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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 Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 250 Forms/Pack
Online
$26.50 for PK
Mfr PN: 50135R
Stock: 536
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
$26.50 for PK
Mfr PN: 50135R
Stock: 536

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 Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 250 Forms/Pack
Online
$26.50 for PK
Mfr PN: 50135R
Stock: 536
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
$26.50 for PK
Mfr PN: 50135R
Stock: 536

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 Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 500 Forms/Pack
Online
$47.26 for PK
Mfr PN: 50126R
Stock: 1186
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
$47.26 for PK
Mfr PN: 50126R
Stock: 1186

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 Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 500 Forms/Pack
Online
$47.26 for PK
Mfr PN: 50126R
Stock: 1186
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
$47.26 for PK
Mfr PN: 50126R
Stock: 1186

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