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TOPS CMS-1500 Medicare/Medicaid Forms for Laser Printers, One-Part (No Copies), 8.5 x 11, 250 Forms Total Product Image
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TOPS CMS-1500 Medicare/Medicaid Forms for Laser Printers, One-Part (No Copies), 8.5 x 11, 250 Forms Total

Part # TOP50135RV

UPC 025932513503

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Product Details

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.

Additional Information

  • Part #: TOP50135RV
  • MPN: 50135RV
  • UPC: 025932513503
  • UNSPC: 14111806

  • 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.
Brand TOPS
Form Size 8.5 x 11
Forms Per Page 1
Form Quantity 250
Principal Heading(s) 1500 Health Insurance Claim Form
Layout One Form per Sheet
Printer Compatibility Laser
Paper Stock 20-lb.
Paper Color(s) White
Print and Ruling Color(s) OCR Red
Pre-Consumer Recycled Content Percent 0%
Post-Consumer Recycled Content Percent 0%
Total Recycled Content Percent 0%
Special Features For Laser Printers
Country of Origin US
Prop65 No
Unit of Measure PK
Last Updated 11/8/2020

Additional Information