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TOPS CMS-1500 Laser Printer Forms
TOP50126RV
20 lb - 1 Part - 8.50" x 11" Form Size - White - Red Print Color - Paper - 500 / Pack
- Approved by the AMA and the National Uniform Claim Committee (NUCC)
- Printed in red OCR ink without a sensor bar
- Compatible with laser printers
- Detached size: 8-1/2" x 11"
20 lb - 1 Part - 8.50" x 11" Form Size - White - Red Print Color - Paper - 500 / Pack
- Approved by the AMA and the National Uniform Claim Committee (NUCC)
- Printed in red OCR ink without a sensor bar
- Compatible with laser printers
- Detached size: 8-1/2" x 11"
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TOPS CMS-15000 Health Insurance Claim Forms
TOP50135RV
20 lb - 11" x 8.50" Sheet Size - White Sheet(s) - Red Print Color - 1 Pack
- CMS, NUCC and OMB approved format
- Printed front and back
- Convenient scanning
- Compatible with laser printers
20 lb - 11" x 8.50" Sheet Size - White Sheet(s) - Red Print Color - 1 Pack
- CMS, NUCC and OMB approved format
- Printed front and back
- Convenient scanning
- Compatible with laser printers
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TOPS 1-part UB-04 Laser-cut Forms
TOP59870R
1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton
- Continuous forms are designed for hospitals to file a claim with the patient's insurance company
- Forms are printed to GPO standards in OCR ink on 20 lb. bond
- Health Care Finance Administration format ensures accuracy in reporting all necessary information
- 11" Length x 8.50" Width; 2500 / Carton
- Replaces the UB-92
1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton
- Continuous forms are designed for hospitals to file a claim with the patient's insurance company
- Forms are printed to GPO standards in OCR ink on 20 lb. bond
- Health Care Finance Administration format ensures accuracy in reporting all necessary information
- 11" Length x 8.50" Width; 2500 / Carton
- Replaces the UB-92
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