CMS 1500 (02/12) Claim Forms, 1-Part Continuous, Nonpersonalized, 9-1/2 " W x 11" H, 1000/Pkg

Patterson Office Supplies
Patterson Item #: 022-8098
Mfg Item #: VJO-228098-PAT3
Images may not accurately represent the product. Please order product based on its description.

Specifications

# of Parts:
1 part
Compatible Envelopes:
9" W x 4-1/2" H: 073-5324 Security-Lined, Gummed-Flap, 073-5381 Security-Lined, Self-Seal. 9-1/2" W x 4-1/8" H and 9" W x 13" H envelopes check website or call 800-637-1140.
Design Color:
Red
Dimensions:
9-1/2" W x 11" H
Manufacturer Name:
PATTERSON OFFICE SUPPLIES
Material:
20lb Bond Continuous With Body Of Form Pre-printed In OCR Red Ink, with 1/2" Pin Feed
Package Quantity:
1,000/Pkg
Product Color:
White

Legend

Promotion
Auto Free Good
My Catalog
My Catalog (Rep)
On Formulary
On Contract
Prescription
Hazmat-Chargeable
Hazmat-No Charge
MSDS / SDS
Schedule 2 and 2N
Schedule 3, 3N, 4 and 5
List 1
No Freeze
Prices in Green indicate discounted price.