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HCFA FORMS

Laser
One-Part Continuous
Two-Part Continuous
 

HCFA ENVELOPES

Std Gum Plain (RW)
Std Gum Imprinted (RW)
Std Self Seal Plain (RW)
Std Self Seal Imprinted (RW)
 

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Item Details
HCFA Forms Laser REVISED
Item Name:
HCFA Forms Laser REVISED
Item #:
WCMS-1500-CS-12
Price/ea:
$37.80

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HCFA FORMS: Laser (WCMS-1500-CS-12) Case of 2,500

This is the REVISED form (see changes)

Health Insurance Claim Forms are United States government approved to serve federal programs and private insurers as a universal claim form

  • Accommodates reporting of National Provider Identifier (NPI) numbers
  • Approved by the National Uniform Claim Committee and CMS; aligned with electronic HIPAA ASC X12N 837 Non-Institutional Transaction Standard
  • Forms are for use with laser printers
  • Size: 8 1/2" x 11"
Quantity:
 
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