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Claim Forms CMS/UB04/ADA
> CMS-1500 Form (New 02/12 version), 1 Part Continuous, 2500/box
Laser CMS-1500 Form (New 02/12 version)
CMS-1500 Form (New 02/12 version), 1 Part Continuous, 2500/box
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Price
Your Price:
$39.95
Availability:
In Stock.
Part Number:
WEB-WCMS-1500-112
Quantity
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Quantity Pricing
Quantity
Price
5 - 9
$38.95
10 - 19
$37.95
20+
$37.50
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Description
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1 Part Continuous- 9.5" x 11" for pinfed printers
Box quantity: 2500
Printed in red, OCR scannable ink in compliance with government standards
Medicare approved for billing Medicare Part A claims
Shipping for all claim forms is $9.50/box in the 48 states (not including Alaska, Hawaii & Puerto Rico)
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