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Hospital Insurance Claim Form, 8 1/2 x 11 inches, 250 Forms

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Product Information

(CMS 1450) Health Insurance Claim Form, Laser / Ink-JetFormat
1 Part 8-1/2 x 11 (Letter Size)
Accommodates reporting of the National Provider Identifier (NPI) number
Detailed Layout: The form features clearly labeled fields to capture patient information, diagnosis codes, procedure details, and billing data required for accurate claim processing.

Product Identifiers

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AIDC6WENK001

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