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CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 100 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: 100; Sheet Size: 8.5 x 11.
Product Specifications
| Dimensions / Specifications | |
|---|---|
| Unit of Measure | PK |
| Item Dimensions | 8.52 in. x 0.31 in. x 11.06 in. (W x H x D) |
| Item Weight | 1.065 lbs |
| Carton Pack Quantity | 500 PK |
| Carton Pack Dimensions | 8.36 in. x 2.99 in. x 12.08 in. (W x H x D) |
| Carton Pack Weight | 5.872 lbs |
| Pack Quantity | 100 SH |
| This item is sold by the PK which contains 100 SH | |
| 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 | 100 |
| 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. | 650657 |
| Staples Equivalent SKU | 1032415 |
| Quill Equivalent SKU | CMS12650657 |
| Retail GTIN (UPC) | 00015171105096 |
| Country of Origin | US |
| UNSPSC Number | 00141118 |
| Product ID | 7533334 |
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