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Tops UB-04 Hospital Claim Form - 1 Part - 11\" x 8.5\" Form Size - 2500 / Carton

Product Details

Tops UB-04 Hospital Claim Form - 1 Part - 11\" x 8.5\" Form Size - 2500 / Carton

Tops Tops UB-04 Hospital Claim Form - 1 Part - 11\" x 8.5\" Form Size - 2500 / Carton

Item Number: TOP59770R 
  • 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.
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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.
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