TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 1/Page, 250 Forms/Pack
TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 1/Page, 250 Forms/Pack
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TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 1/Page, 250 Forms/Pack
TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 1/Page, 250 Forms/Pack

Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 1/Page, 250 Forms/Pack

Item #: TOP50135R

$27.99/Each

Estimated Delivery: Fri 4/26 to Mon 4/29
Qty:Add to cart
RSIRewards

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 #: 836952, B0013CNXDK

UPC: 025932513503

ITEM #: TOP50135R

Product Type: General Forms

White General Forms
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Product Specifications

Case Pack
Each
Color
White
Dimensions
8 1/2" x 11"
Form Quantity
250
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
2.66 lb(s)
TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 1/Page, 250 Forms/Pack (TOP50135R)