TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton
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Estimated delivery between Jun 16 - Jun 18
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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.
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General Item Color
White
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Printed Side
Front
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Product Name
1-part UB-04 Laser-cut Forms
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Environmental Certification
Sustainable Forestry Initiative (SFI)
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Print Technology
Laser
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Number of Parts
1
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Type
Claim Form
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Manufacturer Website Address
http://www.tops-products.com
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Model
UB-04
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Length
11"
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Recycled
No
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Print Color
Red
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Width
8.50"
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Number of Forms per Sheet
1
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Certifications & Standards
American Medical Association
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Commercial Use Type
Not Provided
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