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TOPS CMS-1500 Medicare/Medicaid Forms for Laser Printers, One-Part (No Copies), 8.5 x 11, 500 Forms Total (50126RV)

TOPS CMS-1500 Medicare/Medicaid Forms for Laser Printers, One-Part (No Copies), 8.5 x 11, 500 Forms Total (50126RV)

$37.94

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TOPS CMS-1500 Medicare/Medicaid Forms for Laser Printers, One-Part (No Copies), 8.5 x 11, 500 Forms Total (50126RV)

TOPS CMS-1500 Medicare/Medicaid Forms for Laser Printers, One-Part (No Copies), 8.5 x 11, 500 Forms Total (50126RV)TOPS CMS-1500 Medicare/Medicaid Forms for Laser Printers, One-Part (No Copies), 8.5 x 11, 500 Forms Total (50126RV)
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TOPS CMS-1500 Medicare/Medicaid Forms for Laser Printers, One-Part (No Copies), 8.5 x 11, 500 Forms Total (50126RV)
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Product Details

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$37.94 $39.44 Pack of 500 ($0.08/Each)

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Estimated Delivery Date: 07/21/2026

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Estimated Delivery Date: 07/21/2026

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In Stock
SKU: TOP50126RV
Bulk Discounts
Bulk
Discounts
1-2 Day Shipping
1-2 Day
Shipping
Easy Returns
Easy
Returns
Made in USA
Made
in USA
AutoShip Eligible
AutoShip
Eligible
Google Trusted Store
Google
Trusted
Secure Checkout
Secure
Checkout
Satisfaction Guaranteed
Satisfaction
Guaranteed

Product Details

  • CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits.

  • Top sensor bar for microfiche duplication, as required in some states.

  • OCR red ink for scanning.

  • Shop TOPS Products

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Product 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. Laser Printer Compatible. Form Type Details: CMS-1500; Dated/Undated: Undated; Forms Per Page: 1; Form Size: 8.5 x 11.

Product Specs

Manufacturer

MPN

TOP50126RV

Model#

50126RV

Alternate Product Number

309934

UPC Code

025932512605

UNSPSC Code

1

Copy Types

One-Part (No Copies)

Dated/Undated

Undated

Form Size

8.5 x 11

Forms Per Page

1

Global Product Type

Paper Color(s)

White

Paper Stock

20 lb Bond

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

Printer Compatibility

Laser

Special Features

Laser Printer Compatible

Total Recycled Content Percent

0%

Color Family

White

Form Type Details

CMS-1500

Format Indicator

Unbound

Form Quantity (Total)

500

Assembly Required

No assembly is required

Contains Recycled Materials

N

Green Product

N

Unit of Measure

Pack

Item Weight

5.4

Ships via UPS

Y

Carton Pack Quantity

5 Pack

Pack Quantity

500 Each

This item is sold by the

Pack which contains 500 Each

GTIN Item

025932512605

UPC Retail

025932512605

UPC Carton

50025932512600

Brand

TOPS

Manufacturer Stock No.

50126RV

Country of Origin

US

UNSPSC Number

14111806

Q & A (10)

Questions & Answers

Q: Are the forms pre-printed with any information?

1 Answers

Are the forms pre-printed with any information?
09-23-2024

A: No, the forms are blank and ready for customization.

09-24-2024

Q: Is there a place to input the patient's signature?

1 Answers

Is there a place to input the patient's signature?
08-11-2024

A: Yes, these forms have a space for the patient's signature.

08-12-2024

Q: What size are these forms?

1 Answers

What size are these forms?
07-13-2024

A: The forms are 8.5 x 11 inches

07-14-2024

Q: Are these forms one-part or multi-part?

1 Answers

Are these forms one-part or multi-part?
06-24-2024

A: These forms are one-part and do not include copies.

06-25-2024

Q: Do these forms meet the CMS guidelines?

1 Answers

Do these forms meet the CMS guidelines?
06-05-2024

A: Yes, these forms meet the CMS guidelines for claims.

06-06-2024
Showing 1 to 5 of 10 (2 Pages)

Review

4.67 Out of 5

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