TOPS UB-04 Forms, 1 Part, White, 8 1/2in x 11in, Box Of 2, 500 MPN:59870R
TOPS UB-04 Forms, 1 Part, White, 8 1/2in x 11in, Box Of 2, 500 MPN:59870R
TOPS UB-04 forms are the ideal solution for any healthcare provider, medical office or facility needing a cost-effective solution to ensure compliance with HIPAA standards and streamline administrative workflow. Featuring white paper stock, easy to read formatting, and a secure binding system, these forms ensure that patient information is easily accessible and accurately documented. Additionally, the box of 2,500 forms provides a bulk order option for cost savings compared to purchasing individually. Whether you're billing insurance companies or managing in-house paperwork, TOPS UB-04 forms help keep operations running smoothly while maintaining patient privacy and security.
Used by hospitals and institutions to file a medical claim with a patients 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.
Features
- Brand Name: TOPS
- Carbonless: Yes
- Color (Ink): Red
- Double Sided: Yes
- Eco Label Standard: SFI Certified Fiber Sourcing
- Manufacturer: TOPS BUSINESS FORMS
- Number of Holes Punched: False
- Number of Parts: True
- Product Line: UB-04 Forms
- Quantity: 2500
- Sheet Size: Letter (8-1/2" x 11")
- Total Quantity: 2500 Medical Claim Forms
Additional Information
- Country of Origin: US
- UNSPSC Code: 14111806
- UNSPSC Commodity: Business forms or questionnaires
- Green: No
- Recycled Content: FALSE
- Hazardous: No
- Prop 65: No
- MSDS URL: nan
- Package Length: 11.50
- Package Width: 8.50
- Package Height: 11.00
- Package Weight: 26.00
Related ASINs: B001E662W4, B001FME684, B00EK3IF1Y
Product info last updated on January 6, 2025 12:06am UTC Category: Business Forms and Bookkeeping