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

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$15.20 / PK
$14.77 / PK
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List Price: $24.96
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  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.


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