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ComplyRight CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total
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Product Details
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.
Product Specifications
| Dimensions / Specifications | |
|---|---|
| Unit of Measure | PK |
| Item Dimensions | 8.71 in. x 1.29 in. x 11.22 in. (W x H x D) |
| Item Weight | 2.598 lbs |
| Carton Pack Quantity | 2 PK |
| Carton Pack Dimensions | 9.65 in. x 9.21 in. x 11.80 in. (W x H x D) |
| Carton Pack Weight | 20.461 lbs |
| Pack Quantity | 250 EA |
| This item is sold by the PK which contains 250 EA | |
| Shipping Info | |
|---|---|
| Can Ship via UPS? | Yes |
| Can Ship via Air Carrier? | Yes |
| Hazmat restrictions? | No |
| Additional Information | |
|---|---|
| Considered Green (less environmental impact)? | No |
| Made of Some or All Recycled Materials? | No |
| Item Specifications | |
|---|---|
| Form Type Details | CMS-1500 |
| Global Product Type | Insurance Forms |
| Dated | No |
| Forms Per Page | 1 |
| Form Size | 8.5 x 11 |
| Sheet Size | 8.5 x 11 |
| Format Indicator | Unbound |
| Form Quantity (Total) | 250 |
| Copy Types | One-Part (No Copies) |
| Principal Heading(s) | 1500 Health Insurance Claim Form |
| Paper Color(s) | White |
| Color Family | White |
| Print and Ruling Color(s) | OCR Red |
| Product Biodegradability Indicator | N |
| Product Compostability Indicator | N |
| Pre-Consumer Recycled Content Percent | 0% |
| Post-Consumer Recycled Content Percent | 0% |
| Total Recycled Content Percent | 0% |
| Manufacturer Info | |
|---|---|
| Brand | ComplyRight® |
| Manufacturer SKU | CMS12LC250 |
| Retail GTIN (UPC) | 00758399422254 |
| Country of Origin | US |
| UNSPSC Number | 14111806 |
| Product ID | 7606379 |
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