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    Tops UB-04 Continuous Billing Form

    Tops UB-04 Continuous Billing Form

    UB-04 continuous forms are designed for hospitals to file a claim with the patient's insurance company. The Health Care Finance Administration format ensures accuracy in reporting all necessary information. Forms meet the requirements of the Centers... more

    $64

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    Adams CMS-1500 Health Insurance Claim Forms, 2-Part, Continuous, 9.5 x 11 Inches, 100 Sets per Pack (CMS1500CV)

    Adams CMS-1500 Health Insurance Claim Forms, 2-Part, Continuous, 9.5 x 11 Inches, 100 Sets per Pack (CMS1500CV)

    Adams CMS-1500 Health Insurance Claim Forms are approved by the CMS, the National Uniform Claim Committee (NUCC) and the OMB. These continuous, 2-part forms are printed in OCR red ink for scanning with a white/white paper sequence. The continuous... more

    $13.46

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    Adams Health Insurance Claim Forms for Laser Printer, 8.5 x 11 Inches, 250 per Pack (CMS1500L2V)

    Adams Health Insurance Claim Forms for Laser Printer, 8.5 x 11 Inches, 250 per Pack (CMS1500L2V)

    Adams CMS-1500 Health Insurance Claim Forms are approved by the CMS, the National Uniform Claim Committee (NUCC) and the OMB. These quality forms are printed in OCR red ink for scanning and are for use with laser printers. Sheets measure 8.5 x 11... more

    $22.82

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    Adams Health Insurance Claim Forms for Laser Printer, 8.5 x 11 Inches, 100 per Pack (CMS1500L1V)

    Adams Health Insurance Claim Forms for Laser Printer, 8.5 x 11 Inches, 100 per Pack (CMS1500L1V)

    Adams CMS-1500 Health Insurance Claim Forms are approved by the CMS, the National Uniform Claim Committee (NUCC) and the OMB. These quality forms are printed in OCR red ink for scanning and are for use with laser printers. Sheets measure 8.5 x 11... more

    $10.14

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    Simplified Claim Form Signature Release Labels (1)

    Simplified Claim Form Signature Release Labels (1)

    (1 count) Signature release labels can easily be applied to patient insurance forms to avoid claims processing delays. Compatibility: For use with Simplified Claim Forms - Item #4049. Handy! Get a patient signature on self-adhesive labels, then affix... more

    $23.79

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    Tops UB04 Hospital Insurance Claim Form

    Tops UB04 Hospital Insurance Claim Form

    Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association AMA approved format. Form Size: 8 1/2 x 11 Forms Per Page: 1. more

    $198.36 $103.01

    FREE shipping

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    Shoplet.com

    (25,000+)
    Tops Insurance/UB04 Hospital Claim

    Tops Insurance/UB04 Hospital Claim

    Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Global Product Type: Forms-Insurance Claim; Form Size (W x H): 8 1/2 in x 11 in; Format: Continuous Form; Forms Per Page: N/A. more

    $162.27 $94.21

    FREE shipping

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    Shoplet.com

    (25,000+)
    Domtar 5.5 Microperforated Custom Cut Sheets - Letter - 8.5 x 11 - 20lb - 5 / Carton - White

    Domtar 5.5 Microperforated Custom Cut Sheets - Letter - 8.5 x 11 - 20lb - 5 / Carton - White

    Punched and perforated paper is ideal for health care forms, medical charts, invoices, statements, remittance coupons and more. Letter-size sheets are custom laser cut. more

    $32

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    Adams CMS1500L2 Health Insurance Claim Form 1 Part

    Adams CMS1500L2 Health Insurance Claim Form 1 Part

    One-part health insurance claim form (1500) is designed for use in laser printers more

    $45.00 $24.38

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    Rakuten.com Shopping

    (1,000,000+)
    Adams Health Insurance Claim Form

    Adams Health Insurance Claim Form

    One-part health insurance claim form (1500) is designed for use in laser printers. more

    $27

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    TOPS Health Insurance Claim Forms for Laser Printer, 8.5 x 11 inches, 500 Sheets per Pack (50126RV)

    TOPS Health Insurance Claim Forms for Laser Printer, 8.5 x 11 inches, 500 Sheets per Pack (50126RV)

    TOPS CMS-1500 Health Insurance Claim Forms are approved by the National Uniform Claim Committee (NUCC) and the OMB. For use with laser printers, these forms are printed in red OCR ink on white 20# bond paper. They measure 8.5 x 11 inches and come 500... more

    $30.22

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    TOPS Health Insurance Claim Forms for Laser Printer, 8.5 x 11 Inches, 250 Sheets per Pack (50135RV)

    TOPS Health Insurance Claim Forms for Laser Printer, 8.5 x 11 Inches, 250 Sheets per Pack (50135RV)

    TOPS CMS-1500 Health Insurance Claim Forms are approved by the National Uniform Claim Committee (NUCC) and the OMB. For use with laser printers, these forms are printed in red OCR ink on white 20# bond paper. They measure 8.5 x 11 inches and come 250... more

    $14.44

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    TOPS CMS-1500 Health Insurance Claim Forms, 1-Part, Continuous, 9.5 x 11 Inches, 3000 Sheets per Carton (50122RV)

    TOPS CMS-1500 Health Insurance Claim Forms, 1-Part, Continuous, 9.5 x 11 Inches, 3000 Sheets per Carton (50122RV)

    TOPS CMS-1500 Health Insurance Claim Forms are approved by the National Uniform Claim Committee (NUCC) and the OMB. These 1-part, continuous forms are printed in red OCR ink on white 20# paper. They measure 9.5 x 11 inches and have a detached size of... more

    $137.19

    FREE shipping

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    TOPS 59870R UB04 Hospital Insurance Claim Form, 8-1/2 x 11 Inches, 2500 Forms

    TOPS 59870R UB04 Hospital Insurance Claim Form, 8-1/2 x 11 Inches, 2500 Forms

    Tops 59870R Billing Forms, 20 lb., 8-1/2'' x 11'', 2500/CT, TOP59870R, TOP 59870R, UB-04 laser-cut forms are designed for medical offices to file a claim with the patient's insurance company. The Health Care Finance Administration format ensures... more

    $198.36 $116.00

    FREE shipping

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    Rakuten.com Shopping

    (1,000,000+)
    Ub04 Hospital Insurance Claim Form, 8 1/2 X 11, 2,500 Forms

    Ub04 Hospital Insurance Claim Form, 8 1/2 X 11, 2,500 Forms

    Printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. Form Size: 8 1/2 x 11; Forms Per Page: 1. more

    $179.03

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    Rakuten.com Shopping

    (1,000,000+)
    Tops UB-04 Hospital Claim Form

    Tops UB-04 Hospital Claim Form

    UB-04 laser-cut forms are designed for medical offices to file a claim with the patient's insurance company. The Health Care Finance Administration format ensures accuracy in reporting all necessary information. Forms meet the requirements of the... more

    $99

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    Tops UB-04 Hospital Claim Form

    Tops UB-04 Hospital Claim Form

    UB-04 continuous forms are designed for hospitals to file a claim with the patient's insurance company. The Health Care Finance Administration format ensures accuracy in reporting all necessary information. Forms meet the requirements of the Centers... more

    $88

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    Domtar 3.5"" Microperforated Custom Cut Sheet

    Domtar 3.5"" Microperforated Custom Cut Sheet

    Punched and perforated paper is ideal for healthcare forms, medical charts, invoices, statements, remittance coupons and more. Compatible with high-speed copiers, laser and inkjet printers and offset presses. Letter-size sheets are custom laser cut. 20... more

    $31

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    DOMTAR PAPER Custom Cut Sheets, 2-Hole Top, 8-1/2""x11"", 5 RM/CT, White DMR851221

    DOMTAR PAPER Custom Cut Sheets, 2-Hole Top, 8-1/2""x11"", 5 RM/CT, White DMR851221

    DOMTAR PAPER Custom Cut Sheets, 2-Hole Top, 8-1/2""x11"", 5 RM/CT, White Punched paper is ideal for healthcare forms, medical charts, invoices, statements, remittance coupons and more. Compatible with high-speed copiers, laser and inkjet printers and... more

    $30

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    Domtar 3.6"" Microperforated Custom Cut Sheet

    Domtar 3.6"" Microperforated Custom Cut Sheet

    Punched and perforated paper is ideal for healthcare forms, medical charts, invoices, statements, remittance coupons and more. Compatible with high-speed copiers, laser and inkjet printers and offset presses. Letter-size sheets are custom laser cut. 20... more

    $31

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    Domtar 3.6"" Microperforated Custom Cut Sheet

    Domtar 3.6"" Microperforated Custom Cut Sheet

    Punched and perforated paper is ideal for healthcare forms, medical charts, invoices, statements, remittance coupons and more. Compatible with high-speed copiers, laser and inkjet printers and offset presses. Letter-size sheets are custom laser cut. 20... more

    $31

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    Domtar 19-Hole Custom Cut Punched Paper

    Domtar 19-Hole Custom Cut Punched Paper

    Punched paper is ideal for healthcare forms, medical charts, invoices, statements, remittance coupons and more. Compatible with high-speed copiers, laser and inkjet printers and offset presses. Letter-size format sheets are laser cut sheet with 19-hole... more

    $30

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    Domtar 5-Hole Punched Top Custom Cut Sheet

    Domtar 5-Hole Punched Top Custom Cut Sheet

    Punched paper is ideal for healthcare forms, medical charts, invoices, statements, remittance coupons and more. Compatible with high-speed copiers, laser and inkjet printers and offset presses. Letter-size sheets are laser cut with premade hole punches... more

    $28

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    Domtar 5.5"" Microperforated Custom Cut Sheet

    Domtar 5.5"" Microperforated Custom Cut Sheet

    Punched and perforated paper is ideal for healthcare forms, medical charts, invoices, statements, remittance coupons and more. Compatible with high-speed copiers, laser and inkjet printers and offset presses. Letter-size sheets are custom laser cut. 20... more

    $30

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    Paris Health Insurance Claim Forms 8 1/2" X 11" 74 Gsm , White,2500

    Paris Health Insurance Claim Forms 8 1/2" X 11" 74 Gsm , White,2500

    PRODUCT DETAILS 8 1/2 x 11 laser cut sheet medical healthcare form are required for all federal insurance claims and many private healthcare organizations. White Size: 8 1/2 x 11 74 GSM 500/ream, 2500/carton Grain direction: Grain long Acid free,... more

    $128.72

    FREE shipping

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    Paris Health Insurance Claim Forms 8 1/2" X 11" 20 Lbs. White,2500

    Paris Health Insurance Claim Forms 8 1/2" X 11" 20 Lbs. White,2500

    PRODUCT DETAILS 8 1/2 x 11 UB-04 laser cut sheet medical healthcare form are required for all federal insurance claims and many private healthcare organizations. White Size: 8 1/2 x 11 2500/Case Acid free, preserves documents for a longer period of... more

    $142.26

    FREE shipping

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    Paris Health Insurance Claim Forms 2-Part Healthcare Form; 9 1/2 x 11, White/Canary, 1000/Case

    Paris Health Insurance Claim Forms 2-Part Healthcare Form; 9 1/2 x 11, White/Canary, 1000/Case

    White/canary. Size: 9 1/2in x 11in more

    $114.99

    FREE shipping

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    Adams Health Insurance Claim Form

    Adams Health Insurance Claim Form

    CMS-1500 health insurance claim form is approved by the AMA and the National Uniform Claim Committee. Laser-compatible form is printed in OCR Red for scanning. Detached size of this one-part form is 8-1/2" wide x 11" high. more

    $31.32

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    LD Products

    (100,000+)
    Adams(R) Health Insurance Claim Forms, 8 1 - 2in. x 11in., White, Pack Of 250

    Adams(R) Health Insurance Claim Forms, 8 1 - 2in. x 11in., White, Pack Of 250

    Easy-to-read forms make it easy to submit your claims Form for submitting your Federal health insurance claims. Compatible with laser printers. Forms are printed on white paper with red ink. SFI Certified. Adams(R) Health Insurance Claim Forms, 8 1 -... more

    $22.96 $16.99

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    Office Depot

    (950,000+)
    Adams(R) Health Insurance Claim Forms, 8 1 - 2in. x 11in., White, Pack Of 100

    Adams(R) Health Insurance Claim Forms, 8 1 - 2in. x 11in., White, Pack Of 100

    Easy-to-read forms make it easy to submit your claims Form for submitting your Federal health insurance claims. Compatible with laser printers. Forms are printed on white paper with red ink. SFI Certified. Adams(R) Health Insurance Claim Forms, 8 1 -... more

    $9.99

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    Office Depot

    (950,000+)
    Tops CMS Health Insurance Claim Form with Sensor Bar

    Tops CMS Health Insurance Claim Form with Sensor Bar

    CMS 1500 Claim Form is in the AMA approved format. Printed front and back in red OCR ink on white, letter-size 20 lb. bond. Compatible with laser printers. more

    $13

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    ABFCMS1500L2 Adams Health Insurance Claim Form

    ABFCMS1500L2 Adams Health Insurance Claim Form

    ABFCMS1500L2 CMS-1500 health insurance claim form is approved by the AMA and the National Uniform Claim Committee. Laser-compatible form is printed in OCR Red for scanning. Detached size of this one-part form is 8-1/2" wide x 11" high. more

    $25.13

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    Adams Business Forms ABFCMS1500L2 Health Insurance Claim Form- 1 Part

    Adams Business Forms ABFCMS1500L2 Health Insurance Claim Form- 1 Part

    $38.84

    FREE shipping

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    ADAMS Health Insurance Claim Form, 1 Part

    ADAMS Health Insurance Claim Form, 1 Part

    ADAMS Health Insurance Claim Form, 1 Part more

    $28.49

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    CMS Health Insurance Claim Form, 9-1/2 x 11, Three-Part, 100 Continuous Forms

    CMS Health Insurance Claim Form, 9-1/2 x 11, Three-Part, 100 Continuous Forms

    $17.99

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    2500 Laser Cms-1500 (02-12) Insurance Hcfa Claim Forms

    2500 Laser Cms-1500 (02-12) Insurance Hcfa Claim Forms

    No Charge if you are not 100% satisfied. NEW CMS-1500 (02/12) format Health Insurance Claim Forms for laser printers, ink jet printers, or handwritten.The new format contains the ability to have up to 12 diagnosis codes Continuous format available upon... more

    $37.50

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    ADALBL ADA 2002 & 2007 Insurance Claim Form Signature Release Label 4 X 1 5/8"

    ADALBL ADA 2002 & 2007 Insurance Claim Form Signature Release Label 4 X 1 5/8"

    ADALBL ADA 2002 & 2007 Insurance Claim Form Signature Release Label 4 X 1 5/8" more

    $20.16

    FREE shipping

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    (250+)
    60151X CMS-1500 Two-Part Carbonless Insurance Claim Form 0212 Size: 8 1/2 x 11"

    60151X CMS-1500 Two-Part Carbonless Insurance Claim Form 0212 Size: 8 1/2 x 11"

    60151X CMS-1500 Two-Part Carbonless Insurance Claim Form 0212 more

    $39.48

    FREE shipping

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    (250+)
    60170 Imprinted ADA 2012 Insurance Claim Form Padded - One-Part

    60170 Imprinted ADA 2012 Insurance Claim Form Padded - One-Part

    60170 Imprinted ADA 2012 Insurance Claim Form Padded - One-Part more

    $40.32

    FREE shipping

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    (250+)
    Blumberg New York Health Care Legal Forms, 95

    Blumberg New York Health Care Legal Forms, 95

    Blumberg New York health care legal form. Health care proxy with living will directives, 4 pp., 7-94, 24 per pkg more

    $43.20

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