https://www.staples-3p.com/s7/is/image/Staples/s1053550_sc7
TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250/Pack (50135RV)
$18.69
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Product image 1
Highlights
View all 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
New at Staples

TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250/Pack (50135RV)

Item #: TOP50135RVModel #: TOP50135RV
Ask a question
Final price is $18.69
pack

Free Returns

Online. In store. Always free.

Learn More

Sign in to unlock exclusive deals and picks just for you. sign in
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30

Consider this similar product

Adams CMS-1500 Health Insurance Claims, 100/Pack (CMS1500L1V)~#|#~sp38165292_sc7
Price is $24.79
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Over 30
Customers bought together
TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250/Pack (50135RV)TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250/Pack (50135RV)
TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250/Pack (50135RV) is Your Product
Price is $18.69
Staples 30% Recycled File Folders, 1/3-Cut Tab, Letter Size, Manila, 100/Box (ST56675)~#|#~FD6708EB-0D9C-4710-B97EE04BFBA39232_sc7Staples 30% Recycled File Folders, 1/3-Cut Tab, Letter Size, Manila, 100/Box (ST56675)~#|#~5C934D7B-B3EC-4A1C-AF00C0533240423D_sc7
Price is $11.99, Regular price was $19.99, You save 40%
Avery Easy Peel Laser Address Labels, 1" x 2 5/8", Matte White, 3000 Labels/Box (5160)~#|#~D33F37E0-29DA-4DE1-A60DA5F5135EC483_sc7Avery Easy Peel Laser Address Labels, 1" x 2 5/8", Matte White, 3000 Labels/Box (5160)~#|#~977ED9C1-4868-495A-9EF8BDABECFAE33D_sc7
Price is $38.09
Price for all 3
$68.77

    • About this product

    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
    • Made in the USA
    • 250 forms per pack

    Compare similar items

    Product specifications table
    Attributes TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250/Pack (50135RV) Adams CMS-1500 Health Insurance Claims, 100/Pack (CMS1500L1V) TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250/Pack (50135RV) TOPS CMS-1500 Health Insurance Claims, 500/Pack (TOP 50126RV) ComplyRight 2024 ADA Dental Claim Forms, 500 Forms/Pack (20241500)
    Your product
    TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250/Pack (50135RV)
    Price is $18.69
    Adams CMS-1500 Health Insurance Claims, 100/Pack (CMS1500L1V)~#|#~sp38165292_sc7
    Price is $24.79
    TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11" (50135RV)~#|#~s1053550_sc7
    Price is $34.59
    TOPS CMS-1500 Health Insurance Claims, 500/Pack (TOP 50126RV)~#|#~43D41C18-579A-4B95-856C2FF6A9BDA1E7_sc7
    Price is $51.89
    ComplyRight 2024 ADA Dental Claim Forms, 500 Forms/Pack (20241500)~#|#~8C5CF2B1-C564-4834-B70E58035F19DEAC_sc7
    Price is $43.59
    Reviews
    4.43
    7
    4.72
    69
    4.69
    13
    4.92
    12
    No reviews yet
    Delivery Information
    Delivery by Tue, May 12
    Delivery by Tue, May 12
    Delivery by Tue, May 12
    Free delivery by Tue, May 12
    Free delivery by Mon, May 18
    Available in my store
    No
    Yes
    No
    No
    No
    Length in Inches
    11
    11
    11
    11
    11
    Width in Inches
    8.5
    8.5
    8.5
    8.5
    8.5
    Medical Form Pack Size
    250
    100
    250
    500
    500
    Medical Form Type
    Consent
    Health Insurance Claims
    Consent
    Health Insurance Claims
    Dental Claims
    True Color
    Red and White
    White / Red
    Red and White
    White / Red
    White
    Number of Parts
    1
    1
    1
    1
    1
    Print Type
    Continuous
    Data not available
    Continuous
    Laser
    Laser
    Form Size
    8 1 / 2" x 11"
    8 1 / 2" x 11"
    8 1 / 2" x 11"
    8 1 / 2" x 11"
    8-1 / 2" x 11"
    Pack Qty
    1
    100
    1
    1
    Data not available
    Series or Collection
    Centers for Medicare and Medicaid Services
    CMS-1500
    Centers for Medicare and Medicaid Services
    CMS-1500
    Data not available
    Next Day Delivery
    Yes
    Yes
    Yes
    Yes
    Data not available
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart
    featuredProductsCarouselImage
    featuredProductsCarouselImage