![cms1500](https://cdn.cocodoc.com/cocodoc-form/png/cms1500-x-01.png)
cms 1500 claim form
Health insurance claim form. note: claims must be submittedwithin 3 months of being incurred to be eligible forreimbursement. 1. insured's name (last name, first name, middle initial). 8.patient's name (last name, first name, middle initial). 9....
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