Item #: TOP50135RV | Model #: 50135RV
TOPS™ Centers for Medicare and Medicaid Services (CMS) Forms, 11 x 8 1/2, 250/Pack (50135R)
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TOPS™ Centers for Medicare and Medicaid Services (CMS) Forms, 11 x 8 1/2, 250/Pack (50135R)

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$21.89
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Product Details
  • 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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21.89
21.89
https://www.staples-3p.com/s7/is/image/Staples/m007150786
00025932513503
TOPS
TOPS™ Centers for Medicare and Medicaid Services (CMS) Forms, 11 x 8 1/2, 250/Pack (50135R)
Product Description
CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid, or private insurance benefits. Features OCR red ink for scanning.

CMS-1500 claim forms 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.

  • 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 Type Refinement: Insurance Claim
  • Manufacturer: Tops Business Forms
Specifications
HR Form Type Cms-1500
HR Form Pack Size 250
Width in Inches 8.5
Length in Inches 11
True Color Red and White
Thickness Millimeters 27.94
Pack Qty 1
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