Tops Business Forms CMS-1500 Health Insurance Claim Forms - CMS-1500 Benefits Claim Forms - 50135R

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$53.99
SKU 50135R
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Product Information: CMS-1500 Benefits Claim Forms

Manufacturer Part # 50135R

Description

  • The right form to submit to Medicare, Medicaid or private insurance
  • Format (02/12 version) approved by CMS, AMA and NUCC
  • Printed front and back in red OCR ink for scanning
Color White
HPIS Code 999_140_20_0
Latex Free No
UNSPSC 14111806

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