Sale!
Original price was: $268.99.$96.99Current price is: $96.99.
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Accommodates reporting of the NPI number and is approved by the AMA’s Council on Medical Services and CMS.
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Snapset form for use by all medical facilities for billing insurance companies, Medicaid and Medicare; aligned with the electronic HIPAA ASC X12N 837 Non-institutional Transaction Standard
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8-1/2″ W x 11″ L
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2-part, white/canary, carbonless
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500 sets per pack
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Printed on recycled paper
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Option to personalize tax ID#, service facility location and provider information
| # Up Per Sheet/Page | 1 |
|---|---|
| Lines | Varies |
| Security Features | No |
| Personalization | Yes |
| Package Quantity | 500 |
| Numbered | Yes |
| Number of Parts | 2 |
| NCR Paper | No |
| Media Quantity | 500 |
| Holes Punched | No |
| Binding Type | Glued/Gummed |
| Format | Medical Complaint Form |
| Form Type | Medicare |
| Form Size | 8 1/2" x 11" |
| Customizable | Yes |
| Color | White |
| Carbonless | No |
| Brand | Quill |
| Sheet Size | 8 1/2" x 11" |
Be the first to review “Top 10 ⭐ Quill Brand Custom CMS Forms Custom 2-Part Snapset CMS Forms, 8-1/2″ X 11″, 500 Sets Per Pack 🧨”
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