Attention Customers:

We and our supply partners are experiencing a high volume of orders on health and safety products and inventories are rapidly changing. Due to this situation, orders are being processed slower than normal. We are working to communicate your order status as it progresses. Thank you again for your business and we appreciate your patience.

OS
TOPS TOP50124RV Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms
Manufacturer: TOPS
UPC: 025932512407
SKU: TOP50124RV
Condition: New
TOPS TOP50124RV Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms
Global Product TypeForms-Insurance
Form Size8 1/2 x 11
Forms Per Page1
Form Quantity1500
Principal Heading1500 Health Insurance Claim Form
LayoutOne Form per Sheet
Copy TypesTwo-Part Carbonless
PunchingDot Matrix Pin Feed Holes
Printer CompatibilityDot Matrix
Paper Stock20-lb.
Paper ColorWhite
Print and Ruling ColorOCR Red
Pre-Consumer Recycled Content Percent0%
Post-Consumer Recycled Content Percent0%
Total Recycled Content Percent0%
Footnote 1Carbonless Duplicate
Special FeaturesCarbonless Duplicate-Continuous Form.
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.