TOPS 50135RV Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 250 Forms/Pack

SKU
TOP50135RV
for Pricing or Request a Quote
Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 250 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: 250; Principal Heading(s): 1500 Health Insurance Claim Form.
More Information
UPC Retail 025932513503
UPC Carton 50025932513508
Copy Type No Copy
Form Type Insurance
Numbered No
SKU TOP50135RV
Inventory Unit Code PK
UPC 025932501357
Manufactured In United States
Manufacturer TOPS Products
Manuf Part # TOP50135RV
Model 50135RV
Usually Ships 1 - 3 Business Days
Condition New
Weight 2.640000
Commercial Price $34.80
UNSPSC 14111806