• #876547
  • Phoenix Printing #790-0116QR

Healthcare Form Claim Form

FORM, HCFA 1 PT CONT REVISION DATE 02/12 (2500/CT)

Features
  • Continuous revision date 02/12
  • More …
Type
Billing Form Claim Form Medical Claim 2 Part
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Product Specifications


McKesson #876547
Manufacturer #790-0116QR
ManufacturerPhoenix Printing
Country of OriginUnknown
ApplicationHealthcare Form
ColorWhite / Red
MaterialPaper
TypeClaim Form
UNSPSC Code42142304
Features
  • Continuous revision date 02/12