EZP, Inc.

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

.............................................

Business Hours

Order online 24 hrs a day

Phone Orders Call
888 333-3494

Monday through Thursday
9:30 AM to 5:30 PM EST
Fri. 9:30 AM to 1:00 PM

HEALTH INSURANCE CLAIM FORMS
HCFA FORM CMS-1500  & UB-04
Forms
For Laser & Tractor Feed Printers
With &Without Barcode

All Orders Are Shipped Within 2 business days

Get 100 sheets next day 10:30am by FedEx Express for only $25.99 - shipping included
Rush orders must be placed by 12:00pm EST Monday - Thursday or Friday by 10:00AM

 

Item

Format

Size Wt.

Type

Samples

HCFA    L
CMS-1500 

LASER FORM
CMS 1500 

8-1/2" X 11" 24#

Laser One Part

LASER
 FORM CMS-1500 

 NEW ITEM   HCFA CMS-1500
 Laser/Inkjet  Health Insurance Claim Form ( for laser/inkjet printers)

    New Form CMS-1500 APPROVED OMB-0938-0999
                             
SEE  SAMPLE
Select Quantity:                                
 
 
                                                                  

HCFA    1

CMS-1500

CONTINUOUS (SINGLE)
HCFA CMS-1500 FORM  

8-1/2" X 11" 20#

One Part for
pin feed printer

TRACTOR FEED
HCFA CMS-1500

 NEW ITEM   HCFA CMS-1500 (1 part)
 Continuous Health Insurance Claim Form (for tractor feed printers)

    New Form CMS-1500 APPROVED OMB-0938-0999
                             
SEE  SAMPLE
Select Quantity:                                
 
                                                 

HCFA    2

CMS-1500

CONTINUOUS (Duplicate)
HCFA CMS-1500 FORM  

8-1/2" X 11"  

Two Part for
pin feed printer

TRACTOR FEED
HCFA CMS-1500

NEW ITEM      HCFA CMS-1500 (2 part)
 Continuous Health Insurance Claim Form
    New Form CMS-1500 APPROVED OMB-0938-0999
                             
SEE  SAMPLE

                  2 Part Carbonless
(white 20# and Canary 15# )

Select Quantity:                                  
                                      

 call us  to order for discount prices on  larger quantities  888.333.3494

Item

Format

Size Wt.

Type

Samples

Hospital
Claim Form

LASER FORM
UB-04

8-1/2" X 11" 24#

One Part

UB-04 

 NEW ITEM    Form UB-04     Hospital Claim Form UB-04
                                              
Laser Sheets One Part
 

Select Quantity:                                  

Hospital
Claim Form

CONTINUOUS (SINGLE) 
FORM UB92

8-1/2" X 11" 20#

One Part for
pin feed printer

Pin Feed
 UB-04 

 NEW ITEM     Form UB-04   Hospital Claim Form UB-04
                                              
Continuous (One Part)
 
   CONTINUOUS
Select Quantity:                                
 
                                                  

HCFA 1 1450
UB92

CONTINUOUS (Duplicate)
FORM UB92   

8-1/2" X 11"  

Two Part for
pin feed printer

Pin Feed
 UB-04 

NEW ITEM   Form UB-04    Hospital Claim Form UB-04
                                            
 Continuous (Two Part)
 
   CONTINUOUS
   2 Part Carbonless (white 20# and Canary 15# )

Select Quantity:                                  
                                        

Click Here For
Security Paper &
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