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CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack
Model: 650657
Model: 650657
CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack
$4.95 $5.10 ($0.05/SH)
In Stock 1-2 Day Delivery
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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 and is a direct replacement for the previous 08/05 version. Printed in scannable, OCR "dropout" red ink. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 100; Sheet Size: 8.5 x 11.
Meet billing requirements for Medicare Part B.
Easy-to-read forms for faster claims processing.
Comply with CMS standards and requirements for paper, layout and ink.
Printed in scannable, dropout OCR red ink.
Include all 02/12 NUCC revisions, replacing the previous 08/05 version.
Manufacturer
Categories
MPN
TFP650657
Model#
650657
UPC Code
015171105096
UNSPSC Code
0
Copy Types
One-Part Carbonless
Form Quantity
100
Form Size
8.5 x 11
Forms Per Page
1
Global Product Type
Forms-Insurance
Layout
One Form per Sheet
Paper Color(s)
White
Post-Consumer Recycled Content Percent
0%
Pre-Consumer Recycled Content Percent
0%
Principal Heading(s)
1500 Health Insurance Claim Form
Print and Ruling Color(s)
OCR Red
Sheet Size
8.5 x 11
TAA Compliant
Yes
Total Recycled Content Percent
0%
Assembly Required
No assembly is required
Contains Recycled Materials
N
Green Product
N
Unit of Measure
PK
Item Weight
1.065
Ships via UPS
Y
Carton Pack Quantity
500 PK
Pack Quantity
100 SH
This item is sold by the
PK which contains 100 SH
GTIN Item
00015171105096
UPC Retail
015171105096
EPA Registration
N
Pesticide Product
N
FDA Certified
N
TSCA 6(h)
N
TSCA 12(b)
N
Brand
ComplyRight
Manufacturer Stock No.
650657
Country of Origin
US
UNSPSC Number
14111806
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