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CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 500/Box

Item #: TFP650656-ES 
Available: Special Order
ComplyRight® CMS-1500 Health Insurance Claim Form
  • 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.
35.21
BOX
Quantity:
TFP650656-ES
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: 500; Sheet Size: 8.5 x 11.

Forms

Copy Types
One-Part Carbonless
Form Quantity
500
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
Total Recycled Content Percent
0%
UPC
015171105904

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