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 - Red Print Color - 2500 / Carton
| $263.38 |
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UB-04 laser-cut forms are designed for medical offices 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 Centers for Medicare and Medicaid Services (CMS). Forms are printed on 20 lb. bond paper.
Product Specifications
| Brand Name | TOPS |
| Certifications & Standards | American Medical Association |
| Color | White |
| Country of origin | United States |
| Environmental Certification | SFI |
| Environmentally Friendly | Yes |
| Form Length | 11" |
| Form Width | 8.50" |
| Manufacturer | TOPS Products |
| Manufacturer Part Number | 59870R |
| Manufacturer Website Address | http://www.tops-products.com |
| Number of Parts | 1 |
| Packaged Quantity | 2500 / Carton |
| Print Color | Red |
| Print technology | Laser |
| Printed Side | Front |
| Product Model | UB-04 |
| Product Name | 1-part UB-04 Laser-cut Forms |
| Product Type | Claim Form |
| Recycled | No |
Material Safety Data Sheet
A Material Safety Data Sheet (MSDS) is a document that contains information on the potential hazards (health, fire, reactivity and environmental) and how to work safely with the chemical product.
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