Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 500 Forms/Pack

SKU: 7300035080

Mfg: TOPS™

Mfg part #: TOP50126RV

$49.61

Savings: $21.86 (30.58 %)

Pack 500 EA/PK

Availability: In stock

Reward Points: 4

Qty:

Delivery date: Typically 3-5 days, but due to COVID related issues, there may be a delay

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. Form Size: 11 x 8 1/2; Forms Per Page: 1; Form Quantity: 500; Principal Heading(s): 1500 Health Insurance Claim Form.

Products specifications

UOM
Pack	500 EA/PK
Form Quantity	500
Form Size	11 x 8 1/2
Forms Per Page	1
Global Product Type	Forms-Insurance Claim
Layout	One Form per Sheet
Paper Color(s)	White
Paper Stock	20-lb.
Post-Consumer Recycled Content Percent	0%
Pre-Consumer Recycled Content Percent	0%
Principal Heading(s)	1500 Health Insurance Claim Form
Print and Ruling Color(s)	OCR Red
Printer Compatibility	Laser
Special Features	For Laser Printers
Total Recycled Content Percent	0%
UBN	COST
UBN	PRODUCTIVITY
UBN	Sustainability
Category	Forms
Manufacturer	TOPS™