Item #562817

TOPS® Laser CMS Forms With Bar, 8 1/2" x 11", White, Pack Of 250

Item #562817
$28.09/pack

Description

    Simple-to-read, government-approved form helps you fill out CMS claims

    • Centers for Medicare and Medicaid Services (CMS) claim form.
    • Compatible with laser printers.
    • Features the American Medical Association approved format, revised 2/2012.
    • 20-lb white paper is printed on the front and back in red OCR ink for easy reading.
    • SFI Certified.
    Specifications
    Item #562817
    Manufacturer #TOP50135RV
    Color (Ink)Red
    sheet sizeLetter (8-1/2" x 11")
    printer compatibilityLaser Printer
    number of holes punched0
    double sidedYes
    claim typeMedical
    sensor barsNo
    number of parts1
    carbonlessNo
    acid freeNo
    Product LineLaser CMS Forms With Bar
    quantity250
    brand nameTOPS
    Eco Label StandardSFI Certified Fiber Sourcing
    manufacturerTOPS BUSINESS FORMS
    Packaged Quantity250
    $28.09/pack