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60152X, CMS-1500 Laser Insurance Claim Form, Version 02/12 - Padded Forms
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Padded CMS-1500 Laser Insurance Claim Form - Item # 60152X
Choose Options and Quantity
5 Pads of 100 - $33.00
10 Pads of 100 - $47.00
20 Pads of 100 - $86.00
50 Pads of 100 - $206.00
100 Pads of 100 - $402.00
SHIPS FREE, $33 - 5 | $47 - 10 | $86 - 20 | $206 - 50 | $402 – 100
Item # 60152X, CMS-1500 Laser Insurance Claim Form (padded), Version 02/12
AMA and CMS approved claim form.
Insurance claim laser forms, 100 sheets per pad, single sheet format. 8-1/2" x 11" 1-part laser form on 20# white bond stock, printed in OCR red ink. Accommodates NPI numbers as mandated by HIPAA. Accepted by most insurance companies.
IN-STOCK READY TO SHIP
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