Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms by TOPS
$111.31 / CT
$107.89 / CT
when buying 4+
when buying in bulk
- 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.
|Copy Types||Two-Part Carbonless|
|Forms Per Page||1|
|Global Product Type||Forms-Insurance|
|Layout||One Form per Sheet|
|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||Dot Matrix|
|Punching||Dot Matrix Pin Feed Holes|
|Total Recycled Content Percent||0%|
|Special Features||Carbonless Duplicate|
|Form Size||8 1/2 x 11|
|Footnote 1||Carbonless Duplicate|