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ComplyRight™ CMS-1500 Health Insurance Claim Form (02/12), 2-Part Continuous, White/White, 1,000/Box
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Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250 Forms
$21.59
Per pack
Centers for Medicare and Medicaid Services Forms, 8-1/2" x 11", 250 Forms
Item #:
901-2408453
Model #:
50135RV
Brand:
TOPS
(12 reviews)
Item #:
901-2408453
Frequently bought together
+
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Total
$95.57
$21.59
Per pack
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Description
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
Specifications
Brand
TOPS
Form Size
8 1/2" x 11"
Length in Inches
11
Medical Form Pack Size
250
Number of Parts
1
Pack Qty
1
Series or Collection
Centers for Medicare and Medicaid Services
True Color
Red and White
Width in Inches
8.5