Home >   TOP 59772R Tops UB-04 Continuous Forms TOP59772R
Tops UB-04 Continuous Forms	List Price: $142.96 Our Price: $119.17 You save $23.79! • Quantity 1000/CT • Claim Forms • Forms • General Office Supplies Quantity in Stock:61 Product Code: TOP59772R Qty:

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.   Features Tops UB-04 Continuous Forms

Accessories for this product... Debit Credit Memo Forms Tops Our Price: $11.10 Add Claim Forms TOPS Our Price: $92.87 Add

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