| Item | Medicare and Medicaid ServicesForm,PK500 |
| Number of Sheets | 1 Form per Page |
| Features | Laser Printer Compatible |
| Style | Forms |
| Number of Duplicates | One-Part (No Copies) |
| Sheet Size | 8.50 in W x 11 in L |
| Paper Color | White |
| Form Size | 8.5 x 11 |
| Dated/Undated | Undated |
| Principal Heading(s) | 1500 Health Insurance Claim Form |
| Paper Stock | 20 lb Bond |
| Print and Ruling Color | OCR Red |
| Number of Forms | 500 |
| Printer Compatibility | Laser |
| Format Indicator | Unbound |
| Number of Parts | 1 |
| Standards | SFI Certified |
| Post Consumer Waste | 0 |
| Printed Side | Back/Front |
| Country of Origin (subject to change) | United States |
| Package Quantity | 500 |
Medicare and Medicaid ServicesForm, PK500, TOPS, Mfr# 50126R
$76,89
Free shipping will be applied on orders over $50
Medicare and Medicaid ServicesForm,PK500, Package Quantity 500
9999 in stock
Must order in multiples of 1
Subtotal:
$76.89
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