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Tops HCFA Claim Forms Without Sensor Bar - 1 Part - Carbonless - 11 x 8.5 Sheet Size - White
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Tops HCFA Claim Forms Without Sensor Bar - 1 Part - Carbonless - 11" x 8.5" Sheet Size - White

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Tops Business Forms 
Manufacturer:  Tops Business Forms
Mfg Part #:  50126R
Product ID:  TOP50126R
Shipping Weight:  6.1 lbs.
Sold As:  1 PACK
 
 
* Handling fee may apply if shipped to the following states: CA
Product Details
 

Health Insurance Claim (CMS) Forms come in a format approved by the AMA Council of Medical Services. Printed on 20 lb. paper using Optical Character Recognition red ink for scannability, fulfilling requirements of most insurance companies. Compatible with current software programs. Includes no sensor bar. 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".



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Some items may not comply with California Proposition 65.

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Product Specifications
 
Product Name:  Tops HCFA Claim Forms Without Sensor Bar - 1 Part - Carbonless - 11" x 8.5" Sheet Size - White
Manufacturer Name:  Tops Business Forms
Product ID:  TOP50126R
Equivalents:  50126R
Manufacturer Part Number:  50126R
UPC:  025932501265
Vendor Description:  FORM,CMS 1500, LASER,WE
Product Notes:  FORM,CMS 1500, LASER,WE
Shipping Weight:  6.1 lbs.
Product Weight:  5.6 lbs.
Product Cube:  1

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