Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR ink for scanning. Laser Printer Compatible. Form Type Details: CMS-1500; Dated/Undated: Undated; Forms Per Page: 1; Form Size: 8.5 x 11.
TOP50126RV
TOP-50126RV