Claim/Medical Forms

20 lb - 11" x 8.50" Sheet Size - White Sheet(s) - Red Print Color - 1 Pack

• CMS, NUCC and OMB approved format
• Printed front and back
• Convenient scanning
• Compatible with laser printers

20 lb - 11" x 8.50" Sheet Size - White Sheet(s) - Red Print Color - 1 Pack

• CMS, NUCC and OMB approved format
• Printed front and back
• Convenient scanning
• Compatible with laser printers

20 lb - 1 Part - 8.50" x 11" Form Size - White - Red Print Color - Paper - 500 / Pack

• Approved by the AMA and the National Uniform Claim Committee (NUCC)
• Printed in red OCR ink without a sensor bar
• Compatible with laser printers
• Detached size: 8-1/2" x 11"

20 lb - 1 Part - 8.50" x 11" Form Size - White - Red Print Color - Paper - 500 / Pack

• Approved by the AMA and the National Uniform Claim Committee (NUCC)
• Printed in red OCR ink without a sensor bar
• Compatible with laser printers
• Detached size: 8-1/2" x 11"

1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton

• Continuous forms are designed for hospitals to file a claim with the patient's insurance company
• Forms are printed to GPO standards in OCR ink on 20 lb. bond
• Health Care Finance Administration format ensures accuracy in reporting all necessary information
• 11" Length x 8.50" Width; 2500 / Carton
• Replaces the UB-92

1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton

• Continuous forms are designed for hospitals to file a claim with the patient's insurance company
• Forms are printed to GPO standards in OCR ink on 20 lb. bond
• Health Care Finance Administration format ensures accuracy in reporting all necessary information
• 11" Length x 8.50" Width; 2500 / Carton
• Replaces the UB-92