CMS1500, 2012 REVISION, 2 PART CONTINUOUS, 1000 PER CASE

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UB04 / CMS 1500 Medical Claim Forms, 2,500 continuous-feed 2-part forms

These are the current 1500 claim forms

This is the latest/newest form that accommodates reporting of the National Provider Identifier (NPI) number

Meets all Government Standards

CMS1500, 2012 REVISION, 2 PART CONTINUOUS, 1000 PER CASE
Publisher's Stock #:	I1500C212
List Price:	$55.00
Discount:	$0.00
Your Price:	$55.00