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Insurance Claim Forms

TOPS CMS-1500 Health Insurance Claim Forms for Laser Printer, 8.5 x 11 Inches, 250 Sheets per Pack (50135RV),White

R 1,441

or 4 x payments of R360.25 with Payflex

Payflex

Availability: Currently in Stock

Delivery: 10-20 working days

Please be aware orders placed now will not arrive in time for Christmas, please check delivery times.

This item may be available in a different size, colour, scent, version or platform:

Variations

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.
Country USA
Brand Tops
Manufacturer TOPS Products
Binding Office Product
ItemPartNumber 50135RV
Model 50135RV
Color White
ReleaseDate 2018-08-17
Size 11 x 8.5
UnitCount 1
UPCs 025932513503
EANs 0025932513503

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