Cms 1500 pdf fillable form

DENVER HEALTH MEDICAL PLAN, INC. 1500 Claims Processing Manual DHMP Health Insurance Claim Form CMS-1500 Box 1 ­ Medicare, Medicaid, Group Health Plan or other insurance Information Show the type of health insurance coverage applicable to this claim by checking the appropriate box. When DHMP (Group Health Plan) Box 1a ­ Insured's ID Number Enter the patient's DHMP Health Insurance ID Number This is a required...
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cms 1500 pdf fillable