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TOPS™
  • TOP50126RV
  • Item #: TOP50126RV
  • Your Price:
    $48.97  PK

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

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    • 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.

  • 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.
  • List Price: $48.97
Product Details
Global Product Type Forms-Insurance
Special Features For Laser Printers
Forms Per Page 1
Form Quantity 500
Layout One Form per Sheet
Paper Stock 20-lb.
Paper Color(s) White
Printer Compatibility Laser
Print and Ruling Color(s) OCR Red
Principal Heading(s) 1500 Health Insurance Claim Form
Form Size 8 1/2 x 11
Pre-Consumer Recycled Content Percent 0%
Post-Consumer Recycled Content Percent 0%
Total Recycled Content Percent 0%
Carton Pack Quantity 5
Carton Weight 28.0 lbs.
  Description Price Qty
  1. TOP50122RV
  2. TOPS™
    Centers for Medicare and Medicaid Services Forms, 3000 Forms/Carton
    • 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.
$205.35  CT
  1. TOP50135RV
  2. TOPS™
    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.
$27.00  PK
  1. TOP50124RV
  2. TOPS™
    Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms
    • 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.
$213.31  CT