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Claim Forms CMS/UB04/ADA
> CMS-1500 Form (New 02/12 version), Unit Set, 8.5 x 11
Laser CMS-1500 Form (New 02/12 version)
CMS-1500 Form (New 02/12 version), Unit Set, 8.5 x 11
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Price
Your Price:
$39.95
Availability:
In Stock.
Part Number:
WEB-WCMS1500U2-2012
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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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Unit Set- 8-1/2" x 11" (glued edge at top of 8-1/2" side)
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 $9.50/box in the 48 states (not including Alaska, Hawaii & Puerto Rico)
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