1-Part Laser Form CMS-1500 printed in red ink
New Version 02/12 (APPROVED OMB-0938-1197)
Medicare began accepting this Version 02/12 on 1/06/14. Starting 04/04/14 Medicare will accept this Version 02/12 only.
Size: 8-1/2' X 11'
For Laser and Inkjet Printers

Technical Details

Product Details

Product Dimensions

Package Dimensions
Width : 8.7 inch
Height : 2.32 inch
Length : 11.54 inch

Item Weight: 5.2 pounds (View shipping rates and policies)
Shipping Weight: 5.39 pounds (View shipping rates and policies)

ASIN : B00HNDPJMQ