by TOPS |
Item # 954544
Model # TOP50124RV |
About this item
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. OCR red ink for scanning.
- GLOBAL PRODUCT TYPE: Forms-Insurance Claim
- FORM SIZE: 11 x 8 1/2
- FORMS PER PAGE: 1
- FORM QUANTITY: 1500
- PRINCIPAL HEADING(S): 1500 Health Insurance Claim Form
- LAYOUT: One Form per Sheet
- COPY TYPES: Carbonless Duplicate
- PUNCHING: Dot Matrix Holes
- PRINTER COMPATIBILITY: Dot Matrix
- PAPER STOCK: 20-lb.
- PAPER COLOR(S): White
- PRINT AND RULING COLOR(S): OCR Red
- FOOTNOTE 1: Carbonless Duplicate
- SPECIAL FEATURES: Carbonless Duplicate
* Pricing valid online only, December 1 - December 6, 2015, unless otherwise noted. No rain checks. While supplies last.
This product is covered by the Sam's Club Member Satisfaction Guarantee.
8.5"W x 11"H
Standard - 2 to 6 business days