TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton
Brand: TOPS · Item TOP59870R · Mfr # 59870R · UPC 025932598708
$247.44 / 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.
| Packaged Quantity | 2500 / Carton |
|---|---|
| Product Type | Claim Form |
| Number of Forms per Sheet | 1 |
| Form Length | 11" |
| Form Width | 8.50" |
| Number of Parts | 1 |
| Printed Side | Front |
| Print Color | Red |
| Print Technology | Laser |
| Color Family | White |
| Product Color | White |
| Recycled | No |
Questions? Call 718-599-1809 or email orders@silverofficesupplies.com.