TOPS CMS-1500 Health Insurance Claim Forms for Laser Printer, 8.5 x 11 Inches, 250 Sheets per Pack (50135RV),White
R 1,584
or 4 x payments of R396.00 with
Availability: Currently in Stock
Delivery: 10-20 working days
This item may be available in a different size, colour, scent, version or platform:
TOPS CMS-1500 Health Insurance Claim Forms for Laser Printer, 8.5 x 11 Inches, 250 Sheets per Pack (50135RV),White
Sold as 250/Pack.
Top sensor bar for microfiche duplication, as required in some states.
OCR red ink for scanning.
OCR red ink for scanning.
Made in the USA.
The TOPS CMS-1500 Health Insurance Claim Form is the standard paper claim form used to bill Medicare Fee-For-Service (FFS) Contractors when a paper claim is allowed. It is approved by the National Uniform Claim Committee (NUCC) and the Office of Management and Budget (OMB). Designed for use with a laser printer, the form is printed in red optical character recognition (OCR) ink on 20-lb., white bond paper. It is 8-1/2" x 11" and comes 250 forms per pack. This version (02/12) went into use January 6, 2014.