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Top Seller

TOPS Laser CMS Forms With Bar, 8 1/2" x 11", White, Pack Of 250

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Product Number: TOP50135RV
Other Product Options
TOPS Laser CMS Forms With Bar, 8 1/2" x 11", White, Pack Of 250
20 lb - 11" x 8.50" Sheet Size - White Sheet(s) - Red Print Color - 250 / Pack
$16.68
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Delivered by Thu 12/26 Fri 12/27 - This is an estimated delivery timeline
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Product Description

TOPS Laser CMS Forms With Bar, 8 1/2" x 11", White, Pack Of 250
20 lb - 11" x 8.50" Sheet Size - White Sheet(s) - Red Print Color - 250 / Pack
Description:
Simple-to-read, government-approved form helps you fill out CMS claims
  • Centers for Medicare and Medicaid Services (CMS) claim form.
  • Compatible with laser printers.
  • Features the American Medical Association approved format, revised 2/2012.
  • 20-lb white paper is printed on the front and back in red OCR ink for easy reading.
  • SFI Certified.
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Product Specifications

  • Additional Information
    20lb Bond Paper
  • Assembly Required
    No
  • Brand Name
    Tops
  • Certifications & Standards
    CMS NUCC OMB
  • Color
    White
  • Copy Types
    One-Part (No Copies)
  • Country of Origin
    US
  • Dated/Undated
    Undated
  • Environmental Certification
    SFI
  • Environmentally Friendly
    Yes
  • Features
    Double Sided
  • Form Length
    11"
  • Form Size
    8.5 x 11 8.5 x 11
  • Form Width
    8.50"
  • Forms Per Page
    1
  • Global Product Type
    Insurance Forms
  • Manufacturer
    TOPS BUSINESS FORMS
  • Manufacturer Part Number
    50135RV
  • Manufacturer Website Address
    www.tops-products.com
  • Marketing Information
    CMS 1500 Claim Form is in the AMA approved format. Printed front and back in red OCR ink on white, letter-size 20 lb. bond. Compatible with laser printers.
  • Number of Holes Punched
    0
  • Number of Parts
    1
  • Packaged Quantity
    250 / Pack
  • Packaging
    250
  • Paper Color(s)
    White
  • Paper Stock
    20 lb Bond
  • Post-Consumer Recycled Content Percent
    0%
  • Pre-Consumer Recycled Content Percent
    0%
  • Principal Heading(s)
    1500 Health Insurance Claim Form
  • Print Color
    Red
  • Print Technology
    Laser
  • Print and Ruling Color(s)
    OCR Red
  • Printer Compatibility
    Laser Laser Printer
  • Product Line
    Laser CMS Forms With Bar
  • Product Name
    CMS-15000 Health Insurance Claim Forms
  • Product Type
    Medical Claim Form
  • Quantity
    250
  • Recycled
    No
  • Refurbished
    N
  • Sheet Size
    Letter (8-1/2" x 11")
  • Special Features
    Laser Printer Compatible
  • Total Recycled Content Percent
    0%

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