ComplyRight CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack (650657)
- Meet billing requirements for Medicare Part B.
- Easy-to-read forms for faster claims processing.
- Comply with CMS standards and requirements for paper, layout and ink.
Product#: 650657
EXPIDITED SHIPPING - Estimated Delivery Mon 4/22
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Product Description
Meet billing requirements for Medicare Part B. Easy-to-read forms with crisp, clean text help ensure faster claims processing. Paper, layout and ink comply with CMS standards and requirements. Layout includes all 02/12 NUCC revisions and is a direct replacement for the previous 08/05 version. Printed in scannable, OCR "dropout" red ink. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 100; Sheet Size: 8.5 x 11.
Meet billing requirements for Medicare Part B.
Easy-to-read forms for faster claims processing.
Comply with CMS standards and requirements for paper, layout and ink.
Printed in scannable, dropout OCR red ink.
Include all 02/12 NUCC revisions, replacing the previous 08/05 version.
Product Specification
| Manufacturer | ComplyRight |
|---|---|
| Categories | ComplyRight Office SuppliesComplyRight Forms, Recordkeeping & Reference MaterialsComplyRight Forms |
| Manufacturer Stock No. | 650657 |
| MPN | TFP650657 |
| Model# | 650657 |
| UPC Code | 015171105096 |
| UNSPSC Code | 0 |
| Copy Types | One-Part Carbonless |
| Form Quantity | 100 |
| Form Size | 8.5 x 11 |
| Forms Per Page | 1 |
| Global Product Type | Forms-Insurance |
| Layout | One Form per Sheet |
| Paper Color(s) | White |
| Post-Consumer Recycled Content Percent | 0% |
| Pre-Consumer Recycled Content Percent | 0% |
| Principal Heading(s) | 1500 Health Insurance Claim Form |
| Print and Ruling Color(s) | OCR Red |
| Sheet Size | 8.5 x 11 |
| Total Recycled Content Percent | 0% |
| Assembly Required | No assembly is required |
| Contains Recycled Materials | N |
| Green Product | N |
| Unit of Measure | PK |
| Item Weight | 1.065 |
| Ships via UPS | Y |
| Carton Pack Quantity | 500 PK |
| Brand | ComplyRight |
| Country of Origin | US |
| UNSPSC Number | 14111806 |
