TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11" (50135RV)
$33.69
1
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
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
MADE IN AMERICA
TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11" (50135RV)
Item #: 2408453Model #: 50135RV
250/pack
Free Returns
Online. In store. Always free.
Learn More
1
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
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
Frequently bought together
Price is $8.89
Unit of measure 3/Pack Price per unit $2.96/Pen
Delivery by Fri, May 16
1-hr pickup
1
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
Price is $11.99
Unit of measure 3/Pack Price per unit $0.01/Post-it® Note
Delivery by Fri, May 16
1
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
52% off of Staples Pop-up Notes, 3" x 3", Berry Blast Collection, 100 Sheet/Pad, 12 Pads/Pack (52225)
Price is $6.99, Regular price was $14.59, You save 52%
Unit of measure 12/Pack
Delivery by Fri, May 16
1-hr pickup
1
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
Price is $6.49
Unit of measure 100/Box
Delivery by Fri, May 16
1
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
Price is $12.29
Unit of measure Dozen
Delivery by Fri, May 16
1
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
Price is $21.19
Unit of measure 100/Box Price per unit $0.21/File Folder
Delivery by Fri, May 16
1-hr pickup
1
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
21% off of Sharpie Permanent Marker, Fine Tip, Black, 12/Pack (30001)
Price is $9.99, Regular price was $12.69, You save 21%
Unit of measure Dozen Price per unit $0.83/Marker
Delivery by Fri, May 16
1-hr pickup
1
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
Price is $15.69
Unit of measure Dozen Price per unit $0.01/Post-it® Note
Delivery by Fri, May 16
1-hr pickup
1
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
13% off of Staples Notepads, 8.5" x 11.75", Wide Ruled, White, 50 Sheets/Pad, Dozen (ST57339M/57339)
Price is $16.99, Regular price was $19.59, You save 13%
Unit of measure Dozen Price per unit $1.42/Pad
Delivery by Fri, May 16
1-hr pickup
1
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
Price is $19.49
Unit of measure 10/Pack Price per unit $1.95/Correction Tape
Delivery by Fri, May 16
1-hr pickup
1
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
Price is $8.69
Unit of measure 60/Pack Price per unit $0.14/Pen
Delivery by Fri, May 16
1-hr pickup
1
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
Price is $10.79
Unit of measure 1000/Pack Price per unit $0.01/Paper Clip
Delivery by Fri, May 16
1-hr pickup
1
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
Price is $8.19
Unit of measure 4/Pack Price per unit $2.05/Correction Tape
Delivery by Fri, May 16
1-hr pickup
1
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
11% off of Staples 30% Recycled File Folders, 1/3-Cut Tab, Letter Size, Manila, 250/Box (ST56673-CC)
Price is $27.99, Regular price was $31.69, You save 11%
Unit of measure 250/Box Price per unit $0.11/File Folder
Delivery by Fri, May 16
1
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
16% off of Staples Notepads, 5" x 8", Narrow Ruled, White, 50 Sheets/Pad, Dozen (ST57338)
Price is $9.99, Regular price was $11.99, You save 16%
Unit of measure 12/Pack Price per unit $0.83/Pad
Delivery by Fri, May 16
1-hr pickup
1
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
Price is $20.49
Unit of measure 10/Pack Price per unit $2.05/Roll
Delivery by Fri, May 16
1
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
Price is $11.19
Unit of measure 144/Pack Price per unit $0.08/Binder Clip
Delivery by Fri, May 16
1-hr pickup
1
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
Price is $8.69
Unit of measure 12/Pack Price per unit $0.72/Binder Clip
Delivery by Fri, May 16
1
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
17% off of Pilot G2 Retractable Gel Pens, Fine Point, 0.7mm, Black Ink, Dozen (31020)
Price is $16.99, Regular price was $20.49, You save 17%
Unit of measure Dozen Price per unit $1.42/Pen
Delivery by Fri, May 16
1-hr pickup
1
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
Price is $7.59
Unit of measure 24/Pack Price per unit $0.32/Binder Clip
Delivery by Fri, May 16
1
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
Compare similar items
| Attributes | TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11" (50135RV) | ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 250 (CMS12LC250) | TOPS CMS-1500 Health Insurance Claims, 500/Pack (TOP 50126RV) | ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 500 (CMS12LC500) | ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1) |
|---|---|---|---|---|---|
Your product TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11" (50135RV) Price is $33.69 |  Price is $26.29 |  Price is $50.59 |  Price is $46.89 |  Price is $83.79 | |
| Reviews | |||||
| Delivery Information | Delivery by Fri, May 16 | Delivery by Fri, May 23 | Free delivery by Fri, May 16 | Free delivery by Fri, May 23 | Free delivery by Fri, May 16 |
| 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 | 250 | 500 | 500 | 1000 |
| Medical Form Type | Consent | Health Insurance Claims | Health Insurance Claims | Health Insurance Claims | Health Insurance Claims |
| Print Type | Continuous | Laser | Laser | Laser | Laser |
| True Color | Red and White | White / Red | White / Red | White / Red | White / Red |
| Number of Parts | 1 | 1 | 1 | 1 | 1 |
| Form Size | 8 1 / 2" x 11" | Data not available | 8 1 / 2" x 11" | Data not available | Data not available |
| Pack Qty | 1 | 250 | 1 | 500 | 1000 |
| Series or Collection | Centers for Medicare and Medicaid Services | Data not available | CMS-1500 | Data not available | Data not available |
| Add To Cart | Add To Cart | Add To Cart | Add To Cart |
Featured Products
Price is $21.95
Delivery by Tue, May 27
1
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
Price is $20.19
Delivery by Tue, May 27
1
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
Price is $32.09
Unit of measure 100/Pack
Delivery by Wed, May 21
1
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
Price is $32.09
Unit of measure 100/Pack
Delivery by Wed, May 21
1
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
Price is $20.79
Unit of measure 50/Pack
Delivery by Wed, May 21
1
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
Price is $32.09
Unit of measure 100/Pack
Delivery by Wed, May 21
1
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
Price is $15.69
Unit of measure Dozen Price per unit $0.01/Post-it® Note
Delivery by Fri, May 16
1-hr pickup
1
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
Price is $36.79
Unit of measure 50/Pack
Free delivery by Wed, May 21
1
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
Price is $25.29
Unit of measure 50/Pack
Delivery by Wed, May 21
1
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
Price is $40.19
Unit of measure 50/Pack
Free delivery by Wed, May 21
1
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
Price is $45.79
Unit of measure 50/Pack
Free delivery by Wed, May 21
1
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
37% off of Hammermill Copy Plus 8.5" x 11" Copy Paper, 20 lbs., 92 Brightness, 5000 Sheets/Carton (105007)
Price is $49.99, Regular price was $79.99, You save 37%
Unit of measure 5000/Carton
Free delivery by Fri, May 16
1-hr pickup
1
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
Price is $38.89
Unit of measure 50/Pack
Free delivery by Wed, May 21
1
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
Price is $120.19
Free delivery by Tue, May 27
1
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
Price is $26.49
Unit of measure 50/Pack
Delivery by Wed, May 21
1
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