Tops HCFA Claim Form Without Sensor Bar TOP50126R + Click to enlarge

Tops HCFA Claim Form Without Sensor Bar

1 Part - Carbonless - 11" x 8.50" Sheet Size - White - 500 / Pack

This product is discontinued.

CMS-1500 forms comply with current physicians' standards for expediting Medicare and Medicaid payments. Each meets requirements of the Centers for Medicare and Medicaid Services, Champus and the AMA Council of Medical Service. Front and back are printed in red OCR ink on white 20 lb. bond without sensor bar. Forms are compatible with laser printers.

SKU
TOP50126R
Manufacturer
Tops Products
Manufacturer Part Number
50126R
Brand Name
Tops
Packaged Quantity
500 / Pack
Product Type
Claim Form
Sheet Size
8.5" W x 11" L
Number of Parts
1 Part
Copy Type
Carbonless
Print
Double Side Form With Red Ink
Print Technology
Laser
Recycled
No
Green Compliant
Yes
Green Compliance Certificate/Authority
SFI