NEW CMS 1500 Claim Forms - HCFA (Version 02/12) (250 Sheets)
</br></br>
<div style="text-align:left">
<b>[Product Information]</b><br>
<ul>
<li>1-Part Laser Form CMS-1500 printed in red ink</li>
<li>New Version 02/12 (APPROVED OMB-0938-1197)</li>
<li>Medicare will begin accepting this Version 02/12 on 1/06/14. Starting 04/04/14 Medicare will accept this Version 02/12 only.</li>
<li>Size: 8-1/2" X 11"; Weight: 24# Paper</li>
<li>For Laser and Inkjet Printers</li>
</ul>
</div>
</br></br></br></br></br></br></br></br></br></br>

</br></br></br></br></br></br></br></br></br></br>
<img src='http://ecx.images-amazon.com/images/I/51oUX3gUf%2BL.jpg'></br>
<img src='http://ecx.images-amazon.com/images/I/51aNVxXlY4L.jpg'></br>
<img src='http://ecx.images-amazon.com/images/I/51%2Bfy4wdKqL.jpg'></br>
<img src='http://ecx.images-amazon.com/images/I/2185nLmHh-L.jpg'></br>
<img src='http://ecx.images-amazon.com/images/I/51oUX3gUf%2BL.jpg'></br>