Home / Nurse's Station and Office Supplies / Forms / Healthcare Form / Healthcare Form Medical Claim 2 Part 9-1/2 X 14 Inch790-0129QR
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Healthcare Form Medical Claim 2 Part 9-1/2 X 14 Inch790-0129QR

Healthcare-Form-Medical-Claim-2-Part-9-1-2-X-14-Inch790-0129QR

SKU #

#854054

MPN #

790-0129QR

Brand

Phoenix Printing

Stock

In Stock

Quantity

100

Features

FORM, HCFA 1PART NEW REV 2012 LASER CUT(500/PK 5PK
8-1/2 X 11 Inch
9-1/2 X 14 Inch
Billing Form
Claim Form
Medical Claim 2 Part

$122.32 USD

Product Specifications Product Usage Additional Information
Print
Attribute Name Attribute Value
McKesson # 854054
Manufacturer # 790-0129QR
Manufacturer Phoenix Printing
Application Healthcare Form
Color White / Red
Dimensions 9-1/2 X 14 Inch
Material Paper
Type Medical Claim 2 Part
UNSPSC Code 42142304
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  • New revision 2012