CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 100 Forms Total
Product Number: ESS-TFP650657
$6.99
Meet billing requirements for Medicare Part B. Easy-to-read forms with crisp, clean text help ensure faster claims processing. Paper, layout and ink comply with CMS standards and requirements. Layout includes all 02/12 NUCC revisions. Printed in scannable, OCR "dropout" red ink.
Meet billing requirements for Medicare Part B. Easy-to-read forms with crisp, clean text help ensure faster claims processing. Paper, layout and ink comply with CMS standards and requirements. Layout includes all 02/12 NUCC revisions and is a direct replacement for the previous 08/05 version. Printed in scannable, OCR "dropout" red ink.
ESS-TFP650657
Data sheet
- Paper Color(s)
- White
- Global Product Type
- Forms-Insurance
- Global Product Type
- Insurance Forms
- Dated/Undated
- Undated
- Color Family
- White
- Pre-Consumer Recycled Content Percent
- 0%
- Post-Consumer Recycled Content Percent
- 0%
- Total Recycled Content Percent
- 0%
- Unit Of Measure
- PK
- Form Size
- 8.5 x 11
- Forms Per Page
- 1
- Form Quantity
- 100
- Sheet Size
- 8.5 x 11
- Principal Heading(s)
- 1500 Health Insurance Claim Form
- Layout
- One Form per Sheet
- Print and Ruling Color(s)
- OCR Red
- Copy Types
- One-Part Carbonless
- Copy Types
- One-Part (No Copies)
- Form Type Details
- CMS-1500
- Format Indicator
- Unbound
- Form Quantity (Total)
- 100
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Meet billing requirements for Medicare Part B. Easy-to-read forms with crisp, clean text help ensure faster claims processing. Paper, layout and ink comply with CMS standards and requirements. Layout includes all 02/12 NUCC revisions. Printed in scannable, OCR "dropout" red ink.