I need a CMS 1500 Form (used by healthcare providers to submit claims to insurance companies) developed in Windows .Net 1.X using C#.
The form must look and print exactly like the real form. (Sample available here, but real form is in red color:
[url removed, login to view])
The form should be populated from variables / paramteres, and should be printed with or without the form. In other words, I may want the form to print on a pre-printed CMS 1500 form or have both the form and the data print out together.
I will be using the source code to interface with another application that will provide the data variables to populate the form.
You can also download a trial version of similar software at [url removed, login to view] (This is not my software, please respect their license agreement when using).
8 freelancers are bidding on average $556 for this job
I don't know the specific form but have done work of this kind before. My bid is allowing for an expectation of some analysis needed but could be reduced post-work.