Centers for Medicare and Medicaid Services Forms, 3000 Forms

Manufacturer: TOPS®

• CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits.
• Top sensor bar for microfiche duplication, as required in some states.
• OCR red ink for scanning.

Centers for Medicare and Medicaid Services Forms, Two-Part, 1500 Forms

Manufacturer: TOPS®

• CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits.
• Top sensor bar for microfiche duplication, as required in some states.
• OCR red ink for scanning.

Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 500 Forms

Manufacturer: TOPS®

• CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits.
• Top sensor bar for microfiche duplication, as required in some states.
• OCR red ink for scanning.

Centers for Medicare and Medicaid Services Forms, 8 1/2 x 11, 250 Forms

Manufacturer: TOPS®

• CMS-1500 claim forms (formerly known as HCFA-1500 claim forms) expedite Medicare, Medicaid or private insurance benefits.
• Top sensor bar for microfiche duplication, as required in some states.
• OCR red ink for scanning.

UB04 Hospital Insurance Claim Form, 8 1/2 x 11, 2,500 Forms

Manufacturer: TOPS®

• Printed to Government Printing Office standards.
• OCR ink for scanning.
• American Medical Association (AMA) approved format.