TOPS Products TOPS 59870R TOPS 1-part UB-04 Laser-cut Forms
TOPS Products TOPS 59870R TOPS 1-part UB-04 Laser-cut Forms
TOPS Products TOPS 59870R TOPS 1-part UB-04 Laser-cut Forms
TOPS Products TOPS 59870R TOPS 1-part UB-04 Laser-cut Forms
TOPS Products TOPS 59870R TOPS 1-part UB-04 Laser-cut Forms
TOPS Products TOPS 59870R TOPS 1-part UB-04 Laser-cut Forms
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TOPS Products TOPS 59870R TOPS 1-part UB-04 Laser-cut Forms

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TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / CartonFeatures:Continuous forms are designed for hospitals…
SKU:
TOPS Products TOPS 59870R
UPC:
818237890116
Condition:
New
Weight:
26.00 LBS
Minimum Purchase:
1 unit
Shipping:
Calculated at Checkout
Country of Origin:
US
$240.74
Hurry up! Current stock:
Product Details  
TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton

Features:

  • Continuous forms are designed for hospitals to file a claim with the patient's insurance company
  • Forms are printed to GPO standards in OCR ink on 20 lb. bond
  • Health Care Finance Administration format ensures accuracy in reporting all necessary information
  • 11" Length x 8.50" Width; 2500 / Carton
  • Replaces the UB-92

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