TOPS 50126RV Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 500 Forms/Pack

SKU
TOP50126RV
for Pricing or Request a Quote
Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 500 Forms/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.

Eligible Contracts:

  • Fed-OS4-Office-47QSEA18D008C
  • Fed-OS4-DOJBPA-15G1AC25F00000024
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: 8 1/2 x 11; Forms Per Page: 1; Form Quantity: 500; Principal Heading(s): 1500 Health Insurance Claim Form.
More Information
UPC Retail 025932512605
UPC Carton 50025932512600
Copy Type No Copy
Form Type Insurance
Numbered No
SKU TOP50126RV
Inventory Unit Code PK
UPC 025932512605
Manufactured In United States
Manufacturer TOPS Products
Manuf Part # TOP50126RV
Model 50126RV
Usually Ships 1 - 3 Business Days
Condition New
Weight 5.500000
Commercial Price $92.77
UNSPSC 14111806