60158X, ADA 2012 2 Part Continuous Insurance Claim Form

60158X, ADA 2012 2 Part Continuous Insurance Claim Form
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ADA 2012 Continuous Insurance Claim Form, Item # 60158X

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$46 - Item # 60158X, ADA 2012 2 Part Continuous Insurance Claim Form
AMA and CMS approved claim form for your continuous printer, accepts updated CDT-2007 billing codes.  Single sheet format, 2-part continuous form on 8-1/2" x 11" 20lb white, 15lb yellow bond stock with convenient fold lines for easy placement of address in envelope window.
 
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