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CMS 02/12 Insurance Claim Form, 2-Part, White/White, 9 1/2 x 11, 1000 Forms

Item #: PRB07114
by Paris Corporation
Made in USA
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Nationwide Stock: 16 CT
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Product Details

CMS 02/12 Insurance Claim Form, 2-Part, White/White, 9 1/2 x 11, 1000 Forms

Expedite Medicare, Medicaid or private insurance claims processing. Forms meet all Federal regulations. Formerly known as HCFA-1500 forms.


Product Specifications

Item Specifications
Brand Paris Corporation
Global Product Type Forms-Insurance, Forms-Insurance, Forms-Insurance, Forms-Insurance, Forms-Insurance
Form Size 9 1/2 x 11
Forms Per Page 1
Form Quantity 1000
Sheet Size 9 1/2 x 11
Copy Types Carbonless Duplicate
Paper Stock 20 lb.
Paper Color(s) White
Footnote 1 Two-part continuous feed, white/white. Carbonless, Two-part continuous feed, white/white. Carbonless, Two-part continuous feed, white/white. Carbonless, Two-part continuous feed, white/white. Carbonless, Two-part continuous feed, white/white. Carbonless
Special Features Centers for Medicare and Medicaid Services (CMS) Forms, Centers for Medicare and Medicaid Services (CMS) Forms, Centers for Medicare and Medicaid Services (CMS) Forms, Centers for Medicare and Medicaid Services (CMS) Forms, Centers for Medicare and Medicaid Services (CMS) Forms

Dimensions / Specifications
Unit of Measure CT
Item Weight 23.000 lbs
Ships via UPS? y
Carton Pack Quantity 1000 SH
This item is sold by the CT which contains 1000 SH

Catalog Information
Catalog Page No.'s EVERYTHING FOR THE WORKPLACE 2012: Page 954
EVERYTHING FOR THE WORKPLACE 2013: Page 955
EVERYTHING FOR THE WORKPLACE 2014: Page 967
EVERYTHING FOR THE WORKPLACE 2014: Page 967
EVERYTHING FOR THE WORKPLACE 2015: Page 983
EVERYTHING FOR THE WORKPLACE NON-VIRTUAL 2015: Page 983
EVERYTHING FOR THE WORKPLACE NON-VIRTUAL 2016: Page 979
EVERYTHING FOR THE WORKPLACE NON-VIRTUAL 2017: Page 911
Manufacturer Info
Brand Paris Corporation  (website)
Brand Contact 800-523-6454
Manufacturer Stock No. 05104
Retail UPC 090146051042
Country of Origin US
Tariff (Inbound) Code
UNSPSC Number 14111806
Meets ANSI/BIFMA? 090146051042
OTS Product ID 9147943

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Document printed / saved on 07/26/2017. Prices subject to change.