TOPS 1-part UB-04 Laser-cut Forms - 1 Part - 11" x 8.50" Form Size - White - Red Print Color - 2500 / Carton

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TOP59870R

Description

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.

Specifications

UNSPSC Code

14111800

Weight

26lb

Height

8.5in

Width

11in

Length

11.5in

Catalog Page Number

O109

Assembly Required

No

Brand

TOPS

Category

Claim/Medical Forms

Certifications & Standards

American Medical Association

Color Family

White

Country Of Origin

United States

Environmental Certification

Sustainable Forestry Initiative (SFI)

Form Length

11"

Form Width

8.50"

Manufacturer

TOPS Products

Manufacturer Part Number

59870R

Manufacturer Website Address

http://www.tops-products.com

Number of Forms per Sheet

1

Number of Parts

1

Packaged Quantity

2500 / Carton

Print Color

Red

Print Technology

Laser

Printed Side

Front

Product Color

White

Product Model

UB-04

Product Name

1-part UB-04 Laser-cut Forms

Product Type

Claim Form

Recycled

No

Description

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.

Specifications

UNSPSC Code

14111800

Weight

26lb

Height

8.5in

Width

11in

Length

11.5in

Catalog Page Number

O109

Assembly Required

No

Brand

TOPS

Category

Claim/Medical Forms

Certifications & Standards

American Medical Association

Color Family

White

Country Of Origin

United States

Environmental Certification

Sustainable Forestry Initiative (SFI)

Form Length

11"

Form Width

8.50"

Manufacturer

TOPS Products

Manufacturer Part Number

59870R

Manufacturer Website Address

http://www.tops-products.com

Number of Forms per Sheet

1

Number of Parts

1

Packaged Quantity

2500 / Carton

Print Color

Red

Print Technology

Laser

Printed Side

Front

Product Color

White

Product Model

UB-04

Product Name

1-part UB-04 Laser-cut Forms

Product Type

Claim Form

Recycled

No

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