CMS 1500


Document Information
  How to complete a fillable form.
Title CMS 1500
Description

Used by providers to be reimbursed for services. It is NOT for use by injured workers to submit a claim to L&I.

Document number F245-127-000
How to get this document
Alt Language(s)
Valid dates 02/2012
Contact information Claims for Job Injuries, Employer Services
Websites For Medical Provider

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