Health Insurance Claim Forms

Choosing the Right Forms for Your Printer
  1. Identify the type of printer you use with the pictures below.
  2. Select the correct form: CMS-1500, UB-04, or Dental.
  3. For continuous form printers, select the number of parts.

Laser Printer
Laser Printer

If you use a laser / ink jet printer choose 1 Part forms:

  • Item #89005: CMS-1500 Laser Sheets
  • Item #89208: UB-04 Laser Sheets
  • Item #89635: Dental Form Laser Sheets

Sheet Fed Printer
Sheet Fed Printer

If you use a sheet fed printer choose 1 Part forms:

  • Item #89005: CMS-1500 Laser Sheets
  • Item #89208: UB-04 Laser Sheets
  • Item #89635: Dental Form Laser Sheets

Continuous Feed Printer
Continuous Feed Printer

If you use a pin or tractor feed printer choose continuous forms:

  • Item #89010: CMS-1500 1-Part Continuous
  • Item #89015: CMS-1500 2-Part Continuous
  • Item #89020: CMS-1500 3-Part Continuous
  • Item #89030: CMS-1500 1-Part Continuous with Mailing Label
  • Item #89035: CMS-1500 2-Part Continuous with Mailing Label
  • Item #89201: UB-04 1-Part Continuous
  • Item #89202: UB-04 2-Part Continuous
  • Item #89203: UB-04 3-Part Continuous
  • Item #89634: Dental Form 1-Part Continuous
  • Item #89636: Dental Form 2-Part Continuous