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HCFA-1500 & UB 92
CLAIM FORM ENVELOPES
All envelopes are self-seal and have security liner.

 
 
 

Description

Quantity/Case

Price/Case

9x12.5 Right Window for HCFA 1500

500

$89.60

9x12.5 Left Window for HCFA 1500

500

$89.60

9x12.5 Left Window for UB 92

500

$89.60

#10.5 Right Window for HCFA 1500

500

$29.20

 
 

ALL OUR FORMS ARE OF THE HIGHEST QUALITY, ARE PRINTED IN STRICT COMPLIANCE WITH GOVERNMENT SPECIFICATIONS AND ARE APPROVED BY MEDICARE, THE HEALTH CARE FINANCE ADMINISTRATION AND THE INSURANCE INDUSTRY.