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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