TOP59870R UB04-One Part Laser, 2500 SH/CT

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Our price: $314.28
SKU:
TOP59870R
UPC:
025932598708
Weight:
10.80 LBS
Minimum Purchase:
1 unit
Note:
Price listed is for a carton with 1 Carton of 2500 Carton
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Continuous forms are designed for hospitals 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 necessary

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 laser.

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