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TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton

TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton

UB-04 laser-cut forms are designed for medical offices to file a claim with the patient's insurance company. The Health Care Finance Administration format ensures accuracy in reporting all necessary information. Forms meet the requirements of the Centers for Medicare and Medicaid Services (CMS). Forms are printed on 20 lb. bond paper.

Availability: Call or email

Regular Price: $233.91

Special Price $219.88

Regular Price: $233.91

Special Price $219.88

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TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton

OVERVIEW:

Product Color : White

Recycled : No

Country of Origin : United States

Form Length : 11"

Form Width : 8.50"

Environmental Certification : Sustainable Forestry Initiative (SFI)

Number of Parts : 1

Printed Side : Front

Print Color : Red

Additional Info

SKU	0385159870R-BF
Weight	1.0000
Is Featured	N/A
Manufacturer	TOPS Products
Manufacturer Part Number	59870R
Width	1
Length	1
Height	1
Product ID	0385159870R
UNSPSC	N/A
Other Part Number	N/A
Special Price	N/A

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TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton

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