TOPS, TOP59770R, UB-04 Continuous Forms, 2500 / Carton, White

UB-04 continuous forms are designed for hospitals 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). Continuous forms are printed on 20 lb. bond paper. TOPS UB-04 Continuous Forms, White, 2500 / Carton (Quantity)

UB-04 1-part continuous is a form that hospitals use 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 9-1/2" x 11"