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60153X, CMS-1500 1 Part Continuous Insurance Claim Form, Version 02/12

60153X, CMS-1500 1 Part Continuous Insurance Claim Form, Version 02/12
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CMS-1500 Continuous Sheet Insurance Claim Form - Item # 60153X

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Your Price: $169.00

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Item # 60153X, CMS-1500 1 Part Continuous Sheet Insurance Claim Form, Version 0805
AMA and CMS approved claim form for your continuous printer.  Single sheet format, 1-part form on 8-1/2" x 11" 20# white bond stock, printed in OCR red ink. Accommodates NPI numbers as mandated by HIPAA. Accepted by most insurance companies.
 
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