CMS 02/12 Insurance Claim Form, 1-Part Continuous White, 9 1/2 x 11, 2500 Forms

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Required by Centers for Medicaid and Medicare Services (CMS) and by most private healthcare organizations, these forms speed up claims processing and meet all federal guidelines.
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$60.30 USD Retail $133.12
  • Expedite Medicare, Medicaid or private insurance claims processing.
  • Forms meet all Federal regulations.
  • Formerly known as HCFA-1500 forms.
  • More Details
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    Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms.

    Product Specifications

    Brand NameGBC
    ColorClear
    ColorClear
    ColorClear
    CompatibilityGBC - Pinnacle 27 EZload Laminator
    CompatibilityGBC - Pinnacle 27 EZload Laminator
    CompatibilityGBC - Pinnacle 27 EZload Laminator
    Country of originChina
    Country of OriginChina
    Country of originChina
    Environmentally FriendlyYes
    Footnote 1One-part continuous feed white
    Form Quantity2500
    Form Size9 1/2 x 11
    Forms Per Page1
    Global Product TypeForms-Insurance
    Laminating Sheet Length500 ft
    Laminating Sheet Thickness1.50 mil
    Laminating Sheet Width25"
    ManufacturerACCO Brands Corporation
    Manufacturer Part Number3748201EZ
    Manufacturer Website Addresshttp://www.acco.com
    MaterialPolyester
    MaterialPolyester
    MaterialPolyester
    Packaged Quantity2 / Box
    Paper Color(s)White
    Paper Stock20 lb.
    Product LineEZload
    Product NameEZ Load Laminating Roll Film
    Product TypeLaminating Roll
    RecycledNo
    Sealing ProcessHot-run
    Sheet Size9 1/2 x 11
    Special FeaturesCenters for Medicare and Medicaid Services (CMS) Forms
    Special_Benefit_Statement(02/12) version
    Surface FinishMatte
    RecycledNo
    RecycledNo

    Material Safety Data Sheet
    A Material Safety Data Sheet (MSDS) is a document that contains information on the potential hazards (health, fire, reactivity and environmental) and how to work safely with the chemical product.

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