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TOPS Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms

Item # 954544
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About this item

  • 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.
  • TOPS Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms

    Description

  • 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.
  • CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits. OCR red ink for scanning.

    Specifications

    • GLOBAL PRODUCT TYPE: Forms-Insurance Claim
    • FORM SIZE: 11 x 8 1/2
    • FORMS PER PAGE: 1
    • FORM QUANTITY: 1500
    • PRINCIPAL HEADING(S): 1500 Health Insurance Claim Form
    • LAYOUT: One Form per Sheet
    • COPY TYPES: Carbonless Duplicate
    • PUNCHING: Dot Matrix Holes
    • PRINTER COMPATIBILITY: Dot Matrix
    • PAPER STOCK: 20-lb.
    • PAPER COLOR(S): White
    • PRINT AND RULING COLOR(S): OCR Red
    • FOOTNOTE 1: Carbonless Duplicate
    • SPECIAL FEATURES: Carbonless Duplicate

    * Pricing valid online only, December 1 - December 6, 2015, unless otherwise noted. No rain checks. While supplies last.

    Warranty

    This product is covered by the Sam's Club Member Satisfaction Guarantee.

    Assembled Country

    United States

    Assembled Size

    8.5"W x 11"H

    Component Country

    USA

    Shipping Info


    Standard - 2 to 6 business days

  • Delivery is not available to AK, HI or Puerto Rico

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