Claim Form CMS-1500 or HCFA-1500 is a 1-part form; it has already been authorized by Medicare and Medicaid Services to meet all insurance claim requirements. This is a standard form.
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Medicaid Claim Form Laser 1 Part
From:
$45.00
Weight
12 lbs
Dimensions
1 × 2 × 3 in
Quantity
500, 1000
Paper Type
1 part (white only)
Jan 28, 2013
Carol B.
Jan 28, 2013
Cherie
GREAT!! THANK YOU! Easy, quick and painless.
Jan 28, 2013
Anonymous Customer
Jan 28, 2013
Jerry W.
Very easy to work with.
Thank you
Jan 27, 2013
gary s.
Jan 27, 2013
Michelle
Thank you! My uploaded image (pdf) had two pages (I think). Please only print page one, as the other one is blank. This was a word doc glitch I couldn't overcome.
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