Brand: TOPS

Product Code: ESS-TOP50135RV

UPC: 025932513503

Availability: IN STOCK

$32.08
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TOPS Centers for Medicare and Medicaid Services Claim Forms, CMS1500/HCFA1500, 8 1/2 x 11, 250 Forms/Pack
  • 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.

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. For Laser Printers. Form Size: 8 1/2 x 11; Forms Per Page: 1; Form Quantity: 250; Principal Heading(s): 1500 Health Insurance Claim Form.