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Tops UB-04 Continuous Forms

General Office Supplies

Tops UB-04 Continuous Forms

Billing Forms,Continuos,1-Part,20 lb.,9-1/2"x11",2500/CT,WE

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Manufacturer:

Tops

SKU:

TOP59770R

Availability:

In stock

Usually Ships by: Thursday, May 21

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UB-04 continuous forms are designed for hospitals 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). Continuous forms are printed on 20 lb. bond paper.