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CMS 1500 Form for Filing Physician and Supplier Medicare Claims Publisher: Health and Human Services Dept. Description: The new Form CMS-1500 (formerly HCFA 1500) is the basic form prescribed by the U.S. Government's Centers for Medicare & Medicaid Services (CMS) for filing physician and supplier Medicare claims. CMS 1500 is used by numerous Federal agencies and programs, including: Railroad Retirement Board (RRB-1500); Office of Worker Compensation Programs (OWCP-1500) as well as Black Lung Federal Employees' Compensation Act (FECA), and Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). Sign up to receive Forms email updates. Health Insurance Claim Form, CMS-1500 Claim Form (Single Sheet) Publisher: Health and Human Services Dept., Centers for Medicare and Medicaid Services Description: $26/Package of 100. Price: $26.00 Health Insurance Claim Form (CMS-1500) (2 Part Snapout) Publisher: Health and Human Services Dept., Centers for Medicare and Medicaid Services Description: $29/Package of 100. Price: $29.00 Health Insurance Claim Form, CMS-1500 or HCFA 1500 Claim Form (2 part Continuation) Publisher: Health and Human Services Dept., Centers for Medicare and Medicaid Services Description: $78/Carton of 1,400. Price: $78.00 Health Insurance Claim Form (CMS-1500) (1-Part Continuation) Publisher: Health and Human Services Dept., Centers for Medicare and Medicaid Services Description: $97/Carton of 2,500. Price: $97.00 [ Top ]
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