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TOPS CMS-15000 Health Insurance Claim Forms, 20 lb, 11" x 8.50" Sheet Size, White Sheet(s), Red Print Color, 1 Pack

Name: CMS-15000 Health Insurance Claim Forms, 20 lb, 11" x 8.50" Sheet Size, White Sheet(s), Red Print Color, 1 Pack
Brand: TOPS
SKU: TOP50135RV
Price: 25.03 USD
Availability: InStock

Item # TOP50135RV

Brand: TOPS

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Save 28% over Staples price of $34.59

Delivery: 2 - 3 business days

In Stock

308 Available

Must buy in multiples of 8
Qty	Price
40+	$20.48 /PK	7 - 10 business days

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Product Variations View All »

CMS-15000 Health Insurance Claim Forms, 20 lb, 11" x 8.50" Sheet Size, White Sheet(s), Red Print Color, 1 Pack $25.03

CMS-1500 Laser Printer Forms, 20 lb, 1 Part, 8.50" x 11" Form Size, White, Red Print Color, Paper, 500 / Pack $45.97

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Frequently Purchased With

TOP50135RV - CMS-15000 Health Insurance Claim Forms, 20 lb, 11" x 8.50" Sheet Size, White Sheet(s), Red Print Color, 1 Pack

AVE05796 - Assorted Removable See-Through Color Dots, 1/4" Diameter, Removable Adhesive, Round, Green, Light Blue, Red, Yellow, Film, 216 / Sheet, 4 Total Sheets, 864 Total Label(s), 860 / Pack

UNV00116 - Rubber Bands, Size 16, 0.04" Gauge, Beige, 1 lb Box, 1,900/Pack

TOP3284 - Daily Employee Attendance Record Form, 50 Sheet(s), 11" x 8.50" Sheet Size, 3 x Holes, White, White Sheet(s), Green Print Color, 1 Pack

Subtotal

This Item: CMS-15000 Health Insurance Claim Forms, 20 lb, 11" x 8.50" Sheet Size, White Sheet(s), Red Print Color, 1 Pack $25.03/PK
Assorted Removable See-Through Color Dots, 1/4" Diameter, Removable Adhesive, Round, Green, Light Blue, Red, Yellow, Film, 216 / Sheet, 4 Total Sheets, 864 Total Label(s), 860 / Pack $5.47/PK View Item
Rubber Bands, Size 16, 0.04" Gauge, Beige, 1 lb Box, 1,900/Pack $3.88/PK View Item
Daily Employee Attendance Record Form, 50 Sheet(s), 11" x 8.50" Sheet Size, 3 x Holes, White, White Sheet(s), Green Print Color, 1 Pack $14.56/PK View Item

Product Details

Product Highlights

CMS, NUCC and OMB approved format
Printed front and back
Convenient scanning
Compatible with laser printers

Health insurance claim forms are in the CMS, NUCC and OMB approved format. They are printed front and back in red OCR ink on white, letter-size, 20 lb. bond for convenient scanning. Forms are compatible with laser printers.

Product Specifications

Dimensions / Specifications
Unit of Measure	PK
Item Dimensions	8.50 in. x 1.10 in. x 11.00 in. (W x H x D)
Item Weight	2.590 lbs
Carton Pack Quantity	8 SH
Carton Pack Dimensions	9.00 in. x 8.75 in. x 0.00 in. (W x H x D)
Carton Pack Weight	21.130 lbs
Pack Quantity	1 SH
This item is sold by the PK which contains 1 SH

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
Manufacturer	TOPS Products
Manufacturer Part Number	50135RV
Product Name	CMS-15000 Health Insurance Claim Forms
Packaged Quantity	1 Pack
Product Type	Health Insurance Form
Basis Weight	20 lb
Sheet Size	11" Width x 8.50" Length
Sheet Color	White
Print Color	Red
Print Technology	Laser
Certifications & Standards	CMS, NUCC, OMB
Recycled	No
Assembly Required	No
Country of Origin	United States

Manufacturer Info
Brand	TOPS (website)
Brand Contact	800-282-7261
Manufacturer SKU	50135RV
Retail GTIN (UPC)	00025932513503
Country of Origin	US
UNSPSC Number	14111806
Product ID	9472507