TOPS BUSINESS FORMS
Billing Forms, 20 lb., 8-1/2"x11", White
Item # TOP59870R · Mfr part # 59870R
In stock
Contact us for GSA contract pricing.
UB-04 laser-cut forms are designed for medical offices 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.
Specifications
| Brand | TOPS BUSINESS FORMS |
|---|---|
| Item # | TOP59870R |
| Mfr part # | 59870R |
| UPC | 025932598708 |
| Unit of measure | CT |
| Unit of issue | CT (2500 per) |
| Packaging | 2500EA/CT |
| Dimensions (L x W x H, in) | 11.5 x 11 x 8.5 |
| Weight (lb) | 26 |
| Country of origin | United States Of America |
| UNSPSC | 14111800 |
| GSA SIN | 339940 |