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TOPS® Centers for Medicare and Medicaid Services (CMS) Forms Window Envelope Business-weight window envelope for CMS-1500 (formerly HCFA-1500) claim forms. Self-adhesive closure.

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Order Qty	Item No	Description			Sold By	List Price	Your Price	You Save
Right Window Envelope
	For sending claim to insurance carrier.
	TOP50941 Check Stock		2,500 Envelopes/Carton	4-1/8 x 9-1/2	Carton of 2500 EA	383.64	$276.12	28%
	For sending multiple forms to insurance carrier.
	TOP50992 Check Stock		500 Envelopes/Carton	9 x 12-1/2	Carton of 500 EA	172.62	$130.59	24%

TOPS® Business Forms Employee Record Master File Jacket • Employment applications comply with state and federal laws prohibiting discrimination Record and update employment history. Holds pre- and post-hiring forms. Closed sides. Manila stock, printed one side.

Order Qty	Item No	Description			Sold By	List Price	Your Price	You Save
1" Expansion
	TOP32801 Check Stock		15 File Jackets per Pack	9-1/2 x 11-3/4	Pack	23.60	$16.87	29%
No Expansion
	TOP3280 Check Stock		20 File Jackets per Pack	9-1/2 x 11-3/4	Pack	26.77	$18.26	32%

TOPS® Centers for Medicare and Medicaid Services (CMS) Forms with Sensor Bar #CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits. Top sensor bar for microfiche duplication is required in some states. 20-lb. white paper; OCR red ink for scanning. 8-1/2 x 11.

Order Qty	Item No	Description			Sold By	List Price	Your Price	You Save
Continuous Form
	Carbonless duplicate.
	TOP50129R Check Stock		100 Sets per Carton	Two-Part Form	Pack	26.06	$20.93	20%
	For laser printers.
	TOP50135R Check Stock		250 Sets per Carton	One-Part Form	Pack	20.42	$14.51	29%