Health Insurance Claim Form, Laser, 100/PK
$12.16
Adams
Must be purchased in multiples of 5 packs
ABF CMS1500L1V
Approved by CMS, NUCC and OMB.Printed in OCR Red for scanning. Laser format. 100 PG/PKDetached size: 8-1/2" W x 11" H. Version (02/12) for use for beginning January 6, 2014.
Available in increments of 5
- Laser 1-part CMS-1500 health insurance claim form
- Printed in OCR red ink for scanning
- Approved by NUCC, OMB and CMS
- White, letter-size 20 lb. Bond
- Made in the USA
- 100 sheets per pack
- 5 packs per carton
| Item # | ABF CMS1500L1V |
|---|---|
| Length | 11 |
| Width | 8.5 |
| Height | 0.5 |
| Color | White |
| Templates Available | N |
| Load Style | N/A |
| Demo Address | N/A |
| Paper Weight | 20 lb. |
| Acid Free | N/A |
| Dimensions | N/A |
| Cover | No |
| Page Count | N/A |
| Backing | 23 pt. |
| Perforated | N/A |
| Perforation Type | N/A |
| Primary Page Coloring | White |
| Number of Sheets per Pad | N/A |
| Number of Sheets per Pack | N/A |
| Pages Numbered | N/A |
| Pages Consecutively Numbered | No |
| Hole Punched | No |
| Cover Weight Thickness | N/A |
| Printed Front and Back | Yes |
| Form Type | Medical |
| Number of Columns | N/A |
| Forms Per Page | 1 |
| Number of Entry Lines | N/A |
| Form Quantity | 100 |
| Sections | N/A |
| Duplicate Page Coloring | N/A |
| Triplicate Page Coloring | N/A |
| Detached Form Size | N/A |
| Sheet Size | 11 x 8.5 |
| Form Duplicate | No |
| Number of Forms Per Page | 1 |
| Number of Sets per Book/Package | N/A |
| Hole Punch Location | N/A |
| Compatibility - Describe | Laser/inkjet printers |
| CD Included | No |
| Wrap-around Cover | No |
| Stub | No |
| Time Clock Compatibility | N/A |
| Time Increments | N/A |
| Corner and Spine Color | N/A |
| Cover Texture | N/A |
| Cover Interior Printing | N/A |
| Book Size | N/A |
| Pages per Book | N/A |
| Format | N/A |
| Ribbon Bookmark | N/A |
| Purchasing Quantity | Must be purchased in multiples of 5 packs |
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