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Claim Forms CMS/UB04/ADA
> 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
1 Review(s)
5
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Price
Your Price:
$39.95
Availability:
In Stock.
Part Number:
WEB-WCMS-1500-212
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
Customer Reviews
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)
Doctor of Chiropractic
Perfect ordering, delivery and product and price!
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Reviewed by:
Dr. Richard Horowitz
from Maine.
on 12/23/2015
5
/
5
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