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

Item #: PRB07116
by Paris Corporation
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Nationwide Stock: 46 CT
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Product Details

CMS 02/12 Insurance Claim Form, 2-Part, White/Canary, 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
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) Canary, White
Copy Paper Color(s) Canary
Footnote 1 Two-part continuous feed, white/canary. Carbonless
Special Features Centers for Medicare and Medicaid Services (CMS) Forms

Dimensions / Specifications
Unit of Measure CT
Item Weight 23.000 lbs
Ships via UPS? Yes
Carton Pack Quantity 1000 SH
This item is sold by the CT which contains 1000 SH
Warranty Offered? No
Manufacturer Info
Brand Paris Corporation  (website)
Brand Contact 800-523-6454
Warranty Offered? n
Manufacturer Stock No. 05106
Retail UPC 090146051066
Country of Origin US
UNSPSC Number 14111806
Meets ANSI/BIFMA? 090146051066
OTS Product ID 9147935

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Document printed / saved on 05/26/2018. Prices subject to change.