TOPS™ Centers for Medicare and Medicaid Services (CMS) Forms

4 item variations by TOPS™
FREE shipping on orders over $75!
starting at $16.69 USD / PK
bulk from $12.60 / PK

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Product Variations

TOP50135RV Thumbnail
8 1/2 x 11, 250 Forms/Pack
Item #: TOP50135RV
BUY EACH
$16.69 /PK
DELIVERY: 1 - 2 business days
Stock: 527
BUY BULK
$12.60 /PK
Minimum buy 16, then 8+
DELIVERY: 5 - 7 business days
TOP50126RV Thumbnail
8 1/2 x 11, 500 Forms/Pack
Item #: TOP50126RV
BUY EACH
$28.93 /PK
DELIVERY: 1 - 2 business days
Stock: 3,318
BUY BULK
$22.85 /PK
Minimum buy 10, then 5+
DELIVERY: 5 - 7 business days
TOP50122RV Thumbnail
3000 Forms/Carton
Item #: TOP50122RV
BUY EACH
$116.87 /CT
DELIVERY: 1 - 2 business days
Stock: 34
BUY BULK
$95.77 /CT
Minimum buy 2
DELIVERY: 5 - 7 business days
TOP50124RV Thumbnail
Two-Part, 1500 Forms
Item #: TOP50124RV
BUY EACH
$133.17 /CT
DELIVERY: 1 - 2 business days
Stock: 31
BUY BULK
$105.21 /CT
Minimum buy 2
DELIVERY: 5 - 7 business days

Product Details

TOPS™ Centers for Medicare and Medicaid Services (CMS) Forms

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.

Product Specifications

Item Specifications
Global Product Type Forms-Insurance
Form Size 8 1/2 x 11
Forms Per Page 1
Form Quantity Available in: 250, 500, 1500 or 3000
Principal Heading(s) 1500 Health Insurance Claim Form
Layout One Form per Sheet
Printer Compatibility Available in: Dot Matrix or 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 Available in: Carbonless Duplicate, Continuous Form or For Laser Printers
Brand TOPS™
Copy Types Two-Part Carbonless
Punching Dot Matrix Pin Feed Holes
Footnote 1 Carbonless Duplicate
Manufacturer Info
Brand TOPS™  (website)
Brand Contact 800-282-7261

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.

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Document printed / saved on 08/19/2018. Prices subject to change.