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Get The Updated 1500 Claim Form 2013-2024

● Deleted “EMPLOYER’S NAME OR SCHOOL.” Changed title to “OTHER CLAIM ID (Designated by NUCC).” ● Added dotted line in the left-hand side of the field to accommodate a 2-byte qualifier. 16 Form Changes – 14 ● Changed title to “DATE OF CURRENT ILLNESS, INJURY, or PREGNANCY (LMP).” ● Removed the arrow and text in the right-hand side of the field. ● Added “QUAL.” with a dotted line to accommodate a 3-byte qualifier. 17 Form Changes – 15 ● Changed title fro.

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