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This item qualifies for FREE Shipping on orders over $75!
This item qualifies for FREE Shipping on orders over $75!
To purchase this item for the contract price, please sign up or login as a government customer.
NOTE: Only Federal Government customers qualify for our contract pricing. State and Local agencies (e.g. city/county/state government, schools, police, etc) unfortunately do not qualify for FSSI/GSA pricing due to our contract restrictions. Individual who are purchasing items for themselves (e.g. retired military, etc.) also do not qualify for FSSI/GSA contract pricing. We verify all GSA accounts before processing orders.
CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits. OCR red ink for scanning.
| Item Specifications | |
|---|---|
| Brand | TOPS® |
| Global Product Type | Forms-Insurance Claim |
| Form Size (W x H) | 8 1/2 in x 11 in |
| Forms Per Page [Nom] | 1 |
| Form Quantity [Nom] | 250 |
| Principal Heading(s) | 1500 Health Insurance Claim Form |
| Layout | One Form per Sheet |
| Printer Compatibility | Laser |
| Paper Stock | 20-lb. |
| Paper Color(s) | White |
| Print and Ruling Color(s) | OCR Red |
| Form Special Features | For Laser Printers |
| Pre-Consumer Recycled Content Percent [Nom] | 0 % |
| Post-Consumer Recycled Content Percent [Nom] | 0 % |
| Total Recycled Content Percent [Nom] | 0 % |
Product Dimensions / Specifications |
|
| Unit of Measure | PK |
| Item Weight | 2.660 lbs |
| Ships via UPS? | y |
| Carton Pack Quantity | 8 PK |
| Pack Quantity | 250 EA |
| This product is sold by the PK which contains 250 EA | |
Catalog Information |
|
| Catalog Page No.'s |
Everything For The Workplace 2011: Page 950 |
| Manufacturer Info | |
|---|---|
| Brand | TOPS® |
| Manufacturer Stock No. | 50135R |
| Retail UPC | 025932501357 |
| Country of Origin | US |
| Tariff (Inbound) Code | |
| UNSPSC Number | 14111806 |
| Meets ANSI/BIFMA? | 025932501357 |
| Manufacturer Website | www.tops-products.com |
| Manufacturer Phone | 800-282-7261 |
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