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TOPS® Continuous UB-04 Forms, 1-part, White, 9 1/2" x 11", Box Of 2500 Item # 524950
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Used by hospitals and institutions to file medical claims with a patient's insurance company
- Each form meets the requirements of the Centers for Medicare and Medicaid Services (CMS).
- Printed in OCR black ink on perforated, carbonless, 20-lb paper to ensure better scanning and reproduction.
- Available in laser or continuous formats.
|sheet size||9 1/2" x 11"|
|number of parts||1|
|Product Line||Continuous UB-04 Forms|
|Product Type||Medical Claim Form|
|Number of Forms per Sheet||1|
|Product Name||UB-04 Continuous Forms|
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