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Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms
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Product Details
Product Highlights
- CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits.
- Top sensor bar for microfiche duplication, as required in some states.
- OCR red ink for scanning.
Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR ink for scanning.
Product Specifications
| Dimensions / Specifications | |
|---|---|
| Unit of Measure | CT |
| Item Dimensions | 10.13 in. x 12.50 in. x 11.63 in. (W x H x D) |
| Item Weight | 31.000 lbs |
| Carton Pack Quantity | 1500 ST |
| Carton Pack Dimensions | 10.13 in. x 12.50 in. x 11.63 in. (W x H x D) |
| Carton Pack Weight | 31.000 lbs |
| This item is sold by the CT which contains 1500 ST | |
| Shipping Info | |
|---|---|
| Can Ship via UPS? | Yes |
| Can Ship via Air Carrier? | Yes |
| Hazmat restrictions? | No |
| Additional Information | |
|---|---|
| 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 | TOPS |
| Global Product Type | Forms-Insurance |
| Form Size | 8 1/2 x 11 |
| Forms Per Page | 1 |
| Form Quantity | 1500 |
| Principal Heading(s) | 1500 Health Insurance Claim Form |
| Layout | One Form per Sheet |
| Copy Types | Two-Part Carbonless |
| Punching | Dot Matrix Pin Feed Holes |
| Printer Compatibility | Dot Matrix |
| Paper Stock | 20-lb. |
| 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% |
| Footnote 1 | Carbonless Duplicate |
| Special Features | Carbonless Duplicate-Continuous Form. |
| Manufacturer Info | |
|---|---|
| Brand | TOPS |
| Warranty Offered? | n |
| Manufacturer Stock No. | 50124RV |
| Staples Equivalent SKU | 2408491 |
| Office Max Equivalent SKU | 21297482 |
| Office Depot Equivalent SKU | 561593 |
| Retail GTIN (UPC) | |
| Country of Origin | US |
| UNSPSC Number | 00141118 |
| Product ID | 9472549 |
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