TOPS CMS-1500 Health Insurance Claim Forms - 250 Sheets, 8.5 x 11 Inches, White (50135RV) - Compatible with Laser Printers for Medical Billing, Healthcare Offices & Insurance Claims Processing

The TOPS CMS-1500 Health Insurance Claim Form is the standard paper claim form used to bill Medicare Fee-For-Service (FFS) Contractors when a paper claim is allowed. It is approved by the National Uniform Claim Committee (NUCC) and the Office of Management and Budget (OMB). Designed for use with a laser printer, the form is printed in red optical character recognition (OCR) ink on 20-lb., white bond paper. It is 8-1/2" x 11" and comes 250 forms per pack. This version (02/12) went into use January 6, 2014.

Sold as 250/Pack.

Top sensor bar for microfiche duplication, as required in some states.

OCR red ink for scanning.

OCR red ink for scanning.

Made in the USA.