TOPS 50124RV | TOPS Centers

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Retail: $197.22
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TOPS Centers

for Medicare & Medicaid Services Forms, 2-Part, 8-1/2"W x 11"H, 1500 Forms

Item #: TOP50124RV

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Description: 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.
Features:
  • 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.
TAA Compliant
TAA Compliant

Product Specifications

Form Size:
8 1/2 x 11
Forms Per Page:
1
Form Quantity:
1500
Principal Heading(s):
1500 Health Insurance Claim Form
Layout:
One Form per Sheet
Copy Types:
Two-Part Carbonless
Punching:
Dot Matrix Pin Feed Holes
Printer Compatibility:
Dot Matrix
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%
Footnote 1:
Carbonless Duplicate
Special Features:
Carbonless Duplicate

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