☰

Office Products

Office & School Supplies

Forms, Recordkeeping & Money Handling

Human Resources Forms

Insurance Claim Forms

TOP50135R - CMS-1500 Claim Forms, 250 Pack

R 1,521

or 4 x payments of R380.25 with Payflex

Payflex

Availability: Currently in Stock

Delivery: 10-20 working days

TOP50135R - CMS-1500 Claim Forms, 250 Pack
- Form Size - 8 1/2 x 11
- Form Type - Insurance Claim
- Format - Loose Form
- Layout - One Form per Sheet
- Paper Stock - 20-Lb. 250 Sheets to a pack
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. Form Size: 8 1/2 x 11; Forms Per Page: 1; Form Quantity: 250; Principal Heading(s): 1500 Health Insurance Claim Form.

Country	USA
Brand	Tops
Manufacturer	TOPS Business Forms, Inc.
Binding	Office Product
ItemPartNumber	TOP50135RV
Model	TOP50135RV
Color	White
Size	8 1/2 x 11
UnitCount	1
UPCs	025932501357
EANs	0025932501357
ReleaseDate	0000-00-00

Customers who purchased this also purchased...

TOPS CMS-1500 Form Self-Seal Window Envelopes, Box of 500 (50992)

TOPS CMS-1500 Form Self-Seal Window Envelopes, Box of 500 (50992)

TOPS 3280 Employee Record Master File Jacket, 9 1/2 x 11 3/4, 10 Point Manila (Pack of 20)

TOPS 3280 Employee Record Master File Jacket, 9 1/2 x 11 3/4, 10 Point Manila (Pack of 20)

TOPS Employee Record Master File Jacket, 1-1/4 Inch Expandable, 11.75 x 9.5 Inches, Manila, 15-Pack (32801)

TOPS Employee Record Master File Jacket, 1-1/4 Inch Expandable, 11.75 x 9.5 Inches, Manila, 15-Pack (32801)