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

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$15.60 / PK
$15.15 / PK
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  Estimated delivery time 2-3 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.


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