SKU: 917557
Manufacturer part number: 50126R
Availability: Out of stock
$111.99
$78.39

OF4S TOPS HCFA 1-Part Laser Forms, 8 1/2" x 11", Pack Of 2,500

TOPS HCFA 1-Part Laser Forms, 8 1/2" x 11", Pack Of 2,500
Manufacturer: TOPS

Forms help expedite medical benefit payments from Medicare, Medicaid and insurance companies

  • Formats are approved by the American Medical Association. 
  • Printed front and back in red OCR ink on 20-lb paper to ensure better scanning and reproduction. 
  • SFI certified. 
Item # 917557 
Manufacturer # 50126R  
claim type medical 
number of parts
carbonless no 
sheet size 8 1/2" x 11" 
paper color White 
quantity 2,500 
brand name TOPS 
manufacturer TOPS 
Ecolabel SFI Certified Sourcing 
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