Product Media

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

Product Number: ESS-TFPCMS12LC250
$43.53
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.
Quantity

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-TFPCMS12LC250

Data sheet

Paper Color(s)
White
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
Sheet Size
8.5 x 11
Principal Heading(s)
1500 Health Insurance Claim Form
Print and Ruling Color(s)
OCR Red
Copy Types
One-Part (No Copies)
Form Type Details
CMS-1500
Format Indicator
Unbound
Form Quantity (Total)
250

Related products