TOPS BUSINESS FORMS 59870R TOPS UB-04 Forms, 1 Part, White, 8 1/2in x 11in, Box Of 2,500
TOPS BUSINESS FORMS 59870R TOPS UB-04 Forms, 1 Part, White, 8 1/2in x 11in, Box Of 2,500
TOPS BUSINESS FORMS 59870R TOPS UB-04 Forms, 1 Part, White, 8 1/2in x 11in, Box Of 2,500
Previous Next

TOPS BUSINESS FORMS

TOPS BUSINESS FORMS 59870R TOPS UB-04 Forms, 1 Part, White, 8 1/2in x 11in, Box Of 2,500

0 review Write a Review
Used by hospitals and institutions to file a medical claim with a patients insurance company Meets the requirements of the Centers for Medicare and Medicaid Se…
SKU:
TOP59870R
UPC:
025932598708
Condition:
New
Weight:
26.00 LBS
Minimum Purchase:
1 unit
Shipping:
Calculated at Checkout
Unit of Measure:
CT
QPU:
2500
Country of Origin:
US
UNSPSC Code:
14111806
UNSPSC Commodity:
Business forms or questionnaires
DEPT:
DATED AND FORMS
CLASS:
FORMS / BUSINESS FORMS
Color (Ink):
Red
Eco Label Standard:
SFI Certified Fiber Sourcing
Product Line:
UB-04 Forms
carbonless:
Yes
double sided:
Yes
number of holes punched:
0
number of parts:
1
quantity:
2500
sheet size:
Letter (8-1/2" x 11")
$293.12
Hurry up! Current stock:
Product Details  
Used by hospitals and institutions to file a medical claim with a patients insurance company Meets the requirements of the Centers for Medicare and Medicaid Services (CMS). Printed on carbonless, 20-lb bond, 1-ply paper with red ink.

Customers Also Viewed