Care Warehouse

Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 250 Forms/Pack Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 250 Forms/Pack

Online

$21.21 for PK

Retail $24.96

Mfr PN: 50135R

Stock: 713

Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR ink for scanning. Top sensor bar for microfiche duplication, as required in some states. OCR red ink for scanning. Form Size: 11 x 8 1/2; Forms Per Page: 1; Form Quantity: 250; Principal Heading(s): 1500 Health Insurance Claim Form.

Online

$21.21 for PK

Retail $24.96

Mfr PN: 50135R

Stock: 713

Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 250 Forms/Pack Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 250 Forms/Pack

Online

$21.21 for PK

Retail $24.96

Mfr PN: 50135R

Stock: 713

Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR ink for scanning. Top sensor bar for microfiche duplication, as required in some states. OCR red ink for scanning. Form Size: 11 x 8 1/2; Forms Per Page: 1; Form Quantity: 250; Principal Heading(s): 1500 Health Insurance Claim Form.

Online

$21.21 for PK

Retail $24.96

Mfr PN: 50135R

Stock: 713

Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 500 Forms/Pack Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 500 Forms/Pack

Online

$37.82 for PK

Retail $45.28

Mfr PN: 50126R

Stock: 1315

Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR ink for scanning. Form Size: 11 x 8 1/2; Forms Per Page: 1; Form Quantity: 500; Principal Heading(s): 1500 Health Insurance Claim Form.

Online

$37.82 for PK

Retail $45.28

Mfr PN: 50126R

Stock: 1315