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Office Forms, Recordkeeping & Reference Materials Forms & Recordkeeping Systems Medical & Insurance Forms TOPS TOP50122RV

TOPS Centers for Medicare and Medicaid Services Forms, 3000 Forms

Item # TOP 50122RV by TOPS (Mfg. Part # TOP50122RV, UPC # 025932512209)


CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits. OCR red ink for scanning.


  • Quantity : 3000 per Carton

  • Form Size : 8 1/2 x 11

  • Forms Per Page : 1

  • Principal Heading : 1500 Health Insurance Claim Form

  • Layout : One Form per Sheet

  • Punching : Dot Matrix Holes

  • Printer Compatibility : Dot Matrix

  • Paper Stock : 20-lb.

  • Paper Color : White

  • Print and Ruling Color : OCR Red

  • Special Features : Continuous Form

TOP50122RV - TOPS® Centers for Medicare and Medicaid Services (CMS) Forms
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Retail Price: $149.39
BettyMills Discount Price: $110.66 Per Carton
Quantity   
Order 3+ and Save an Extra $2.21 Per Carton
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Prescription Required !

Unless you are a licensed care provider or similar
qualified entity, a prescription is required
to purchase this item.

Thanks! -- Betty Mills




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