Material Handling Solutions Llc Material Handling Solutions Llc
4001 S Shary Rd Ste 550
Mission, TX 78572

Phone: 956-465-4177
Fax: 206-984-3770

Tops® Centers For Medicare And Medicaid Services (Cms) Forms printable version

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

Click on the Product No(s). below to view further information and order now!


Product No. TOP50129R
Global Product Type
Form Type Insurance Claim
Format Continuous Form Set
Form Size (W x H)
Form Size 8 1/2 x 11
Forms Per Page
Principal Heading(s) 1500 Health Insurance Claim Form
Form Quantity
Layout One Form per Sheet
Copy Type Black Print Carbonless Duplicate
Punching Dot Matrix Holes
Copy Types
Printer Compatibility Dot Matrix
Paper Stock 20-lb.
Paper Color(s) White
Print and Ruling Color(s) OCR Red
Form Special Features
Pre-Consumer Recycled Content Percent 0 %
Post-Consumer Recycled Content Percent 0 %
Total Recycled Content Percent 0 %
Price
PK$22.80


Product No. TOP50135R
Global Product Type Forms-Insurance Claim
Form Type Insurance Claim
Format Loose Form
Form Size (W x H) 8 1/2 in x 11 in
Form Size 8 1/2 x 11
Forms Per Page 1
Principal Heading(s) 1500 Health Insurance Claim Form
Form Quantity 250
Layout One Form per Sheet
Copy Type
Punching
Copy Types
Printer Compatibility Laser
Paper Stock 20-lb.
Paper Color(s) White
Print and Ruling Color(s) OCR Red
Form Special Features For Laser Printers
Pre-Consumer Recycled Content Percent 0 %
Post-Consumer Recycled Content Percent 0 %
Total Recycled Content Percent 0 %
Price
PK$22.10


Product No. TOP50126R
Global Product Type Forms-Insurance Claim
Form Type
Format
Form Size (W x H) 8 1/2 in x 11 in
Form Size
Forms Per Page 1
Principal Heading(s) 1500 Health Insurance Claim Form
Form Quantity 500
Layout One Form per Sheet
Copy Type
Punching
Copy Types
Printer Compatibility Laser
Paper Stock 20-lb.
Paper Color(s) White
Print and Ruling Color(s) OCR Red
Form Special Features For Laser Printers
Pre-Consumer Recycled Content Percent 0 %
Post-Consumer Recycled Content Percent 0 %
Total Recycled Content Percent 0 %
Price
PK$40.08


Product No. TOP50124R
Global Product Type Forms-Insurance Claim
Form Type
Format
Form Size (W x H) 8 1/2 in x 11 in
Form Size
Forms Per Page 1
Principal Heading(s) 1500 Health Insurance Claim Form
Form Quantity 1500
Layout One Form per Sheet
Copy Type
Punching Dot Matrix Holes
Copy Types Carbonless Duplicate
Printer Compatibility Dot Matrix
Paper Stock 20-lb.
Paper Color(s) White
Print and Ruling Color(s) OCR Red
Form Special Features Carbonless Duplicate
Pre-Consumer Recycled Content Percent 0 %
Post-Consumer Recycled Content Percent 0 %
Total Recycled Content Percent 0 %
Price
CT$180.49


Product No. TOP50122R
Global Product Type Forms-Insurance Claim
Form Type
Format
Form Size (W x H) 8 1/2 in x 11 in
Form Size
Forms Per Page 1
Principal Heading(s) 1500 Health Insurance Claim Form
Form Quantity 3000
Layout One Form per Sheet
Copy Type
Punching Dot Matrix Holes
Copy Types
Printer Compatibility Dot Matrix
Paper Stock 20-lb.
Paper Color(s) White
Print and Ruling Color(s) OCR Red
Form Special Features Continuous Form
Pre-Consumer Recycled Content Percent 0 %
Post-Consumer Recycled Content Percent 0 %
Total Recycled Content Percent 0 %
Price
CT$178.96