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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

    $74

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    Tops Tops Hcfa Continuous Claim Forms

    Tops Tops Hcfa Continuous Claim Forms

    Description CMS Claim Form,2 Part Continuous,9-1/2 x 11 ,1500Sht/CT,WE Specifications Updated Health Insurance Claim (CMS) Forms with no sensor bar come in a format approved by the AMA Council of Medical Services Printed front and back on 20 lb paper... more

    $166.26

    FREE shipping

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    500-tops Cms Health Insurance Claim Form Version 12/2 W/sensor Bar - Top50135rv

    500-tops Cms Health Insurance Claim Form Version 12/2 W/sensor Bar - Top50135rv

    *NEW*HEALTH INSURANCE CLAIM FORM 500 Forms per Carton NUCC Approved OMB-0938-1197 Latest Version 02-12 Form CMS-1500 (02-12) which contains the addition of the NPI (National Provider Identifier) field as well as the QR code (upper left).This product is... more

    $29.95

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    Cms 1500 Hcfa Claim Forms (02/12) 500 Forms With 25 Hcfa Envelopes

    Cms 1500 Hcfa Claim Forms (02/12) 500 Forms With 25 Hcfa Envelopes

    Pack includes 500 New HCFA claim forms plus 25 9 x 12-1/2" self seal claim form envelopes. New Health insurance claim form, for use starting January 6, 2014. Pack of 500 HCFA CMS-1500 claim forms comply with current physicians' standards for expediting... more

    $29.99

    FREE shipping

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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

    $15.21

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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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    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

    $13.97

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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 $102.37

    FREE shipping

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    Shoplet.com

    (25,000+)
    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 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

    $30.27

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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

    $20.91

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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

    $117.35

    FREE shipping

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    Cms / Hcfa 1500 Health Insurance Claim Forms, 25 Sheets

    Cms / Hcfa 1500 Health Insurance Claim Forms, 25 Sheets

    Brand New! Soon to be discontinue! (08/05 Version) (without Bar Code) Jam-free performance and are printed in OCR-scannable red ink . All forms are government approved CMS-1500 to serve federal programs and private insurers as a universal claim form.... more

    $5.99

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    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

    $26

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    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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    Blumberg New York Health Care Legal Forms, 70

    Blumberg New York Health Care Legal Forms, 70

    Blumberg New York health care legal form. Health care proxy 2 pp. 7-91, 48 per pkg more

    $43.20

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    Blumberg New York Calendar Practice Legal Form

    Blumberg New York Calendar Practice Legal Form

    New York health and hospital records form for calendar practice. Request for patient information, PHLS18, 48 per pkg more

    $39.60

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    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 $96.65

    FREE shipping

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    Shoplet.com

    (25,000+)
    2500 Laser Ub-04 Cms-1450 Insurance Claim Forms

    2500 Laser Ub-04 Cms-1450 Insurance Claim Forms

    This is the approved OMB-0938-0997 form which includes the addition of the NPI (National Provider Identifier) field. Laser forms are compatible with both laser and inkjet printers. Continuous format available upon request. Printed in OCR-scannable red... more

    $47.00

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    Tops 5987or Ub04 Hospital Insurance Claim Form Cms-1450 Case Of2500 Top59870r

    Tops 5987or Ub04 Hospital Insurance Claim Form Cms-1450 Case Of2500 Top59870r

    Tops 5987OR UB04 Hospital Insurance Claim Form CMS-1450 Case of2500 TOP59870R Single 8 1/2" X 11" forms printed to Government Printing Office standards. OCR ink for scanning. American Medical Association (AMA) approved format. This is the approved... more

    $84.00

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