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TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11" (50135RV)
$32.49
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TOPS Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11" (50135RV)~#|#~s1053550_sc7
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
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250/pack
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Only $9.89 Staples Smooth Paper Clips, 1000/pack. Add to cart.
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ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Pack of 250 (CMS12LC250)
Price is $25.39
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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" (50135RV) is Your Product
Price is $32.49
Medical Arts Press Reinforced End Tab File Folder, Letter-Size, Manila, 50/Box (S-01316)~#|#~654177A8-8DA9-4D95-98B5F05B8F8A847A_sc7Medical Arts Press Reinforced End Tab File Folder, Letter-Size, Manila, 50/Box (S-01316)~#|#~6C5B3244-BC20-4E8C-98F1CFDCE4DA56D8_sc7
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Avery Easy Peel Laser/Inkjet Color-Coding Labels, 1-1/4" Dia, Light Blue, 400 Labels/Pack (5496)~#|#~E54C11AB-6D2A-4382-A984396C4E080BB8_sc7Avery Easy Peel Laser/Inkjet Color-Coding Labels, 1-1/4" Dia, Light Blue, 400 Labels/Pack (5496)~#|#~54133F0A-AFFC-4492-B2863223FEA9D250_sc7
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Pukka Pad Rochelle & Jess 3-Hole Punched 2-Pocket Portfolio Folders, Assorted Colors, 6/Pack (9108-ROC)~#|#~3519ED7A-FE8A-43AD-B59C167ADFAC16A8_sc7Pukka Pad Rochelle & Jess 3-Hole Punched 2-Pocket Portfolio Folders, Assorted Colors, 6/Pack (9108-ROC)~#|#~15D51313-86DC-4887-B316F5C3C51A8716_sc7
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Price for all 4
$138.66
    • Details

    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

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    Specifications
    Specifications table
    Attribute nameAttribute value
    Length in Inches 11
    Pack Qty 1
    Number of Parts 1
    Form Size
    		8 1/2" x 11"
    Width in Inches
    		8.5
    Series or Collection
    		Centers for Medicare and Medicaid Services
    Medical Form Pack Size 250
    Medical Form Type Consent
    Print Type Continuous
    True Color
    		Red and White
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    ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1)
    Price is $80.99
    ComplyRight 2024 ADA Dental Claim Forms, 500 Forms/Pack (20241500)~#|#~8C5CF2B1-C564-4834-B70E58035F19DEAC_sc7
    Price is $40.99
    ComplyRight 2024 ADA Dental Claim Forms, 2,500 Forms/Pack (20241)~#|#~30211E02-A935-406B-A6832AFD0B88E088_sc7
    Price is $125.99
    ComplyRight 2024 ADA Dental Claim Forms, 100 Forms/Pack (20241100)~#|#~652ADB45-0A5E-495C-B7A6ABBF7660E69C_sc7
    Price is $15.79
    ComplyRight 2024 ADA Dental Claim Forms, 1,000 Forms/Pack (202411)~#|#~4A9BEC59-372C-4BA2-98230C384214A03F_sc7
    Price is $62.99
    ComplyRight UB-04 Hospital Claim Form, 500 Forms/Pack (UB04LC5)~#|#~BEEB25B0-3006-416D-A7EB845F6AB6205B_sc7
    Price is $27.59
    ComplyRight Notice of Privacy Practice, 100/Pack (A1349)
    Price is $36.79
    Adams Health Insurance Claims (CMS1500CV)
    Price is $33.19
    ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250)
    Price is $32.09
    Cosco Privacy Sign-In Sheets, 3-Part, 125 Forms/Pack (074040)~#|#~EC8D77B4-AFCA-45F3-A1ED3E5B8288210F_sc7
    Price is $56.29
    Reviews
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    13
    4.6
    25
    4.9
    12
    4.7
    31
    4.9
    42
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    Delivery Information
    Delivery by Tue, May 06
    Delivery by Tue, May 13
    Free delivery by Tue, May 06
    Free delivery by Tue, May 13
    Free delivery by Tue, May 06
    Free delivery by Tue, May 13
    Free delivery by Tue, May 13
    Delivery by Tue, May 13
    Free delivery by Tue, May 13
    Delivery by Thu, May 15
    Free delivery by Wed, May 14
    Pick up in 1 hour
    Delivery by Tue, May 06
    Free delivery by Wed, May 14
    Available in my store
    No
    No
    No
    No
    No
    No
    No
    No
    No
    No
    No
    Yes
    No
    No
    Length in Inches
    11
    11
    11
    11
    11
    11
    11
    11
    11
    11
    11
    11
    11
    11.625
    Width in Inches
    8.5
    8.5
    8.5
    8.5
    8.5
    8.5
    8.5
    8.5
    8.5
    8.5
    8.5
    9.5
    8.5
    8.5
    Medical Form Pack Size
    250
    250
    500
    500
    1000
    500
    2500
    100
    1000
    500
    100
    100
    250
    125
    Medical Form Type
    Consent
    Health Insurance Claims
    Health Insurance Claims
    Health Insurance Claims
    Health Insurance Claims
    Dental Claims
    Dental Claims
    Dental Claims
    Dental Claims
    Health Insurance Claims
    Privacy Practice
    Health Insurance Claims
    Health Insurance Claims
    Privacy Sign-In Sheets
    True Color
    Red and White
    White / Red
    White / Red
    White / Red
    White / Red
    White
    White
    White
    White
    Data not available
    White
    White
    White
    Green
    Print Type
    Continuous
    Laser
    Laser
    Laser
    Laser
    Laser
    Laser
    Laser
    Laser
    Laser
    Data not available
    Data not available
    Laser
    Digital
    Number of Parts
    1
    1
    1
    1
    1
    1
    1
    1
    1
    Data not available
    Data not available
    Data not available
    Data not available
    3
    Form Size
    8 1 / 2" x 11"
    Data not available
    8 1 / 2" x 11"
    Data not available
    Data not available
    8-1 / 2" x 11"
    8-1 / 2" x 11"
    8-1 / 2" X 11"
    8-1 / 2" x 11"
    Data not available
    8 1 / 2" x 11"
    9 1 / 2" x 11"
    8 1 / 2" x 11"
    8.5" x 11.625"
    Pack Qty
    1
    250
    1
    500
    1000
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    1
    100
    Data not available
    125
    Series or Collection
    Centers for Medicare and Medicaid Services
    Data not available
    CMS-1500
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    Data not available
    ADA
    CMS-1500
    Data not available
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