TOPS 1-part UB-04 Laser-cut Forms, White, 2500 / Carton, TOP59870R

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.

Sold as: 1 Carton

Supplier pack: 2500EA/CT

Case quantity: 2500 each

MPN: 59870R