Sub total:
$138.00
total:
$138.00
TOPS 1-part UB-04 Laser-cut Forms
TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11 x 8.50 Form Size - Red Print Color - 2500 / Carton
In Stock
Item: 59870R | By: TOPS
$228.49EA
Condition
New
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Product description
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.
Specifications
Brand Name
TOPS
Certifications & Standards
American Medical Association
Color
White
Country of origin
United States
Environmental Certification
SFI
Environmentally Friendly
Yes
Form Length
11"
Form Width
8.50"
Manufacturer Part Number
59870R
Manufacturer Website Address
http://www.tops-products.com
Number of Parts
1
Packaged Quantity
2500 / Carton
Print Color
Red
Print technology
Laser
Printed Side
Front
Product Model
UB-04
Product Name
1-part UB-04 Laser-cut Forms
Manufacturer
TOPS Products
Product Type
Claim Form
Recycled
No