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1 Part Continuous CMS-1500 Form

Part Number: WCMS15001
Price
$35.95

9 1/2" x 11" continuous feed for dot matrix printers

Printed in red, OCR scannable ink in compliance with government standards

The new CMS-1500 (08/05) Health Insurance Claim Form, often referred to as the HCFA-1500, now accommodates the reporting of the National Provider Identifier. This new version replaces the old HCFA 12/90 version.

2500/box

1 Part Continuous CMS-1500 Form
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