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Page 23 of hcfa cms 1500 health insurance business forms

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Custom Service Stations Sales Books 3 Parts, 1 Color Printing, 3 3/8 x 5 1/8, 1000/Pack
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Custom Service Stations Sales Books 3 Parts, 1 Color Printing, 3 3/8" x 5 1/8", 1000/Pack
Item #: 901-D513
Item #: 901-D513
Pricing details
Take complete orders: Preprinted areas simplify write-ups of customer information, salesperson, description of items, payment method & more
Get the details: 9 lines enable even the biggest orders to fit on a single page
Stay organized: Bottom copy stays bound in book for a permanent record
$272.99
1 pack
($0.27/EACH)
Save 38%
$167.99
8 pack
($0.17/EACH)
Customize
Earn 272 points
Free delivery
Custom Classic Large Sales Orders, 4 Parts, 1 Color Printing, 8 1/2 X 11 ,500/Pack
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Custom Classic Large Sales Orders, 4 Parts, 1 Color Printing, 8 1/2" X 11" ,500/Pack
Item #: 901-D534
Item #: 901-D534
Pricing details
Extra long, record up to 27 items
Consecutively numbered for easy recordkeeping
Promote your business: Personalization includes your imprint plus choice of typeface and standard logo or custom logo
$523.99
1 pack
($1.05/EACH)
Save 42%
$302.99
8 pack
($0.61/EACH)
Customize
Earn 523 points
Free delivery
Custom Service Orders, Booked, Large Format 3 Parts, 1 Color Printing, 5 1/2 x 8 1/2, 500/Pack
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Custom Service Orders, Booked, Large Format 3 Parts, 1 Color Printing, 5 1/2" x 8 1/2", 500/Pack
Item #: 901-D3213
Item #: 901-D3213
Pricing details
Take complete orders: Preprinted areas simplify write-ups of vehicle make and model, service, parts, time and more
Get the details: 12 lines provide ample room so orders can fit on a single page
Track customer acceptance: Signature line for customer authorization prevents disputes
$319.99
1 pack
($0.64/EACH)
Save 52%
$154.99
8 pack
($0.31/EACH)
Customize
Earn 319 points
Free delivery
Custom Service Orders, Booked, Large Format 2 Parts, 1 Color Printing, 5 1/2 x 8 1/2, 500/Pack
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Custom Service Orders, Booked, Large Format 2 Parts, 1 Color Printing, 5 1/2" x 8 1/2", 500/Pack
Item #: 901-D3212
Item #: 901-D3212
Pricing details
Take complete orders: Preprinted areas simplify write-ups of vehicle make and model, service, parts, time and more
Get the details: 12 lines provide ample room so orders can fit on a single page
Track customer acceptance: Signature line for customer authorization prevents disputes
$251.99
1 pack
($0.50/EACH)
Save 56%
$109.99
8 pack
($0.22/EACH)
Customize
Earn 251 points
Free delivery
Custom Carbonless Itemized Service Slips, 3-1/4 x 5, 100 Sheets per Pad
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Custom Carbonless Itemized Service Slips, 3-1/4" x 5", 100 Sheets per Pad
Item #: 901-QFW1303001
Item #: 901-QFW1303001
Pricing details
Self-duplicating; everything is printed on original and duplicate, including consecutive numbers
Pads are 6-5/8" W x 5" L; detached slips are 3-1/4" W x 5" L
White self-duplicating carbonless stock; pre-printed in black ink
$32.99
10-19 pad
($0.33/EACH)
Save 29%
$23.29
100+ pad
($0.23/EACH)
Customize
Earn 329 points
Free delivery
Bankers Box Liberty Corrugated File Storage Boxes, String & Button Closure, Check & Form Size, White/Blue, 12/Carton (00005)
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Bankers Box Liberty Corrugated File Storage Boxes, String & Button Closure, Check & Form Size, White/Blue, 12/Carton (00005)
Item #: 901-FF5
(29)
Item #: 901-FF5
String & button, basic-duty box perfect for storing checks and forms
White/Blue corrugated storage box with standard assembly is sturdy and lightweight
Check Size, holds 10.75" x 23.27" files
$219.99
Per carton
($18.33/EACH)
Add to cart
Earn 219 points
Free delivery
Medical Arts Press® Single Copy Rx Blanks; Vertical, Alter-Proof
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Medical Arts Press® Single Copy Rx Blanks; Vertical, Alter-Proof
Item #: 901-16034
(11)
Item #: 901-16034
Tamper-resistant Rx pad features 5 security features; meets October 1st 2008 Medicaid Requirements
Alter-proof blue pattern background to ensure there are no erasures or modifications of information
Void Pantograph — the word "void" will appear when photocopied
See details
Free delivery w/ $25+
Custom Progress Notes, 8-1/2 x 11, 60# White Stock, 250 Sheets per PackCustom Progress Notes, 8-1/2 x 11, 60# White Stock, 250 Sheets per Pack
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Custom Progress Notes, 8-1/2" x 11", 60# White Stock, 250 Sheets per Pack
Item #: 901-QFW2058501
Item #: 901-QFW2058501
Pricing details
For use in patient charts and files
8-1/2" W x 11" L
White 60# text stock, pre-printed in black ink
$53.99
1 pack
($0.22/EACH)
Save 13%
$46.99
20+ pack
($0.19/EACH)
Customize
Earn 53 points
Free delivery
ComplyRight™ Expanded Employee Records Folder, Letter Size, Pack of 25 (A5008)ComplyRight™ Expanded Employee Records Folder, Letter Size, Pack of 25 (A5008)
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ComplyRight™ Expanded Employee Records Folder, Letter Size, Pack of 25 (A5008)
Item #: 901-1949181
Item #: 901-1949181
Made in the U.S.A of thick, long-lasting manila card stock
Developed by Employment Attorneys for 100% Compliance
Expanded folder has 1.5” spine which holds more than 100 employee documents
$165.99
1-2 each
Save 19%
$134.99
3+ each
Add to cart
Earn 165 points
Free delivery
ComplyRight Notice of Privacy Practice, 100/Pack (A1349)
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ComplyRight Notice of Privacy Practice, 100/Pack (A1349)
Item #: 901-398024
Item #: 901-398024
Describes how medical information about patients may be used and disclosed
Includes a Tip Sheet in each package that explains the purpose of the form, relevant laws, definitions and do's and don'ts
Size: 8 1/2" x 11"
$35.39
Per pack
Add to cart
Earn 35 points
Free delivery
Posting File, For Forms Up To 7-1/2x9-1/2
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Posting File, For Forms Up To 7-1/2x9-1/2"
Item #: 901-31134
Item #: 901-31134
Large tray features 3 tilt plates for support
Sturdy metal construction with gray baked enamel finish
Holds forms up to 7-1/2Wx9-1/2Hx6"D, up to a 6" stack of forms
$234.29
1-2 each
Save 9%
$213.39
3+ each
Add to cart
Earn 234 points
Free delivery
Custom Pocket-Size Receipts, Booked, 3 Parts, 1 Color Printing, 6 3/4 x 3 3/8, 500/Pack
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Custom Pocket-Size Receipts, Booked, 3 Parts, 1 Color Printing, 6 3/4" x 3 3/8", 500/Pack
Item #: 901-D6913
Item #: 901-D6913
Pricing details
Get the details: Receipt form features preprinted areas that document payment, payment method & account balance
Promote your business: Personalization includes your imprint plus choice of typeface and standard logo
Imprint Color: Black
$292.99
1 pack
($0.59/EACH)
Save 42%
$169.99
8 pack
($0.34/EACH)
Customize
Earn 292 points
Free delivery
Custom Progress Notes, 8-1/4 x 10-3/4, 28# Ivory Stock, 250 Sheets per PackCustom Progress Notes, 8-1/4 x 10-3/4, 28# Ivory Stock, 250 Sheets per Pack
Quick view
Custom Progress Notes, 8-1/4" x 10-3/4", 28# Ivory Stock, 250 Sheets per Pack
Item #: 901-QFW2012101
Item #: 901-QFW2012101
Pricing details
For use in patient charts and files
8-1/4" W x 10-3/4" L
Ivory 28# ledger stock, pre-printed in black ink
$12.79
1 pack
($0.05/EACH)
Save 31%
$8.79
20+ pack
($0.04/EACH)
Customize
Earn 12 points
Free delivery w/ $25+
Custom Classic Large Sales Orders, 2 Parts, 1 Color Printing, 8 1/2 X 11 ,500/Pack
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Custom Classic Large Sales Orders, 2 Parts, 1 Color Printing, 8 1/2" X 11" ,500/Pack
Item #: 901-D532
Item #: 901-D532
Pricing details
Extra long, record up to 27 items
Consecutively numbered for easy recordkeeping
Promote your business: Personalization includes your imprint plus choice of typeface and standard logo or custom logo
$368.99
1 pack
($0.74/EACH)
Save 42%
$212.99
8 pack
($0.43/EACH)
Customize
Earn 368 points
Free delivery
Custom Repair Orders, 3 Parts, 1 Color Printing, 11 X 8 1/2 ,500/Pack
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Custom Repair Orders, 3 Parts, 1 Color Printing, 11" X 8 1/2" ,500/Pack
Item #: 901-D6583A3
Item #: 901-D6583A3
Pricing details
Authorized signature line included
Consecutively numbered for easy recordkeeping
Promote your business: Personalization includes your imprint plus choice of typeface and standard logo or custom logo
$518.99
1 pack
($1.04/EACH)
Save 32%
$352.99
8 pack
($0.71/EACH)
Customize
Earn 518 points
Free delivery
Custom Service Orders, HVAC, Large Format, 3 Parts, 1 Color Printing, 8 1/2 X 11 ,500/Pk
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Custom Service Orders, HVAC, Large Format, 3 Parts, 1 Color Printing, 8 1/2" X 11" ,500/Pk
Item #: 901-D65323
Item #: 901-D65323
Pricing details
EPA checklist ensures you're in compliance with regulations on every job
Last part is durable tag stock, useful for tracking jobs & calculating profit.
Track customer acceptance: Signature line for customer authorization prevents disputes
$518.99
1 pack
($1.04/EACH)
Save 32%
$352.99
8 pack
($0.71/EACH)
Customize
Earn 518 points
Free delivery
Custom Service Orders, HVAC, w/Checklist, Large Format, 3 Parts, 1 Color Printing, 8 1/2 X 11 ,500/Pack
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Custom Service Orders, HVAC, w/Checklist, Large Format, 3 Parts, 1 Color Printing, 8 1/2" X 11" ,500/Pack
Item #: 901-D65313
Item #: 901-D65313
Pricing details
EPA checklist ensures you're in compliance with regulations on every job
Lots of checkboxes & specialized fields let you write up every job quickly & include all the details
Last part is durable tag stock, useful for tracking jobs & calculating profit.
$518.99
1 pack
($1.04/EACH)
Save 32%
$352.99
8 pack
($0.71/EACH)
Customize
Earn 518 points
Free delivery
Custom Garage Repair Orders - Large with Side-Stub and Carbons, 4 Parts, 1 Color Printing, 11 X 8 1/2 ,500/Pack
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Custom Garage Repair Orders - Large with Side-Stub and Carbons, 4 Parts, 1 Color Printing, 11" X 8 1/2" ,500/Pack
Item #: 901-D6544
Item #: 901-D6544
Pricing details
Durable: Last part is durable tag stock
Consecutively numbered for easy recordkeeping
Promote your business: Personalization includes your imprint plus choice of typeface and standard logo or custom logo
$654.99
1 pack
($1.31/EACH)
Save 42%
$378.99
8 pack
($0.76/EACH)
Customize
Earn 654 points
Free delivery
Custom Plumbing Work Orders - Side-Stub, 3 Parts, 1 Color Printing, 11 X 8 1/2 ,500/Pack
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Custom Plumbing Work Orders - Side-Stub, 3 Parts, 1 Color Printing, 11" X 8 1/2" ,500/Pack
Item #: 901-D65353
Item #: 901-D65353
Pricing details
Sturdy: Last part is sturdy manila tag
Authorized signature line included
Consecutively numbered for easy recordkeeping
$518.99
1 pack
($1.04/EACH)
Save 32%
$352.99
8 pack
($0.71/EACH)
Customize
Earn 518 points
Free delivery
Custom Work Orders - Side-Stub with Carbons, 2 Parts, 1 Color Printing, 11 X 8 1/2 ,500/Pack
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Custom Work Orders - Side-Stub with Carbons, 2 Parts, 1 Color Printing, 11" X 8 1/2" ,500/Pack
Item #: 901-D2452
Item #: 901-D2452
Pricing details
Perforated. You can send invoice section with or without detachable materials list, as needed
Durable: Last part is durable tag stock
Customer sign-off section: Includes preprinted section, for customer to sign-off on service/work as acceptable
$481.99
1 pack
($0.96/EACH)
Save 42%
$278.99
8 pack
($0.56/EACH)
Customize
Earn 481 points
Free delivery
Custom Plumbing Invoice - Invoice with Checklist, 3 Parts, 1 Color Printing, 8 1/2 X 11 ,500/Pack
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Custom Plumbing Invoice - Invoice with Checklist, 3 Parts, 1 Color Printing, 8 1/2" X 11" ,500/Pack
Item #: 901-D65403
Item #: 901-D65403
Pricing details
Simplify: Combined work order and invoice covers everything: work write-ups, invoicing and cost documentation
Get the details: Lots of checkboxes and specialized fields let you write up every job quickly and accurately
Track customer acceptance: Signature line for customer authorization prevents disputes
$518.99
1 pack
($1.04/EACH)
Save 32%
$352.99
8 pack
($0.71/EACH)
Customize
Earn 518 points
Free delivery
Custom Service Orders, HVAC, w/Checklist, Large Format, 4 Parts, 1 Color Printing, 8 1/2 X 11 ,500/Pack
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Custom Service Orders, HVAC, w/Checklist, Large Format, 4 Parts, 1 Color Printing, 8 1/2" X 11" ,500/Pack
Item #: 901-D65014
Item #: 901-D65014
Pricing details
EPA checklist ensures you're in compliance with regulations on every job
Lots of checkboxes & specialized fields let you write up every job quickly & include all the details
Last part is durable tag stock, useful for tracking jobs & calculating profit.
$650.99
1 pack
($1.30/EACH)
Save 42%
$376.99
8 pack
($0.75/EACH)
Customize
Earn 650 points
Free delivery
Custom HVAC Service Orders - Side-Stub, 3 Parts, 1 Color Printing, 11 X 8 1/2 ,500/Pack
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Custom HVAC Service Orders - Side-Stub, 3 Parts, 1 Color Printing, 11" X 8 1/2" ,500/Pack
Item #: 901-D65343
Item #: 901-D65343
Pricing details
Includes Environmental check list
Authorized signature line included
Sturdy: Last part is sturdy manila tag
$518.99
1 pack
($1.04/EACH)
Save 32%
$352.99
8 pack
($0.71/EACH)
Customize
Earn 518 points
Free delivery
Custom Contractor Invoice - Itemized Invoice for Large Jobs, 3 Parts, 1 Color Printing, 8 1/2 X 11 ,500/Pack
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Custom Contractor Invoice - Itemized Invoice for Large Jobs, 3 Parts, 1 Color Printing, 8 1/2" X 11" ,500/Pack
Item #: 901-D2093
Item #: 901-D2093
Pricing details
Consecutively numbered for easy recordkeeping
Promote your business: Personalization includes your imprint plus choice of typeface and standard logo or custom logo
Imprint Color: Black
$499.99
1 pack
($1.00/EACH)
Save 42%
$288.99
8 pack
($0.58/EACH)
Customize
Earn 499 points
Free delivery
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