Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 250 Forms/Pack

Item #: TOP50135RV
by TOPS™
FREE Shipping on Orders over $75!
Delivery in 1 - 2 business days
Nationwide Stock: 549 PK
FREE Shipping on Orders over $75!
Buy 16+ $14.04 /PK 7 - 10 business days
Buy 80+ $13.11 /PK 7 - 10 business days
Ordering over $500? Need larger quantities?
Use our Bulk Request Form

To get bulk pricing, you must purchase this item in multiples of 8 PK

Compare Us to Big Box Retailers!
Office Depot
checked on 06/20/18
$19.89 + shipping
checked on 06/20/18
$23.49 + shipping


Customers who bought this item also bought

Product Details

Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 250 Forms/Pack

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

Item Specifications
Brand TOPS™
Global Product Type Forms-Insurance
Form Size 8 1/2 x 11
Forms Per Page 1
Form Quantity 250
Principal Heading(s) 1500 Health Insurance Claim Form
Layout One Form per Sheet
Printer Compatibility Laser
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%
Special Features For Laser Printers

Dimensions / Specifications
Unit of Measure PK
Item Weight 2.660 lbs
Ships via UPS? Yes
Carton Pack Quantity 8 PK
Pack Quantity 250 EA
This item is sold by the PK which contains 250 EA
Warranty Offered? No
Manufacturer Info
Brand TOPS™  (website)
Brand Contact 800-282-7261
Warranty Offered? n
Manufacturer Stock No. 50135RV
Staples Equivalent SKU TOP50135RV
Office Depot Equivalent SKU 562817
Retail UPC 025932513503
Country of Origin US
UNSPSC Number 14111806
Meets ANSI/BIFMA? 025932513503
OTS Product ID 9472507

Customer Questions and Answers

Your question has been received, and we will work to answer it quickly! If you need immediate assistance, please call us at 1-866-501-6055.

Customer Reviews

No written reviews yet for this product. Help others by writing one!

Recommended For You

Join Our Mailing List!
Connect With Us
Shop With Confidence!
  • Inc 500 Logo
  • BBB Logo
  • SSL Shield
  • GSA Logo
  • Payment Icons
  • HP Authorized Reseller
Shopper Approved
Document printed / saved on 06/21/2018. Prices subject to change.