Price is for CT. Manufacturer Part Number: TOP50122RV 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. Centers for Medicare and Medicaid Services (CMS) claim form with sensor bar. Global Product Type: Forms-Insurance Claim Printer Compatibility: Dot Matrix Principal Heading(s): 1500 Health Insurance Claim Form Punching: Dot Matrix Pin Feed Holes Form Size: 11 x 8 1/2 Forms Per Page: 1 Form Quantity: 3000 Layout: One Form per Sheet Paper Stock: 20-lb. Paper Color(s): White Print and Ruling Color(s): OCR Red Pre-Consumer Recycled Content Percent: 0% Post-Consumer Recycled Content Percent: 0% Total Recycled Content Percent: 0% Special Features: Continuous Form Carton Pack Quantity: 3000 SH Country Of Origin: US Carton Weight: 32.0 lbs. UPC: 025932501227 UNSPSC: 14111806 NOTE: International/P.O. Boxes deliveries are not available. The images are just for your reference. Price is only for Model #: TOP50122RV. The item can't be shipped to PR in the Unite States.
We don't know when or if this item will be back in stock. Please check back later for updates.
Manufacturer | - |
---|---|
Brand | Tops |
Item model number | 50122RV |
Color | Red |
Weight | - |
Height | - |
Depth | - |
Product Id | 457766 |
---|---|
User Reviews and Ratings | 3 (1 ratings) 3 out of 5 stars |
UPC | 025932501227 |
# | Title | Reviews | User Ratings | Price |
---|---|---|---|---|
1 |
Search on Amazon
Price:
Search
on
![]() |
Search
on
![]() |