TOPS 59870R UB04 Hospital Insurance Claim Forms
$217.28
Brand: TOPS
Model: Tops 59870R
Features
- 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
Details
TOPS continuous UB04 hospital insurance claim forms are designed for hospitals filing claims with patients’ insurance companies. Printed in OCR ink and formatted to GPO and Health Care Finance Administration standards, they support accurate reporting of necessary information and replace the UB-92.
UPC: 823019819933