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

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.