ComplyRight CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack
ComplyRight CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack
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ComplyRight CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack
ComplyRight CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack

CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack

Item #: TFP650657

$6.79/Pack of 100

Estimated Delivery: Tue 4/23 to Wed 4/24
Qty:Add to cart
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Product Details

Meet billing requirements for Medicare Part B. Easy-to-read forms with crisp, clean text help ensure faster claims processing. Paper, layout and ink comply with CMS standards and requirements. Layout includes all 02/12 NUCC revisions and is a direct replacement for the previous 08/05 version. Printed in scannable, OCR "dropout" red ink.


UPC: 015171105096

ITEM #: TFP650657

Product Type: General Forms

General Forms
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Product Specifications

Case Pack
Pack of 100
Copy Types
One-Part Carbonless
Form Quantity
100
Form Size
8.5 x 11
Forms Per Page
1
Global Product Type
Forms-Insurance
Layout
One Form per Sheet
Manufacturer Name
ComplyRight
Paper Color(s)
White
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
Sheet Size
8.5 x 11
Total Recycled Content Percent
0%
Weight
1.06 lb(s)
ComplyRight CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack (TFP650657)