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. TOP50124R
Global Product Type Forms-Insurance Claim
Form Type
Format
Form Size (W x H) 8 1/2 in x 11 in
Form Size
Forms Per Page 1
Principal Heading(s) 1500 Health Insurance Claim Form
Form Quantity 1500
Layout One Form per Sheet
Copy Type
Punching Dot Matrix Holes
Copy Types Carbonless Duplicate
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 %
CT $180.49
Quantity