TOPS™ - Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms

Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms

Product No.	TOP50124RV
Global Product Type	Forms-Insurance Claim
Form Size	11 x 8 1/2
Forms Per Page	1
Form Quantity	1500
Principal Heading(s)	1500 Health Insurance Claim Form
Layout	One Form per Sheet
Copy Types	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
Form Special Features	Carbonless Duplicate
Pre-Consumer Recycled Content Percent	0%
Post-Consumer Recycled Content Percent	0%
Total Recycled Content Percent	0%
Footnote 1	Carbonless Duplicate
Special Features	Carbonless Duplicate
Availability	Unavailable

List Price	N/A
CT	N/A

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*Company:
*Name:
*Email:
*Phone:
Address:
City:
State:
Ship to Zip code:
Location type:
Do you have a forklift or Loading Dock? Yes No
Do you Require a call to Schedule Delivery? Yes No