Material Handling Solutions Llc Material Handling Solutions Llc
4001 S Shary Rd Ste 550
Mission, TX 78572

Phone: 956-465-4177
Fax: 206-984-3770

Tops® Centers For Medicare And Medicaid Services (Cms) Forms printable version

   
Product No. TOP50129R
Global Product Type
Form Type Insurance Claim
Format Continuous Form Set
Form Size (W x H)
Form Size 8 1/2 x 11
Forms Per Page
Principal Heading(s) 1500 Health Insurance Claim Form
Form Quantity
Layout One Form per Sheet
Copy Type Black Print Carbonless Duplicate
Punching Dot Matrix Holes
Copy Types
Printer Compatibility Dot Matrix
Paper Stock 20-lb.
Paper Color(s) White
Print and Ruling Color(s) OCR Red
Form Special Features
Pre-Consumer Recycled Content Percent 0 %
Post-Consumer Recycled Content Percent 0 %
Total Recycled Content Percent 0 %
PK $22.80
Quantity