Office Supplies → Forms, Recordkeeping & Reference Materials → ComplyRight 650657 CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack (TFP1032415)

ComplyRight 650657 CMS-1500 Health Insurance Claim Forms, One-Part, 8.5 x 11, 100/Pack (TFP1032415)

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Summary
  • Meet billing requirements for Medicare Part B.
  • Easy-to-read forms for faster claims processing.
  • Comply with CMS standards and requirements for paper, layout and ink.
  • Printed in scannable, dropout OCR red ink.
  • Include all 02/12 NUCC revisions, replacing the previous 08/05 version.

Product Description

Meet billing requirements for Medicare Part B. Easy-to-read forms with crisp, clean text help ensure faster claims processing. Paper, layout and ink comply with CMS standards and requirements. Layout includes all 02/12 NUCC revisions and is a direct replacement for the previous 08/05 version. Printed in scannable, OCR "dropout" red ink. Form Size: 8.5 x 11; Forms Per Page: 1; Form Quantity: 100; Sheet Size: 8.5 x 11.

Product Specs

Global Product TypeForms-Insurance
Form Size8.5 x 11
Forms Per Page1
Form Quantity100
Sheet Size8.5 x 11
Principal Heading(s)1500 Health Insurance Claim Form
LayoutOne Form per Sheet
Copy TypesOne-Part
Paper Color(s)White
Print and Ruling Color(s)OCR Red
Pre-Consumer Recycled Content Percent0%
Post-Consumer Recycled Content Percent0%
Total Recycled Content Percent0%
Country of OriginUS
Carton Weight6 lbs.
Carton Pack Quantity500 PK
UNSPSC14111806

Shipping Weight & Item Dimensions

Weight5.872
Width8.362
Height2.993
Depth12.077

National Chemical Laboratories
Victory Innovations