Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 500 Forms/Pack by TOPS

Product ID:


$26.07 / PK
$25.34 / PK
when buying 4+
Price Quote
when buying in bulk
List Price: $45.28
You Save: -$19.21 (-42%)
Price: $26.07 / PK and get $0.37 back in Rewards
  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.


Pre-Consumer Recycled Content Percent 0%
Global Product Type Forms-Insurance
Forms Per Page 1
Paper Color White
Form Quantity 500
Principal Heading 1500 Health Insurance Claim Form
Layout One Form per Sheet
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
Special Features For Laser Printers
Paper Stock 20-lb.
Sign Up for Special Savings!
Follow Us