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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.
More Details
$123.46 $239.97
OUT OF STOCK

Product#: 50122RV

EXPIDITED SHIPPING - Estimated Delivery Mon 7/4

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

TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 1/Page, 3,000 Forms/Carton (50122RV) Reviews

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