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TOPS Centers for Medicare and Medicaid Services Forms 8 1/2 x 11 250 Forms/Pack 50135RV
- Sold as 250/Pack.
- 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.
- Made in the USA.
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CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid, or private insurance benefits. Features OCR red ink for scanning.
CMS-1500 claim forms 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.
- 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.
- Made in the USA.
- Sold as 250/Pack.
CMS-1500 claim forms 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.
- 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.
- Made in the USA.
- Sold as 250/Pack.
Warranty & Returns
Warranty, Returns, And Additional Information
Return Policies
- Return for refund within: non-refundable
- Return for replacement within: non-replaceable
- Read full return policy for details.
Manufacturer Contact Info
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TOPS 50135RV is a 250-pack of 8.5 x 11-inch CMS-1500 paper claim forms for medical practices and billing offices filing Medicare, Medicaid, or private insurance claims; the forms use OCR red ink for scanning.
Recommended For
- Small physician, therapist, or other non-institutional provider offices that qualify to submit professional claims on paper and need preprinted CMS-1500 forms for their billing workflow.
- Medical billing staff who use software to print professional claims onto red-and-white CMS-1500 stock for payers that accept or require paper submissions.
- Practices or suppliers that submit occasional paper claims under an applicable Medicare exception and want a 250-form pack of OCR-red CMS-1500 stock.
- Providers billing some Medicaid programs on paper, after confirming that their state Medicaid agency accepts this CMS-1500 form and submission method.
Spec Summary
| Attribute | Value |
|---|---|
| Best For | Submitting Medicare, Medicaid, or private-insurance claims on CMS-1500 forms |
| Product Type And Format | Form holders in 8.5 × 11 in format; laser style |
| Pack Quantity | 250 forms per pack; one package and one box |
| Color And Ink | Red-and-white form with red ink |
| Packaging Dimensions And Weight | Item dimensions: 11 × 8.5 × 1.1 in; package dimensions: 2.7 × 21.8 × 28.2 cm; weight: 2.59 lb (1.178 kg) |
| Brand And Model Identifiers | TOPS Products; model 50135RV (TOP50135RV) |