Tops HCFA Continuous Claim Forms
Tops Claim Forms: Tops 50126R CMS Claim Form, Laser, 8-1/2÷ x 11÷, 500SH/PK, WE, TOP50126R
Tops Claim Forms: Tops 50126R CMS Claim Form, Laser, 8-1/2÷ x 11÷, 500SH/PK, WE, TOP50126R, CMS-1500 forms comply with current physicians? standards for expediting Medicare and Medicaid payments. Each meets requirements of the Centers for Medicare and Medicaid Services, Champus and the AMA Council of Medical Service. Printed front and back in red OCR ink on white 20 lb. bond without sensor bar. Compatible with laser printers. UPC 0
Manufacturer: Tops
Quantity: 500/PK
SKU: TOP50126R
LIST PRICE: $32.91
OUR PRICE: $19.31
Tops Claim Forms
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| 3-9 | $18.73 (per item) | all customers |
| 10+ | $18.34 (per item) | all customers |
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