Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms

New 
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.
0 Review(s) Item: 50124RV | By: Tops Business Forms | In Stock
$211.18 USD Retail $213.31
  • 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.
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    Product Specifications

    Copy TypesTwo-Part Carbonless
    Footnote 1Carbonless Duplicate
    Footnote 1Carbonless Duplicate
    Footnote 1Carbonless Duplicate
    Form Quantity1500
    Form Quantity1500
    Form Quantity1500
    Form Size8 1/2 x 11
    Forms Per Page1
    LayoutOne Form per Sheet
    Paper Color(s)White
    Paper Color(s)White
    Paper Color(s)White
    Paper Stock20-lb.
    Post-Consumer Recycled Content Percent0%
    Post-Consumer Recycled Content Percent0%
    Post-Consumer Recycled Content Percent0%
    Pre-Consumer Recycled Content Percent0%
    Pre-Consumer Recycled Content Percent0%
    Pre-Consumer Recycled Content Percent0%
    Principal Heading(s)1500 Health Insurance Claim Form
    Print and Ruling Color(s)OCR Red
    Printer CompatibilityDot Matrix
    Product TypeForms-Insurance
    Product_DescriptionFORMCMS 1500 2-PARTWE
    PunchingDot Matrix Pin Feed Holes
    Special FeaturesCarbonless Duplicate-Continuous Form.
    Special FeaturesCarbonless Duplicate-Continuous Form.
    Special FeaturesCarbonless Duplicate-Continuous Form.
    Total Recycled Content Percent0%
    Total Recycled Content Percent0%
    Total Recycled Content Percent0%
    Copy TypesTwo-Part Carbonless
    Form Size8 1/2 x 11
    Forms Per Page1
    LayoutOne Form per Sheet
    Paper Stock20-lb.
    Principal Heading(s)1500 Health Insurance Claim Form
    Print and Ruling Color(s)OCR Red
    Printer CompatibilityDot Matrix
    Product_DescriptionFORMCMS 1500 2-PARTWE
    PunchingDot Matrix Pin Feed Holes

    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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