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Made in the USA

TOPS Centers

for Medicare & Medicaid Services Forms, 8-1/2"W x 11"H, 250 Forms

Item #: TOP50135RV
$14.22/PK
Retail Price:
$23.44
You Save:
39%
Item Weight:
2.66 LBS / PK
In Stock!
Description: Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR ink for scanning.
Part Numbers: TOP50135R, 50135R
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Specifications
Form Size:
8 1/2 x 11
Forms Per Page:
1
Form Quantity:
250
Principal Heading(s):
1500 Health Insurance Claim Form
Layout:
One Form per Sheet
Printer Compatibility:
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:
For Laser Printers
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