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  TOP 59772R Tops UB-04 Continuous Forms TOP59772R
  TOP 59772R Tops UB-04 Continuous Forms TOP59772R
Tops UB-04 Continuous Forms


 
List Price: $142.96
Our Price: $94.80
You save $48.16!

• Quantity 1000/CT
• Claim Forms
• Forms
• General Office Supplies

Quantity in Stock:45

Product Code: TOP59772R
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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: $109.72
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TOP 50122R Tops CMS-1500 Health Care Forms TOP50122R

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