ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 250 (CMS12LC250)
$26.29
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
MADE IN AMERICA
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 250 (CMS12LC250)
Item #: 125555Model #: CMS12LC250
Final price is $26.29
250/box
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
Consider this similar product
Customers bought together
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 $10.99
Price per unit $10.99/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 $15.29
Unit of measure Dozen
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 $8.39
Unit of measure Dozen Price per unit $0.70/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 $18.39
Unit of measure Dozen Price per unit $1.53/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 $20.49
Unit of measure 12/Pack Price per unit $0.02/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 $18.39
Unit of measure Dozen Price per unit $1.53/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 $6.99, Regular price was $10.99, You save 36%
Unit of measure Dozen
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 $6.69
Unit of measure 100/Box Price per unit $0.07/Paper Clip
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 $11.99, You save 16%
Unit of measure 12/Pack Price per unit $0.83/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 $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 $10.59, Regular price was $12.69, You save 16%
Unit of measure Dozen Price per unit $0.88/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 $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
Price is $1.00, Regular price was $3.79, You save 73%
Unit of measure 3/Pack Price per unit $0.33/Eraser
Next-Day Delivery by tomorrow
1-hr pickup
1
1
2
3
4
5
6
7
8
9
10
Compare similar items
| Attributes | ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 250 (CMS12LC250) | 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) | ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC) | Adams CMS-1500 Health Insurance Claims, 100/Pack (CMS1500L1V) |
|---|---|---|---|---|---|
Your product ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 250 (CMS12LC250) Price is $26.29 |  Price is $46.89 |  Price is $33.19 |  Price is $89.59 |  Price is $24.79 | |
| Reviews | |||||
| Delivery Information | Delivery by Wed, Jul 02 | Free delivery by Wed, Jul 02 | Next-Day Delivery by tomorrow | Free delivery by Wed, Jul 02 | Next-Day Delivery by tomorrow |
| Available in my store | No | No | No | No | Yes |
| Medical Form Type | Health Insurance Claims | Health Insurance Claims | Health Insurance Claims | Health Insurance Claims | Health Insurance Claims |
| True Color | White / Red | White / Red | White | White / Red | White / Red |
| Medical Form Pack Size | 250 | 500 | 250 | 2500 | 100 |
| Length in Inches | 11 | 11 | 11 | 11 | 11 |
| Number of Parts | 1 | 1 | Data not available | 1 | 1 |
| Width in Inches | 8.5 | 8.5 | 8.5 | 8.5 | 8.5 |
| Print Type | Laser | Laser | Laser | Laser | Data not available |
| Pack Qty | 250 | 500 | Data not available | 2500 | 100 |
| Acid Free | Acid Free | Acid Free | Data not available | Acid Free | Data not available |
| Sustainable Forestry Initiative certified | Yes | Data not available | Data not available | Yes | Data not available |
| Add To Cart | Add To Cart | Add To Cart | Add To Cart |
Featured Products
Price is $21.95
Delivery by Thu, Jul 03
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 Thu, Jul 03
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 Thu, Jul 03
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 Thu, Jul 03
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 Thu, Jul 03
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 $15.59
Unit of measure 10/Pack
Delivery by Mon, Jun 30
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 Thu, Jul 03
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
Delivery by Thu, Jul 03
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 Mon, Jun 30
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 $40.19
Unit of measure 50/Pack
Free delivery by Mon, Jun 30
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 $20.79
Unit of measure 50/Pack
Delivery by Mon, Jun 30
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 $32.09
Unit of measure 100/Pack
Delivery by Mon, Jun 30
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 Mon, Jun 30
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 $49.59
Unit of measure 250/Box
Free delivery by Mon, Jun 30
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 $25.29
Unit of measure 50/Pack
Delivery by Mon, Jun 30
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