

📑 Claim your edge with Jaxplaza’s ultimate insurance form pack!
Jaxplaza Insurance Claim Form ver 02/12 offers 2,500 high-quality, single-part sheets designed for laser and inkjet printers. Featuring OCR-scannable red ink and accommodating National Provider Identifier (NPI) reporting, this government-approved CMS-1500 form ensures smooth, jam-free processing for federal and private insurance claims.
| Manufacturer | Jaxplaza |
| Brand | Jaxplaza |
| Item Weight | 27 pounds |
| Product Dimensions | 8 x 12 x 11 inches |
| Item model number | CMS1500-2500-02-12 |
| Is Discontinued By Manufacturer | No |
| Color | White |
| Material Type | Paper |
| Sheet Size | Letter |
| Paper Weight | 22 |
| Paper Finish | Smooth |
| Manufacturer Part Number | CMS1500-2500-02-12 |
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