Error:
Success:

Centers For Medicare And Medicaid Services Claim Forms, Cms1500/Hcfa1500, 8.5 X 11, 500 Forms/Pack

Original
SKU: TOP50126RV • Catalog SKU: TOP-50126RV

DETAILS

CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits. Top sensor bar for microfiche duplication, as required in some states. OCR red ink for scanning.
$57.39 /PK
761 In stock
You pay:
$57.39
Qty
Your purchase will provide
1 minutes
of employment to people who
are blind or visually impaired.
Have questions or need help?
1.800.891.9295

You Might Also Like...

DESCRIPTION

Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR ink for scanning.

SPECIFICATIONS

Basis Weight 20 lb
Brand Name TOPS
Number of Parts 1
Manufacturer Website Address http://www.tops-products.com
Packaged Quantity 500 / Pack
Assembly Required No
Form Length 8.50"
Width 11"
Product Type Health Insurance Form
Product Name CMS-1500 Laser Printer Forms
Height 9.5"
Manufacturer Part Number 50126RV
Recycled No
Form Width 11"
Country of Origin United States of America
Certifications & Standards
  • AMA
  • NUCC
  • Champus
Color(s) White
Manufacturer TOPS Products
Print Technology Laser
Print Color Red
Material Paper
Post-Consumer Recycled Content Percent 0%
Form Quantity 500
Forms Per Page 1
Print and Ruling Color(s) OCR Red
Paper Stock 20-lb.
Pre-Consumer Recycled Content Percent 0%
Paper Color(s) White
Layout One Form per Sheet
Form Size 8 1/2 x 11
Total Recycled Content Percent 0%
Principal Heading(s) 1500 Health Insurance Claim Form