Item #: 486075 | Model #: CMS1500L1V
TOPS Health Insurance Claim Form, Laser, 100/Pack (CMS1500L1V)
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TOPS Health Insurance Claim Form, Laser, 100/Pack (CMS1500L1V)

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Delivered by Tue, Apr 24
with Next-Day Delivery
$19.99
1-Hour Pick Up
$19.99
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Product Details
  • Sheet size: 8 1/2" x 11"
  • Number of parts: 1
  • Double sided printing
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19.99
19.99
https://www.staples-3p.com/s7/is/image/Staples/s0831097
00087958150018
TOPS
TOPS Health Insurance Claim Form, Laser, 100/Pack (CMS1500L1V)
Product Description
Tops Health insurance claim form is printed in OCR red ink for scanning and is compatible for use with laser printers.

Tops Health insurance claim form measuring 8 1/2" x 11" features double sided printing with loose sheet binding. Form is compatible for use with laser printers, sold as 100 per pack.

  • Sheet size: 8 1/2" x 11"
  • Number of parts: 1
  • Double sided printing
  • Easy-to-read forms make it easy to submit your claims
  • Form for submitting your Federal health insurance claims
  • Compatible with laser printers
  • Forms are printed on white paper with red ink
  • Printed in OCR red ink for scanning
  • 100 forms
  • 1 form per page
  • CMS-1500 health insurance claim form
  • Approved by NUCC
  • Laser compatible
  • Made in the USA
  • SFI Certified Sourcing
Specifications
HR Form Type Health Insurance Claims
HR Form Pack Size 100
Width in Inches 8.5
Length in Inches 11
Number of Parts 1
True Color White
Pack Qty 1
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