TOPS Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 250 Forms/Pack

Sku:

TOP50135R

Upc:

025932501357

(0)
$14.88 / PK
$14.47 / PK
when buying 4+
Price Quote
when buying in bulk
List Price: $24.96
You Save: -$10.08 (-40%)
Price: $14.88 / PK and get $0.21 back in Rewards
Qty:
  Free Shipping on orders over $ 60
  Estimated delivery time 1-3 business days
  • 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.

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

Global Product Type Forms-Insurance
Form Size 8 1/2 x 11
Forms Per Page 1
Form Quantity 250
Principal Heading 1500 Health Insurance Claim Form
Layout One Form per Sheet
Printer Compatibility Laser
Paper Stock 20-lb.
Paper Color White
Print and Ruling Color OCR Red
Pre-Consumer Recycled Content Percent 0%
Post-Consumer Recycled Content Percent 0%
Total Recycled Content Percent 0%
Special Features For Laser Printers
Sign Up for Special Savings!
Follow Us