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General Office Supplies > Forms > Claim Forms > Tops Ub-04 Continuous Forms > Tops Business Forms


Tops UB-04 Continuous Forms


$93.17

Manufacturer: Tops Business Forms
Part Number: TOP59772R
MSRP: $97.83


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).

Forms are printed on 20 lb. bond paper..




Tops UB-04 Continuous Forms

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We do also ship internationally and will have a representative contact you with shipping costs before your order is finalized. We can process your with any valid major credit card. If you are a school or government entity, order will be processed promptly upon approval by our credit department after you submit your PO. Damaged, defective or shorted items must be reported within 7 days of receipt. All other merchandise can be returned in good condition for any reason within 30 days of ship date. Looking for even better deals? Check out our Specials Page or like us on facebook for access to rock-bottom prices and great store discounts.

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ITEMDESCRIPTIONPRICESEE SITE
Tops UB-04 Continuous FormsUB-04 continuous forms are designed for hospitals to file a claim with the patient's insurance compa...$105.06


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