FLASH SALE: EVERYTHING HALF PRICE! LIMITED TIME ONLY!
Sale! TOPS 1-part UB-04 Laser-cut Forms – 1 Part – 11" x 8.50" Form Size – White – Red Print Color – 2500 / Carton
- $312.26
- $93.68
General Information Manufacturer:TOPS ProductsManufacturer Part Number:59870RManufacturer Website Address:http://www.tops-products.comBrand Name:TOPSProduct Model:UB-04Product Name:1-part UB-04 Laser-cut FormsMarketing Information: UB-04 laser-cut forms ar
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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
Product Color:White
Miscellaneous
Certifications & Standards:
American Medical Association
Recycled:No
Assembly Required:No
Country of Origin:United States
Environmental Certification:Sustainable Forestry Initiative (SFI)
Cost:
$25
Free Shipping:
We offer free shipping on orders over $30. Please check the free - shipping eligibility at checkout.
Delivery Time:
It usually takes [3-5] business days for standard shipping. Please note that this is an estimated time frame and may be affected by local holidays, and unforeseen circumstances.
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