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CMS-1450 FORMS   Back to Products

Our forms are designed for processing on high-speed OCR scanning equipment and are printed in red "dropout" ink on special bond paper in strict compliance with government printing specifications.

CMS-1450, UB-04 Claim Form, hospital claim form

Forms/CMS-1450/Laser-Inkjet
Product Number in the Box Price Add to Cart
CMS 1450 - Claim Form - 1-Part - Laser/InkJet (single sheets) 2500 ONLY: $42.00 compare @ $107.99
CMS 1450 - Claim Form - 1-Part - Laser/InkJet (single sheets) 5000 ONLY: $83.00 compare @ $215.99
Forms/CMS-1450/2-Part
Product Number in the Box Price Add to Cart
Claim Form - 2-Part - Continuous 1000 ONLY: $55.00 compare @ $88.99
Claim Form - 2-Part - Continuous 3000 ONLY: $165.00 compare @ $266.79
Claim Form - 2-Part - Continuous 5000 ONLY: $267.00 compare @ $444.59
Forms/CMS-1450/3-Part
Product Number in the Box Price Add to Cart
CMS-1450 3-Part -Claim Form - 3-Part - Continuous 1000 ONLY: $80.00 compare @ $154.29
CMS-1450 3-Part - Claim Form - 3-Part - Continuous 3000 ONLY: $242.00 compare @ $462.69
CMS-1450 3-Part - Claim Form - 3-Part - Continuous 5000 ONLY: $392.00 compare @ $771.99


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