Product #: TOP 50135RV
Volume: 102.85
Weight: 2.66
Description
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. Form Size: 8 1/2 x
11; Forms Per Page: 1; Form
Quantity: 250; Principal
Heading(s): 1500 Health
Insurance Claim Form.