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HEALTH CLAIM FORMS & ENVELOPES


health insurance claim form

In Business since 1969, Sterling Business Forms, Inc. is one of the largest suppliers of Health Claim Billing Forms to the independent forms professional on the west coast. We pride ourselves on having the most current government revisions of CMS-1500 and UB-04 Health Claim Forms. For your convenience, we also offer Dental Claim Forms and Envelopes to address your customer's needs.

Our products are available in Laser, Continuous and Unit Set. Please see below for stocking.

As always, most products are available to ship within 24 hours from one of our five strategically located west coast distribution centers.



STOCKING LIST - CMS 1500 (Rev 2012)
CMS 1500 2012 CONTINUOUS: 9½" x 11"
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
501-12 X X X X
502-12 X X X X
532-12 X

CMS 1500 2012 LASER: 8½" x 11"
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
511-12 X X X X X

CMS 1500 2012 UNIT SET: 8½" x 11"
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
522-12 X

1984 REVISION (C-2) CONTINUOUS: 9½" x 11"
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
112       X  
112B     X  

CMS - 1450/UB 4 CONTINUOUS: 9½" x 11"
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
601N X X X X
602N X X X X  
603N   X X    
604N   X X    

CMS - 1450/UB 4 LASER: 8½" x 11"
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
611N X X X X X

BLANK HOSPITAL PUNCHED PAPER
BLANK PUNCHED PAPER: 8½" x 11"
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
405 (5 Hole Left)     X    
407 (7 Hole Left)     X    

ATTENDING DENTISTS STATEMENTS (9 ½" x 11" CONTINUOUS ONLY)
ADA / ADS 07 J400 CONTINUOUS 9 ½" x 11"
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
301-12 X        
302-12 X        

ADA / ADS 07 J400 LASER 8 ½" x 11"
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
311-12 X        

ADA / ADS 85
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
312     X X  

ADA / ADS 86
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
351     X    

ADA / ADS 87
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
361   X      
372   X X    

ADA / ADS 90
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
371     X    
382       X  

ADA / ADS 94
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
391     X    

ENVELOPES
RH WINDOWS
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
R10 X X X X  

SELF SEAL RH
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
T10 X X X X  

MAILER
FORM NO. MEDFORD SPOKANE SACRAMENTO VISTA PORTLAND
SL125T X X X X  

Call today for pricing and availability.

F.O.B. Spokane, WAF.O.B. Medford, OR
F.O.B. Sacramento, CAF.O.B. Vista, CA
F.O.B. Portland, OR
Phone: (800) 876-5525Fax: (800) 964-2520