Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms
New
Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR ink for scanning.
| $86.01 USD Retail $197.22 |
Extended Warrenty
| 1 Year Extended Warrenty | $17.20 |
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Expedite Medicare, Medicaid or private insurance benefits. NUCC, CMS and AMA approved format. (02/12) version. Printed front and back in red OCR ink for scanning.
Product Specifications
| Copy Types | Two-Part Carbonless |
| Footnote 1 | Carbonless Duplicate |
| Form Quantity | 1500 |
| Form Size | 8 1/2 x 11 |
| Forms Per Page | 1 |
| Global Product Type | Forms-Insurance |
| Layout | One Form per Sheet |
| Paper Color(s) | White |
| Paper Stock | 20-lb. |
| Post-Consumer Recycled Content Percent | 0% |
| Pre-Consumer Recycled Content Percent | 0% |
| Principal Heading(s) | 1500 Health Insurance Claim Form |
| Print and Ruling Color(s) | OCR Red |
| Printer Compatibility | Dot Matrix |
| Punching | Dot Matrix Pin Feed Holes |
| Special Features | Carbonless Duplicate |
| Special_Benefit_Statement | Continuous Form. |
| Total Recycled Content Percent | 0% |
Material Safety Data Sheet
A Material Safety Data Sheet (MSDS) is a document that contains information on the potential hazards (health, fire, reactivity and environmental) and how to work safely with the chemical product.
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