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ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2 x 11, Box of 1,000 (CMS12LC1)ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2 x 11, Box of 1,000 (CMS12LC1)
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1)
Item #: 901-CMS12LC1
Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$58.99
Per carton
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2 x 11, Pack of 500 (CMS12LC500)ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2 x 11, Pack of 500 (CMS12LC500)
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500)
Item #: 901-CMS12LC500
Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$35.99
Per pack
ComplyRight 1-Part Continuous CMS-1500 Health Insurance Claim Form (02/12), 2,500/Pack (CMS121)ComplyRight 1-Part Continuous CMS-1500 Health Insurance Claim Form (02/12), 2,500/Pack (CMS121)
TFP UB-04 CMS-1450 1-Part Health Insurance Claims, 2500/Carton (UB04LC)
TFP UB-04 CMS-1450 1-Part Health Insurance Claims, 2500/Carton (UB04LC)
Item #: 901-519727
Designed for hospitals to file a medical claim with the patient's insurance carrier
One-part health insurance forms
Contains 2500 forms per carton
$92.99
Per carton
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), 2-Part Continuous, White/Yellow, 1,000/Bo
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), 2-Part Continuous, White/White, 1,000/Box
ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), 2-Part Continuous, White/White, 1,000/Box
Item #: 901-CMS12W2
Printed with OCR "dropout" red ink on 20# paper, as per government regulations
1,000 per case
Form is "8.5x11"
$86.99
Per box

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