HCFA Forms Banner

Health Insurance Claim Forms: HCFA Form CMS-1500 & UB-04 Forms


Orders Are Shipped Within 48 Hours

Note: Rush orders must be in by 3:30pm ET Monday - Thursday; Friday by 11:30am


NEW HCFA CMS 1500 Laser Forms - Version 02/12

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HCFA Forms
Description:

  • Item: HCFA N / CMS-1500
  • Format: Laser Form CMS-1500
  • Type: Laser One Part
  • Size: 8-1/2" X 11"
  • Weight: 24#
  • Version: 02/12
  • Medicare began accepting Version 02/12 on 1/06/14. On 04/04/14 only Version 02/12 will be accepted.

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HCFA CMS 1500 Continuous 1-Part

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HCFA Forms
Description:

  • Item: HCFA 1 / CMS-1500
  • Format: Laser Form CMS-1500
  • Type: One Part for pin feed printer
  • Size: 8-1/2" X 11"
  • Weight: 20#

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HCFA CMS 1500 Continuous 2-Part

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HCFA Forms
Description:

  • Item: HCFA 2 / CMS-1500
  • Format: Continuous (Duplicate)
  • Type: Two Part for pin feed printer
  • Size: 8-1/2" X 11"
  • Weight: White 20# and Canary 15#

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Hospital Claim Form UB-04

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Description:

  • Item: Hospital Claim Form
  • Format: Laser Form UB-04
  • Type: One Part
  • Size: 8-1/2" X 11"
  • Weight: 24#

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Hospital Claim Form UB92- Continuous 1-Part

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Description:

  • Item: Hospital Claim Form
  • Format: Continuous (Single) Form UB92
  • Type: One Part for pin feed printer
  • Size: 8-1/2" X 11"
  • Weight: 24#

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Hospital Claim Form UB92- Continuous 2-Part

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Description:

  • Item: HCFA 1 1450 UB92
  • Format: Continuous (Duplicate) Form UB92
  • Type: Two Part for pin feed printer
  • Size: 8-1/2" X 11"
  • Weight: White 20# and Canary 15#

 


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Prescription/Medical Security Paper

 
 
EZP, Inc.

20-E Robert Pitt Drive
Monsey, NY 10952
Tel. 888.333.3494
Fax 845.356.3654
info@formsandchecks.com

Specialty Blank Laser Paper
Hospital/Medical/Security