price is $40.99
Free delivery by Tue, Oct 07
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Over 30
Price is $5.59
Delivery by Tue, Oct 07
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Over 30
Price is $21.99
Unit of measure Roll
Delivery by Tue, Oct 07
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Over 30
Price is $15.39
Unit of measure 4/Pack Price per unit $3.85/Moistener
Delivery by Tue, Oct 07
30-min pickup
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Over 30
Price is $30.99
Unit of measure 500/Box Price per unit $0.06/Envelope
Delivery by Tue, Oct 07
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Over 30
Price is $22.49
Unit of measure 100/Box Price per unit $0.22/Envelope
Delivery by Tue, Oct 07
30-min pickup
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Over 30
Price is $37.89
Unit of measure 24/Pack
Free delivery by Thu, Oct 09
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Price is $90.09
Unit of measure 12/Carton Price per unit $7.51/CT
Free delivery by Tue, Oct 07
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Compare similar items
| Attributes | ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC) | ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1) | TFP UB-04 CMS-1450 Health Insurance Claims, 2500/Carton (UB04LC) | ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500) | ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250) |
|---|---|---|---|---|---|
Your product ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC) Price is $91.89 |  Price is $85.89 |  Price is $91.59 |  Price is $48.09 |  Price is $34.09 | |
| Reviews | |||||
| Delivery Information | Free delivery by Tue, Oct 14 | Free delivery by Tue, Oct 07 | Free delivery by Tue, Oct 14 | Free delivery by Tue, Oct 14 | Delivery by Tue, Oct 07 |
| Available in my store | No | No | No | No | No |
| Medical Form Pack Size | 2500 | 1000 | 2500 | 500 | 250 |
| Medical Form Type | Health Insurance Claims | Health Insurance Claims | Health Insurance Claims | Health Insurance Claims | Health Insurance Claims |
| Length in Inches | 11 | 11 | Data not available | 11 | 11 |
| Width in Inches | 8.5 | 8.5 | Data not available | 8.5 | 8.5 |
| True Color | White / Red | White / Red | White / Red | White / Red | White |
| Print Type | Laser | Laser | Laser | Laser | Laser |
| Number of Parts | 1 | 1 | 1 | 1 | Data not available |
| Form Size | 8 1 / 2" x 11" | Data not available | Data not available | Data not available | 8 1 / 2" x 11" |
| Pack Qty | 2500 | 1000 | 250 | 500 | Data not available |
| Acid Free | Acid Free | Acid Free | Data not available | Acid Free | Data not available |
| Series or Collection | CMS-1500 | Data not available | UB-04 CMS-1450 | Data not available | CMS-1500 |
| Sustainable Forestry Initiative certified | Yes | Data not available | 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 $20.19
Delivery by Wed, Oct 15
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Over 30
Price is $17.39
Unit of measure 50/Pack
Delivery by Fri, Oct 10
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Price is $21.95
Delivery by Wed, Oct 15
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Over 30
Price is $16.79
Unit of measure 100/Pack
Delivery by Fri, Oct 10
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Over 30
Price is $24.49
Unit of measure 100/Pack
Delivery by Fri, Oct 10
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Over 30
Price is $33.29
Delivery by Wed, Oct 15
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Over 30
Price is $59.59
Free delivery by Wed, Oct 15
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Price is $17.95
Delivery by Wed, Oct 15
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Over 30
Price is $36.19
Unit of measure 50/Box
Free delivery by Wed, Oct 15
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Over 30
Price is $34.49
Unit of measure 50/Pack
Delivery by Fri, Oct 10
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Over 30
Price is $52.19
Unit of measure 50/Pack
Free delivery by Wed, Oct 15
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Over 30
Price is $49.59
Unit of measure 250/Box
Free delivery by Fri, Oct 10
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Over 30
Price is $21.69
Delivery by Wed, Oct 15
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Over 30
Price is $306.69
Free delivery by Wed, Oct 15
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Over 30
Price is $52.59
Unit of measure 50/Pack
Free delivery by Fri, Oct 10
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