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    • Size: 8.5 x 11
    • Stock Item – no customization
    • Paper: 2 part carbonless snap-apart format
    • Form printed in red ink
    • Check FAQ for production times.
SKU: CMS-1500-2-OS-NP-OS Tag:

Medicaid Claim Form 2 Part

Medicaid Claim Form CMS-1500 – 2 Part Carbonless

This Medicaid Claim Form is available in a 2-part carbonless snap-apart format. This form has been already approved by Medicare and Medicaid for insurance claims.

 

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Medicaid Claim Form 2 Part

From: $58.00
1Stock Item

Stock Items are not personalized and print as shown.

2Configure & Price

Proof will be emailed to you after the order is placed.

Final total:
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