Tops

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

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R 1,352
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Description

  • Sold as 250/Pack.
  • Top sensor bar for microfiche duplication, as required in some states.
  • 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.

Technical Specifications
Manufacturer
TOPS Products
Model
50135RV
Color
White
Size
11 x 8.5
Height
2.8 cm
Length
27.9 cm
Width
21.6 cm
Weight
2.59 kg
Release date
17 August 2018
Shipping & Delivery

Your order is shipped from the USA and delivered to your door in South Africa in 10–20 working days. All items are fully tracked.

Returns & Exchanges

We offer a 30-day return window. If something isn't right, contact our support team and we'll make it right.