---
product_id: 8991090
title: "Jaxplaza Insurance Claim Form ver 02/12, White, 2,500 Sheets (CMS-1500)"
brand: "formsandchecks"
price: "¥55524"
currency: JPY
in_stock: true
reviews_count: 7
category: "Formsandchecks"
url: https://www.desertcart.jp/products/8991090-jaxplaza-insurance-claim-form-ver-02-12-white-2-500
store_origin: JP
region: Japan
---

# Government-approved CMS-1500 2,500 jam-free sheets Laser & Inkjet compatible Jaxplaza Insurance Claim Form ver 02/12, White, 2,500 Sheets (CMS-1500)

**Brand:** formsandchecks
**Price:** ¥55524
**Availability:** ✅ In Stock

## Summary

> 📑 Claim your edge with Jaxplaza’s trusted, jam-free insurance forms!

## Quick Answers

- **What is this?** Jaxplaza Insurance Claim Form ver 02/12, White, 2,500 Sheets (CMS-1500) by formsandchecks
- **How much does it cost?** ¥55524 with free shipping
- **Is it available?** Yes, in stock and ready to ship
- **Where can I buy it?** [www.desertcart.jp](https://www.desertcart.jp/products/8991090-jaxplaza-insurance-claim-form-ver-02-12-white-2-500)

## Best For

- formsandchecks enthusiasts

## Why This Product

- Trusted formsandchecks brand quality
- Free international shipping included
- Worldwide delivery with tracking
- 15-day hassle-free returns

## Key Features

- • **Bulk Efficiency:** 2,500 single sheets to power through high-volume billing without pause
- • **Jam-Free Workflow:** Engineered smooth paper finish to keep your office running without frustrating paper jams
- • **OCR-Ready Precision:** Printed in OCR-scannable red ink for flawless automated processing
- • **Compliance Guaranteed:** Fully compliant with federal and private insurer standards, including NPI reporting
- • **Seamless Compatibility:** Optimized for both laser and inkjet printers ensuring crisp, clear claims every time

## Overview

Jaxplaza Insurance Claim Form ver 02/12 offers 2,500 high-quality, government-approved CMS-1500 sheets designed for laser and inkjet printers. Featuring OCR-scannable red ink and smooth, jam-resistant paper, these forms streamline insurance billing with full compliance for federal and private programs.

## Description

1 Part Laser (2,500 Single Sheets - for Laser/Inkjet Printers). 02/12 Version. Factory Sealed

Review: Great Product - This item was just as expected. Great price. We use these in large quantities for our paper billing in the office, and this was perfect. Great service, fast delivery. Will order from again
Review: Works great - Product is exactly like the ones I buy at my retailer but for half the price....great product and have had no problems with them. Will continue buying them till new ones are a requirement.

## Features

- Version 02/12, 2,500 Sheets
- Accommodates reporting of the National Provider Identifier (NPI) number
- Jam-free performance Paper are printed in OCR-scannable red ink
- All forms are government approved CMS-1500 to serve federal programs and private insurers as a universal claim form.
- Approved OMB 0938-1197

## Technical Specifications

| Specification | Value |
|---------------|-------|
| ASIN | B002VR6JZ0 |
| Best Sellers Rank | #567,680 in Office Products ( See Top 100 in Office Products ) #61 in Health Insurance Claim Forms |
| Brand | Formsandchecks |
| Color | White |
| Customer Reviews | 4.8 4.8 out of 5 stars (10) |
| Date First Available | November 5, 2009 |
| Is Discontinued By Manufacturer | No |
| Item Weight | 27 pounds |
| Item model number | CMS1500-2500-02-12 |
| Manufacturer | Jaxplaza |
| Manufacturer Part Number | CMS1500-2500-02-12 |
| Material Type | Paper |
| Paper Finish | Smooth |
| Paper Weight | 22 |
| Product Dimensions | 8 x 12 x 11 inches |
| Sheet Size | Letter |

## Product Details

- **Brand:** Formsandchecks
- **Color:** White
- **Item Weight:** 27 Pounds
- **Paper Finish:** Smooth
- **Sheet Size:** Letter

## Images

![Jaxplaza Insurance Claim Form ver 02/12, White, 2,500 Sheets (CMS-1500) - Image 1](https://m.media-amazon.com/images/I/912Hbvfo-fL.jpg)

## Customer Reviews

### ⭐⭐⭐⭐⭐ Great Product
*by G***C on June 7, 2013*

This item was just as expected. Great price. We use these in large quantities for our paper billing in the office, and this was perfect. Great service, fast delivery. Will order from again

### ⭐⭐⭐⭐ Works great
*by R***O on January 2, 2014*

Product is exactly like the ones I buy at my retailer but for half the price....great product and have had no problems with them. Will continue buying them till new ones are a requirement.

### ⭐⭐⭐⭐⭐ Just what's needed...
*by R***M on May 14, 2013*

At least for my office! Thanks! A good product at a good price and will probably come back for more when needed.

## Frequently Bought Together

- Jaxplaza Insurance Claim Form ver 02/12, White, 2,500 Sheets (CMS-1500)
- BIC Wite-Out Brand EZ Correct Correction Tape, 39.3 Feet, 10-Count Pack of White Correction, Tear-Resistant Tape Office or School Supplies
- SHARPIE Permanent Markers, Fine Point, Black, 40 Count

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**Shop now:** [https://www.desertcart.jp/products/8991090-jaxplaza-insurance-claim-form-ver-02-12-white-2-500](https://www.desertcart.jp/products/8991090-jaxplaza-insurance-claim-form-ver-02-12-white-2-500)

---

*Product available on Desertcart Japan*
*Store origin: JP*
*Last updated: 2026-01-22*