 |
 |
|
 |
CMS 1500 Laser Personalized (imprinted) | |
|---|---|---|
If you need additional information, email me at drsforms1@aol.com I'd be glad to hear from you. Martin Berliner, Vice President Sales. |
Get Expert
Help on |
|
|
CMS 1500
Form |
||
|
CMS (HCFA) 1500 Medicare Claim Forms (08/05) Personalized |
|
|
|
We
personalize the following boxes at no additional charge: 25:Federal Tax I.D. No. - SSN or EIN 27: Accept Assignment 33: Billing Provider Info.Note:33a is for national provider no. |
||
Allow
7-10 working days for personalized CMS 1500 Forms |
||
|
Only
at DRS you can have any other box personalized to reduce the time |
||
| Form No: L-CMSIMP
1000
CMS 1500 Laser Medicare Claim Forms Personalized $77.00 2000
CMS 1500 Laser Medicare Claim Forms Personalized $74.75 per 1000 |
||
| CMS
1500 Laser Size: 8-1/2" X 11" |
||
 |
||
Personalize
box 25 and below can be ordered on line. |
||
| Custom
information above box 25. |
||
 For Fax or Mail |
 |
|
| Telephone
Toll Free: 1-866-696-0800 New York State: 1-631-696-4900 Fax: 1-631-696-4901 |
||
|
Download
from www.nucc.org the 57 page users instructional manual
Copy and paste in your browser window: www.nucc.org |
||
| Return To Previous Page |  |
|
|
||
|
||
CMS 1500 Laser Personalized |
||