Tops TOP 59870R 1part Ub04 Lasercut Forms 1 Part 11 X 8.50 Form Size White Red Print Color 2500 Carton

SKU: E70R9C4PO1 |  Mfg. Part: TOP 59870R
In Stock (75)

Special Price $223.10 Regular Price $301.19

Condition: New
TOPS

Free Shipping TOPS

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:

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
Physical Characteristics
Color:White
Miscellaneous
Certifications & Standards:

American Medical Association


Recycled:No
Assembly Required:No
Environmentally Friendly:Yes
Environmental Certification:SFI
Country of Origin:United States
  • Weight:
  • UPC:
  • Condition:
  • Manufacturer:
  • Mfg#:

Updated: Aug 12, 2022
Added: Dec 02, 2021
Wt: 26.00 lbs

Request For Quote.


Tops TOP 59870R 1part Ub04 Lasercut Forms 1 Part 11 X 8.50 Form Size White Red Print Color 2500 Carton

TOP 59870R

Your Opinion!