CMS 02/12 Insurance Claim Form, 2-Part, White/Canary, 9 1/2 x 11, 1000 Forms

Product ID:

415003

(0)
$154.58 / CT
$148.28 / CT
when buying 4+
Price Quote
when buying in bulk
List Price: $185.61
You Save: -$31.03 (-17%)
Price: $154.58 / CT and get $3.15 back in Rewards
Qty:
  Free Shipping
  Estimated delivery time 1-3 business days
  • Expedite Medicare, Medicaid or private insurance claims processing.
  • Forms meet all Federal regulations.
  • Formerly known as HCFA-1500 forms.

Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms.

Includes 1,000 forms.

Specifications

Copy Paper Color Canary
Copy Types Carbonless Duplicate
Form Quantity 1000
Forms Per Page 1
Global Product Type Forms-Insurance
Paper Color White, Canary
Paper Stock 20 lb.
Sheet Size 9 1/2 x 11
Special Features Centers for Medicare and Medicaid Services (CMS) Forms
Form Size 9 1/2 x 11
Footnote 1 Two-part continuous feed, white/canary. Carbonless
Sign Up for Special Savings!
Follow Us