- 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.
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CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 1,000 Forms Total
Product Code: TFPCMS12LC1
Product Unit: CT1000
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Product Details
Product Information
| Code | TFPCMS12LC1 |
| Manufacturer | TFP DATA SYSTEMS |
| Manufacturer Part Number | 295078 |
| Global Product Type | Insurance Forms |
| Form Type Details | CMS-1500 |
| Dated/Undated | Undated |
| Forms Per Page | 1 |
| Format Indicator | Unbound |
| Copy Types | One-Part (No Copies) |
| Color Family | White |
| Form Size | 8.5 x 11 |
| Sheet Size | 8.5 x 11 |
| Form Quantity (Total) | 1,000 |
| Principal Heading(s) | 1500 Health Insurance Claim Form |
| Paper Color(s) | White |
| Print and Ruling Color(s) | OCR Red |
| Product Biodegradability in Days | 0 |
| Pre-Consumer Recycled Content Percent | 0% |
| Post-Consumer Recycled Content Percent | 0% |
| Total Recycled Content Percent | 0% |
| UPC | 813859024444 |
| UNSPSC | 14111806 |
Additional Info
| Package | Small Package; Eligible for UPS Shipping |
Shipping Weight & Item Dimensions ( Carton )
| Weight | 11 lbs. |
| Height | 4.886 in |
| Length | 11.414 in |
| Width | 9.1 in |
Additional Info
| Country of Origin | United States of America (the) |
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.