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Tops TOP 59870R 1part Ub04 Lasercut Forms 1 Part 11 X 8.50 Form Size
In Stock (71)
Special Price $219.87 Regular Price $296.82
Condition: New
Model Number: TOP 59870R
Special Price $219.87 Regular Price $296.82
Condition: New
Model Number: TOP 59870R
TOPS 1-part UB-04 Laser-cut Forms
General Information
Manufacturer:TOPS Products
Manufacturer Part Number:59870R
Manufacturer Website Address:http://www.tops-products.com
Brand Name:TOPS
Product Model:UB-04
Product Name:1-part UB-04 Laser-cut Forms
Marketing Information:
Packaged Quantity:2500 / Carton
Product Type:Claim Form
Manufacturer:TOPS Products
Manufacturer Part Number:59870R
Manufacturer Website Address:http://www.tops-products.com
Brand Name:TOPS
Product Model:UB-04
Product Name:1-part UB-04 Laser-cut Forms
Marketing Information:
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
Product Information
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
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
Physical Characteristics
Color:White
Color:White
Miscellaneous
Certifications & Standards:
Recycled:No
Assembly Required:No
Environmentally Friendly:Yes
Environmental Certification:SFI
Country of Origin:United States
Certifications & Standards:
American Medical Association
Recycled:No
Assembly Required:No
Environmentally Friendly:Yes
Environmental Certification:SFI
Country of Origin:United States
Mfg#: TOP 59870R
Updated: Jul 02, 2022
Added: Dec 02, 2021
Wt: 26.00 lbs
More Info:
- Updated:
- Added:
- Weight:
- UPC:
- Condition:
- Manufacturer:
- Mfg#:
- Jul 02, 2022
- Dec 02, 2021
- 26.00lbs
- 000000000000
- New
- TOPS
- TOP 59870R
Request For Quote.
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Tops TOP 59870R 1part Ub04 Lasercut Forms 1 Part 11 X 8.50 Form Size
TOP 59870R
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