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Centers For Medicare And Medicaid Services Claim Forms, Cms1500/Hcfa1500, 8.5 X 11, 1/Page, 250 Form

Original
SKU: TOP50135RV • Catalog SKU: TOP-50135RV

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.
$36.69 /PK
198 In stock
You pay:
$36.69
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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
Manufacturer Part Number 50135RV
Manufacturer Website Address http://www.tops-products.com
Packaged Quantity 250 / Pack
Assembly Required No
Product Name Laser 1-part CMS-1500 Health Insur. Clm Forms
Sheet Size 11" Width x 8 1/2" Length
Product Type Health Insurance Form
Recycled No
Certifications & Standards
  • CMS
  • NUCC
  • OMB
Country of Origin United States of America
Manufacturer TOPS Products
Sheet Color White
Print Technology Laser
Print Color Red
Post-Consumer Recycled Content Percent 0%
Form Quantity 250
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