Item #MCF-389-1 CMS-1450 revised insurance claims form for laser printer.
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Item #MCF-389-1 Claim Form

CMS-1450 revised 1-part insurance claims form for laser printer. National Uniform Claim Committee approved version. Accommodates the National Provider Identifier (NPI) number. Priced per each. Blank only. Sized envelope available, please inquire.

Quantity 2500
$0.04

* You will be able to enter notes and/or submit your artwork on the next page.

White
Colors
White
Size
8 1/2 " x 11 "
Material
Paper
Additional Information
Your satisfaction is guaranteed. We are proud of the work we do. If we don't do it right, we'll make it right. Period.

Product Detail

  • Booking available. Carbonless Snap-A-Part Forms can be booked into sets of 50 (stapled through the stub and wrapped with a heavy manila backer).

    • Charge Type: Product Option Charge (Per Quantity)

      Quantity1
      Price$12.73

      Price Includes: N/A

    • Carbonless Snap-A-Part Forms

  • Envelopes

    • Charge Type: Product Option Charge (Per Quantity)

      Quantity1
      PriceQuoted

      Price Includes: N/A

    • Envelopes available

  • Product Option

    Hole Punches are available
    • 1 hole
    • 2 holes
    • 3 holes
    • 4 holes

  • Product Option

    Multi-Part Color Sequence available
    • Multi-Part Color Sequence

  • Product Option

    Stock logos available
    • American flag - MI-3
    • Capsule "RX" - DR-1
    • Mortar & Pestle - DR-2
    • Mortar & Pestle "RX" - DR-4
    • Mortar & Pestle Bold "RX" - DR-3
    • Quote "Thank You" - MI-1
    • Skull and bones - DR-6
    • Sun - MI-2
    • US "Small Business keeps America Growing" - MI-4

Imprint

Imprint Method: Unimprinted

Full Color Process: No

Personalization: No

Sold Unimprinted: Yes

Imprint Method

Unimprinted

Production and Shipping

  • Packaging

    • Packing with drilled holes - Per 500

      • Charge Type: Packaging Charge (Per Quantity)

        Quantity500
        Price$0.04

        Price Includes: N/A

    • Packing without drilled holes - Per 100

      • Charge Type: Packaging Charge (Per Quantity)

        Quantity50010005000
        Price$0.03$0.02$0.02

        Price Includes: N/A

    • Packing without drilled holes - Per 50

      • Charge Type: Packaging Charge (Per Quantity)

        Quantity2505001000
        Price$0.05$0.04$0.03

        Price Includes: N/A

  • Rush Time

    Rush Service

    Rush Service

    • Charge Type: Rush Service Charge (Other)

      Quantity1
      PriceQuoted

      Price Includes: N/A

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