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 Without Sensor Bar printable version

   
Product No. TOP50126R
Form Type Insurance Claim
Format Loose Form
Form Size 8 1/2 x 11
Principal Heading(s) 1500 Health Insurance Claim Form
Layout One Form per Sheet
Copy Type
Punching
Printer Compatibility Laser
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 %
PK $31.79
Quantity