Centers for Medicare and Medicaid Services Forms, 3000 Forms/Carton by TOPS

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$105.05 / CT
$98.57 / CT
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List Price: $189.86
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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.


Punching Dot Matrix Pin Feed Holes
Paper Color White
Form Quantity 3000
Layout One Form per Sheet
Global Product Type Forms-Insurance
Forms Per Page 1
Pre-Consumer Recycled Content Percent 0%
Paper Stock 20-lb.
Principal Heading 1500 Health Insurance Claim Form
Printer Compatibility Dot Matrix
Post-Consumer Recycled Content Percent 0%
Total Recycled Content Percent 0%
Form Size 8 1/2 x 11
Print and Ruling Color OCR Red
Special Features Continuous Form
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