CMS 1500 Medicare
Laser Claim Forms Personalized
CMS
1500 Forms Single
Sheets for Laser Printer, Jet Ink Printers or Typewriter
Where you get all the News about The NEW CMS 1500 Medicare Forms
Claim Forms (08/05)
Personalized
27: Accept Assignment
33: Billing Provider Info.Note:33a is for national provider no. Note: 33b is for local provider no's.
CMS 1500 Medicare Claim Forms
Only
at DRS you can have any other box personalized to reduce the time it takes
to fill out the CMS form.
Fill the order form and fax the information to us at 1-631-696-4901
CMS 1500 Medicare Laser Forms
Personalized
$69.00
CMS 1500 Medicare Laser Forms
Personalized
$65.00 per 1000
Custom
information above box 25.
Fax in a CMS form with the imprint information you require.
If you do not have a CMS form to use, Call us at 1-866-696-0800. We will
fax one to you.
DRS will advise you the additional charges for your approval before we
start production.
For Fax or Mail
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"Filling out the new qualifiers, NPI numbers and
Boxes 33, 32,17 and 24 of the
New CMS Medicare 1500 forms "
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