CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

Item Code: TFPCMS12LC250

Category Forms

Manufacturer TFP Data Systems

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. Form Type Details: CMS-1500; Dated: No; Forms Per Page: 1; Form Size: 8.5 x 11.

Specifications

Made In

US

UNSPSC Code

14111806

Weight

2.6lb

Height

1.29in

Width

8.71in

Length

11.22in

Brand

ComplyRight

Category

Forms

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

CMS-1500 Health Insurance Claim Form, One-Part (No Copies), 8.5 x 11, 250 Forms Total

Item Code: TFPCMS12LC250

Category Forms

Manufacturer TFP Data Systems

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. Form Type Details: CMS-1500; Dated: No; Forms Per Page: 1; Form Size: 8.5 x 11.

Specifications

Made In

US

UNSPSC Code

14111806

Weight

2.6lb

Height

1.29in

Width

8.71in

Length

11.22in

Brand

ComplyRight

Category

Forms

selection not available, try a different combination

selection not available, try a different combination

Call for price

Add to quick list

Compare

SEARCH ×

Items ()

Item	Description	Item Code	Qty
	Product Name {{product.name}}	Item Code {{product.sku}}

Clear All

Details

Enter a SKU or Manufacturer Ref

LET'S CREATE AN ORDER
Enter an item code above to start your list

Drag and drop
or click to upload CSV file

Import requirements

{{ errorMessage }}

CSV row	PRODUCT_CODE	QUANTITY	Reason
{{ item.line != null && item.line !== '' ? item.line : '-' }}	{{ item.sku }}	{{ item.quantity }}	Not in catalog or could not be priced for quick order Product code column is empty Quantity is missing, zero, or not a valid number Over the maximum lines allowed for one import Could not import this row ({{ item.reason }})

One line item per row
Row format should be: PRODUCT_CODE,QUANTITY
Max allowed file size 1M
Max of 75 line items

{{ manualEntrySearchMessage }}

Uploading.....

{{product.brand_name}}

{{product.item_name}}

Item Code: {{product.item_sku}} Original SKU: {{product.original_sku}}

Customer Code : {{product.customer_product_code}}

Category {{product.category_name}}

Maximum order quantity {{ product.item_maximum_order }}

Select Item For Bundle

Main Product

{{ product.item_name }} Main Product Can not be changed

{{ item.item_name }}

Out of stock Included

Skip & Add to cart

Call for price

- +

Starting from

/ {{product.item_pack_uom}}

{{product.item_pack_include}}

{{ product.display_uom_price }} / {{ product.display_uom }}

- +

Buy {{qtyprice.quantity}} or more for each

{{attribute.name}}

{{attribute.value}}

{{attribute.name}}

{{attribute.value}}

${{product.item_name}}$

{{{product.item_description}}}

{{selling_point}}

	Location	Stock
	{{location.warehouse}}	{{location.quantity}}

Want To Swap ?

{{reason}}

${{product.item_name}}$

{{product.item_name}}

Item Code: {{product.item_sku}}

Maximum order quantity {{ product.item_maximum_order }}

{{product.item_pack_uom}}

Call for price

- +

{{reason}}

${{selectproduct.item_name}}$

{{selectproduct.item_name}}

Item Code: {{ selectproduct.item_sku }}

Maximum order quantity {{ selectproduct.item_maximum_order }}

{{selectproduct.item_pack_uom}}

Call for price

- +