TOPS� UB-04 Forms, 1 Part, White, 8 1/2" x 11", Box Of 2,500 59870R
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Buy TOPS� UB-04 Forms, 1 Part, White, 8 1/2" x 11", Box Of 2,500 59870R
When you make a purchase through links on our site, we may receive a affiliate commission.
TOPS� UB-04 Forms, 1 Part, White, 8 1/2" x 11", Box Of 2,500 59870R | $308.79 | | |||
Used by hospitals and institutions to file a medical claim with a patient's 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.
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