TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 500 Forms/Pack
TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 500 Forms/Pack
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TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 500 Forms/Pack
TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 500 Forms/Pack

Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 500 Forms/Pack

Item #: TOP50126R

$44.99/Pack of 500

Estimated Delivery: Tue 9/26 to Wed 9/27
Qty:Add to cart
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Product Details

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.


COLOR: White
ALTERNATE ITEM #: 917557, B000DZ9X6Y

UPC: 025932512605

ITEM #: TOP50126R

Product Type: General Forms

White General Forms
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Product Specifications

Case Pack
Pack of 500
Color
White
Dimensions
8 1/2" x 11"
Form Quantity
500
Form Size
8.5 x 11
Format
Loose Form
Forms Per Page
1
Global Product Type
Forms-Insurance
Layout
One Form per Sheet
Manufacturer Name
TOPS
Paper Color(s)
White
Paper Stock
20 lb
Post-Consumer Recycled Content Percent
0%
Pre-Consumer Recycled Content Percent
0%
Principal Heading(s)
1500 Health Insurance Claim Form
Print and Ruling Color(s)
OCR Red
Printer Compatibility
Laser
Product Type
Insurance Claim
Special Features
For Laser Printers
Total Recycled Content Percent
0%
Weight
6 lb(s)
TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 500 Forms/Pack (TOP50126R)