UB-04 Hospital Claim Form Laser-Cut Sheet (2,500/case)

New CMS-1500 Insurance Claim Forms, HCFA (Version 02/12) - 1 CASE (2500 Sheets/Forms)

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NEW CMS-1500 INSURANCE CLAIM FORMS, HCFA (Version 02/12) - 1 CASE (2500 SHEETS/FORMS)

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NEW CMS-1500 INSURANCE CLAIM FORMS, HCFA (Version 02/12) - 1 CASE (2500 SHEETS/FORMS)

1-Part Laser Form CMS-1500 printed in red ink - Quantity: 2500 Forms
New Version 02/12 (APPROVED OMB-0938-1197)
Medicare Accepts Only This Version 02/12 Beginning 04/04/14.
Size: 8-1/2" x 11"; Weight: 24lb Paper
Designed For Laser & Inkjet Printers

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