New York    607-428-0474
New Jersey    732-269-2345

CMS 1500 (08/05)
   CMSLC "New Version"
      1 Part : Laser
HCFA 1500 (12/90)
   No Bar Code
      1 Part : Continuous
      2 Part : Continuous
      3 Part : Continuous
      1 Part : Laser
   Bar Code
      1 Part : Continuous
      2 Part : Continuous
      3 Part : Continuous
      1 Part : Laser
      2 Part : Snap Set
   Jumbo HCFA Envelopes
      Left Window w/Wording
      Right Window w/Wording
      Right Window w/o Wording
   #10.5 Window Envelopes
      Gum-Seal w/o Imprinting
      Gum-Seal w/Imprinting
      Self-Seal w/o Imprinting
      Self-Seal w/Imprinting

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We are Your Source for
CMS 1500, HCFA-1500, UB-92 and other Health and Dental
Insurance Claims Forms

We Deliver...QUALITY & SERVICE! "No Breaks" in our cartons - guaranteed! This means you can run our forms unattended without having to worry about breaks or jamming.

All of our forms are officially approved. The paper and inks we use for our forms are of the highest quality and have been officially approved by the Health Care Finance Administration, as well as the Insurance Industry. Our forms meet the high-quality standards needed to ensure your claims are processed quickly on the automated equipment now used by most insurance processors.

We ship our forms in a two-piece, telescopic carton. Our carton prevents form jamming, which is often caused by flaps on a traditional box. This carton also serves as a handy archival storage box once the forms have been used.



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