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a TOPS 50124R Two-part CMS-1500 Forms

TOPS 50124R Two-part CMS-1500 Forms

2 Part - Carbonless Copy - 8 1/2" x 11" Sheet Size - White Sheet(s) - Red Print Color - 1500 / Carton

Item # TOP50124R

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Retail/List price: $191.48
Your price:$120.02 for Carton
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Inventory last updated: 11/19/2017 4:30pm EST

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  • Meets requirements of Champus and the AMA Council of Medical Service
  • Meets requirements of the Centers for Medicare and Medicaid Services
  • Complies with current physicians' standards for expediting Medicare and Medicaid payments
  • Printed in OCR red ink for scanning
  • Approved by NUCC
The Manufacturer's Description Two-part CMS-1500 forms comply with current physicians' standards for expediting Medicare and Medicaid payments. Each meets requirements of the AMA Council of Medical Service. Forms come in a continuous format.


Product TypeClaim Form
Brand NameTOPS
ManufacturerTOPS Products
Product NameTwo-part CMS-1500 Forms
Manufacturer Part Number50124R
Manufacturer Website Address
Packaged Quantity1500 / Carton


Sheet Size8 1/2" Width x 11" Length
Number of Parts2
Sheet ColorWhite
Carbonless CopyYes
Country of OriginUnited States
Assembly RequiredNo
Print ColorRed


UPC code025932501241
Alternate code/substitutionTOP50124R
MPC number (Moore product code)674167
Moore prefix and stock numberTOP50124R
Package Weight20
Package Height12.1
Package Length12.5
Package Width10.3
Product Classification CodeEFAA
Country of OriginUS
Ready to AssembleN
Recommended substitutionsTOP50124RV
Old item number
Minority/Women-Owned/Challenged Vendor
Old item number
Special order itemN
Relevant Terms
 forms & record keeping tops 50124r 11971171 14111800 025932501241 top50124r top 50124r top50124 0025932501241 22584197 p350124r 0668424 tops business forms claims hcfa billing insurance medicare medicaid medical health claim form white hfca complain certificates tops two-part cms-1500 forms 2 part carbonless copy 8 1/2" 11" sheet size white sheets red print color 1500 / carton Two-part CMS-1500 Forms Claim Form No
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