Sale!
Original price was: $265.99.$96.99Current price is: $96.99.
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- High quality products, low prices.
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Revised Format
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AMA approved format
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The UB-04 is the form hospitals and institutions use to file a medical claim with the patient’s insurance company
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Use TOPS UB-04 forms with confidence
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They meet the requirements of the Centers for Medicare and Medicaid Services (CMS) and are available in Laser and Continuous formats
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Made in the USA
| Brand | TOPS |
|---|---|
| Customizable | No |
| Height in Inches | 11 |
| HR Form Type | Health Insurance Claims |
| Number of Parts | 1 |
| Pack Qty | 2500 |
| True Color | White/Red |
| Width in Inches | 8.5 |
Be the first to review “Wholesale 🛒 TOPS HR & Medical Forms UB04 Health Care Form, Revised, HCFA Compliant, 1-Part Continuous, White, 20# Paper, Detached Size Of 8 1/2″ X 11″ 🔥”
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