TOPS CMS-1500 Medicare/Medicaid Forms for Laser Printers, One-Part (No Copies), 8.5 x 11, 250 Forms Total

Part # TOP50135RV

UPC 025932513503

$32.45

$21.79

Less than 10 available

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Product Details

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.

Additional Information

Part #: TOP50135RV
MPN: 50135RV
UPC: 025932513503
UNSPC: 14111806

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.

Brand	TOPS
Form Size	8.5 x 11
Forms Per Page	1
Form Quantity	250
Principal Heading(s)	1500 Health Insurance Claim Form
Layout	One Form per Sheet
Printer Compatibility	Laser
Paper Stock	20 lb
Paper Color(s)	White
Print and Ruling Color(s)	OCR Red
Pre-Consumer Recycled Content Percent	0%
Post-Consumer Recycled Content Percent	0%
Total Recycled Content Percent	0%
Special Features	For Laser Printers
Country of Origin	US
Prop65	No
Unit of Measure	PK
Last Updated	2/4/2022