CMS-1500 02/12 version supports ICD-10 diagnosis codes.
| Item No. | Description | No. of forms | 1 box | 2-4 boxes | 5 or more boxes |
|---|---|---|---|---|---|
| CMS12L | Single sheet for laser and ink jet printers. | 2500 | $99.95 each | $97.95 each | $95.95 each |
CMS-1500 Claim Form
CMS-1500 02/12 version supports ICD-10 diagnosis codes.
| Item No. | Description | No. of forms | 1 box | 2-4 boxes | 5 or more boxes |
|---|---|---|---|---|---|
| CMS12L | Single sheet for laser and ink jet printers. | 2500 | $99.95 each | $97.95 each | $95.95 each |