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Health Insurance Claim Form- CMS 1500 (1000/Carton)
Health Insurance Claim Form- CMS 1500 (1000/Carton)

Health Insurance Claim Form- CMS 1500 (1000/Carton)

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$34.75
Part Number:79109QR

  • Record confidential information
  • Government approved
  • Compatible with laser printers
  • Printed in red ink
  • Carbonless paper transfers information to the back sheet
    • Quantity Pricing
    Quantity
    Price
    • 3 - 4
    • $31.97
    • 5+
    • $31.28
    This medical billing form is used to serve federal programs and private insurers as a universal claim form. 02/12 version.

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