|
|
|
CMS 02/12 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms
Required by Centers for Medicaid and Medicare Services (CMS) and by most private healthcare organizations, these forms speed up claims processing and meet all federal guidelines.
| $111.24USD | Retail $171.41 |
Manufacturer:
PARIS CORPORATION
Item:
07116
UPC Code:
090146051066
Condition
New
Extended Warrenty
| 1 Year Extended Warrenty | $22.25 |
$111.24USD
$171.41
$171.41
Availability
In Stock
You may be also interested
Product description
Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms.
Specifications
Copy Paper Color(s)
Canary
Copy Types
Carbonless Duplicate
Footnote 1
Two-part continuous feed white/canary. Carbonless
Form Quantity
1000
Form Size
9 1/2 x 11
Forms Per Page
1
Global Product Type
Forms-Insurance
Paper Color(s)
Canary
Paper Color(s)
White
Paper Stock
20 lb.
Sheet Size
9 1/2 x 11
Special Features
Centers for Medicare and Medicaid Services (CMS) Forms
Special_Benefit_Statement
(02/12) version