Centers for Medicare and Medicaid Services Claim Forms

Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. 02/12 version. Printed front and back in red OCR ink for scanning. For Laser Printers. Form Size: 8 1/2 x 11 Forms Per Page: 1 Form Quantity: 500 Principal Headings: 1500 Health Insurance Claim Form.