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Tops HCFA Claim Form - 1 Part - Carbonless - 9.5" x 11" Sheet Size - White
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| * Handling fee may apply if shipped to the following states: CA |
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| Product Details |
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Health Insurance Claim (CMS) Forms with no sensor bar come in a format approved by the AMA Council of Medical Services. Printed front and back on 20 lb. paper using Optical Character Recognition red ink for scannability, fulfilling requirements of most insurance companies. Compatible with current software programs. The Health Care Finance Administration has changed its name to Centers for Medicare and Medicaid Services (CMS). The only change to the form is the name change from "HCFA" to "CMS". Detached continuous carbonless forms.
Products are sometimes shown with optional equipment - material choices and/or finishes may affect pricing for furniture.
Some items may not comply with California Proposition 65.
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| Product Specifications |
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| Product Name: |
Tops HCFA Claim Form - 1 Part - Carbonless - 9.5" x 11" Sheet Size - White |
| Manufacturer Name: |
Tops Business Forms |
| Product ID: |
TOP50122R |
| Equivalents: |
50122R |
| Manufacturer Part Number: |
50122R |
| UPC: |
025932501227 |
| Vendor Description: |
FORM,CMS 1500 1-PART,WE |
| Product Notes: |
FORM,CMS 1500 1-PART,WE |
| Shipping Weight: |
32.5 lbs. |
| Product Weight: |
32 lbs. |
| Product Cube: |
1.3 |
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190 In Stock:
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