TOP 59770R Tops UB-04 Continuous Forms TOP59770R

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TOP 59770R Tops UB-04 Continuous Forms TOP59770R

Tops UB-04 Continuous Forms

Claim Forms, Tops 59770R Billing Forms, Continuos, 1-Part, 20 lb., 9-1/2'' x 11'', 2500/CT

List Price: $170.38
Our Price: $107.44
You save $62.94!

• Quantity 2500/CT
• Claim Forms
• Forms
• General Office Supplies

Quantity in Stock:47

Product Code: TOP59770R

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Description

Extended Information

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 Centersfor Medicare and Medicaid Services (CMS). Forms are printed on 20 lb. bond paper.

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Tops UB-04 Continuous Forms

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Claim Forms TOPS

Our Price: $109.53
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TOP 50122R Tops CMS-1500 Health Care Forms TOP50122R

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