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CMS Health Insurance Claim Form, Two-Part Carbonless, 8.5 x 11, 100 Forms Total
CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits. OCR red ink for scanning.
Unit of Measure: PK
Assembly Effort: None
Manufacturer Part Number: CMS1500L1V
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