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

$139.83

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Part #: 50122RV

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

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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.

Features

  • 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.

Similar Products View Product Specs

$139.83

Free Shipping

Part #: 50122RV

Product Specs

  • Form Quantity

    3,000

  • Form Size

    8.5 x 11

  • Forms Per Page

    1

  • Global Product Type

    Forms-Insurance

  • Layout

    One Form per Sheet

  • Manufacturer Stock No.

    50122RV

  • 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%

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