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TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 1/Page, 3,000 Forms/Carton (50122RV)
- 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.
$123.46 $239.97
OUT OF STOCK
Product#: 50122RV
EXPIDITED SHIPPING - Estimated Delivery Mon 6/5
TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 1/Page, 250 Forms/Pack (50135RV)
$20.62 $39.40
TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8.5 x 11, 500 Forms/Pack (50126RV)
$37.83 $71.47
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Product Description
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. Continuous Form. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 3,000; Principal Heading(s): 1500 Health Insurance Claim Form.
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.
Product Specification
| Manufacturer | TOPS |
|---|---|
| Categories | TOPS Office SuppliesTOPS Forms, Recordkeeping & Reference MaterialsTOPS Forms |
| Manufacturer Stock No. | 50122RV |
| MPN | TOP50122RV |
| Model# | 50122RV |
| UPC Code | 025932512209 |
| UNSPSC Code | 0 |
| Form Quantity | 3,000 |
| Form Size | 8.5 x 11 |
| Forms Per Page | 1 |
| Global Product Type | Forms-Insurance |
| Layout | One Form per Sheet |
| Paper Color(s) | White |
| Paper Stock | 20 lb |
| 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 |
| Printer Compatibility | Dot Matrix |
| Punching | Dot Matrix Pin Feed Holes |
| Special Features | Continuous Form |
| Total Recycled Content Percent | 0% |
| Assembly Required | No assembly is required |
| Contains Recycled Materials | N |
| Green Product | N |
| Unit of Measure | CT |
| Item Weight | 34.4 |
| Ships via UPS | Y |
| Carton Pack Quantity | 3000 SH |
| This item is sold by the | CT which contains 3000 SH |
| Brand | TOPS |
| Country of Origin | US |
| UNSPSC Number | 14111806 |
