TOPS HCFA Claim Form

Product Specifications

• Assembly Required
  No
• Brand Name
  Tops
• Certifications & Standards
  AMA Council of Medical Service
• Country of Origin
  United States
• Environmental Certification
  Sustainable Forestry Initiative (SFI)
• Environmentally Friendly
  Yes
• Features
  Scannable
• Form Length
  8.50"
• Form Quantity
  3,000
• Form Size
  8.5 x 11 8.5 x 11
• Form Width
  11"
• Forms Per Page
  1
• Global Product Type
  Forms-Insurance
• Height
  9.5"
• Layout
  One Form per Sheet One Form per Sheet
• Manufacturer
  Tops
• Manufacturer Part Number
  50122R
• Manufacturer Website Address
  www.tops-products.com
• Marketing Information
  CMS-1500 form comply with current physicians standards for expediting Medicare and Medicaid payments. Each meets requirements of the Centers for Medicare and Medicaid Services, Champus and the AMA Council of Medical Service. Comes in a continuous format.
• Number of Parts
  1
• Packaged Quantity
  3000 / Carton
• Paper Color(s)
  White
• Paper Stock
  20 lb
• Post-Consumer Recycled Content Percent
  0%
• Post-consumer-waste%
  0%
• Pre-Consumer Recycled Content Percent
  0%
• Principal Heading(s)
  1500 Health Insurance Claim Form
• Print Color
  Blue Red
• Print and Ruling Color(s)
  OCR Red
• Printer Compatibility
  Dot Matrix
• Product Color
  White
• Product Material
  Paper
• Product Name
  HCFA Claim Form
• Product Type
  Claim Form
• Punching
  Dot Matrix Pin Feed Holes
• Recycled
  No
• Sheet Size
  11" Width x 9.50" Length
• Special Features
  Continuous Form
• Total Recycled Content Percent
  0%
• Width
  11"