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Health Insurance Claim Forms

CMS 1500
Env
UB-04
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Health Insurance Claim Forms, CMS 1500

Form Number

Description

CMS1		1 PT CMS 1500 CONT. 08/05
CMS1B		1 PART CMS 08/05 W/BLOWN ON LABEL
CMS2		2 PT CMS 1500 CONT. 08/05
CMS2B		2 PT CMS WITH B/0 LABEL 08/05
CMS3		3 PT CMS 1500 CONT. 08/05
CMSLC		LASER CMS1500 CUT SHEET (08/05)
CMSS		SNAPOUT CMS 1500 2 PT 08/05

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