1
TOPS 1-part UB-04 Laser-cut Forms
- Product Type : Claim Form
- Item # : TOP59870R
Quick Overview
- 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
Add Line Note
