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Health Insurance Claim Form, 2-Part, Continuous, 100 Sets

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Product Description

Approved by CMS, NUCC and OMB.Printed in OCR Red for scanning.2-part continuous format.White/white paper sequence for 2-part continuous format.Continuous form works with most dot matrix/pin-feed printers and typewriters. Detached size: 8-1/2" W x 11" H.Version (02/12) for use beginning January 6, 2014.

Availability: In stock

Must be purchased in multiples of 4 packs
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