TOPS™ Centers for Medicare and Medicaid Services (CMS) Forms
- 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.
Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR ink for scanning.
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Prices and Availability Subject to Change
| Product Number |
Details |
Price |
Quantity |
|
TOP50135R-337550
|
|
Global Product Type:
Forms-Insurance Claim
|
Form Size:
11 x 8 1/2
|
|
Forms Per Page:
1
|
Form Quantity:
250
|
|
Principal Heading(s):
1500 Health Insurance Claim Form
|
Layout:
One Form per Sheet
|
|
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%
|
|
Special Features:
For Laser Printers
|
|
N/A
|
Unavailable
|
|
TOP50126R-337549
|
|
Global Product Type:
Forms-Insurance Claim
|
Form Size:
11 x 8 1/2
|
|
Forms Per Page:
1
|
Form Quantity:
500
|
|
Principal Heading(s):
1500 Health Insurance Claim Form
|
Layout:
One Form per Sheet
|
|
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%
|
|
Special Features:
For Laser Printers
|
|
N/A
|
Unavailable
|
|
TOP50124R-337548
|
|
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
|
|
N/A
|
Unavailable
|
|
TOP50122R-337547
|
|
Global Product Type:
Forms-Insurance Claim
|
Form Size:
11 x 8 1/2
|
|
Forms Per Page:
1
|
Form Quantity:
3000
|
|
Principal Heading(s):
1500 Health Insurance Claim Form
|
Layout:
One Form per Sheet
|
|
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:
Continuous Form
|
|
Pre-Consumer Recycled Content Percent:
0%
|
Post-Consumer Recycled Content Percent:
0%
|
|
Total Recycled Content Percent:
0%
|
Special Features:
Continuous Form
|
|
N/A
|
Unavailable
|
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