Home > Business Forms, Record Keeping Forms & Reference Supplies > Human Resources > Personnel Forms > TOPS® Centers for Medicare and Medicaid Services (CMS) Forms with Sensor Bar > TOP50129R

CMS 1500 Health Insurance Claim, Lttr, 2-Part, 100 Continuos Form Sets/Pack

  • 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. Form Type: Insurance Claim; Format: Continuous Form Set; Form Size (W x H): 8 1/2 in x 11 in; Sheet Size (W x H): N\A.
  • Usually arrives in 1-2 business days
  • Brand: TOPS®
  • more TOPS® products…
  • more Personnel Forms Human Resources…
Item# Description Price Unit Stock Ship Order
TOP50129R (2.0 lbs) $23.48 $21.18 (save 9%) Pack 642 Ship via UPS
Add item to shopping cart
Specifications
Copy Types Black Print Carbonless Duplicate
Form Size (W x H) 8 1/2 in @ 11 in
Form Type Insurance Claim
Format Continuous Form Set
Layout One Form per Sheet
Paper Color(s) White
Paper Stock 20-lb.
Principal Heading(s) 1500 Health Insurance Claim Form
Print and Ruling Color(s) OCR Red
Printer Compatibility Dot Matrix
Punching Dot Matrix Holes
UOM from Inventory Unit Code PK
Product Information
Universal Product Code (UPC) 50025932501291
United Nations Product Code 14111806
Country of origin US
Keywords Carbonless Duplicate, Claim Form, Claim Forms, CMS, CMS-1500, Continuous Form, HCFA Claim Form, Health Care Claim Forms, Human Resources, Insurance Forms, Personnel, Personnel Forms, TOPS
Other related items:
TOP50135R (2.6 lbs) $18.40 $14.31 (save 22%) Pack 680 Ship via UPS
Add item to shopping cart