TOPS™ Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms
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TOPS™

TOPS™ Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms

Item: TOP50124RV9AZ

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Copy Types: Black Print Carbonless Duplicate   Form Size: 8 1/2 in x 11 in  
Format: Continuous Form Set   Layout: One Form per Sheet  
Paper Color(s): White   Paper Stock: 20-lb.  
Principal Heading(s): 1500 Health Insurance Claim Form   Print and Ruling Color(s): OCR Red  
Printer Compatibility: Dot Matrix   Punching: Dot Matrix Holes  
Total Recycled Content Percent [Nom]: 0 %