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CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 500 Forms Total
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Product Details
Product Highlights
- Meet billing requirements for Medicare Part B.
- Easy-to-read forms for faster claims processing.
- Comply with CMS standards and requirements for paper, layout and ink.
- Printed in scannable, dropout OCR red ink.
- Include all 02/12 NUCC revisions, replacing the previous 08/05 version.
Meet billing requirements for Medicare Part B. Easy-to-read forms with crisp, clean text help ensure faster claims processing. Paper, layout and ink comply with CMS standards and requirements. Layout includes all 02/12 NUCC revisions and is a direct replacement for the previous 08/05 version. Printed in scannable, OCR "dropout" red ink. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 500; Sheet Size: 8.5 x 11.
Product Specifications
| Dimensions / Specifications | |
|---|---|
| Unit of Measure | BX |
| Item Dimensions | 8.90 in. x 5.30 in. x 12.00 in. (W x H x D) |
| Item Weight | 9.600 lbs |
| Box Pack Quantity | 500 EA |
| Box Pack Dimensions | 8.90 in. x 5.30 in. x 12.00 in. (W x H x D) |
| Box Pack Weight | 9.600 lbs |
| Carton Pack Quantity | 1 BX = 500 EA (This item is sold by the BX) |
| Carton Pack Dimensions | 8.91 in. x 5.31 in. x 12.01 in. (W x H x D) |
| Carton Pack Weight | 9.600 lbs |
| This item is sold by the BX which contains 500 EA | |
| Shipping Info | |
|---|---|
| Can Ship via UPS? | Yes |
| Can Ship via Air Carrier? | Yes |
| Hazmat restrictions? | No |
| Additional Information | |
|---|---|
| Has Energy Star Rating? | No |
| Is Certified with EPA/CPG? | No |
| Considered Green (less environmental impact)? | No |
| Made of Some or All Recycled Materials? | No |
| Warranty Offered? | No |
| Underwriter's Laboratory Approval? | No |
| Item Specifications | |
|---|---|
| Brand | ComplyRight® |
| Global Product Type | Forms-Insurance |
| Principal Heading(s) | 1500 Health Insurance Claim Form |
| Copy Types | One-Part Carbonless |
| Form Size | 8.5 x 11 |
| Forms Per Page | 1 |
| Form Quantity | 500 |
| Sheet Size | 8.5 x 11 |
| Layout | One Form per Sheet |
| Paper Color(s) | White |
| Print and Ruling Color(s) | OCR Red |
| Pre-Consumer Recycled Content Percent | 0% |
| Post-Consumer Recycled Content Percent | 0% |
| Total Recycled Content Percent | 0% |
| Manufacturer Info | |
|---|---|
| Brand | ComplyRight® |
| Warranty Offered? | n |
| Manufacturer Stock No. | 650656 |
| Retail GTIN (UPC) | |
| Country of Origin | US |
| UNSPSC Number | 00141118 |
| Product ID | 7499361 |
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