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)
$34.59
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
  • 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 AMERICA

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

Item #: 2408453Model #: 50135RV
Final price is $34.59
250/pack
First time subscribers save 5% off your entire AutoRestock order! Save up to 10% on all following orders. Learn more
Order within 4 hrs 50 mins

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
Medical Arts Press Periodontal Chart; Rainbow FormFamily (10008)~#|#~m002247884_sc7
Price is $22.19
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" (50135RV)~#|#~s1053550_sc7
TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250/Pack (50135RV) is Your Product
Price is $34.59
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 $19.99
Avery PermaTrack Metallic Laser Asset Tag Labels, 1-1/4" x 2-3/4", Glossy Silver, 112 Asset Tags/Pack (61528)~#|#~3F3C0061-7A31-452D-9C0BB56ADD501CD2_sc7Avery PermaTrack Metallic Laser Asset Tag Labels, 1-1/4" x 2-3/4", Glossy Silver, 112 Asset Tags/Pack (61528)~#|#~A98DC348-50FE-48D5-887970918619010F_sc7
Price is $53.19
Staples 10% Recycled Matte Other Pocket Quantities Cardstock Portfolio Folder, Red, Green, Yellow, Purple (18118-US)~#|#~09610060-A3F8-4F92-806EEABA8E5ED318_sc7Staples 10% Recycled Matte Other Pocket Quantities Cardstock Portfolio Folder, Red, Green, Yellow, Purple (18118-US)~#|#~427522BF-953B-407E-8BFCEEC1B82A69C6_sc7
Price is $13.39
Price for all 4
$121.16
  • 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) TOPS CMS-1500 Health Insurance Claims, 500/Pack (TOP 50126RV) ComplyRight 2024 ADA Dental Claim Forms, 500 Forms/Pack (20241500) ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5) ComplyRight 2024 ADA Dental Claim Forms, 2,500 Forms/Pack (20241)
    Your product
    Price is $34.59
    Reviews
    4.69
    13
    4.92
    12
    No reviews yet
    No reviews yet
    No reviews yet
    Delivery Information
    Next-Day Delivery by tomorrow
    Free Next-Day eligible by tomorrow
    Free delivery by Mon, Nov 24
    Delivery by Mon, Dec 01
    Free delivery by Mon, Nov 24
    Available in my store
    No
    No
    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
    500
    500
    500
    2500
    Medical Form Type
    Consent
    Health Insurance Claims
    Dental Claims
    Health Insurance Claims
    Dental Claims
    True Color
    Red and White
    White / Red
    White
    Data not available
    White
    Print Type
    Continuous
    Laser
    Laser
    Laser
    Laser
    Form Size
    8 1 / 2" x 11"
    8 1 / 2" x 11"
    8-1 / 2" x 11"
    Data not available
    8-1 / 2" x 11"
    Number of Parts
    1
    1
    1
    Data not available
    1
    Pack Qty
    1
    1
    Data not available
    Data not available
    Data not available
    Series or Collection
    Centers for Medicare and Medicaid Services
    CMS-1500
    Data not available
    Data not available
    Data not available
    Next Day Delivery
    Yes
    Yes
    Data not available
    Data not available
    Data not available
    Add To Cart
    Add To Cart
    Add To Cart
    Add To Cart