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Home > Claim Forms CMS/UB04/ADA  >  CMS-1500 Form (New 02/12 version), 2 Part Continuous, 1000/bx
CMS-1500 Form (New 02/12 version), 2 Part Continuous, 1000/bx
Laser CMS-1500 Form (New 02/12 version)

CMS-1500 Form (New 02/12 version), 2 Part Continuous, 1000/bx

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1 Review(s)
5
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Your Price:$39.95
In Stock.
Part Number:WEB-WCMS-1500-212
Quantity Pricing
Quantity
Price
  • 5 - 9
  • $38.95
  • 10 - 19
  • $37.95
  • 20+
  • $37.50
2 Part Continuous- 9.5 x 11 for pin fed printers
Box quantity: 1000

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 $10.00/box in the 48 states (not including Alaska, Hawaii & Puerto Rico)
5 Stars
Doctor of Chiropractic
Perfect ordering, delivery and product and price!
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Reviewed by:  from Maine. on 12/23/2015
5/5

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