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TOPS UB-04 Forms, 1 Part, White, 8 1/2in x 11in, Box Of 2,500
Original price was: $346.57.$246.99Current price is: $246.99.
The More You Buy, The More You Save:
| Quantity | 2 + | 5 + | 10 + |
|---|---|---|---|
| Price | $246.74 | $246.50 | $246.25 |
Out of stock
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.
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
0
NUMBER OF PARTS
1
PRODUCT LINE
UB-04 Forms
QUANTITY
2500
SHEET SIZE
Letter (8-1/2" x 11")
TOTAL QUANTITY
2500 Medical Claim Forms
| Weight | 26 lbs |
|---|---|
| Dimensions | 11.5 × 8.5 × 11 in |
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