TOP59770R UB04-One Part Continuous, Removable Margins, 2500 EA/CT

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MSRP: $193.62
Our price: $117.20
(You save $76.42 )
SKU:
TOP59770R
UPC:
025932597701
Weight:
25.00 LBS
Minimum Purchase:
1 unit
Note:
Price listed is for a carton with 1 Carton of 2500 Carton
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UB-04 1-part continuous is a form that hospitals use to file a claim with the patient's insurance company
Forms are printed to GPO standards in OCR ink on 20 lb. bond
Health Care Finance Administration format ensures accuracy in reporting all n

Product Overview

The UB-04 is the form hospitals and institutions use to file a medical claim with the patient's insurance company. Use TOPS UB-04 forms with confidence. They meet the requirements of the Centers for Medicare and Medicaid Services (CMS). 1 part continuous.

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