Provides information of items to be serviced, description of parts, materials and estimated cost of labor. Tag stock quadruplicate has form on back for labor/materials recap. Consecutive red numbering expedites filing and bookkeeping.
Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR...
Provides information of items to be serviced, description of parts, materials and estimated cost of labor. Tag stock quadruplicate has form on back for labor/materials recap. Consecutive red numbering expedites filing and bookkeeping.