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. Laser Printer Compatible. Form Type Details: CMS-1500; Dated/Undated: Undated; Forms Pe
- 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 Details
| SKU: | TOP50126RV |
| Manufacturer: | TOPS BUSINESS FORMS |
| Mfr. Part Number: | 50126RV |
| Brand Name: | TOPS |
| Alternate Part Numbers: | TOP50126RV, TOP-50126RV, 50126RV, 50025932512600 (GTIN), 00025932512605 (GTIN) |
| Country of Origin: | US (United States) |
| TAA Compliant: | Yes |
| UNSPSC Code: | 0014111806 |
| Unit of Measure: | PK (Package of 500) |
| UPS Shippable: | Yes |
| Air Shippable: | Yes |
| Item Dimensions: | 11.00 in. x 8.50 in. x 2.20 in. |
| Weight: | 5.1900 lb. |
| Expiration Date: | No |
| Keywords: | Claim Form; Claim Forms; CMS; CMS-1500; Continuous Form; HCFA Claim Form; Health Care Claim Forms; Human Resources; Insurance Forms; Personnel; Personnel Forms; TOPS; Paperwork; Records; Documents; Pre-Printed; Record-Keeping |
Environmental Properties
| Green Indicator: | No |
| Recycled: | No |
