Shopping Cart

Your cart is empty.

Your cart is empty.

TOPS 50126RV Laser Printer Claim Forms,CMS-1500,1-Part,9-1/2-Inch x11-Inch ,500/PK

5.0 Write Review
Free shipping on orders over $29.99

$36.06

$ 16 .99 $16.99

In Stock
  • Sold as 500/Pack.
  • Top sensor bar for microfiche duplication, as required in some states.
  • OCR red ink for scanning.
  • Contains 500 forms per package. SFI certified sourcing.
  • Printed in OCR red ink on laser-cut white paper for scanning. Made in the USA.


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.