Page 70 of hcfa cms 1500 health insurance business forms
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SaharaCase Folio Case for Microsoft Surface Pro 9, Black (SB-C-MSPX-FL-BK)
Item #: 901-24568327
Item #: 901-24568327
Designed for use with Microsoft Surface Pro 9 - Complement your Microsoft device with this lightweight, form-fitting case featuring an open-button design.
Robust TPU and plastic materials - The triple-hardened construction ensures durability.
Screen protection - This case protects the screen from cracks and scratches.
Tenikle Bendable Suction Cup Camera Mount & Holder, iPhone & Android Compatible, Black (TPRO-01-BLK)
Item #: 901-TPRO01BLK
Item #: 901-TPRO01BLK
The Tenikle tripod is universal for all types of phones and cameras
Easily suction to smooth surfaces where you can bend it, stick it or stand it.
Revamped phone clip with universal fit ensuring a robust design that's built to last while reducing the size to a smaller form
Ergodyne ProFlex 7070 Nitrile Coated Cut-Resistant Gloves, ANSI A7, Heat Resistant, Green, Small, 1 Pair (18042)
Item #: 901-18042ERG
Item #: 901-18042ERG
CUT RESISTANT – ANSI A7 cut protection and level 5 abrasion resistance for heavy-duty protection around extremely sharp materials
HIGH STRENGTH GRIP – Durable sandy nitrile coated palms and thumbs for secure handling on rough surfaces and materials
COMFORTABLE FORM FIT – 13-gauge seamless aramid fiber knit with nitrile coating moves with you for enhanced dexterity and minimal hand fatigue
SaharaCase Case for Sony WF-1000Xm4 Headphones, Black (HP00109)
Item #: 901-24558524
Item #: 901-24558524
Designed for use with Sony WF-1000Xm4 headphones - For a proper fit.
Triple silicone material - Ensures reduced stretching and yellowing and protects against dirt and scratches.
Form-fitting design - Enhances portability and simplifies installation.
Canson XL Series 11" x 14" Sketch Pad, 100 Sheets/Pad, 2/Bundle (MCXC100510923-2)
Item #: 901-24625166
Item #: 901-24625166
RECOMMENDED BY ART TEACHERS—A finely toothed surface used for classwork studies of still life, portraits, figures, perspective, shapes, forms & tonal values
11" x 14"
2 Pads
Vangoddy 13" Laptop Sleeve, Pink/Gray (NBKLEA643)
Item #: 901-2435040
Item #: 901-2435040
Form fitting sleeve with quick top loading access
Slim design allows you to carry the case by itself or in a bag
Water resistant neoprene material offers lightweight design and superior protection
Supertek Polypropylene Beakers, Multicolored, 5/Pack (SKFCH10160)
Item #: 901-24643141
Item #: 901-24643141
Set of 5 of our most popular sized low form polypropylene beakers.
Ages: 7+ years
Easy to read graduations printed in blue
Smiley Face Mighty Brights™ Border, 3" x 36", 12/pkg
Item #: 901-JV59049
Item #: 901-JV59049
Smiley faces borders for prekindergarten to fifth grade students
Twelve individual strips can be linked to form a 36' long border
Dimensions: 36"L x 3"W
Formax AutoSeal Automatic Pressure Sealer, 200 Sheets (FD1606)
Item #: 901-24536076
Item #: 901-24536076
Mid-volume pressure seal with automatic fold settings and full-color touch screen creates a clean and appealing mail-ready piece with ease
Hopper capacity of up to 200 forms and processing speed of up to 100 forms per minute enable an operator to complete daily jobs in no time
Dimensions: 13"H x 17"W x 24"D
PM Company 8 1/2" x 11" Carbonless Paper, 1670/Carton (PMC59102)
Item #: 901-958699
Item #: 901-958699
Save time in handling and inventory
Create forms on an "as needed" basis
Paper size: 8 1/2"(W) x 11"(L)
$215.99
Per carton
Startech 8-Outlet Surge Protector, 12' Cord, Space Gray (8N515S12-POWER-STRIP)
Item #: 901-24622169
Item #: 901-24622169
Surge Protector & Power Strip form factor for versatile use.
Number of Outlets 8 outlets.
Cord Length 12 ft
Quantum Storage Systems 27" x 8" x 21" Bench Racks With Bins, Red, 12/Carton (QBR2721-230-12R)
Item #: 901-688391Q
Item #: 901-688391Q
Bench racks can be joined together to form continuous systems
Bench racks are available in 3 configured choices
Red bins
Startech SDOCK2U33RE USB 3.0/eSATA to 2.5/3.5" SATA HDD/SSD Duplicator Dock
Item #: 901-IM1VW2478IN
Item #: 901-IM1VW2478IN
Interface: Serial ATA/600 drive and USB 3.0/eSATA host
Form factor: External
Dimensions: 2.8"(H) x 5.2"(W) x 5.8"(L)
Top Tab Out Guides, 14-3/4"Wx10"H, Legal, Red Top
Item #: 901-69446
Item #: 901-69446
Out guides put an end to lost folders by clearly marking where folders have been removed from the file
Pre-printed forms indicate which file has been taken, who is using it and the date it was taken
A red OUT tab in the center facilitates quick identification
SaharaCase HybridFlex Arts 13.6" Laptop Case for Apple MacBook Air, Blue Marble (LT00008)
Item #: 901-24587890
Item #: 901-24587890
Made to fit Apple MacBook Air 13.6" M2 and 13" M3 Chip - Ensures top-tier protection against accidental drops, keeping your valuable device safe and secure at all times.
Sleek and form-fitting design - For an elegant yet durable appearance.
Precise cutouts - Enable seamless access to all ports, sensors, speakers, and cameras, ensuring effortless use of all functions.
Medical Arts Press® File Folder Dividers, Side Position
Item #: 901-31471
Item #: 901-31471
Each Divider Is Extended In Length, Scored for Folding and Comes with A Pre-Affixed 1-Inch Capacity Fastener
Fold On Score Line To Form Flap and Slip Divider Over Existing Fastener In Folder
The Next Divider Is Attached to The Fastener On The First Divider and So On
$48.99
Per box
JAM Paper 8.5" x 11" Matte Paper, 28lb, Light Purple, 100 Sheets/Pack (16729267G)
Item #: 901-24565145
Item #: 901-24565145
Color: Light Purple | Make your work stand out with premium colored paper.
Size: Standard Letter (8.5 x 11 inches) | Ideal for newsletters, brochures, invitations, announcements, flyers, forms, and more.
Quantity: 100 sheets | Plenty of paper for a big project, or to last a long time.
JAM Paper 8.5" x 11" Matte Paper, 28lb, Olive Green, 100 Sheets/Pack (16729244G)
Item #: 901-24565094
Item #: 901-24565094
Color: Olive Green | Make your work stand out with premium colored paper.
Size: Standard Letter (8.5 x 11 inches) | Ideal for newsletters, brochures, invitations, announcements, flyers, forms, and more.
Quantity: 100 per pack | Plenty of paper for a big project, or to last a long time.
English/Spanish Collection Pre-Printed Labels, Final Notice, 1.75 x 3.25 inch, 500 Labels
Item #: 901-24471
Item #: 901-24471
Accelerate Collections & Keep Patients InFormed of Critical InFormation
Powerful Messages In English & Spanish Compel Deliquent Accounts To Take Action
Pressure-Sensitive Labels Come In A H&y Dispenser for Easy Application
$40.99
Per pack
($0.08/EACH)
SaharaCase Venture Series Phone Case for Motorola Razr Ultra, Shock Absorbing, Scorpion Black (CP00850)
Item #: 901-24647627
Item #: 901-24647627
A form-fitting lightweight design that is specifically made to fit the Motorola Razr Ultra (2025).
An ergonomic closed button design that ensures ease of use.
Triple Hardened Material that minimizes the risk of stretching and yellowing.
2026 Willow Creek Jeep 6.5" x 8.5" Daily & Monthly Personal Organizer (55250)
Item #: 901-24654962
Item #: 901-24654962
PLAN IN STYLE – Stay organized in 2026 with our plastic-free 6.5” x 8.5” engagement calendar. Enjoy crisp, colorful imagery throughout, alongside ample space for your weekly plans, notes, and to-do lists. This planner contains 26 full-color images in
side (every other week). Its compact size fits easily into bags and purses, ensuring you're always organized on the go. ...
side (every other week). Its compact size fits easily into bags and purses, ensuring you're always organized on the go. ...
PICTURE-PERFECT QUALITY – Our engagement calendars prioritize form and function with high-quality paper to ensure smooth writing, soy-based inks that provide crisp readability, and a secure spiral binding for lay-flat pages that makes jotting down no ...
Ergodyne ProFlex 7024 PU Coated Cut-Resistant Gloves, ANSI A2, Gray, XXL, 1 Pair (10406)
Item #: 901-10406ERG
Item #: 901-10406ERG
CUT RESISTANT – ANSI A2 cut protection and level 5 abrasion resistance for durable protection when working with sharp materials
FLEXIBLE NO-SLIP GRIP – PU coated palms provide strong but flexible grip for secure handling with enhanced dexterity on a variety of surfaces
COMFORTABLE FORM FIT – 13-gauge HPPE polyester-spandex knit with PU coating moves with you for all-day comfort and minimal hand fatigue
Standard 3 Hole Punch
Item #: 901-3HNAVQ
Item #: 901-3HNAVQ
Taylor Forms Upcharge
Taylor Forms Upcharge
Taylor Forms Upcharge
Super Lube 0.03 oz. Grease Lubricant (82340)
Item #: 901-24617570
Item #: 901-24617570
Does not evaporate or form gummy deposits; will not melt or separate
0.03 oz packet
Synthetic base with mild odor
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