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TOPS™ Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms # TOP50124RV
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Centers for Medicare and Medicaid Services (CMS) claim form with sensor bar.
Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR ink for scanning. Continuous Form. Form Size: 8 1/2 x 11; Forms Per Page: 1; Form Quantity: 1500; Principal Heading(s): 1500 Health Insurance Claim Form.
CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits.
Top sensor bar for microfiche duplication, as required in some states.
OCR red ink for scanning.
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