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TOPS Tops HCFA Claim Forms Without Sensor Bar
2 Part - Carbonless - 11" x 8.5" Sheet Size - White

Item Number: TOP50124R

Package Size: 1 Carton of 1500 Sets
Two-part CMS-1500 forms comply with current physicians' standards for expediting Medicare and Medicaid payments
List Price $191.48
You Pay: $156.54
Delivery estimate: 9/23/2014
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Tops HCFA Claim Form - 1 Part - Carbonless - 9.5" x 11" Sheet Size - White - 3000 / CartonTops HCFA Claim Form Without Sensor Bar - 1 Part - Carbonless - 11" x 8.5" Sheet Size - White - 500 / Pack
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Description Specifications Reviews
  • Two-part CMS-1500 forms comply with current physicians' standards for expediting Medicare and Medicaid payments
  • Each meets requirements of the Centers for Medicare and Medicaid Services, Champus and the AMA Council of Medical Service
  • Forms come in a continuous format.

Shipping Weight: 31 lbs.

Copy TypeCarbonless
Copy TypesCarbonless Duplicate
Form Quantity1500
Form Size (W x H)8 1/2 in x 11 in
Form Special FeaturesCarbonless Duplicate
Forms Per Page1
Global Product TypeForms-Insurance Claim
LayoutOne Form per Sheet
Number of Parts2 Part
Paper Color(s)White
Paper Stock20-lb.
Principal Heading(s)1500 Health Insurance Claim Form
PrintRed Ink
Print and Ruling Color(s)OCR Red
Printer CompatibilityDot Matrix
Product NameHCFA Claim Forms Without Sensor Bar
Product TypeClaim Form
PunchingDot Matrix Holes
Sheet Size11" Length x 8.50" Width White
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