CMS 485, 486, 487  HOME HEALTH CARE CLAIM FORMS
CMS 485 AND CMS 487 FORMS ARE AVAILABLE AS 4 PART CONTINUOUS (TRACTOR-FEED) FORMS AND CMS 486 FORMS ARE AVAILABLE AS 3 PART CONTINUOUS FORMS.

CMS-485

CMS-486

CMS-487

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Description

Quantity/Case

Price/Case

Secure Order

CMS 485
4 Part Continuous

500

$55.00

Quantity:

 

CMS 486
3 Part Continuous

1000

$75.00

Quantity:

 

CMS 487
4 Part Continuous

500

$55.00

Quantity:
 

Discounts available for large quantities.
Contract pricing available. Call for details!

ALL OUR FORMS ARE OF THE HIGHEST QUALITY,  ARE PRINTED IN STRICT COMPLIANCE  WITH GOVERNMENT SPECIFICATIONS AND ARE APPROVED BY CENTERS FOR MEDICARE AND MEDICAID SERVICES AND THE INSURANCE INDUSTRY.
OUR FORMS HAVE BEEN APPROVED BY THE GOVERNMENT.
The American HCFA Forms division of DFL Enterprises, Inc. is an independent supplier of US Government
approved claim forms and NOT an affiliate of CMS (
www.cms.gov)

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