Medical Forms, Health Insurance Claim Forms, CMS1500, UB92, Hospital Claim Forms

Durable Medical Equipment Claims

Durable Medical Equipment Claims:
These forms serve as a vehicle for a physician or a medical provider to authorize a patient to obtain certain "Durable Medical Equipment" that will be paid by Medicare.

The size is 9.5" x 11" Continuous Feed and are a two part carbonless form, printed on both sides in black ink.


 
Quantity Unit Price Net Price
 
Durable Medical Equipment Claims. Choose the type of durable claim from the drop down menu.
1000$79.95$79.95
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