TOPS HCFA Claim FormClaim Forms
1 Part - Yes - 9.50" x 11" Sheet Size - White Sheet(s) - Red, Blue Print Color - 3000 / Carton - View Complete Details
Product Number: TOP50122RV
In Stock - Hurry, only 30 left.
Estimated Delivery - 1 business day(s) - Mon 12/12 2 business days - Tue 12/13
Free Shipping - This item qualifies for Free Shipping
Note: Must buy in quantities of 1 starting at 3.
Estimated Delivery 10 business day(s) - Fri 12/23 - The products will be shipped directly from the Manufacturer and will require additional time for delivery. 10 business days - Fri 12/23 - The products will be shipped directly from the Manufacturer and will require additional time for delivery.
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Made in America
This product was manufactured in the United States.
TOPS HCFA Claim Form - 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.
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