TOPS Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms

(2) Reviews Product Number: TOP50124RV
  • 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.
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$118.51
$102.58 Bulk Pricing $102.58 when you buy 3 or more
Free 2-Day Shipping Estimated Delivery Wed 11/14 Thu 11/15
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Product Description

TOPS Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms - CMS-1500 forms 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.

  • 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 Specifications

  • Assembly Required
    No
  • Brand Name
    Tops
  • Certifications & Standards
    AMA NUCC Champus
  • Color
    White
  • Copy Types
    Two-Part Carbonless
  • Country of Origin
    United States
  • Footnote 1
    Carbonless Duplicate
  • Form Length
    8.50"
  • Form Quantity
    1500
  • Form Size
    8 1/2 x 11 8 1/2 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
    50124R
  • Manufacturer Website Address
    www.tops-products.com
  • Number of Parts
    2
  • 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 and Ruling Color(s)
    OCR Red
  • Print Color
    Red
  • Printer Compatibility
    Dot Matrix
  • Product Name
    Two-part CMS-1500 Forms
  • Product Type
    Claim Form
  • Punching
    Dot Matrix Pin Feed Holes
  • Recycled
    No
  • Recycled Content
    0%
  • Sheet Size
    8 1/2" Width x 11" Length
  • Shipping Weight (Approximate)
    31 lb
  • Special Features
    Carbonless Duplicate
  • Total Recycled Content Percent
    0%
  • Width
    11"

Customer Reviews

5 2 reviews

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