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CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 500/Box

Meet billing requirements for Medicare Part B. Easy-to-read forms with crisp, clean text help ensure faster claims processing. Paper, layout and ink comply with CMS standards and requirements. Layout includes all 02/12 NUCC revisions and is a direct replacement for the previous 08/05 version. Printed in scannable, OCR "dropout" red ink. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 500; Sheet Size: 8.5 x 11.
Item#:
TFP650656-ES
Available:
Special Order
Your Price:
35.21
BOX

CMS Health Insurance Claim Form, One-Part, 8.5 x 11, 100 Forms

CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits. OCR red ink for scanning. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 100; Sheet Size: 8.5 x 11.
Item#:
ABFCMS1500L1V-ES
Available:
Out of Stock
This item is temporarily unavailable.

CMS Health Insurance Claim Form, Three-Part Carbonless, 9.5 x 11, 1/Page, Continuous, 100 Forms

CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits. OCR red ink for scanning. Form Size: 9.5 x 11; Forms Per Page: 1; Form Quantity: 100; Principal Heading(s): 1500 Health Insurance Claim Form.
Item#:
ABFCMS1500CV-ES
Available:
In Stock
Your Price:
17.31
PACK

Comprehensive Employee Application Form, 8.5 x 11, 1/Page, 25 Forms

The most comprehensive inquiry into a candidate's history, including past employment, references, education, personal information and check-offs for special questions. Full page for interviewer's appraisal. Complies with state and federal laws prohibiting discrimination. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 25; Sheet Size: 17 x 11.
Item#:
TOP3288-ES
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Contractor Proposal Form, Three-Part Carbonless, 8.5 x 11.44, 1/Page, 50 Forms

Proposal forms include space for total cost and terms of payment. General contract provisions are printed on back. Three-part carbonless. Form Size: 8.5 x 11.44; Forms Per Page: 1; Form Quantity: 50; Sheet Size: 8.5 x 11.44.
Item#:
ABFNC3819-ES
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Credit Card Sales Slip, Three-Part Carbonless, 7.78 x 3.25, 1/Page, 100 Forms

Universal format fits in standard credit card imprinters. Carbonless: no carbon tissues with credit card imprints to worry about. Ruled. Triplicate sets. Perforated for easy separation. Form Size: 7.78 x 3.25; Forms Per Page: 1; Number of Entry Lines: 4; Form Quantity: 100.
Item#:
TOP38538-ES
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Credit Memo Book, Three-Part Carbonless, 5.5 x 7.88, 1/Page, 50 Forms

Wrap-around stop card prevents write-through to other form sets. Consecutively numbered for record keeping. Two-hole punched to store in post binder. Form Size: 5.5 x 7.88; Forms Per Page: 1; Number of Entry Lines: 8; Form Quantity: 50.
Item#:
RED7L787-ES
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Daily Attendance Card, 8.5 x 11, 1/Page, 50 Forms

Record one year of attendance for an employee. Three-hole punched at top for use in a ring binder. White index printed in green ink. Form Size: 11 x 8.5; Forms Per Page: 1; Form Quantity: 50; Principal Heading(s): Daily Attendance Record.
Item#:
TOP3284-ES
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Daily Time and Job Sheets, 8.5 x 5.5, 1/Page, 200 Forms/Pad, 2 Pads/Pack

For daily manual time record keeping. Columns for job number, kind of work, time begun, time finished and total hours. Room for employee name, department, rate per hour, productive hours and non-productive hours. Two pads per pack. Form Size: 8.5 x 5.5; Forms Per Page: 1; Form Quantity: 200; Principal Heading(s): Daily Time Sheet.
Item#:
TOP30041-ES
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Delivery Receipt Book, Three-Part Carbonless, 6.38 x 4.25, 1/Page, 50 Forms

Records delivery for sender and receiver. Wrap-around stop card prevents write-through to other form sets. Consecutively numbered. Form Size: 6.38 x 4.25; Forms Per Page: 1; Number of Entry Lines: 8; Form Quantity: 50.
Item#:
RED6L614-ES
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Desk Saver Line Wirebound Message Book, Two-Part Carbonless, 6.25 x 4.25, 1/Page, 50 Forms

Space-saving booklet with full-size While You Were Out messages. Attached page protector flap prevents write-through onto other messages. Flip saved duplicate over top binding to move on to next message. Form Size: 4.25 x 6.25; Forms Per Page: 1; Form Quantity: 50; Principal Heading(s): While You Were Out.
Item#:
RED47296-ES
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Driver's Daily Log, Two-Part Carbonless, 7.88 x 5.5, 1/Page, 31 Forms

Log a day's driving summary in separate section at right side of each form. Vehicle report on back of original with odometer start and finish, mileage today, time in, stops, time out, layover time, daily vehicle inspection report. Two-Part CarbonDaily record with hours summary. Form Size: 7.88 x 5.5; Forms Per Page: 1; Form Quantity: 31; Principal Heading(s): Driver's Daily Log.
Item#:
RED6K681-ES
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