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.
Product Details**
| Global Product Type | Insurance Forms |
| Form Type Details | CMS-1500 |
| Dated/Undated | Undated |
| Forms Per Page | 1 |
| Format Indicator | Unbound |
| Copy Types | Two-Part Carbonless |
| Color Family | White |
| Form Size | 8.5 x 11 |
| Sheet Size | 8.5 x 11 |
| Form Quantity (Total) | 250 |
| Principal Heading(s) | 1500 Health Insurance Claim Form |
| Paper Color(s) | White |
| Print and Ruling Color(s) | OCR Red |
| Pre-Consumer Recycled Content Percent | 0% |
| Post-Consumer Recycled Content Percent | 0% |
| Total Recycled Content Percent | 0% |
| Country Of Origin | US |
| Carton Weight | 21 lbs. |
| Carton Pack Quantity | 2 PK |
| Pack Quantity | 250 EA |
| UPC | 758399422254 |
| UNSPSC | 14111806 |
Shipping Weight & Item Dimensions
| Weight | 2.598 lbs. |
| Length | 11.224 in |
| Height | 1.29 in |
| Width | 8.714 in |
Warranty
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