1-Part Laser Form CMS-1500 printed in red ink
New Version 02/12 (APPROVED OMB-0938-1197)
Medicare will begin 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'; Weight: 24# Paper
For Laser and Inkjet Printers

Technical Details

Product Details

Product Dimensions

Package Dimensions
Width : 8.5 inch
Height : 1.1 inch
Length : 10.8 inch

Item Weight: 2.65 pounds (View shipping rates and policies)
Shipping Weight: 2.65 pounds (View shipping rates and policies)

ASIN : B003TXA6FO