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 Without Sensor Bar printable version

Product No. TOP50124R Form Type Insurance Claim Format Continuous Form Set Form Size 8 1/2 x 11 Principal Heading(s) 1500 Health Insurance Claim Form Layout One Form per Sheet Copy Type Black Print Carbonless Duplicate Punching Dot Matrix Holes Printer Compatibility Dot Matrix Paper Stock 20-lb. Paper Color(s) White Print and Ruling Color(s) OCR Red Pre-Consumer Recycled Content Percent 0 % Post-Consumer Recycled Content Percent 0 % Total Recycled Content Percent 0 % CT $151.43 Quantity