ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500)
$48.09
1
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 500 (CMS12LC500)
Item #: 125556Model #: CMS12LC500
$48.09
500/pack
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 $11.99, Regular price was $13.89, You save 13%
Unit of measure 3/Pack Price per unit $0.45/Fl Oz
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 $91.39
Unit of measure 250/Pack
Free delivery by Wed, Oct 15
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 $96.49
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 $26.59
Unit of measure 75/Pack Price per unit $0.36/Wipe
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 $45.69
Unit of measure 500/Pack
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 $43.09
Unit of measure 100/Box
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 $20.49
Unit of measure 3/Pack
Delivery by Tue, Oct 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 $43.19
Unit of measure 500/Ream
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 $31.00
Unit of measure 90/Box
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 $33.39
Unit of measure 12/Box
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 $6.09
Next-Day Delivery by tomorrow
30-min 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 $10.49
Unit of measure 100/Box Price per unit $0.10/Envelope
Next-Day Delivery by tomorrow
30-min 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
Fujifilm INSTAX Mini 12 Instant Print Camera, Clay White (16806274)Â is In-store only
Price is $93.99
See alternate delivery items
30-min pickup
2026 Global Printed Products 5-Cover 8.5" x 11" Calendar Year Monthly Standard Planner, Paperboard Cover (NRY26-8511M-F)Â is New at Staples
Price is $13.29
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 $59.79
Unit of measure 125/Pack
Free delivery by Wed, Oct 15
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 $10.39
Unit of measure 3/Pack Price per unit $3.46/Refill
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 $38.59
Unit of measure 25/Box
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
2026 Blue Sky Baccara Dark Floral 8" x 10" Monthly Planner, Plastic Cover (110216-26)Â is New at Staples
Price is $15.39
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 $109.99, Regular price was $134.99, You save 18%
Free Next-Day eligible by tomorrow
30-min pickup
1
1
2
Compare similar items
| Attributes | ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500) | ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 250 (CMS12LC250) | TOPS CMS-1500 Health Insurance Claims, 500/Pack (TOP 50126RV) | Adams CMS-1500 Health Insurance Claims, 100/Pack (CMS1500L1V) | ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250) |
|---|---|---|---|---|---|
Your product ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500) Price is $48.09 |  Price is $26.99 |  Price is $51.89 |  Price is $24.79 |  Price is $34.09 | |
| Reviews | |||||
| Delivery Information | Free delivery by Mon, Oct 13 | Delivery by Mon, Oct 13 | Free Next-Day eligible by tomorrow | Next-Day Delivery by tomorrow | Next-Day Delivery by tomorrow |
| Available in my store | No | No | No | Yes | No |
| Medical Form Pack Size | 500 | 250 | 500 | 100 | 250 |
| 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 / Red | White / Red | White |
| Length in Inches | 11 | 11 | 11 | 11 | 11 |
| Width in Inches | 8.5 | 8.5 | 8.5 | 8.5 | 8.5 |
| Print Type | Laser | Laser | Laser | Data not available | Laser |
| Number of Parts | 1 | 1 | 1 | 1 | Data not available |
| Acid Free | Acid Free | Acid Free | Data not available | Data not available | Data not available |
| Pack Qty | 500 | 250 | 1 | 100 | Data not available |
| Add To Cart | Add To Cart | Add To Cart | Add To Cart |
Featured Products
Price is $26.49
Unit of measure 50/Pack
Delivery by Fri, Oct 10
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 Wed, Oct 15
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 $12.69
Delivery by Wed, Oct 15
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 Wed, Oct 15
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 50/Pack
Delivery by Fri, Oct 10
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 $166.39
Free delivery by Wed, Oct 15
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
Unit of measure 10/Pack
Delivery by Fri, Oct 10
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 $52.19
Unit of measure 50/Pack
Free delivery by Wed, Oct 15
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 $26.49
Unit of measure 50/Pack
Delivery by Fri, Oct 10
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 $59.59
Free delivery by Wed, Oct 15
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 Wed, Oct 15
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 Fri, Oct 10
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 $16.49
Unit of measure 100/Pack
Delivery by Fri, Oct 10
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 Wed, Oct 15
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
Free delivery by Wed, Oct 15
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