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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
254 In stock
You pay:
$57.39
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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