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CMS-1500 Health Insurance Claim Forms

for use by Private Practitioners

Accommodates reporting of your NPI - National Provider IdentiÓĀČer.

Designed for processing on high speed OCR scanning equipment.

Printed in special red “dropout” ink on basis weight 20# paper.

Available for laser, continuous form pin-feed and snap-apart sets.

Optional pressure sensitive mailing label available on continuous forms. Label is blown-on, self-imaging.

Laser Cut Sheets Item # CMSLC - Single sheet - 2,500 per case

Continuous Forms Item # CMS1 - 1 part form - 2,500 per case

Item # CMS2 - 2 part form - 1,000 per case Paper sequence: White/Canary

Item # CMSW2 - 2 part form - 1,000 per case Paper sequence: White/White

Item # CMS3 - 3 part form - 1,000 per case Paper sequence: White/Canary/Pink

Continuous Forms with Labels Item # CMS1B - 1 part form - 1,000 per case

Item # CMS2B - 2 part form - 1,000 per case Paper sequence: White/Canary

2-Part Snap-Apart Forms Item # CMSS - 2 part form - 500 per case Paper sequence: White/Canary

See our Form Filler Software for CMS-1500 on page 7

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