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TOPS®: CMS Health Insurance Claim 1500, Lttr, 3000 Continuous Forms per Carton
	Quantity in Basket: None Code: TOP-50122R Price: $112.57
	Quantity:
TOPS® Centers for Medicare and Medicaid Services (CMS) Forms without Sensor Bar Centers for Medicare and Medicaid Services (CMS) claim form without sensor bar. CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits. OCR red ink for scanning. • UPC = 025932501227 • Weight = 32 lbs/CT • Mfgr Code: 50122R • Mfgr Name: TOPS BUSINESS FORMS • PRICED PER CT List Price = $149.08 Our Price = $112.57 Your Savings = $36.51 If your SHIP TO address is in California, you will receive a second invoice showing the California SALES TAX that you paid for this item